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Research Track

Research Track: Developing Future Physician Investigators

The research track is designed to train and support residents interested in becoming future leaders in translational, health services, and basic science research that will have a significant impact on mental health. The specific goal is to increase the number and quality of outstanding clinical investigators skilled at leading multidisciplinary research teams.

Highlights

  • 12 weeks of 100%, dedicated, time for research during 2nd year of training in three month-long blocks throughout the year
  • 50% clinical time and 50% research time during third year of training.
  • 50% dedicated research time during 4th year of training
  • Individually tailored methodology courses, including online courses, dependent on resident’s interests
  • Work in progress sessions with research chief resident or faculty director
  • Opportunity to present at national meetings and attend a three day course co-sponsored by the American Society of Clinical Psychopharmacology

Overview

The Research Track is supported by the Department of Psychiatry and its Division of Research. Residents apply to the track during their intern year. Accepted residents receive protected time during their second, third, and fourth years to develop and implement a program of research. The track includes didactics in research methods and statistics, a supportive environment, mentoring, and access to faculty who provide expertise and guidance in research design, measurement, study coordination, data management, biostatistical analysis, publishing and presenting research, and manuscript and grant writing. Graduates of the research track are positioned to pursue a career as a physician investigator.

Background

The Zucker Hillside Hospital (ZHH), a standalone psychiatric hospital affiliated with the department of psychiatry at the Hofstra North Shore-LIJ School of Medicine, consists of 220 inpatient beds with various specialty units, a partial hospital and day treatment programs, and multiple specialized outpatient clinics with a focus on geriatric patients, substance use disorders, clozapine treated patients, first-episode psychosis patients, bipolar disorder, and OCD, and one of the largest ECT services in the nation.

The hospital is also the primary site for training of Hofstra’s residency and fellowship training programs in psychiatry, which currently consists of 12 residents per year, 20 fellows in child and adolescent psychiatry, 7 fellows in geriatric psychiatry, 4 fellows in consultation/liaison psychiatry (psychosomatic medicine), and 2 fellows in addiction psychiatry.

In addition to its clinical services, the hospital has long been recognized for its pioneering research. Affiliated with the Feinstein Institute for Biomedical Research. Led by Dr. Anil K. Malhotra MD, our research division includes over 100 members that includes principal investigators, fellows, trainees, and support staff. Multiple methodologies are employed including genetics, neuroimaging, neuropsychology, neuromodulatory techniques (e.g. ECT), animal models, clinical trials, and health services/implementation research.

This unique combination of expertise in clinical services and research provides an excellent opportunity for mentoring and nurturing a motivated resident’s growth toward a career as a physician-investigator.

Eligibility

The research track accommodates psychiatry residents who have no or minimal exposure to scientific research in the past as well as those with substantial prior research experience (e.g. PhD).

Limited Prior Experience:
For those with limited experience the track offers the opportunity to develop strong foundational skills that may support future research efforts such as a subsequent research fellowship.

Substantial Prior Experience:
For more experienced candidates, the track offers development toward becoming an independent investigator with extramural funding. Thus, the track allows residents to tailor their experience based upon their experience, interests, and goals with the time and support they need to successfully engage in both their clinical and research training.

The following criteria will be considered when selecting research track residents. Consideration of the resident’s prior experience with research will be taken into consideration and designated as limited vs. substantial.

  1. Track Record: Creativity of the candidate and potential to lead excellent multidisciplinary research judging by track record in some or all of the following: leadership; areas of expertise and prior training; publications and presentations.
  2. Research Plan: Scientific value of, potential clinical importance, and feasibility of the written multidisciplinary research plan.
  3. Training Plan: Quality, appropriateness, and multidisciplinary complementarity of the proposed mentors, and plan for additional didactic and other training.
  4. Resources: Likelihood that the department has the mentor and infrastructure to support the trainees proposed area of focus.
  5. Career Potential: Global assessment of the likelihood that the candidate will develop a career as an outstanding investigator who will lead multidisciplinary teams and have an important impact on health.

Mentorship and Sub-Tracks

Independent of prior experience research interests of a resident are considered. Some examples of potential areas of study that can be pursued include the following:

1. Clinical study/psychopharmacology track
Principal investigator/mentor: Christoph U. Correll, MD, John Kane, MD
This track provides the opportunity to gain experience expertise with designing, conducting and analyzing clinical psychopharmacological studies.

Recent or current examples of projects:

a. Double blind randomized control study of aripiprazole vs risperidone in first episode psychosis
b. Double blind randomized control study of the effect of omega-3 fatty acid augmentation in first episode psychosis
c. Effectiveness of ketamine vs methohexital as anesthetic agent in ECT of major depression

2. Human analytic genetics track
Principle investigator/mentor: Todd Lencz, PhD
For residents who are interested in human genetics, bioinformatics, and its increasing impact on how we understand the biology, diagnosis and treatment of mental illnesses.

Recent or current examples of projects:

a. CYP2D6 polymorphisms and effects on metabolism of risperidone
b. GWAS to explore links between predictors of general intelligence and the predictors of psychotic illness
c. MHC gene variants and relationship to schizophrenia in the Ashkenazi population

3. Neuroimaging track
Principal investigators/mentors: Phil Szeszko, PhD, Katie Karlsgodt, M.D.
This track would facilitate conducting and analyze neuroimaging studies with techniques such as structural MRI, fMRI, DTI/DSI. Many projects in this lab are affiliated with other research areas, such as genetics (imaging genomics), or clinical trials (pharmacologic neuroimaging).

Recent or current examples of projects:

a. The effect of omega-3 fatty acids on the white matter integrity
b. The effect of impulsivity on neuroimaging markers in the early prodrome
c. Antipsychotic medication effects on resting state functional connectivity in healthy controls
d. The effect of ECT and on the human brain: resting state fMRI study
e. The effect of clozapine in schizophrenia: a longitudinal neuroimaging study.
f. Multimodal imaging of executive and reward networks across the psychotic spectrum in adolescents

4. Neuropsychology research track
Principal investigator/mentor: Pam DeRosse, PhD
This theme track will offer training in various aspect of neuropsychological measurement in mental disorders and how they interact with other research domains (imaging, genetics, etc).

Recent or current examples of projects:

a. The training effect in measuring cognitive performance
b. Neuropsychological characterization of the prodromal population
c. Multisite collaboration and analysis of the COGENT database

5. Animal research track
Principal investigator/mentor: Eric Chang, PhD
For the residents who are interested in more basic science research.

Recent or current examples of projects:

a. Mouse models of Alzheimer’s disease
b. Behavior analysis of schizophrenia gene knock in mice models

6. Implementation (Health Services) Research
Principal investigator: John Kane, MD
For residents interested in implementation research that focuses on how to bridge the gap between best practice and actual practice.

Recent or current examples of projects:

a. Recovery After an Initial Schizophrenia Episode (RAISE) -- an NIMH research project on the trajectory and prognosis of schizophrenia treatment in the earliest stages of illness in order to reduce long term disability.
b. Improve Care and Reduce Cost (ICRC) – a large study interested in improvement of disease management via technology (e.g. cell phones, computerized pills) in schizophrenia to reduce overall morbidity and health care cost.
These are examples of tracks and provide a broad overview of research activities in the department. They do not entirely encompass the research endeavors of the department or include all principle investigators.

Training and Schedule

Overall Program Requirements:

  • Application to enter intern year: initial statement of interest that addresses track record, proposal research plan, and proposed training plan
  • Effort and commitment to research and the activities of the track
  • Individually tailored methodology courses dependent on resident’s interests
  • Close collaboration with mentor on research projects within resident’s sub-track.
  • Work in progress sessions with research chief resident or faculty director;
  • Didactics: sessions with faculty and participation in monthly research seminars, and journal clubs/presentations
  • Expert advice and guidance throughout track with designated research mentor
  • Update plan with progress report Spring of second year and Spring of Third Year

Timeline for the research track:

PGY 1 year:
Research track residents are selected and recruited into the track. During the first half of the year, the program director will reach out to residents to inquire who in the class is interested in the research track. Residents wanting to pursue the track submit an application by March 1. Early in the second half of the year, the program director and the director of research (Dr Anil K. Malhotra, MD) interview candidates and decide who will be selected onto the track by April 1. The research chief resident meets with individuals to further explore their interests, strengths and weaknesses and facilitate interactions between residents and faculty members within the research department.

PGY 2 year:
The year has 12 weeks of 100%, dedicated, time for research in three month-long blocks throughout the year. During these blocks there will be two individual weeks in which the research tracks residents will receive lectures by faculty members in the Division of Research in study design, data analysis/statistics and research methodologies in psychiatry. Lectures will include both theoretical and practical sessions and will include an overview of groundbreaking manuscripts which will be discussed.

Throughout the year, the resident will work with their mentors on developing projects, obtaining IRB approval, and if possible, collecting/analyzing data. In addition to this, all research track residents will be offered to attend a three day course co-sponsored by the American Society of Clinical Psychopharmacology. This will be mandatory for residents whose interests are related to the clinical study/psychopharmacology theme. Additionally each research track resident will meet monthly with the research chief resident and/or faculty lead for work in progress sessions. In these sessions, goals of the resident’s project, mentorship, and other challenges will be discussed

PGY 3 year:
The year is individualized based on progress of the project and the theme of the resident’s research. While the third year of residency is spent in various outpatient clinics, the clinical load overall will be reduced to 50% clinical time and 50% research time. To achieve this, the research track will have a reduced clinical load with fewer intake evaluations, will spend half of a year of geriatric outpatient clinic (instead of one whole year), will not attend the child and adolescent clinic, and will attend the substance abuse clinic one half-day (instead of 2) per week (in half of year not in geriatric clinic). The animal research track residents will have blocked-off time from Friday afternoon to Tuesday morning and will have additional assistance with scheduling their outpatients. Mentorship is individualized year-round, with meetings with the research chief resident approximately once/months or as needed. Individual milestones will be determined based on the resident’s experience and research domain. Every half-year, the resident will complete an extra online course related to his interest of research (on Coursera or similar website, determined together with research chief).

PGY 4 year:
Approximately 50% of the resident’s time will be allocated to research-related activities; the other 50% will be dedicated to clinical duties. In addition to ongoing mentorship, the resident will complete educational activities tailored to their needs (e.g. one online course/year) similarly as in PGY3.

All research trackers:

  • Highly encouraged to attend weekly research seminars. This is either journal club discussion or a research presentation by visiting speakers.
  • Attend a monthly research forum meeting. This is an informal meeting in which research track residents convene with at least one research track resident discussing the status of his/her projects or a pertinent article. This provides opportunity to receive feedback from peers and help residents reflect of their own progress.
  • Research track residents are expected to attend national/international meetings and present their work at least one time at such a meeting.

Additional information on methodological training

A critical function of the Research Division is to assist the Biostatistics and Data Management Unit in the training of investigators, particularly young investigators, in statistical methods, study design, and data management. This is accomplished by short seminars, full courses, and journal clubs. 

  • An optional introductory course in SPSS for statistical analysis is provided. Topics covered include: formatting data for input, labels, formats, as well as select SPSS syntax.
  • We have also developed an optional course in research design and statistical methodology for research-track residents, fellows, and other trainees, led by Dr. Lencz.
  • Some of the formal seminars and courses offered to investigators include: (1) Design of Case-Control Studies; (2) Design of Cohort Studies; (3) Design of Clinical Trials (Phase I, II, III, IV) including General Principles, Intention-to-Treat, Interim Analysis and Early Stopping and Sample Size Considerations; (4) Short Course in Biostatistics; (5) Fellows Course in Research Methods; (6) Estimation and Confidence Intervals; (7) Hypothesis Testing; (8) Regression and Correlation; (9) Survival Analysis; (10) Data Transformations; (11) Data Smoothing; and (12) Statistical Interactions in Medical Studies.

Training in psychopharmacological clinical trials

Every year the research department organizes a course on psychopharmacological clinical trials. This course is co-sponsored by the American Society of Clinical Psychopharmacology, Inc., the National Institute of Mental Health and The Zucker Hillside Hospital. It is intended for physicians, PhDs, and other interested researchers in the pharmaceutical industry, clinical research organizations, foundations, governmental agencies or academic settings who are involved in psychopharmacology clinical trials and CNS drug development. The program directors of our general psychiatry and child and adolescent psychiatry residency programs send residents and fellows at least once during their training to participate in this 3-day clinical workshop. The program focuses on the general problems and challenges of designing and implementing clinical trials with an emphasis on methodology. Topics include trial design, diagnosis, clinical assessments, patient ascertainment, and recruitment. It also reviews recent developments in psychotropic drug research and ethical issues in the conduct of clinical trials. The organization of the course includes didactic sessions, discussion and interactive workshops.

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