Dr Diana Dunstan (formerly Director of Research & Training at the Medical Research Council, and now working part-time for the UK Research Councils) and Professor John Iredale (Professor of Medicine at the MRC Centre for Inflammation Research, University of Edinburgh and Director of a Wellcome Trust funded Clinician Scientist Training Programme) undertook an external review of the MMI Clinician Scientist Fellowship Programme on 11-12 June 2009.
The MMI Clinician Scientist Fellowship Programme (CSFP), funded under Programme for Research in Third Level Institutions (Cycle 4), provides a systematic way to train clinician scientists through a structured PhD programme for medical graduates of three years in length. 22 medical graduates were awarded CSFP fellowships, and they are currently pursuing PhD research in the five MMI partner institutions and participating in a national structured curriculum developed and delivered through collaboration. For more information on the programme, please visit the dedicated area of the MMI website: https://www.crdi.ie/csfp
We express our thanks to Dr Dunstan and Professor Iredale for their diligence to the task and we thank all those who participated in the review and contributed their time and views to the process. Dr Dunstan’s and Professor Iredale’s report is available here in full, including an Annexe that lists those who contributed to the review: MMI CSFP: Review of Progress and Recommendations for the Future.
The reviewers were impressed with the vision and delivery of the CSFP. They felt that the cohesion MMI has achieved between the direct stakeholders across Ireland was highly impressive, and they noted that the centralised appointments process was perceived as fair and essential in assuring quality. The reviewers identified particular strengths of the programme: the high quality, well-motivated and dedicated cohort of fellows, the structured training modules, and the co-supervision of research projects that brought together basic and clinical scientists.
The following summarises the reviewers’ recommendations to MMI:
- In order to help develop an effective cadre of translational clinician scientists and to capitalise on the initial success of the programme, MMI should appoint 5-10 CSFP Fellows per annum over a period of 10 years.
- For future intakes, consider co-supervision of fellows with supervisors based in different institutions. This would facilitate development of collaborative projects across Irish higher education institutions.
- Develop distance learning modules to create more flexibility and widen the availability of structured taught components.
- Appoint long-term clinical academic mentors to support fellows as they return to the clinical arena.
- Establish an annual retreat for fellows and supervisors to encourage development of a self-supporting group of clinician scientists in training. This should include those on other complementary training schemes.
- Make the widest possible use of the internet in advertising future calls (e.g. email cascades among stakeholders) to ensure visibility.
- Consider the introduction of a more uniform salary structure, likely based on a starting point of Registrar grade.
- Appoint only those fellows that succeed in the MMI convened selection process.
- Encourage MMI fellows to apply for Wellcome Trust Intermediate and Senior Clinical Fellowships as their careers progress. Their success rate should be seen as an important metric for success of the CSFP.
The reviewers also highlighted some wider considerations for clinical academic training in Ireland:
- Urgent attention should be given to creating schemes that provide an appropriate career pathway after the PhD (at the early Postdoctoral/Specialist Registrar stage and at the Senior Lecturer/Honorary Consultant level).
- A leading academic should head an executive with the aim of developing a ‘joined-up’ clinical academic track with the support of all stakeholders. Such a collaborative training network would be optimally placed to bid successfully for clinician scientist training schemes offered by international funding bodies.
MMI’s response to the reviewers’ recommendations is as follows:
- Sustainability of the programme. Pursuing recommendations in this area is subject to availability of funding. MMI will explore whether suitable programme funding calls will be issued in the near future by national and international agencies.
- Clinician scientist career track. Career development aspects are a priority for the next period of CSFP structured training (to be held in University College Cork in 2010). MMI will seek participation from funding agencies to highlight career opportunities in research. MMI will seek the appointment of a clinical academic career mentor for each MMI fellow, with engagement to commence two years into the 3-year fellowship.
- Further development of the taught component. Pursuing recommendations with respect to creating distance learning modules is subject to availability of funding. This is a priority area for MMI and we will work to ensure that the results of investment in online learning are applied to clinician scientist training.
- Annual retreat. MMI considers the existing CSFP Annual Scientific Meeting to be fit for purpose. This event will be further developed and attendance will be opened to other clinician scientists in training.
In addition, several of the reviewers’ recommendations will be addressed by the MMI strategic aim to mainstream the clinician scientist structured PhD curriculum, developed through PRTLI Cycle 4 funding. Work is underway to prepare a curriculum for accreditation in the five MMI partners which will then be available to all medical graduates undertaking PhDs in the MMI partner institutions:
- Working with stakeholders. As part of mainstreaming the curriculum, MMI is engaging with numerous stakeholders (including fellows, supervisors, medical training and funding bodies, academics, industry representatives).
- Joined-up collaborative training. An MMI structured taught curriculum available to all medical graduates undertaking PhDs will constitute an important step towards collaborative training.
- External funding opportunities. An accredited and sustained cross-institutional clinician scientist structured PhD curriculum will be of considerable value in supporting individual fellowship applications as well as programme funding bids.
MMI will commission another external review at the conclusion of first intake fellowships (July 2011), and follow-up the fellows’ career progress at regular intervals thereafter.