Translational Science Highlight
- An NCATS-funded educational program provides trainees with the skills, knowledge and core competencies needed to advance translational science while also fostering a diverse, transdisciplinary workforce.
Peter Nagele, M.D., M.Sc., always knew he wanted to be a researcher. If he had attended medical school in the United States, he might have also pursued a Ph.D., which includes significant training in research. But studying in Austria offered few opportunities for physicians to learn how to conduct research.
“In Austria, it was understood that during my residency, if you wanted to continue in academia, you should go to the U.S.,” he explained.
This understanding led Nagele to Washington University in St. Louis to work in a basic science laboratory, where he studied how anesthesia works. He later became part of the university’s Institute of Clinical and Translational Sciences (ICTS), funded through NCATS’ Clinical and Translational Science Awards (CTSA) Program, an innovative national network of medical research centers working together to improve the translational research process to get more treatments to more patients more quickly.
Cultivating the next generation of clinical and translational researchers relies on the availability of robust scientific training and career development programs to disseminate required knowledge, skill sets and core competencies. Offering support to trainees across the country through the CTSA Program is just one way NCATS addresses a national shortage of clinical investigators.
The Scientific Workforce of the Future
In most academic medical centers, research has historically focused on basic biomedical research in the lab. Physician-scientists who wanted to conduct clinical trials or large population-based studies often had to acquire those skills on their own, according to Vicky Fraser, M.D., director of the KL2 Mentored Career Development Program at Washington University and former director of the ICTS Clinical Research Training Center (CRTC).
“Now, NCATS has created a more standardized path for training in clinical research, providing the resources and framework to train groups of individuals from diverse disciplines on topics such as study design, research ethics, community-engaged research, statistics and scientific writing.”
“We aim to help trainees become proficient in research methodology, regardless of whether they’re in neurology or physical therapy research,” said David Warren, M.D., M.P.H., director of the ICTS CRTC. “We provide many of the necessary tools to be successful clinical and translational researchers.”
Nagele became one of the first investigators trained in clinical research at the ICTS CRTC. He took part in its Postdoctoral Mentored Training Program in Clinical Investigation. He also received additional NIH funding through a program that supports career development for investigators who have made a commitment to focus on patient-oriented research.
“A lot of people have ideas for studies, but you need to be able to design the study in such a way that it moves the science forward,” he said. “If you make methodological mistakes, no one is going to believe you and no one is going to fund you.”
“CRTC offerings are designed to mentor and develop diverse groups of trainees from many different scientific and medical fields, with broad research interests and educational backgrounds,” Fraser said.
“We pay attention to diversity of disciplines, gender and ethnicity,” she added. “Having a more diverse and inclusive community fosters excellence, innovation and new ways of thinking.”
The Road to Independent Investigator
While Ana María Arbeláez, M.D., M.S., was in medical school in Colombia, South America, her community had very high rates of cervical cancer, raising concerns about local risk factors that may have influenced the development of the disease. Without computers, she studied the epidemiology of cervical cancer in the community with two of her classmates, calculating the statistics by hand. Arbeláez followed her interest in academic medicine and research to the University of Miami for her pediatric residency, and then to Washington University for endocrinology training, where she joined Nagele in the first group of ICTS trainees.
Arbeláez began working in a lab that focused on the effects of hypoglycemia, a complication of diabetes triggered by taking too much insulin. After participating in the ICTS Postdoctoral Mentored Training Program in Clinical Investigation, she received CTSA Program KL2 Career Development funding that guarantees young researchers two to three years of protected time to focus on research, including learning how to conduct studies.
“Having that protected time makes a big difference,” she explained. “Otherwise, it’s very easy to be pulled in too many directions.”
As a non-native English speaker, Arbeláez found the writing classes particularly useful. The network of students from a variety of disciplines and backgrounds also helped.
“There were trainees in situations similar to my own and we read each other’s grant applications,” she said.
Today, both Nagele and Arbeláez are independent researchers. Nagele is supported through a grant from NIH’s National Heart, Lung, and Blood Institute to test a method for reducing the risk of heart attack, a serious complication after surgery, and by NIH’s National Institute of Mental Health to study the use of nitrous oxide, also known as “laughing gas,” for depression. Arbeláez is studying the effects of hypoglycemia on the brain with a research grant from NIH’s National Institute of Diabetes and Digestive and Kidney Diseases.
The Work Pays Off
As part of their training, both Arbeláez and Nagele earned a Master of Science in Clinical Investigation. The CRTC also offers a Master of Science in Applied Health Behavior Research and a Master of Population Health Sciences. CRTC program coursework counts toward these degrees.
In addition to a research mentor, trainees also have what Warren calls a close “programmatic mentor” — a CRTC director or associate director who is a successful researcher and who helps trainees stay on track with career development. The mentoring continues as trainees take steps toward independence, such as applying for their own grants.
Many CRTC alumni, including Arbeláez, become mentors themselves. In addition to chief of pediatric endocrinology, Arbeláez is now director of an additional Washington University pre-doctoral training initiative that NCATS funds through its CTSA Program to provide training in clinical and translational research to students who are working toward an M.D. or Ph.D.
“As a physician, you make a difference one patient at a time,” Arbeláez said. “By conducting research, you can have a much broader impact.”
Posted January 2018