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Clinician-scientists serve to bridge the gap between addiction research and clinical practice but cultivating clinician-scientists, who are able to develop and publish clinical research, remains a challenge (Einhorn, 2006; Hauser, et al., 2006; Roberts, et al., 2012; Wilson-Kovacs, et al., 2012). Therefore, we describe the design and first-year data from a controlled, non-randomized comparison trial that prospectively evaluates how a dedicated research-training program for addiction medicine physicians contributed to subsequent research involvement and research productivity.
In order to evaluate our Canadian research-training fellowship, funded by the U.S. National Institute on Drug Abuse (NIDA), we compared accepted fellows with non-admitted controls, based on baseline questionnaire and rate of peer-reviewed publication (Wood, et al., 2013). The study sample was drawn from those physicians who applied to the part-time, one-year addiction research immersion-training program. Of the eight top-ranked individuals from the 11 applicants, four were selected to participate in the training program and another four were designated to serve as a comparison group. Participants' publication rates were followed via biomedical databases (e.g., PubMed, EMBASE) after applying to the program. The main outcome measure was the number of first-author publications at the end of the one-your fellowship.
The addiction research immersion training program consisted of three half-days per week of addiction research training, two half-days per week of longitudinal research methods training, and three half-days per week of mentored publication and grant development. The control group continued in their usual clinical practice. Participants were not compensated for their time. The Providence Health Care/University of British Columbia Behavioural Research Ethics Board (PHC/UBC REB) has approved this study (Certificate no. H14-00244).
At baseline (N=8, five women), six participants reported any past research involvement, three had one or more advanced graduate degrees (e.g., MPH, PhD) and four had published peer-reviewed publications as a first author (total of six). They were internal medicine physicians (one), family physicians (five), psychiatrists (one) and one public health physician. At the end of end of the one-your fellowship, the four fellows published seven papers and the controls published one paper; however, this difference was not statistically significant due to the small sample size (Table 1).
These preliminary results suggest that a structured clinical research-training program could lead to an increased rate of publications, as indicated by previous, non-experimental research (Alford, et al., 2009; Truncali, et al., 2012; Guydish, et al., 2015). The study has a number of limitations including: a non-randomized design, small sample size and a limited follow-up interval. The fellowship cohort had more papers published as first author papers than the control group. We did not evaluate the impact of being married and possibly having family responsibilities on research productivity. Based on the first-year data, we expect that, with further prospective follow up and cohorts of fellows and controls, undertaking the research fellowship program will be independently associated with significant research outputs, signalling successful training of the next generation of addiction clinician-scientists, who can help close the gap between clinical evidence and standards of care in this area.
We thank participants for completing the surveys and staff for assisting with fellowship administration: Deborah Graham, Peter Vann, Emily Wagner, Carmen Rock, and Tricia Collingham. The study was supported by the US National Institutes of Health (R25DA037756). This research was undertaken, in part, thanks to funding from the Canada Research Chairs program through a Tier 1 Canada Research Chair in Inner City Medicine that supports Dr. Evan Wood. ELEVATE: Irish Research Council International Career Development Fellowship – co-funded by Marie Curie Actions (ELEVATEPD/2014/6), and Marie Sklodowska- Curie Individual Fellowship (701698) – supported Dr. Jan Klimas. Dr. Kanna Hayashi is supported by the Canadian Institutes of Health Research New Investigator Award (MSH-141971). Dr. Milloy is supported in part by the National Institutes of Health (R01-DA021525) and the Michael Smith Foundation for Health Research. His institution has received unstructured funds from NG Biomed, Ltd., to support his research. Dr. Kora DeBeck is supported by a MSFHR/St. Paul's Hospital Foundation-Providence Health Care Career Scholar Award and a Canadian Institutes of Health Research New Investigator Award.