Top Research Institutions Reveal All

The three top-earning US medical schools, which together garnered nearly $1 billion (US) from the National Institutes of Health in 2001, employ strategies that lesser known institutions can also use, according to administrators. The medical faculties at Johns Hopkins University, the University of Pennsylvania, and the University of California, San Francisco, acquired nearly $982 million in NIH grants, more than 11% of the $8.67 billion awarded to 122 US medical schools in fiscal year 2001. Johns Hopkins researchers amassed $334.1 million covering 865 NIH grants; Penn won $327 million; and UCSF received $320.8 million, according to the NIH (grants1.nih.gov/grants/award/rank/medttl.htm). Last month, the agency released its medical school rankings by total 2001 award amounts. The ability to raise federal funding helps schools dominate in the competition for talent, and each of the country's top 10 received more than $200 million in NIH grants. The top 30 medical schools received more than $100 million each. "Medical schools are major partners for the NIH in accomplishing our mission," says Wendy Baldwin, deputy NIH director for extramural research. "They are responsible for such a broad range of research and are especially critical when it comes time to translate basic research into clinical application. It is that translation that is the ultimate goal." While many of the top earners obviously benefit from ample endowments and from reputations that attract ambitious faculty members, university deans say they have employed strategies that could prove beneficial to smaller institutions. "In the biomedical arena, Johns Hopkins has a reputation for collegiality," says Mike Amey, assistant dean of research administration at the medical school. "We try to have administrative procedures that encourage and support the cross-departmental collaborations." The school's fund for medical discovery, for example, provides institutional seed money to encourage staff scientists to devise new, cross-departmental research projects that, once proven feasible, can compete for NIH funds. Nurturing New Talent The school also awards institutional research grants to new faculty. "These are small amounts of money, but they allow junior faculty to explore new areas," says Chi V. Dang, vice dean for research at Hopkins. "We look for ways to prime the pump." Since 1986 the university has also provided salary stipends to new clinician scientists, allowing them to spend more time on research. These career-development awards, paid out of the university's general budget, provide as much as 75% of a clinician's salary, relieving junior faculty members of clinical duty so they can develop research projects and compete for external funding. The program has been hugely successful. After five years, 80% of participants are established as independently financed principal investigators. Like the other leading medical schools, Johns Hopkins has invested in creating shared facilities, including cores devoted to genetic resources, DNA microarray technology, protein sequencing, computing, spectroscopy, and imaging. "These core facilities make it easier for people to do their work, and it makes their grants very competitive," Dang says. Hopkins offers courses in designing and conducting clinical research, which include information on locating sources of funding. But the school offers few formal grant classes. "People are trained to do science and most of the excellent scientists learn grant writing from their mentors," Amey says, terming this approach the "Darwinian theory of career development." Strategic Solutions To help select areas for research concentration, the University of Pennsylvania School of Medicine uses formal strategic planning. The goal is to match emerging areas of research with existing or acquirable strengths. To accomplish this, senior officials in the medical school and university survey the faculty and staff to learn their areas of interest. The officials then cross-reference these interests to citation indices and previously awarded grants to validate and benchmark research strengths. "We do a self-assessment, examining our areas of excellence and growth for the future," says Glen Gaulton, vice dean for research and research training. A decade ago, this process led Penn to focus on retrovirology, cancer biology, translational research, and genomics. "We had some people working in retrovirology and others working in HIV, but their efforts were disorganized," he says. The school has since hired additional faculty and established a well-regarded center for AIDS research whose researchers have won numerous NIH grants. Penn's School of Medicine has launched its strategic planning for the coming decade. The goal is not to win grants, but to do excellent research, Gaulton says. "We do the science and don't worry where the money comes from," he adds. "To move forward, we may need to obtain more resources from targeted fundraising and endowments. But that's a separate decision from doing the science." The university also offers a comprehensive mentor program that includes required courses in grant writing and career development seminars for postdoctorate trainees. And like Hopkins, Penn offers extra instruction to promising researchers. The Medical Science Training Program, for instance, pays tuition and stipends for MD/PhD students enrolled in the oldest and largest joint-degree program in the country. The medical school has a dedicated staff that helps faculty members write grant applications for multi-investigator or multidisciplinary grants. "The amount of paperwork is staggering," Gaulton says. "It discourages most people from beginning the grant process." Like Penn, UCSF counsels junior faculty in grant writing. New faculty members can select three senior professors to serve on an informal advisory committee for applications. "The secret is, they begin with an hour and a half conversation, not a 35-page draft," says Keith Yamamoto, UCSF medical school's vice dean for research. The junior faculty member distills that discussion into a one-page document outlining three-to-five research project goals. The group enters a second round of talks and the researcher writes the grant proposal after this round. "This really changes the way applications are prepared and presented," Yamamoto says. "What they get is real feedback. We call it 'feed-forward.'" UCSF also sets aside about $7 million each year in an Opportunities Fund that supports researchers' crazy new ideas. These proposals, usually lacking preliminary data, are peer-reviewed with an eye to innovation and potential significance. While most ideas fail, many pan out. "When they get a hit, they can apply for and win NIH grants," Yamamoto says, adding that many UCSF grants originated with the crazy-idea fund. Trauma and Treasure For Johns Hopkins researchers seeking new NIH grants, this past year has been particularly challenging. Following the tragic death last June of a healthy volunteer in an NIH-supported asthma study at Hopkins, the federal Office for Human Research Protections (OHRP) directed the medical school to reexamine more than 2,600 previously approved research protocols, delaying the dispersal of funds and putting new grant applications requiring Institutional Review Board (IRB) approval on hold. To expedite and improve the review, in October 2001 the school contracted with Western IRB in Olympia, Wash., to process new protocols. "This has been very useful," Dang says. "The backlog was quickly alleviated." Some research grant applications fell through the cracks and failed to receive funding, but the IRB reviewed most to meet deadlines. (After the 1999 death of a patient in a gene therapy trial at Penn, OHRP investigators found no systemic problems and did not suspend medical school research activities.) Johns Hopkins' high profile and political savvy in obtaining federal grants no doubt contributed to President George W. Bush's decision in March to nominate Elias Zerhouni as NIH director. Bush said Zerhouni, head of the Hopkins medical school, would bring strong management skills to the NIH. While it can't hurt Hopkins research-ers for their former boss to be in charge at the NIH, it shouldn't help them either; the NIH director isn't supposed to get involved in peer-reviewed grant decisions. Despite the focus on fundraising, Gaulton cautions that the finances are not an end in themselves. "The purpose is not to get grants for the money," Gaulton says. "It's to create an opportunity for the re-searchers to do the best science." Ted Agres (tedagres@lycos.com) is a freelance writer in Washington DC. Supplemental Materials Medical School Largesse

Top Research Institutions Reveal All

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