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Seattle-Denver Center of Innovation (COIN)

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MD Fellowship - Seattle

The Seattle Center of Innovation for Veteran-Centered and Value-Driven Care Advanced Fellowship in Health Systems Research is for physicians who have completed residency training and focuses on preparing them for successful academic research careers.

Fellowship Curriculum Overview
This two-year fellowship is designed to have physicians develop and apply their research skills by completing a publishable research project. Emphasis is placed on one-on-one mentorship and peer interaction. The curriculum fundamentals include orientation to VA, general research methodology, and written and oral communication skills. The shared emphasis of education, research, and mentorship allows fellows to hone their skills in biostatistics, clinical epidemiology, clinical trial design, medical decision making, health care organizations and delivery, financing of health care, ethical issues related to research, health policy, medical informatics, meta-analytic techniques, qualitative research methods, survey design, grant preparation, and project administration.

Fellowship Requirements

Research
Fellows will spend approximately 75 percent of their time in research and education activities. Fellows are expected to complete a research project, submit at least one manuscript to a peer-reviewed journal, present at a national meeting, participate in grant writing, learn and use the latest technology in teaching, and participate in inter-professional project teams.

Clinical Care
Fellows spend approximately 25 percent of their time in clinical care. Typically, fellows hold clinic one ½ day per week at the Seattle Division in relevant general medicine or specialty clinics (Internal Medicine, Cardiology, etc.).

Education
Work-in-Progress (WIP) Seminars: All fellows are expected to attend bimonthly WIP presentations held throughout the year. This seminar allows fellows to contribute to and benefit from the experiences and knowledge of the larger group of fellows and mentors.

Eligibility Requirements
To be eligible, candidates must have:
1. Graduated from an Accreditation Council for Graduate Medical Education (ACGME) accredited residency program.
    (Please Note: International medical graduates must also have an Educational Commission for Foreign Medical    Graduates (ECFMG) certificate that is valid indefinitely)

2. Be board eligible or certified in their relevant specialty or sub-specialty area
3. Be a United States citizen
4. Have an active, full and unrestricted license to practice in the United States

Additional Selection Criteria
Candidates who meet the eligibility requirements will be selected based on their:
1. Interest – candidate desires to conduct health systems research in rapidly changing health care settings and
    demonstrates interest in ongoing research areas active at the Seattle-Denver HSR&D COIN

2. Potential – candidate has a high probability of success in incorporating health systems research for US Veterans into
    their career trajectory
3. Match – clear mentorship plan that includes investigators at the Seattle-Denver HSR&D COIN in the mentorship
    team

Funding
Support for the fellowship is provided by VA Office of Academic Affiliations (OAA) and is guaranteed for two years as long as satisfactory progress is being made by the fellow. Typically, the fellowship is completed in two years; however, fellows can apply for a third year of funding from OAA with the support of mentors and the Program Director.

OAA started the VA Advanced Fellowship Program in health systems in 1991 when a broad array of concerns was challenging health care delivery in VA and across the nation. These concerns ranged from issues involving approaches for incorporating patient perspectives in decision making to quality, cost, and measurement issues. Few physicians had the training in health systems research needed to address these critical issues, and the need for such trained physicians was increasingly dramatically. In response, OAA started the training program to develop a cadre of physicians with health systems expertise for the VA health care system and to foster the development of high quality health systems research and development at local and national levels.

Stipend Determination
Starting salaries are competitive and depend upon the number of years of previously completed ACGME accredited physician residency (post-graduate year pay scale, PGY) and on local VA stipend rates. 

The rates by fiscal year and VA facility may be reviewed here: Physician and Dentist Advanced Fellows Rate Schedule

Benefits & Other Support
Fellows receive similar benefits (such as health insurance) as VA paid employees. Other support available during fellowship includes office space with a secure work station equipped with statistical, word processing, and database management software and statisticians offer in-house consultation and guidance on analysis.

Pre-Application Phone Call
If you plan to apply to the fellowship and you meet the eligibility requirements, we recommend that you schedule a pre-application telephone call with Co-Directors Engel and Doll. Please email the Fellowship Manager, Erica Tartaglione, your current CV and, a brief summary of your research interests, and indicate that you would like to set up a telephone call with the Co-Directors to discuss the fellowship. Please be prepared to discuss your research interests and career goals on this call. The purpose of the call is to determine whether there is a good fit between your interests and those of investigators at the center and to assess how well your research interests and career goals align with the aims of the program. A pre-call is recommended but not required.

Formal Application Steps
To apply, please assemble the following documents:
1. An updated CV
2. A brief statement of research interests or a personal statement, approximately ½ page to one page in length
3. Three letters of recommendation.

Please submit all application materials by email to Erica Tartaglione, Fellowship Manager (erica.tartaglione@va.gov).
Questions about the application process should be directed to Erica.

Deadline
Applications are accepted on a rolling basis.

Interviewing
The interview process is individualized and often depends on the distance of the candidate to Seattle and the preferences of the Program Director. Select candidates are invited for interviews after all application materials have been received and reviewed by the program directors and center investigators. Interviews generally take place September through December prior to the anticipated start date. The Fellowship Manager works with the candidate and the selected interviewers to design an interview schedule. VA funding does not allow for the reimbursement of interview-related travel expenses. The Program Directors in consultation with center investigators will typically make admission decisions between December and January.

Hiring
Once an offer is accepted and a target start date is negotiated, the Fellowship Manager will provide instructions on the hiring process and procedures. Note that in order to be allowed to hold clinic, candidates must first be credentialed and privileged by VA Puget Sound Health Care System.

After the VA Puget Sound Credentialing and Privileging Office (C&PO) approves the candidate, the fellowship appointment paperwork is submitted to OAA. OAA must approve and issue the fellowship appointment on the national level before the Human Resources (HR) office in Seattle at VA Puget Sound Health Care System can proceed to hire.

The VA Puget Sound HR office requires fellows to have a physical exam completed at the Seattle Division prior to hiring. Upon successful completion of the physical, HR will generate a local offer letter and schedule orientation. All fellows must attend the 2-day New Employee Orientation hosted by HR. This orientation is designed to orient new employees with VA policies and procedures and to complete critical paperwork (health insurance, direct deposit, etc).