Transcript Oxidative Damage in Bipolar Disorder

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Surgical Scientist Training:
Gifts for the Faculty of Medicine and Society
Allan S. Kaplan MD MSc FRCP(C)
Vice Dean, Graduate & Life Sciences Education
Professor of Psychiatry, Faculty Medicine
[email protected]
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Where We Have Been
Historically surgical scientists have significantly impacted patient
care:
6 Surgeon Scientists have been awarded the Nobel Prize in
Medicine* :
•Theodor Kocher 1909: Thyroid pathophysiology
•Alexis Carrell 1912: Vascular suturing
•Sir Frederick Banting 1923: Insulin discovery
•Werner Forssman 1956: Heart catheratization
•Charles Huggins 1966: Prostate cancer
•Joseph Murray 1990: Organ transplantation
* Suliburk et al Ann Surg Vol 247, No 5, 2008
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Where We Have Been
Surgical research contributions in the last 50 years*:
•Cardiopulmonary bypass
•Transplantation
•Vascular surgery
•Total parenteral nutrition
•Burn care
•Surgical cancer treatment ( breast)
•Minimally invasive surgery
•Joint replacement
•Stereotactic neurosurgery
•Urinary lithotripsy
* Thompson, J Am Coll Surg 2000; 190: 393-403; 2000
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The Context: U of T Medicine’s Strategic Plan 2011-16
emphasizes three goals:
INTEGRATION, INNOVATION and IMPACT
The Faculty of Medicine’s Strategic Plan for
2011‐2016 reaffirms the commitment to
physician scientist training.
Our new vision statement reads:
“International leadership in improving health
through innovation in research
and education”.
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The Context: Recommendations of FoM Task Force on
Physician Scientist Training
1. The FoM should establish an Integrated Physician Scientist
Training Pathway (IPSTP). (Steering Committee established)
2. The FoM should develop a greater breadth of graduate level
training opportunities for its learners, including the
establishment of new joint programs with partners outside of
the FoM or existing ‘traditional’ programs in the life
sciences and medical sciences areas
3. The FoM should establish a mentorship program aimed at
supporting successful physician scientist careers.
4 The FoM should facilitate the development and alignment of
physician scientist career development and retention
strategies across the Faculty and TAHSN
5 The Faculty of Medicine should engage with its national
partners (RCPSC, AFMC, ACAHO) on the establishment of a
national model of training that embraces the various potential
careers of physician scientists.
A new pathway is under design to tackle the issues
6
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Assessing Impact of SSTP
Metrics:
1)SSTP participation in the FoM Clinician
Investigator Program ( CIP)
2)Number of graduates and degrees confirmed
for SSTP participants
3)Career outcomes
4)Evidence of Commercialization in the
Department of Surgery
Clinician Investigator Program (CIP) Trainees by Clinical Department
2009-2015 incl. January 2015 admissions
Clinical Department
M
Anaesthesia
Graduates*
F
Total
3
3
Clinical Pharmacology/Toxicology
Medicine (excl Clin Pharm/Tox)
Medical Genetics
Medical Imaging (Diagnostic Radiology)
1
13
1
10
1
4
Obstetrics and Gynaecology
2
Ophthalmology & Vision Science
Otolaryngology Head & Neck Surgery
Paediatrics
Laboratory & Medical Pathobiology
(Anatomical/Neuro)
Psychiatry
Radiation Oncology
Surgery (see below)
TOTAL
3
0
Clinical Public Health
Family & Community Medicine
M
Current Trainees**
F
Total
3
1
1
1
1
2
23
1
18
12
0
30
4
2
2
4
2
1
1
2
0
1
1
8
1
5
2
13
1
2
1
8
2
9
1
1
2
2
1
3
3
1
29
58
2
5
1
42
96
7
5
32
76
17
45
12
0
48
121
13
38
*Total number of trainees who graduated between 2009-2014; this includes graduates enrolled prior to 2009 (n=53).
** Total current number of CIP trainees (n = 121) comprises all trainees in research phase or clinical phase of CIP who have not fulfilled all
CIP program requirements. This includes trainees enrolled before 2009 (n=22) who have not completed requirements or whose completion
is in progress, or whose status will be determined as lapsed or withdrawn (latter to be added to total number of lapsed/withdrawn of 82).
CIP Trainees by Graduate Department
2009-2015 (incl. January 2015 admissions)
Graduate Department
University of Toronto:
Institute of Medical Science
Institute for Biomaterials and Biomedical
Engineering
Institute for Health Policy, Management and
Evaluation
Public Health Sciences (Dalla Lana School of
Public Health)
Laboratory Medicine and Pathobiology
M
34
1
1
2
1
3
17
21
38
33
1
2
3
1
4
1
1
2
1
2
4
0
Department of Pharmaceutical Sciences
2
2
1
5
1
1
0
1
0
3
9
1
10
0
1
1
1
2
0
1
58
6
1
Johns Hopkins School of Public Health
TOTAL
2
1
2
University of Illinois at Chicago
Total
53
0
2
Department of Immunology
Department of Physiology
Non-Graduate Stream (PDF)
Other Universities:
University of Dundee Centre for Medical
Education
Harvard School of Public Health
M
36
17
2
Current Trainees**
F
17
Total
48
16
Medical Biophysics
Ontario Institute for Studies in Education1
Graduates*
F
14
1
1
38
96
1
0
76
45
121
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Assessing Impact
University of Toronto Clinician Investigator
Program (CIP) Data
Additional CIP Surgery Data:
•Of total 512 trainees over life of program
(1993-2015), 233 were from Surgery (45.5%)
•Of 306 CIP graduates, 145 from Surgery (47.3%)
•Of 233 Surgery admissions, 32 withdrawals/lapsed (13.7%)
•Of 82 total withdrawals/lapsed in CIP , 39 % from Surgery
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Assessing Impact
SSTP Graduate Survey 2014: 1983 – 2014
Total enrolled since 1983 - 352
Degrees received
MSc –
163
DPhil –
1
MEd –
21
PDF –
3
MASc –
3
PhD –
98
MBA –
1
Incomplete/withdrew – 28
MHSc –
1
Currently enrolled – 32
MPH –
1
Surgeon Scientist Training Program 2002-2014
40
Continuing
New Entry
30
20
10
0
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
New Entry
Continuing
Total
27
11
16
30
6
24
32
14
18
27
5
22
26
12
14
33
13
20
32
9
23
33
13
20
32
11
21
25
6
19
30
11
20
26
10
16
32
18
14
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Assessing Impact
Currently 11.6 % of surgical residents are in
the SSTP
(32 out of 276 total surgical residents)
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Assessing Impact
Graduates of the SSTP 1985-2014
277 Graduates for whom there is data
Academic Appointment: 199 ( 72 % )
•Professor: 46
•Associate Professor: 52
•Assistant Professor: 81
•Lecturer/Fellow: 20
No Academic Appointment: 78 ( 28 %)
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Assessing Impact
Total number of patents filed by members of
the Department of Surgery 2009-2014
2009-10: 15
2010-11: 22
2011-12: 26
2012-13: 11
2013-14: 15
Total = 61, or 15% of the total (400 in this
time period) for the FoM
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Now 30 years old, what is the state of
health of the SSTP ?
The SSTP has been the premier clinician scientist training program
in the FoM:
 Almost 50 % of admissions to CIP are from Surgery
 Fields of study have been extraordinarily broad :
biomedical, surgical education, clinical epidemiology,
health policy, bioengineering, nanotechnology, bioethics
 By any metric, the SSTP has had significant impact locally and
nationally:
72 % of graduates are in academic positions across
country
40th Gallie Day “Commercialization and Research”
notable successes in commercialization
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Going forward, what are the challenges ? *
 Funding- is the current funding model sustainable for both
trainees and for clinician scientists ?
 Is the length of training too long ? Currently 14‐18 years
post‐secondary

Are there academic jobs available for Surgical Scientists in
Canada ?
 What is the best way to integrate clinical and research
training requirements ? Currently fragmented, with no
integrated pathway
 Is there adequate mentorship available ?
* See the report of the FoM Task Force on Physician Scientist Education
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