Local Implementation of the LEAP Program Page 2

About the LEAP Fellowship

Local Implementation of the LEAP Program

• Funding/support: The current IDSA LEAP fellowship provides funding intended to support at least 75% of a fellow’s full-time effort for LEAP activities for the one year of the program. It is expected that any clinical duties will need to be reduced to fit in the 25% of their time that is not supported by the grant. Funding from IDSA is supplied as a one-time block grant of $100,000 at the beginning of the academic year. The grant is specifically intended to support fellow efforts, so use for purposes such as research/project expenses has not been allowed. Exceptions are made for residual funding after a fellow’s FTE cost for the year has been fully obligated, where use of residual funds can be approved on an individual basis for expenses related to specialized training or conference attendance costs for activities directly in line with the aims of LEAP training (such as leadership or public health coursework).

○ Implementation comment: In a comprehensive assessment of the LEAP program conducted in 2023, the paradigm of having a fellow spend at least 75% of their time on LEAP activities was identified as potentially modifiable. Discussion with various stakeholders noted that a lower percentage of required effort (such as 50%) would potentially be sufficient to allow for adequate levels of exposure to the health department and hospital administrative ID specialties, though it might require reduction of the scope of fellows’ projects. One possibility also proposed was to eliminate the fellow project, which might potentially allow for program activities to be completed with support levels as low as 25% for the year.

• Recruitment/fellow selection: Candidates are selected primarily for their level of interest in making hybrid clinical/academic careers working alongside public health, such as careers in health care epidemiology, antimicrobial stewardship, community health care leadership or health department consulting. The target candidate is an early-career ID physician who will be between their second year of fellowship through their fourth year post-fellowship. Candidates who appear to be intent on pure research career tracks are generally not considered optimal for LEAP training given that there are many other funding sources more appropriate for development of a research career, such as NIH K awards. Candidates are required to submit a proposal for their long-term project with their application, and candidates are ranked from highest to lowest based on how closely their career interests match the goals of the LEAP fellowship, and whether their proposed project is both novel and achievable in the program timeframe.

○ Applicant requirements – Currently the LEAP program requires applicants to fulfill the following criteria. Most are in order to ensure that the applicants are active U.S. ID physicians, are within the target demographic cohort for the program and are affiliated with an institution that can accept the program grant and administer its requirements.

■ Have received an MD, DO or foreign equivalent degree from an accredited institution ■ Have a valid, active U.S. medical license at the time of application ■ Have previously completed their first year of an ACGME-accredited ID training fellowship ■ Generally, be no greater than three years postgraduate from an ACGME-accredited ID training fellowship, though candidates beyond three years may still apply and their applications will be considered on a case-by-case basis ■ If not presently in training, be an ABIM board-certified ID physician, or an ABP board-certified or board eligible pediatric ID physician ■ Be affiliated with an ID training program that meets the eligibility criteria defined in this document (acceptable affiliations include being a trainee enrolled in the training program, or a full-time faculty member in the ID division encompassing the training program) ■ Guarantee a minimum dedicated time commitment for LEAP fellowship activities during the academic year of 75% of full-time professional effort, in the event an award is made

○ Applicant institution requirements – The LEAP program requires applicants to be affiliated with an academic ID training program to fulfill the following criteria. These criteria are intended to ensure that there is existing infrastructure able to accept the program grant and administer its requirements, as well as that the training institution host ASP and health care epidemiology/infection prevention programs that can provide the required experiential exposures and a working relationship with a health department.

■ The program must have 501(c)(3) tax status. ■ The program must have an ACGME-accredited ID training fellowship. ■ The program must have an ID physician-led antimicrobial stewardship program fulfilling all of the CDC core elements of hospital antibiotic stewardship. ASP leadership must be supportive of the applicant’s education and participation in antimicrobial stewardship activities. ■ The program must have an ID physician-led hospital epidemiology/infection prevention and control program whose leadership must be supportive of the applicant’s education and participation in epidemiology and infection control efforts. ■ The program must have a working relationship with a local health department (city, county or state). The health department must be supportive of the applicant’s education and participation in health department activities. Candidates newly establishing connections between their institution and a department of health can utilize the CDC’s State-HAI Prevention Activities website to identify emails for the public health contacts for their state.

○ Application components – The national LEAP fellowship application package includes the following components:

■ A core application form, which includes information about the applicant, their chosen mentor, their training program contact information, divisional leadership contact information, contact information for their antimicrobial stewardship and hospital epidemiology/infection prevention program leadership, and contact information for the person at the health department supporting their application ■ A biosketch with personal statement, which is intended to understand the applicant’s overall career goals ■ Curriculum vitae ■ Brief individual development plan, which is intended to get a sense of what the applicant believes they need to achieve their short- to medium-term career plans, as well as how much consideration has gone into their stated career goals ■ Project proposal description and timeline document ■ Letter of support from training program director and ID division head ■ Letter of support from hospital epidemiologist and antimicrobial stewardship program director ■ Letter of support from health department sponsor/mentor ■ Letter of support from applicant-selected mentor

○ Implementation comments:

■ LEAP’s focus on early-career ID physicians was deliberate as that was considered the timeframe where the education, mentoring and networking provided by LEAP would have the largest impact on shaping and accelerating career development. One opportunity for change that has not yet been integrated into the national LEAP program was that the 2023 comprehensive program assessment noted a possible additional cohort where LEAP could be of significant impact: mid-career physicians interested in career shifts.

■ Many of the application requirements for the national LEAP program are intended to help identify candidates whose career aims align well with LEAP program targets and dissuade or identify applicants who are mistakenly applying to LEAP for nonacceptable purposes such as for continued research funding. These documents also are intended to confirm that an applicant is at an institution with the resources to provide educational exposures and experiences that are at the core of LEAP. A locally developed and run program with greater knowledge of both candidates and pre-selected performance locations could use a much more minimalistic set of application documents and still be able to select optimal candidates – for example, just the core application form, health department support letter, biosketch, CV, development plan and project proposal documents.