Survey Shows Intensive HSPH Clinical Effectiveness Program Successful in Training Physician-Researchers

The number of physician-researchers is dropping nationally, but the need is greater than ever for research that quickly translates basic science discoveries into clinical treatments.

“It has often taken many years for research to affect clinical practice, and having strong clinical research is essential for narrowing this gap,” said David Bates, professor of medicine at HMS and professor in the Department of Health Policy and Management.

But the Program in Clinical Effectiveness (PCE) at HSPH is helping to bridge that gap, and a recent survey has demonstrated just how useful the effort has become.

“Our survey found that graduates of the Program in Clinical Effectiveness have been able to obtain grant funding, publish, get promotions, negotiate protected research time, and rise to leadership roles in public health, academic medicine, and the private sector,” said Mary Ellen Goldhamer, lead author of the paper that analyzed the program published recently in Academic Medicine. A physician at Massachusetts General Hospital (MGH), Goldhamer graduated from the PCE in 2005. The journal article is entitled “Protecting an Endangered Species: Training Physicians to Conduct Clinical Research.”

The PCE is an intensive seven-week summer program for physicians who want the quantitative and analytical skills necessary for a career in clinical research. It is a joint program of HSPH, Brigham and Women’s Hospital, and MGH. PCE is thought to be the first and largest program focused on clinical research training for physicians. Almost 1,900 physicians have gone through the program since it started in 1986, most taking it during their post-residency fellowship training.

Goldhamer’s survey results showed that nearly one-third of graduates of PCE are pursuing investigations in epidemiology, clinical trials, and health services. About 34 percent of PCE graduates received federal grant support for their research, 63 percent received support from non-federal funders, and 24 percent were principle investigators on an NIH grant.

Arnold Epstein, chair of the HSPH Department of Health Policy and Management, co-directs the PCE with Bates and E. Francis Cook, a professor of epidemiology at HSPH.

The program has core courses in epidemiology and biostatistics with one final project being an actual grant application for a clinical research study. The survey found that the epidemiology grant proposal led to a research study for 65 percent of physicians, and, of those research studies, 64 percent were published and 43 percent received funding.

In fact, the survey published in Academic Medicine was Goldhamer’s hands-on project that she designed, executed, and analyzed while pursuing MPH coursework at HSPH from 2005 to 2007, which included a summer in PCE. With guidance from her fellowship mentor, Daniel Singer, professor in the Department of Epidemiology at HSPH, and Steven Simon, HMS associate professor in the Department of Ambulatory Care and Prevention, Goldhamer designed her survey during a survey research methods course and analyzed the data while taking a survival analysis course. Amy Cohen, manager of instructional computing at HSPH, was instrumental in data management and analysis.

“HSPH courses became a springboard to my own investigations,” said Goldhamer. The publication of this survey is a case in point for why the Program in Clinical Effectiveness is successful. “We have a better chance at success because HSPH not only offers didactic teaching, but has us apply principles to real-life projects,” said Goldhamer.

PCE is an extremely intensive program. The core courses in epidemiology and biostatistics are taken daily during the seven weeks. Participants also take two electives, which last for half the session. These include such courses as: current issues in health policy, decision analysis in clinical research, introduction to methods and applications in health services research, measuring and analyzing the outcomes of health care, and research with large databases. Participants learn different methods of data analysis in computer labs. Homework may take 20 hours each week.

“Much of the material we teach in the PCE is taught in other courses at HSPH in the academic year, although perhaps not with a clinical research focus or as condensed,” added Cook.

The enrollment in the Program in Clinical Effectiveness has steadily increased each year since its inception. It can now accept 175 students, but has a waitlist for this summer. See the website for more information.

— Ellen Barlow.