US AND INTERNATIONAL
CLINICAL RESEARCH FELLOWSHIP
Past Fellows - Accomplishments
The Doris Duke Clinical Research Fellowship Program at UNC-Chapel Hill is pleased to offer the International Clinical Research Fellowship (ICRF). Applicants interested in this program should read the following information about potential venues and complete the central Doris Duke application by the required deadline. An important difference for the ICRF compared to the domestic program is that applicants will be interviewed prior to selection. Applicants will be notified whether they are invited for an interview shortly after the January 18 application deadline. Specific questions about the international fellowship can be directed to:
Irving Hoffman, PA, MPH- Director of International Operations
Irving_hoffman@med.unc.edu
Lilongwe, Malawi- Program Description
The UNC Center of Infectious Diseases (now the Institute for Global
Health and Infectious Diseases, IGHID) has had great success in STD
and HIV/AIDS research in Africa and in providing research
opportunities for medical students. The UNC Project in Lilongwe is a collaboration
with the Malawi Ministry of Health on the campus of
Kamuzu Central Hospital. The UNC Project is a research, care and
training center that contains clinical research space, laboratory,
satellite-linked data management, UNC-linked library, lecture hall,
teleconferencing capacity and student housing.
There are seven full-time UNC clinical research faculty living
on-site, supported by 250 Malawi employees that are conducting over 15
HIV-related clinical research protocols with an annual budget of over
8 million USD/year. For each research project, there is an investigator
in charge in Malawi who has a counterpart in Chapel Hill.
UNC’s ICRF program will provide an intense and rewarding year long
experience for medical students. Ten months will be conducted in the
well established and UNC-sponsored academic programs in Malawi. The goal
of the program is to impart a complete understanding of, and
appreciation for, the highest quality clinical research possible in a
developing country. This will be accomplished by having the fellow
conduct both their own research project, of which they will take
complete ownership and in addition, each will become a working member
of a research team involved in an on-going, Phase III clinical trial conducted
in Malawi.
Research Activity
The Malawi experience will consist of initiating a project of the mentor
and fellow’s mutual interest (i.e completion of a chart audit project)
AND joining the study team of an ongoing phase III trial. The
following are examples of ongoing projects available to medical
student trainees:
Examples of Phase III projects:
1.HPTN 052: HIV discordant couple study to determine if ART reduces HIV
transmission;
2. ACTG 5208: HIV treatment trial comparing different ART regimens;
3. HPTN 035: Placebo controlled trial to determine the efficacy of 2 vaginal
microbicide gels to prevent the sexual transmission of HIV among women;
4. CHAVI 001: Immunology of acute HIV that includes an
operational component of acute HIV detection, partner notification and
counseling within the context of an STD clinic;
5. CDC BAN: A multi-factorial design study to determine the optimal ART
and nutritional strategies to prevent HIV mother-to-child- transmission
through breast feeding.
Examples of chart audits:
1. Chart audit in adult medical wards to determine the proportion of in-patients
admitted in the categories of HIV opportunistic infections, non-HIV related
infections, and the length of stay and the mortality for each category;
2. A chart review and a verbal autopsy report to determine the outcome
of patients who have been lost to follow up while on antiretroviral therapy
(ART);
3. An audit of the success of the referral system from the prevention
of mother to child HIV transmission program to long term HIV clinical
care;
4. An audit to determine if the median CD4 counts have changed among participants
in HIV counseling and testing since ART has become widely available in
Malawi.
International Mentors:
Mina Hosseinipour MD, MPH, Associate Professor of Medicine, UNC
Division of Infectious Diseases. Dr. Hossseinipour has lived and worked
in Malawi for the past 5 years. She is the Medical Director of the UNC
Project in Malawi and oversees the clinical assignments and performance
of over 20 clinicians.
Francis Martinson MD, PhD, Assistant Professor of Medicine, UNC Division of Infectious Diseases. Dr. Martinson has lived and worked in Malawi for the past 7 years. He is currently the Country Director of the UNC Project in Malawi.
Peter Kazembe MD, Professor of Pediatrics: Baylor University, Malawi College of Medicine; Adjunct Professor of Medicine, UNC. Dr. Kazembe is head of the new Baylor Pediatric HIV Care Center of Excellence in Malawi.
Peter Munthali MD, Adjunct Professor of Medicine and Microbiology at UNC. Dr. Munthali has just returned to Malawi after a 9 year career as a clinical microbiologist in the United Kingdom. He is now the head of the microbiology unit at the UNC Project and will be working on malaria vaccine and tuberculosis surveillance projects.
Dan Namerika MD, Adjunct Professor of Medicine at UNC. Dr. Namerika has recently completed his residency in internal medicine and is the head of the department of medicine in lilongwe. Dan is conducting a study of in-patients with cryptococcal meningitis
Domestic Mentors
Myron Cohen MD, Professor of Medicine, Chief of the Division of Infectious
Diseases at UNC. Dr. Cohen is the Head of the UNC Institute of Global
Health and the Center for Infectious Diseases.
Charles van der Horst MD, Professor of Medicine, Infectious Diseases. Dr. van der Horst is the PI of the CDC BAN study and travels to Malawi every quarter.
Joseph Eron MD, Professor of Medicine, Infectious Diseases. Dr. Eron is the PI for the AIDS treatment studies in Malawi. He travels to Malawi 2 times per year.
Irving Hoffman PA, MPH, Associate Professor of Medicine, Infectious Diseases, Director of International Operations. Mr. Hoffman is the director of the UNC Project in Malawi and travels between Chapel Hill and Malawi every 2 months.
Nanjing, China- Program Description
UNC faculty have worked successfully in China for the past 30 years,
and thus have laid the foundation and built the capacity to provide a
unique research experience for a medical student fellow. UNC has
developed a strong and stable relationship with the Nanjing Center for
STDs and HIV. UNC has worked collaboratively on several research
projects and developed an NIH Ellison Fellowship site that has
successfully supported a series of US medical and public health
students. The site capacity has developed sufficiently to support an
outstanding year long experience for a medical student. The work done
in the Nanjing Center is critical to detection and prevention of
STDs/HIV in China.
Research in China
For the past 6 years the UNC has sponsored medical students for
varying lengths of time in Nanjing. The students have participated in
a remarkable series of publications that include work on “surplus
men”
and STDs, sex workers and STDs, and syphilis. China has a significant
syphilis epidemic and students have done extensive work on syphilis
detection and prevention.
Based on common interests, a student will be matched with a domestic and Chinese investigator and will be expected to craft with their mentors a credible research project. In this case the work undertaken will be related to the management of STDs in China. The student will likely work on projects that are interdisciplinary between social science and infectious diseases, a strength of our program in China. Field work will be conducted in Guanxi Province. Collaboration with China CDC investigators will be required. To date, there has been one student to participate in a summer program in China whose work focused on STDs.
International Mentors
Chen Xiang Shen, Director of Epidemiology, Nanjing National
STD Center. Dr. Chen has worked extensively in collaboration with UNC
investigators and students and he spent a year in Chapel Hill. He will
directly supervise the student.
Yin Yue Pan, Director of Laboratories, Nanjing National STD Center. She has been a key collaborator on all projects.
Domestic Mentors
Myron Cohen MD. Professor of Medicine, Chief of the Division of ID.
Dr. Cohen is the Head of the UNC Institute of Global Health and the
Center for Infectious Diseases.
Gail E. Henderson, Ph.D. Professor of Social Medicine and Sociology. Dr. Henderson is Director of the UNC CFAR International Core, PI of the UNC China R24, and an internationally recognized China expert.
ICRF Preparatory Work and Didactic Instruction
Once the fellows have been chosen, they will be asked to begin to read
protocols and procedures and interact with their international and
domestic mentors to initiate their research protocols and complete any
necessary country-specific activities prior to leaving the U.S. Once
the fellowship year officially begins in July, the ICRF fellows will
join the domestic fellows in the didactic training and any enrichment
activities scheduled during this time. During the first month all ICRF
fellows will obtain vaccinations, air tickets and passports. For the
Malawi fellows, they will select the chart audit project and initiate
the IRB process. The Malawi fellows will also participate in the
African Studies sponsored seminars on “Malawi Culture and the Chichewa
Language”. The China fellows will utilize local resources to practice
language proficiency prior to leaving and will continue to improve spoken
and written Chinese language skills critical to career
development through formal classwork at the Nanjing Language
Institute. This has proven to be invaluable to students in the past.
Language skill in mandarin chinese is required.
Interaction with UNC domestic program:
All ICRF fellows will be expected to interact with the domestic fellows
beginning with the first month of didactic training, continuing via the
monthly progress reports to which they will be linked via videoconference,
and culminatng at the annual DD meeting. The international and domestic
mentors will be requested to attend the
monthly progress reports.
The Malawi fellows will have a weekly meeting with the local mentor to
closely follow progress and address concerns. The student will also be
part of a large clinical trial team and will interact with a local PI.
Similarly, the Chinese local mentor will directly supervise the fellow
on a daily basis. Prior English speaking students in China have organized
research and journal clubs in collaboration with the Chinese
investigators to create an atmosphere of teamwork and collegial learning.