Agency for Health Care Research and Quality Doctoral Training Fellowship in Health Services Research and Policy Analysis

The AHRQ training program is a three-year, full time Ph.D. program offered within Heller's Schneider Institutes for Health Policy (SIHP) to students. The primary objective of the program is the focused and rigorous preparation of doctoral students for teaching and research careers in universities, governmental agencies, or other research settings devoted to health services research and health policy. In addition to offering a core curriculum that emphasizes social sciences, research methods, and applied research courses, the program conceptually links health outcomes, providers and organizations, and health policies. Students are teamed up with SIHP researchers on existing research projects for eight hours per week during the academic year. Each traineeship includes tuition support and an annual stipend as well as a travel budget and University health insurance coverage.

The Academic Content of the Program

The AHRQ training program is sequenced to provide a doctoral education that includes the development of broad substantive knowledge in major policy areas, advanced training in the principles of research design/statistical reasoning, and experiences in the conduct of research. Students entering with a Master's degree must complete a minimum of 15 semester courses. In addition, each doctoral candidate must obtain approval for his or her dissertation by a four-person committee including a professional in health services research outside of the Heller community. Curriculum requirements are as follows:

Four Core Conceptual Courses

  1. Social Science Concepts, Theories and Values
  2. Economic Theory and Social Policy
  3. Policy and Program Implementation
  4. Social Policy and Population Groups
Five Required Research Courses
  1. Applied Regression Analysis
  2. Research Methods
  3. Applied Econometrics
  4. Either Advanced Econometrics or Qualitative Methods
  5. Applied Research: Qualitative Track or Quantitative Track
Required Applied Health Courses
  1. National Health Policy
  2. Advanced Course in Health Care Organizations
  3. Management of Health Care Organizations or Political and Organizational Analysis in Health Care
  4. Advanced: Course in Health Care Financing, Health Economics or Payment and Financing of Health Care
  5. Two from among the advanced courses listed in items 2 or 3 above, or those below:
    • American Health Policy and Law
    • Race/Ethnicity Gender, and Health Care
    • State Health Policy
    • Knowledge, Politics and Children
    • Economics of Mental Health
    • Issues in Substance Abuse
    • Applied Research in Substance Abuse
    • Economics of Aging
    • Long Term Care
In addition to the three specific areas listed above, our Ph.D. students are also required to attend the research seminar and to fulfill the following requirements:

The Core Conceptual Courses

The sequence of core courses in social policy include the different perspectives of the social science disciplines. A sociologist, an economist and a political scientist teach the core courses. These courses highlight the distinctive concepts, theories, and models of the various social science disciplines as applied to major social problems. These courses are designed to strengthen students' multidisciplinary and integrative skills by incorporating historical and institutional perspectives. It is strongly recommended that all AHRQ trainees take an additional theory course in economics, political science or organizational behavior.

In addition to classroom-based instruction, mastery of research methods is promoted through various short courses and seminars. These include the applied health services research seminar and a short course on cost-effectiveness.

The Methods Courses

The goal of the Brandeis doctoral program is for each of its graduates to have a sophisticated understanding of the principles of various research designs and the analytic skills necessary to address social research issues in a systematic and logical manner. All Ph.D. students are required to take four methods courses that provide mastery of quantitative and qualitative research methods:

The introductory Research Methods course provides a survey of social science research methods, as well as exposure to both theoretical and practical issues that determine the approach and conduct of a research study. The Applied Regression course includes statistics, linear regression, and a framework for determining what statistical package is appropriate: SPSS, SAS or LimDep. Applied Econometrics focuses on applications of regression analysis and the impacts of violations of the standard assumptions, especially with regard to limited dependent variables, while also covering applications of logit and probit regressions.

The AHRQ training program, like other National Institute of Health (NIH) funded training at Brandeis University is committed to producing doers of research rather than users of research. Therefore, the leadership of the AHRQ training program is conscious of the advanced methods, particularly quantitative, that we need to instill in the students in the AHRQ training program. Recently, a new course in Advanced Econometrics was developed and incorporated in the methods sequence of the Ph.D. program. We developed this course because most of the trainees needed more knowledge about the multivariate statistical techniques that could be applied for longitudinal and cross-sectional studies in completing their dissertations. In this course, a number of techniques are presented that are particularly important for recognizing the multiple levels or domains that could affect patient or population specific outcomes, including hierarchical linear models, fixed effects, and instrumental variables. This course is highly recommended for all those in the AHRQ training program.

Since many of the research studies addressing organizational issues and populations require great familiarity with qualitative methods, trainees so inclined may take Qualitative Research. The trainee's advanced applied research course can be either in quantitative or qualitative methods depending on the skill set desired by the trainee.

Research Seminar in Health Services Research

All first, second and third year trainees are required to attend a weekly health services research seminar. The year-long seminar attempts to do a number of things. At the conceptual or theoretical level, the goal of the seminar is to provide a focus on the four levels in the health care system and the linkages among them. The seminar focuses on the trainees' area of interest, development of dissertation topics and the preparation of the dissertation proposal. Critical to this major research undertaking is defining what is being studied, what factors are explanatory, and what factors must have controls. Each semester, we focus on new thinking (innovative methods and/or new theory) that could be applied to health services research.

Interspersed with student presentations are presentations by faculty from SIHP and/or outside experts. These presentations are intended to inform trainees about exemplary research activities and current policy initiatives. The seminar also attempts to enrich the AHRQ training program by exposing trainees to guest speakers, who present new ideas and are asked to give a "natural history" of their personal journey in health services research. The goal of having experienced researchers discuss their careers and projects is to provide role models for the trainees. Students present their preliminary dissertation topics and receive feedback on research design and analysis plans in their second year. Emphasis is placed on improving the clarity of the dissertation and delineating the theoretical issues embedded within their dissertation ideas. Students also engage in exchanges regarding appropriate methodologies for investigating specific issues.

Developing Research Skills through Hands-On Opportunities

The third important piece of the educational process is to learn to conduct research projects by actual project experience. This experience also provides research role models for the AHRQ trainees. All the trainees are expected to work on research projects, often but not always with their mentor, during their first two years and their own dissertation project during the third year of study. Trainees are involved in research projects for at least eight hours per week each semester. This experience prepares the student to undertake an independent research project as required for the dissertation. The research placements are negotiated by the trainee's mentor with each trainee at the beginning of the semester based on their joint appraisal of the trainee's strengths and needs.

While the research training gives trainees first-hand experience, they fall short in terms of being a managed learning sequence. Two major changes will coordinate the conduct of research and development of trainees as independent researchers. First, a team research project will be assigned in the first year. This will lead to the students' completion of a research paper by the beginning of their second year and its presentation in the weekly seminar. During the second year, students will be reviewed with regard to their research skills. Research opportunities directed at providing new research skills and addressing any deficits will be discussed and one or more projects selected. Second year students will be asked to write a research paper for presentation at an annual meeting. All the students completing their third year will prepare a paper for presentation at a national meeting relevant to their dissertation -- problem, approach, or findings.

Mentor Program

The AHRQ training program begins the mentoring process in earnest in the first day of the Ph.D. student orientation. All incoming AHRQ students start off with two mentors; one being one of the two co-directors of the training program and the other matched by primary disciplinary interest of the trainee: economics, organizational theory, sociology, politics, or behavioral science. The role of the mentor includes:

By the end of the first year, the mentoring arrangement is reviewed using an educational plan that each trainee is required to develop and share with the co-directors and the other mentor when appropriate. Mentors are also available for formal and informal advice concerning the dissertation process, including the selection of the chair and committee members. Mentors are very accessible to the trainees on a weekly basis in the style of the Oxford tutorial. Although the primary goal of these relationships is educational, allowing trainees to quickly become focused on important research questions, as they become independent researchers, the interaction often leads to many other benefits, including: