AAOS/OREF/ORS Clinician Scholar Career Development Program inspires and prepares the next generation
For the past 13 years, the AAOS/Orthopaedic Research and Education Foundation (OREF)/Orthopaedic Research Society (ORS) Clinician Scholar Career Development Program (CSCDP) has brought together promising residents, fellows, and early-career attending surgeons for a 2-day workshop that inspires and prepares them to meet the unique challenges facing clinician scholars. The most recent program (Sept. 15–17, 2016) was organized by the AAOS Research Development Committee in close collaboration with the ORS.

Challenges facing the orthopaedic clinician scholar
The CSCDP arose from concerns by AAOS leaders about declines in the numbers of active and new clinician scientists. In early 2000, an AAOS task force recommended making "a bold and concerted effort … to maintain orthopaedic clinician-scientists." In 2003, this sentiment inspired the creation of the CSCDP, then called the Clinician Scientist Development Program, to advise orthopaedic surgeons interested in this path.

The barriers to success for orthopaedic clinician scholars are numerous. As Shari Cui, MD, one of the 2016 CSCDP participants, stated, "Throughout our training, we as surgeons are subject to rigorous trials to build our medical and technical knowledge bases. For those interested in research, however, there is surprisingly little to guide us on where and how to start."

A recent survey of CSCDP alumni found concerns regarding funding, balancing research with clinical work, and finding mentorship. Because the integration of a surgical practice with scholarly work requires special consideration, the CSCDP aims to promote interaction with successful orthopaedic clinician scholars for a better understanding of patterns and tools for success.

The CSCDP experience
As a 2016 CSCDP participant, I found it incredibly useful to learn from honest and practical perspectives about the challenges facing orthopaedic clinician scholars. The event began with faculty mentor Francis Y. Lee, MD, outlining the definition and direction of the clinician scientist/scholar. I was inspired by the candid discussion of his own "trials and errors," including the several years and multiple rejected applications it took to obtain stable funding from the National Institutes of Health (NIH). This was the start of an incredibly enriching series of more than 30 subsequent talks by leading orthopaedic clinician scholars. Some highlights included the discussion by Michael Yaszemski, MD, on collaborating with industry and the session by Kevin Bozic, MD MBA, on developing new research programs. I also appreciated the conversation about burnout led by James R. Ficke, MD, and his tips on how to maintain enthusiasm despite increasing and competing demands on time.

A panel of prior CSCDP participants, all academic faculty members early in their careers, discussed the state of their research and the support by their departments. Common themes included difficulties obtaining departmental protected time for research, negotiating starting contracts, obtaining sustained funding, and maximizing efficiency in collaborative partnerships. Discussion on each of these topics was supplemented by personal examples shared by established clinician-scientists and research collaborators.

After presentations on the challenges faced by clinician scholars, the focus shifted to overcoming them. For instance, Charles Washabaugh, MS, PhD, the new NIH orthopaedic liaison and program director at the National Institute of Arthritis and Musculoskeletal and Skin Diseases, outlined how best to utilize NIH open access databases to apply for NIH grants and to find collaborators.

Mathias P.G. Bostrom, MD, introduced the ORS and its various support mechanisms for investigators. Kristy L. Weber, MD, spoke about academic promotion in orthopaedics, with useful specifics on contract language and promotion protocol.

Yet the informal networking and community building at CSCDP was just as important. Elizabeth Gausden, MD, described her participation as an important experience that "provided the attendees with access to research leaders in orthopaedics." That view was shared by 2016 participant Sravisht Iyer, MD, who said "My conversations at the 2016 CSCDP helped me get a roadmap for my future academic career."

CSCDP impact
CSCDP is the star program of the AAOS Research Development Committee and competition to attend is fierce. Many participants apply two or three times before receiving an invitation. To facilitate open discussions among faculty and participants, attendance has been limited to approximately 30 invitees, with 15 attendees sponsored by the AAOS, and another 10 to 15 attendees sponsored by orthopaedic specialty societies.

Recently, the Research Development Committee conducted an alumni survey of all participants from the years 2003 through 2015 and received 99 responses. Most had attended as senior PGY-4 or PGY-5 residents, or as fellows, or early attending surgeons. Although follow-up times varied from 1 to 12 years, the survey showed promising results for the participants' success.

As shown in Fig. 1, approximately 77 percent percent of respondents were assistant, associate, or full professors. As shown in Fig. 2, available in the online version of this article, nearly 90 percent of respondents received at least one grant, and 34 percent received more than three grants. Additionally, 29.3 percent of CSCDP respondents reported receiving more than $100,000 in grant funding. Unquestionably, this is an impressive track record for early career orthopaedic surgeon scholars.

The AAOS Research Development Committee is committed to continuing CSCDP's record of success. Martha M. Murray, MD, will chair the 2017 CSCDP, and many of the faculty mentors from this year will return. Most importantly, the community of committed orthopaedic surgeon scholars will be invigorated with a new class of CSCDP graduates.

As 2016 CSCDP participant Benedict U. Nwachukwu, MD, MBA, stated, "The intimate mentorship environment with program leaders, as well as the opportunity to network with like-minded peers, provided lasting inspiration toward the goal of becoming an innovative clinician-scholar."

Sariah Khormaee, MD, PhD, is the resident member of the AAOS Research Development Committee and participated in the 2016 Clinician Scholar Career Development Program. For more information on the CSCDP, visit www.aaos.org/cscdp

Orthopaedic Specialty Societies that Sponsored Participants in the 2016 CSCDP

• American Association for Hand Surgery (AAHS)
• Arthroscopy Association of North America (AANA)
• American Orthopaedic Society for Sports Medicine (AOSSM)
• American Shoulder and Elbow Surgeons (ASES)
• American Spinal Injury Association (ASIA)
• Limb Lengthening and Reconstruction Society (LLRS)
• Musculoskeletal Tumor Society (MSTS)
• North American Spine Society (NASS)
• Orthopaedic Trauma Association (OTA)
• Pediatric Orthopaedic Society of North America (POSNA)
• Society of Military Orthopaedic Surgeons (SOMOS)

Additional Information:
Complete lists of the sponsoring organizations, participating faculty, and attendees for the 2016 CSCDP

Reference:
Brand RA, Hannafin JA: The environment of the successful clinician-scientist. Clin Orthop Relat Res 2006;449:67–71.