Pierce Gardner

Nurturing the Global Workforce in Clinical Research: The National Institutes of Health Fogarty International Clinical Scholars and Fellows Program

The Fogarty International Clinical Research Scholars and Fellows Programs goal is to foster the next generation of clinical investigators and to help build international health research partnerships between American and international investigators and institutions. Through June 2012, 61 sites in 27 countries have hosted 436 Scholars (American students or junior trainees from the host countries) and/or 122 Fellows (American and host country postdoctoral fellows) for year-long experiences in global health research. Initially, the program was oriented toward infectious diseases, but recently emphasis on chronic disease research has increased. At least 521 manuscripts have been published, many in high-impact journals. Projects have included clinical trials, observational studies, translational research, clinical-laboratory interface initiatives, and behavioral research. Strengths of the program include training opportunities for American and developing country scientists in well-established international clinical research settings, and mentorship from experienced global health experts.

Training Programs Within Global Networks: Lessons Learned in the Fogarty International Clinical Research Scholars and Fellows Program

The Fogarty International Clinical Research Scholars and Fellows Support Center at Vanderbilt describes administrative lessons learned from the management of 436 scholars (American students or host country junior trainees) and 122 post-doctoral fellows (Americans or host country nationals). Trainees spent 10-11 months working on mentored research projects at 61 well-vetted sites in 27 low- or middle-income host countries (LMICs) with strong US partners. Economies of scale, strong centralized information exchange, and effective standardized operations linking US institutions with LMIC field sites were achieved in a program that minimized administrative overhead. Advantages and drawbacks of this approach are presented and discussed. Training of a new generation of global research leaders is greatly facilitated by an overseas mentored research experience that is administratively streamlined to optimize the use of resources for training, research, and capacity building.

Recruiting Trainees for a Global Health Research Workforce: The National Institutes of Health Fogarty International Clinical Research Scholars Program Selection Process

Between 2004 and 2012, the National Institutes of Health Fogarty International Clinical Research Scholars (FICRS) Program provided 1-year mentored research training at low- and middle-income country sites for American and international health science doctoral students. We describe the centralized application process, US applicant characteristics, and predictors of selection/enrollment. FICRS received 1,084 applicants representing many health professions and biomedical disciplines at 132 US academic institutions; 219 students from 72 institutions were accepted and enrolled. Medical/osteopathic students comprised 88.9% of applicants and 85.8% of enrollees. Applicants from institutions with higher applicant numbers were two times as likely to be selected. In 2012, FICRS was decentralized among 20 institutions in five consortia (Global Health Fellows), with autonomous selection processes that emphasize post-doctoral trainees. If academia, government, or charitable foundations offer future opportunities to health professions students for international research, the FICRS experience predicts that they can attract substantial numbers of motivated trainees from diverse backgrounds.

The Gram-Stained Smear and Its Interpretation

This classic technique deserves wider application than in the laboratory identification of cultured organisms for which it is now most often used. In particular, direct staining of clinical specime...

Recruiting Post-Doctoral Fellows into Global Health Research: Selecting NIH Fogarty International Clinical Research Fellows

From 2008 to 2012, the National Institutes of Health (NIH) Fogarty International Clinical Research Fellows Program (FICRF) provided 1-year mentored research training at low- and middle-income country sites for American and international post-doctoral health professionals. We examined the FICRF applicant pool, proposed research topics, selection process, and characteristics of enrollees to assess trends in global health research interest and factors associated with applicant competitiveness. The majority (58%) of 67 US and 57 international Fellows were women, and 83% of Fellows had medical degrees. Most applicants were in clinical fellowships (41%) or residencies (24%). More applicants proposing infectious disease projects were supported (59%) than applicants proposing non-communicable disease (NCD) projects (41%), although projects that combined both topic areas were most successful (69%). The numbers of applicants proposing research on NCDs and the numbers of these applicants awarded fellowships rose dramatically over time. Funding provided to the FICRF varied significantly among NIH Institutes and Centers and was strongly associated with the research topics awarded.

Principles of building the global health workforce

Publisher Summary Recent past has brought a sea change in the attention focused on global health problems, and a determination to take action to alleviate the distress. There is a broadening of political will and support beyond the traditional humanitarian base to include economic, security, diplomatic, scientific, ecologic, and other self-interests that favor aid growth of global health assistance. The entire spectrum of government and nongovernment organizations is increasingly focused on global health, as evidenced by the setting of the UN Millennium Development Goals to be achieved over the next decade, and dramatic commitments of additional funds by government and nongovernment sources. A critical limiting factor in the response to the formidable global health challenge is the paucity of human resources in most low- and middle-income nations. Help is needed at all levels, from national leadership and planning to the most downstream interactions of health workers with individuals and communities. It is believed that certain key factors/principles are core to the success of health-training activities, whether the focus is clinical, research, public health, or administration/infrastructure building. There is a growing consensus in the scientific community that the determinants of infectious diseases are much more complex than simply the traditional host–pathogen interaction, and that social, economic, ecological, and political factors are powerful forces.