Background

Elekta support for Fellowship programs is distinctly different from support we sometimes provide for educational activities such as conferences, symposium and the like, both in terms of underlying purpose, duration, and scope.

This document summarizes the distinctive issues and considerations regarding Fellowship programs, and outlines the application process for Elekta fellowship support requests.

A Fellowship is defined as a period of sub-specialized medical training that a physician may undertake after completing a specialty training program (residency). Fellows are capable of acting as attending physicians or consultant physicians in the field in which they were trained and credentialed, such as radiation oncology, neurosurgery or internal medicine. In some cases, these sub-specialitists are certified by an accredited body prior to practicing independently in the area, but in some cases certification may not be necessary. Fellows sometimes seek subspecialty training in an area of interest that would not necessarily require special credentialing in order to practice. Examples are regional, and may include areas such as pediatric radiation oncology, brachytherapy, gamma-knife surgery, SBRT and the like.

Fellowship Support Guidelines

Elekta provides support for fellowship programs that go beyond the mere training of a single physician seeking further specialization.  We focus on fellowships that serve a broader purpose, such as addressing physician shortages in critical need sub-specialty areas, geographies, and advanced technologies, or identifying and promoting safer and more effective methods of treating cancer and brain disorders in patients.    

In order to comply with applicable laws, as well as conflict of interest policies of both Elekta and Fellowship recipients, potential support for Fellowship programs and the decisions related to such support are made separate and independent from Elekta’s commercial operations.  

Likewise, Elekta does not provide fellowship support directly to individuals, only to fellowship programs at institutions with a genuine educational function. 

These Guidelines ensure all Fellowship decisions are made based strictly on the educational value, scientific merit and other broader purposes served by the program.

Qualifications

Minimum Qualifications

We are very selective about the Fellowship programs we support.  Below are the minimum qualifications a Program must meet to be considered by Elekta:
a.    Clear and well defined objectives that serve broad-based patient, educational, developmental, societal or scientific goals    
b.    Fair, transparent and open fellowship selection process
c.    Budget that is reasonable and consistent with the objectives of the program 
d.    Full documentation identifying projected program costs and allocation of funds provided by Elekta
e.    Demonstrated success with past Fellowship or similar programs 

Preferred Qualifications

In addition to the minimum qualifications listed above, Elekta considers the following preferred qualifications when evaluating Fellowship Progams seeking support:
a)    Programs that result in scientific publications in peer-reviewed journals, abstracts or presentations at professional meetings
b)    Programs that align with the product capabilities or potential future capabilities of Elekta technology
c)    Programs that may produce advances in the safe and effective use of treatments using Elekta technology
d)    Programs that may generate intellectual property Elekta is authorized to use to enhance the safety and effectiveness of its technologies   

Relative Disqualifications

Elekta will consider, but may not be able to support, Fellowship programs that meet the following attributes:
a.    Limited benefits beyond the host institution and/or individual Fellow
b.    A central or primary purpose is to gain educational or clinical experience with existing technology, which is prevalent in the market and not in research or early stages of clinical use
c.    Significant amount of time spent on providing reimbursable medical services directly to patients, especially using existing and prevalent technology, 
d.    Specialty or sub-specialty area that is already well represented in the field,
e.    Institution already receiving support from Elekta in connection with a similar program  

Research and Scientific Consideration:

In some cases, a Fellowship program may have potential scientific merit and potential for derivative research output that could be of interest and value to Elekta.  
a.    Specifics of that research, the resultant material, and its scientific value to Elekta need to be clear and transparent.  

It is important to note that established mechanisms within Elekta to directly support scientific and clinical research activities (i.e. - Investigator Initiated Research (IIR) Grant Program) already exist.  This granting process is transparent, regulated, and provides funding at fair market value for investigator initiated research of interest to Elekta.  In light of this and the incumbent Fellowship support considerations, applications that may impart significant scientific merit should be directed to our IIR program unless other overriding considerations exist.

Application Considerations, Submission and Review Process

Any Fellowship application received by Elekta will be processed and evaluated for its merits by Elekta Medical Affairs.  A structured process will need to be followed that begins, in a stepwise manner, with the completion of the form included with this material.   

Applications should be submitted to Elekta by 6 months (ordinarily, late December) preceeding the intended beginning of the Fellowship in order to allow sufficient time for evaluation, and to assess budgetary considerations.

a.    Prior to initiation, applicants are strongly encouraged to speak with an Elekta representative in Medical Affairs for guidance.   Please contact joel.goldwein@elekta.com or ben.pais@elekta.com.
b.    Applicants are initially asked to complete only Section I of the form and to submit the form to Elekta via email at joel.goldwein@elekta.com or ben.pais@elekta.com.  
c.    If an application includes a component intended as a request for clinical or scientific research support, the application will be returned and an Elekta IIR application process will be suggested as an alternative.  This step would normally be unnecessary provided there is discussion with Medical Affairs as stipulated in the first steps of this process.
d.    Section I will be reviewed by Medical Affairs and others as appropriate within Elekta Medical Affairs and Scientific Research.  The review will determine whether the proposal fulfills all the requirements, and will be returned along with further guidance as to appropriatness, value and funding potential.  In general, this review process will take approximated 3 – 4 weeks and will result in a “accept”, “accept with modifications” or “reject” status.
e.    Depending on the outcome of the previous step, applicants are then asked to complete Section II of the form and submit this along with Section I to Elekta Medical Affairs.  Elekta will then start a more comprehensive review and communicate the result back to the applicant. Review will consider merit, as well as circumstances whereby Fellowship funding may or may not be favored (see above guidance).  In general, 6 to 8 weeks will be required to fully process requests.
f.    The outcome can again be “approved”, “approved with modifications” (comments will be provided, and in that case the applicant will have to modify the proposal and resubmit) or “rejected”.  

If fully approved, a Statement of Work and/or Master Agreement between Elekta and the Institution or Organization being supported is required.  This agreement incudes information regarding mainly the timetable and payments.  

Review Process

The review process of Section I and Section II proposal will take into consideration, in addition to the Guidelines, Qualifications and completeness of the application, the following questions:

a)    Does the timeline proposed by the organization lead to the training proposed? 
b)    Is there (or might there be) significant overlap or redundancy with other Fellowships already being supported by either Elekta or others? 
c)    If there is scientific and research activities included in the program, does the application satisfactorily explain why they have chosen not to apply for support via an Elekta IIR Grant? 
d)    Will/might the Fellow require additional resources either from Elekta or from elsewhere that are not stipulated in the proposal, and if so, what might they be?

Transparency Policy

In some cases, we are required by law to report the funding we provide for Fellowship support to government or other agencies.  In the USA, this is a provision of the Affordable Care Act (ACA, section 6002) that applies to US licensed medical doctors and Institutions.  Some additional governments and agencies may also have such requirements.  Consequently, any support or cost equivalent provided by Elekta to an individual and/or any Institution may be reported under applicable laws, and in the case of the ACA, such information is available on a public, searchable website.