Research activity at the University of Cincinnati (UC) College of Medicine faces substantial challenges, but those challenges can be overcome through teamwork, willingness to change and a shared striving for excellence, the college’s senior associate dean for research said in a presentation Tuesday, Jan. 17.
Stephen Strakowski, MD, delivered the special presentation titled "Art is I, Science is We: Research at the College of Medicine” in Medical Sciences Building Room 5051. The title is a quote from French physiologist Claude Bernard (1813-1878), noting the difference between the creative individuality of art and the consensus-driven teamwork of science.
"If we pull together, we’re going to be fine,” Strakowski told about 200 faculty and staff that filled the lecture hall. "If we don’t, it will be very difficult to navigate this tough economic time.”
Strakowski, also the Dr. Stanley and Mickey Kaplan Professor and Chairman, Department of Psychiatry and Behavioral Neuroscience, and vice president of research for UC Health, stressed that the research mission is central to the identity, prestige and success of the College of Medicine and UC Health.
"It’s really what separates our health system from all of the other health systems in the region,” he said. "We do research—groundbreaking discover to help our patients get better.
"So our research mission is a critical mission that we have to continue to foster, grow and promote.”
The most pressing challenge facing research at the College of Medicine, he said, is growing it in a tough fiscal environment that includes the after-effects of national and international recessions, reduced National Institutes of Health (NIH) funding levels and a $10 million financial shortfall for the College of Medicine in the current fiscal year.
College of Medicine research funding dollars were $169 million in Fiscal Year (FY) 2010 (July 1, 2009-June 30, 2010). That dropped to $133 million in FY 2011, partly due to the absence of one-time American Recovery and Reinvestment Act (ARRA) funding. Primary funded areas include neuroscience ($40 million), diabetes/obesity ($21 million), cardiovascular ($18 million), cancer ($12 million), infectious disease ($10 million) and military/trauma ($10 million). Much of the funding in several of these areas is in UC’s strong department of environmental health.
When combined with research funding brought in by the college’s research faculty at Cincinnati Children’s Hospital Medical Center, Strakowski pointed out, UC’s NIH research funding consistently outstrips that of Ohio State University. Nevertheless, he said, the College of Medicine cannot continue on the same path in which research is concerned.
"We have a trend (in funding levels), and the trend is not going the way we’d like it to. … It is going the wrong way, and we really want to figure out how to fix that,” Strakowski said, adding that publications and grant applications have also declined.
Strakowski said the college’s research community must accept change to meet the challenge.
"Even when things are going well, typically you have to be prepared to change,” he said. "Human beings don’t like change … but it turns out that the anxiety about change is typically far worse than the change itself. So we’re facing challenges, and we’re going to have to change things—it’s just that simple.”
Strakowski outlined a change model for the College of Medicine, including elimination of redundancies and excesses.
"We have to find areas where we can cut costs because that’s the fastest way to get the budget in line,” he said, adding that the change model also includes:
• Expansion of key areas.
• Anticipation and skillful management of economic threats.
• Refining, updating and supporting of critical infrastructure.
With that model in mind, Strakowski said, the College of Medicine needs to reach a better understanding of its research programs and complete a revised plan for research in 2012.
Key strategies, he said, will include a focus on excellence and translation, featuring investment in strong programs, top individual investigators and multidisciplinary programs.
"Being really good at something gives you an advantage,” Strakowski said. "Excellent science will get funded all the time, so we need to keep focusing on excellence. Being the best is what makes you successful in tough economic times.”
A clear research organizational structure is also vital, Strakowski said, and must be characterized by transparency and communication.
"If you all know what’s going on, if you contribute and are active, it contributes to what we’re doing here,” he said. "This is not Tom’s (Boat) College of Medicine, or my College of Medicine—it’s all our College of Medicine, and we all have to participate or it’s not going to move forward.”
The College of Medicine has already taken steps toward building a sounder infrastructure, including the creation of the senior associate dean for research position by Thomas Boat, MD, after he took over as dean of the college and UC vice president for health affairs July 1, 2011. Strakowski’s duties in that position include leading the College’s research mission, developing and implementing a strategic plan for that mission, overseeing research infrastructure development, advising Boat on research-related matters and sitting on the Dean’s Cabinet to manage the college.
• The University of Cincinnati Physicians Clinical Trials Office has expanded to UC Health systemwide and increased revenues by more than $3 million in the past 18 months.
• Two basic and two clinical research advisory groups have been created, charged with brainstorming for solutions to improve the College’s research effort and improving communication and transparency.
• A task force has been created to examine models for basic research.
• Core (shared) facilities and services will be reviewed.
Strakowski said a Research Cabinet has been created, with responsibilities and priorities that include strategic planning and implementation, review of the College of Medicine’s research infrastructure, review of the college’s graduate education and improved communication. The Research Cabinet meets twice a month under Strakowski’s direction and includes representation from the College of Medicine, UC Health, Cincinnati Children’s and the Cincinnati Department of Veterans Affairs Medical Center.
Future plans aimed at enhancing the research effort, Strakowski said, include developing a research database, creating a College of Medicine "study section” in which senior investigators mentor junior faculty, developing a program to identify and retain the best and the brightest students and fellows at the College of Medicine, developing a plan for effectiveness research, developing plans to implement research in the Epic electronic medical records system, developing a pilot research program and enhancing the university’s pre-med program.
A clinical research infrastructure is vital to the operation of UC Health and the College of Medicine, he said, noting that a new UC Health organizational chart for research operations will be instituted effective July 1.
"We want to continue to reinvigorate clinical trials,” he said.
Strakowski closed by again stressing teamwork, noting that the substantial challenges facing research at the College of Medicine must be faced as a group. Scientists are used to working in teams, he said, and must pull together for the good of the College of Medicine through good planning, sharing of resources retooling careers to help the greater good and striving together for excellence.
"We’re used to working in teams—we can do this,” he said. "Let’s really work on planning, sharing and developing multidisciplinary research teams.”
Strakowski’s presentation followed an Oct. 26, 2011, presentation by Thomas Boat, MD, dean of the College of Medicine and UC vice president for health affairs, in which he described his vision for the College of Medicine. Presentations by the other senior associate deans of the College of Medicine will be made by Lori Mackey (operations and finance), Feb. 28 in MSB E-351; Andrew Filak Jr., MD (academic affairs), March 20 in Kresge Auditorium; and Myles Pensak, MD (clinical programs), April 25, in Kresge Auditorium. All presentations will begin at 12:15 p.m.
View slides from Strakowski's presentation.