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UCLA NRSA GIM Fellowship in Primary Care & Health Services Research

Introduction

The UCLA NRSA 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 Debra Saliba. Please direct inquiries to Dr. Neil Wenger at (310) 794-2288 or via e-mail to 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 base of operations at UCLA. 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, the UCLA Healthcare Ethics Center and others, can also be accessed by fellows for specific relevant projects.

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:

   
  • an educational program in health services research - auditing courses might be possible with permission of the instructor and your mentor
  • a health services research project
  • an ongoing relationship with a program mentor and a research mentor
  • communication

  • 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.
    Application
      - NRSA/VA Application (Microsoft Word doc)
      - NRSA/VA Application (Adobe PDF)

     
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