Clinician Investigator Program Research Articles

Nicolas Garel: Combining psychoactive molecules and psychotherapy for patients suffering from mood and substance use disorders: a new therapeutic paradigm

Dr Nicolas Garel is an Assistant Professor in the Department of Psychiatry and Addictology at the University of Montreal and a junior investigator at the Research Center of the Centre Hospitalier de l'Université de Montréal. Dr Garel did his psychiatry residency at McGill University before completing the Clinician-Investigator Program and a Master's degree at McGill University, studying the potential role of ketamine in the discontinuation of benzodiazepines and related drugs. Dr Garel then completed a clinical fellowship in Addiction Medicine at Stanford University. His research program focuses on the integration of psychoactive molecules in conjunction with psychotherapy as a unique potential treatment approach for patients with comorbid mood and alcohol/sedative use disorders. In this “Innovators & Ideas” section, we are excited to feature Dr Garel in our latest Genomic Press Interview. We are thrilled he took the time to answer our questions and share his valuable insights with our readers.

Scholarly Curriculum at a Psychiatry Residency Program in Canada: 10-Year Outcomes.

For research in medicine to address needed interventions and produce outcomes relevant to patient care, it is important for physicians to gain hands-on experience in scientific methods during their training. However, the results of recent studies in the United States and Canada indicate low interest in research among residents. In 2011, involvement in a scholarly activity was made mandatory for all residents joining the Western University psychiatry residency program (WUPRP). A faculty member was appointed as a research coordinator who collaborated with research-intensive faculty members and prepared a list of potential projects suitable for resident involvement; organized monthly research meetings to support residents in initiating scholarly activities, monitor their progress, and address challenges; and developed competency-based research objectives, guidelines, and assessment tool. Data on all residents enrolled at WUPRP from 2011 to 2017 (the latter graduated in 2022 with completed scholarly requirements) were analyzed with respect to residents' participation in a scholarly project. A total of 54 residents were enrolled during this period. Fifty-two (96%) residents were involved in a scholarly project; of these 52, 38 (73%) completed their project. Of these 38, 32 (84%) had academic achievements, which include poster and oral presentations at a conference, publications, and prizes and awards. Of the 52 residents involved in a scholarly project, 14 (27%) residents could not complete their projects, though they still met scholarly activity requirements and 1 (2%) enrolled in the Western University Clinician Investigator Program with the goal of pursuing research as a career. There is a lack of data on how many WUPRP graduates from 2011 to 2017 are currently pursuing careers in research. The authors plan to perform longer and closer follow-up of residents to evaluate whether a scholarly curriculum makes an impact on residents' career choices.

Evaluating the Outcomes and Trainee Performance of a Canadian Medical Imaging Clinician Investigator Program.

Purpose: To measure the research productivity of trainees from the University of Toronto's Medical Imaging Clinician Investigator Program (MI-CIP) and comparing it with the research productivity of trainees from MI-non-CIP and General Surgery (GSx) Clinician Investigator Program. Methods: We identified residents who completed an MI-CIP, MI-non-CIP and GSx-CIP from 2006-2016. In each group of trainees, we assessed 3 research productivity outcomes with non-parametric tests before residency and at 7years post-CIP completion/post-graduation. Research productivity outcomes include the number of total publications, the number of first-author publications, and the publication's average journal impact factor (IF). Results: We identified 11 MI-CIP trainees (male/female: 9 [82%]/2 [18%]), 74 MI-non-CIP trainees (46 [62%]/28 [38%]) and 41 GSx-CIP trainees (23 [56%]/18 [44%]). MI-CIP trainees had statistically significant higher research productivity than MI-non-CIP in all measured outcomes. The median (interquartile range, IQR) number of total publications of MI-CIP vs MI-non-CIP trainees was 5.0 (8.0) vs 1.0 (2.0) before residency and 6.0 (10.0) vs .0 (2.0) at 7years post-CIP completion/post-graduation. The median (IQR) first-author publications of MI-CIP vs MI-non-CIP trainees was 2.0 (3.0) vs .0 (1.0) before residency and 2.0 (4.0) vs (.0) (1.0) at 7years post-CIP completion/post-graduation. The median (IQR) average journal IF of MI-CIP vs MI-non-CIP trainees was 3.2 (2.0) vs .3 (2.4) before residency and 3.9 (3.2) vs .0 (2.6) at 7years post-CIP completion/post-graduation. Between MI-CIP and GSx-CIP trainees, there were no significant differences in research productivity in all measured outcomes. Conclusion: MI-CIP trainees actively conducted research after graduation. These trainees demonstrated early research engagement before residency. The similar research productivity of MI-CIP vs GSx-CIP trainees shows initial success of MI-CIP trainees.

University of Montreal’s Clinician-Investigator Program: A 10-Year Descriptive Evaluation

Clinician-investigators have an important role in the development and implantation of new therapies and treatment modalities; however, there have been several reports highlighting a pending shortage in the clinician-investigators' workforce. In Canada, the Royal College has promoted the development of clinician-investigators programs (CIP) to facilitate the training of these individuals. There is currently a paucity of data regarding the outcomes of such programs. This study aims to identify the strengths and areas of improvement of the Montreal University CIP. Methods: An internet-based 51-question survey was distributed to all the alumni from the University of Montreal CIP. Participation was voluntary and no incentives were provided. The response rate was 64%. Results: Among respondents, 50% (n=16) had completed their clinical residency and all CIP requirements. The majority of these individuals (63%) had become independent investigators and had secured provincial and national funding. Satisfaction of the respondents was high regarding the overall program (85%), the research skills developed during the CIP (84%) and the financial support obtained during the program (72%). The satisfaction rate regarding career planning was lower (63%). Conclusion: This survey demonstrates that, while indicators are favorable, some areas still require improvement. Several steps to improve the CIP have been identified; notably, the transition from the CIP to early independent career has been identified as critical in the development of clinician-investigators and steps have been taken to improve this progression.

A111 A RECTUM-SPECIFIC SELECTIVE RESECTION ALGORITHM OPTIMIZES ONCOLOGIC OUTCOMES FOR LARGE NON-PEDUNCULATED RECTAL POLYPS

BackgroundEndoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are complementary techniques for large (≥ 20mm) non-pedunculated rectal polyps (LNPRPs). A mechanism for appropriate technique selection has not been described.AimsTo evaluate whether a selective resection algorithm using EMR and ESD, based on real-time optical evaluation, optimizes oncologic outcomes for LNPRPsMethodsWe evaluated the performance of a selective resection algorithm (SRA; 08/2017-04/2021) compared to a universal EMR algorithm (UEA; 07/2008-07/2017) for LNPRPs within a prospective observational study. In the SRA, LNPRPs with features of superficial submucosal invasive cancer (SMIC < 1000μm; S-SMIC; Kudo pit pattern Vi), or with an increased risk of SMIC (Paris 0-Is or 0-IIa+Is non-granular, 0-IIa+Is granular with a dominant nodule ≥ 10mm) underwent ESD. The remaining LNPRPs underwent EMR. Algorithm performance was evaluated by SMIC identified after EMR, curative oncologic resection (R0 resection, S-SMIC, absence of negative histologic features), technical success, adverse events, and recurrence at first surveillance colonoscopy.Results480 LNPRPs were evaluated (290 UEA, 190 SRA). Median lesion size was 40mm (IQR 30-60mm). In the SRA, 103 (54.2%) and 87 (45.8%) LNPRPs underwent EMR and ESD, respectively. SMIC was identified in 56 (11.7%) LNPRPs. Significant differences in SMIC after EMR (SRA 1 (1.0%) vs. UEA 35 (12.1%); p = 0.001), curative oncologic resection (SRA 7 (33.3%) vs. UEA 2 (5.7%); p = 0.010), and recurrence (SRA 2 (1.6%) vs. UEA 40 (17.2%); p < 0.001) were identified. No significant differences in technical success or adverse events were identified (all p > 0.137). Among potentially curable malignant LNPRPs which underwent ESD, 100% (7/7) were cured.ConclusionsA SRA optimizes oncologic outcomes for LNPRPs and mitigates the risk of piecemeal resection of cancers.Oncologic Outcomes for Malignant LNPRPsOverall LNPRPs (N = 56, %)UEA LNPRPs (N = 35, %)SRA LNPRPs (N = 21, %)P-valueSMIC after EMR*36 (9.2)35 (12.1)1 (1.0)0.001En Bloc Resection23 (41.1)4 (11.4)19 (90.5)<0.001R0 Resection20 (35.7)2 (5.7)18 (85.7)<0.001Curative Resection9 (16.1)2 (5.7)7 (33.3)0.010EMR, endoscopic mucosal resection; LNPRP, large non-pedunculated rectal polyp; SMIC, submucosal invasive cancer; SRA, selective resection algorithm; UEA, universal endoscopic mucosal resection algorithm *Denominator: Large non-pedunculated rectal polyps which underwent endoscopic mucosal resectionFunding AgenciesThe Cancer Institute of New South Wales provided funding for a research nurse and data manager to assist with the administration of the study. Neal Shahidi was supported by the University of British Columbia Clinician Investigator Program. There was no influence from either institution regarding study design or conduct, data collection, management, analysis, interpretation, preparation, review, or approval of the manuscript.

P.167: Gene Expression and Function in Pig Islets From One-day-old Pigs

Introduction: Islet transplantation is a budding alternative treatment for type 1 diabetics. A potential solution to the limited number of human pancreas donors is pig islet xenotransplantation. Limited study has been performed on pig islet cell signaling pathways, which may differ from the mechanisms seen in humans. We have identified molecules involved in the insulin secretion pathway, including the glucose transporter GLUT2, GTPase RAC1, which is involved in F-actin remodeling in islet cells, and SNAP25, a protein involved in insulin release. We evaluated these molecules across different days of culture in neonatal pig islets. We also quantified the gene expression of common cadherins associated with cell-cell adhesion and islet function as determined by insulin secretion. Method: Islets from 1-day-old pigs (n=3) were isolated and samples collected on days 0, 3, 5 and 7 of culture to quantify GLUT2, SNAP25, RAC1, E-, N- and VE-cadherin gene expression by qRT-PCR. Immunofluorescence staining was performed to localize protein expression. Static glucose stimulation insulin secretion assays (GSIS) and ELISA were used to quantify the ability of these islets to secrete insulin under conditions containing low glucose, high glucose and high glucose with KCl. Kruskal-Wallis testing was completed with GraphPad Prism software. Results: Qualitatively, the islets developed visible membranes and had fewer contaminating exocrine cells as they moved from 0 to 7 days in culture. E-cadherin, SNAP25 and GLUT2 all peaked on day 5 of culture, correlating with when islets formed a distinct spherical structure in-vitro. N-cadherin consistently rose, peaking at day 7 of culture. VE-cadherin was highest at day 0 and decreased with a linear trend. RAC1 gene expression decreased from day 0, remaining stable between days 5 and 7. P-values are indicated in Figure 1. Preliminary immunofluorescence staining showed co-localization of SNAP25 and insulin at all-time points. The amount of insulin secreted in low vs high glucose settings was similar without KCl, and as expected, the amount of insulin secreted when islets were cultured in high glucose with KCl was greater. Kruskal-Wallis testing demonstrated significant differences amongst GSIS groups (Figure 2). Discussion/Conclusion: Our data demonstrates variation in the gene expression of our molecules of interest across 7 days of culture. Our immunofluorescence results demonstrate that SNAP25 colocalized with insulin, suggesting their proximity in islet cells. Our results also demonstrate the limited ability of glucose to stimulate islets from 1-day-old pigs at 7 days of culture. This is different than results seen previously in our lab suggesting islets from 7-day-old pigs at 7 days of culture secrete greater amounts of insulin when exposed to high glucose conditions. These findings may be important for the development of pig islets in vitro and warrant further investigation.Royal College of Physicians and Surgeons of Canada (RCPSC) - Clinician Investigator Program. Natural Sciences and Engineering Research Council of Canada (NSERC) Discovery Grant. Canadian Institutes of Health Research (CIHR) - Canadian Graduate Scholarships - Master’s Program. Walter H. John’s Graduate Fellowship (University of Alberta). Alberta Graduate Excellence Scholarship (AGES).

International training considerations of Canadian Clinician-Scientist Trainees - A national survey.

Canadian clinician-scientist trainees enrolled in dual degree programs often pursue an extended training route following completion of MD and MSc or PhD degrees. However, the proportion, plans and reasoning of trainees who intend to pursue training internationally following dual degree completion has not been investigated. In this study, we assessed the international training considerations of current clinician-scientist trainees. We designed an 11-question survey, which was sent out by program directors to all current MDPhD program and Clinician Investigator Program (CIP) trainees. Responses were collected from July 8, 2019 to August 8, 2019. We received a total of 191 responses, with representation from every Canadian medical school and both MD-PhD program and CIP trainees. The majority of trainees are considering completing additional training outside Canada, most commonly post-doctoral and/or clinical fellowships. The most common reasons for considering international training include those related to quality and prestige of training programs. In contrast, the most common reasons for considering staying in Canada for additional training are related to personal and ethical reasons. Irrespective of intentions to pursue international training, the majority of trainees ultimately intend to establish a career in Canada. While most trainees are considering additional training outside of Canada due to prestige and quality of training, the majority of trainees intend to pursue a career as a clinician-scientist back in Canada. Trainees would likely benefit from improved guidance and mentorship on the value of international training, as well as enhanced support in facilitating cross-border mobility.

Queen's University Faculty of Health Sciences.

Queen's University Faculty of Health Sciences.

Newsletter Fall 2019: Clinician Investigator Trainee Association of Canada (CITAC)

A message from Elina Cook (President): Demystifying and promoting the MD-PhD/MSc world—our progress&#x0D; &#x0D; Clinician Investigator Trainee Association of Canada (CITAC) seeks to promote, support and advocate for trainees whose goal is to become physician/ clinician/surgeon investigators. These include trainees of MD-PhD/MSc programs and Clinician Investigator Programs (CIP), who are preparing themselves to succeed in the overlapping world of medicine and research. Thanks to the wealth of talent, skill and motivation of the CITAC leadership this year, we are delivering new opportunities to these trainees in a number of ways: 1) developing international partnerships and initiatives; 2) revitalizing the Annual General Meeting (AGM); 3) advocating for clinician/physician/surgeon-scientist trainee support among influencers and policy makers; and 4) collecting data on the academic “health” of our training programs and trainees across Canada.

Scientific Overview on CSCI-CITAC Annual General Meeting and 2018 Young Investigators’ Forum

The 2018 Annual General Meeting (AGM) and Young Investigators’ Forum (YIF) of the Canadian Society of Clinician Investigators (CSCI) and Clinician Investigator Trainee Association of Canada/Association des Cliniciens-Chercheurs en Formation du Canada (CITAC/ACCFC) was held in Toronto, Ontario on November 19–20, 2018, in conjunction with the University of&#x0D; Toronto Clinician Investigator Program Research Day. The theme for the meeting was “Prepare for Success—Things to Master Now for Clinician Scientists in Training”; with lectures and workshops that were designed to provide knowledge and hands-on skills to navigate life as a clinician investigator. The opening remarks were by Jason Berman (President of CSCI), Josh Abraham (President of CITAC/ACCFC) and Nicola Jones (University of Toronto Clinician Investigator Symposium Chair). The keynote speakers were Dr. Ruth Ann Marrie (University of Manitoba), who received the Distinguished Scientist Award, Dr. Davinder Jassal (University of Manitoba), who received the CSCI-RCPSC Henry Friesen Award, and Dr. Aleixo Muise (University of Toronto), who received the Joe Doupe Young Investigator Award. Dr. Minna Woo (University of Toronto), Canada Research Chair in Diabetes Signal Transduction, delivered the keynote lecture “From Onion Cells to Single Cell Seq—A Constant Change in Lenses: A perspective of an evolving clinician scientist”.&#x0D; &#x0D; The workshops, focusing on career development for clinician-scientists, were hosted by Drs. Robert Chen, Stephen Juvet, Lorraine Kalia, Phyllis Billia, Neil Goldenberg, Nicola Jones, Srdjanaa Filipovic, Jason Berman, Josh Abraham, Melanie Szweras, Joseph Ferenbok and Uri Tabori. The AGM also included presentations from clinician investigator trainees from across the country, and these abstracts are summarized in this review. Over 80 abstracts were showcased at this year’s meeting during the poster session, with six outstanding abstracts selected for oral presentations during the President’s Forum.

Cutting-edge Innovations in Cardiac Health: Galvanic Insights from a Clinician-Scientist, Dr. Benjamin Hibbert

Dr. Benjamin Hibbert, MD, PhD, FRCPC is an interventional cardiologist, an assistant professor, as well as the director of the Vascular Biology and Experimental Medicine Laboratory at the University of Ottawa Heart Institute (UOHI). With a focus on performing revolutionary bench-to-bedside research, Dr. Hibbert’s clinical and basic science research interests include the development of novel cardiac biomarkers, elucidating the mechanisms that underlie pathological arterial remodelling in transplant vasculopathy, and the pharmacodynamics of adjuvant antiplatelet and antithrombotic agents in cardiac disease. We had the privilege of speaking with Dr. Hibbert about his career path, research experiences, and perspectives on the importance of the clinician-investigator program in training the oncoming generation of clinician-scientists.

Newsletter Spring 2019: Clinician Investigator Trainee Association of Canada (CITAC).

Message from the President: Demystifying and promoting the MD-PhD/MD+ world Since its inception in 2006, the Clinician-Investigator Trainee Association of Canada (CITAC) has investigated, supported and promoted the needs of Canadian trainees on track to building a career in research and medicine. Membership in CITAC signals interest in such a career as a physician/clinician/surgeon-scientist. MD+ trainees (e.g., those in Clinician Investigator Programs (CIP), MD-PhD and MD-MSc programs) are involved in discussions surrounding this dual career often enough to have a sense of what it entails. Trainees assume and trust that the training they receive, and the opportunities they seize, can lead them to the dual career. Yet, when considering practical questions about this career outcome, such as what is the success rate in landing a faculty position with that job description, we realize that much is unknown.

Model organisms-the critical link between gene discovery and therapeutic intervention.

Jason graduated from the University of Toronto Medical School in 1997 followed by a pediatric residency at the Hospital for Sick Children, a fellowship in pediatric hematology/oncology at Boston Children's Hospital and post-doctoral training at the Dana-Farber Cancer Institute. He is a professor at Dalhousie University in the Departments of Pediatrics, Microbiology and Immunology and Pathology, was appointed as the director of the Clinician Investigator Program (CIP) and the Graduate Program in Medical Research at Dalhousie (2014), elected president of the Canadian Society for Clinical Investigation (CSCI) (2017) and currently serves as Associate Chair Research in the Department of Pediatrics and Interim VP Research at the IWK, and as an assistant editor of the Journal of Clinical and Investigative Medicine (CIM).

Scientific overview on CSCI-CITAC Annual General Meeting and 2017 Young Investigators' Forum.

The 2017 Annual General Meeting of the Canadian Society of Clinician Investigators (CSCI) and Clinician Investigator Trainee Association of Canada/Association des Cliniciens-Chercheurs en Formation du Canada (CITAC/ACCFC) was a national Annual General Meeting (AGM) held in Toronto, Ontario November 20-22, 2017, in conjunction with the University of Toronto Clinician Investigator Program Research Day. The theme for this year's meeting was "Roll up your sleeves-How to manage your physician scientist career", emphasizing lectures and workshops that were designed to provide tools for being proactive and successful in career planning. The keynote speakers were Dr. Rod McInnes (McGill University and Canadian Institutes of Health Research Acting President), who was the Distinguished Scientist Award recipient, Dr. David Goltzman (McGill University), who was the 2017 Henry Friesen Award recipient, Dr. Gillian Hawker (University of Toronto), Dr. Mike Sapieha (Université de Montréal), who was the 2017 Joe Doupe Award recipient, and Dr. Alex MacKenzie (Children's Hospital of Eastern Ontario Research Institute, University of Ottawa). The workshops, focusing on career development for clinician scientists, were hosted by Dr. Lisa Robinson, Dr. Nicola Jones, Kevin Vuong, Fran Brunelle, Dr. Jason Berman and Dr. Alan Underhill. Further to this, the Young Investigators' Forum encompasses presentations from scientist-clinician trainees from across the country. All scientific abstracts are summarized in this review. There were over 100 abstracts showcased at this year's meeting during the highlighted poster sessions, with six outstanding abstracts selected for oral presentations during the President's Forum.

Scientific Overview on CSCI-CITAC Annual General Meeting and 2016 Young Investigators' Forum.

The 2016 Annual General Meeting of the Canadian Society of Clinician Investigators (CSCI) and Clinician Investigator Trainee Association of Canada/Association des Cliniciens-Chercheurs en Formation du Canada (CITAC/ACCFC) was a national conference held in Toronto November 21-23, 2016, in conjunction with The University of Toronto Clinician Investigator Program Research Day. The theme for this year's meeting was "Mapping Your Career as a Clinician-Scientist"; emphasizing essential skills for developing a fruitful career as clinician-scientist. The meeting featured an opening presentation by Dr. Alan Underhill, Dr. Nicola Jones and Alexandra Kuzyk. The keynote speakers were Dr. Nada Jabado (McGill University), who discussed the association between cancer and histones, Dr. Norman Rosenblum (University of Toronto), who addressed the career path and the "calling" of the Clinician Scientist, Dr. Martin Schmeing (McGill University), who was the 2016 Joe Doupe Award recipient, and Dr. Linda Rabeneck (Cancer Care Ontario and University of Toronto), who received the Friends of CIHR lectureship. The workshops, focusing on career development for clinician scientists, were hosted by Drs. Alan Underhill, Nicola Jones, Lynn Raymond, Michael Schlossmacher and Norman Rosenblum, as well as University of Toronto communication specialists, Caitlin Johannesson and Suzanne Gold. In addition, the Young Investigators' Forum included presentations from clinician investigator trainees from across the country. The research topics were diverse and comprehensive: from basic sciences to clinical practice; from epidemiology to medical engineering. All scientific abstracts are summarized in this review. Over 70 abstracts were showcased at this year's meeting during two poster sessions, with six outstanding abstracts selected for oral presentations during the President's Forum.

Scientific Overview: CSCI-CITAC Annual General Meeting and Young Investigators' Forum 2015.

The 2015 Annual General Meeting of The Canadian Society of Clinician Investigators (CSCI) and Clinician Investigator Trainee Association of Canada/Association des Cliniciens-Chercheurs en Formation du Canada (CITAC/ACCFC) was held in Toronto November 23-25, 2015, in conjunction with The University of Toronto Clinician Investigator Program Research Day. The theme for this year's meeting was "It takes a village" and the focus was the various support systems necessary to train a successful clinician scientist. The meeting featured an opening presentation by Dr. Vincent Dumez and workshops by Dr. Peter Nickerson, Dr. Jane Aubin, Dr. Kelly Warmington and Dr. Norman Rosenblum, and MD/PhD trainees Nardin Samuel, Kevin Wang and Kirill Zaslavsky. The keynote speakers were Dr. David Malkin (Hospital for Sick Children) who received the CSCI-RCPSC Henry Friesen Award, Dr. Brent Richards (McGill University) who received the Joe Doupe Award and Ernesto Shiffrin (Lady Davis Institute) who received the Distinguished Scientist Award. As always, the conference showcased outstanding scientific presentations from clinician investigator trainees from across the country at the Young Investigators' Forum. The research topics, which ranged from basic sciences to clinical medicine and translational work, are summarized in this review. Over 90 abstracts were presented at this year's meeting during two poster sessions, with several of the outstanding abstracts selected for oral presentations.

Research projects in the Surgeon-Scientist and Clinician-Investigator programs at the University of Toronto (1987-2016): a cohort study.

Physicians have traditionally been at the forefront of medical research, bringing clinical questions to the laboratory and returning with ideas for treatment. However, we have anecdotally observed a decline in the popularity of basic science research among trainees. We hypothesized that fewer resident physicians have been pursuing basic science research training over time. We examined records from residents in the Surgeon-Scientist and Clinician-Investigator programs at the University of Toronto (1987-2016). Research by residents was categorized independently by 2 raters as basic science, clinical epidemiology or education-related based on the title of the project, the name of the supervisor and Pubmed searches. The study population was divided into quintiles of time, and the proportion pursuing basic science training in each quintile was calculated. Agreement between the raters was 100%; the categorization of the research topic remained unclear in 9 cases. The proportion of trainees pursuing basic science training dropped by 60% from 1987 to 2016 (p = 0.005). Significantly fewer residents in the Surgeon-Scientist and Clinician-Investigator Programs at the University of Toronto are pursuing training in the basic sciences as compared with previous years.

Pursuing clinician investigator programs in residency.

Pursuing clinician investigator programs in residency.

Scientific overview: CSCI-CITAC Annual General Meeting and Young Investigators’ Forum 2014

The Canadian Society of Clinician Investigators (CSCI) and Clinical Investigator Trainee Association of Canada/Association des cliniciens-chercheurs en formation du Canada (CITAC/ACCFC) annual general meeting (AGM) was held in Toronto during November 21-24, 2015 for the first time in conjunction with the University of Toronto Clinician-Investigator Program Research Day. The overall theme for this year's meeting was the role of mentorship in career development, with presentations from Dr. Chaim Bell (University of Toronto), Dr. Shurjeel Choudhri (Bayer Healthcare), Dr. Ken Croitoru (University of Toronto), Dr. Astrid Guttman (University of Toronto), Dr. Prabhat Jha (University of Toronto) and Dr. Sheila Singh (McMaster University). The keynote speakers of the 2014 AGM included Dr. Qutayba Hamid, who was presented with the Distinguished Scientist Award, Dr. Ravi Retnakaran, who was presented with the Joe Doupe Award, and Dr. Lorne Babiuk, who was the CSCI-RCPSC Henry Friesen Award winner. The highlight of the conference was, once again, the outstanding scientific presentations from the numerous clinician investigator (CI) trainees from across the country who presented at the Young Investigators' Forum. Their research topics spanned the diverse fields of science and medicine, ranging from basic science to cutting-edge translational research, and their work has been summarized in this review. Over 120 abstracts were presented at this year's meeting. This work was presented during two poster sessions, with the six most outstanding submitted abstracts presented in the form of oral presentations during the President's Forum.

Challenges facing physician scientist trainees: a survey of trainees in Canada's largest undergraduate and postgraduate programs in a single centre.

A number of indicators suggest that the physician scientist career track is threatened. As such, it is an opportune time to evaluate current training models. Perspectives on physician scientist education and career path were surveyed in trainees at the University of Toronto, home to Canada's longest standing physician scientist training programs. Trainees from the Clinician Investigator Program (CIP) and MD/PhD Program at the University of Toronto were surveyed. Liekert-style closed-ended questions were used to assess future career goals, present and future perspectives and concerns about and beliefs on training. Demographic information was collected regarding year of study, graduate degree program and focus of clinical and health research. Statistical analysis included non-parametric tests for sub-group comparisons. Both groups of trainees were motivated to pursue a career as a physician scientist. While confident in their decision to begin and complete physician scientist training, they expressed concerns about the level of integration between clinical and research training in the current programs. They also expressed concerns about career outlook, including the ability to find stable and sustainable careers in academic medicine. Trainees highlighted a number of factors, including career mentorship, as essential for career success. These findings indicate that while trainees at different stages consistently express career motivation, they identified concerns that are program- and training stage-specific. These concerns mirror those highlighted in the medical education literature regarding threats to the physician scientist career path. Understanding these different and changing perspectives and exploring those differences could form an important basis for trainee program improvements both nationally and internationally.