Divisional Fellows (M.D. and M.D./Ph.D. postdoctoral fellows) develop professional skills and perspectives through participation in program activities including multidisciplinary clinics in rheumatic diseases (10-20% effort), the weekly Immunology Seminar Series, Journal Clubs, the annual Stanford Immunology Retreat, the weekly Immunology Program Seminar Series, and a variety of other educational opportunities. Attendance at a course in the Responsible Conduct of Research and a course on bioethics, as well as monthly seminars and quarterly symposia sponsored by the Center for Clinical Immunology at Stanford (CCIS), are mandatory. Trainees have been encouraged to present their research at local and national rheumatology conferences. Trainees have access to modern clinics, the GCRC, and state-of-the-art specialized research facilities. We have a new T32 Training Grant that provides two years of support for M.D or M.D./Ph.D postdoctoral fellows in adult rheumatology. The T32 Training Program has three tracks:
(i.) biomedical translational science;
(iia.) clinical trials and therapeutics; and
(iib.) components of Health Services Research.
Divisional Faculty in each of the tracks has ties with other programs in their disciplines within the School and the University. The fundamental focus of the trainee is in the field of their mentor. In order to provide cohesion within the training program and to broaden each trainee’s experience, the trainees will have developed a variety of activities. These consist of the Division’s weekly Grand Rounds and Journal Club plus time spent in the clinic. There will also be special conferences for the fellows that include a weekly teaching session, a significant portion of which is clinical material mandated by the ACGME. However, during the course of any year, approximately a third of the time is used to introduce relevant biomedical and other scholarly subject’s including the work of the Division’s faculty. Another activity is a bi-weekly conference introduced through this training program, in which the trainee and their mentors present and discuss the trainee’s research activities, a type of conference developed from our other training experiences; it provides excellent opportunity for both critical review and broadening of the trainee’s work. Finally, our trainees will be welcome in many other conferences and seminars organized by other units of the School in such subjects as Immunology, Epidemiology, Health Services Research and their respective methodologies.
a) Hypothesis-Driven Research. Trainees in this track will spend a majority of their effort (~90%) performing hypothesis-driven research in one of the research labs in the Division of Immunology and Rheumatology. Mentors will work directly with the trainees to help them identify a testable hypothesis, to aid them in design and execution of rational experiments, and to assist with interpretation of results. The emphasis of all of the labs participating in this pathway is on clinically-relevant scientific questions, and trainees will be encouraged to pursue projects related to animal models of disease; biochemistry of proteins involved in immunity; cellular biology of transplantation, autoimmunity, tolerance, and signaling; and translational research related to genomics and proteomics. Particular emphasis is being placed on projects that provide a multidisciplinary interface between 2 or more labs in the Division.
b) Training for a Career as a Clinician Scientist. Training of fellows in grants preparation, manuscript preparation, organization and delivery of scientific lectures, and data analysis is frequently overlooked, yet critical to success as an independent investigator. Fellows are given informal training by individual lab mentors in preparation of grants and manuscripts, and preparation and delivery of Powerpoint presentations. Formal seminars on these topics are already organized as part of the Interdepartmental Program in Immunology training and include Divisional trainees.
The recent decline in emerging physician-scientist rheumatologists, across the country in general, along with the limited number of training programs in rheumatology that attract and prepare physicians for independent research careers, is of serious concern for maintaining the rapid pace of novel and creative advances in biomedical research. Such advances enhance the care of patients with chronic rheumatic diseases. Rheumatic diseases in aggregate affect over 30 million individuals in the US alone, and extract a cost to society of well over $40 billion annually.
