Data on the 40 graduates of the Clinical Scholars (KL2) program from 2006 to 2016 are provided in Table 2, online Supplementary Table S2, and Fig. 1.
There was nearly equal sex distribution with 21 female and 19 male graduates. In total, 26 Clinical Scholars had M.D. degrees on entering the program, whereas 12 held M.D./Ph.D. degrees, and 2 held Ph.D. degrees. Seven of the 40 scholars (18%) were from underrepresented minority groups. Out of the 40 graduates, 22 (55%) were US citizens and 3 (8%) were US permanent residents; the remaining 15 (38%) came to the United States from 9 different countries, with more than one coming from Israel (4), Germany (2), France (2), and the Philippines (2). Five of the 40 scholars (13%) used their first year of participation in the program in partial fulfillment of the close-up research requirement for their US clinical residency or fellowship. The areas of focus of the scholars are shown in the online Supplementary Table S2. There was a wide distribution of disciplines; the areas most heavily represented were infectious diseases (6), dermatology (4), rheumatology (4), endocrinology (3), and gastroenterology (3).
The positions Clinical Scholars held at the time of graduation from the program and at the time of writing are shown in Figs. 1a and b. Out of 40, 18 (45%) of the scholars remained at Rockefeller immediately after graduating, whereas 9/40 (23%) took faculty positions in the United States or Canada (6) or in their native country (3). Out of 40, 3 (8%) US citizen graduates returned to, or started US ACGME-approved training programs, 1/40 (3%) US graduates entered a postdoctoral fellowship at a US academic institution to obtain additional training, and 2/40 (5%) non-US graduates decided to repeat their clinical training in an ACGME-approved US clinical training program so that they could obtain US licensure. In the latter case, all of the trainees planned translational careers, including basic mechanistic studies. Out of 40, 4 (10%) graduates entered industry, 2/40 (5%) entered government service, joining the US Agency for International Development and the San Francisco Department of Health, and 1 went into the private practice of gastroenterology.
The positions of the Clinical Scholars at the time of writing (Fig. 1b
) shows a shift to a higher percentage (42%) of trainees in faculty positions in US and Canadian academic medical centers, including the ones at Harvard Medical School, Icahn School of Medicine at Mount Sinai, Memorial Sloan Kettering Cancer Center, New York University School of Medicine, Northwestern University, Stanford School of Medicine, the University of Pennsylvania, the University of Pittsburgh, and Weill Cornell Medical College (online Supplementary Table S3). Out of 40, 2 (5%) additional scholars chose research positions in industry, yielding 6/40 (15%). Those industry translational research positions are at Bristol-Myers Squibb, Genentech, Amgen, Celgene, CLINiLABS, and Neurogenetics. Their titles include Clinical Research Director; Medical Director; Director, Exploratory Translational Research; Executive Director of Clinical Research and Development; Associate Medical Director; and Director of Medical Sciences.
The 4/40 (10%) of scholars who returned to their native country after participating in the Clinical Scholars program have all competed successfully for academic positions and are continuing to participate in clinical and translational science. They hold positions at Hadassah Hospital, Hebrew University, Israel; University of Cologne, Germany; Beilinson Hospital, Rabin Medical Center, Israel; and Institute of Molecular Biology and Biotechnology, University of the Philippines National Institutes of Health. Their titles include Head, Department of Medicine; Associate Professor of Medicine; and Associate Professor of Experimental Immunology.
Overall, scholars showed good progress in their records of publication, but with considerable variability in the cumulative number of publications as of 2016 (median 14; Fig. 1c
). In general, the 15/40 (38%) scholars who came to the United States after attending medical school and obtaining some clinical training abroad had stronger publication records before entering the program and they maintained their publication productivity after graduation (median 26 vs. 12, p<0.002; Wilcoxin). As expected, the 11/40 (28%) scholars who entered the program with M.D./Ph.D. degrees had stronger publication records on entry than those with single M.D. or Ph.D. degrees and so their cumulative number of publications trended higher (median 19 vs. 12; p=0.10). There are, however, limitations to the publication record as an index of contributions to translational science. For example, the 6/40 (15%) graduates who joined industry after graduating trended to having fewer publications (median 11 vs. 15; p=0.42), but they lead the development of exciting new medications.
Graduates have been lead authors on major publications in the most prestigious journals and are leading paradigm changing research programs (see Clinical Scholar Graduates Publications and Scientific Programs in online Supplementary Materials).
Six scholars admitted to the program between 2006 and 2016 did not graduate from the program. The reasons for leaving the program varied widely. One Scholar received an outstanding offer to lead a program in genomic and molecular pathology and has continued on in a translational research career. A second Scholar returned to an academic position because of the untimely death of his Rockefeller mentor and has continued on in a successful academic career. A third Scholar with an entrepreneurial orientation received an attractive offer from industry and has continued in a translational research career in industry. A fourth Scholar, who came from another country and had a distinguished prior research record, decided that it was vital to his career goals as a physician scientist to obtain a US license to practice medicine and so he entered an internal medicine program at a major US academic medical center. One Scholar became a clinical gastroenterologist and is now on the teaching faculty of a medical school. The last Scholar decided that he did not want to pursue a research career and so he entered the private practice of dermatology.
Table 3 summarizes the success of the graduates who are in academic positions in the United States in obtaining NIH peer-reviewed funding, including the type of award and the distribution by Scholar degree and sex. To date, they have obtained 23 grants and awards for a total of $23 million. These include 6 different K series grants, with K08 (6) and K23 (4) most common. Graduates have also obtained 8 R and U series awards. Given the national concerns about the competitiveness of women in science [7, 8], we are gratified that the female graduates of the program have been awarded 9 of the 14 K awards, all 4 of the R awards, and 2 of the U awards. Similarly, given the concern about the competitiveness of M.D. investigators , we are gratified that M.D.s represented 11 of the 14 K awards, 2 of the R awards, and 2 of the U awards.
Table 3 NIH grant support for Clinical Scholar graduates 2006–2016
Scholars in the United States have also been successful in obtaining more than $20.3 million peer-reviewed grant and career development award funding from major US foundations, professional societies, and related organization. These include the Gates Foundation, the Chan Zuckerberg Initiative, the American Association for Cancer Research, the Crohn’s and Colitis Foundation of America, the Patient Centered Outcomes Research Institute (PCORI), the National Organization of Rare Diseases, the Doris Duke Foundation, the Dana Foundation, and the Simons Foundation for Autism Research. Thus, the total peer-reviewed funding for the 25/40 Scholar graduates in academic positions in the United States is $40.8 million.
The 4 scholars who returned to their native countries have also been successful in competing for government and foundation awards, including the ones from the European Union and organizations in France, Germany, and Israel totaling more than $6 million.