Physician Scientist Training Report
Associate Dean’s Message
I am delighted to share the innovations of the past year in the Physician Scientist Training Portfolio. Our efforts to integrate all aspects of training and mentoring future clinical investigators have resulted in newly implemented educational innovations, detailed below. Our growing cadre of trainees across the expanse of undergraduate and postgraduate medicine continue to excel.
There is still more work to be done – we must continue to grow and strengthen the community of clinician scientists in Canada. As we look to the future, curricular and regulatory innovations in both undergraduate and postgraduate medicine have the potential to generate a physician scientist development pathway that is coherent and relevant to the educational needs of our students and which prepares our students for a strong transition to a career beyond training.
Norman Rosenblum, MD, FRCPC
Associate Dean, Physician Scientist Training
Innovation in Education – Integrated Physician Scientist Training Pathway (IPSTP)
Medical education is undergoing a transformational reform to better meet the needs of Canadians, both now and in the future. The IPSTP situates the University of Toronto as an international leader by offering an integrated and enriched training model for physician scientists. The pathway is guided by the innovation principles of integration, flexibility, customization and sustainability in the training of physician scientists. The past year has seen significant advances towards this goal with changes to the way our students are learning - both inside and outside the classroom. Educational innovations during the past year include:
- Entering MD/PhD students are integrating their graduate and undergraduate studies. As early as first year, full-time MD students are also taking graduate courses to prepare for their PhD studies.
MD/PhD Summer CREMS Program provides a tailored, 6-week research experience that is initiated by the MD/PhD student with a supervisor of their choice. This new program is funded by a generous endowment from Miss Jessie Calder.
- CBL: The Case Based Learning component of the Foundations Curriculum has an enriched curriculum focused on the integration of clinical medicine with research and innovation for MD/PhD students and other medical students considering a career as a clinical investigator.
- LInC: The Longitudinal Integrated Clerkship (LInC) now features an enriched curriculum for MD/PhD students and other MD students interested in health research. LiNC promises customization of the clerkship experience to include patients in particular areas of interest and physician-scientist mentors who can enhance their understanding of the physician-scientist career.
- The MD/PhD Longitudinal Mentorship Program was created to connect our students with physician scientists, with the aim of supporting their successful physician scientist careers. 2015-16 was the third year of this initiative and there were 34 participants.
CIHR Vanier Award Winner: Shrey Sindhwani
Shrey Sindhwani and his supervisor, Professor Warren Chan, have modified and improved a technique to turn organs transparent, allowing them to track the locations of nanoparticles in the body. “It was kind of like taking off a blindfold,” says Shrey, a PhD candidate in the Institute of Biomaterials & Biomedical Engineering (IBBME). “When we know more about which type of cell is taking up which kind of nanoparticle, we can ensure we are using the right drug for the right application.”
* excerpted from UofT Engineering News , Tyler Irving, May 11, 2016.
A 2013 External Advisory Committee, mandated by CIHR’s SPOR (Strategy for Patient-Oriented Research), concluded that “Canada needs a major increase in the number of health clinician scientists.” Prior to this announcement, the University of Toronto MD/PhD Program had set a goal to grow to 80 students - a number that can sustain the professional community of physician scientists and build the reputation of the Program. Since 2011, more students than ever are applying to the MD/PhD Program. In 2016, we have the largest cohort in our history.
MD/PhD Student Financial Support
Lack of financial support is a significant barrier to students pursuing careers as a clinician scientist. Funding is essential to our mission of helping these trailblazers. In 2015, the Canadian Institutes of Health Research (CIHR) announced it was ceasing funding to MD/PhD programs in Canada after the 2015-16 academic year. Despite this, the University of Toronto remains committed to this important program, which has trained generations of leaders in the field of medical research. We don’t foresee the withdrawal of financial support by CIHR as an impediment to admitting qualified students into the program, and we continue to seek out the best qualified candidates to support in their physician scientist career path.
Our visionary partners, such as the McLaughlin Centre and other generous donors, and collaborating departments and institutes within the Faculty of Medicine, Faculty of Applied Science and Engineering and the Dalla Lana School of Public Health, continue to support our programming and students. Further gifts, such as the new Dean Catherine Whiteside Scholarship for Clinician-Scientists, will ensure the continued admissions and support of Canada’s future health innovators.
Hannah Kozlowski was awarded the inaugural Dean Catharine Whiteside Scholarship for Clinician-Scientists, as our top, incoming student to the MD/PhD program in 2016. This endowment was established with the philanthropic leadership of Terry Donnelly, in order to celebrate the accomplishment of the former Dean in her administrative role, and her career as a clinician-scientist. She spoke with Faculty of Medicine writer Carolyn Morris about her research and plans. Read more about Hannah in this feature article.
MMD/PhD students have a passion for both research and clinical care. With these skills, they are uniquely positioned as leaders of transformational change for society. Our students’ research includes education, philosophy of medicine, engineering, epidemiology, in addition to a cross-section of basic science research such as molecular genetics and biophysics.
In 2015-16, our student achievements include:
2 Graduates: Patrick McVeigh (Vascular Surgery, University of Toronto) & Sean Nestor (Psychiatry, University of Toronto)
13 PhD’s Completed
25 Competitive, External Awards and Scholarships
McLaughlin Scholar & Ruggles Innovation Award Winner: Linda Vi
Linda Vi’s primary research focuses on the pathophysiological changes that underlie delayed/impaired bone fracture healing in aging. Previous work in the Alman laboratory showed that exposing old mice to a youthful circulation rejuvenated fracture repair in these older animals. Her project focused on elucidating the cellular origin of this rejuvenation, with the long-term goal of identifying these ‘youth factors’ and developing therapeutics to restore this healing process.
Linda's career was recently featured by the Orthopedic Research Society.
2015-16 brought new engagement with our alumni. With the elimination of the CIHR MD/PhD funding came the need to more fully understand their successes. Of the 36 MD/PhD alumni who have completed training, 20 are clinician scientists, approximately 28 are actively engaged in research, and 30 hold academic positions.
Comprehensive Research Experience for Medical Students (CREMS)
The Associate Dean, Physician Scientist Training, provides academic and strategic oversight of the Comprehensive Research Experience for Medical Students (CREMS) Program, which is directed by Dr. Neil Sweezey. The CREMS Program provides medical students with a suite of research experiences, including the summer program, and a 20 month research experience called CREMS Scholar. While interest in the CREMS programs continues to rise, funded positions are decreasing. CIHR funding cuts have caused a decline in funded positions. 2016 saw 159 prospective projects submitted while just 53 were funded. Supervisors submitted a total of 30 proposals for CREMS Scholar projects, and 13 were funded.
Royal College of Physicians and Surgeons of Canada Clinical Investigator Program (CIP)
One of the major attractions to train at the University of Toronto is the diversity of outstanding research programs, and the capacity of these programs to train clinical investigators in the context of post-MD education. CIP provides a structure of guidance and community for post-graduate MD trainees to undertake research training, with our trainees representing approximately 5% of University of Toronto residents. In 2015-16, there were a total of 108 trainees in the program. 50% of the trainees are in PhD Stream Programs, 10% are post-doctoral fellows, and the remaining are in masters programs across 3 faculties. 2016-17 is our largest cohort to date, with 118 trainees.
A major challenge for Post Graduate Medical Education (PGME) is to identify the financial resources to fund these CIP positions in a sustainable manner. The Ministry of Health CIP funding constitutes approximately 50% of the funding needed to support the salaries of new CIP residents. The MOH-CIP supported trainees are selected for their academic excellence and potential as a future clinician-scientist. In 2016, the CIP program tracked the career progress of the 74 trainees who have received CIP funding. 3 PhD-level trainees have completed all training, and all of them are working as clinician-scientists. They have positions at the University of Ottawa, University of Toronto, and University of Western Ontario. 9 trainees at the MSc and MEd-level have completed all training, and 6 of those are working as clinician scientists.
CIP trainees collaborated with Dr. Norman Rosenblum to publish a paper titled, “Research projects in the Surgeon–Scientist and Clinician–Investigator programs at the University of Toronto (1987–2016): a cohort study.” The study’s aim was to investigate any changes in the number of resident physicians pursuing training in basic science research over the last 30 years.
CIHR Vanier Award Winner: Dr. Dmitry Rozenberg
As a Respirologist with training in Kinesiology, Dr. Rozenberg is looking to translate his clinical expertise and passion for exercise training to improve health outcomes in people with lung disease. A doctoral student at IMS and CIP trainee, he is studying the contribution of skeletal muscle dysfunction before and after lung transplantation. His research aims to understand the impact of muscle dysfunction on daily physical function, quality of life, health care use, and survival before and after lung transplantation.
Annual Symposia for Physician-Scientist Trainees
30TH ANNUAL MEDICAL STUDENT RESEARCH DAY
On February 2, 2016, students and faculty from across the MD and MD/PhD Programs gathered at the annual Medical Student Research Day (MSRD). A daylong conference for medical students to exhibit their research; this year’s 30th anniversary of the event celebrates our longstanding tradition of discovery and innovation at the University of Toronto.
2015 Young Investigators Forum
The 2015 Young Investigators Forum and CITAC-ACCFC Annual General Meeting (AGM) was hosted in Toronto with the theme “It Takes a Village.” There were a record number of participants with 160 attendees, including 48 UofT CIP trainees. This year’s program featured lecture-awards honoring clinician-scientists, opportunities for attendees to present their research through poster sessions and oral platforms, and workshops geared towards career development. A new workshop tailored to MD/PhD students called “Choosing the Right Specialty for You” was introduced.