Introduction
The UCLA Primary Care and Health Services Fellowship and the Greater Los
Angeles VA Ambulatory Care Fellowship share a common vision, recruitment process
and administration. The fellowship stresses development of primary or
ambulatory medicine physicians into independent investigators in health
services research or epidemiology. This is accomplished through formal
class work in the UCLA School of Public Health, an informal series of
seminars led by local experts, and the development, implementation, and
completion of an original, independent research project. Mentors include
well-known investigators from the UCLA Divisions of General Internal
Medicine, Family Medicine and Pediatrics, the GIM sections at the VAMCs, the UCLA School
of Public Health and the RAND Health Program. These institutions
encourage a collaborative, interdisciplinary research environment most
likely to foster successful health services research in almost any aspect of
health services or health policy including: access to care, quality of
care, clinical epidemiology, preventive care, women's health, clinical
ethics, and the care of patients with specific diseases or psychosocial
problems. Fellowships are 2 or 3 years in duration. The UCLA fellowship is
open to general internists, family physicians and pediatricians only; the VA programs are
open to physicians (including surgeons) that deliver ambulatory care. Directors of the
fellowship programs at UCLA and the VA are, respectively, Neil Wenger and Steve Asch.
Please direct inquiries to Dr. Neil Wenger at (310) 794-2288 or via e-mail at
vgonzalez@mednet.ucla.edu.
Fellowship Mission, Goals and Expectations
Mission and Goals: The fellowship's mission is to train creative,
independent, ethical and productive leaders in health services research and
related fields. To achieve this mission, our goal is to provide a program
that has enough structure and resources to enable fellows to progress in
areas relevant to our mission and to ensure that they do so, yet to
recognize fellows as independent adults whose own interests and goals will
be the primary determinants of the paths they will follow.
Faculty and Resources: The program directors and co-directors at each
fellowship site form the program's core faculty. The pool of research and educational faculty
available to fellows, however, spans a wide variety of individuals at UCLA,
RAND, and both VA's. New relationships between the Fellowship and new
faculty members, as well as continuation of old ones, are set up each year
as fellows pursue their individual interests and goals.
Sources of Support: The Fellowship Program provides links to
extensive health services research resources, but provides limited
research funds to fellows above and beyond their salaries. Fellows must
therefore be aware of the resources needed to complete their educational
programs and research projects, and work with their mentors to ensure that
these are realistically available.
The Clinical Scholars Program, with the School of Public Health and RAND,
provides the Fellowship's core curriculum, and works with the UCLA
Fellowship directors to provide a limited base of operations at UCLA since
fellows will spend significant amounts of time there participating in
classes. Fellows also have access to desks, computers and resources at
their home base site.
The VA HSR&D Center for the Study of Healthcare Provider Behavior, based at
Sepulveda but involving many of the Fellowship's core faculty, provides
access to additional resources. Other Centers, such as the Managed Care
Center based in Psychiatry at UCLA, the Geriatric Research and Education
Centers at Sepulveda VA and West Los Angeles, and others, can also be
accessed by fellows for specific relevant projects. These Centers can often
provide access to technical assistance that is not tied to a faculty
member's own project, and thus can allow fellows to pursue a more
independent agenda when their interests do not happen to be tightly linked
to a faculty member's.
When a fellow's interests are tightly linked to a faculty member's
interests, funding for the fellow's project can often occur through the
faculty member's existing grants and resources. The fellow provides the
faculty member with additional investigator time on a project that enables
the project to carry out additional relevant data analysis and produce
additional publications, and the project provides the fellow with resources
to pursue his/her ideas as relevant to the project. Care should be taken to
ensure that the fellow knows what resources have been allocated to her/him,
and how to access them; fellows should also be sure that their work is
designed to lead to a first author-type publication.
Faculty members can also often assist fellows in obtaining small grants of
various kinds to help support their projects. Such grants are often very
fruitful, but care must be taken that too much energy goes into proposals
with delayed timelines and uncertain futures, thus inhibiting the fellow's
progress.
Expectations: The Multicampus Fellowship has four main expectations. You
must complete:
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an educational program in health services research - auditing courses
might be possible with permission of the instructor and your mentor
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a health services research project
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an ongoing relationship with a program mentor and a research mentor
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communication
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The fellowship represents a shared responsibility. The program is
responsible for providing the structure and advice that enable fellows to
acquire needed knowledge and skills. The fellow is responsible for
acquiring them. This means that fellows should be devoting the majority of
their time and effort to activities relevant to the program for the two to
three years they are enrolled in it. Fellows who at any point are determined
by the Multicampus Fellowship program to be falling behind or whose progress
is not known will be contacted by one of the program directors and asked for
an update. If an update is provided and shows good progress, no further
actions are necessary. If progress is not adequate, the Fellowship will
work with the fellow to ensure that barriers are eliminated and progress is
made. If an update is not forthcoming, or the fellow will not follow a plan
that is deemed adequate by the Fellowship, the fellow will receive a letter
indicating the specific concerns of the Fellowship directors. If these
concerns are not successfully resolved, the Fellowship reserves the right to
terminate the individual's fellowship stipend, with three month's notice.
Notice will be given prior to the beginning of the next academic year,
except under extreme circumstances (e.g., the fellow is elsewhere, is a
danger to patients, is unethical).
Program Mentors: The individual who monitors your progress in education and
research is your program mentor, whom the program assigns to you, usually
from among the directors, co-directors, or program directors at your site.
Your program mentor need not be the same as the research mentor who works
with you, often weekly, on your research project. Your program mentor needs
to be in contact with you at least monthly throughout your fellowship
program. Your program mentor will be meeting monthly with the other
fellowship directors to review fellow progress, and will need to know your
progress and plans. You will also formally present your project to the
group of Fellowship directors and co-directors at intervals.
Research Mentors: Your research mentors are the two individuals responsible
for primary supervision over your project. One is a physician faculty
member, and the other is a non-physician faculty member. Your research
mentors may or may not know what your responsibilities, resources, or
resource limits are in relationship to the Fellowship, so it will be up to
you to communicate these things to your mentors, if the individuals are not
one of the Fellowship directors or co-directors. You should be meeting with
these individuals weekly during intensive periods of project development.
Your research mentors will also help you to assemble a protocol committee to
review your research protocol, and assist you in procuring the resources
necessary to carry out your project.
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