Doctors at GA East Hospital undergoing training on implementing the CCP locally, localised training delivered by Dr John Amuasi, ALERRT Network

Career Development Fellowship Scheme

 

Thanks to the support of the Bill and Melinda Gates Foundation, 2019 saw ISARIC launch the first round of its two Career Development Fellowship Schemes.

The fellowship scheme aims to help fellows, from our member networks, to further their careers and develop new skills in generating and disseminating clinical research evidence for outbreak-prone infectious diseases. The scheme aspires to build existing networks in providing a proficient, coordinated, and agile research response to outbreak-prone infectious diseases.

Health professionals (e.g. qualified doctors, pharmacists, or nurses) from the ISARIC Member Networks or partners, are able to apply for the Track 1 and or Track 2 schemes.

In response to the COVID-19 pandemic, a further track was developed in 2021, forming a collaborative partnership amongst two networks.

Preference has initially been given to Low and Middle income countries nationals as we focus on building up our networks in resource-poor settings.

We are constantly evaluating the fellowship scheme and there will be new opportunities arising in the future.

 

 

Overview of the Fellowship Scheme

 

Track 1: MSc in International Health and Tropical Medicine (temporarily on hold).

Candidates undertake a Masters in International Health and Tropical Medicine at the University of Oxford.  This is a full-time, one-year multi and interdisciplinary programme – thereafter, fellows will undertake a research capacity initiative at the sponsor institution.

Track 2: Short-term fellowships, offering a series of 8-week placements, allowing fellows to choose from any of the three options currently available;

  • Pathway 1 – a placement at The World Health Organisation (WHO), or
  • Pathway 2 – Secondment to an ISARIC International Training Site, or
  • Pathway 3 – Studying a selection of modules at the University of Oxford on the MSc in International Health and Tropical Medicine.

Due to international travel restrictions during the COVID-19 pandemic the track 2 programme underwent a substantial change and candidates were able to transfer to a mentored research programme tailored to their setting.

 

Who can become a fellow?

Anyone with a medical, pharmacy, or nursing degree from a reputable university, with 3 – 10 years’ of clinical experience; experience of inpatients and outpatients management of infectious diseases, and / or ward based infection work.

Fellows should have an understanding of the role of research preparedness to facilitate a rapid clinical response.  Other desirable criteria are that they have been participating in clinical research involving emerging pathogens with epidemic potential – preferably in LMICs; had experience of setting up an audit project, and have facilitated a skills-training project.

Each fellowship includes a mentor and alumni component, and a research capacity initiative(s) at the sponsor institution.

 

The fellows

The case studies on the right introduces you to some of our ISARIC fellows and their ongoing research projects.

 

 

Supported by

Bill and Melinda Gates Foundation logo

 

 

Read the case study examples below
Track 1: Supporting a medical doctor, Colombia, South America
MSc in International Health and Tropical medicine – completed

Photo of one of the ISARIC fellows, Felipe

Our fellow, Luis Felipe Reyes (Felipe), had already been actively collaborating with member networks, with experience in working with the ISARIC dataset and is Co-Chair of the Critical Care Analysis Group of the ISARIC Data Platform Cohort.

Felipe undertook his research placement (May – July 2022) at ISARIC Global Support Centre (GSC).  It was during his work on his thesis that he was able to identify the clinical characteristics of long COVID and the factors during the acute episode of COVID-19, that could predict the development of Long Covid.

By accessing data on ISARIC Clinical Data Platform, Felipe evaluated the association among Long Covid and important demographic characteristics (age categories, sex, ethnicity, socioeconomic deprivation, comorbidities), specific exposures (mild, moderate, severe acute COVID-19, critical care admission, ventilation), and initial clinical presentation, sequelae (complications on their index admission for COVID-19) and basic medical management. He used the data registered in the platform to conduct analyses that coincide with public health or scientific need.  Data was accessed by following the applicable guidelines, in line with the governance framework for ISARIC Partner Analyses.

Felipe analysed data documented in the self-reported recovery form, persistent and ongoing symptoms not existing before Covid-19 onset, complications, breathlessness (MRC dyspnea scale), fatigue (Visual analog scale), impact on daily activities and functioning (EQ-5D-5L), disability assessment (UN/Washington disability score), impact on occupation, sickness absence, and socioeconomic deprivation data.

Using the data extracted from these instruments, he identified the most frequently affected organs and prevalent symptoms.

To characterise the middle to the long-term impact of SARS-CoV-2 infection on physical and psychosocial health, the fellow first provided simple summaries of incidence and describe which patients are at risk of developing these.

To assess the associations of demographics, disease severity, and treatments with complications, functional impairment, or quality of life, he will fit linear (for numeric outcomes) and logistic (for binary outcomes) regression models, adjusting for potential confounders. Then, he fit models in each country separately, with adjustment for a site if appropriate.

He assessed heterogeneity between nations and, where applicable, either used a random-effects meta-analysis or combined data into multilevel models with random effects for the country.

To identify which patients were likely to develop persistent complications, functional impairment, or reduced quality of life, he used multilevel models to adjust for potential confounders.

 

Felipe is currently preparing the manuscript and plans to present the results at an international meeting.

Track 2: Supporting three acute care physicians in Ghana, Africa
Short-term fellowship case study 2 – in progress

Emergency Medicine Specialists & Specialist Anaesthesiologist and Intensivist.

The following fellowships are in collaboration with the African coaLition for Epidemic Research, Response and Training (ALERRT) & Mahidol Oxford Tropical Medicine Research Unit (MORU), through the Global Effort on COVID-19 (GECO) funding call.  GECO is a cross-UK government funding call aimed at supporting applied health research addressing COVID-19 knowledge gaps.

The project brings together Member Networks ALERRT and ’Network for Improving Critical Care Systems and Training (NICST)’, which is part of the Critical Care Africa (CCA) project – supporting healthcare teams to build a best-practice network of hospitals and ICUs in Africa.

The project started in January 2021; So far, the implementation of a clinical data collection system has allowed healthcare professionals to improve the quality of patient care by enabling clinicians to make informed decisions.

The studies are based at the Emergency Departments of Komfo Anokye Teaching Hospital (KATH) and St. Patrick’s Hospital. The other sites are the Adult and Pediatric Intensive Care Units of the Komfo Anokye Teaching Hospital (KATH).

The three local physicians/researchers have each developed three unique research projects collecting data using the critical care registry.  Their research projects aim to:

  • Detect early warning signs for critical care patients in the Emergency Department: Developing an algorithm that looks at the triage details like treatments performed and outcomes of patients during their hospital stay. It aims to assess whether there are any warning signs during their hospital stay and when in the timelines these can be picked up
  • Determine patient deterioration in the Emergency Department and the development of an algorithm for decision-making: using the same algorithm developed with the first project, to help clinicians make decisions in regards to treatment and patient care that would guarantee the best outcome; and
  • Assess the appropriateness of antimicrobial use in the Intensive Care Unit: It seeks to compare the existing practice to some selected CDC guidelines on the subject. They are in the process of expanding the ICU data to include other quality indicators such as Deep Vein Thrombosis (DVT) prophylaxis and stress ulcer prophylaxis.