Written by Patrick Steadman; edited by Ellen Zhou and Kirill Zaslavsky

     During 2016, CITAC members worked hard to establish answers to pressing questions on Canada’s clinician-investigator (CI) training. This hard work continues CITAC’s tradition of conducting research on CI training and publishing this work and is especially relevant following changes to Canada’s support of CI training in 2015 (Webster). CI’s are important to the medical and research community as they are clinicians who spend at least 50% of their time working on essential research. Clinician-scientists are those who spend 80% of their time on research.

     A fundamental question that had remained open in Canada was how successful are MD-PhD programs at training CIs? While in the US, NIH-funded programs report that 66% or more (depending on data source) of their graduates become clinician-scientists (Brass et al., 2010). No similar measures have been compiled for Canada until now. From Zhou et al. (2016), who surveyed all alumni of McGill’s MD-PhD program found that of those that have completed training, 60% had roles defined as clinician-scientists. For its part, University of Toronto’s latest annual report states that 55% of its graduates have become clinician-scientists (found here). CITAC has completed a national survey of graduates from all MD-PhD programs in Canada, which has been accepted in CMAJ Open. To date, 60% of the graduates have become clinician-scientists, and nearly 90% are primary investigators on research grants with 77.8% holding more than one. This data clearly demonstrates that Canadian MD-PhD programs are a vital source of clinician-investigators for our healthcare system.

    The survey also highlighted several areas that facilitate trainee success. For example, a key pillar of training is mentorship by peers and senior CIs. This has been discussed before by CITAC (see Yoon et al., 2013) and examined in detail by Jones et al. (2016), who surveyed MD-PhD program directors and trainees on program structure, funding, and integration of research and clinical training available within their institutions. Surprisingly, we found that more than half of all programs did not have formal mentorship opportunities, a serious barrier to trainee success. Furthermore, stipend amount and tuition varied, especially when students were in the MD portion of their training. Such variability in trainee support, coupled with limited mentorship opportunities, may compromise the success of training programs in generating CIs. CITAC strongly believes that MD-PhD training programs would benefit from sharing practices and data on how individual program structures meet their trainee needs. A key goal for CITAC this year is to improve communication across member institutions and between trainees and program leadership. This nationwide collaboration can help increase opportunities for mentorship, career development opportunities and help inform design of best practices for training clinician-scientists.

    CITAC also examined the role of non-governmental organizations (NGOs) for promoting research in medical students (Manoranjan et al., 2017). By collaborating with the Mach-Gaensslen Foundation, CITAC analysed data on the 621 Canadian medical student research projects sponsored since 2005. Using pre- and post-research questionnaires and 5 and 10-year follow-up they found 96% of students would recommend a similar experience to other medical students and similarly that it was of great value to their medical training. At 10 years following the experience, 41.67% of respondents were physicians with a research component in their career and 58% held faculty appointments at a medical school. It is unclear whether these students would have become clinician researchers without the experience, but within this cohort participants report the experience as being impactful.

    Taken together, our work over the past year highlights the importance of supporting and expanding clinician-investigator training capacity in Canada. Though dwindling in proportion to the overall number of medical graduates, clinician-investigators remain a vital national resource that is fundamental to continued integration of medicine with research. In 2017, CITAC will continue to advocate for addressing trainee needs and increasing the viability of the clinician-investigator career pathway by encouraging nationwide collaboration across training programs and stakeholders.

 

References:

1. Brass, L. F., Akabas, M. H., Burnley, L. D., Engman, D. M., Wiley, C. A., & Andersen, O. S. (2010). Are MD-PhD programs meeting their goals? An analysis of career choices made by graduates of 24 MD-PhD programs. Academic Medicine : Journal of the Association of American Medical Colleges, 85(4), 692–701. http://doi.org/10.1097/ACM.0b013e3181d3ca17

2. Jones, A. A., Ng, E., Deguise, M.-O., Mak, L., Ouyang, B., Sivapragasam, M., et al. (2016). MD/PhD Training in Canada: Results from a national trainee and program director review. Clinical and Investigative Medicine …, 39(4), E132–9.

3. Manoranjan, B., Dey, A. K., Wang, X., Kuzyk, A., Petticrew, K., Carruthers, C., & Arnold, I. (2017). Role of non-government organizations in engaging medical students in research. Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research, 65(3), 709–716. http://doi.org/10.1136/jim-2016-000348

4. Webster, P. C. (2015). CIHR cutting MD/PhD training program. Canadian Medical Association Journal, 187(12), E381–2. http://doi.org/10.1503/cmaj.109-5124

5. Yoon, J.-Y., Appleton, T., Cecchini, M. J., Correa, R. J., Ram, V. D., Wang, X., et al. (2013). It begins with the right supervisor: Importance of mentorship and clinician-investigator trainee satisfaction levels in Canada. Clinical and Investigative Medicine , 36(6), 269–276.

6. Zhou, T. E., Savage, P. A., & Eisenberg, M. J. (2016). Canadian M.D.-Ph.D. Programs Produce Impactful Physician-Scientists: The McGill Experience. Journal of Biomedical Education, 2016(4), 1–4. http://doi.org/10.1155/2016/3836467

CITAC/ACCFC AGM: November 21-23, 2016

Update: Book of Abstracts Released

Thank you to everyone who registered and/or submitted an abstract. The 2016 Annual General Meeting will take place November 21-23, 2016, and the meeting will be held in Toronto, ON at the Chestnut Residence.  This year's AGM theme will be "Mapping Your Career as a Clinician Scientist". You can find the book of abstracts here.

We have an exciting lineup of speakers and interactive workshops geared towards MD/PhD and CIP trainees. A tentative agenda can be found here. This year’s meeting also includes an interactive CIP trainee-led mentorship session for MD+ trainees, focused on overcoming challenges of residency training towards a successful career as a clinician-scientist. We extend an invitation to CIP trainees from all specialties to join as mentors. Please contact us for details at This email address is being protected from spambots. You need JavaScript enabled to view it. and a list of suggested topics will also be provided to you.

(note, the below link directs to the old website)

Register Here!

Instructions for Abstract Preparation and Submission

  1. Formatting of Abstracts
    • Abstracts should be no more than 200 words.
    • Use Times New Roman font, 12 pt.
    • Use a concise title, in bold font. Capitalize the first word.
    • List name, initials and institution of each author.
    • You are welcome to separate text into structured abstract headings: Background/Purpose, Methods, Results, Conclusion
    • Please do not include any figures or tables
    • Please limit your poster to 6' (width) x 3' (height)
  2. By submitting an abstract to the Young Investigators’ Forum (YIF) you are consenting to publication in Clinical and Investigative Medicine (CIM). The abstract text will not appear on PubMed. If you do not want your abstract summary to be included in the YIF, please email This email address is being protected from spambots. You need JavaScript enabled to view it..
  3. Limit submissions to one abstract per person. Please submit your submission by email to the CITAC AGM chair at This email address is being protected from spambots. You need JavaScript enabled to view it.. Submissions will be forwarded to the CSCI abstract adjudication committee. Include the following information in your email:
    • Name of presenting author
    • Institution
    • Program and year
    • Research Area: Basic Science, Clinical Research, Clinical Epidemiology, Translational Research, Other (please specify)
    • Indicate whether interested being considered for an oral presentation (N/A for late abstracts)
  4. Absolute deadline for abstract submission is September 23, 2016.
  5. All abstracts submitted will be eligible for participating in the poster competition and select top-ranking abstracts will be selected for oral presentation. Candidates who wish to be considered for an oral presentation should indicate their interest in doing so.
  6. Based on feedback from last year, we are excited to introduce a brand new format for the poster presentation.  Stay tuned for further details.

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