Clinician Investigator Program

The Clinician Investigator Program in Anesthesia at the University of Toronto

The Department of Anesthesiology and Pain Medicine at the University of Toronto is the largest Anesthesia program in Canada and 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 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 130 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 through a graduate degree program or
  2. To provide a post-higher degree research experience for anesthesia residents who already hold a higher degree by research.

 

Review of the CIP Program

After a full internal review of the CIP program in 2020 we have relaunched the CIP program in Anesthesiology and Pain Medicine. Key changes include:

  1. A full road map of the program and identification of key nodes in road map where CIP need additional support
     
  2. Better orientation into the program in first year
CIP Road Map

 

              3. A full development of a supervision and mentorship plan within the program

 

CIP Supervision and Mentorship webimage

The CIP trainee will meet with the Vice Chair (Research) twice in the first year in the program and at least annually after that to assure they meet their goals and milestones, find high quality research supervision, and are generally successful on the program.

 

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 and one weekend of on-call per month).

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 a minimum of 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. This provision will be dependent on approval from the University department, the CIP trainee’s supervisor and also be dependent on financial support from beyond the University department.

 

What are our CIP program graduates doing now ?

 

Objectives of Training

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.

Objectives of Training for CIP

 

Definition

A Clinician Investigator can be broadly defined as a specialist physician who devotes substantial professional effort to health-related research.

 

Goals

Upon completion of training, a resident is expected to be a competent clinician investigator in their discipline.

The major goal of the Clinician Investigator Program (CIP) is to assist in the career development of clinician investigators in Canada. The program provides a formal postgraduate medical education pathway that fulfils the existing discipline requirements of the Royal College and provides integrated, structured, and rigorous research training. The training requires a minimum of two years of research intensive training that involves enrolment in a graduate degree program (graduate stream), to complete a thesis or equivalent, or in a postdoctoral fellowship program if the trainee already has a graduate degree (postdoctoral stream).

For the purposes of this program, health research includes not only the traditional areas of biomedical, clinical, population health, and health services research but also research into medical education, bioethics, economics, management, social, behavioural and information sciences as they apply to human health and disease.

The practical value of the Royal College CIP includes: structured research training with integration of clinical and research training plans; enhanced academic programming in preparation for a career as a Clinician Investigator, complemented by enhanced mentorship and networking opportunities; and exposure to a culture in which research and clinical care are both highly valued.

Only candidates certified or eligible for certification by the Royal College of Physicians and Surgeons of Canada in their primary discipline may be eligible for attestation in the Clinical Investigator Program.

At the end of the research component of the program, the resident will be expected to have acquired the knowledge, skills, and attitudes fundamental to embarking on a career in health research. After completion of the CIP, further research training specific to the resident’s field of interest is often required for success as an independent investigator.

 

Competencies

Individual objectives of training will be developed for each resident relevant to each of the following overall competencies. At the completion of training, the resident will have acquired the following competencies and will function effectively as a:

Medical Expert

Clinician Investigators are able to

  1. Function effectively as a clinician investigator, integrating all of the CanMEDS Roles to function as a clinician and to conduct ethical research
  2. Identify and appropriately respond to relevant ethical issues arising in research
  3. Demonstrate the ability to prioritize professional duties effectively when faced with multiple patient and research problems
  4. Seek appropriate consultation from others as required, recognizing the limits of their own clinical research expertise
     

Communicator

Clinician Investigators are able to…

  1. Develop rapport, trust and ethical relationships with research participants, peers and other professionals
  2. Convey relevant information and explanations accurately to research subjects, peers and other professionals, including but not limited to scientific presentations, grant proposals, publications and other communications
  3. Maintain clear, concise, accurate, and appropriate records of research
     

Collaborator

Clinician Investigators are able to…

  1. Participate effectively and appropriately in interprofessional research teams
  2. Work effectively with others in research teams to prevent, negotiate and resolve interprofessional conflicts
     

Manager

Clinician Investigators are able to…

  1. Manage activities for research skill and career development effectively
  2. Manage research project and resources appropriately, effectively and efficiently
  3. Manage experimental data recording and result interpretation appropriately in research endeavours
  4. Serve in administration and leadership roles, as appropriate to their research career
     

Health Advocate

Clinician Investigators are able to…

  1. Participate in activities that demonstrate an ability to advocate for research programs, patients, communities and populations, as appropriate to improve the health of populations and the research enterprise
     

Scholar

Clinician Investigators are able to

  1. Establish and maintain knowledge, skills and attitudes appropriate to their research practices, with a thorough understanding and appreciation of the components of proper scientific inquiry
  2. Elicit and accurately synthesize relevant research information and perspectives from relevant sources
  3. Evaluate information and its sources critically and apply this appropriately to research practices and decisions
  4. Demonstrate proficient and appropriate use of research skills. Perform complete and appropriate assessments of research questions and problems, using effective experimental methodologies, study designs and analysis to address questions
  5. Consult appropriately for feedback on knowledge and performance
  6. Maintain and enhance professional activities through ongoing learning
  7. Facilitate the learning of others about research, including patients, families, students, residents, other health and research professionals, the public and others, as appropriate
  8. Contribute to the creation, dissemination, application and translation of new knowledge and practices
     

Professional

Clinician Investigators are able to…

  1. Demonstrate a commitment to the profession, society, subjects and patients through ethical and honest research practices
  2. Demonstrate commitment, honesty, integrity and compassion in research activities, including participation in profession-led regulation, peer-review activities, and the prevention of academic misconduct
  3. Participate in ethical research, with appreciation for the importance of research to the social, economic and biologic factors that impact health
  4. Demonstrate a commitment to clinician researcher health and sustainable practice

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 & Entry Pathways

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 Anesthesiology and Pain Medicine). 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 but these days could be flexible in discussion with the program director. 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.