Division of Clinical Care Research
Tufts-New England Medical Center
Boston, MA.
Training
Program
Environment
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The Postdoctoral Fellowship Program is offered
through the Department of Medicine’s Division
of Clinical Care Research at the Tufts-New England Medical Center and
Tufts Sackler School of Graduate Biomedical Sciences. It is intended
for individuals who are fully-trained physicians, or have an analogous
background, and want further training to enhance their research
career.
The program’s primary focus is to train
individuals to critically evaluate health issues, formulate hypotheses
for a particular research plan, and develop bio-statistical models
that will enhance and facilitate the use of appropriate, effective
care as well as impact patient outcomes. This focus is achieved by the
program’s curriculum which involves teaching core research methods
and skills and by developing a clinical research foundation to pursue
clinical research activities that will ultimately integrate into a
required independent research project.
Possessing the skills to self-initiate and successfully execute
clinical research in an environment where excellence and innovation
are expected will be crucial to the selected postdoctoral fellow, and
thus is central to this program. The aim is to train clinical care
researchers so that they may subsequently embark onto successful and
pioneering biomedical careers.
This two-year fellowship is a non-clinical program
and includes a core curriculum in the methods of study design,
biostatistics, epidemiology, special research methods, medical ethics,
manuscript and grant writing, and other health related issues.
In addition to the courses, seminars, and
workshops, the program supports a fellow-initiated research project.
Developing the skill to self-initiate and successfully execute
research will be key to the fellows’ success following training, and
thus is central to this program. Accordingly, the fellow’s most
important accomplishment in the program will be completion of an
independent research project. Available faculty mentors for projects
include a large number of national and international leaders and
innovators in health services and clinical care research. The faculty’s
wide range of projects illustrates the variety and fruits of extensive
collaboration in health services research. Project opportunities
include their ongoing work and also many opportunities at New England
Medical Center, other affiliated hospitals, and affiliated components
of the health care system. To facilitate optimal use of these
opportunities for their projects, fellows have Project Mentors to
support their acquisition of specific skills and resources and to
promote timely progress towards completion. In addition, each fellow
has a Program/Career Mentor, who acts as an advisor and ensures that
the fellow gets appropriate resources and support while in the
program.
Although the primary objective of this fellowship
is to train individuals in clinical research, the combination of
participating in the program's training and curriculum could apply
towards a Master of Science (MS) or a Doctorate of Philosophy (Ph.D.)
in Clinical Research through Tufts University’s Sackler School of
Graduate Biomedical Sciences. Each degree track offers three areas of
concentration: Clinical Investigation, Health Services & Outcomes
Research, or Epidemiology / Biostatistics.
The Environment, Resources, and
Partnerships
Tufts-New England Medical Center and Tufts University School of Medicine
New England Medical
Center (NEMC), the primary teaching hospital of Tufts
University School of Medicine, is internationally known for its
excellence in patient care, research, and training. NEMC’s
state-of-the-art diagnostic technology, modern facilities for
inpatient and outpatient services, and dedicated medical professionals
have helped establish the Medical Center as one of the country’s
leading medical institutions.
Located in the heart of Boston, New England Medical
Center has 16,000 annual admissions, 35,000 emergency/trauma visits,
and 300,000 outpatient clinic visits per year. It is part of the
Lifespan Health System, a non-profit hospital network that also
includes Rhode Island Hospital, Miriam Hospital, Newport Hospital, and
other hospitals.
Directly adjoining Tufts-New England Medical Center is
Tufts University of Medicine, including its Sackler Medical Library and Center for
Health Communications.
The Clinical Research / Health Services fellowship program is funded
through The Agency for Healthcare Research and Quality (AHRQ), aka the
Agency for Health Care Policy and Research. AHRQ, a branch of the U.S.
Department of Health and Human Services, is not only the lead Federal
agency on quality research but also is the lead agency charged with
supporting research designed to improve the quality of health care,
reduce its cost, and broaden access to essential services. AHRQ's
programs of research bring practical, science-based information to
medical practitioners and to consumers and other health care
purchasers.
The Sackler School was established in 1980 in
cooperation with the Tufts University Schools of Medicine, Dental
Medicine, and Veterinary Medicine and the Graduate School of Arts and
Sciences. Since its inception, the Sackler School has built a
world-renowned reputation in the field of biomedical sciences.
Together with Tufts clinicians at the Tufts-New England Medical Center
Hospitals, the University’s health science schools, and the Jean
Mayer USDA Human Nutrition on Research Center on Aging, the
perseverance of understanding, treating and preventing human diseases
is reinforced.
The fellowship program comprises of approximately
50 faculty that are affiliated with the Tufts-New England Medical Center /
Tufts University School of Medicine’s Division of Clinical Care
Research (CCR). Within the Division are several components
dedicated to the study of factors that affect clinical care, its
outcomes, and the development of treatment strategies, decision aids,
and computer-based systems aimed at improving overall patient care.
Its members have pioneered in areas such as predictive mathematical
models of medical outcomes and use of "predictive
instruments", innovations in statistical analysis and study
design, the synthesis of data from different clinical studies, and in
the conduct of meta-analysis. Its Chief, Dr. Harry Selker, is the
director of the Clinical Research / Health Services Fellowship
Program, and its participating faculty include Ms. Joni Beshansky
(Associate Program Director), Drs. Robert Goldberg, John Griffith,
Joseph Lau, Debra Lerner, Dana Gelb-Safran, Christopher Schmid, David
Snydman, Norma Terrin, and Deborah Zucker, to name a few. As outlined
below, the Division includes the Biostatistics Research Center,
The Center for Cardiovascular Health Services Research, The Center
for Clinical Evidence Synthesis, which includes an Agency for
Health Care Policy and Research (AHCPR) Evidence-Based Practice Center
and the New England Cochrane Center. The Division is also the
center for both the MS and Ph.D. track offered at Tufts University’s
Sackler School of Graduate Biomedical Sciences.
Since 1989, the Biostatistics Research Center
(BRC) is a resource for researchers at NEMC as well as investigators,
institutions, corporations in the Boston area and nationally for
statistical and study design support. The BRC has provided
consultations to NEMC’s Department of Medicine’s Divisions of
Geographic Medicine and Infectious Disease, Hematology-Oncology,
Nephrology, Cardiology, Gastroenterology, and Rheumatology as well as
in the Departments of Surgery, Pediatrics, Rehabilitation Medicine,
Radiation Oncology, and Psychiatry.
The Center for Cardiovascular Health Services Research has
been located at the New Medical Center since 1985 and directed by Dr.
Harry Selker since 1982. In particular, research has been done on
Emergency Department (ED) diagnosis and triage of patients with acute
cardiac ischemia as well as in the development of cardiac predictive
instruments as real-time clinical decision aids to improve ED triage
and treatment of cardiac patients.
The Center for Clinical Evidence Synthesis (CCES),
which includes an AHCPR Evidence-Based Practice Center is
directed by Dr. Joseph Lau. Its mission is to advance the science and
the application of methods of synthesising evidence for clinical
decision making. One example, developed by the CCES investigators,
which has attracted attention, is the development of "cumulative
meta-analysis" by which meta-analyses can be constantly updated
to incorporate new studies’ results. Through the work of this Center
in 1996, the Clinical Care Research Division was designated as the New
England Cochrane Center, one of five U.S. centers in the worldwide
Cochrane Collaboration. The Cohrane Collaboration is a research
collaboration with a mission to provide systematic reviews and
meta-analysis of the effects of healthcare.
The Health Institute is directed by Dr. Dana Safran and focuses
on improving health by advancing measurement of and knowledge about
the social, behavioral, medical, and biological factors that influence
individual and population health. There are five principal program
areas for research within the Institute: the Outcomes Measurement
Development Program; the Program on Primary Care; the Program on
Mental Health Services Research; and the Program on Work and Health.
On-Campus Partners
The Tufts-New England Medical Center Administration has a long
tradition of encouraging and supporting health services research, and
has been very successful in disseminating its own work in improving
care efficiency. Both its TSI hospital cost-accounting system and its
pioneering work in clinical pathways are used worldwide, and many of
its operations models have been widely emulated. Faculty members
include William Santulli, Chief Operating Officer of Lifespan
International; Tufts-New England Medical Center's Associate General Counsel
in the Legal Department, Angela M. Vieira, and New England Medical
Center’s Director of Risk Management, Virginia Fleming. They are
outstanding resources for fellows with interests in related areas.
The Primary Care Outcomes Research Institute (PCORI) is
dedicated to research and demonstration in outcomes and in the quality
of technical and interpersonal care. Under the direction of Dr.
Sheldon Greenfield, Drs. Sherrie Kaplan, and Ira Wilson work together
on projects spanning a broad range of substantive areas from
evaluating the quality of medical care for chronic disease to
"coached care" interventions designed to increase patient’s
involvement in treatment, using a wide range of research approaches,
from multicenter randomized controlled clinical trials, to cross
sectional survey and longitudinal observational studies.
The Division of Clinical Decision Making focuses on the
application of decision analysis and cost-effectiveness analysis to
choices in clinical medicine, and on the development and dissemination
of information technology to clinical care. Its participating faculty
include Drs. Mark Eckman, Stephen Pauker, and John Wong, its Chief.
The NIH-funded General Clinical Research Center
(GCRC) at Tufts-New England Medical Center is directed by a faculty
member, Dr. David Greenblatt. The Tufts-New England Medical Center GCRC has
a long history of fundamental contributions to clinical research and
the availability of the GCRC's in-patient unit and its resources
represent an asset to the fellows’ projects.
The Tufts Managed Care Institute, includes
faculty members Ms. Rosalie Phillips, Executive Director, Dr. Philip
Boulter, its Medical Director, and Dr. Sheldon Greenfield. The
Institute is an independent, not-for-profit educational organization
established in 1995 as a collaborative venture of Tufts University
School of Medicine and Tufts Associated Health Plans, Inc., and is
dedicated to helping physicians and other health care professionals
learn about managed care and how to best practice in a cost-effective
care environment.
Many of the above faculty also have appointments in
the Tufts University School of Medicine Department of Family
Medicine and Community Health, the sponsor of the Tufts University
School of Medicine MPH program. In addition to providing some core
courses, the variety of other courses in the overall MPH Program
allows postdoctoral fellows to supplement their knowledge in special
areas of interest through additional coursework on campus.
The Tufts University School of Medicine MD/MBA
Management Program, led by faculty member Dr. Norman Stearns,
provides additional on-campus course opportunities in health care
management as well as associated courses in the Northeastern
University College of Business Administration, the Florence Heller
Graduate School of Social Welfare at Brandeis University, and the
Tufts Fletcher School of policy.
The Tufts University School of Medicine Office
of the Dean of Educational Affairs, including its Dean, program
faculty Dr. Mary Lee, is a major resource to the program. This office
has extensive experience in developing and evaluating educational
programs for students, trainees, and faculty members, and has led many
courses and workshops nationally.
Tufts Center for the Study of Drug Development is another resource
that studies national and worldwide trends in pharmaceutical and
biotechnology research, development, and regulation. A former
President of the Drug Information Association and current Director of
the Center, Dr. Kenneth Kaitin is actively involved in issues
surrounding pharmaceutical regulation, public policy, and the drug
development process.
Managed Care Partners
For those fellows interested
in working on projects involving managed care policy, this fellowship
program has collaborated with the following managed care companies and
its senior management:
Blue Cross/Blue Shield of Massachusetts. Program faculty include:
Kathleen Goonan, Chief Medical Officer, Harmon Jordan, Director of
Biostatistics, John Mason, Director of Health Services Evaluation,
Anne Meneghetti, Director of Medical Policy and Education, and Evelyn
Murphy, President, Healthcare and Policy Institute. Dr. Selker has
worked with Blue Cross on their Technology Assessment Panel, and has
served on their Corporate Quality Council for a number of years, and
has collaborated on a number of quality improvement issues which
facilitates opportunities for fellows at this largest health insurer
in Massachusetts.
Tufts Associated Health Plan.
Chief Medical
Officer and Executive Vice President, Dr. Philip Boulter, also a
participant through the Tufts Managed Care Institute, is a faculty
member in the postdoctoral program, and acts as a liaison to the many
opportunities available through this 800,000-member HMO which has had
close links to Tufts-New England Medical Center and Tufts University Medical
School since its founding.
The Bloomberg Healthcare
Group.
It’s President, Dr. Mark Bloomberg, is recognized as a
leader of quality systems and has been a faculty member in this
postdoctoral program since its inception, giving seminars, providing
project opportunities, and mentoring fellows.
A fellowship candidate must be a physician who has
completed clinical training or has an analogous background. Selection
criteria include an assessment of the candidate’s commitment to an
academic research career in health services research, the level of
degree that the academic and research interests coincide with
opportunities and resources available at the New England Medical
Center, and his or her potential for research as evidenced by prior
academic activities, research experience, and recommendations from
clinical and/or research faculty who know the candidate well. A visit
to Tufts-New England Medical Center and an interview with members of the
program faculty are required.
Due to the program’s federal funding, candidates
must be citizens or non-citizen nationals of the United States or be
lawfully admitted for permanent residence at the time of appointment
to the program. Individuals on temporary or student visas are not
eligible. We particularly welcome applications from minority group
candidates.
Individuals who meet the above eligibility
requirements may request application forms by contacting: Denise
Langabeer, MBA, Program Manager, at Tufts-New England Medical Center #63,
750 Washington Street, Boston, MA 02111, (617) 636-8323 or by e-mail Dlangabeer@tufts-nemc.org.
The Postdoctoral Fellowship program begins July 1st.
Applications, including on-site interviews, must be completed between
January 1st and April 1st. Candidates are
encouraged to make inquiries and begin preliminary discussions even
prior to this period since fellowship positions are generally limited.
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