T32 CAM Research Training Grant Funded by NIH/NCCAM

Postdoctoral training

Postdoctoral training

Academic requirements
Candidates will hold a PhD in a biological or medical science, including epidemiology, or a professional degree in one of the medical sciences (e.g. MD, ND, DO or DAOM) or more.

Training support
Each fellow will receive up to three years of training support, during which he or she will reciprocally choose to work with a team of two co-mentors, one from the UW, WSU or FHCRC and the other from Bastyr.

The benefit of this structure is two-fold

1. The trainee will have available the expertise of scientists with both CAM and conventional training.
2. Faculty from the two disciplines will have increased exposure to and communication with each other in the context of these mentoring relationships.

Research activities
The primary goal of this training grant is to train fellows in the successful execution of publishable, CAM- and integrated-focused research projects. Thus the main focus of the trainees' activity and the preponderance of their time will be spent performing the research protocols which they will design, with guidance from their mentors, and which they will supervisor and perform on a daily basis. The research activity is intended to be hands-on experience, so that at the end of this training period they will be in a position to train others to do research, and to establish themselves as independent investigators in charge of their own laboratories or clinical research programs.

Course work
Research trainees will participate in research seminars led by Principal Investigator Leanna J. Standish, ND, PhD, LAc, FABNO. Each fellow will be expected to take coursework to augment their prior academic training, with the express intention of generating researchers who are both knowledgeable about CAM therapies and rigorously trained in research design and scientific method. The particular coursework expected of each fellow will be determined by their background, training and research interests coming into the fellowship. For the renewal of this training grant, we are proposing to establish two tracks for fellows based on their previous training as described below.

Clinician Track
Fellows entering with a clinical degree (ND or MD) will be strongly encouraged to apply for a Master's degree program (e.g. the MPH program at UW or the MS Nutrition program at Bastyr that involves a research thesis). If they elect not to pursue an additional degree they will be required to take the following coursework at UW as a non-matriculating student to provide the necessary training in research methods, biostatistics, and grantsmanship.

UW Extension also offers a certificate course in clinical trials methodology that interested fellows may choose to take if desired. This certificate course introduces participants to the fundamental scientific, ethical, practical, regulatory and economic concepts underlying clinical trials. Topics covered include: research design, statistical concepts and data management as related to clinical trials; ethical dimensions of clinical trials, including informed consent, conflict of interest, human subject considerations and the roles of organizations such as Institutional Review Boards; understanding the various levels of clinical trials between the initiation and marketing; and introduction to relevant parts of the Code of Federal Regulations and other rules governing clinical trials.

In addition to the coursework required for all clinically trained fellows, MD fellows who have not had significant coursework or prior training in CAM disciplines will be required to take a minimum of 5 credits from the following at coursework at Bastyr University:

If they choose, fellows may also take courses in homeopathy, medical hypnotherapy, hydrotherapy/ physiotherapy, Advanced Naturopathic Therapeutics, and Ayurvedic medicine.

For MDs entering this program, we expect that they will spend the great majority of their time (4.5 days/week, or 90%) engaged in research activity and coursework. However we also anticipate that they will participate in clinical training activities at Bastyr University Natural Health Clinic or the Bastyr University Oncology Research Clinic as part of the process of becoming familiar with CAM therapeutic modalities. A standard clinic shift comprises one half day/ week for the duration of an academic quarter (11 weeks). MD fellows will engage in a minimum of two clinic shifts during the course of their training, most likely during the first year. MD fellows will work in a pair with an ND resident and will be supervised by the attending ND physician. The clinical rotations from which they may choose are: Physical Medicine, Nutrition, Homeopathy, Counseling, and Acupuncture and Oriental Medicine. Clinically qualified fellows whose research involves clinical investigations will be expected to have extensive exposure to and responsibility for the patients involved in the clinical protocols, under the supervision of a clinically qualified mentor. MD fellows who choose to be involved in bench research will still be expected to participate in CAM subspecialty clinical training. Because the intent of this program is to provide fellows with a significant amount of training in a relatively unfamiliar discipline, we anticipate that each fellow will take up to three quarters of coursework during each academic year. This anticipated course load has informed our decision to allow the duration of training to be as long as three years for each trainee. Clinical fellows who can demonstrate equivalent coursework or training can petition the Executive Committee to waive a particular course.

Basic Sciences (PhD) Track
We recognize that postdoctoral fellows entering the training program with Ph.D. degrees will have had more experience in the design and conduct of research than most clinically trained fellows. Most Ph.D. programs include graduate courses in statistics and research methods, and many graduate students have opportunities to participate in coursework or other training in grantsmanship and scientific writing in addition to actually overseeing a research project. Furthermore, since Ph.D. applicants to this training program will be screened for a demonstrated interest in CAM, many may have had some coursework in CAM disciplines. Thus, the coursework requirements for Ph.D. trainees will be evaluated on a case-by-case basis to be sure that any existing gaps in didactic training in either research methods or CAM approaches will be covered during the postdoctoral period. Ph.D. trainees who wish to engage in clinical research will be encouraged to complete the UW Extension certificate course in clinical research.

Seminars, conferences, journal clubs, reading and annual retreat
All fellows will be encouraged to attend appropriate seminars, conferences and journal clubs. The University of Washington and FHCRC have a plethora of seminar series and journal clubs which these fellows will be eligible to attend. In addition, we have established monthly junior researcher meetings with current postdoctoral trainees and K-award recipients at Bastyr that serve to provide data discussions, manuscript and proposal review and journal club more specifically tailored to CAM research. In addition, there is an annual one-day research retreat held at Bastyr University for the fellows, mentors and associated laboratory personnel. This is a day spent in discussion of the projects being conducted under the auspices of this grant, and each fellow will be expected to present a formal seminar on their work at the retreat. In addition, fellows are expected to present their work at regional and national scientific meetings (e.g. Society of Integrated Oncology, Neuroscience meetings, Pharmacognosy, natural products research meetings, American Association of Naturopathic Physicians annual meetings).

All fellows will be asked to write one or more research proposals (e.g. an NRSA or R21) for continuation of support beyond the period of time encompassed by this training grant. This will benefit the trainees by giving them experience in writing grant proposals and may also allow the recruitment of additional qualified trainees to the program.

Progress of each trainee will be carefully monitored and guided by the combined efforts of the Executive Committee and the co-mentors of the individual trainees. Fellows and mentors will write annual formal reports on the fellow's progress. The fellow will report on the development of their own project, their experience with the didactic elements of the program, and their assessment of the workload. They will also provide a description of their specific goals for the following year of their training. The mentors will similarly provide a written report of the fellow's progress and make recommendations about future coursework and training experiences which will contribute to the development of the trainee's career. While outcome assessments of the success of the proposed training program will take into account these in-progress evaluations, the most useful outcome measure will be the ability of the trainees to have their work published in high-quality, peer-reviewed journals and to write successful grant applications by the second or third year of their training period.

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