Fostering excellence

Remuneration, protected time, and relationship with the DFM

Most full-time academic faculty members in the DFM, including all full-time FP-CIs, participate in a financial partnership in which all members draw similar, prorated financial incomes, based on a combination of pooled clinical earnings and contributions from the DFM. It is important to note that in Canada, CIs cannot draw income from project funding. All contributions to the financial partnership by FP-CIs come from sources such as clinical work, career scientist awards, honoraria, consulting fees, etc. All FP-CIs are provided 50% to 70% of their hours as protected academic time for research and scholarly activities, whereas other clinical career paths are provided 20% to 30% protected academic time. For new FP-CIs, the DFM initially offsets some of their reduced clinical earnings by transferring funds to the financial partnership. The expectation by the DFM has been that within 5 years FP-CIs will acquire independent financial support, usually through career scientist awards, to cover their protected time. Similar to other members of the partnership, FP-CIs are eligible for a 6-month sabbatical after 3.5 years of service.

Orientation

Upon hiring, each new investigator is oriented by the research director, the FP-CI’s research interests are clarified, and opportunities to collaborate with existing projects are identified. Each new FP-CI is initially invited to collaborate with another CTLC investigator on active research in order to promptly benefit from participating in a funded research project, with the intention that this will contribute to early co-authorship and possible future research grants.

Infrastructure

Family physician CIs are each provided office space located within the CTLC to facilitate collaboration with the broader research team. An electronic project-tracking system helps to document research productivity and coordinate activities.

Research and administrative supports

The CTLC has a full-time operations manager who contributes to administrative support. In addition, each full-time FP-CI is provided with a half-time research assistant to support their research and administrative activities. Research assistants are involved in projects at all stages, including identifying grant opportunities, organizing and contributing to grant submissions, conducting literature searches, and writing and submitting manuscripts. Administrative duties can also include project coordination support, organization of meetings, acting as a resource for protocols and procedures of the CTLC, and acting as a liaison to the operations manager.

Mentorship

Mentorship is a core part of the research program at the CTLC. New FP-CIs are mentored by senior investigators through a semiformal mentorship program. The mentor and mentee meet on a regular basis and focus on a range of objectives including assistance with short- and long-term career goals; development of specific research skills and knowledge; and strengthening relationships and collaborations internal and external to the CTLC. To further encourage collaboration and networking between new FP-CIs and senior investigators, we host monthly research-in-progress rounds and a monthly assembly of the CTLC investigators.

Key competencies of FP-CIs

In addition to a medical degree and an active licence to practise family medicine, each FP-CI must hold or be pursuing a health care research–relevant master’s or doctoral degree. Although a doctorate is not a requirement of the position, FP-CIs are supported to pursue this level of education to enhance their research skills and increase their experience. Moreover, the CTLC identified several key competencies drawn from the University of Ottawa Clinical Investigator Program and adapted them to the primary care setting (Box 1).^11,12

Research expectations

The expectation has been that all FP-CIs establish sustainable, independently funded research programs aligned with the thematic research priorities of the CTLC within 5 years of launching their research careers. For a full-time equivalent FP-CI with 50% protected time for research, this means securing external salary support for 2.5 days per week, typically in the form of a career scientist award. For the new FP-CI, an early emphasis is placed on grant writing and publications, as in Canada researchers are eligible for most early career awards only in the first 5 years after earning their last advanced degrees, so early productivity is important. The inability to secure independent funding might result in a career track review for the FP-CI.

Detailed research expectations for FP-CIs are outlined in Table 1. These expectations were developed iteratively during a period of several years with input from all FP-CIs, including those in the early stages of their careers, and are regularly reviewed to ensure that they remain current. These are believed to be the minimum requirements of FP-CIs, as achievement of career scientist awards likely requires at least this degree of success.

Clinical and teaching expectations

To maximize success as researchers, FP-CIs are encouraged to limit their clinical time and redirect their teaching duties to have sufficient protected time for research. Family physician CIs provide care for an approximate panel size of 115 patients per half-day of clinical time. The 3 to 5 clinical half-days are spread throughout the week to maximize continuity of care and lessen the burden on clinical colleagues. In general, FP-CIs do not perform obstetric deliveries, provide emergency department care, or provide in-hospital service. While the FP-CIs participate in after-hours community calls, they do so less frequently than their clinically focused colleagues, as this obligation is proportionate to the amount of clinical service provided. Flexibility is built into the clinical schedule to allow FP-CIs to make up clinic hours that might be cancelled owing to research activities.

Although most FP-CIs do their clinical work in academic teaching units, they are not responsible for the supervision of family medicine residents and do not generally participate in formal postgraduate or undergraduate teaching. However, FP-CIs are expected to support the research efforts of non-CI faculty, supervise resident scholarly projects, and provide clinical teaching related to their research expertise. These efforts help ensure that FP-CIs are valued as integral members of their clinical teams. In addition, FP-CIs might be expected to supervise graduate students in the health sciences, and some FP-CIs have additional teaching responsibilities in affiliated departments at the University of Ottawa.