Clinical Outcomes (Epidemiology) Track

Supported by an NIH T32 training grant, this 4-year program provides advanced training in epidemiology and health outcomes research, including coursework leading to an MSCR degree at the Gillings School of Public Health at UNC. Candidates complete clinical training in adult or pediatric gastroenterology, their MSCR degree program, and advanced training in a clinical area of interest (such as inflammatory bowel disease or transplant hepatology) during this 4-year program.

The Epidemiology and Outcomes Program is supported, in part, by a training grant from the NIH. Fellows in the program spend 4 years in training – a typical schedule starts with 12 months of clinical gastroenterology and hepatology, followed by 18 months of research completing a MSCR degree, followed by completion of 6 months clinical gastroenterology and hepatology. The 4th year includes 6 months of research and 6 months of clinical advanced training in a content area of interest (such as IBD or esophageal diseases). The 4th year can be used to complete transplant hepatology training as well.

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, and outcomes research.

Overview

The goal of the program is to train independent researchers who will improve our understanding of the magnitude, etiology, impact and treatment of digestive and liver diseases, and who will assume leadership roles in GI epidemiology and outcomes research. To accomplish that goal, the program includes the following features:

1. Formal advanced training in epidemiologic methods and biostatistics to provide a strong foundation in research design and analytic techniques
2. A full 2-year period of coursework culminating in an advanced degree, an MSCR in epidemiology
3. Emphasis on design, execution, analysis and publication of research projects to enhance the ability of the trainee to conceptualize and think through research problems with increasing independence
4. Mentors to guide the developing investigator
5. An integrative core curriculum designed to develop skills necessary for an academic career

Underrepresented minorities are especially encouraged to apply. To be eligible for Training Grant support, applicants must be U.S. citizens or permanent residents.

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.

Training Faculty

Core Curriculum

The organized didactic program is based in the School of Public Health. Trainees are expected to obtain an MSCR degree in a training program developed specifically by our School of Public Health for clinicians. This program emphasizes course work to develop skills necessary for the successful clinician-researcher (such as study design and data analysis. Trainees who enter with an MPH can take advanced coursework.

To complete the 36 credit hour degree requirements, students must master a defined set of competencies including:

1. Clinical research study design: Identify testable research hypotheses. Develop appropriate study designs with minimal bias; identify appropriate target populations.
2. Fundamentals of data analysis: Develop appropriate data analysis plans for research hypotheses; implement basic statistical analyses including multivariable regression. Understand sample size and power calculations.
3. Grant proposal development: Develop a proposal for clinical/translational research suitable for submission to the National Institutes of Health or research foundation.
4. Interdisciplinary collaboration: Demonstrate knowledge of team science. Develop skills for collaboration with research methodologists, including biostatisticians.
5. Project oversight and management: Demonstrate skills to implement a research project, including hiring of appropriate team members, developing and managing budget, overseeing project, ethics approvals, and regulatory reviews.
6. Oral and written presentation: Effectively present research findings orally to peers, lay persons, and the media. Write clearly and succinctly for scientific publication and research proposals.
7. Professional development: Demonstrate knowledge of the academic research environment, sources of research support, and professional advancement. Demonstrate the use of strategies to improve professional effectiveness, such as time management, leadership, and management skills.

Duration and sequence of training

The training includes an initial year of clinical GI training. Fellows are appointed to the T32 in their second year. During the summer semester, fellows are introduced to the research, educational and clinical opportunities available at UNC through a series of seminars from training grant faculty geared to this purpose. They meet with their academic advisor to choose specific course work for the coming academic year. They attend research presentations by the training faculty at the weekly Digestive Disease Epidemiology Conference and meet with training faculty to explore mutual interests and to identify a research project. Trainees begin courses in biostatistics and epidemiologic methods during the fall semester of the second year. Course work and seminars continue in the spring semester of the second year. During the third year the trainees complete the remainder of the courses required to satisfy the MSCR degree. In addition to the required courses, fellows select advanced courses or tutorials pertinent to their research. During the spring semester of the 3rd year, trainees complete additional clinical training so that they are board-eligible at the end of the year based on ACGME requirements. During the spring semester they complete their master’s thesis and final coursework so that they can graduate in May.

The fourth year is a ‘flex’ year where fellows participate in research and write papers, as well as have the opportunity to obtain advanced clinical training. Past trainees have completed advanced clinical training in liver transplant, IBD, obesity, preventive medicine, and esophageal diseases.

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

The training program is funded by an Institutional National Research Service Award from the NIH. Stipends from the NIH, based on the number of years since graduation from medical school are supplemented by the GI Division so that all fellows are paid at the rate established by ACGME.

Trainees are provided with approximately $11,950 per year in research funds to cover cost of health insurance, malpractice insurance (only if the nature of the research training requires such special insurance), training-related supplies, and professional memberships. Trainees are provided with office space equipped with a personal computer and printer. Trainees are provided $1,000 in travel funds to cover cost of one national meeting per year often supplemented by additional funds from the GI Division.

The training grant pays tuition and fees in the School of Public Health.

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