The Clinician Investigator Program in Anesthesia at the University of Toronto

The Department of Anesthesia at the University of Toronto is the largest Anesthesia program in Canada and likely the most prolific for research and education. The opportunities for discovery and innovation within our Department abound. The Clinician Investigator Program (CIP) provides a unique opportunity to applicants who are interested in pursuing a career as a clinician scientist, combining medical practice and research.

For additional information, please see the website of the Clinician Investigator Program at the University of Toronto and from the Special Program Training Requirements for the Clinician Investigator Program published by the at Royal College of Physicians and Surgeons of Canada

Background

The University of Toronto Clinician Investigator Program (CIP) is an accredited Postgraduate Training Program of the Royal College of Physicians and Surgeons of Canada. It was the first fully accredited program in Canada and it is now the largest, with approximately 100 trainees enrolled. The Department of Anesthesia CIP graduates have contributed immensely to the advancement of our specialty and they now have faculty appointment at the University of Toronto or other large research-oriented universities in Canada.

The goals of the Anesthesia Clinician Investigator Program are:

1. To support research training for anesthesia residents enrolled in a graduate degree program;
2. To provide a postdoctoral research experience for anesthesia residents who already hold a doctoral degree

Duration of the CIP Training

To achieve these goals and receive the Attestation of Completion of the Clinician Investigator Program, a minimum of 2 years of continuous, intensive research training must be undertaken. During the 2 years of research, the majority of time (at least 80%) must be devoted to research, but some time may be spent in clinical activities (i.e the equivalent of 1 day per week).

Up to one of the research years may also be credited to fulfil the Royal College accredited clinical program requirements with joint approval of the faculty CIP director and the program director. Therefore, the CIP will extend anesthesia residency training by only one year, to a total of minimum 6 years. Additional research training in all CIP pathways can be extended to allow completion of a PhD or other research experiences and will further extend training.

CIP Training Streams

The Anesthesia Clinician Investigator Program is offered in two training streams:

1. The Graduate Stream, where applicants enroll in graduate (M.Sc. or Ph.D.) programs at the University of Toronto. CIP trainees can undertake research not only in laboratory and clinical biomedical research, but also in other health care related fields including education, health care economics, social, behavioural and information sciences, etc. Graduate Units at the University of Toronto that have participated in the program include Institute of Medical Science, Institute of Health Policy, Management and Evaluation, Public Health, Education, Laboratory Medicine and Pathobiology, Medical Biophysics, Institute of Biomaterials and Biomedical Engineering and Physiology. For successful completion of this program, CIP trainees in the Graduate Stream must fulfill all the requirements for clinical Anesthesia specialty training, and also all the course and thesis requirements of the graduate degree program they are enrolled in.
2. The Postdoctoral Stream is intended for anesthesia residents who already have a doctoral degree (Ph.D.) and are interested in undertaking a structured research program in a specialized area. Although the research training may be individualized, it but must be similar in content and rigor to a graduate school degree program. For Postdoctoral Stream trainees, completion of the research component means successfully attaining the specified research goals and objectives to the satisfaction of the CIP Committee.

Funding for CIP Training

Successful candidates will have the salary and tuition covered for 2 years of research. There are various sources of funding and once enrolled in the program, residents will be mentored and guided to find the best funding strategy for training.

The CIP trainees are encouraged to apply for external salary awards and grants to support their research training and enrich their portfolio.

CIP Entry Pathways

There are 2 entry pathways into the CIP:

1. Direct application to the CIP stream through CaRMS. This pathway is preferred because it secures a position in the CIP, it allows better planning of the research training and ongoing mentorship from the beginning of the postgraduate training. Please note that applying to the CIP stream will not negatively impact your application to the regular residency stream of our program, should you also apply.  Candidates who apply to the CIP stream will ALSO need to apply to the regular residency stream to be considered if unsuccessful at CIP.
2. Residents who enter through the regular stream in the Anesthesia Training Program at the University of Toronto can still apply to CIP provided that there are available positions unfilled (only 2 CIP residents/year of training are generally available in the Department of Anesthesia). Generally, the application deadlines for residents already in the anesthesia program are May 1 for July 1 enrollment and November 1 for January 1 enrollment. CIP applications and instruction can be found on the UofT CIP website

All residents who are already accepted in the CIP stream have a position secured in the regular training program.

Goals and Objectives of the CIP

The fundamental aim of the Royal College Clinician Investigator Program is to provide trainees with the knowledge, skills and attitudes necessary to embark on a successful career in health research. In most cases, further research training specific to the candidate’s field of interest will be required so that they can succeed as an independent investigator. CIP educational objectives comply with the Royal College of Physician and Surgeons of Canada CanMEDS competency guidelines.

Communicator

• Communicates clearly with research participants, peers and other professionals to establish rapport, trust and ethical relationships.
• Effectively write research proposals, reports, grant proposals and manuscripts
• Effectively present work at lab meetings, research seminars, thesis advisory committee meetings, scientific meetings, and able to defend and discuss the presentation in an articulate and polished manner

Collaborator

• Participate effectively and appropriately in interprofessional research teams
• Form collaborative relationships within the scientific community
• Effectively work with others in research teams to prevent, negotiate and resolve interprofessional conflicts

Health Advocate

• Demonstrate appreciation of social economic and biologic factors that impact health research
• Demonstrate advocacy for subjects, patients, populations, communities, as appropriate, including ensuring that research subjects have access to appropriate supports, information, and services
• Promote research knowledge translation to patients, populations, communities, other stakeholders, as appropriate

Leader

• Effectively and efficiently manage research project and resources (financial and materials)
• Manage experimental data recording and result interpretation appropriately in research endeavors
• Serve in administration and leadership roles, as appropriate to their research career
• Meet appropriate deadlines (funding, submission, REB, draft manuscripts to reviewers)

Scholar

• Establish and maintain knowledge and understanding of general principles and fundamentals of research, including research ethics
• Establish and maintain knowledge and understanding of the specialized topics in the specific area of research
• Elicit, synthesize, and critically evaluate information and apply it appropriately to research
• Demonstrate overall competence in techniques required for the research project (i.e. experimental design, data collection and management, and analysis)
• Demonstrate overall competence in analyzing and interpreting the results of an experiment
• Consult appropriately for feedback on knowledge and performance

Professional

• Demonstrate commitment to profession, society, research participants, patients and collaborators through absolute objectivity, honesty, and adherence to ethical standards in the conduct and reporting of research
• Demonstrate commitment to ethical research practice, including demonstrating ethical conduct in the treatment of human and animal research subjects.
• Demonstrate a commitment to the application of exemplary bioethical standards to clinical practice and research in such areas as consent, confidentiality, conflict of interest, resource allocation, and research ethics.

Medical Research Expert

• Function effectively as a clinician investigator, integrating all of the CanMEDS Roles to function as a clinician and to conduct ethical research
• Seek appropriate consultation from others as required, recognizing the limits of their own clinical research expertise
• Effectively manages activities for career development, including integration of clinical and research activities

Eligibility Requirements

CIP trainees must be enrolled as Anesthesia residents in the Postgraduate Medical Education Program at the University of Toronto. In addition, they must apply and be enrolled full-time in a Graduate Unit for a minimum of two years. Graduate Units that have participated in the program include: Institute of Medical Science, Institute of Health Policy, Management and Evaluation, Public Health, Education, Laboratory Medicine and Pathobiology, Medical Biophysics, Institute of Biomaterials and Biomedical Engineering and Physiology. Other Graduate Units not listed here are also considered, these are examples only. If pursuing a non-thesis degree (i.e. M.Ed) during their CIP training, the candidates must submit a letter from their potential School of Graduate Studies-qualified supervisor attesting that they will be taking full responsibility for the trainee to receive a well-structured research experience. Applicants must contact the CIP office before applying.

CIP trainees who do not hold a graduate degree will enrol in a graduate program leading to a M.Sc. or Ph.D. degree at the University of Toronto and must fulfill admission requirements of the participating graduate unit. Applicants are reviewed by both the Graduate Admissions Committee of the respective graduate unit and the CIP Committee.

Trainees who have already completed a Ph.D. degree are encouraged to apply and, if accepted, will enter the CIP as a postdoctoral fellow. For such individuals, the CIP will provide an opportunity to integrate research and clinical care to add to their previous research experience in an appropriate mentoring environment. These individuals must still fulfil the requirements of the CIP program.

Frequently Asked Questions

Why should I enroll in the CIP?

There are many advantages to being part of the CIP during your anesthesia residency training. Here is a list of just a few advantages of this program:

• Anesthesia Residents will have an opportunity to train as clinician investigators in an accredited and audited Royal College research training program and concomitantly pursue a Master of Science or Applied Science, Master of Education, Doctor of Philosophy degree, or Postdoctoral training
• The Clinician Investigator Program is designed to provide dedicated and funded research time
• CIP trainees have the opportunity to attend practical and informative research and career-focused seminars
• CIP trainees receive bioethics training
• CIP graduates obtain a certificate of completion from the RCPSC, attesting to the completion of the research and clinical components of the program
• CIP graduates are better able to compete for grant funding opportunities because they have proven dedication to a clinician-investigator career by enrolling in CIP.

How long am I expected to engage in full-time research to complete the research component of the CIP?

All CIP trainees are required by the RCPSC standards to complete two years (24 months) of full-time (min. 80%) research. However, we acknowledge that various degrees have different requirements and we are committed to work with the trainee and the CIP Committee to allow maximum flexibility in organizing the research training component.

Does the CIP find a supervisor for me?

No, the CIP does not find a supervisor for its trainees. However, the Anesthesia Department and the CIP Committee will provide mentorship and guidance to find a supervisor. The graduate units usually have a list of faculty members in their department who could be potential supervisors.

I started my graduate studies already, may I still apply to CIP?

Yes, the CIP committee will permit up to six months of retroactive registration in the CIP. However, you must remain in the program for a total of two years in full-time research and fulfill all program requirements in order to receive your CIP certificate.

Will I be allowed to take a leave of absence during the CIP training?

Yes, you are allowed to take a leave of absence or parental leave, the program is very flexible. However, this will extend your training by the number of weeks/months you take off and must be reviewed and approved by the Program Director, your research supervisor and the CIP Committee.

When do I receive my CIP certificate from the RCPSC?

You will only receive your certification as a clinician investigator from the Royal College after you have finished both the clinical and research components of your training. You must pass the Royal College Anesthesia Examinations, received your degree from the School of Graduate Studies, and approval of your CIP requirements by the CIP Committee.