CoRe brings new research opportunities for medical learners in the Faculty of Medicine & Dentistry
Keri Sweetman - 5 December 2022
The Faculty of Medicine & Dentistry has established a new community of researchers this fall whose goal is to help create the next generation of clinician-scientists in Canada.
The Community of Research (CoRe) program is open to all first- and second-year undergraduate medical students as well as graduate students in the faculty. CoRe director Adam Kinnaird says the program’s organizers have created a curriculum to teach tangible research competencies to medical trainees and show students pathways to pursuing careers as clinician-scientists.
“A program like CoRe can reinvigorate the potential for increasing the number of clinician-scientists by breaking down barriers and making it easier to pursue this path,” says Kinnaird, who is a urologist and chair of the Alberta Prostate Cancer Research Initiative. He also holds the Frank and Carla Sojonky Chair in Prostate Cancer Research at the University of Alberta.
Traditionally, the curriculum at most medical schools has focused mainly on teaching clinical skills because there is so much to learn over a four-year period. U of A’s medical school does offer several programs for medical students interested in pursuing research, such as the MD with Special Training in Research Program (MD/STIR) for first-year students and the combined MD/PhD program. For residents interested in academic careers, the faculty offers the Clinician Investigator Program, which allows postgraduate trainees to pursue a master’s degree or a PhD during their residency.
But Kinnaird was given a mandate by Darryl Rolfson, associate dean for the MD program, to increase the number of opportunities for medical students to pursue their interests in research during their pre-clerkship years.
Planning began last spring and the program started in August. It is overseen by Kinnaird and four medical students, including two from a student group called Bench to Bedside Students’ Association, which is partnering with CoRe on programming.
CoRe offers monthly elective seminars, in person and by Zoom, on different routes students can take to become clinician-scientists and on funding opportunities for trainees and early-career researchers. The first session, entitled “The Life of a Clinician-Scientist,” brought together seven clinician-scientists from diverse backgrounds for a Q&A with students.
Kinnaird says the most recent session attracted 50 students, about 80 per cent of whom were medical students, while the rest were graduate students in the faculty. Many students have graduate degrees when they arrive at medical school and they already have research experience they want to build on.
That is the situation for second-year medical student Claudia Turco, who arrived at U of A having already completed a PhD in kinesiology at McMaster University, where her research was in neurophysiology. Turco, who is one of the CoRe organizers, is the research representative for the class of 2025.
When she began medical school last year, she realized that a lot of her classmates were unfamiliar with how to conduct research and unsure about the process for seeking research opportunities. Last winter, Rolfson, the associate dean, reached out to Turco and the research representative for the 2024 class, asking them to help spearhead the community-of-research idea, bringing the students’ perspective to the project.
For Turco, melding research and clinical training is exactly what brought her to the U of A.
“One of the reasons why I decided to go to medical school was that I felt like a lot of the research that I was doing in basic science wasn’t really having an impact on patient populations, which is what I really wanted to get out of my work,” she says. “I could see how it was difficult to translate the knowledge that was being generated in basic science to a clinical setting. I wanted to pursue an MD so I could have a hand in both the clinic side and also the research side.”
Clinician-scientists can work in any field of medicine, says Kinnaird, and in most cases, their research is seamlessly intertwined with their clinical practice. What motivates people to be clinician-scientists is a desire to advance their field, he adds.
“If we did not have clinician-scientists then we would not have new treatments. Medicine would stagnate. You could cancel all clinician-scientists right now and make them all just do clinical work but that would mean that we would be forever providing the medical care that we have available to us in 2022.”
It is typically clinicians who recognize a problem that needs to be solved with research or new products or solutions, says Sean McMurtry, a clinician-scientist at the Mazankowski Alberta Heart Institute and an associate professor in the Division of Cardiology.
“There are many, many clever outstanding non-clinician scientists whose work is very valuable, but the clinician-scientist is uniquely positioned to ask very good questions and to guide the scientific enterprise towards products and services that are needed and new cures — well, that’s the dream,” says McMurtry, who is director of the U of A’s long-standing Clinician Investigator Program (CIP).
CIP is a residency program accredited by the Royal College of Physicians and Surgeons of Canada. Its aim is to equip postgraduate medical residents with the research training they need to be competitive in academic careers, says McMurtry. He was the first graduate of the program, in 2006, and has now come full circle to lead CIP.
The program typically accepts four or five residents a year, from all speciality areas. Trainees complete the first two years of clinical training in their residency programs, then move over to CIP for two or three years to obtain a master’s degree or a PhD, doing research in their chosen medical field. They remain connected to their clinical program during CIP, with an obligation to do a small amount of clinical work to keep their skills fresh.
During their CIP stint, they are paid the same salary they would have received as a resident doing clinical work, based on their year of residency. McMurtry says that salary arrangement — funding for residents’ salaries comes from the provincial government — is critical to attracting residents for an extra two or three years of schooling, since most are in their 30s by the time they apply and are ready to start families and buy homes.
McMurtry welcomes the addition of CoRe to the faculty’s initiatives to encourage trainees to pursue translational medical research along with clinical careers.
Kinnaird calls clinician-scientists “the bridge between the clinical environment and the research lab.” He hopes CoRe and the faculty’s other research-centric programs will help stem a decades-long decline in the number of clinician-scientists worldwide, caused in part by a tougher research-funding environment. Pre-pandemic figures from the U.S., for example, show that the number of physicians engaged in research there has declined from 4.75 per cent to 1.5 per cent since the 1980s, according to an April 2022 paper published in MDLinx.
“The clinician-scientist is a dying breed,” says Kinnaird. “We need to bring it back.”