The Doris Duke International Clinical Research Fellowship (ICRF) is designed to encourage medical students to pursue clinical research careers by exposing them to exciting research opportunities in developing countries. Students who are matriculated at any U.S.-based medical school are eligible for the ICRF.
Program Overview
Students who participate in the ICRF program will take a year off from medical school to conduct international clinical research under the direction of a mentor working in global health.
Each fellow will work with a mentor to formulate a specific research project, write up the protocol, and follow the protocol through the relevant approval processes. The student will then take primary responsibility for initiating and conducting the study.
The University of North Carolina at Chapel Hill places Doris Duke fellows in Malawi, Zambia, and China.
Application instructions are below. Questions about the ICRF at UNC should be directed to program coordinator Kirsten Leysieffer, kirsten_leysieffer@med.unc.edu.
Site Descriptions and Programs
Malawi
Site Director: Mina Hosseinipour, MD, MPH
UNC has had a presence in Malawi since 1990. UNC Project-Malawi, a collaboration between UNC and and the Malawi Ministry of Health, was established in 1999 on the campus of Kamuzu Central Hospital in Lilongwe. UNC Project has grown to include more than 300 employees with research, clinical and laboratory space, and living quarters for students and visiting faculty. UNC Project’s current research portfolio includes HIV and STD research, other infectious diseases such as malaria and tuberculosis, emergency obstetrics, cancer, family planning, surgery and trauma.
ICRF students in Malawi may work in the following areas:
Sexually Transmitted Infections: The STI clinic at UNC Project is the setting for many treatment and prevention trials, most focused on the interaction between HIV and STI’s and also acute HIV. Since 2005, the STI clinic has had a robust, real-time database that tracks individual clinical, demographic and behavioral factors. Mentors: Irving Hoffman, PA, MPH; Bill Miller, MD, MPH
Cancer: UNC Project has created a cancer registry that is based on the registry used in the cancer center at UNC. It has also begun cancer chemotherapy trials. Mentors: Satish Gopal, MD, MPH; Agnes Moses, MD; Carol Shores, MD;
Trauma/Burns: Several research projects addressing traumatic injury, burns, and common general surgery emergencies are ongoing. UNC surgery faculty and residents also work with KCH clinicians to provide perioperative and surgical care. Mentors: Anthony Charles, MD; Clara Lee, MD; Jonathan Samuel, MD
Maternal Health and Obstetric Fistula: UNC physicians in OB-GYN and infectious diseases are working with the CDC and other partners to plan prospective evaluations in emergency obstetrics education. The Freedom from Fistula Foundation operates a full-time fistula unit UNC has instituted a comprehensive obstetric fistula database and are currently probing a number of unanswered questions in this field including staging, prediction of surgical success, rates of co-morbid conditions and other topics. Mentors: Jeff Wilkinson, MD; Jennifer Tang, MD
Contraception and Family Planning: Investigators have completed studies on immediate postpartum contraception and interactions between HIV, antiretrovirals and hormonal contraception. A database is being created to spearhead a new focus area of contraception and family planning among women with obstetric fistula. Mentors: Gretchen Stuart, MD; Jennifer Tang, MD
Universal ART for pregnant and breastfeeding women: Together with the Malawi Ministry of Health, UNC Project is rolling out universal ART for all pregnant and breastfeeding women. There is a monitoring and evaluation team working to address operational issues related to the rollout of PMTCT and ART activities and best practices for the integration of additional services, including tuberculosis screening, malaria control, family planning and laboratory services. Research activities will include cost effectiveness evaluation of novel programs including point of care testing, modification of ART eligibility guidelines, couple recruitment and retention strategies such as cell phone reminders, the evaluation of the impact on HIV transmission to the infant, and evaluation of the impact of such programs if expanded nationally. Mentors: Mina Hosseinipour, MD, MPH; Innocent Mofolo, MSc
New technologies for HIV and TB Diagnosis: Many companies are working on point of care assays to better diagnose and monitor HIV infection and tuberculosis. UNC Project has been working with more sensitive diagnostic testing capacity, but it is unclear how these tests should be integrated into the TB and HIV programs. Research activities will include development of optimal screening algorithms. Mentors: Susan Fiscus, PhD; Irving Hoffman, PA, MPH; Mina Hosseinipour, MD, MPH; Peter Gilligan, PhD; Debbie Kamwendo, MS; Bill Miller, MD, MPH; Charles van der Horst, MD
Treatment of HIV: The Malawi ART program, initiated in 2004, has now evolved to provide more comprehensive integrated services including family planning, cervical cancer screening, tuberculosis screening and treatment, pre-ART, and other prevention programs, including anti-malaria bednet distribution. Fellows may develop projects focused on program evaluation of existing services or models of integration within the program. Mentors: Mina Hosseinipour, MD, MPH; Sam Phiri, PhD
For more information about UNC Project-Malawi, click here.
Zambia
Site Director: Benjamin Chi, MD
The Centre for Infectious Disease Research in Zambia (CIDRZ) is an independent Zambian non-profit organization and a key collaborator to the Zambian Ministry of Health. Currently, six UNC faculty live and work full-time at CIDRZ, including those in the departments of obstetrics and gynecology and medicine. The organization’s scope of work comprises the implementation of large public health programs, rigorous evaluations of program effectiveness, and the conduct of locally relevant clinical trials. We have core competencies in: (1) HIV prevention, including mother-to-child HIV transmission, (2) HIV care and treatment, (3) child health, (4) women’s health, and (5) tuberculosis.
These are the potential topical areas for the coming year:
Prevention of mother-to-child transmission of HIV (PMTCT): UNC-CIDRZ investigators are internationally recognized for their work in PMTCT and we have conducted numerous epidemiological studies, public health impact evaluations, and randomized clinical trials. In the coming year, we will implement two NIH-funded projects in the field: (1) a cluster-randomized trial of the point-of-care SAMBA platform for early infant diagnosis of HIV, and (2) a validation of a community survey methodology to assess population PMTCT program impact. Mentors: Ben Chi, MD, MSc; Mwangelwa Mubiana-Mbewe, MBChB; Jeff Stringer, MD; Carla Chibwesha, MD, MSc
Cervical cancer prevention: In collaboration with the Ministry of Health, University of Zambia, and the Centers for Disease Control and Prevention, CIDRZ has helped to establish one of the largest cervical cancer prevention programs in the region. With more than 80,000 women screened since 2005, our program relies heavily on resource-appropriate approaches – including “see-to-treat” methods and nurse provider models – to increase access nationwide. Mentors: Groesbeck Parham, MD; Mulindi Mwanahamuntu, MD; Carla Chibwesha, MD, MSc; Sharon Kapambwe, MD
Pediatric diarrhea surveillance: Through funding from the Bill and Melinda Gates Foundation, we are conducting community and facility-based assessments throughout Lusaka Province to determine (i) trends in pediatric diarrhea-related morbidity and mortality, (ii) epidemiology of enteric pathogens, (iii) rotavirus vaccine effectiveness, and (iv) cost-effectiveness of a comprehensive public health initiative to reduce diarrhea-related mortality supported by the Ministry of Health, Absolute Return for Kids, Glaxo-Smith Kline, and CIDRZ. Mentors: Roma Chilengi, MD; Brad Guffey, MD; Jeff Stringer, MD
Tuberculosis-HIV co-infection: CIDRZ has extensive clinical and research expertise dedicated to improving the screening, diagnosis and management of TB in HIV-infected patients. With PEPFAR/CDC support, we work in over 250 clinics in Eastern, Lusaka, Southern, and Western provinces to promote integrated services. We have developed a robust portfolio of clinical and implementation science studies and are currently conducting trials funded by the NIH, CDC, and World Health Organization. Mentors: Stewart Reid, MD, MPH; Nzali Kancheya, MD; German Henostroza, MD; Annika Kruuner, MD
Primary health care: Funded by the Doris Duke Charitable Foundation, the BHOMA initiative (Better Health Outcomes through Mentoring and Assessment) aims to improve primary health care through standardized medical care, on-going clinical mentorship, and intensive community engagement. We have implemented a rigorous evaluation plan to evaluate services across the rural districts of Chongwe, Kafue, and Luangwa. Mentors: Roma Chilengi, MD; Jeff Stringer, MD
Epidemiologic research using large observational databases: In collaboration with the Ministry of Health, CIDRZ maintains large programmatic databases in the areas of HIV care and treatment (280,000+ patients), cervical cancer screening (58,000+ patients), and obstetrical care (250,000+ patients). This has been an important resource for local and international investigators and is supported on-site by an analysis team comprised of one PhD biostatistician and two Masters-level analysts. We are an active participant in the IeDEA collaboration (International Epidemiologic Databases to Evaluate AIDS) and have successfully conducted analyses with data pooled both regionally and globally. Mentors: Ben Chi, MD; Patrick Musonda, PhD; Jeff Stringer, MD
For more information about CIDRZ, click here.
China
Site Director: Joseph D. Tucker, MD, MA
UNC has a long history of collaborative health research, service, and training in China. The mission of UNC Project-China is to work collaboratively to improve the health of China and promote UNC-Chapel Hill’s presence in China. UNC faculty, students, and trainees are leading research on non-communicable diseases, HIV and STIs, maternal and child health, and other global health areas.
China has tremendous inequalities and unique capacity for public health implementation, providing a dynamic and rich environment in which to pursue mentored research through the Doris Duke program. China’s rapid resurgence of sexually transmitted diseases creates opportunities for clinical, epidemiological, behavioral, and basic science research focused on sexual health. Large funded projects supported by the NIH, WHO, and Gates Foundation create opportunities for students to carve out parallel mentored research.
Students interested in working with UNC Project-China must demonstrate proficiency in Mandarin (preferable) or Cantonese during an in-person interview.
ICRF China students will work in Guangzhou, Nanjing or Beijing, depending on the project.
Social entrepreneurship for sexual health (SESH): Funds to support HIV/syphilis services for men who have sex with men (MSM) are decreasing just as HIV/syphilis incidence increases in many regions of the world. New models of care are needed to expand HIV/syphilis screening among MSM. In cooperation with the Global SESH NGO, this project focuses on evaluation of health, social, and business metrics associated with innovative testing programs. Opportunities for qualitative and quantitative research are available. Mentors: Joseph D. Tucker, MD, MA; Kathryn Muessig, PhD; Rosanna Peeling, PhD.
African Migrant Health Project in Guangzhou: There are over 100,000 African migrants in Guangzhou, but access to health services is limited by a number of cultural, linguistic, and other barriers. Local colleagues have established a clinical service for Africans in the Xiaobei Lu area. Building on this foundation, this project examines biomarker and behavioral aspects of this subpopulation in order to provide high quality migrant health services. The project also examines how larger foreign policy questions and trade issues influence health and wellness. Mentors: Joseph D. Tucker, MD, MA; Li Ling, PhD; Margaret Lee, PhD.
Sexually Transmitted Infections: China has a resurgent syphilis epidemic and some of the highest rates of purchasing sex among urban men of anywhere in the world. The Guangdong Provincial STD Control Center plays a key role in organizing a response to STIs in Guangdong, a southern province with a high syphilis burden. This provides unique opportunities for clinical, behavioral, epidemiological, and modeling STI research. Mentors: Ligang Yang, MD, MS; Heping Zheng, PhD; Bin Yang, MD, MS; Joseph D. Tucker, MD, MA.
HIV-HCV Co-infections: The Number Eight Hospital in Guangzhou sees over 3700 HIV-infected patients and has detailed data on a cohort of HIV-HCV co-infected patients. Clinical, behavioral, and basic science research opportunities are available. Mentors: Stanley Lemon, MD; Joseph D. Tucker, MD, MA; Weiping Cai, MD.
Methadone Maintenance: A province-wide system of methadone maintenance clinics regularly engages over 15,000 individuals and provides opportunities for infectious disease testing, treatment, and retention among drug users. This project led by the Sun Yat-sen Center for Migrant Health Policy explores the methadone system and its optimization. Mentors: Li Ling, PhD, Joseph D. Tucker, MD, MA.
For more about UNC Project-China, click here.
Application Procedure
Applications are obtained and submitted through the Doris Duke website.
A complete application package must include the following seven components (the first six items are the same for each school and must be submitted online, while the seventh varies by school):
- Completion of the online common application form
- A letter of support from the Dean’s office of the medical school in which you are currently matriculated
- Two letters of support from faculty who can comment on your academic performance and potential for clinical research
- A personal statement
- A copy of your curriculum vitae
- A copy of your medical school transcript (unofficial)
- Invited, in-person interviews for finalists (UNC )
Detailed instructions are provided below for each of the six components listed above required by Doris Duke Charitable Foundation. Read the FAQs before starting to prepare your application for helpful guidance on questions about the program, application process and eligibility, as well as for students who are considering applying to schools at which they are not matriculated.
1. Online Application Form
Complete all sections of the online application form, which requests the following information:
- Your contact information
- Education history (students interested in the China program should indicate their language training and level of proficiency in Mandarin or Cantonese)
- Areas of clinical research you are interested in during fellowship year (UNC discourages applicants from specifying a mentor their application)
- Schools to which you are applying
- Description of prior medical and/or research experience in an international setting, if applicable
2. Letter from the Dean
Request the letter of support from your Dean on the online application form well in advance of the deadline. Your Dean will receive an e-mail from ddcfcrf@aibs.org and will be asked to submit their recommendations through the online DDCF Application system by 11:59PM EST, January 15, 2013.
3. Letters of Support
Request the letter of support from your references on the online application form well in advance of the deadline. Your references will receive an e-mail from ddcfcrf@aibs.org and will be asked to submit their recommendations through the online DDCF Application system by 11:59PM EST, January 15, 2013.
4. Personal Statement
A personal statement containing a description of a) your reasons for undertaking global clinical research; b) your plans for future professional or graduate education as well as your long-term career plans; and c) a brief description of your research interests. Limit to 1 page, 10 pt. font. (PDF)
5. Curriculum Vitae
You will need to upload a copy of your CV (PDF) to submit your application. (Limit to 2 pages, 12pt. font.)
6. Medical School Transcript
Request your medical school transcript well in advance of the deadline. You will need to upload a copy (PDF) to submit your online application. This can be an unofficial copy.
7. In-person Interview
Five to eight finalists will be invited to Chapel Hill for an interview prior to final selection. Matching specific research topics and mentors with individual fellows and their interests will not be discussed until the time of the face-to-face interview.
Dates and Deadlines
The application process for the 2013-2014 fellowship year begins in November, and applications are due January 15, 2013.
Questions
For questions about the ICRF at UNC, please contact program coordinator Kirsten Leysieffer at kirsten_leysieffer@med.unc.edu.