Program: The proposed training program would provide two years of basic and clinical research experience to physicians who have completed their medical school and internship requirements and are entering the University of Iowa clinical residency program in Otolaryngology-Head and Neck Surgery. Trainees would devote 100% of their effort to research training for two years prior to completing their four-year clinical residency. A multidisciplinary research environment is proposed that would include research opportunities in neuroscience, molecular genetics, molecular biology, and epidemiology. Trainees admitted to the program would complete a Basic Science Training Course that is part of the residency program in Otolaryngology, as well as a Clinical Research Methods course and a graduate level course each semester, for the first three semesters, that is relevant to their research interests (e.g., Behavioral Neurosciences, Physiology of Hearing). Trainees will also be required to attend a Communicative Disorders Seminar that meets quarterly during the academic year, a Seminar in Bioethics, and a daily Clinical Conference that includes Grand Rounds presentations in a variety of areas. The course offerings are adequately described and seem relevant and important for the proposed training program. Additional courses in clinical trials are available to interested trainees, but a separate training program has been established for physicians whose primary interest is in clinical trials as opposed to basic research. A detailed plan and timetable are presented for assisting the trainee in identifying an area of research interest and an appropriate mentor. In the first three months of the training program, trainees are introduced to research labs and mentors during the Basic Science Course and monthly meetings with Drs. Bruce Gantz and Richard Smith, the Director and Co-Director of the program. Trainees then select a mentor, learn the research methods appropriate to that laboratory, and begin preparing a formal research proposal. The Research Training Committee reviews the proposal and if acceptable, the trainee has approximately 15 months to complete the study. A preliminary report is filed at the end of the two-year training period and additional released time is built into years 3 and 4 of their clinical residency (3 months each year) to facilitate ongoing collaboration with the mentor and publication or presentation of the results. Progress reported in the current application suggests that this additional time facilitates continued research collaboration during residency training and provides additional time for research presentations and publication. The progress of the trainees will be reviewed by the Research Training Committee every six months and trainees will be required to submit written and oral progress reports at this time. Research mentors will provide written evaluations of their trainees once a year. Following completion of the program, trainees meet with the program director to discuss any suggestions or concerns. This training program offers a breadth of research opportunities that range from research on the electrophysiology and molecular biology of the auditory system to craniofacial deformities, head and neck cancer, and gene transfer. The researchers providing mentorship have well-established, federally supported research programs and are leaders in their field. The program is likely to be successful in achieving its aim of fostering the development of independent investigators in the field of Otolaryngology. Progress over the past four years has been very good. The program has had no difficulty filling its slots, and to date four trainees have completed the program, two trainees are completing their first year of research training and two are completing their second year. Trainees for the 1997 and 1998 budget years have already been selected. Although recruitment has gone well, one issue that should be addressed is the small number of women and minorities who have been enrolled in the program. Over the past five years, only one woman and two trainees of Asian descent have entered the program; one woman will begin the program in 1998. The application describes various efforts to encourage women and minorities to apply (e.g., faculty encouragement, word of mouth), however, a more concerted effort should be made to attract these applicants. Productivity of the trainees has been impressive. Thus far, 19 peer-reviewed papers have been published, 26 abstracts have been published, and trainees have given 24 national presentations. Several trainees have received independent research awards and grants.
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