It is nice to see some discussion about research at DO institutions. I hope that all of you consider a career in clinical research. Maybe I can shed some light on this topic for you.
The American Osteopathic Association, American Association of Osteopathy and the American Association of Colleges of Osteopathic Medicine have also issued mission statements to increase research among Osteopathic physicians and Osteopathic institutions.
The major challenge to among DO institutions is how to best implement, foster, and develop a competitive research program in institutions with no research tradition and minimal research infrastructure.
Here are the issues:
1. Infrastructure
The majority of income for some DO schools comes from tuition and fees. This is contrary to the distribution of sources of revenue for medical schools nationwide which includes medical service (44%), federal research (20%), other income (15%), state and local government (14%), tuition and fees (6%), and other federal income (5%). DO schools need to seek monies to develop an environment to perform research. This includes start-up costs for a laboratory, research administration, grants and contracts people, etc. They will have to seek outside funding otherwise tuition will just go up and up and up and so will the number of students in each school. (is this already happening?)
2. Faculty
Information on the clinical research training of Osteopathic medical school faculty is limited. Overall, the training of clinical researchers is variable and has included subspecialty fellowship training, masters programs in public health and epidemiology, and one or more years of laboratory-based research. The NIH, Robert Wood Johnson Clinical Scholars program, University of Michigan School of Public Health, and the Harvard School of Public Health (Clinical Effectiveness program) provides training for physicians in clinical research. The curriculum of these programs typically consists of statistics, epidemiology, study design, grant proposal preparation and the ethics of clinical research. DO faculty members need at least one year of research training.
Nationwide the distribution of medical school faculty is about 80% clinical and 20% non-clinical. About 65% of medical school faculty have a medical degree, 25% have a PhD and 10% have other degrees. Information on the research involvement of faculty at allopathic and osteopathic medical schools is limited. A 1987 study found that the median effort of physician faculty was 25% compared to 95% of PhD faculty in the same department (Beaty 1987). This suggest that more PhDs are doing research than physicians. All PhDs at DO institutions should be doing some type of scholarly activity.
3. Funding
Research funding among Osteopathic institutions ranges from zero to over 7 million dollars. The Osteopathic institutions with the most funding include, Kirksville, Oklahoma, Ohio, Texas, Michigan State, Chicago, UMDNJ and Nova Southeastern. Research conducted by faculty members at these institutions is supported by the University and through agencies such as the American Osteopathic Association, National Institutes of Health, the National Oceanic and Atmospheric Administration, the American Heart Association, the American Diabetes Association, and the Arthritis Foundation.
Many research institutions fund a portion of their own research activities, including start-up funds for new investigators, bridging funds for experienced investigators and funding research that cannot be funded by other sources. The NIH and other government agencies provide the largest amount of support for clinical research.
DO institutions need to secure more funding.
4. Students
Here is where you come in.
Why should I do clinical research?
? There is a lack of clinical researchers in the Osteopathic community.
? Nationwide, there has been a decline in physician-conducted research and physician scientists.
? The NIH has recommended that more patient-oriented research by physicians be funded.
? Clinical research allows for collaboration between colleagues and institutions.
? Clinical investigators are highly sought after by academic centers, government and industry.
? Promotion committees at academic centers recognize clinical research as scholarly activity.
? Clinical research provides academic recognition.
Where can I get clinical research training?
Osteopathic Institutions
Osteopathic medical institutions conduct basic science and clinical research and offer advance training in public health and biomedical sciences.
1) Arizona College of Osteopathic Medicine of Midwestern University. The Health Professions Education program offers coursework in research design and methods and research biostatistics.
2) Chicago College of Osteopathic Medicine. The doctor of Osteopathic medicine program has formal coursework in epidemiology during the second year.
3) Kirksville College of Osteopathic Medicine. The health management graduate program offers three masters degrees (geriatric medicine, public health and health administration) all three have formal coursework in epidemiology, biostatistics and health policy.
4) Lake Erie College of Osteopathic Medicine. Research training information not available.
5) Michigan State University of Osteopathic Medicine. The doctor of Osteopathic medicine program has formal coursework in epidemiology and biostatistics during the third semester. MSU also offers a Medical Scientist Training Program and a DO/PhD degree.
6) New York College of Osteopathic Medicine. Research training information not available.
7) Nova Southeastern University. The doctor of Osteopathic medicine program has formal coursework in medical epidemiology during the second semester. There are also research electives each year.
8) Ohio University College of Osteopathic Medicine. The doctor of Osteopathic medicine program has formal coursework in medical epidemiology during the first year.
9) Oklahoma State University College of Osteopathic Medicine. The school offers a PhD program in biomedical sciences.
10) Philadelphia College of Osteopathic Medicine. PCOM offers a combined DO/MPH program and an MS in Biomedical Sciences. The MPH program is a joint program with Temple University.
11) Pikesville College of Osteopathic Medicine. Research training information not available.
12) Touro University College of Osteopathic Medicine. Research training information not available.
13) University of Health Sciences College of Osteopathic Medicine. Research training information not available.
14) University of Medicine and Dentistry of New Jersey College of Osteopathic Medicine. The school offers a DO/PhD program.
15) University of New England College of Osteopathic Medicine. The doctor of Osteopathic medicine program has formal coursework in epidemiology and Public Health during the first year.
16) University of North Texas Health Science Center - Texas College of Osteopathic Medicine. The school offers a DO/MPH and DO/PhD degree.
17) University of Osteopathic Medicine and Health Sciences College of Osteopathic Medicine and Surgery. The college of health sciences offers an MPH degree but the program has just been started and is not accredited by the Council on Education for Public Health at this time.
18) West Virginia school of Osteopathic Medicine. The doctor of Osteopathic medicine program has formal coursework in medical ethics during the first year.
19) Western University of Health Sciences ? College of Osteopathic Medicine. The school offers a offers a Masters of Science in Health Professions Education.
Schools of Public Health
There are 29 schools of public health and 23 graduate programs in community health and preventive medicine accredited by the Council on Education for Public Health in the United States. Schools of public health offer formal training in research methods, epidemiology and biostatistics. John Hopkins, Harvard University, University of North Carolina, University of Washington, University of Michigan, University of California at Berkley, Columbia University, University of Minnesota, Emory University, University of Pittsburgh, Yale University, University of California-Los Angeles, Tulane University and University of Texas-Houston are the top-ranked public health schools in the United States. Some of these schools offer a one-year condensed program for students with advanced degrees (D.O.).
My recommendations:
1. Find a mentor
2. Get advanced training (ie MPH, PhD, subspecialty training, extra classes in epidemiology, biostatistics, study design, grant writing, scientific writing)
3. Consider a rotation or fellowship at the NIH or another research institution
Contact me if you have any further questions:
John Kylan Lynch, DO, MPH
National Institutes of Health/NINDS
Neuroepidemiology Branch
Federal Building, Room 714
7550 Wisconsin Avenue
Bethesda, MD 20892-9130
Email:
[email protected]