Cancer and Blood Disorders Center

Clinical Research Training

 The Clinical Research Fellowship Track aims to produce leading clinical scientists in pediatric oncology and hematology. Fellows in this track will accomplish these key signposts of clinical research expertise:

• Expertise in a specific area of interest (in a disease, a therapeutic modality, or in relevant fields of risk reduction, outcomes research or cancer control) that will lead to national recognition.
• Proficiency in the methods necessary to independently carry out clinical research.
• A portfolio of research that demonstrates competency in various aspects of clinical research.
• Completion of a grant to support of his/her research.

Clinically-based research within the Program is broadly defined as any research that impacts on clinical outcomes and experiences of children with cancer, genetic and hematologic diseases. The goal of the program is to create independent investigators whose research will not only improve the outcome but also the quality of life for children with these and transplant-related diseases. In addition to “traditional” clinical research: i.e. clinical trial design and evaluation, the current expertise of the faculty includes bioethics, medical education, improvement of patient-parent-physician communication, refinement of risk stratification systems, evaluation and mitigation of late effects and optimization of palliative care.

 To facilitate the clinical research within the program, the Dana-Farber/Children’s Hospital Cancer Center (DF/CHCC) has established the Clinical Translational Investigational Program (CTIP).  CTIP includes protocol specialists, who are available to advise on the development and submission of protocols for clinical research, as well as statisticians with expertise in study design, data collection and evaluation, clinical research associates and clinical research nurses. CTIP will augment the fellow’s research experience through this readily-available expert support.

 Fellows choose a research mentor during the first year of fellowship and will develop a portfolio of possible research topics. For fellows who come without substantial research methods training, the core didactic training is the Clinical Effectiveness Program at Harvard School of Public Health (HSPH) which is typically taken the summer after the first or second year of fellowship training. Tuition for this course is fully funded by the training program. This intensive 7-week, 15 credit program includes core courses in epidemiology and biostatistics as well as 2 electives. For students with prior experience, higher level courses are offered in Analytic Issues of Clinical Epidemiology, Principles of Clinical Trials, and Survival Methods in Clinical Research. One important goal of the summer course is to develop a complete clinical research proposal, including background, objectives, methods, statistical analysis, with input from both the clinical research mentor as well as the HSPH faculty. This project will serve as the blueprint for at least one of the projects the fellow intends to complete during the subsequent year(s) of fellowship.

 Students who complete the Clinical Effectiveness Program can apply for a degree-granting program at the Harvard School of Public Health (either Master of Science or Master of Public Health).  There are several training grants available at Harvard (see table below) that will cover the cost of the full master’s program and provide another source of mentoring for fellows.  Current training programs include: the Cancer Prevention Fellowship at Harvard School of Public Health, the Clinical Investigator Training Program at Beth Israel Deaconess Medical Center, the Harvard Pediatric Health Services Research Fellowship Program at Children’s Hospital Boston, and the Program in Cancer Outcomes Research Training at the Massachusetts General Hospital. Fellows in the program may also take advantage of the training and research opportunities made available through the Harvard Catalyst. The Harvard Clinical and Translational Science Center is a pan-Harvard University enterprise dedicated to improving human health. It is a shared enterprise of Harvard University, its ten schools and 18 affiliated academic healthcare centers (AHCs), the Boston College School of Nursing, MIT, the Cambridge Health Alliance, Harvard Pilgrim Health Care, and numerous community partners.

 Masters programs are combined under the auspices of Harvard Catalyst, including the Scholars in Clinical Sciences Program http://catalyst.harvard.edu/services/scholars/and the more translational Clinical Investigation Training Program http://catalyst.harvard.edu/services/citp/.

 The division also sponsors a weekly Children’s Hematology/Oncology Clinical Research Seminar Series (CHOCRS), at which senior and junior faculty, and fellows, present their work on a rotating basis.  The intent of the seminar series is to simulate a “lab meeting atmosphere” in which the work presented is mostly work-in-progress that will benefit from the comments and criticisms of colleagues.

 Fellows working towards a career in clinical research are encouraged to apply for grant funding, either from a private foundation or for a National Institute of Health Career Development award (K series) near the end of their fellowship. In addition to support from their mentor, fellows receive comprehensive support and guidance throughout the grant application process as the program recognizes this as an important component to becoming an independent researcher. Fellows have access to a designated faculty member with expertise in grant writing for consultation on the grant writing process.

Fellowship in Global Health Research in Pediatric Hematology/Oncology

The Global Health in Hematology/Oncology Fellowship Track offers a unique opportunity to train in aspects of global health as they relate to hematology and oncology health care in developing countries. For fellows interested in global health a 4-year fellowship is offered. Mentored clinical and clinical research training will take place in one of the Dana-Farber/Children’s Hospital Cancer Center (DF/CHCC) partner institutions in a low or middle income country. Currently the sites that are available to fellows include any of the member institutions of AHOPCA (La Asociacion de Hemato-Oncologia Pediatrica de Centroamerica y Republica Dominicana), a pediatric oncology association that has a designated pediatric oncology facility in every country in Central America and the Dominican Republic. In addition, the DF/CHCC program is developing a pediatric oncology program at the Black Lion Hospital in Addis Ababa, Ethiopia and has current efforts in Egypt (Children’s Cancer Hospital ‘57357’ in Cairo), Sub-Saharan Africa, South East Asia, and South America. Fellows will spend a minimum of one month and up to three months per year at one of these sites during their second, third and fourth year of their fellowship training. Since this requires additional time to be spent off-site during the fellowship we extend training to four years for most fellows.

Global health fellows will develop clinical research projects at these sites which will be co-mentored by DF/CHCC faculty and on-site mentors. Ongoing collaboration when the fellow is not in residence at the site will be facilitated with interactive information technology, such as the Cure4Kids website. For fellows who come without substantial research methods training, the core didactic training is the Clinical Effectiveness Program at Harvard School of Public Health (HSPH) which is typically taken the summer after the first or second year of fellowship training. Tuition for this course is fully funded by the training program. This intensive 7-week, 15 credit program includes core courses in epidemiology and biostatistics as well as 2 electives. For students with prior experience, higher level courses are offered in Analytic Issues of Clinical Epidemiology, Principles of Clinical Trials, and Survival Methods in Clinical Research. The overarching project for the summer course is to develop a complete clinical research proposal, including background, objectives, methods, statistical analysis, with input from both the clinical research mentor as well as the HSPH faculty. This project will serve as the blueprint for the project the fellow will work on at the international site.