AHRQ Post Doctoral Fellowship Program

AHRQ Post Doctoral Fellowship Program

The AHRQ Post Doctoral Fellowship Program is rooted in the premise that a multi-level, multi-disciplinary approach is the most appropriate one to adopt in studying how health services are delivered to meet the needs of individuals with chronic illness. In this program clinician and non-clinician scientists not only work together on funded projects, they also teach each other about the clinical aspects of the population and the research methods necessary to study it systematically. Further, special care is taken to ensure a good fit between the needs of each trainee and the interests, available resources, and capabilities of his or her faculty mentor.

In recent years the program has increased its emphasis on long-term care, pharmaco-epidemiology, chronic disease management and CER/PCOR, and has sharpened its methodological focus. There are numerous opportunities for ongoing collaboration with investigators in other Centers and Departments and at the Veteran’s Administration Health Service Research Program.  The program also now covers geriatric pharmaco-epidemiology and organizational factors influencing the delivery of health care. Most recently, the program has added substantial expertise in CER and PCOR, especially through the research synthesis and evidence contextualization available through close collaboration with the Center for Evidence-based Medicine (CEBM) at Brown. Furthermore, collaborations with research centers focusing on behavioral medicine and social epidemiology offer additional opportunities for postdoctoral fellows in this program.

Program Goals

  • to teach health services research methods as well as content material relevant to gerontology, long-term care, chronic disease management, CER and PCOR;
  • to train both clinician and non-clinician researchers;
  • to give trainees didactic as well as "hands-on" supervised experience in health services research.

Program Structure

Generally speaking, this is a two-year program. Since postdoctoral fellows arrive with different backgrounds and career goals, there is both a general curriculum, which all trainees must follow, and a trainee-specific curriculum. The general curriculum includes weekly, informal meetings with the program director, bi-weekly seminars in epidemiological or health services research methods, and monthly seminars on clinical or health policy issues in geriatrics delivered by leaders in the field. The trainee-specific curriculum consists of participation in a "major" and a "minor" research project as well as coursework in either the graduate program in epidemiology, biostatistics, health services research, evidence based medicine or in other summer institute programs in research methods.

Two tracks exist to accommodate differences in background:

  • For the physician or doctorally prepared clinician who comes without substantial prior research training, enrollment in a Masters degree in Epidemiology or Clinical and Translational research the Master of Public Health is desirable.  Over the two years of the fellowship, the physician fellow completes the Masters degree in concert with the other fellowship activities. He or she also continues seeing patients one half-day each week. Clinical activities are developed in conjunction with faculty in an affiliated hospital.
  • For the non-physician, formal coursework is usually limited to specialty courses that offer further methodological expertise.

At the beginning of each quarter throughout the fellowship, each fellow meets with his or her mentor and the program director. Goals for the coming three months are set and at each subsequent quarterly review, these are reviewed to determine whether they have been met and strategies for overcoming any barriers to achieving goals are implemented.

During the second year, major project activities continue, but fellows focus on preparing manuscripts for publication and presentations for national meetings. During the second year fellows participate in mentors’ grant proposals, write their own small grant proposal and work on securing a research and/or academic position. Before the end of the second year, fellows present their research at both a departmental seminar and a fellows' seminar.

Evaluation

Evaluation of fellows is largely outcome-oriented. Given the close association with faculty, the work of all fellows is frequently reviewed and critiqued, from the specification of research questions to the writing of a manuscript. More proximate opportunities for observing fellows’ performance include presentations at research seminars and national meetings and in their competition for research positions following completion of the program. Acceptance of articles for publication is another indicator of success. The ultimate measure of success is whether fellows become independently funded researchers; to date, more than 60 percent of all fellows who have completed the program have attained that goal.

For physicians, an additional outcome measure is completion of the Master’s degree.

Clinical Exposure

Fellows have the opportunity to do clinical work in a number of specialized settings related to the interface of psychiatry and general health care, including:

  • an extensive behavioral medicine program comprising active research programs in obesity treatment and smoking cessation
  • a memory disorder clinic
  • a geriatric assessment rotation at a local hospital and an adjacent nursing home

Resources

Exposure to the various technical aspects of database management systems, whether for primary data collection or for use on existing data sets, is a critical aspect of the program. Fellows have access to a state-of-the-art research environment, complete with equipment, software, programming environments, systems programming, and data processing maintained by the Center’s technical staff. The Center houses an archive of computerized data sets, including studies that its faculty and associates have conducted, as well as publicly available data sets with a focus on long-term care and aging and preventive health practices, generally from national studies commissioned by governmental agencies. Center faculty and staff have years of experience working with administrative data sets such as Medicare and Medicaid claims, as well as with specialized clinical data from all US nursing homes and Home Health Agencies. These are available to fellows working on the relevant projects.

Fellows will also have opportunities to participate in the work at the AHRQ-designated Brown Evidence-based Practice Center (EPC), housed at the Center for Evidence-Based Medicine (CEBM) in the School of Public Health. The EPC produces stakeholder-driven comparative effectiveness reviews and technology assessments for AHRQ and used by a wide range of decision-makers. The Center for Gerontology collaborates closely with CEBM, whose faculty conduct multidisplinary research in, and teach the principles of, research synthesis and evidence contextualization with a focus on comparing the effectiveness of interventions, tests and processes in clinical medicine.

Stipend and Benefits

Fellows receive health benefits, vacation days and sick days. The summer is utilized as an active part of the training program; however, the academic component of the program is suspended during July and August.

The stipend amount is decided by the awarding unit, NIH, and is based on graduate status of the fellow. The stipend increases with the number of years of relevant post-doctoral experience at the time of the appointment. Please note that fellowship stipends are taxable. The annual stipend levels for all individuals receiving support through institutional or individual National Research Service Awards (NRSA) made under Section 487 of the Public Health Service Act are detailed below effective as of 2.10.14. Additional information can be found at the National Institutes of Health website.