CNRM Military TBI Fellowship Program

fellowship logo

CNRM Military TBI Fellowship Program

The CNRM Military Traumatic Brain Injury Research Group Fellowship Training Program

 

fellowship pictureThe goal of the Center for Neuroscience and Regenerative Medicine (CNRM)-sponsored traumatic brain injury fellowship program is to train the next generation of civilian and military leaders in military-relevant traumatic brain injury (TBI) research and clinical care, attracting world-class applicants to the field and giving them an opportunity to flourish in a rich and collaborative intellectual environment. The program is intended to be the premier TBI training program in the United States, the first choice for the very best civilian and military applicants. The program is primarily for research training, but clinical training and clinical observerships are an essential part of the program. Fellows are encouraged to pursue innovative interdisciplinary projects with multiple mentors.

The Training Program

     The program will be open to two types of applicants:

  • Clinically trained fellows, starting after completion of medical residency in any specialty including but not limited to neurology, neurosurgery, PM&R, psychiatry, radiology, internal medicine, emergency medicine, family practice, pediatrics, trauma surgery, and general surgery.
  • PhD fellows, starting after completion of PhD or equivalent scientific degree in any relevant field, including but not limited to biochemistry, biomedical engineering , chemical engineering, cognitive science, computer science, genetics, immunology, mechanical engineering, medical physics, molecular biology, neural engineering, neuroscience, nursing, pharmacology/drug discovery, physiology, psychology, and statistics/applied mathematics.

Advertising for and recruiting the two types of fellows will proceed independently, though the two types of fellows will have substantial interaction.

The program will accept up to 4 fellows per year, up to 12 fellows total in the program at any time. Initially we will start with 1-2 fellows, and then build the program over 3-4 years. Training duration will be up to 3 years duration, with support for subsequent years contingent on satisfactory progress in initial years. The 3 years does not have to be continuous; pauses for family events, personal circumstances, and military deployments will be allowed. No specific number of clinical fellows vs. PhD fellows will be accepted each year. If world-class fellowship candidates do not apply in any given year, the fellowship class will be smaller that year and funds will be reserved for future years. 

Members of underrepresented minority groups are explicitly encouraged to apply.  Therapists, advanced practice nurses, physician’s assistants, and clinical psychologists with advanced scientific degrees are explicitly encouraged to apply.

Active duty military personnel and public health service personnel are invited to apply, but will not receive additional salary.

The fellows will not be committed to a single lab or research group; the fellowships will be awarded to the individuals, who can use them in any appropriate fashion.

Civilian salaries will be up to $115,000 per year for clinical fellows, up to $85,000 per year for PhD fellows. Salary support will not be dependent on additional external funding.

The fellows will have appointments as Henry Jackson Foundation junior scientists, including benefits. Funds for Henry Jackson Foundation junior scientists will come from CNRM, with supplementation in appropriate cases from the office of the Vice President for Research at the Uniformed Services University (USU). Scientifically mature neurologists and neurosurgeons will also have the option to have a secondary appointment at NINDS through the K22 program, which will be arranged in a cooperative fashion with the NIH. https://grants.nih.gov/grants/guide/pa-files/PAR-16-340.html. This will require a primary mentor at the NIH intramural program.

There will be no upper limit to the number of years post-training for applicants; experienced clinicians and researchers in other fields wishing to move into the field of TBI are encouraged to apply.

Later phase applicants interested in switching fields are invited to apply, but will not receive additional salary commensurate with experience.

Each fellow will also receive $50,000 per year for research funds to allocate independently of their mentors. These funds may be used to purchase equipment and supplies, pay clinical research costs, pay animal costs, hire additional research or administrative personnel, pay for travel to scientific meetings, pay for travel for scientific collaborations, or any other appropriate research use allowable under NIH and DoD grants.

Each fellow will receive a $5,000 1-time travel/relocation allowance.

Each fellow will receive $1,000 per year to cover transportation costs (~$20/week x ~50 weeks per year) within the National Capital Area/Baltimore for seminars, collaborative meetings, and training events.

By the time of award, the individual must be a citizen or a non-citizen national of the United States or have been lawfully admitted for permanent residence (i.e., possess a currently valid Permanent Resident Card USCIS Form I-551, or other legal verification of such status. Non-citizens may have some additional restrictions on training at some US Military medical facilities.

Candidates are required to commit a minimum of 9 person-months (75% of full-time professional effort) to their career development and research training during the entire award period. Surgeons must devote a minimum 6 person-months (50% of full-time professional effort) to research and career development activities. Surgeons may also qualify for Assistant Clinical Investigator titles during fellowship. Candidates may engage in other duties as part of their remaining full-time professional effort (up to a maximum of 25% full time professional effort for non-surgeons, up to a maximum of 50% full time professional effort for neurosurgeons) not covered by this award, as long as such duties do not interfere with or detract from the proposed career development program. Other duties may include consulting, research activity, and clinical activities as long as they are allowable by the primary appointing institution.

Research projects are expected to have clear clinical relevance, though the projects may involve humans, animal models, in vitro models, or datasets. Fundamental neuroscience research with only hypothetical applicability to human TBI will be less favored.

Fellows may work with any primary research group at NIH, USU, Walter Reed National Military Medical Center (WRNMMC), University of Maryland including Shock Trauma, Walter Reed Army Institute for Research (WRAIR), Naval Medical Research Center (NMRC), and the Defense and Veterans Brain Injury Center (DVBIC). Fellows are encouraged to collaborate with the leading TBI research group in the United States, and potentially elsewhere if appropriate arrangements can be made.

Fellows will have full access to the CNRM TBI research group activities and resources https://www.usuhs.edu/cnrm including its core facilities at NIH and USU. These include animal models of TBI, animal behavioral testing, small animal imaging, neuropathology, informatics, acute human studies, human imaging, human image processing, fluid biomarkers, recruitment, and phenotyping. https://www.usuhs.edu/cnrm/coresindex.

Clinical training (for clinical fellows) and clinical observerships (for PhD fellows) may take place at any military medical treatment facility and regional civilian hospitals. Inpatient or intensive outpatient clinical rotations and observerships may be 2-8 weeks in duration, either full or part time. Longitudinal outpatient clinic rotations and observerships may be 1-2 half days per week. The specific clinical program will be customized for each fellow in accordance with interests and career goals. The total clinical training will be not more than 25% for clinical fellows, and the total time spend in observerships will be not more than 10% for PhD fellows. PhD fellows will have introductions and preemptive counseling prior to clinical observerships to reduce the likelihood of potential psychological distress. Examples of clinical opportunities include:     

  1. Trauma Resuscitation Unit training/observership at Shock Trauma/University of Maryland in Baltimore, including helicopter and ground-ambulance pre-hospital/EMS. This part of the program will be directed by Dr. Neeraj Badjatia.
  2. Neurotrauma ICU observership/clinical training for qualified providers at Shock Trauma, directed by Dr. Neeraj Badjatia.
  3. Intensive outpatient training/observership at the National Intrepid Center of Excellence on the Walter Reed National Military Medical Center campus in Bethesda, directed by Drs. Walt Greenhalgh and Lou French. Recommended at least 4 weeks.
  4. Intensive outpatient training/observership at Landstuhl Regional Medical Center in Landstuhl, Germany, directed by Dr. Juan Rivera. Recommended 6 weeks.
  5. Outpatient TBI clinic at Ft. Belvoir, a regional military medical center and Intrepid Spirit Center in Northern Virginia, directed by Dr. Heechin Chae. Recommended 4 weeks.
  6. Weekly outpatient TBI clinic at National Intrepid Center of Excellence.
  7. Weekly outpatient TBI clinic at the NIH clinical center, directed by Dr. Christine Turtzo.
  8. Neurorehabilitation at the NIH clinical center, directed by Dr. Leighton Chan.
  9. Outpatient TBI clinic at any major military TBI center, including Camp Lejeune (North Carolina), Camp Pendleton (California), Ft. Bragg (North Carolina).
  10. Outpatient Neurotrauma Recovery Clinic at the University of Maryland, directed by Dr. Neeraj Badjatia.

 

Application Process

Applications will be accepted on a rolling basis. There will not be specific application deadlines. Applications will be submitted through the office of the Vice President for Research at USU, to the director at david.brody@usuhs.edu, or through the NIH for those applying to the K22 program.  USU applications should include 1 page statement of career goals, CV, 2 page initial ideas regarding the fellowship plan including initial mentor or mentorship team, 2-4 letters of recommendation from previous mentors and collaborators, letter of support from proposed initial mentor or mentorship team.

Initial review will be performed by the director David Brody and the executive group, currently Drs. Neeraj Badjatia (U. Maryland Shock Trauma), Leighton Chan (NIH), Jessica Gill (NIH), Irwin Lucki (USU), Yvonne Maddox (USU), Dorian McGavern (NIH), Avi Nath (NIH), and Todd Rasmussen (USU), with input from USU, WRNMMC, NIH and external advisors.

Invitations for interviews will be announced within 2 weeks of receipt of the application.

One or more on-site or VTC interviews will be conducted for each appropriate applicant, with the cost of the travel paid by the fellowship program, not by the applicant.

Each of the executive group members will score the applicants (1-9 using NIH criteria) within 1 month of completion of the application process based on the following equally weighted criteria:

1) Potential for leadership in the field of TBI

2) Academic and clinical achievement

3) Fellowship plan.

If an applicant proposes to work with one of the executive group members, this member will abstain from scoring.

Typically, applicants with average scores of 3 or better will be recommended for awards.  Award recommendations will be presented to CNRM program oversight committee for approval.

Each awardee will have up to 1 month to accept or decline. At the discretion of the executive group, positions will remain unfilled if there are not enough appropriate applicants.

Start dates will typically be July 1, with substantial flexibility.

Clinical fellows may defer for 1 year, applying in their penultimate year of residency training rather than in their last year.

Each applicant will receive feedback from the program director at each stage of the application process.

Applicants may reapply up to 3 times.

Applicants are encouraged to consult with executive group members, through executive group members may recuse themselves from rankings if real or perceived conflicts of interest arise.

 

Formal training

Each fellow will complete formal training at the NIH in responsible conduct of research, ethics, scientific writing, grant applications, statistical analysis, scientific communication skills and scientific financial management.

Each fellow will have a mentorship team consisting at a minimum of:

  • The primary scientific mentor
  • The clinical mentor (including supervision of clinical observerships for PhD fellows)
  • One member of the executive group.
  • One scientist or clinician in the opposite branch of the federal government as the primary mentor (e.g. a Department of Defense investigator for fellows primarily based at NIH, and an NIH or civilian academic investigator for fellows primarily based at a DoD facility).

The mentorship team will meet quarterly during the first year, and then at appropriate intervals in subsequent years.

Additional mentoring activities available at the NIH will be included as appropriate.

Clinical fellows interested in pursuing formal accreditation in either Brain Injury Medicine, or Behavioral Neurology/neuropsychiatry will be supported by the program. There is no obligation to pursue these formal accreditations.

Clinical fellows engaged in a formal NeuroICU fellowship program may have their research training integrated with their clinical fellowship training.

 

Review

Annual review will be performed in person by the mentorship team and the executive group each year typically between June 1 and June 30, with second and subsequent years of funded contingent on satisfactory annual review. Fellows will prepare a 2 page written summary of their accomplishments the previous year and plans for the subsequent year, and submit the summary to the mentorship team and the executive group 1 week in advance of the review.

 

The Seminar Series

The program will include a weekly or every-other-week TBI seminar series, open to the scientific community. There will be 1-3 internal speakers each month and 1 external speaker each month. The external speakers invited will be among the top TBI researchers in the world. Internal speakers will include researchers and clinicians from NIH, USU, WRNMMC, WRAIR, NMRC, DVBIC, Ft. Belvoir, Johns Hopkins, and University of Maryland.

The fellows will have an opportunity to meet with the external speakers while they are in town, and will be encouraged to interact with the internal speakers.

Each fellow will present a seminar each year in the Spring.

Seminars location will alternate between USUHS, NIH, and WRAIR/NMRC Silver Spring annex, with fellows expected to attend seminars at all locations.

Video conferencing capabilities will be available for those off site (e.g. rotating at LRMC or other military treatment facilities).

Seminars will be recorded and archived for later viewing.

In addition, the fellows will be expected to present their work in poster format at the National Capital TBI Research Symposium held in March each year, and attend the CNRM retreat each fall.

 

The Reading List

Distributed in advance at the beginning of year 1. Each class of fellows will discuss 1 paper each week at a 1 hour lunch-time journal club during the first year with the director and/or other faculty members. This will also give an opportunity for fellows to interact with director and other faculty. Importantly, PhD fellows will be immersed in the clinical TBI literature, which along with direct clinical observerships, will ensure that PhD fellows become fully committed to clinically relevant research.

 

Transition and Post-Fellowship Follow-Up

The mentorship team and executive group will contribute substantially to ensuring successful transition of fellows to the next stage in their career goals, including but not limited to academic faculty, government service, and industry leadership positions. The fellowship program will track the careers of the fellows after completion at 4 year intervals and request feedback from former fellows with regard to improving the fellowship training program.

 

Point of Contact

Inquiries should be made to the fellowship program director at

david.brody@usuhs.edu or 301-480-3039

Logistical support will be provided by Carly Larkin at carly.larkin.ctr@usuhs.edu and

by Kathy Ireland at kathyi@ninds.nih.gov.