Innovations in Career Development through Mentoring in the VTEU/IDCRC Programs

Abstract

Through the infrastructure of both the Vaccine Trial and Evaluation Units and the Infectious Disease Clinical Research Consortium, young investigators have been supported in their development and integration into these research programs. We share the history, current approach and future directions in mentoring to build the scientific leadership for these vaccinology-focused programs.

A Legacy of Mentorship

The support and training of young clinical investigators within the Vaccine Trial and Evaluation Units (VTEU) infrastructure has been a major focus of the program. As outlined in the manuscript on the History of the VTEU, many of the initial physician scientists who led the early VTEU sites were trained in the Laboratory of Infectious Diseases (LID) at the National Institutes of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health (NIH)¹ After leaving LID to assume academic appointments, they brought their acquired laboratory skills to conduct surveillance for bacterial and viral pathogens. They also utilized their expertise in contemporary immunologic methods to measure immune responses to natural pathogens and vaccines, and their experiences in conducting clinical vaccine trials to evaluate the safety and immunogenicity of new vaccine candidates.

Focused investigative programs targeting vaccines directed against influenza, pertussis, respiratory syncytial virus (RSV), and rotavirus included fellows and junior faculty who gained valuable expertise with these pathogens and their respective vaccines.^2–7 Additionally, the diverse age range and clinical conditions of vaccinees provided substantial training opportunities for young pediatricians, obstetricians, and internists alike.^8–10 Vaccine candidates were developed in both the intramural and extramural NIH-funded programs and tested in individuals of all ages. Many of the young investigators who trained within the VTEU infrastructure have achieved professorships at academic medical center and leadership positions in foundations, government, and pharmaceutical companies.

Early studies on maternal immunization conducted at Baylor University trained junior faculty members, including Janet Englund MD, Flor Munoz MD, and Mary Healy, MBBCh who are now leaders in the field of maternal immunization.^11–13 In the early 1990s, the reactogenicity of whole-cell pertussis vaccines led to the rejection of pertussis vaccination by many countries, prompting initiatives to develop safer yet still effective pertussis vaccines. ¹⁴ Many junior investigators from the VTEU sites collaborated in a consortium that resulted in the Multicenter Acellular Pertussis Trial (MAPT) which evaluated 13 different acellular pertussis vaccines and two whole cell vaccines in over 2000 children.¹⁵ Drs. Kathryn Edwards, Janet Englund, Margaret Rennels, Michael Pichichero, Mark Steinhoff, Edwin Anderson, and Michael Decker led these pertussis vaccine studies at individual VTEU sites and subsequently became recognized leaders in vaccine evaluation. Barney Graham was a fellow, PhD candidate, and later a faculty member at Vanderbilt and dedicated much of his career to working on RSV vaccines in animal models and clinical trials.^16–19 Dr. Graham and other Vanderbilt mentors trained Kathleen Neuzil MD, MPH, who has had a productive career focused on vaccinology at the University of Washington, at the Population Approach to Health program, the University of Maryland, and who previously led the Fogarty Center at the NIH.^20–23 It is also important to highlight that many of the early investigators evaluating vaccines against human immunodeficiency virus (HIV) received their training within the VTEU infrastructure before individual HIV vaccine evaluation units were established.

As the initial junior investigators evolved into established investigators another generation of vaccine researchers were trained using the VTEU infrastructure, particularly for their Mentored Early Career Development K-award supported research. Notable examples of these investigators include Natasha Halasa MD, MPH who studied neonatal pertussis vaccines and Helen Keipp Talbot MD, MPH who evaluated the impact of vaccines in older individuals hospitalized with influenza.^24–27

While significant mentoring and support of emerging investigators took place within the VTEU infrastructure, the advent of the Infectious Disease Clinical Research Consortium (IDCRC) marked the initiation of a more formal two-year mentorship program. The IDCRC Mentoring and Career Development Program (MCDP), launched in 2021, was designed to support a diverse range of investigators engaged in vaccine-focused research.

Mentees were selected from nominees within the existing VTEU sites based on their interest in pursuing an academic career in vaccine evaluation. To qualify, nominees needed to submit a proposal for a vaccine related project, backed by a strong commitment of an experienced mentor to support their development. A formal application process was established, and a committee was formed to evaluate the candidates. The intent, components, assessment and iterative improvements of the program are detailed herein.

Components of Program: Engagement from the Onset

The MDCP was designed to provide not only a foundational understanding of how the IDCRC and VTEU functioned but also to offer substantive opportunities to address common challenges faced in an academic career. The program was led by two senior members of the VTEU group, both of whom had extensive prior experiences in mentorship. The first two years, Drs, Igho Ofotokun and Kathryn Edwards led the program, with Dr. Lara Danziger-Isakov, also an experienced mentor, taking over from Dr. Edwards in the third year.

With 18 mentees including fellows and junior faculty representing various disciplines (infectious disease, medicine, pediatrics, pulmonary medicine, rheumatology) in each cohort, the program fostered an intimate environment that encouraged the development of long-term relationships over the two-year period. A mentor-mentee contract was established to ensure both mentees and their mentors understood their commitments, not only to the program, but also to each other.

One of the initial goals of the mentorship program was to create dedicated time for the mentees to engage with one another. Given that the program was launched during the COVID-19 pandemic, this interaction was accomplished virtually through regularly scheduled web-based meetings.

The initial and ongoing components of the program included a web-based series of educational didactics focused on the structure of the IDCRC and how to effectively navigate its framework. Highlights in these presentations encompassed available resources for protocol development and execution, statistical methodology support, and regulatory guidance.

Additional interactive discussions targeted career and personal development, covering topics such as manuscript writing, overcoming imposter syndrome, enhancing time management skills, developing social media and communication skills, and fostering mentoring relationships. Training on how to leverage social media for academic engagement and advancement was also included.

Another well-received component consisted of career development presentations that outlined various pathways to success and leadership in academia, governmental and industry positions, all emphasizing vaccine-related research. Presenters shared the breadth of their experiences, including both their professional and personal journey, as well as lessons learned throughout their career. These talks often highlighted the challenges faced by now-established researchers, such as feelings of the imposter syndrome, difficulties in engaging with the mentors, inadequate time to conduct proposed research, and difficulties around contribution acknowledgement within team science. Additional sessions supplemented the targeted topic-driven interactive discussions. Discussion time was allotted for questions and responses, and served to foster engagement among mentors, mentees and guest speakers alike.

Finally, the IDCRC supported the MCDP by offering a Pilot Project Grant Award each year, aimed at young investigators, including participants in the MCDP, to enhance their competitiveness for independent funding. To date, fifteen of these pilot awards have been granted, including at least one project that leveraged existing samples from a previous IDCRC project.

Creating community

Mentees

While the overall structure provided professional and research development support, a primary focus of the MCDP was to create a community that fostered relationships among participants. Early in the program, both mentees and the leadership team identified the need for dedicated time and space for discussions leading to the establishment of an independent mentee forum. This forum allowed mentees to share personal experiences and problem-solve in real time. Initially, discussion prompts were provided to jumpstart conversations, however, these quickly became unnecessary as strong relationships were formed and expanded.

During the first MCDP cohort, which took place during the COVID-19 pandemic, mentees raised challenges related to early-stage faculty positions in infectious disease. These discussions led to the development of suggestions to address pressing issues such as childcare interruptions, increased clinical responsibilities, and need for accelerated recruitment in clinical COVID 19 vaccine trials, ultimately resulting in a peer-reviewed publication in Clinical Infectious Diseases.²⁸

Peer-to-peer coaching was actively encouraged during all forums to further enhance connectivity and address common challenges. Once the IDCRC reestablished a yearly in-person meeting, mentees were encouraged to attend for networking opportunities with other mentees. A scheduled overlap between cohorts with several shared meeting times was initiated to expand engagement between the individual cohorts.

The overall impact of the program was the deliberate establishment of a mentee community that also grew organically, including peer-directed sponsorship as invited speakers across institutions and research collaborations. In addition, the MCDP Directors met individually with each mentee for one hour every six months. The mentee was asked to prepare an agenda regarding the topics that they wanted to discuss to maximize the benefit of these meetings. MCDP Directors emphasized support and encouragement, praise for accomplishments and suggestions to overcome various challenges. Discussions during these individual sessions were held in strict confidence, offering mentees a safe space to voice their concerns. Feedback from these sessions was highlighted in the mentee survey, indicating that access to unincumbered feedback during periods of growth and transition was perceived as essential to the program’s success.

Mentors

In addition to fostering mentee community, efforts to enhance mentor-mentee engagement included involving mentors in didactic sessions and extending invitations for career talks. These experiences enabled mentors from multiple institutions to share valuable insights regarding research and professional development.

IDCRC/VTEU Leadership

Ultimately, the MCDP aimed to elevate mentees through direct engagement with the leadership of the IDCRC and the broader vaccinology community. Within the current MDCP prior mentees from the initial cohort including Felicia Scaggs Huang, Erin Scherer and Tara Reid have taken on roles in organizing the lecture series and participating in pilot grant review since completing the program.

Leaders of the IDCRC from across the participating institutions were invited to serve as educational didactic speakers and to give career talks. Mentees were encouraged to select which Expert Working Groups (EWG) within the IDCRC they wished to join, allowing them to gain valuable experience in proposal development and review, alongside other members of the IDCRC community.

Additional open forums, designed and moderated by the mentees, featured discussions with thought leaders in vaccinology including Anthony Fauci, Kathleen Neuzil and Jeanne Marrazzo. Even after completion of the MCDP, former mentees are invited and encouraged to attend the monthly web-based programs to foster continuity in their professional development. Pilot grant award recipients presented their study findings in the monthly IDCRC leadership meetings, further increasing their visibility, underscoring the commitment of the IDCRC to developing future leaders in vaccinology.

Measuring Impact

Any program, especially innovative, multi-faceted initiatives, requires ongoing input for iterative improvement and measurement for overall impact. The MCDP, which spans two years per cohort, has engaged 18 mentees in each cohort, with the third cohort set to begin in 2025. With administrative support from the IDCRC, all aspects of the program have undergone consistent evaluation by both mentors and mentees to ensure effective programming is retained, while less impactful components are modified.

Yearly overview assessments are conducted to review the content of the didactic sessions and career talks, ensuring that programming is tailored to the specific needs of each cohort. Additional topics are incorporated based on requests, including discussions on promoting research results via social media and manuscript preparation. Notably, prominent journal editors from JAMA and the Journal of Infectious Diseases (JID) have shared their insights on enhancing the likelihood of manuscript acceptance.

The success of the program can be measured by the achievements of the participating mentees (Table 1). Early in its implementation, with only two completed cohorts, the MCDP has demonstrated substantial engagement and progress. Among the first cohort (2021–2022), 72% received a sponsored award, and individuals produced a mean of 19 (range 1–39) publications since their participation in the program started. Additionally, 63% remain affiliated with the IDCRC, and 27% have received academic promotions.

Table 1:

Profile of IDRCR MCDP mentees in Cohorts 1, 2, and 3

	Cohort 1	Cohort 2	Cohort 3*
Number of Mentees	16	18	15
Female	81%	61%	73%
Male	19%	39%	26%
MDs	77%	94%	93%
PhDs	19%	28%	13%
Number of publications since the start of the program (range)	19 (range 1–39)	21 (range 1–75)
Received IDCRC Pilot Award	27%	14%
Remained engaged with the VTEU (%)	63%	78%
Received research funding as PI (%)	72%	35%
Serve as a Co-investigator on sponsored award (%)	72%	85%
Received academic promotion (%)	27%	50%

^*Cohort 3 currently active: outcome measures not assessed to date

The second cohort (2023–2024) has also experienced notable success, with 78% maintaining affiliation with the IDCRC, 85% serving as co-investigator on sponsored awards or subawards, and 50% achieving academic promotions.

Conclusions and future directions

The VTEU has a long-standing track record of mentorship in vaccinology. Notably, many current leaders in the field were nurtured through influential VTEU mentorship. With the advent of the IDCRC, the culture of mentorship in vaccinology has been strengthened by organization into a formal structure known as the MCDP.

In just four years and three cohorts of mentees, the MCDP has demonstrated remarkable accomplishments, facilitating meaningful engagement among mentees and mentors while fostering professional growth, as evidenced by the high number of publications, academic promotions, and receipt of sponsored awards.

The didactic and career lecture series, the supportive community, and the engagement of IDCRC leadership at all levels have been crucial to the program’s success, providing opportunities for professional development and networking while enhancing the visibility of the mentees. Furthermore, the establishment of mentee forums has proven effective in offering a platform for sharing challenges and fostering collaboration. The program’s commitment to continuous evaluation and refinement ensures that it remains responsive to the needs of mentees leveraging the iterative process to adapt programming to address emerging trends and challenges in vaccinology.

As the program continues to grow and evolve, we plan to enhance our evaluation process by incorporating robust systems for tracking the long-term career progress of mentees even after program completion. These data should provide valuable insights into the sustained impact of the mentorship experience. We also intend to continue the formalized feedback mechanism that allows participants to continually offer suggestions for program improvement through regular surveys and/or focus groups, providing additional means to address the evolving needs of mentees.

Other areas for growth include fostering cross-VTEU collaborative research projects among mentees, mentors, and experienced investigators within the IDCRC network to catalyze innovative studies and maximize resource utilization. Lastly, our ultimate goal is to expand the pool of independently funded leaders who can continue to advance the field of vaccinology. Therefore, we will place continued emphasis on grant writing and impactful science to strengthen our mentees’ competitive advantage in applying for funding prioritizing career development awards.

With the progress we have made to date and the new initiatives being contemplated, we are confident that the MCDP will continue to play a vital role in nurturing the next generation of leaders in vaccinology while adapting to the dynamic landscape of infectious disease research.

Figure 1:

IDCRC Mentoring and Career Development Program (MCDP) Overview. IDCRC: Infectious Disease Clinical Research Consortium; VTEU: Vaccine and Treatment Evaluation Units; EWG: Expert Working Groups;