“Prior to fellowship, I thought clinical trials were exclusively in the purview of senior physicians. One of the unique aspects of our program is the requirement for each fellow to write a clinical trial, which we call the LOI project. The LOI project at WashU taught me that it is never too early to be involved in clinical research. The experience has given me insight into the process: how many people are involved, the nuanced questions that must be addressed, the finances that must be secured.”
Stefan Tarnawsky MD PhD, Current Fellow
Clinical research is an expectation of the fellowship program. During year 1, all fellows are expected to identify a mentor and to work with them to develop a clinical protocol. Mentors are a good source of potential ideas, a sense of feasibility, and guidance through a successful project. Engaging a research project provides important training and understanding into how new medical knowledge is acquired, how to critically read a clinical paper, and how to incorporate new approaches into practice. A thorough research experience is essential for fellows anticipating academic careers and is instrumental in teaching clinicians how to decipher the rapidly changing literature.
A “letter of intent” (LOI) represents a 1-2 page description of the rationale, broad study design, projected sample sizes, and statistics. Fellows are expected to complete an initial LOI by the beginning of 1st year winter, and they will present their concepts at the Spring and Fall research symposia as they evolve into clinical trials and completed projects.
Multiple resources are available to assist in the initial concept and LOI. Fellows are encouraged to meet regularly with their mentor to discuss concepts and details. A database of prior LOIs is available as examples. We have established a “Clinical Trial Bootcamp” that consists of lectures on LOI formatting, clinical trial designs, clinical trial statistics, navigating IRB submission, database utilization, and polishing your biosketch.
Current Fellow LOI Projects
Research is a central component of training at Washington University. Fellows are encouraged to publish interesting case reports as they find them, to complete retrospective studies, clinical trials, and basic science projects.
Second and third-year fellows are encouraged to apply for external research training opportunities in programs such as the ASH CRTI, the ASCO Vail Clinical Trials Workshop, or the ASBMT Clinical Research Training Course. One fellow per year may be sponsored in the Masters in Clinical Investigation Program at Washington University. Internal funding mechanisms are in place and often facilitate research during the third year that may extend into the initial years after fellowship. These include the R25 Cancer Genomics and Outcomes Research Program (STRENGTH), the K12 Paul Calabresi Career Development Award, the KL2 Program, and the T32 training program in molecular oncology. Fellows on the laboratory investigator track (including those in the Physician Scientist Training Pathway Program) may be appointed to the T32 training program in molecular hematology.
Fellows are encouraged to attend one national meeting per year and many fellows participate in meetings sponsored by the Alliance for Clinical Trial to understand how cooperative research projects are organized and completed.
Senior fellows are expected to present their research in subspecialty “work in progress” meetings and in Grand Rounds forums.
“The bench-to-bedside pipeline of cancer therapy development at Washington University is astounding. The Division and faculty are incredibly supportive of integrating basic and translational research into clinically relevant strategies. As fellows, we are welcomed and encouraged to participate in this process, and I have not seen these opportunities, especially at this scale, elsewhere.”
Career Development and Mentorship
Fellows are encouraged to explore diverse career options in Hematology/Oncology. Broad clinical exposure to major tumor types in oncology and to benign and malignant hematology is required. Diverse subspecialty clinics are available for training in the 2nd and 3rd years as fellows identify areas of interest. Broad opportunities exist for clinical, translational, and basic science research. Two co-chief fellow positions provide opportunities for administrative experience.
Fellows meet with the program directors twice a year to discuss progress, development, and future goals. These meetings provide critical feedback and opportunities to individualize the fellow’s training opportunities and make use of local and external resources.
Mentors play a key role in guiding fellow career development. Fellows are expected to identify a primary mentor during their first year, and then to identify additional mentors who form a career development committee. The primary mentor is expected to meet regularly with the fellow and help them develop their research program and career. Members of the career development committee meet with fellows twice a year, commonly organized around work in progress presentations. They provide a broader mentorship opportunity and an external review of research and career development.
Fellowship Program Productivity
Our fellows are well represented at local, national and international meetings and are competitive for grants and awards.
In Academic Year 2020 notable achievements include:
- 3 Fellows accepted to FDA/ASCO Fellows Day Workshop
- 2 Fellows accepted to ASCO/AACR Methods in Clinical Cancer Research Workshop
- 1 Fellow accepted to AACR Molecular Biology in Clinical Oncology Workshop
- 2 Fellows accepted to R25 STRENGTH program
- 2 Fellows awarded abstract merit awards
- 3 Fellows awarded funded grants: ASH RTAF, Emerson Collective Cancer Research Fund; BETRNet Developmental Research Program