Weill Medical College of Cornell University

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Clinical Epidemiology and Evaluative Sciences Research

Health Services Fellowship

• Information for Applicants

The goal of the T32 AHRQ Fellowship Program is to train post-residency physicians to conduct methodologically rigorous health services research in a multidisciplinary environment. The two-year training program requires participation in a formal didactic curriculum consisting of courses and seminars that are designed to provide both foundations and skills in clinical epidemiology and health services research. In addition, trainees continue to participate in a series of multidisciplinary conferences and methodology meetings, as well as interact in their own weekly seminar, working with each other and devoting effort to their own respective research projects. In accordance with program objectives, each trainee has begun to integrate his/her knowledge and skills to design and conduct his/her own original research project with the close supervision of the participating faculty.

Our strengths have been developing trainees to perform question-driven research in an area of their own interest, recruiting minority candidates, and requiring completion of a Master's Degree in Clinical Epidemiology and Health Services Research. The program fosters the development of new investigators who become independent researchers, using methodologically rigorous approaches to address important health issues. Another strength of our program has been our multidisciplinary faculty with expertise in the basic sciences of clinical research, specifically in clinical epidemiology, biostatistics, economics, decision sciences, and behavioral sciences. Our new strength is the collaboration with New York Presbyterian Hospital in the areas of patient safety and quality improvement.

Graduates from our fellowship program are principal investigators or co-principal investigators on 99 grants. The funding on grants for which they are principal investigators or co-principal investigator totals $59,828,156. They have received funding from the National Heart Lung and Blood Institute, the National Institute on Aging, the National Institute of Mental Health and the New York State Department of Health, as well as from the Robert Wood Johnson Foundation, the Fan Fox and Leslie R. Samuels Foundation, the Arthritis Foundation, the Hartford Foundation, the Hyde and Watson Foundation, and the Aaron Diamond AIDS Research Institute.

Our program recruits individuals from underrepresented racial/ethnic groups. Our program has an outstanding record of recruiting and retaining minority candidates with 31% of our 36 past and current fellows being African American or Latino. Of our former 36 fellows, 11 are African American or Latino; specifically 8 are African American women, 1 is a Latino woman and 2 are African American men. Of our 5 current fellows, 1 (20%) is a latina woman. The fellows participate in the core courses of the Master of Science Program in Clinical Epidemiology and Health Services Research which is based in the Weill Cornell Graduate School of Medical Sciences.

The curriculum is designed to provide fellows with the conceptual and theoretical background and the practical knowledge and skills necessary to conduct interdisciplinary health services research. The courses are designed to give the participants a solid grasp of the fundamentals of conceptual and theoretical principals underlying health services, behavioral and clinical research. Fellows learn how and when to apply different research designs, quantitative, qualitative and mixed methods. They learn how to use existing measures, how to develop surveys and to create new measures to collect their own data. They learn sufficient computer programming and analytic skills to analyze their own data, including basic and advanced biostatistics techniques including hierarchical models, and structural equation modeling. They learn about decision analysis, economic analyses, including cost-effectiveness and cost-benefit analysis. They learn how to access secondary data. They also learn about the importance of adapting methods to different cultures. They learn about the responsible conduct of research.

Research:AHRQ designates several priority areas for clinical research. During their fellowship training, fellows conduct research in these diverse priority areas which include:

1. Translating Research into Practice and Policy
2. Patient Safety and Information Transfer
3. Quality Improvement
4. Patient-centered Care and Education
5. Healthcare Disparities

Fellows Projects: Past and Present

Weekly Seminar:

Advanced Seminar and Health Services Research - The Advanced Seminar is designed to guide, support, and exchange ideas between fellows and their mentors. Fellows are given several opportunities to present on the various steps of their research project. Presentation topics include identifying a focused topic, developing their objective, hypothesis, background and significance of a question and outlining their methods. In subsequent seminars, the fellows' presentations are project updates. Thus, in this seminar, the fellows refine and develop their own projects, while critiquing and helping their colleagues in their projects. This provides the opportunity for the fellows to learn from each other's experiences.

Biweekly Conferences:

Research Methodology Conference - The objective of this conference is to review problems with design and conduct of studies. The course operates as a "think tank" on issues, and includes a full meeting of a multidisciplinary group consisting of clinical epidemiologists, biostatisticians, health educators, health services researchers, health economists, data systems experts, psychologists and cooperating investigators.

Center for Complementary and Integrative Medicine Conference - The objective of this conference is for Center faculty, collaborating investigators, and outside visiting scientists to present various research projects or reviews of the literature relevant to complementary and integrative medicine. These conferences provide fellows with the opportunity to hear about diverse research areas in the field. This conference has been approved for Continuing Medical Education accreditation.

Health Services Research Journal Club - This weekly journal club is led by our fellows. Each week the fellows lead a discussion on recent literature on methods to improve safety and quality, including approaches to patient centered care. The sessions provide the chance to review and debate results in the recent literature.