Scott D. Gitlin, MD
Member of CRTI faculty for six years and a former member of the CRTI Oversight Subcommittee
ASH is in the midst of celebrating the 10-year anniversary of the Clinical Research Training Institute (CRTI). This intense, longitudinal, mentored educational and training experience is designed to accelerate the development of early-career hematologists interested in pursuing patient-oriented clinical research (POCR). The 10th class of participants recently completed the weeklong workshop in La Jolla, CA.
Among the obstacles that interfere with the successful recruitment and retention of trainees into careers focused on POCR, paucity of clinical research-specific training programs and effective mentorship appears paramount.1 Productive development and implementation of POCR projects has been shown to correlate with mentor involvement specifically for hematology/oncology trainees.2 To encourage POCR careers in hematology, the Society has invested both capital and human resources in programs that support clinical investigation, including the CRTI.
The program consists of a weeklong workshop in the summer that includes didactic, interactive large-group, small-group, and one-on-one experiences that cover a variety of topics that are important for conducting POCR and for academic career development. Following the workshop, participants are expected to use the CRTI experience to guide further development and implementation of their research projects under the auspices of their “home mentor” and with the advice of a “CRTI mentor.” Participants reconvene with their CRTI small groups at the ASH annual meeting in December to review project progress and ongoing career-development activities. Networking opportunities with other CRTI participants and faculty are provided at the annual meeting. At the end of the CRTI program year, participants meet once again to review progress on both research aims and career development.
A review and assessment of CRTI participants from the program’s first seven years was recently completed by ASH volunteers and staff. Participant racial and gender characteristics were diverse. Sixty-seven percent (67%) of trainees were white, and 33 percent were from other racial/ethnic groups. Fifty-five percent (55%) of trainees were female. Although the majority of participants were in their fellowship while participating in CRTI, 32 percent had previously completed their fellowship training and were in early-career positions. The majority of participants have been from the United States with 8 percent from Canada. (Initially, eligibility was limited to applicants from institutions in the United States and Canada. Beginning two years ago, individuals from anywhere in the world became eligible to apply to the program.)
Both non-malignant and malignant diseases were the focus of wide-ranging areas of investigation during the program’s first 10 years. More than one-half of these projects were either completed or ongoing at the time of the survey. An emphasis of CRTI is development of collaborative research teams. Collaborations with other participants and/or program faculty continue today. As part of the ongoing 10-year anniversary coverage, look for an article in the November/December issue of The Hematologist that focuses on a past participant and how she used the CRTI experience productively to obtain funding and catapult her career to the next level.
Of the 140 people who participated in CRTI during the survey period, 85 percent currently consider themselves to be clinical investigators. Nearly 90 percent of former CRTI participants are conducting research as part of their current jobs, with more than 80 percent in academic research settings. Others are conducting research in industry, government, or private practice.
Traditional measures of academic success are publications and the ability to attract research support. CRTI graduates have excelled in these areas. Although participants have completed the CRTI program from zero to seven years prior to our survey, they have amassed more than 1,000 peer-reviewed publications, generated more than 100 review articles, and authored 173 book chapters. They have also been successful in obtaining extramural research funding. For example, CRTI graduates have been the recipients of 78 U.S. NIH grants, 19 grants from other U.S. or Canadian federal agencies, and 133 foundation awards. Additionally, more than 40 CRTI-developed clinical trials have received corporate funding.
The survey revealed that the vast majority of former participants felt strongly that CRTI provided education, experience, and mentorship that contributed to their development as POCR investigators. There was a sense that the CRTI experience accelerated the pace of career development, and, in some instances, the CRTI experience was the determining factor in the decision to pursue a career in POCR.
The ASH CRTI has become both a model program for preparing physicians early in their careers for leadership positions in POCR and a valuable resource for promoting hematology research. The emphasis on mentoring, both for the research project and for career development, is a key feature of the program, and the success of CRTI graduates reinforces the importance of mentorship in career development.1,2 Thus the continued success of CRTI depends on ASH’s most valuable resource – its dedicated membership.
1. Varmus H. Statement before Subcommittee on Public Health and Safety. United States Senate. October 9, 1997.
2. Gitlin SD, Yuan Z, Little RJ, et al. Factors that influence successful training and faculty career development in hematology/oncology patient-oriented clinical research. J Cancer Educ. 2005;20:72-78.
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