- Email: [email protected]
immunologists
Workshop B: Fostering allergists/immunologists* Diana Marquardt, Comoderators
Moderator,
Daniel Adelman
Several issues concerning the fostering of junior academic allergists/immunologists were raised in an attempt to improve the attractiveness and quality of our specialty as well as to improve the quality and retention of academic allergists/immunologists. The strongest priority identified by the committee was to establish allergy and immunology (AI) as a desirable, viable career. The committee wholeheartedly supports the recent institution of the Education and Research Trust by the American Academy of Allergy and Immunology. We recommend that the AAAI use whatever endowment funds that are available to support excellent basic and clinical scientific investigation. In particular, we support the use of monies to fund clinically relevant AI research grants submitted to the National Institutes of Health (NIH) and/or equivalent Canadian funding agency that are just below the successful funding level to help bridge the times of inadequate funding during early to mid career transitions. We believe that this particular mechanism of funding to support junior faculty may be more important than providing additional start-up research monies for new faculty, considering that there are apparently more resources available to this latter group at the beginning of an academic career. We encourage the faculty member’s institution to provide matching funds to better support the proposed research activities and to allow the AAAI to provide as many grants as possible. We believe that the Shannon Awards recently initiated by the NIH would provide a reasonable model for this funding support. The committee recommended that the AAAI develop a mechanism to encourage communication among fellows planning to enter careers in academic medicine and among junior faculty early in academic medicine career pathways. We suggest that a weekend workshop for these individuals be organized and funded by the AAAI, where speakers from academic medicine, preferably both from clinical and basic research backgrounds and both from relatively recent *Participants, workshop B: John Georgitis, Tom Smith, Todd Mahr, William Solomon, Mark Fletcher, Jay Portnoy, Michelle Liert, Alan S. Josephson, and Elena Reece.
998
of junior
academic
and Burton
Zweiman,
and more extensive academic medicine experience, provide information regarding academic careers. We suggest that the outline used for this workshop could be used to help organize the content of this weekend retreat. In particular, advice regarding job opportunities, what to ask for in recruitment situations, how to approach issues of authorship and credit for independent work, and how to balance clinical and research time should be forthcoming. We realize that the concerns of this diverse group of individuals at different career levels would vary, and we recommend addressing the issues that are most appropriate in smaller group sessions within the weekend workshop format. This weekend workshop should not substitute for the establishment of a mentor relationship with a more senior faculty member. Part of the nurturing of a junior faculty member requires a mentor to help foster career development throughout the first several years of a faculty appointment. Just as a mentor serves as a distinct role model, we would encourage the furtherance of women and minority role models in our specialty and the encouragement of effective communication within these groups in AI. We believe that as part of a generally recognized need to expand the horizons of allergy and immunology that junior faculty need to be encouraged to develop expertise in other areas of clinical immunology, including cytokine therapy and transplantation biology. The diagnostic laboratory immunology and clinical immunology programs should expand their clinical consult profile and be encouraged to provide support for young faculty. Furthermore, we believe that some programs would be well-served by recruiting excellent immunologic scientists not necessarily with classical AI training to improve our ability to educate fellows and to expand our scientific horizons. We would also encourage collaboration between scientists in other disciplines to establish program projects that bridge the basic and clinical sciences and ultimately provide long-standing research support. We support the goal of the American Academy of Allergy and Immunology to establish new AI programs at schools of medicine that presently lack these programs. Therefore we suggest that junior academic
VOLUME 90 NUMBER 6. PART 1
allergists/immunologists who plan to pursue basic scientific research would be well-served to develop a lirm grounding in their research endeavors before embarking on the establishment of a new program. However, those well-trained academic allergists / immunologists who plan to focus their careers on teaching and clinical activities may be more successful in helping to establish new AI programs and not require the same critical mass of colleagues necessary to complete successfully for research grant funds. Finally, the committee believes that it is no longer realistic to expect academic faculty in AI to have the time to devote to running a clinical service, performing basic research of the caliber to compete for NIH ROI grants, and participating in clinical research projects. Therefore we would encourage each training program to nurture their fellows and faculty in the areas where they are most likely to succeed and excel. Faculty members should be aware of the expectations of their departments and divisions when they accept their appointments. If an AI division needs a faculty member to supervise clinical training, outpatient care, and teaching, that faculty member should be encouraged to excel in those areas and not be expected to provide his or her own private research funding. If a junior
Fostering
of junior
academic
allergjsts;imn:urrologists
faculty member is to be expected to obtain competitive independent research funding to complete his or her salary support and maintain a viable basic research program, that expectation should be made clear at the outset, and research time should be strongly protected, with limited clinical and teaching responsibilities. In this way it is hoped that young AI faculty will be able to do what they do well. Recommendations
1. We urge the AAAI to begin providing research support to the extent possible to promising allergists/immunologists who narrowly miss NIH or equivalent Canadian grant funding. 2. We recommend that the AAAI institute a weekend workshop for fellows and junior faculty with career aspirations in academic medicine, similar in theory to the ACAI workshop for fellows planning to enter private practice. 3. We encourage the AAAI to allow the participation of more junior allergists/immunologists on committees , planning groups, and the like, w itb special consideration for greater involvement given to women and minority AI when possible.
Workshop C: The growing importance of clinical immunolagy: Impact on the a training program and the practice of Peyton A. Eggleston, David P. Huston, and William T. Shearer, Moderators; Kurt J. Bloch, William W. Busse, and Robert R. Rich, Discussion Leaders
Principtes
The practice of the specialty of allergy is based primarily on the principles of immunology. Thus the physiologic and therapeutic principles involved in the specialty are relevant primarily in the context of immunologically mediated inflammation. During the last 20 years in the combined specialty of allergy and
*Participants, workshop C: Vincent R. Bonagura, Rebecca H. Buckley, Lynn Des Prez, J. Andrew Grant, James F. Jones, Alan P. Knutsen, Richard F. Lackey, Manuel Lopez, Sam R. Mamey, Jr., Stephen J. McGeady, Dean D. Metcalfe, Andre Nel, James M. Oleske, Stephen H. Polmar, David L. Rosenstreich, Martin I. Sachs, Mandel R. Sher, David J. Valacer, Thurman R. Vaughan, and Richard W. Weber.
immunology (AI), the most rapid expansion of knowledge has occurred within the area of clinical immunology. The training of the allergist/immunologist must therefore change to meet the challenges of this expansion. Historically, training in Al has been guided by the special requirements developed by the Residency Review Committee for Allergy and Immunology (RRC-AI) and certified by the American Board of Allergy and Immunology (ABAI), a Conjoint Board of the American Board of Internal Medicine (ABIM) and the American Board of Pediatrics (ABP). We believe that the guidance and certification of expanded training in clinical and laboratory immunology should remain with these established agencies. The change in our understanding of the patho999
Moderator,
Daniel Adelman
Several issues concerning the fostering of junior academic allergists/immunologists were raised in an attempt to improve the attractiveness and quality of our specialty as well as to improve the quality and retention of academic allergists/immunologists. The strongest priority identified by the committee was to establish allergy and immunology (AI) as a desirable, viable career. The committee wholeheartedly supports the recent institution of the Education and Research Trust by the American Academy of Allergy and Immunology. We recommend that the AAAI use whatever endowment funds that are available to support excellent basic and clinical scientific investigation. In particular, we support the use of monies to fund clinically relevant AI research grants submitted to the National Institutes of Health (NIH) and/or equivalent Canadian funding agency that are just below the successful funding level to help bridge the times of inadequate funding during early to mid career transitions. We believe that this particular mechanism of funding to support junior faculty may be more important than providing additional start-up research monies for new faculty, considering that there are apparently more resources available to this latter group at the beginning of an academic career. We encourage the faculty member’s institution to provide matching funds to better support the proposed research activities and to allow the AAAI to provide as many grants as possible. We believe that the Shannon Awards recently initiated by the NIH would provide a reasonable model for this funding support. The committee recommended that the AAAI develop a mechanism to encourage communication among fellows planning to enter careers in academic medicine and among junior faculty early in academic medicine career pathways. We suggest that a weekend workshop for these individuals be organized and funded by the AAAI, where speakers from academic medicine, preferably both from clinical and basic research backgrounds and both from relatively recent *Participants, workshop B: John Georgitis, Tom Smith, Todd Mahr, William Solomon, Mark Fletcher, Jay Portnoy, Michelle Liert, Alan S. Josephson, and Elena Reece.
998
of junior
academic
and Burton
Zweiman,
and more extensive academic medicine experience, provide information regarding academic careers. We suggest that the outline used for this workshop could be used to help organize the content of this weekend retreat. In particular, advice regarding job opportunities, what to ask for in recruitment situations, how to approach issues of authorship and credit for independent work, and how to balance clinical and research time should be forthcoming. We realize that the concerns of this diverse group of individuals at different career levels would vary, and we recommend addressing the issues that are most appropriate in smaller group sessions within the weekend workshop format. This weekend workshop should not substitute for the establishment of a mentor relationship with a more senior faculty member. Part of the nurturing of a junior faculty member requires a mentor to help foster career development throughout the first several years of a faculty appointment. Just as a mentor serves as a distinct role model, we would encourage the furtherance of women and minority role models in our specialty and the encouragement of effective communication within these groups in AI. We believe that as part of a generally recognized need to expand the horizons of allergy and immunology that junior faculty need to be encouraged to develop expertise in other areas of clinical immunology, including cytokine therapy and transplantation biology. The diagnostic laboratory immunology and clinical immunology programs should expand their clinical consult profile and be encouraged to provide support for young faculty. Furthermore, we believe that some programs would be well-served by recruiting excellent immunologic scientists not necessarily with classical AI training to improve our ability to educate fellows and to expand our scientific horizons. We would also encourage collaboration between scientists in other disciplines to establish program projects that bridge the basic and clinical sciences and ultimately provide long-standing research support. We support the goal of the American Academy of Allergy and Immunology to establish new AI programs at schools of medicine that presently lack these programs. Therefore we suggest that junior academic
VOLUME 90 NUMBER 6. PART 1
allergists/immunologists who plan to pursue basic scientific research would be well-served to develop a lirm grounding in their research endeavors before embarking on the establishment of a new program. However, those well-trained academic allergists / immunologists who plan to focus their careers on teaching and clinical activities may be more successful in helping to establish new AI programs and not require the same critical mass of colleagues necessary to complete successfully for research grant funds. Finally, the committee believes that it is no longer realistic to expect academic faculty in AI to have the time to devote to running a clinical service, performing basic research of the caliber to compete for NIH ROI grants, and participating in clinical research projects. Therefore we would encourage each training program to nurture their fellows and faculty in the areas where they are most likely to succeed and excel. Faculty members should be aware of the expectations of their departments and divisions when they accept their appointments. If an AI division needs a faculty member to supervise clinical training, outpatient care, and teaching, that faculty member should be encouraged to excel in those areas and not be expected to provide his or her own private research funding. If a junior
Fostering
of junior
academic
allergjsts;imn:urrologists
faculty member is to be expected to obtain competitive independent research funding to complete his or her salary support and maintain a viable basic research program, that expectation should be made clear at the outset, and research time should be strongly protected, with limited clinical and teaching responsibilities. In this way it is hoped that young AI faculty will be able to do what they do well. Recommendations
1. We urge the AAAI to begin providing research support to the extent possible to promising allergists/immunologists who narrowly miss NIH or equivalent Canadian grant funding. 2. We recommend that the AAAI institute a weekend workshop for fellows and junior faculty with career aspirations in academic medicine, similar in theory to the ACAI workshop for fellows planning to enter private practice. 3. We encourage the AAAI to allow the participation of more junior allergists/immunologists on committees , planning groups, and the like, w itb special consideration for greater involvement given to women and minority AI when possible.
Workshop C: The growing importance of clinical immunolagy: Impact on the a training program and the practice of Peyton A. Eggleston, David P. Huston, and William T. Shearer, Moderators; Kurt J. Bloch, William W. Busse, and Robert R. Rich, Discussion Leaders
Principtes
The practice of the specialty of allergy is based primarily on the principles of immunology. Thus the physiologic and therapeutic principles involved in the specialty are relevant primarily in the context of immunologically mediated inflammation. During the last 20 years in the combined specialty of allergy and
*Participants, workshop C: Vincent R. Bonagura, Rebecca H. Buckley, Lynn Des Prez, J. Andrew Grant, James F. Jones, Alan P. Knutsen, Richard F. Lackey, Manuel Lopez, Sam R. Mamey, Jr., Stephen J. McGeady, Dean D. Metcalfe, Andre Nel, James M. Oleske, Stephen H. Polmar, David L. Rosenstreich, Martin I. Sachs, Mandel R. Sher, David J. Valacer, Thurman R. Vaughan, and Richard W. Weber.
immunology (AI), the most rapid expansion of knowledge has occurred within the area of clinical immunology. The training of the allergist/immunologist must therefore change to meet the challenges of this expansion. Historically, training in Al has been guided by the special requirements developed by the Residency Review Committee for Allergy and Immunology (RRC-AI) and certified by the American Board of Allergy and Immunology (ABAI), a Conjoint Board of the American Board of Internal Medicine (ABIM) and the American Board of Pediatrics (ABP). We believe that the guidance and certification of expanded training in clinical and laboratory immunology should remain with these established agencies. The change in our understanding of the patho999