NIDCR Dual Degree Dentist-Scientist Predoctoral to Postdoctoral Transition Award

September 2020

Research Training and Career Development Branch
Division of Extramural Activities (DEA)

Goal

This program is intended to stimulate research and retain dentist-scientists in the dental, oral and craniofacial research workforce and enhance their progression to independent research careers. NIDCR has invested in predoctoral dentist-scientist training programs (DSTP) that support integrated dental and PhD training. The goal of this initiative is to provide support and mentorship for these dual degree dentist-scientists across the transition from predoctoral student to postdoctoral scholar, a critical research career transition point for clinician scientists.

In order to achieve this objective, a two phased program using the F99/K00 model is proposed. The first phase (F99) will support the final two years of predoctoral training for students in dual degree DDS/DMD-PhD DSTP programs. Following graduation and attainment of a postdoctoral research position, the second phase (K00) will provide support for up to three years of mentored postdoctoral research training. This initiative will emphasize mentorship across the predoctoral to postdoctoral transition. Applicants to this program will be encouraged to assemble a team of mentors for research career development advice and insight into the dentist-scientist career pathway. The K00 phase will permit awardees to dedicate some outside effort to clinical practice or clinical specialty training, which will enable continued engagement with clinical dentistry.

Eligibility to this program will be limited to students enrolled in an integrated predoctoral graduate (PhD) and clinical dental (DDS/DMD) program. Students who apply to this program must provide a plan for successful completion of predoctoral dissertation research and clinical training during the two year F99 phase. These individuals also must identify a dental, oral, and craniofacial research field for postdoctoral research and long-term research career goals as a dentist-scientist. A postdoctoral research mentor and postdoctoral institution are not required at the time of F99/K00 application. Postdoctoral research mentor(s) and sponsoring institutions will be identified prior to activation of the second award phase (K00). Transition to the postdoctoral phase (K00) of the program will be contingent upon the candidate’s successful completion of the dual degree program and achievement of a postdoctoral research position with strong institutional support for promoting the candidate’s research career. Prior to activating the postdoctoral support phase, the candidate will work with the identified postdoctoral advisor(s) and sponsoring institution to provide an updated research training plan through the new postdoctoral research institution. NIDCR will provide oversight of the transition to the K00 phase to ensure that the candidate has appropriate postdoctoral mentorship, a strong research training plan, and robust institutional support that will ultimately facilitate an independent research career.

Successful implementation of this program is expected to enhance the research career trajectories of dual degree dentist-scientists and foster progression to research independence. Success of the program will be evaluated based on short term outcomes of whether program participants complete both doctoral degrees (DDS/DMD and PhD), obtain postdoctoral research positions and produce research publications during the training period. Longer term outcomes of the F99/K00 program will be measured in terms of whether trainees achieve and retain independent research faculty positions and compete for subsequent independent research grants as principal investigators.

Background

NIDCR invests in integrated predoctoral dual degree DDS/DMD and PhD training to develop a clinician-scientist workforce with the unique abilities to incorporate basic and clinical perspectives into dental, oral and craniofacial health research.

Between 1995-2019, 134 individuals received NIDCR support through institutional T32/T90 training grants and/or individual F30 fellowships to support predoctoral dual degree dentist-scientist research training. To date, twenty of the individuals (15%) have achieved research intensive faculty positions and an additional sixteen individuals (12%) have achieved academic clinical faculty positions. Forty-four of these DDS-DMD/PhD graduates (32%) are currently engaged in dental clinical specialty or postdoctoral research training. However, fifty-four (40%) of these individuals have left the research workforce pipeline to engage in private practice.

Following completion of predoctoral dual degree training, dentist-scientists can find it challenging to transition to postdoctoral research training positions. High levels of educational debt from combined degree programs and low postdoctoral salaries can disincentivize research career progression (D’Souza et. al. 2017, Physician-Scientist Workforce Report, 2014). Research intensive faculty positions in most dental schools require dental specialty and/or rigorous postdoctoral research training (Physician-Scientist Workforce Report, 2014.) Clinician Scientists particularly benefit from mentorship across career stage transitions (Permar et. al. 2020). Dual degree dentist-scientists often struggle to identify institutional support and mentorship to enable them to balance research training with clinical practice or dental clinical specialty training.

In September 2017, NIDCR hosted a workshop for predoctoral Dentist-PhD trainees on the NIH campus in Bethesda Maryland. Participants reported challenges negotiating postdoctoral positions that combined protected research time with clinical practice or clinical specialty training. This challenging phase is addressed through this proposed structured predoctoral to postdoctoral transition program.

Gaps and Opportunities

Based on subsequent outcomes of NIDCR DDS/DMD-PhD predoctoral research training programs showing 40% of trainees pursing private practice, and challenges expressed by recent dual degree trainees, new strategies are required to build and sustain a robust and vibrant dentist-scientist oral health research workforce.

NIDCR offers opportunities tailored for dentist-scientist training at the predoctoral and postdoctoral career stages. Predoctoral dual degree dentist-scientist training is supported through NIDCR Ruth L. Kirschstein National Research Service Award (NRSA) institutional T32/T90 training awards and individual predoctoral F30 fellowships (NIDCR Opportunities for Dual Degree Students DDS/DMD-PhD) Recently graduated dual degree dentist-scientist may seek Institutional T32/T90 postdoctoral support, individual F32 fellowships, career development awards (Ks) or career transition awards (K22, K99/R00) (NIDCR Opportunities for Dentists and Physicians).

The NIDCR Dual Degree Dentist-Scientist Pathway to Independence Award (K99/R00) provides phased support across the transition from postdoctoral scholar to tenure track faculty and is uniquely structed to encourage dentist-scientists to focus on mentored postdoctoral research training during the K99 training phase. This program provides two additional R00 grant support years to individuals who achieve independent tenure track faculty positions at dental schools that provide grant recipients with tenure track faculty positions along with customized, part-time, dental specialty education programs (NIDCR Dual Degree Dentist-Scientist Pathway to Independence Award (K99/R00). However, NIDCR does not offer a program in support of the transition from predoctoral student to postdoctoral scholar. Additionally, postdoctoral Ruth L. Kirschstein National Research Service Awards (T32, T90, F32), which are best suited for early stage postdoctoral researchers, require 100% dedicated research effort. The postdoctoral phase of a Dentist-Scientist F99/K00 program allows up to 25% effort devoted to clinical practice or concurrent dental specialty training. In addition, like career development and career transition awards, the postdoctoral K00 phase can provide a higher salary than postdoctoral NRSA stipends, thereby offering additional incentive for dentist-scientists to remain in the research workforce.

The F99/K00 program provides opportunity to support transition of dentist-scientists to the postdoctoral research career stage and enable continued engagement in clinical practice or dental specialty training. K00 awardees remain eligible to apply to subsequent Career Development (K) and Pathway to Independence (K99/R00) award programs. Early stage dentist-scientist postdoctoral researchers may not be immediately competitive for K and K99/R00 award programs, and the F99/K00 can enable these individuals to generate preliminary data to achieve a subsequent award. The F99/K00 would complement existing NIDCR programs for dentist-scientist training to enhance retention of NIDCR trained dentist-scientists in the research workforce.

Specific Areas Of Interest

This program is designed for advanced stage predoctoral dual degree dentist-PhD students enrolled in dual degree programs in the United States. Individuals are anticipated to seek funding for the final two years of dual degree doctoral training and to demonstrate commitment to pursuing dental, oral, and craniofacial research careers.

References

• Advisory Committee to the Director, Physician-Scientist Workforce Report, 2014.
• D'Souza RN, Colombo JS, Embree MC, Myers JM, DeRouen TA. Our Essential and Endangered Dentist-Scientist Workforce. JDR Clin Trans Res. 2017 Jan;2(1):10-22..
• NIDCR opportunities for Dual Degree Students (DDS/DMD-PhD).
• NIDCR Opportunities for Dentists and Physicians.
• NIDCR Dual Degree Dentist-Scientist Pathway to Independence Award (K99/R00 Independent Clinical Trial Not Allowed).
• Permar SR, Ward RA, Barrett KJ, Freel SA, Gbadegesin RA, Kontos CD, Hu PJ, Hartmann KE, Williams CS, Vyas JM. Addressing the physician-scientist pipeline: strategies to integrate research into clinical training programs. J Clin Invest. 2020 Mar 2;130(3):1058-1061.