First Year Fellows
Clinical
The first year will be predominately dedicated to the acquisition of basic clinical skills in REI. This includes participation in our sizable Reproductive Endocrinology practice, as well as exposure to related areas, such as andrology, medical endocrinology and pediatric endocrinology. Fellows will learn all aspects of Assisted Reproductive Technologies (ART) monitoring, oocyte retrievals and embryo transfers by daily participation in our ART program, which performs over 250 cycles of IVF-embryo transfer annually. The fellow will be an active participant in our daily ART Team Meetings, where the care for all patients undergoing IVF, frozen embryo transfer, or ovulation induction is reviewed. In addition, formal REI Teaching Rounds will be conducted weekly by an REI faculty member during the Friday AM educational period. To broaden their education, fellows will participate in off-service rotations one half day per week during the first year: Medical Endocrinology, Pediatric Endocrinology, Male Infertility and Reproductive Genetics, in turn.
Research
Scientific effort in the first year will be devoted primarily to identifying a research question and choosing a research mentor. During the first year, each fellow will design a research project that can be completed within the next two years. The project will be written as a research proposal and submitted to the UHCMC Institutional Review Board for approval
Scientific Writing
An essential aspect of a successful academic career is the ability to write clearly and concisely. Writing requirements will be an important part of all three fellowship years. Each fellow will be given a basic writing textbook (Zeiger, M. Essentials of Writing Biomedical Research Papers. 2nd ed. New York: McGraw-Hill; 2000) and individually mentored in the art of medical writing by various faculty members.
In addition to writing their research proposal, each fellow will choose a case report or a clinical topic on which to write a review paper. Upon completion, these papers will be submitted to the appropriate journal for publication.
Didactics
Graduate Courses
During the first year, the fellow will take two graduate courses. A passing grade will be required of all fellows.
CRSP 402 Study Design and Epidemiologic Methods
This course covers the methods used in the conduct of epidemiologic and health services research. The course begins with how to quantify disease frequency and compare it across populations, often as a way to generate hypothesis about what factors may cause a given condition. The course will introduce methodological issues that need to be considered in the design and conduct of epidemiologic studies, including classification of disease and exposure status, types and consequences of misclassification, effect modification and related concepts. Additional sessions will focus on the control of confounding and on the three main types of study designs: randomized trials, cohort studies and case-control studies.
CRSP 403: Biostatistics for Clinical Research
This course introduces biostatistical methods appropriate for clinical investigators involved in patient-oriented, translational, epidemiologic, health services and public health research. We anticipate that students will be primarily involved in designing and interpreting their own studies, but will also be critically evaluating the work of others. The course thus emphasizes what the statistical process is all about: how to conduct studies, what the results mean and what can be inferred about the whole from pieces of information. The focus is on understanding and describing comparisons and relationships between complex phenomena, and on measuring how well these relationships fit data. A course project will involve problem specification, data collection, management, analysis and presentation. Students will use software extensively and will see output from multiple packages.
Second Year Fellows
Clinical
During the second fellowship year, clinical activity will be limited to 10% (6 hours per week). They will continue to rotate on weekend call once monthly and assist with some ART and surgical procedures during the week in an effort to continue to improve their clinical skills. All fellows will continue to attend and participate in Friday morning conferences.
Research
The second year of the fellowship will be devoted primarily to research under the direction of the fellow’s research mentor. The majority of effort will be directed towards making significant progress on the project identified during the first year.
Scientific Writing
An important aspect of the second year will be writing and submitting a Grant application. This will help focus the fellow’s research plans and also serves as an introduction to grantsmanship. The application will be submitted to the most appropriate funding source as determined by the fellow and his/her Research Committee, most of which have October 1 deadlines (Appendix B). Any awarded grants will be utilized for salary support and supplies for the fellow’s research program.
In addition, fellows will be required to submit one or more abstracts containing preliminary data for possible presentation at a regional or national scientific meeting. Abstract submission deadlines most commonly occur in the Fall and Spring.
Third Year Fellows
Clinical
During the first half of the third year, clinical activity will continue to be limited to 6 hours per week. Fellows will attend the fellows REI clinics, rotate on ART weekend call, and assist with a limited number of ART and surgical procedures during the week. During the second half of the third year, clinical activity will increase to 12 hours per week in an effort to help prepare fellows for the clinician-scientist role.
Research
Third year fellows will continue to devote the majority of their time to their research program with a particular emphasis on project completion, data analysis and publication. Fellows will also be assisted with the development and planning of an independent research project to be carried out at their first academic position.
Scientific Presentations and Writing
The primary writing goal of the third year will be to write and submit at least one manuscript for publication in a peer-reviewed journal based on data generated during the fellowship. This manuscript, with the fellow as first author, will be written as a defensible thesis for ABOG certification purposes. In addition, all fellows will present their research at the Annual Departmental Paper Day and present Grand Rounds to the Department at least once during their fellowship.
Another important writing goal of the third year will be the preparation of an independent research grant application for submission after completion of their fellowship. These efforts will help continue to develop and improve both scientific writing and grantsmanship ability.
Optional Masters Degree: Clinical Research Scholars Program
Fellows have the option of applying to participate in the Clinical Research Scholars Program (CRSP) at Case Western Reserve University during their second and third years. The Program’s objectives are to provide physicians with rigorous, high-quality, didactic education in clinical research methods coupled with an in depth mentored investigative experience. This two-year training program consists of three overlapping parts: formal didactic course work, a longitudinal seminal series, and an intensive mentor experience centered on a specific clinical research problem. The combination of course work outlined by the program and the scholarly investigative activities chosen by the fellows is designed to fulfill the requirements for a Masters degree in a) Public Health (MPH), b) Health Services Research (MHSR) or c) Clinical Research (MSCR). THE CRSP is supported by K-30 grant from the National Institutes of Health that provides the financial support and scholarship to cover the costs of the fellow’s training.
Duty hours and call responsibilities
Duty hours during weekdays will be 8:00 AM to 6:00 PM (50 hours per week). Weekend hours will be 8:00 AM to 10:00 AM twice monthly during the first year, and once monthly thereafter. Fellows will take at-home call (pager call) with attending backup two weeks per month during the first year of fellowship and one week per month thereafter.
“Moonlighting” Opportunities
Fellows can elect to take in-house OB/GYN resident coverage call twice monthly, for which they will be paid.