About the Program

The VA Quality Scholars program develops the next generation of health professionals to improve healthcare through innovations, quality improvement, and patient safety.

Our Vision

Upon completing this program, fellows will demonstrate competence in:

  • Interprofessional Collaboration and Teamwork
  • Improvement Methods and Skills
  • Organization and System Leadership for Quality and Safety
  • Research
  • Teaching and Learning

Our Mission

The Mission of this fellowship program is to develop leaders, researchers, and educators who can:

  • Apply knowledge and methods of health care improvement for the care of Veterans
  • Innovate and continually improve healthcare within and outside of VA
  • Teach health professionals about quality improvement and patient safety
  • Perform scholarly activities that contribute new knowledge to the quality and value of healthcare

Faculty at the Iowa City VAQS site are sought after for their expertise in research methods and specific content. Expertise includes nurse-physician communication, rural health, pharmaco-epidemiology, women’s health, infection control, and hospital medicine. Through the CADRE core investigators, fellows can access experts in qualitative research methods, quasi-experimental study design, implementation research, and secondary analysis of large databases.

Fellows come to our VAQS site to gain an expertise in locally driven quality improvement and access to VA data sources and expertise.

Our program site is known for a robust research infrastructure to support fellows in their scholarly endeavors whether they follow traditional health-services careers or healthcare delivery and quality improvement.

Recent fellows have completed degree or certificate programs in Health Administration, Clinical Investigation, Public Health, and Medical Education through support from our academic affiliate.

Clinical Educator Pathway

Fellows pursuing the clinician-educator pathway can identify expert mentorship in hospital and ambulatory medicine and quality improvement education. Faculty members will work with fellows to identify and support their interests, and tailor a balanced plan of clinical teaching, coursework, curriculum development, large and small group teaching, and guided self-study. Precepting at both University of Iowa Hospitals & Clinics and the Iowa City Veterans Affairs Medical Center, fellows will enjoy the opportunity to teach residents and medical students in acute care and continuity clinics, on the surgical co-management service, on the Medical-Psychiatry service and in both attending-directed and traditional team-based settings, as best suits their career focus. Fellows will participate in the Fellows as Clinician Educators (FACE) program, and can pursue additional coursework through the Master’s in Medical Education offerings, as well as through formal and informal faculty development sessions.

Clinical Investigator Pathway

Fellows wishing to pursue training in clinical investigation begin their training with an intensive "Summer Seminar in Patient-Oriented Research" (in fact, all fellows are encouraged to take the seminar). The fellow works closely with a faculty mentor to develop areas of interest for investigation. Fellows may qualify to enter the VA Quality Scholars Program, an innovative program to enhance the care delivered to the nation's veterans.

Clinician investigator fellows continue a clinical practice but focus the majority of their efforts on research training and methodology. Participation in faculty development skills sessions is expected.

Teaching Skills and Faculty Development

All GIM fellows participate in the teaching skills and faculty development sessions. These are organized and presented monthly in a seminar fashion. Depending on circumstances, some prior preparation is expected or follow-up assignments given. Topics include teaching in the clinic, teaching on the ward, lecture preparation, presentation of research papers or posters, and leadership in small groups. Faculty development involves the development of personal statements of teaching philosophy, organization of a teaching portfolio, career guidance, mentoring, and survival skills. The sessions are jointly developed and presented by members of the division and of the Office of Consultation and Research in Medical Education of the College of Medicine. Plans to expand participation by offering the sessions to other fellows in the department are underway.

Clinical Opportunities

Clinical Opportunities

All GIM fellows practice medicine in a continuity clinic, either at University of Iowa Hospitals & Clinics or at the VA Hospital. There are numerous opportunities for additional clinical skills. Fellows can arrange directly with the GI endoscopy service to perform flexible sigmoidoscopy. Rotations can be sought in medicine specialty clinics for fellows who wish further training in specific medical problems. Fellows who wish to gain experience in fields outside internal medicine can work with the Fellowship Director to identify appropriate venues. Members of GIM are helping to develop a Women's Health Center and fellows can rotate through this medical niche.

Fellows may choose to direct clinical attention towards the developing field of hospitalist medicine. Faculty members from GIM now supervise half of the medicine residency general ward experiences and a member of the division directs an active hospitalist program. Over a two-year period, enough experiences in hospitalist services can be gained to justifiably approach academic centers with credentials as a hospitalist. Similarly, a fellow interested in consultative general medicine can participate in the active General Medicine Consult Service.

All fellow continuity clinics function semi-autonomously with faculty interaction and advice readily available. Activity in other clinics or inpatient rotations occurs under varying degrees of supervision depending on the circumstances.

In addition to teaching assignments, fellows pursuing a clinician educator track can expect to be in clinics or on wards 50% time or more.

Ethics

Ethics

The Division of General Internal Medicine offers several opportunities for fellows to engage in meaningful discussion about ethics topics.

Biomedical Ethics Journal Club

The Journal Club meets once a month. Its goals are to foster interest in and knowledge of key topics in biomedical ethics, and to provide an open forum for discussion of issues related to clinical research ethics in an interdisciplinary environment.

Seminar in the Ethical and Legal Issues in Clinical Research

(in development). Specifically designed for clinical researchers, this course will fulfill the ethics requirements for T32 grants and other NIH training grants. Topics to be covered include: informed consent, confidentiality and privacy, conflicts of interest, the proper gathering, interpretation and retention of data, plagiarism, scientific misconduct, guidelines for responsibly determining authorship, issues in genetic research, the allocation of scarce medical resources, cross-cultural issues, "end of life" concerns, and legal and regulatory matters.

House Staff Curriculum in Clinical Medical Ethics

Sponsored by the Department of Internal Medicine and the Program in Biomedical Ethics, physician-ethicist Lauris Kaldjian, MD directs a series of monthly noontime conferences in clinical ethics. He is currently assisted by co-director Robert Canady, MD, resident in internal medicine. These sessions are case-based, interactive, and accompanied by didactic presentations. Topics pertain to broad issues in clinical medical ethics and are oriented to the practical realities faced by physicians-in-training. Topics covered thus far include end-of-life issues, futility, ethics in clinical education, treatment refusal, persistent vegetative state, and physician impairment. House staff are encouraged to suggest additional topics and to present patient cases from their own experience in order to make these conferences as current and relevant as possible.

Clinical Research Opportunities

Areas of Clinical Research

Clinical Preventive Services Delivery
Interactions of medical and psychiatric disorders
Geriatric studies (epidemiology, health care)
Quality improvement
Infections in the elderly
Decision analysis
Long-term care studies
Clinical trials methodology
Creation of educational programs
Molecular genetics
Molecular cardiology
Electronic medical records and automated decision support
Medically unexplained illness
Medical Comorbidity

Other Interfaces for clinical researchers

Researchers in the division of General Internal Medicine collaborate extensively with researchers from other fields within the University. Please explore the following links for more information on:

Seminar in Clinical Research

Seminar in Clinical Research

The Seminar in Clinical Research provides a forum for presenting and discussing ongoing research projects and methodology in patient-oriented research. Assigned readings are drawn from contemporary literature and works in progress of participants and guest speakers from various disciplines. Topics vary from semester to semester, depending on the interests and research needs of the participants. Relevant topics include: NIH and federal funding process, obtaining pilot grants, writing and speaking skills, adjustments for comorbidity, clinical guideline implementation, qualitative methods, and issues in quality improvement, among others.

Interdisciplinary Fellowship Conference

Below is an example of the Department of Internal Medicine Common Curriculum Schedule. It is shared between Fellows from all divisions of the Department.

PDF icon20-21 Fellows Conference Master Schedule.pdf

Fellows as Clinician Educators (FACE)

The Fellows as Clinician Educators (FACE) Program is designed to introduce future clinician-educators to a set of skills which may be of use in their career. The program presents concepts of educational design and research, lecture development, evaluation, observation and feedback. At the conclusion of the program, FACE participants are required to develop a teaching portfolio.

Learn more about FACE