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UCSF Primary Care Research Fellowship
IV. Mentored Research
Mentorship:
We believe that the single most important aspect of a primary care research fellowship is the experience of designing and conducting research projects under the guidance of a dedicated and outstanding mentor. The program and site directors begin the process of identifying suitable research mentors for each candidate during the interview process, and make every effort to expose each candidate to a variety of faculty members with similar interest and expertise. We place great emphasis on finding a good "match" between the fellow and the mentor that includes not only a common research interest, but a complementary style that will foster the most productive working relationship.
The fellowship faculty have been selected because of their proven track record of commitment and successful mentorship of former clinical research fellows. Faculty members who are matched with mentors commit to meeting with their assigned fellow at least monthly, and, in most cases, more frequently to discuss details of designing and implementing research projects, presentations, manuscripts, and grants. Our goal is to match each fellow with a primary mentor within the first 3 months of fellowship, if not before. In some cases, candidates will select mentors prior to starting the fellowship and may even begin initial discussions with their mentors about planned research activities.
Each fellow will also receive ongoing mentorship and guidance from their fellowship site director through regularly scheduled meetings. We also promote a relaxed "open door" environment, and find that much of the best advice and guidance comes when fellows walk into their mentor or site director's office to get prompt answers to pressing questions.
Research Environment:
The School of Medicine at the University of California, San Francisco (which includes the three clinical and research sites of the UCSF Medical Center, the San Francisco General Hospital, and the San Francisco VA Medical Center - see more information at http://medschool.ucsf.edu) is a worldwide leader in clinical research, epidemiology, and biostatistics. Some of the highlights of the UCSF community include:
- The Department of Medicine ranks 1st and the School of Medicine 4th in research funding from the National Institutes of Health
- The Department of Family and Community Medicine is ranked 5th in NIH support and 4th in terms of its publication record.
- UCSF Faculty members include 3 Nobel Laureates, 16 Howard Hughes Medical Institute Investigators, and over 70 members of the Institute of Medicine
- San Francisco VA Medical Center ranks 2nd in research funding among all VA Medical Centers Nationwide.
- The Medical School was ranked among the top 10 Medical Schools in the Nation, according to US News and World Report
From the perspective of a fellow in primary care, this research environment provides an almost unlimited ability to access experts in both content and research methodology. Whether you are interested in the approach to rare neuro-opthalmological disorders, disparities in access to health care, quality improvement, or the use of time-dependent variables in multivariable logistic regression, chances are you will be able to find an outstanding research mentor with in-depth knowledge of your chosen field. Furthermore, many of our research faculty manage large databases from ongoing clinical trials, cohort, and case control studies. These data sources are frequently used by fellows to pursue a focused research question, without the time-consuming data collection process that is, in many cases, impractical for the goals and interests of a two-year fellowship. Just a small sample of some of these datasets include:
- The Improving Antibiotic Use in Acute Care Treatment (IMPAACT)
Trial (Principal Investigator, Ralph Gonzales, MD) - An
AHRQ-funded 16-site national, multicenter randomized trial of
different quality improvement strategies to improve the management of
acute respiratory tract infections in emergency departments and VA
urgent care clinics.
- The Heart/Estrogen Replacement Study (HERS)
(Principal Investigator, Steven Hulley, PhD) - A completed randomized controlled trial involving 2,763 postmenopausal women with heart disease who were randomly assigned to estrogen/progesterone or placebo.
- The Heart and Soul Study
(Principal Investigator, Mary Whooley, MD) - A cohort study of 1,024 men with coronary artery disease to determine the role of psychosocial factors and depression in the progression of coronary artery disease.
- Saw palmetto Treatment for Enlarged Prostates Study (STEP)
(Project Director, Stephen Bent, MD) - An NIH funded, randomized controlled trial of saw palmetto vs. placebo for the treatment of benign prostatic hyperplasia in men over the age of 55.
- Coronary Artery Risk Development In Young Adults (CARDIA)
(Principal Investigator, Steven Hulley, PhD) - a multi-center prospective cohort study of 1,724 adults followed for over 10 years to examine risk factors for the development of coronary artery disease.
- Study of Osteoporotic Fractures (SOF)
- (Principal Investigator, Steven Cummings, MD) - a prospective cohort study involving over 10,000 elderly women with over 15 years of follow-up to examine predictors for osteoporosis and fracture.
- Multicenter Hospitalist Study - (UCSF PI Andrew Auerbach MD MPH). A 2 year randomized trial of inpatient general medical care for 33,000 patients at 6 academic medical centers.
- UCSF Perioperative Quality Initiative - (PI Andrew Auerbach MD MPH). A 2 year observational study of quality of care for 1200 surgical patients at UCSF Medical center.
- California's hospital discharge database.
electronic abstracted information on all acute hospitalizations in the state are publicly available on an annual basis for more than 20 years through California's Office of Statewide Health Planning and Development. Faculty in the fellowship have extensive experience using this data either in isolation or at times in linkage with Medicaid, Medicare, and vital statistics records. This resource has served as the basis for numerous studies on ambulatory care sensitive hospitalizations and hospital quality of care.
- The Health Records Electronic Data Set (THREDS)
The Division of General Internal Medicine at San Francisco General Hospital has worked in close collaboration with the San Francisco General Hospital General Clinical Research Center (SFGH/GCRC) to convert the hospital and its affiliated community clinics' clinical database into this research database. Since 1996, THREDS includes patient demographics, insurance information, inpatient, outpatient, and emergency room visit data and data on physician, procedures, tests, medications, and diagnoses from San Francisco General Hospital (inpatient and outpatient services), the Laguna Honda facility, and the ten community-based public health clinics run by the San Francisco Department of Health. With resources from a grant from the Community Access Program, THREDS was expanded in 2003 to include visits in San Francisco's not for profit health centers as well making it one of the most complete electronic clinical databases of a safety net delivery system in the United States. There are currently more than 70 research protocols using this database to identify patients for intervention studies, to perform pilot projects as a part of applying for a grant, and to complete outcomes research projects.
- San Francisco VAMC Computerized Patient Record System (CPRS)
- This database tracks a vast array of patient information on veterans both at the San Francisco VAMC and at all VA medical centers nationwide. Since the system is relatively new, it has not been extensively explored, but represents a vast and untapped potential to evaluate research questions involving veteran populations.
Current Fellows and Areas of Interest:
- Kirsten Kangelaris, MD - the contribution of genetic variation and proteomic factors as they apply to risk, pathogenesis, prognosis and patient-specific treatment in general medicine and hospitalized patients
- Yael Schenker, MD - Doctor-patient communication and the effects of linguistic and cultural differences on medical decision making
Recent Fellows:
2008
- Beth Cohen, MD . Assistant Professor of Medicine, UCSF
- Stacey Jolly, MD . Case-Western University, Cleveland OH
- Yeuen Kim, MD . Santa Clara Valley Medical Center, Santa Clara, CA
- Grace Lin, MD . Assistant Professor of Medicine, UCSF
- Urmimala Sarkar, MD, MPH . Assistant Professor of Medicine, UCSF
- Eduard Vasilevskis, MD . Assistant Professor of Medicine, Vanderbilt
- Emily Wang, MD . Instructor of Medicine, Yale University
2007
- Rebekah Gardner, MD . Assistant Professor of Medicine, Brown University
- Alison Huang, MD, MPhil. . Assistant Professor of Medicine, UCSF
- Andrew Moran, MD . Assistant Professor of Medicine, Columbia University
2006
- Arati Desai, MD - Oncology Fellow, Johns Hopkins University
- Lauren Goldman, MD - Assistant Professor of Medicine, UCSF
- Vanessa Grubbs, MD - Nephrology Fellowship, UCSF
- Carmen Peralta, MD - Assistant Professor, Nephrology Fellowship, UCSF
- Kristen Wood Reid, MD - Assistant Professor of Medicine, UCSF Emory University, UCSF
- Hilary Seligman, MD - Assistant Professor, UCSF
- Sara Swenson, MD - California Pacific Medical Center
- Judith Tsui, MD - Roadmap K12 Multidisciplinary Research Fellow, UCSF
2005
- Eleanor B Schwarz, MD, MS - Assistant Professor of Medicine, University of Pittsburgh School of Medicine
- Elisa Tong, MD - Assistant Professor of Medicine, University of California, Davis
2004
- David Haggstrom, MD - Assistant Professor of Medicine, Indiana University
- Paul Helgerson, MD - Assistant Professor of Medicine, Stanford University
- Leah Karliner, MD - Assistant Professor of Medicine, UCSF
- Bernice Ruo, MD - Assistant Professor of Medicine, Northwestern University
2003
- Kirsten Bibbins-Domingo, MD, PhD - Assistant Professor of Medicine, UCSF
- Peter Hunt, MD - Assistant Professor of Medicine, UCSF
- Tom Denberg, MD - Assistant Professor of Medicine, University of Colorado Health Sciences Center
- Mark Pletcher, MD - Assistant Professor of Medicine and Epidemiology & Biostatistics, UCSF
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