Sherine Gabriel, M.D., M.Sc.

"There are two objects in medical education: to heal the sick and advance the science."
- Dr. Charles H. Mayo

When "Dr. Charlie" offered this definition of medical education he implied something novel at the time - that healing and science were inextricably intertwined. Today that means translating discoveries made in the laboratory swiftly to the patient in what is called "translational research." The National Institutes of Health chose Mayo Clinic as one of the first 12 institutions to receive Clinical and Translational Science Awards (CTSA) in October 2006.

The Mayo Brothers believed that medical knowledge should be disseminated so all could benefit. Yet even in the 21st century, medical discoveries often languish in that "no-man's-land" between the lab and the patient bedside. The other "disconnect" is often the distance between the academic medical center or the medical literature and the thousands of practices across the country and around the world. The result is that the standard treatment for a given condition may not be standard everywhere. From state to state or even practice to practice, medical care may not reflect the latest validated treatment because that finding has not been effectively "translated." That sad fact is one reason why NIH Director, Dr. Elias Zerhouni advanced the concept of the CTSA, which has also become the acronym for Mayo's Center for Translational Science Activities, which is supported by the nearly $72 million award.

One pillar of Mayo Clinic's CTSA is innovative training for the people who will stand at the juncture of science and healing.

"How do you take knowledge about human biology and translate that knowledge into improved health for the public?" posits Sherine Gabriel, M.D., M.Sc. "That's difficult to do given our discipline-specific training which, historically has not included translational science - the ability of taking insights gleaned from one discipline and understanding their implications in another." Dr. Gabriel - an epidemiologist and rheumatologist - is Director of Education Resources for the Mayo CTSA. Along with her team Dr. Gabriel is creating new kinds of graduate programs that encompass just that issue.

"Most physicians were trained in a very specific discipline," explains Dr. Gabriel. "I was trained as a rheumatologist and an epidemiologist, so that's what I know. Others may have been trained in physiology, biochemistry, or neurology or other clinical or research specializations. Our CTSA education programs aim to ensure that the next generation of physicians and scientists not only have depth in expertise in their primary discipline but can also see the possible connections across and between disciplines. We must develop a new class of investigators, people who understand the entire continuum, the translators." Dr. Gabriel says its also important for these translators to develop expertise in study design, biostatistics and other fundamental methodological sciences. "What we're talking about is preparing clinician investigators to rapidly apply new knowledge to clinical practice," says David Warner, M.D., Associate Director of the CTSA. "We have to create the next generation of innovative medical investigators by providing them with a working knowledge of the many different fields needed to address complex clinical problems."

The new Clinical and Translational Science Ph.D. to be offered through Mayo Graduate School , will be a four-year program (including dissertation) that can be entered directly from an undergraduate degree; as part of an M.D./Ph.D. program; or from a residency or fellowship program. The degree, will provide a broad perspective, but have a very focused research application. It will offer three sub tracks: clinical science, population science and laboratory science. Candidates will be able to understand other relevant sciences that pertain to their focus or to human health in general so they can become innovators, translators, and leaders of multidisciplinary teams. It's an approach and a philosophy that fits well at Mayo, where integration or team science has been emphasized along with the guiding principle of the "needs of the patient come first."

The Ph.D. program is just the latest addition to Mayo's research education program. From continuing education classes and certificates through postdoctoral Master's degrees, Mayo offers mentoring and training for all members of clinical and translational research teams.

Predoctoral programs , under the direction of Anthony Windebank, M.D., provide specialized training in clinical and translational science for students in all areas of basic and clinical science.

• Ph.D. and M.D./Ph.D. in Clinical and Translational Science - as described above, this innovative new program is part of NIH's strong focus on recruiting and training the researchers of tomorrow. Students will choose either an M.D. track or a laboratory science track, and receive training in clinical and translational science that will complement their area of specialty as they move into research careers.
• Clinical Research Training for Medical Students - this program offers courses in the conduct of clinical research that are integrated into the curriculum at Mayo Medical School and the University of Puerto Rico School of Medicine. These students will then have an opportunity to participate in a 2- or 3-month research experience during their medical school curriculum. to gain an understanding of research methodology and how research informs and complements their clinical practice.

Postdoctoral programs , under the direction of Michael Camilleri, M.D., are geared toward mentoring and training the next generation of principal investigators. The postdoctoral offerings were developed with funding from two of NIH's most prominent research education grants: the K30 Clinical Research Curriculum Development award and the K12 Clinical Research Mentored Career Development award. As NIH re-engineers the clinical research enterprise under its Roadmap initiative, these two grant mechanisms have been incorporated into the CTSA program.

• Clinical Research Training Program (CRTP) offers a 24-credit postdoctoral Master's of Science degree and a 12-credit certificate in Clinical Research. Many enrollees are physicians who come to Mayo for their residency in a clinical specialty and elect to earn a clinical research M.S. or Certificate at the same time.
• Mentored Career Development Program offers young clinicians and scientists a Master's Degree in Clinical Research - along with protected time for research and the invaluable benefit of individual mentoring from an experienced career scientist or clinician-investigator in their field. Successful awardees are junior faculty members that have been recruited by their departments to lead the research initiatives of the future.

Clinical Research Coordinator (CRC) and Continuing Education Programs , under the direction of David Warner, M.D., offer a range of training opportunities for allied health staff involved in research.

• CRC Degree and Diploma Programs - offered in conjunction with Rochester Community and Technical College (RCTC), provides a diploma-level or Associate of Arts degree in Clinical Research Coordination. Curriculum is developed jointly by Mayo and RCTC staff, and program graduates find ample employment opportunities in Mayo Clinic laboratories and research centers.
• Continuing Education Programs are offered for research team members at all levels currently, the programs include monthly noontime seminars as well as various workshops on a variety of clinical and administrative topics for study coordinators.