Clinical Outcomes (Epidemiology) Track

The program takes advantage of unique and considerable institutional strengths in epidemiology and digestive disease research. A diverse, experienced, multidisciplinary faculty has been assembled to provide trainees with expert guidance in epidemiology, biostatistics, health policy, outcomes research and nutrition. We welcome minority applicants. Applicants with advanced training may also be considered.

Overview

The purpose of the program is to train independent researchers who will be able to compete successfully for grant support. The program includes one predoctoral and three postdoctoral candidates. The predoctoral candidate is chosen in conjunction with the UNC Department of Epidemiology. Postdoctoral candidates complete clinical training in adult or pediatric gastroenterology either prior to or subsequent to participation in the training program. The program includes a comprehensive curriculum with the following features:

  • Advanced training in epidemiologic methods and biostatistics
  • A two-to-three-year period of training culminating in an MPH or PhD in epidemiology
  • Emphasis on design, execution, analysis and publication of a research project
  • A research preceptor to guide the developing investigator
  • Training that would permit fellows to link classical epidemiologic methods with contemporary molecular and cellular biology (biomolecular epidemiology)

Potential areas of research include all areas of digestive diseases and nutrition. We have special strengths in the areas of chronic disease and cancer epidemiology, clinical epidemiology, health policy, economics and outcomes research. In addition to formal course work in the School of Public Health, additional campus resources include our NIH-funded Center for Gastrointestinal Biology and Disease, the Sheps Center for Health Services Research, and the UNC Lineberger Comprehensive Cancer Research Center. Limited clinical activities are permitted during the research fellowship years.

Training Faculty

The faculty members listed below participate in training fellows in the digestive disease epidemiology training program. Trainees may elect other members of the medical school and public health school faculty to serve as their preceptors

Robert Sandler, MD, MPH, is the director of the training program, former chief of the Division of Gastroenterology and Hepatology and director of the NIH-funded Digestive Disease Research Center, the Center for Gastrointestinal Biology and Disease.  His research has concerned the epidemiology of a number of chronic gastrointestinal conditions including individuals at higher risk to develop gastrointestinal malignancies, diverticulosis, irritable bowel syndrome, gastric cancer, inflammatory bowel disease, constipation and colon adenomas.  His current research is focused on colorectal cancer etiology and prevention and diverticulosis.

John Baron, MD, MS, received a Master’s degree in statistics from Yale and was a doctoral student in mathematical statistics at Stanford before receiving a medical degree from the University of Michigan.  He was a longtime faculty member at Dartmouth where he established an international reputation as a clinical and cancer epidemiologist.  He is perhaps best known for his work in colorectal cancer chemoprevention with important papers in the New England Journal.  In 2010 he was listed among the top 6 investigators in R01 funding.

A.Sidney Barritt, MD, MSCR joined the GI faculty after serving as a trainee on this award. He is a transplant hepatologist with a special interest in nonalcoholic fatty liver disease.  He will serve as a junior mentor.

Ramon Bataller, MD, PhD. Dr. Bataller joined the UNC faculty in 2011. Prior to moving to UNC he was a member of the Liver Unit, Hospital Clinic, Barcelona Spain where he coordinated management of patients with alcoholic and nonalcoholic steatohepatitis. He directed the ‘Laboratory of Liver Fibrosis” developing new therapies for liver fibrosis and conducting translational research in human samples to identify molecular determinants of alcoholic hepatitis. In the short time that he has been in the US he was successful in putting together a consortium to study alcoholic hepatitis.

Evan S. Dellon, MD MPH.  Dr. Dellon joined the UNC faculty in 2008 after obtaining an MPH degree on the training grant.  He has been funded by a career development award from the American College of Gastroenterology, the UNC institutional NIH KL2 Award, and most recently an NIH K23 award.  He is a member of the UNC Center for Esophageal Diseases and Swallowing, and his major research interest is in eosinophilic esophagitis.  In particular, he has active investigations in both etiologic and clinical epidemiology on this topic.

Michael Fried, MD.  Dr. Fried directs the liver program at UNC.  He has been involved with clinical and laboratory studies of hepatitis C since 1990 when he served for three years as a medical staff fellow in the Liver Diseases Section of the National Institutes of Health. Dr Fried has been the principal investigator on numerous Phase I, II and III clinical trials of various antiviral agents for chronic hepatitis B and hepatitis C. Since his appointment to UNC in 1998, Dr. Fried continues his commitment to the development of new and more effective treatments for these and other chronic liver diseases.  He has received funding from the NIH for investigator-initiated research and has been funded by a K24 Mid Career Investigator Award.

Hans Herfarth, MD, PhD.  Dr. Herfarth is a gastroenterologist with clinical and research interest and expertise in inflammatory bowel disease.  He is currently the chair of the CCFA Clinical Alliance.  He is also the PI for “Merit-UC: methotrexate response in treatment of ulcerative colitis” a randomized, double blind, prospective trial that is investigating the efficacy of methotrexate in induction and maintenance of steroid free remission in ulcerative colitis (U01DK092239).

Paul Hayashi, MD, MPH. Skip Hayashi joined the UNC faculty in 2006 and is currently an Associate Professor of Medicine and Medical Director of Liver Transplantation. After completion of a fellowship in gastroenterology at the University of California Davis, he did two additional hepatology fellowships one in clinical research at the NIH and another in transplant hepatology at the University of Colorado. He was a transplant hepatologist at Saint Louis University prior to coming to UNC. Dr. Hayashi is interested in clinical outcomes research, particularly liver transplant outcomes, organ allocation and hepatocellular carcinoma. He also has an interest in drug induced liver disease.

Susan J. Henning, Ph.D. Dr. Henning was recruited to UNC in 2007 from Baylor College of Medicine in Houston where she had served as Director of Research Training in Pediatric Gastroenterology for the past 18 years. The Baylor training program has been viewed as a model program because of its successful recruitment of faculty from basic science departments as active participants in the training of pediatric gastroenterologists.  She is a basic science investigator with long-term research interests in intestinal development and gene therapy, and more recent interests in intestinal stem cells.  Although she has always worked with rodent models, her research has been translational in nature.  Dr. Henning has extensive experience mentoring physician scientists and previously served on the NIDDK-C study section.

Michael Kappelman, MD, MPH.  Michael Kappelman is a pediatric gastroenterologist with interests in epidemiology, pharmacoepidemiology, and health services research in the area of inflammatory bowel disease (IBD).  He recently joined the UNC faculty after completing fellowships in pediatric gastroenterology and pediatric health services research at Harvard Medical School and a Master’s in Public Health in Clinical Effectiveness at the Harvard School of Public Health.  His current work is focused on 1) analyzing the utilization of resources and economic impact of IBD, and 2) studying the quality of care in this patient population.

Millie Long, MD, MPH. Millie Long received an MPH while a fellow on this grant and will serve as a junior mentor. During her fellowship she also completed board certification in Preventive Medicine.  Her research interest is inflammatory bowel disease.

David Ransohoff, MD was the founding director of the Clinical Research Curriculum Award (K30) Program at UNC that has been folded into the CTSA as a career-development course (EPID 986).  This course, along with associated CTSA activities, provides an in-depth, two-year training program for a group of carefully selected trainees, each of whom is committed to a career as a clinical investigator. A major goal for each trainee is to develop appropriate grant funding. The clinical research methods that are taught include: patient-oriented, epidemiologic/population based and outcomes-oriented health services. The UNC CRC has particular emphasis on drug development as a paradigm for teaching the principles of clinical research.  The postodoctoral trainees participate in the Clinical Research Curriculum  (described subsequently).  Dr. Ransohoff’s research has concerned clinical epidemiology methodology with important contributions to our understanding of asymptomatic gallstones, colorectal cancer screening and recently the application of clinical epidemiology principles to genomics and proteomics.  Dr.  Ransohoff has collaborated with former and current trainees on research projects, papers, grant submissions, mock reviews and manuscript preparation.

Nicholas Shaheen, MD, MPH, is a gastroenterologist who received a Master’s in Public Health in Epidemiology from UNC’s School of Public Health as a previous trainee on this grant.   He is the current chief of the Division. His research is in the areas of Barrett’s esophagus, esophageal adenocarcinoma, and gastroesophageal reflux disease.   His current work seeks to better define the risk factors for Barrett’s esophagus and esophageal adenocarcinoma.  Healthcare utilization issues are especially important in GERD, and a major focus of his work has been the utilization of endoscopy and other healthcare expenditures related to GERD and Barrett’s esophagus.

Til Stürmer, MD, PhD. Dr. Stürmer, a recent recruit to UNC, has a dual focus in epidemiologic methods and clinical epidemiology. His research in epidemiologic methods includes the development of more efficient matching strategies in genetic epidemiology; measurement error correction methods in case-control studies; the value of propensity scores for pharmacoepidemiologic studies; and the novel integration of ideas from measurement error correction and propensity score analysis to improve control for confounding by medication-use choices using data from validation studies.

William Whitehead, PhD., is Professor of Medicine and a member of the UNC GI Division. He is the director of the UNC Center for Functional Bowel Disease and Motility Disorders.  His research is designed delineate the physiological and psychological mechanism responsible for functional bowel disorders and to identify causes and best treatments for pelvic floor disorders such as fecal incontinence, constipation and rectal pain.

Stipends, Insurance, Tuition, Fees, Travel, Research Expenses

The training program is funded by an Institutional National Research Service Award from the NIH. As such, the program abides by the rules established for these awards.

Stipends are established by the NIH. The current annual stipend for postdoctoral trainees is determined by the number of FULL years of relevant postdoctoral experience at the time of appointment. Relevant experience may include research experience (including industrial), teaching, internship, residency, clinical duties, or other time spent in full-time studies in a health-related field following the date of the qualifying doctoral degree.

The training grant covers the cost of health insurance, malpractice insurance (if relevant), full-time tuition in the School of Public Health, travel to one national meeting each year ($1000), textbooks and approximately $2000 per year in discretionary research funds. Trainees are provided with an office equipped with a personal computer and printer.

As part of the general MD fellowship program through the Match, our epidemiology track is equivalent to the ‘clinical outcomes’ option.

Summary of Requirements for the Master's Programs

The School of Public Health has some general requirements for the MPH and MSPH degrees. A minimum of thirty hours is required, although most Master’s students find it necessary to take more. Requirements for a Ph.D. are the same with the addition of a dissertation.

Please note that the Department of Epidemiology has instituted a new program geared for MD clinicians, “Master of Science in Clinical Research” (MSCR). Given its practicality in relation to direct clinical research as opposed to the more traditional or conservative methods, this program is highly recommended for our clinical epidemiology fellows.

Specific details about the requirements of these programs can be found on the Department of Epidemiology website.  In the past, some fellows have also taken advantage of the Public Health Leadership Program.