Sustaining Fellowship Funding

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Sustaining Fellowship Funding

• Tina L. Cheng, MD, MPH
• Johns Hopkins University
• Academic Pediatric Association

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DISCLOSURE STATEMENT

• Tina Cheng
• has documented that she has no relevant financial
  relationships to disclose.

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• Fellowships and their Funding
• Funding Challenges
• Advocacy to Ensure Funding

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Strengthening Academic General Pediatric
Fellowships

• Academic Pediatric Association Guidelines

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How Many AGP Fellowships Are There?

• APA Website
• 23 General Pediatrics
• 5 Health Services Research
• 2 Hospitalist, 3 Child Abuse, 1 Environ H
• JPeds annual listing for General Pediatrics
• 2006 17
• 2007 23
• 2008 17

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Pediatrics. 2007 119e46-52

• Does your Division have a fellowship program
  focusing on clinical care, education, or
  research?
• 31 have a fellowship (36)
• Of those, 76 offer a degree
• 15 one yr, 50 two yr, 35
  three yr
• 65 funded by
  federal/foundation
• 32 funded by
  hospital/department
• 13 plan to start a new fellowship within 2 yrs

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Fellowship Funding Sources

• Federal Grants
• Title VII Faculty Development Grants
• Primary Care Clinician Research Fellowship
• Primary Care Master Educator Fellowship
• Community Preceptor Faculty Development
• HRSA and AHRQ NRSA Program Grants
• NIH T-32 Program Grants, Center Grants
• NIH individual NRSAs, K99/R00

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Fellowship Funding Sources

• Division/Department/Institution
• Clinical Contracts
• Other Sources

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Challenges in Fellowship Funding

• Where in the pipeline should the focus be?
• What generalists (educators, researchers,
  practitioners) should be priority?
• What performance measures?

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Fellowship Funding Challenges

• Title VII 747 Faculty Development Grants
• Poor review by Office of Personnel Management
• President zeros out in budget every year
• Big funding cuts, no pediatric awards last year
• Last RFA cut out research fellowships but
  replaced after advocacy efforts
• Up for reauthorization

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Title VII Faculty Development Goals

• Training teachers of
• Primary care physicians in the workforce
• Primary care academic faculty
• Other physicians and health professionals
• Training minority physicians and minority
  academic faculty

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Title VII Faculty Development Goals

• Training researchers leaders to address
• Healthy People 2010 and 2020 objectives
• Racial, ethnic and economic disparities in access
  to health care, health outcomes
• Primary care practice issues, practice models,
  and health outcomes

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Fellowship Funding Challenges

• HRSA and AHRQ NRSA Grants
• NIH pass through to HRSA AHRQ legislative
  language glitch
• NIH Training Funds
• Flat NIH budget

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Opportunities for Advocacy

• Title VII Faculty Development
• Make clear successful performance
  outcomes/Publicize the success of trainees to
  HRSA and to Congress
• APA Policy Brief for HRSA
• HRSA Advisory Committee
• Publications
• Legislative advocacy
• Work on reauthorization

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Opportunities for Advocacy

• Title VII Reauthorization APA-led FOPO letter
  emphasizing
• Enhancing Pediatrics funding
• Training PCPs in the workforce serving
  underserved
• Training all physicians about primary care,
  underserved, emerging health need
• Training minority physicians and faculty

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Opportunities for Advocacy

• Title VII Reauthorization APA-led FOPO letter
  emphasizing
• Training primary care researchers and leaders to
  address HP 2010, disparities, primary care
  practice and health outcomes
• Funding research and innovations in primary care
  training and health care delivery with
  demonstrated impact on health care quality

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Opportunities for Advocacy

• NIH and others
• Need to fund new investigators
• AGP Accreditation Project
• Creative institutional funding