Oncology Fellows Derive the Greatest Benefit From Advanced Research Training

Aron Simkins, MD

Recognizing the need to develop physicians who are well versed in basic science and clinical research in biomedical research, the National Institutes of Health (NIH) established the Clinical and Translational Science Award (CTSA) program in 2006. The program established CTSA program hubs designed to act as “catalysts and test beds for policies and practices that can benefit clinical and translational research organizations” throughout the United States.^1,2

These hubs provide funding opportunities to further support “preclinical innovation, clinical innovation, and multidisciplinary collaboration.” They also promote education and training to “develop the next generation of translational research physician scientists.” Aimed at growing the translational workforce, most hubs offer different accelerated advanced degree opportunities to oncology trainees, such as master’s degrees in clinical and/or translational research (CTR), or graduate certificates and courses in CTR.^1,2

The CTSA program currently supports more than 60 leading medical research institutions and medical schools.^1,2 Not surprisingly, the vast majority of these research-focused institutions also sponsor graduate medical education (GME) and offer fellowship opportunities in different oncological specialties.

The question, then arises whether oncology fellows should take advantage of these programs during their fellowship training, and what the return on investment will be. Will it help in terms of career advancement? Will it increase productivity in terms of research output? Will it help junior faculty secure new funding opportunities?

Measuring Impact on Career Development

Measuring the tangible impact of a graduate program on career development for physicians is complicated and, in some cases, highly individualized. Completing a master’s program in public health seems to have a positive implication on initiating a career as a clinical investigator.³ Obtaining a graduate certificate in CTR can have a meaningful effect on retaining faculty in CTR careers, as well as increasing the number of first and last author peer-reviewed publications.⁴

However, there is little to no data available for oncology fellows to make an informed decision regarding the value of participating in these CTSA programs. Given the personal time and dedication required to obtain these advanced degrees while balancing clinical obligations and research expectations, knowing the potential pros and cons before embarking on the journey is vital.

With this in mind, my colleagues and I surveyed more than 225 practicing medical oncologists, surgical oncologists, and radiation oncologists who had completed a PhD, a master’s degree in CTR, a graduate certificate in CTR, or non–degree granting CTR courses to determine the impact on their careers and research productivity.

We particularly looked at the impact and satisfaction on new research projects, ability to secure federal and private funding, publications per year (stratified by years since completing GME), new job opportunities, and their career choices: academic vs nonacademic jobs and tenure track positions.

Regarding practice setting and tenure track, there was a significant difference between those who had completed a graduate degree and those who had not, suggesting that those who completed a master’s in CTR or a MD/ PhD were more likely to stay in academia instead of moving to a community-based or hospital-affiliated practice, industry, or private practice. We found no difference between professorship ranks in those who remained in academia.⁵

Those who completed a master’s degree in CTR had higher satisfaction establishing new research projects and better ability to secure funding, and fostered new multidisciplinary collaborations both within and outside their institution (Figure 1).⁵ Research output satisfaction was also higher, but overall average number of publications per year was similar, suggesting that productivity can be attributed to other factors.⁵

Figure 1. Satisfaction Ratings of Perceived Benefit by Category

The perceived usefulness of their degree for career advancement was generally high among the group who had advanced training, again suggesting that completing a master’s program, for those already practicing independently, helped them achieve the job opportunities they were seeking and attain the professorship ranks they aspired to to advance their careers (Figure 2).⁵ Time and financial investment seemed to be well spent for those who were able to complete a graduate degree, supporting the notion that they had an overall good return on investment.

Figure 2. Perceived Usefulness of Advanced Training in Clinical and Translational Science

The high satisfaction noted in those with advanced degrees does suggest that additional training had a positive impact for practicing oncologists. Based on the results of our survey, medical oncologists, radiation oncologists, and surgical oncologists viewed their formal research education as a positive step in their professional development. Furthermore, respondents felt their formal research training was of particular benefit to those seeking to continue working in academic medicine.

Although not necessary to be a successful clinical investigator, master’s programs and other educational opportunities, such as graduate certificates offered by CTSA hubs, can help shape future physician-scientists. They can also help establish new connections with others at their institutions and in the region, leading to new ideas and advancement of the translational spectrum, ideally bringing novel drugs and therapies to clinical use faster.

CTR During Fellowship or as Junior Faculty

The data suggest that CTR training provides a significant benefit to career advancement. However, it is still unclear whether fellows should take advantage of these opportunities for formal research training while in training or as junior faculty.

In our opinion, various factors tip the balance toward completing advanced CTR training during fellowship. First, fellowship is a unique environment and phase of medical training in which one may have access to greater institutional support, including tuition remission, and protected time to complete additional studies. Second, although fellows have a rigorous schedule, they do not have demands on their time that they may later face as junior faculty, such as networking, administrative tasks, and other duties. Finally, during fellowship, trainees must decide the setting of their future practice, and completing a master’s program during fellowship is likely to foster success in academia on a more accelerated trajectory.

The constraints on a fellow’s busy schedule aside, it seems advisable to complete the CTR during fellowship. Whether a full master’s program in clinical and/or translational research or a graduate certificate, this training at this stage of education lays the groundwork for future productivity and professional satisfaction.

Aron Simkins, MD, is a medical oncologist at Mount Sinai Comprehensive Cancer Center, in Miami Beach, FL.

References

1. Zerhouni EA. Translational and clinical science—time for a new vision. N Engl J Med. 2005;353(15):1621-1623. doi:10.1056/NEJMsb053723
2. Leshner AI, Terry SF, Schultz AM, Committee to Review the Clinical and Translational Science Awards Program at the National Center for Advancing Translational Sciences; Board on Health Sciences Policy; Institute of Medicine, et al., eds. The CTSA Program at NIH: Opportunities for Advancing Clinical and Translational Research. Washington (DC): National Academies Press (US); 2013.
3. Kapoor K, Wu BU, Banks PA. The value of formal clinical research training in initiating a career as a clinical investigator. Gastroenterol Hepatol (NY). 2011;7(12):810-813.
4. Comeau DL, Alvarez JA, Bhatti P, et al. Building diverse careers in clinical and translational research: evaluation of a certificate program in translational research. J Clin Transl Sci. 2018;2(1):38-47. doi:10.1017/cts.2018.19
5. Simkins A, Lee M, Paez W, et al. Impact of advanced clinical and transla-tional research educational programs on oncology specialties and career development. J Clin Oncol. 2021;39(suppl 15):11026-11026. doi:10.1200/jco.2021.39.15_suppl.11026