Creating a Productive Postdoctoral Experience: The Cancer Prevention Fellowship Program at NCI

Do you remember the excitement you felt when you completed your doctoral degree? For many, enthusiasm and research momentum may be dampened by postdoctoral positions or jobs that do not live up to expectations. It is therefore refreshing to learn of a postdoctoral fellowship opportunity that, for those with an interest in cancer prevention and control, garners glowing reviews.

The National Cancer Institute's (NCI's) Cancer Prevention Fellowship Program ( CPFP) provides training, support, and unique opportunities to postdocs for developing their own interdisciplinary research program. "Given the model of most traditional postdoctoral fellowships, I am continually pleasantly surprised by the degree to which I am able to carve out my own niche within the fellowship," says second-year Cancer Prevention Fellow Kay Wanke. "We are encouraged to craft our own fellowship experience and even begin our own research program."

Founded in 1986 with the goal of training scientists and clinicians in cancer prevention and control through mentored research opportunities, CPFP invariably attracts a unique cadre of individuals, including laboratory-based scientists, behavioral scientists, epidemiologists, statisticians, nurses, physicians, ethicists, and lawyers. Despite their diverse backgrounds, individuals who apply to the program share a strong desire to explore the potential public health implications of their research. Leah Mechanic, a third-year fellow, realized that her previous training had been very focused and that she "really wanted and needed more training to address the public health impact of my research."

CPFP fellows obtain a master's degree in public health (M.P.H.) during their first year in the program to ensure that they have a strong foundation in the population-based research methods relevant to public health research and disease control. In the ensuing years of mentored research at NCI, fellows integrate their area of expertise with didactic training in epidemiology and statistics. The ultimate goal of the program is to enable fellows to develop and implement interventions in the field of cancer prevention.

Melinda Butsch Kovacic, a first-year Cancer Prevention Fellow currently enrolled in the M.P.H. program at Harvard University, did not want to do a normal postdoc. Instead, she "wanted something that would give me flexibility and allow me to work at different levels of science in basic research and epidemiology." Similarly, Ashley Smith, a first-year fellow completing her M.P.H. degree at the University of Pittsburgh, wanted to build on her background in "psychosocial research to develop a more comprehensive approach to cancer prevention through a public health model."

Getting In: The Application and Interview Process

CPFP targets junior scientists from diverse backgrounds, and candidates undergo a two-part selection process. First, submitted applications are evaluated based on academic merit, letters of recommendation, and a personal statement. Thirty individuals are selected from all of the applicants for onsite interviews--the second part of the evaluation process--at NCI in Bethesda, Maryland. Applicants spend a day meeting with fellows, CPFP alumni/ae, and program directors. They are given an overview of the program and attend the Division of Cancer Prevention colloquium. They also participate in a group interview with members of the Scientific Education Committee, which is made up of researchers in the field of cancer prevention and control. In describing the program to potential fellows, Douglas Weed, CPFP director, proudly states: "If accepted into the program, this is the last postdoc you will ever do." Although exhausting for the candidates, and probably for the Scientific Education Committee as well, the interview experience is worthwhile. The events of the day are informative and provide an opportunity for applicants to learn more about the program.

The Training Program: Year One

Fellows without formal training in public health begin CPFP back in school, working toward an M.P.H. degree, a cornerstone of the fellowship. After acceptance into CPFP, individuals independently apply to an accredited school that offers a 1-year M.P.H. program. NCI provides support for the M.P.H. training with the expectation that fellows will subsequently spend 2 to 3 years at NCI in a mentored research setting. Individuals who have an M.P.H. degree or advanced training in epidemiology or biostatistics before joining CPFP begin their mentored research at NCI in their first year.

Time and again, the M.P.H. component of the fellowship program has proven to be extremely valuable. Wanke sums up the views expressed by her colleagues: "Exposure to the philosophy and tools of the fields of public health and epidemiology broadened not only my competence as a researcher but also my ability to clearly analyze and investigate the research questions that I will encounter as a behavioral cancer prevention scientist." Mechanic agrees: "I enjoyed the M.P.H. experience, and I have found it very useful. My current research combines ... epidemiologic methods and basic science methods. Individuals need to have some training in both fields to bridge the gaps."

Another third-year fellow, Susan Vadaparampil, said of her M.P.H. experience, "It was one of the most valuable things I could have done in my career. Having the time to really concentrate on all the coursework ... proved invaluable to me in my later research." Cancer Prevention Fellow Amanda Greene, whose background is in clinical health care services, initially questioned the usefulness of pursuing another year of formal education. "However, I found that the M.P.H. filled in some gaps in my previous education, and this has made me a better researcher. Additionally, the M.P.H. training increased my ability to communicate across disciplines and to translate research to both laypeople and policymakers."

The Research Program: Year 2 and Beyond

After completing the M.P.H. degree, all fellows attend NCI's Summer Curriculum in Cancer Prevention, "Principles and Practice of Cancer Prevention and Control." This course affords fellows the opportunity to acquire a broader understanding of the expansive field of cancer prevention. Opportunities to interact with faculty members are plentiful, which often helps fellows identify potential preceptors at NCI. In addition, the Summer Curriculum includes the "Molecular Prevention Course," which consists of a hands-on laboratory component and lectures in molecular biology given by investigators doing cutting-edge research in the field of cancer prevention. Upon completion of the summer courses, the real fun begins: working on a research project that typically bridges scientific disciplines.

The transition to the M.P.H. and then to research can be difficult. As a third-year fellow, Erik Augustson explained, "these transitions are extremely stressful. There will definitely be some adjustments which will require a person to be flexible and to be able to step back and take a moment to ... remember the whole reason you are here." To cope, he suggests working closely with peers. Greene concurs: "I continually asked multiple questions of my peers, faculty, and the CPFP staff. Whenever possible, I met with researchers from NCI and other places to get a better sense of what the opportunities for research in my area were and to see how this was connected to other research areas."

But fellows are not alone in negotiating these transitions. CPFP is committed to the professional advancement of its fellows and actively tracks their progress throughout the program. Second-year fellows receive formal training in writing grant proposals and oral presentation skills. Throughout the fellowship experience, fellows are strongly encouraged and supported to take advantage of the many training opportunities available to them through formal courses, field experiences, and seminars.

Recognizing the importance of attending scientific meetings, CPFP supports fellows to attend one scientific meeting per year, with attendance at additional meetings being supported by the fellows' preceptors. Dina Paltoo, a third-year fellow, says she "expected to receive adequate mentoring and training in my area of research interest, but the CPFP far exceeded my expectations. The mentoring that I have received has been excellent. Through the CPFP, I have been able to set up collaborations within and outside of the government, attend scientific meetings and symposia, and participate in weekly colloquia and fellows' research meetings. I have been able to train in scientific courses and other courses related to professional development, and I have been able to work on multiple projects at once."

In addition to onsite mentoring, CPFP fosters a network of former Cancer Prevention Fellows, which has evolved into an invaluable resource. CPFP alumni/ae hold positions at academic and government institutions, funding agencies, in clinical practice, and at policy organizations in the United States and worldwide. A prime example is Stephen Hursting, a leader in the field of cancer prevention research. Upon completing CPFP, he became an assistant professor at the University of Texas M. D. Anderson Cancer Center, an NCI-designated Comprehensive Cancer Center, in Houston. After launching a successful career at M. D. Anderson and becoming a leader in cancer prevention research, he was recruited to NCI to join the Division of Cancer Prevention as deputy director of the CPFP. He has continued to build his research program at NCI, and current fellows continually profit from his scientific knowledge, enthusiasm, and mentoring skills.

To learn more about the mentored research, professional development, and leadership training components of CPFP, stay tuned for Part 2 of this series.

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