Life as a Duke Fellow

Because each trainee is different, we tailor our fellowship training plans, including the identification of potential research areas, for each fellow. Our goal is to understand our trainees’ unique interests and aspirations and guide them forward on their chosen path within pediatric pulmonary.

There are several divisional conferences that contribute to fellow education. On Monday mornings, the division has an administrative and educational conference for the fellows, faculty, and other providers. The purpose of these conferences is to discuss any issues that have arisen within the division and review interesting and informative cases from the inpatient services and outpatient clinic. These conferences provide an exciting, interactive forum where clinical management decisions are discussed in a collegial environment. On Wednesday mornings, the fellows and select faculty participate in a session dedicated to preparing the fellows for the American Board of Pediatrics pulmonary certification exam. Didactic sessions on Wednesday also include a rotating journal club/interesting case seminar and rotates between fellow and faculty. Other conferences that we strongly encourage our fellows to attend include Pediatric Grand Rounds (Tuesday morning) and Pulmonary Scholars Series (Tuesday afternoon). In addition, the Department of Pediatrics has several forums in place for the education of all subspecialty fellows, including the Pediatric Fellows Core Curriculum and the Pediatric Fellows Research Conference, which occur monthly on a rotating schedule. Faculty cover the fellows’ pagers during these sessions so that they can participate without distraction.

The selection, organization, and cultivation of a fellow’s research project follows a very detailed and established timeline that begins well before the research years start. Since most trainees are selected to begin the fellowship training program while they are finishing their residency, this allows ample time for discussion and correspondence between the incoming fellow and fellowship program leadership regarding areas of research interest. These discussions continue as the fellow moves through his or her clinical year of training. During the first six months of the clinical year, the fellow will formally meet with the program director and associate director every one to two months to help with the transition to being a fellow. In addition, the program director, associate program director, and all other faculty are available for informal discussions.

To assist with research mentor selection, fellowship program leadership help fellows schedule meetings with faculty to explore research options and possibilities for mentors. A successful training experience is dependent on extensive involvement by the mentor, and our participating faculty members understand the significance of this commitment. Following the selection process, the fellow meets with the program director, associate program director, and the mentor to further develop a research project that is creative, challenging, and feasible. In addition, any specific training needs beyond the required curricula are identified and incorporated into the schedule for the subsequent two years.

At the end of the first six months of the first year (January), the fellow is expected to have generated a broad research project topic, identified a mentor(s), and narrowed the topic to specific aims. At this time, the clinical fellow will submit a two-page written project plan to the program director describing the hypothesis and specific aims he or she will pursue during the research component of the training. The last six months of the clinical year are used to organize the upcoming research components, including planning and ordering laboratory supplies or submitting an application for IRB approval. The ultimate goal is to establish a well-designed, thoroughly peer-reviewed research project plan prior to the beginning of the research years.

All fellows have a Scholarship Oversight Committee, or SOC, assigned to assist with career development and research progress. The SOC is composed of four to five members of the university faculty who provide mentorship and career development advice. The SOC includes at least two faculty members from the Division of Pediatric Infectious Diseases, other departmental faculty based on the fellow’s research interest, and often faculty from outside of the Department of Pediatrics. The SOC is assembled by the program director and associate program director with input from the fellow.

SOC’s convene at least once every six months. During these meetings, the fellow is expected to give a formal 30-minute presentation of their research progress and plans for the future. The SOC will critically evaluate the fellow’s progress, determine if the work is appropriate to meet the American Board of Pediatrics subspecialty program requirements and the department’s expectations for future physician-scientists, complete a written evaluation, and offer career development advice to the fellow. These sessions begin in February of the first year of fellowship and culminate at the end of the third year of fellowship when the fellow presents a summary of his/her scholarly work. 

Once the research years begin, fellows present their experimental results at weekly laboratory or clinical research group meetings, at least once per year at Pediatric Infectious Diseases Division meetings, and at least twice per year to their SOC. A formal presentation to all faculty and fellows in the Department of Pediatrics occurs annually through the Fellows Research Conference series. Further, fellows are expected to present results at national and international meetings and to publish their results in quality peer-reviewed journals. These graduated and repeated series of presentations are designed to allow the fellows to gain experience and confidence with giving research presentations.

Certain competencies that extend beyond scientific training are required for a successful academic career, including grant and medical writing, public speaking, and mentoring skills. Duke offers numerous courses and seminars that can provide formal training in these areas during fellowship:

• The Scientific Writing Course is a 12-hour, four-part series conducted annually (October/November) by Dr. George Gopen of the University Writing Program. Dr. Gopen is a dynamic speaker and expert on reader expectation theory who has improved faculty and fellow grant writing habits and contributed to countless successful grant applications.

• The annual Duke University School of Medicine Write Winning Grants Proposals full-day seminar assists with the identification of the most appropriate granting agency, provides guidance on how to write for reviewers, and offers tips and strategies for successful grant applications. This seminar is widely attended by both Duke faculty and trainees.

• The Duke University School of Medicine “K Club” program assists trainees and junior faculty preparing NIH career development (K) grant applications. Launched in 2012, the K Club consists of structured reviews and feedback on grant applications by both peers and experienced senior faculty. The program is offered three times per year beginning five months prior to each NIH K application deadline. The program consists of seminars and workshops targeting each section of the K award application. Final applications are reviewed by senior Duke faculty mentors and discussed in a mock study section that trainees have the opportunity to attend. Numerous junior faculty in our Division have submitted successful K applications with the assistance of this program.

• Path to Independence: Career Transition and Continued Mentorship for three years AFTER fellowship). A critical point for future academic independence is successful navigation of the first faculty position. Because a trainee’s growth and development does not stop at the conclusion of their training, our fellowship program’s mentorship extends for a full three years after fellowship training and into the first faculty position, regardless of the location of that faculty position. This extended mentorship program includes the following components: 1) trainee written summary of manuscript and grant progress and timelines provided every six months to the program director; and 2) review of written summary through in person or video conference (Skype) with the program director. During these 30-minute reviews, the program director focuses on timelines, priorities, and competing obligations of the new faculty member, and specific objectives for the next 6, 12, and 24 months. The spirit of this mentorship program includes continued mentoring during the transition to independence, especially in the current competitive funding environment. Our program evaluations have illustrated the importance that past trainees place on sustaining their mentoring relationships and past trainees consistently remark that this is a unique and valued aspect of our fellowship program.

• All trainees are encouraged to apply to the NIH Loan Repayment Plan (LRP), for which fellows in our division have a high rate of successful funding.