An Innovative, Dean's-Office Based Approach Designed to Increase Faculty Success

1. An Innovative, Dean's-Office Based Approach Designed to Increase Faculty Success Eugene P. Orringer, MD Professor of Medicine Executive Associate Dean for Faculty Affairs & Faculty Development Director, UNC MD-PhD Program

2. DISCLOSURES NONE

3. Background In 1999, I was minding my own business when my pager went off. It was Dean Jeff Houpt who was calling to inquire as to my possible interest in moving to the Dean’s Office, becominga Dean, and helping him develop the various academic aspects of the UNC School of Medicine.

4. A Dean????

5. A Dean???? He must be kidding!!!!!

6. A Dean???? • I had never even considered becoming a Dean • In fact, I had always thought that a Dean was not something that you actuallybecome • I always thought that a Dean was something that you turn into after: • All of your good ideas are used up • You are no longer able to compete for grant support

7. A Dean ???? • I had always been well-funded: • In fact, 1999, I was: • Program Director of the General Clinical Research Center (GCRC), a role I had held for over 10 years • Director of UNC’s MD-PhD Program • Co-Director of our NIH-funded Sickle Cell Center • Holding support from extramural sources for >90% of my time/effort

8. A Dean ???? Therefore, I was rather surprised when I was asked about my possible interest in moving to the Dean’s Office to assist Dean Houpt as he assumed the leadership of the UNC School of Medicine

9. My Own Personal Reflections My experiences with the MD-PhD Program made me realize just how much I enjoy working with young people and doing everything possible to help them succeed

11. UNC MD-PhD Program • Assumed responsibility for this program in 1995 & seen it grow from 12 students to 68 students today • Competed successfully for UNC’s first MSTP award which is now in its 10th year • Built an endowment that today is almost $4 million • Taught the students to write their own grant applications such that now 10 of our students hold F30 awards and several more F30 applications are at the NIH pending review • Particularly enjoyed watching as our graduates are now assuming academic positions at schools of medicine across the country

12. My Own Personal Commitments • Based on my experiences with the MD-PhD Program, I realized just how much I have always enjoyed working with young people and doing everything possible to help them succeed • In addition, I have always seemed to be successful growing programs

13. A partial listing of some of the UNC-Based Programs that I have worked to develop • UNC Comprehensive Sickle Cell Program • UNC GCRC Program • UNC MD-PhD Program • UNC BIRCWH Program • NCRR & Roadmap K12 Programs • K30 (Clinical Research Curriculum) Program • UNC CTSA Program • UNC Simmons (Minority) Scholar Program • UNC Program in Translational Science • UNC Bridge Funding Program

14. My Personal Reflections As I thought about Dean Houpt’s invitation, I realized that: • I am pretty good at building programs • I very much enjoy working with young people and doing everything possible to help them succeed • I have a passionate commitment to clinical & translational research • Moving to the Dean’s Office would provide a substantially larger stage on which I might be able to accomplish a great many things • Contrary to the “Gloom & Doom” predictions, I actually felt that 1999 was a quite a good time for young people committed to an academic, research-oriented career

15. Why 1999 seemed to me to be a good time • This was the beginning of the period of the NIH doubling • The Nathan Committee had recommended to Dr. Varmus that he do a number of things including creation of several new career development programs (K23, K24, K30, etc) • The Clinical Research Enhancement Act (CREA), which was likely to pass the congress, would: • Mandate the proposed K Programs • Set up a Loan Repayment Program for clinical researchers • Put the GCRC Program into statutory language

16. Status of UNC SOM in 1999 • Well into the top 20 in total NIH grant support • Lots of well-funded, very senior investigators • Numerous NIH-funded Centers & Program Project Grants • BUT, relatively few junior faculty members with a passion for & commitment to academic, research-intensive careers

17. My Institutional Philosophy At the end of the day, it is really the young people who are absolutely critical to the growth and the ultimate success of any School of Medicine

18. A Dean ???? During my initial discussion with Dean Houpt, he offered me the role of: Executive Associate Dean for Faculty Affairs

19. Executive Associate Dean I therefore told Dean Houpt that I was willing to consider assuming the role of Executive Associate Dean for Faculty Affairs, but only if he was willing to expand it to: Executive Associate Dean for Faculty Affairs AND Faculty Development

20. Executive Associate Dean A critical aspect of my negotiation with Dean Houpt was his agreement to support the creation of an office that we have referred to as the: Office of Research & Faculty Development

21. UNC Office of Research & Faculty Development • The cost of this office was a little over $500K/year. It gradually increased to a bit over $600K/year and has remained stable over the past several years • This includes a substantial percentage of my salary as well as that of the Associate Dean for Research • The development of this office was done in such a way that we were incentivized to obtain support for our salary from grants and contracts

22. UNC Office of Research & Faculty Development This office was created in 1999. When established, we set two overall goals for this office. These were: • To increase the amount of NIH grant support received by investigators in the School of Medicine • To reverse what appeared to be an inverse pyramid (i.e., numerous very well-funded senior investigators but few research-oriented, NIH-funded members of the junior faculty)

23. UNC Office of Research & Faculty Development When originally established, this office hoped to achieve these goals in three specific ways: • By assisting faculty members with the preparation of large multi-disciplinary, multi-school, and/or multi-institutional proposals • By developing & writing certain institutional grants (e.g., Renovation grants, K12 grants, Roadmap grants, etc.) that otherwise might never be written • By supporting junior faculty members with the preparation of their own, individual grant proposals (e.g., K awards, etc.)

24. UNC Office of Research & Faculty Development Has this office succeeded?

25. NIH Grant SupportUNC School of Medicine: 1970 - 2005

26. UNC Office of Research & Faculty Development Additional evidence of success comes from a spring 2002 report from a School of Medicine re-engineering task force that stated: “The budget of this office should NOT be cut. In fact, this office doesn’t cost us money - it actually generates money. Therefore, if anything the budget of this office should be increased!”

27. UNC Office of Research & Faculty Development Finally, we arranged for an independent evaluation of this Office to be conducted. Our goal was to evaluate the Return on Investment (ROI) that accrued to the School of Medicine from the various activities of the Office of Research & Faculty Development.

28. UNC Office of Research & Faculty Development The independent evaluation concluded that this Office is remarkably cost-effective. • Depending upon the year & the specific methodology employed, our Office was shown to generate somewhere between $4 and $10 for each dollar spent.

29. Office of Research & Faculty DevelopmentRepresentative Institutional Grants • Several NCRR-funded Renovation Awards • T32 & T35 Medical Student Research Training Grants • Doris Duke Medical Student Training Grant • Medical Scientist Training Program (MSTP) Grant • K30 Clinical Research Curriculum • K12 BIRCWH Grant • K12 Clinical Research Career Development • K12 Multidisciplinary Clinical Research Career Program • RTRC & several other NIH Roadmap Grants • HRSA-funded Minority Center of Excellence • CTSA Planning Grant & Final CTSA Award • etc, etc, etc………….

30. UNC Office of Research & Faculty Development

31. UNC Office of Research & Faculty Development Based on these data, we argued that in many ways this office functions much more like a Center than as a Unit of the Deans Office

32. Institutional K Awards K30 Program K12 Programs BIRCWH NCRR K12 Roadmap K12 Individual K Awards K01 K08 K23 Role of the NIH in Career Development at UNC

33. K30 - Clinical Research CurriculumUNC-Chapel Hill • K30 Award • UNC received funding as 1 of the initial cohort of 35 • The K30 grant provides funds for infrastructure • No funds for the trainees • Recently awarded a 5 year renewal

34. K30 - Clinical Research CurriculumUNC-Chapel Hill • Most K30 Programs placed emphasis on a new degree-granting program (e.g., MS or an MPH in Clinical Research or the equivalent) • Typical ‘product’ of our K30 Program is not a degree, but rather has been a grant (e.g., K23 or equivalent)

35. K30 - Clinical Research CurriculumUNC-Chapel Hill Representative Components • Course Work • Work-in-Progress Presentations • Small Groups Meetings • Mentoring Panels • Mock Reviews

36. K30 - Clinical Research CurriculumUNC-Chapel Hill Even more importantly, the K30 Program has become the foundation or platform upon which we have developed all aspects of our junior faculty development program

37. Development of Clinician-Scientists UNC-Chapel Hill Programs for Career Development • K30 Program • K12 Awards

38. K12 Award • A K12 grant is an institutional award designed to provide protected time to a group of scientists committed to academic research careers. • A K12 Award is very much like a training grant, but one that is designed for junior faculty rather than for post-doctoral fellows

39. UNC BIRCWH Program Building Interdisciplinary Research Careersin Women’s Health

40. What is meant by “interdisciplinary” • Aninterdisciplinaryapproach draws together experts from diverse disciplines with a goal of bringing their expertise to bear on a complex problem. • Each individual is expected to address this complex problem from the perspective of his or her own discipline. • It is very likely that the collective efforts of this diverse group of experts will have a far better chance of solving the complex problem than will any one of them working on it individually.

41. BIRCWH Program - National Data • Total # of BIRCWH RFAs - 4 (2000, 2002, 2005, 2007) • Total # of BIRCWH awards funded in these 4 cycles - 50 • Total # of BIRCWH Programs currently funded - 26 • Total # of institutions receiving at least 1 award - 37

42. Class of 2005 UC-Davis UCLA UCSF Kansas Kentucky Harvard Michigan Washington U UNC-Chapel Hill Cincinnati UTMB - Galveston Class of 2007 Colorado Northwestern U of Illinois- Chicago Tulane Maryland Boston U Minnesota Duke Oregon Pittsburgh Penn State MUSC Vanderbilt Virginia Commonwealth Wisconsin CURRENTLY FUNDED BIRCWH PROGRAMS

43. BIRCWH Program - National Data • Total # of BIRCWH Scholars (2000 - present) - 335 • Females = 264 (79%) • Males = 71 (21%) • Terminal Degree held by all of the BIRCWH Scholars • MD = 148 (44%) • PhD = 137 (41%) • MD-PhD = 40 (12%) • Other (PharmD, DVM, DDS, etc) = 10 (3%)

44. BIRCWH Program - National Data • The success of each BIRCWH Program is judged, in part, by the success of the Scholars competing for grants. • From the inception of the BIRCWH Program until the end of 2007, 335 BIRCWH Scholars have received a total of 117 NIH grants. These grants include: • Individual K awards 36 • R awards 72 • P awards 3 • U awards (cooperative agreements) 2 • Other NIH award mechanisms 4

45. BIRCWH Program History of the BIRCWH at UNC-Chapel Hill

46. UNC BIRCWH Program • UNC BIRCWH Award was first funded in 2000 & successfully renewed for 5 more years in 2005 • Each year, this grant has brought us a total of $500,000 • We have used the vast majority of these $’s to provide salary support to junior faculty members in exchange for 75% of their time that is carefully protected for research • Our goal has always been to assure that within 2 yearseach BIRCWH Scholar is able to write and submit an independent NIH grant (e.g., K23, K08, R01)

47. UNC BIRCWH Program Developed the concept that the UNC BIRCWH Program would have both: • BIRCWH Scholars • BIRCWH Associates

48. BIRCWH Scholar An individual who is receiving salary support from the BIRCWH grant

49. BIRCWH Associate An individual who had previously received salary support from the BIRCWH grant, but who subsequently went on to compete successfully for his/her own, independent grant support

50. UNC BIRCWH Program • This concept (i.e., Scholars and Associates) has enabled us to grow the UNC BIRCWH Program substantially. • By the end of year - 04, our BIRCWH Program had grown to a critical mass of 17 young people (9 MDs, 6 PhDs, 1 PharmD, and 1 MD-PhD), who came to us with remarkably diverse interests and from very different backgrounds.