An interview with Carrie L. Byington, MD founder of the Clinical and Translational Scholars (CATS) mentoring program
To many people narrowing the gender gap in science is mostly an issue of equal opportunities for men and women working in research.
Others believe instead that it is actually more about giving diverse opportunities to science itself. It is the case of Carrie L. Byington, MD, Professor of Pediatrics, researcher and Co-Director of the Utah Center for Clinical and Translational Science.
“Science needs an inclusive environment because we need every idea in order to get the best results,” she said. And this principle is also what drove her to found the innovative mentorship program Clinical and Translational Research Scholars (CATS). She says it was “a program designed to provide support and to launch the faculty careers of clinical and translational scientists.” This includes those who feel like outsiders to the worlds of science and medicine as she herself once did.
“Sometimes I felt opportunities were not available to me, perhaps because I am a woman,” she said.
Starting from the assumption that a single mentor is not sufficient for an effective training, Dr. Byington set up the program with several layers of mentorship, in which differences are highlighted rather than flattened out. Scholars in the program are surrounded by a mix of senior mentors, scientific mentors, peer mentors and staff mentors; and most importantly they are taught to be “their own best mentors.”
If you had to describe the CATS program using 5 keywords, which ones would you choose?
The first word I would use is holistic: a mentorship directed to the entire person not just for the research aspect of their career. As clinician scientists, we have to balance our clinical practice, our research career, our educational responsibilities and our family. All of those things do not exist alone; they exist within a context. You need to help people with tools to manage all these different factors.
I also wanted it to be inclusive. I came from the field of Pediatrics where most of the physicians are women, but only few investigators – in my department, but also nationally – were women. There were fewer women who were doing research than the ones I thought there should be and I think part of the reason was because it was hard for them to find mentors. If you are just looking for an one-on-one type of mentorship, then it may be hard for women or underrepresented minorities to find that type of mentor. Instead we wanted to have a mentorship program which was available for everyone.
The program needed to be collaborative, because I feel like you need a lot of different types of mentoring. People need to work together. We can work together in peer groups even if our clinical interests are slightly different or our medical disciplines are different. There are so many things that we share together as investigators.
I wanted to be sure the mentors we provided were experts. I chose people with a lot of experience in writing different proposals, people who were resilient, people who were able to find creative ways to continue to do research and people who could balance their research with other aspects of their career and personal life.
Finally, as a pediatrician and as a mother, I wanted it to be a nurturing environment. Becoming an investigator is a developmental process. Junior faculty members have trained for a long time, and in order to maximize the investments that have been made in their training, academic institutions need to provide an environment in which they can develop into principal investigators.
What prompted you to set up the CATS program?
I began to think about mentoring in a very serious way in 2005. This was after I was promoted to professor and I had security within the institution and within my department. I could see that the way we were training our clinical and translational investigators was very different from the way we trained those who were engaged in basic science laboratory science.
If you were in a laboratory you had an entire structure around you. You were being mentored and followed, and you had weekly goals, monthly goals and annual goals. Instead clinician scientists, and especially physician scientists, were often alone. They were the only ones in their division engaged in that type of research and they had no structure around them. We were losing people we have made an investment in. They were smart people capable of doing research and we were losing them. They were leaving research to become practicing clinicians. So I developed a plan and approached my chair, who was very supportive of the idea. We began with a 3-year experiment and it has been so successful, that now we are starting our ninth year.
Do you think the clinical/scientific community is ready for this paradigm shift? Did you experience any resistance when starting the CATS mentoring program?
I do think people are ready for this shift. This program has gone on now for nearly a decade and now many Clinical and Translational Science centers are interested in adopting this model because there is evidence that the Matrix Mentoring Model has a high success rate in developing principal investigators.
We know that historically, about 50 percent of assistant professors leave academic medicine and are no longer engaged in research at the seven year mark. So we are losing half of the workforce. However, if you look at our model, we have 99 percent retention in academic medicine and in research careers. The faculty members we mentor remain in academic research careers because they are successful. Almost everyone has been awarded extramural grant funding during the period of participation in the program.
You asked me if there was resistance to the new model and initially there was some. I started the program in a large Department with 25 divisions and so there were 25 division chiefs. Some of them embraced the idea straightaway, but some of them said “we are doing just fine the way we have always done things.”
As we started to show that we could compress the timeline for launching a successful young investigator and shorten the time to grant funding, all the division chiefs started to come on board. As we demonstrated success, all of the Department of Pediatrics began to participate. As successes in Pediatrics became known, more departments were interested in participating, and now we offer the program to all schools and colleges in the Health Sciences.
Tracking outcomes has been vital. Even in the very first year, the return on investment was about $5 for every $1 invested, just in new grants. Today, when we consider all of Health Sciences, the return is more than 20:1. Another important return, is the retention of our faculty members, which is immeasurable. We are not losing them anymore and that strengthens our health system and produces great benefits for our patients.
In which way do you think scientific publishers can facilitate this process?
They can facilitate it by welcoming team science. It’s not often but occasionally I have received a letter from the editor saying, “We only allow a certain number of authors.” As we move forward we have to embrace multi-author papers and being able to demonstrate the contribution of each person to the paper. Publishers need to make sure all the authors who deserve credit get credit.
For more information about the program and its structure, please see the article: A Matrix Mentoring Model That Effectively Supports Clinical and Translational Scientists and Increases Inclusion in Biomedical Research: Lessons From the University of Utah.