STATE OF THE

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STATE OF THE SCHOOL OF MEDICINE April 15, 2009
Steven T. DeKosky, MD Vice President Dean
2
Our Students

• It is with a deep sense of joy that I move
  that the Faculty of the School of Medicine,
  contingent upon the students' completion of the
  final requirements for their degree, recommend to
  the Faculty of the University of Virginia that
  the listed students be awarded the degree of
  Doctor of Medicine.

3
Our Faculty

• It is with gratitude and appreciationthat I
  thank our distinguished faculty.

4
Overview

• I. SOM Strategy
• Principles Goals
• Vision Communication
• Budget
• Chair Searches
• COI / Disclosure
• II. Faculty Survey
• III. Education
• UME / GME Admissions
• Match Day
• Awards / Grants
• Next Generation Curriculum
• IV. Research
• Funding
• Bridge Funding
• Stimulus Grants

• Cores Updates
• New NIH Awards
• New Research Facilities
• V. Clinical
• Budget MC / HSF
• Clinical Strategy in VA
• Clinical Strategy Group
• Top / Best Doctors
• Top Hospitals
• New Clinical Facilities
• Buchanan Awards
• Development
• VI. Faculty Awards Recognition

5
Fundamental Principles

• Respect
• Culture respect it but do not be bound by it if
  it is not helping accomplish objectives
• Always keep your promises
• Think win-win
• Avoid false dichotomies

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Goals

• To know we are valued for our work teaching,
  administration, patient care, basic research,
  clinical research.
• To have a sense of confidence and purpose
• Realize our competencies
• Recognize that we have excellent resources
• Appreciate our valuable colleagues
• Understand the privilege of working in a
  beautiful place doing what we love getting
  paid to do it
• Have effective communication among us
• Roundtable, public meetings
• AskTheDeanAnything_at_virginia.edu

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Vision for the School of Medicine

• Teaching evolve our curriculum high tech high
  touch
• Research support/expand basic, translational
  clinical
• Support our researchers expand as appropriate
• Assure stability of our graduate MSTP programs
• Support post-doctoral fellows (clinical and
  basic)
• Targeted expansion of cores and areas of
  excellence
• Clinical Service Move As One
• We are not divisible we cannot stand alone
• Address rifts among SOM, HSF, MC
• Interdisciplinary collaboration Nursing SOM
• Expansion/collaboration with partner hospitals
• Faculty Development support make our people
  aware of their possibilities and potential
• TAM, ADE, LAM

8
Communication

• 2008-09 Faculty Survey Comments
• Support the researchers we already have.
  Yes
• Welcome critical input. Yes. Bring a
  solution
• Attend to long term planning vs. short term
  problem-addressing Agreebut we can do both!
• The dean is ignorant of opportunities in
  entrepreneurial outreach Working to learn
  more
• Everyone is entitled to their own opinions but
  not their own facts.
• Daniel Patrick Moynihan

9
Budget

• Salary freeze for University faculty 2009-2010
• HR Managed Hiring Freeze
• SOM Budget
• Decreased endowment
• Decreased Eminent Scholar Match
• ETF unchanged
• 2009-10 budget cut of 6 has been incorporated
  cuts in all areas, greater in administrative
  areas
• UVa Capital Projects
• New Cabell and Ruffner Hall Renovations delayed
• Ivy Translational Building delayed for 1 budget
  cycle
• Medical Education budget is being reorganized
• Recovered funds will support new curriculum
  development Medical Education Building

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Chair Searches

• In Negotiations
• Obstetrics Gynecology
• Ophthalmology
• In Process
• Biomedical Engineering Mark Yeagar, MD, PhD
• Pediatrics Craig A. Peters, MD
• Physical Med. Rehabilitation Bobby Chhabra,
  MD
• Public Health Sciences Karen Johnston, MD,
  MSc
• Radiology Brian H. Annex, MD

Search Committee Chairs John Kattwinkel,
MD Mark E. Shaffrey, MD
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Conflict of Interest

• Financial interests reporting system
• Year 1 reporting went smoothly
• Version 2, which should dramatically increase
  ease of use, to be rolled out in late April
• COI policy modified to prohibit direction or
  participation in interventional human subjects
  research by individuals with a financial interest
  in the sponsor or product being tested of
• gt10K income in the past year/anticipated over
  the coming year or
• gt3 ownership

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Disclosure for Patients Students

• Those meeting the reporting threshold of 10,000
  or more/year or 3 ownership will be listed on a
  website for patients, students and others to
  review. They will be designated as one or more
  of the following
• Scientific Advisory Board member
• Investigator receiving research support
• Other consulting activities

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How do we view ourselves?
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2008-09 Faculty Survey

• n521 (60)

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2008-09 Faculty Survey
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2008-09 Faculty Survey
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Education
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Medical Education

• Medical Students
• Applicants 4,177
• Offers 373 (8.9)
• Target 142 (3.4)

Graduate Students Applicants 572 Offers
71 (12.4) Students 21 (3.7)
(as of April 14, 09)
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Medical Education

• 2009 AMA Foundation Leadership Award
• 2009 UVA Raven Award

Jason Franasiak SOM Class of 2009
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Medical Education

• MATCH DAY 2009SOM Class of 2009 (Dec08 May09)
  matched to wide range of highly competitive
  programs

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Medical Education
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Graduate Medical Education

• 12 Residency Review Committee Visits ALL
  received favorable Letter of Notification
• GME Innovative Grants Awarded
• Drs. Waggoner-Fountain, Bass, Borowitz, Friesen
  "Sign-out Training Development and Evaluation"
• Drs. Romness, Brown, and Chhabra "The
  Development of Web-Based and Surgical Simulation
  Learning Modules for Orthopaedic Conditions and
  Emergencies
• GME Certificate Program graduating its first
  class of 8 residents/fellows
• Certificates in Public Health Policy or
  Clinical Research

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Graduate Medical Education

• BIMS Graduate Education1 New, 2 Renewed
  Predoctoral Training Grants (SOM)
• 15 BIMS students awarded individual extramural
  awards (bringing total to 39 awards)
• American Heart Association NIDDK
• DOD NIGMS
• Epilepsy Foundation NINDS
• NCI NHLBI
• Pharmaceutical Research Manufacturers of
  America Foundation
• Reproduction

24
Medical Education

• Next Generation Curriculum Objectives
• Integrate/coordinate basic science and clinical
  experiences horizontally and vertically
  throughout the four years
• Regular and frequent patient contact in early
  years of medical education
• Integrate/coordinate patient experiences with
  clinical science
• Balance lectures, case-based learning, patient
  experiences and blocks of productive open
  time
• Create opportunities to explore the alternative
  pathways of general medicine, specialty
  medicine and research

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Medical Education

• Next Generation Curriculum Concerns
• What we have works. Why change?
• No evidence that an integrated curriculum is
  better
• Do we have the time resources needed for
  active learning models?
• Students will lose science education
• Loss of teaching funds if less lecturing done
• Changing expectations and impact on promotion
  tenure
• Anxiety about having necessary group facilitation
  skills and active learning methods

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Medical Education

• Curriculum Rationale Mandates
• USMLE Gateway Format - Redesign in progress
  with emphasis on medical science in clinical
  contexts
• Medical education as "the doctor's
  ability to access relevant information,
  evaluate its quality, and apply it to
  solving clinical problems"
• LCME Accreditation - Education Standard,
  ED-33 Medical schools should design,
  manage, and evaluate a "coherent and
  coordinated curriculum, defined as "content
  that is coordinated and integrated within and
  across the academic periods of study
  (horizontal vertical integration)."
• Teaching, practicing, and assessing knowledge
  and skills in context improves recall
  application (Bransford, Brown Cocking, 1999,
  How People Learn)

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Medical Education

• Curriculum Strategy Resources
• Faculty development programs
• New program Teaching in Academic Medicine (TAM)
• Successful pilot in Fall 2008, next course
  Fall 2009
• Medical education support (classroom course
  support)
• Instructional materials websites in development
• Enlist expert help consultation as needed

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Medical Education

• Curriculum Communication Feedback
• NEW WEB SITE for further information
  providing feedback
• http//www.healthsystem.virginia.edu/internet/med
  -curriculum/nextgeneration/advancingcurriculum.cfm
  
• Curriculum Workshop (September 20, 2008)
• "Open House" Forums (February 16, February 24,
  2009)
• ADE Forum on Next Generation Curriculum (March
  19, 2009)
• Presentations to department chairs and faculty
  (Ongoing)
• Listening Luncheons with Faculty (Second fourth
  Thursday of each month, ongoing)
• Medical Student Forums (April 6 May 3, 2009)

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Medical Education
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Research
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UVA SOM Total External Funding
Funding (in millions) by Fiscal Year
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Bridge Funding Program
Current SOM Bridge Funding 25 Department,
25 SOM, 50 VPR
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Stimulus Grants

• Instrumentation grants
• 12 submitted March 23 Large
  instrumentation grants May 6
• Supplements due June 5
• Go through grants and contracts
• Challenge grants due April 27
• Individual or group research
• Construction grants (3/institution) due June 17 
• Jordan Hall HVAC and electrical renovation
• Core renovation grants (2/institution)
• SOM will apply in September

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Research Cores

• NCRR Awards Received for Research Core Facilities
  (Total Awards 3M)
• LSRII polychromatic analytical flow cytometer
  (Flow Cytometry) - Timothy Bender, PhD
• 800 MHz NMR spectrometer (NMR Core) John
  Bushweller, PhD
• Cyclotron for the production of radioisotopes
  for PET scanning (Molecular Imaging) Stuart
  Berr, PhD
• 14 Shared Research Cores Web sites consolidated
  into Office of Research Core Administration
  (ORCA)
• ORCA 2008-09 Activities
• Training sessions/workshops held by 6 cores
• BioNMR Core Opened
• MolMart Reagent supply core opened
• Soon delivery to Fontaine Research Park

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Research NIH

• 2008-09 27 faculty served on NIH Study Sections
  4 served on NIH Special Emphasis Panels
• New NIH Awards
• K01 (Mentored research scientist development
  award)Elayne K. Phillips, PhD (DOM - ID)
• Craig S. Nunemaker, PhD (DOM - Endo)
• K08 (Clinical scientist research career
  development award)
• Yun M. Shim, MD (DOM - Pulmonary)
• Shetal H. Padia, MD (DOM - Endo)
• Christine L. Lau, MD (Surgery)
• Joshua C. Eby, MD (DOM - ID)

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Research NIH Awards

• K23 (Mentored patient-oriented research
  career development award)
• Rebecca A. Dillingham, MD (DOM - ID)
• K99/R00 (Pathway to independence award)
• Shayn Peirce-Cottler, PhD (BME)
• K12 Scholars awarded this year (CTSA)
• Amir A. Jazaeri, MD (Ob/Gyn)
• Michael G. Douvas, MD (DOM Hem/Onc)

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Research NIH Awards
R01
Anindya Dutta, MD, PhD Daniel G. Gioeli, PhD
Kimberly Kelly, PhD Irving L. Kron, MD
Victor E. Laubach, PhD Wendy J. Lynch, PhD
Marcy J. McDuffie, MD Benjamin W. Purow, MD
Heidi Scrable, PhD P. Todd Stukenberg, PhD
Jeremy B. Tuttle, PhD
U01 John C. Herr, PhD
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Research NIH Awards
R03 Daniel A. Engel, PhD R56 Susanna R.
Keller, MD Patrick A. Grant, PhD
R21 Abdullah Al-Osaimi, MBBS Gary Balian,
PhD David Brenin, MD Joanna B. Goldberg, PhD
Jonathan Kipnis, PhD Manoj Patel, PhD R25
Karen Johnston, MD, MSc Jaideep Kapur,
MD, PhD
40
Interactions of Malnutrition Enteric
Infections Consequences for Child Health
Development
Richard Guerrant, MD and William A. Petri, Jr.,
MD, PhD

• 30M from Bill Melinda Gates Foundation for
  Worldwide Study on Links Between Malnutrition,
  Intestinal Infection and Child Development
• William A. Petri, Jr., MD, PhD, additional 6.8M
  award from Gates Foundation to chair the
  Malnutrition Biomarkers Discovery section of the
  Mal-ED Network.

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High Impact Publications 2008-09
Please see State of the School Address on the
web for the full listing of faculty published,
by journal. https//www.healthsystem.virginia.edu/
internet/som/
Cell NatureNature Cell BiologyNature
BiotechnologyNature GeneticsNature
ImmunologyNature Medicine
JAMALancetNew England Journal of
MedicineProceedings of the National Academy of
Sciences (PNAS) Science
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Publishing 2008-09
Cell
Ian G. Macara Stavroula Mili Kodi S.
Ravichandran Dorothy A. Schafer
Daniel J. Burke Anindya Dutta Michael R.
Elliott Donald F. Hunt
Science
Jakub Bielnicki Julio Cordero-Morales Edward
H. Egelman Vitold E. Galkin
Martin A. Schwartz Valeria Vasquez Jason
Yang Xiong Yu
43
Publishing 2008-09
Nature
David L. Brautigan Vikas Chandra Brian G.
Fuller Pengxiang Huang Ian G. Macara
Stavroula Mili
Konstadinos Moissoglu Sara Rosasco-Nitcher Srila
tha Raghuram Fraydoon Rastinejad P. Todd
Stukenborg Page Tobelmann
Nature Cell Biology
Colin K. Choi Alan Rick Horwitz Jason M.
Kinchen Miguel Vicente-Manzanare Kodi S.
Ravichandran
Costi D. Sifri Annie Tosello-Trampont Leanna A.
Whitmore Jessica Zareno
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Publishing 2008-09
Nature Genetics
Nature Biotechnology
Wei-Min Chen Josyf C. Mychaleckyj
Ann E. Mills Patt Tereskerz
Nature Medicine
Nature Immunology
Thomas J. Braciale Benjamin Gaston Lisa
A.Palmer Jie Sun
Mark Cobbold Victor H. Engelhard Angela L.
Zarling
Lancet
Richard .L Guerrant Eric R. Houpt Janine
Jagger Elayne K. Phillips
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Publishing 2008-09
JAMA
David E. Bruns Steven T. DeKosky Barry M.
Farr Dan Larriviere
Michael J. Lipinski Shawn E. Lipinski Tyvin
A. Rich William G. Wilson
New England Journal of Medicine
Scott P. Commins Naren Gupta Jon Heavey

Michael J. Lipinski Thomas A. E.
Platts-Mills Amy P. Stallings
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Publishing 2008-09
Proceedings of the National Academy of Sciences
(PNAS)
David T. Auble Paula Q. Barrett Douglas A.
Bayliss Ann L. Beyer Robert A. Bloodgood John
H. Bushweller Robert M. Carey Xiangdong Chen
Olga Cherepanova Colin K. Choi Tornasz
Cierpicki Maria Sol Collado Arindam
Dasgupta Lucinda A. Davies Edward H. Egelman
Vitold E. Galkin Nick A. Guagliardo Jolanta
Grembecka William H. Guilford Tiffany E. Hamm

Marie-Louise Hammarskjold Jeffrey R. Holt Alan
Rick Horwitz Changlong Hu Donald F. Hunt
Jeneva A. Laib John A. Marin Albina
Orlova David Rekosh Neil Sen Martha L.
Sikes Rebekka Sprouse Trevor Starnes Edmund M.
Talley Ying Wang Cirle A. Warren Xiong
Yu Lei Zhang J. Julius Zhu
47
New Research Facilities
Carter Harrison (MR-6)
48
LiSA (Life Sciences Annex)
New Research Facilities
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Clinical
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Clinical Budget

• Medical Center (Inpatient)
• Economy is driving lower admissions 4.5 below
  last year
• MC has countered drops with cuts in operating
  expenses like pharma and supplies
• Doing better than many other like sized hospitals
  

Move As One
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Clinical Department Work RVUs(in millions)
Move As One
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Clinical Budget

• HSF 9 Month Figures
• Workload YTD RVUs 3.1 above last year but 1.2
  below budget
• Charges Payer Mix YTD gross charges were 3.8
  above last year but 0.3 below budget
• Accounts Receivable Month ending AR remained
  steady for the third consecutive month at
  55.5M
• Patient Collections YTD 5.4 above last year
  but 2.4 below budget. Beginning in March to
  meet budget, not caught up completely yet.
• HSF 8 Month Figures
• Fiscal management break even despite lower
  collections
• Investment Results also down 25-30

Move As One
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Clinical Strategy
Move As One
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Clinical Strategy
Move As One
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Clinical Strategy Group

• Co-Chairs Steven T. DeKosky, MD, VP Dean
  R. Edward Howell, VP CEO
• Robert M. Strieter, MD
• Irving L. Kron, MD
• Marc J. Dettman, JD, MBA
• Raymond F. Morgan, MD
• Brad E. Haws, MBA
• Staff Support Trish Cluff, MA, EdS
• Action Arm of CSG Marketing Strategy Group
• Co-Chairs Ray Costabile Trish Cluff

Larry Fitzgerald, CPA John B. Hanks, MD Jonathon
D. Truwit, MD Sharon L. Hostler, MD Ray A.
Costabile, MD
Move As One
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Clinical Strategy Group

• Augusta Medical Center (In negotiation)
• Cardiology EP, STEMI
• GI
• Pediatric EEG
• Echo Over-reads
• Echo New
• Zions Crossroad MD/VIP
• Primary Care
• Louisa
• Urgent Care
• Lexington
• Cardiology

Culpeper Regional Hospital Endocrine GI
Pain Management Anesthesiology Emergency
Med contract final Radiation Onc Lin/Acc
COPN Rheumatology Infectious Disease Bon
Secours Interventional Neuroradiology HOPE
Group Hem/Onc Kings Daughters Peds TCV
Surgery
Move As One
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Clinical Faculty

• 47 Top Doctors
• 161 Best Doctors in America

Move As One
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UVA Medical Center

• Named One of Americas 100 Top Hospitals

Move As One
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New Clinical Facilities
Move As One
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New Clinical Facilities

• Hospital Bed Expansion - 2011

Move As One
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New Clinical Facilities

• Emily Couric Cancer Center Spring 2011

Move As One
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New Clinical Facilities

• Barry Battle Building 2013

Move As One
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New Clinical Facilities

• Lee Street Connective Elements Spring 2010

Move As One
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Buchanan Endowment Awards

• Co-Chairs Karen Johnston, MD, MSc
• Larry Fitzgerald, CFO
• Total awarded 2008-09 2.2 M
• Helical Tomotherapy-based STAT Stereotactile
  Body Radiation (SBRT) Rapid Palliation Program
• Paul Read, MD, PhD Ke Sheng, PhD
• Stroke Telemedicine Tele-Education (STAT)
  Project
• Nina Solenski, MD Karen Rheuban, MD
• UVa Children's Hospital Heart Center Fetal
  Cardiology
• Anitha Jayakumar, MD Daniel Schneider, MD

Move As One
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Development

• Campaign Statistics
• 448.3M raised (as of Feb. 09)
• 90 of 500M goal achieved in 65 time elapsed
• 32M new commitments, to date FY09

66

• Awards Recognitionof our Distinguished Faculty

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Distinguished Recognition
Robert M.I. Carey, MD Distinguished Scientist
Award American Society of Hypertension Richard
Guerrant, MD Walter Reed Medal American Society
of Tropical Medicine Hygiene Jack M Gwaltney,
MD Alvan R. Feinstein Memorial Award American
College of Physicians Sharon L. Hostler,
MD Thomas Jefferson Award University of
Virginia
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National Leadership

• Robert M.I. Carey, MD
• President, The Endocrine Society
• Alan C. Dalkin, MD
• President, Association of Program Directors in
  Endocrinology Metabolism
• John M. Dent, MD
• President, American College of Cardiology
• Kevin C. Hazen, PhD
• President-Elect, Medical Mycological Society of
  the Americas

69
National Leadership

• Christopher M. Kramer, MD
• President, Society for Cardiovascular Magnetic
  Resonance
• Irving L. Kron, MD
• President-Elect, American Association of Thoracic
  Surgery
• Raymond F. Morgan, MD
• President, American Association of Plastic
  Surgeons
• Edward H. Oldfield, MD
• President, Society of Neurological Surgeons

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National Leadership
Karen S. Rheuban, MD President, American
Telemedicine Association Bruce Schirmer, MD
President-Elect, Fellowship Council President,
SAGES Education and Research Foundation Mark H.
Stoler, MD President-Elect, American Society for
Clinical Pathology
State Leadership
Nancy L. Harthun, MD President, Virginia
Vascular Society
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Editorships

• Vincent V. Arlet, MD
• Editor, European Spine Journal
• George A. Beller, MD
• Editor-in-Chief, Journal of Nuclear Cardiology
• Gordon Laurie, PhD
• Executive Editor, Journal of Experimental Eye
  Research
• Lawrence H. Phillips, MD
• Editor-in-Chief, Muscle Nerve
• Preston Reynolds, MD
• Editor (Special Issue), Academic Medicine

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National Recognition

• Amandeep Bajwa, PhD, Research Fellowship Award
• National Kidney Foundation
• Frederic A. Berry, MD, Robert M. Smith Award
• American Academy of Pediatrics
• James A. Blackman MD, MPH
• Fulbright Senior Scholar Award
• Jamieson Bourque, MD, 2008 Young Investigator's
  Competition, American Society of Nuclear
  Cardiology
• James R. Brookeman, PhD John P. Mugler, III,
  PhD 2009 Edlich-Henderson Inventor of the Year
• and George T. Rodeheaver, PhD, 2008
  Edlich-Henderson Inventor of the Year
• University of Virginia Patent Foundation

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National Recognition

• Timothy N. Bullock, PhD, Scholars Award in Human
  Immunology, Charles A. Dana Foundation Young
  Investigator Award
• Melanoma Research Alliance
• Roger C. Burket, MD, Outstanding Mentor Award
• American Academy of Child Adolescent Psychiatry
• Sheila E. Crowe, MD, Outstanding Women in Science
  Award, American Gastroenterological Association
• Nora Decher, MS, RD Leadership Development Award
• Pennsylvania American Dietetic Association
• Brian R. Duling, PhD, Zweifach AwardMicrocirculat
  ory Society
• Mentoring Award, American Physiological Society

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National Recognition

• Noelle Dwyer, PhD, Basil O'Connor Starter Scholar
  Research Award March of Dimes
• Robin A. Felder, PhD, Engelberger Robotics
  Award, Robotics Industry Association
• Dan Foltz, PhD, Research Scholar Award
• American Chemical Society
• Bruce D. Gaylinn, PhD, 2009 International Award
  for Excellence in Published Clinical Research
• The Endocrine Society
• Yan Ge, PhD, 1st Place
• National Young Investigator's Forum
• David Glover, PhD, Astellas USA Foundation Award
  
• American Society of Nuclear Cardiology

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National Recognition

• Heather M.I. Haughey, PhD, Enoch Gordis Research
  Recognition Award, Research Society on
  Alcoholism International Society for
  Biomedical Research on AlcoholismMark J.
  Jameson,MD, PhD, Young Investigator Combined
  Award, American Head Neck Society and American
  Academy of Otolaryngology Head Neck Surgery
  Foundation
• John Kattwinkel, MD, Virginia Apgar Award
• American Academy of Pediatrics
• Boris Kovatchev, PhD, Leadership Award,
  International Diabetes Technology Society
• David Y. Ling, MD, Fellow
• American College of Physicians

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National Recognition

• Jianhua Liu, PhD, 2009 International Award for
  Excellence in Published Clinical Research, The
  Endocrine Society
• John C. Marshall, MD, Clinical Investigator Award
  
• The Endocrine Society
• Marcus L. Martin, MD, Re-Named "The Marcus L.
  Martin Leadership Award," Society for Academic
  Emergency Medicine
• Danny Mistry, MD, ATC Gold Standard Award
• USA Swimming
• Steven A. Newman, MD, Honor Society Inductee
• American Ophthalmologic Society
• Robert E. O'Connor, MD, MPH, 2009 Keith Neely
  Outstanding Contribution Award, National
  Association of EMS Physicians

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National Recognition

• Edward H. Oldfield, MD, Cushing Medal
• American Association of Neurological Surgeons
• Jennifer K. Penberthy, PhD, Ambassador Award
• Association of Behavioral Cognitive Therapy
• Michael O. Thorner, MD, 2009 International Award
  for Excellence in Published Clinical Research
• The Endocrine Society
• Dale Medalist , Society for Endocrinology
• Brian Wamhoff, PhD, Irvin H. Page Young
  Investigator Research Award, American Heart
  Association
• Judith White, PhD, Fellow American Association
  for the Advancement of Science
• Jing Yu, PhD, Basil O'Connor Starter Scholar
  Research Award , March of Dimes

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