Highlights: December MAC Meeting

Opening Comments from the Dean
David S. Wilkes, MD

  • Implications of HR 1, Tax Cut and Jobs Act, on Graduate Student Stipends
    • Negative impact upon our students, UVA, and nation
      • College will be less affordable
      • Discourages participation in higher education
      • Discourages employer investment in employee learning
      • Decreases US competitiveness
      • Brightest minds will go outside of the US to advance
    • Elimination of Section 117(d) provisions
      • Devastating to research programs
      • No longer able to provide tax-free tuition for graduate students
        • Example: stipend of $24K and tuition waiver of $29K – student’s tax bill triples to $4,920
      • Erodes progress made in developing strong interest in STEM programs
        • Puts STEM education out of the reach of many students
      • Our legislators
      • Themes of Incoming UVA President Ryan
        • Community: opportunity to interact with and learn from a broadly diverse group of students, faculty, staff
        • Discovery: new knowledge that solves problems, leads to practical application, and brings new perspective to enduring questions
        • Service: public universities serve the public, starting with their own states
      • New Strategic Hire: Ken Walsh, PhD. Professor of CV Medicine and Director, Whitaker CV Institute, at Boston University SOM. Starts January 25, 2018. $.9M year one, $3.5M over five years.

Overview of Equal Opportunity & Civil Rights Policies and Reporting Options
Catherine Spear, AVP Equal Opportunity & Civil Rights
Emily Babb, AVP for Title IX Compliance & Title IX Coordinator

  • Presentation addressed:
    • Notice of non-discrimination and equal opportunity
    • Policy of Sexual and Gender-Based Harassment and Other Forms of Interpersonal Violence (Title IX Policy)
    • Preventing and Addressing Discrimination and Harassment (PADH Policy) and Preventing and Addressing Retaliation (PAR Policy)
    • Why reporting is important
    • How to report prohibited conduct under these policies
    • How to address prohibited conduct
  • See presentation.

December Health System Board Update
A. Bobby Chhabra, MD, Chair of Orthopaedic Surgery

  • Dr. Chhabra shared highlights from the December 6, 2017, HSB meeting. The HS goals dashboard showed notable improvement in solid organ and bone marrow transplants and addition investments by Seed & Venture Funds, moving these two indicators to green. All other categories are yellow.
  • FY18 first-quarter financial results were shared.

The next meeting will be Tuesday, Jan. 9, 2018, in the BIMS Classroom.

It’s Time for You to THRIV

THRIV’s inaugural class of scholars: (l-r) Dustin Walters, MD; Jessica Keim-Malpass, PhD, RN; Kathleen McManus, MD, MS; Brynne Sullivan, MD; and Kyle J. Lampe, PhD.

The Translational Health Research Institute of Virginia (THRIV) program has announced a new call for proposals for mentored career development awards for junior faculty at UVA who are pursuing a career in clinical or translational research.

THRIV is a transformational cross-Grounds collaboration that leverages the latest advances in data science to accelerate innovation in health-related research and facilitate team science. THRIV seeks to support highly qualified junior faculty for activities related to the development of a successful clinical research or translational research career.

The first group of scholars came from three different schools across Grounds — the School of Nursing, the School of Engineering and Applied Sciences, and the School of Medicine — and I am excited see that applications are now open for the next group of promising scientists.

The THRIV Scholar Career Development Program aims to train the next generation of translational researchers in principles of data science, the conduct of rigorous and reproducible science, and to promote team science as a means to enhance innovation and discovery in health-related research. The program provides up to 75% salary/fringe support for up to 2 years for Scholars in addition to funding for research-related expenses and training.

For details visit THRIV’s website, or contact Sandra Burks.

Margaret A. Shupnik, PhD
Gerald D. Aurbach Professor of Endocrinology
Professor of Medicine
Senior Associate Dean for Research

Highlights: November MAC Meeting

Opening Comments from the Dean David S. Wilkes, MD

  • We learned a number of lessons from the DARs/CARs.
    • Accountability is key across all missions.
      • In education, we must ensure that students are prepared to perform the Entrustable Professional Activities.
      • In research, we must diversify the funding portfolios, maintain the standards for research funding per square foot of lab space, and maximize salary support on grants.
      • In the clinics, we must improve efficiencies across the board in the ambulatory setting and we must establish a group practice.
    • The reviews highlighted several priorities.
      • As leaders, we are all responsible for working together and guiding institutional change.
      • We must improve organizational structures and processes. In the dean’s office, we are doing this through developing business intelligence, improving IT infrastructure, and piloting the Be Smart initiative (lean processes).
      • We must build and strengthen external relationship across the University, through the Inova partnership, and through the CTSA initiative.
      • We will take education to a higher level through innovations in our graduate and master’s programs.
    • One of the programs we learned about in the DARs is the Silo Busters program in the Child Health Research Center (CHRC) in the Department of Pediatrics. James Nataro described Silo Busters for us.
      • The program is designed to facilitate interactions with basic scientists. Eligible basic scientists who will be working with Pediatrics faculty members are given joint appointments in the CHRC.
      • The research may be conducted in the lab of either the primary or the secondary appointee.
      • The objective is to attract basic scientists to work with clinicians.
      • The first Silo Buster recipients will be announced before the end of this year.

Bobby Chhabra, MD
The Department of Orthopedics’ clinical trials have grown from 4 trials in 2013 to more than 60 today. Over the last year, the clinical trials infrastructure has been fully supported by the overhead negotiated through the industry “rate card” mechanism.

Dr. Chhabra explained the methodology for developing the cost expectations for the rate card. It takes into account salary expenses (investigator and trial support staff) and OTPS. Billing may be based on an hourly rate or on trial enrollment and other milestones.

The rate card provides a process that is more streamlined and transparent for the budgeting process. It makes is easier for industry to set up trials. It provides salary support for MDs and PAs. The rate card helps to ensure that clinical revenues do not support the expenses of clinical trials.

VMED: Making Teaching and Learning Simpler

Making Virginia Medicine Better: (l-r) Dr. Megan Bray, Dr. Mary Kate Worden, Kim Holman, Dr. Maryellen Gusic, Robert Pastor, Dr. Randolph Canterbury, and Mark Moody.

Technology is supposed to make our lives easier and allow us to work faster or smarter; but it has to be the right technology, employed correctly. Too often we find some tech to be “good enough” and try to make it suit our needs. “Good enough” causes us to create Band-Aid solutions and workarounds which can translate to extra work and frustration. Over the years, the School of Medicine has been using a patchwork quilt of commercial and custom educational programs and software, added and modified where needed. We’re getting rid of them for something better.

The School of Medicine is in the process of building VMED, which stands for Virginia Medicine. This is an integrated learning-, curriculum-, and student-management system that is being designed with the specific needs of UVA in mind. We want to provide a seamless experience for students, faculty, and administration. With a system of our own design, we can build it to meet our needs instead of trying to muscle through the constraints of commercial software.

To build VMED, we started with the foundation of the UME NxGen Curriclum, the UVA 12 Competencies for the Contemporary Physician, which are our education program objectives for the MD degree. These competencies drive our educational activities and assessments, and VMED underpins those learning objectives and those, in turn, support our student management, online content delivery, assessments, gradebook, program evaluation, and much more. All of this assists us with our AAMC and LCME reporting and predictive analytics regarding our students’ USMLE performance. VMED, built from the ground up, also provides us with longitudinal data not only to assess our student performance but also provides us with program evaluation data necessary for continuous quality improvement

In simplest terms, we are replacing critical components in the student information system and think it will be a huge improvement for all. Student Source, Oasis, X-Credit, and Faculty Toolbox are a few of the current applications that are being replaced.

The largest pieces of VMED include:

  • the online testing system — Three classes of students are now using this.
  • a clinical assessment tool for undergraduate medical education — iCAN, which stands for Interactive Clinical Assessment Navigator, is the tool we use for assessing entrustable professional activities (EPA).
  • a learning management system for students — A home for resources, schedules, enrollment, and gradebook.
  • evaluations — Student-to-student, student-to-faculty, and student-to-course.
  • mapping of the curriculum — mapping to the physician competencies, which speaks to our accreditation as a medical school.

Most medical schools are using commercial products or open-source tools to deliver their curriculum to students and to map it for accreditation purposes. We’ll be joining a small community that is developing software from scratch. We’re moving forward with this because of the successes we’ve had with the new testing system and EPA programs — they are proof that we have the resources and the talent in the School of Medicine to build something that will suit our specific needs.

What Does This Mean for You?
We’re working on VMED now. Some modules have been piloted, but we’re also gathering requirements for future modules. The initial release of the learning management system will roll out in August 2018 with iterative releases to come in the months and years to follow.

Faculty who are teaching in the classroom or in the clinic have already seen some of these changes, particularly those using the assessment methodology for EPAs and those using the new online testing system. I hope that VMED will simplify teacher workflow for class preparation, approval of teaching materials, setting up exams, and reviewing student performance, and that it will offer faculty a clear view of how your work supports the physician competencies.

I would like to thank Dr. Megan Bray, Dr. Maryellen Gusic, Kim Holman, Mark Moody, Robert Pastor, Michael Szul, and Dr. Mary Kate Worden for their tireless efforts on VMED. It could not have happened without their hard work.

As more modules of VMED are ready for release, I’ll talk about them here. Stay tuned!

R.J. Canterbury, MD
Senior Associate Dean for Education
Wilford W. Spradlin Professor

Pinn Hall Dedication: What a Great Day!

Before I arrived at UVA, a colleague of mine at the National Institutes of Health told me, “When you get to Virginia, you have to meet Vivian Pinn.” It was great advice. I’ve become friends with Dr. Pinn over the past two years and I’ll repeat that advice to you: If you have an opportunity to meet Dr. Pinn — jump at the chance. She is an outstanding scientist and an even better person.

There are many reasons I am excited to be here at UVA. But meeting Dr. Pinn and honoring her legacy by renaming a building in her honor, a building that will be dedicated to advancing science for the betterment of mankind is yet another reason.

We will soon be renovating Pinn Hall to create state-of-the-art research space to support today’s most talented and ambitious scientific leaders. This facility will incorporate the latest technologies to encourage productivity and scientific partnership among interdisciplinary teams. By using open and flexible lab modules and shared equipment, this renovation will increase our space efficiency by 25%. Ultimately, this promotes team science, which is what we need to stay competitive with other elite schools of medicine.

I recommend watching the below 40-minute video from the Sept. 13 dedication ceremony. Her accomplishments and perseverance are truly commendable and worthy of your time. Included are timestamps for ease of use.

  • 00:00 – 05:40 | Teresa Sullivan, President, University of Virginia
  • 05:50 – 09:56 | Frank “Rusty” Conner III, Rector, UVA Board of Visitors
  • 10:15 – 14:01 | Dr. L.D. Britt, UVA Board of Visitors
  • 14:07 – 15:05 | Dr. David Wilkes, Dean, UVA School of Medicine
  • 15:12 – 20:12 | Video: Dr. Francis Collins, Director, National Institutes of Health
  • 20:21 – 25:53 | Dr. David Wilkes, Dean, UVA School of Medicine
  • 26:08 – 40:40 | Dr. Vivian Pinn, Senior Scientist Emerita, NIH Fogarty International Center

Additionally, during Dr. Pinn’s visit to UVA, she participated in the Medical Center Hour entitled “Assuring Fair Access for All.” You can view that video here.

She is an inspiring speaker and I encourage you to take time to watch the video.

David S. Wilkes, MD
Dean, UVA School of Medicine
James Carroll Flippin Professor of Medical Science

 

A Year in Review

Dean David Wilkes

The other day while my wife and I were having morning coffee, we realized that I’m starting my third year as dean of the School of Medicine! We talked about how quickly the first two years have passed, how much we love Charlottesville, and how happy I am at UVA — and what an incredible honor it is to serve as your dean.

In some respects, my role is like that of an orchestra conductor because I’m not the one actually making the music. I only facilitate and fully recognize that you are the ones doing the real work.

When we’re focused on the urgent tasks of each day, it’s easy to forget where we’ve been and what we’ve done. We’ve done a lot! This letter mentions only a few highlights. Because we have so many accomplishments to celebrate, I’ve added this link where you can see what we’ve achieved in specific areas.

UVA moved from 40 to 36 in the NIH rankings of schools of medicine, as reported by the Blue Ridge Institute for Medical Research! Congratulations to all of you who worked hard on writing grants and preparing the submissions! Our FY17 extramural funding was $221 million … our highest level ever, excluding ARRA. This is remarkable growth from $162 million in FY14 and is truly a cause for celebration. The data also show that we are diversifying our research portfolio to spread risk and to create opportunity for further success. Related to this, we have just contracted with The Conafay Group to help us improve our chances of success with funding from the Department of Defense and related federal agencies.

UVA and Inova executed an academic affiliation agreement to establish the Genomics and Bioinformatics Research Institute (GBRI) on the former Exxon campus in Fairfax. We’re just in the early stages of setting this up and it will be a game changer. The affiliation agreement also establishes the UVA School of Medicine — Inova Campus where 72 of our students will complete their 3rd and 4th years in a high-volume, urban environment to begin in 2021. The School of Medicine has taken a lead position in what we anticipate to be a more broad expansion of UVA into northern Virginia.

In September 2016 we renamed Jordan Hall to Pinn Hall, and recently we held the dedication ceremony. A group of SOM leaders identified UVA alumna Dr. Vivian Pinn as the ideal choice for representing excellence in clinical care, research, scholarship, and the character and personal qualities we value. Phased renovations on Pinn Hall have begun. In addition to providing modern, open, flexible laboratories, Pinn Hall will house a Nobel Atrium to honor the Nobel laureates who did their pioneering work at UVA — thus highlighting our future by recognizing stars who represent what is best about us.

We are starting our third year of a tuition freeze. Nationally, medical students are completing their programs with staggering levels of debt. Thanks to the support of our alumni and the scholarship programs they fund, our students graduate with an average debt level that is much lower than the national average. Freezing tuition, while helping to reduce student debt, results from sound fiscal stewardship at the School of Medicine.

For the second year in a row, the University of Virginia Medical Center was recognized as the number one hospital in the Commonwealth of Virginia. Six specialties (Cancer, Ear, Nose & Throat, Orthopedics, Urology, Diabetes & Endocrinology, and Cardiology & Heart Surgery) were ranked in the top 50. And Gastroenterology & GI Surgery, Nephrology, Neurology & Neurosurgery, and Pulmonology were called out as being “high performing” specialties. Congratulations to our caregivers, researchers, and staff for this recognition of your work!

Our accrediting agency, the Liaison Committee on Medical Education, is monitoring our success in increasing diversity among our faculty. While our URM faculty increased from 4.8% to 5.3% we still have much work left to achieve the AAMC 50th percentile of 6.7%.  Now each department has a diversity plan that maps out a strategy and tactics to increase diversity among faculty and trainees.

I also want to share some information that makes a strong statement about our organization. As we continue to move as one Health System, it’s important to note that our partners in the Medical Center contributed $70.1 million in FY17 to the SOM for academic support. This is a significant and tangible statement of our partnership and of the shared trust between the individual entities of the Health System.

As I said, these are just some of the highlights. Clearly, we — that’s all of you! — have been doing a lot and accomplishing great things.

The events of August 11-12 created a lot of anxiety and uncertainty. We can get mired in the confusion or we can recognize something crucial — we are defined by who we are and what our values are, and not by the events of August. The importance of our work hasn’t changed. Let’s focus on our mission and our excellence. When someone asks where you’re from, you can stand a little taller and say, “I’m from the University of Virginia. I’m from Charlottesville.” And say it with pride, because you know who you are.

I’m very excited about what we are going to do together in the coming years. Although I’ve shared my priorities with you before, this is a good time to share them again.

  • Execute the development of the UVA-Inova Genomics Institute.
  • Operationalize the regional medical school campus for UVA 3rd and 4th year medical students at Inova.
  • Continue an aggressive investment in research and faculty recruitment.
  • Increase our NIH portfolio to $150 million by 2020.

This will take a lot of heavy lifting, but based on what we’ve already accomplished, I know we can do it. Every day we have the opportunity to do our best and every day I see the results of our efforts. My thanks to each one of you.

David S. Wilkes, MD
Dean, UVA School of Medicine
James Carroll Flippin Professor of Medical Science

See all accomplishments at https://news.med.virginia.edu/blog/deans-anniversary-letter/

How We Increased Inclusion Among Residents

Every March we’re excited about Match Day, to see where our students will complete their training. (You can see photos of this year’s event here.) The other side of that process is in seeing who matched with UVAHS and in welcoming new residents in July. We recently have seen a positive difference with regard to the number of underrepresented minorities (URM) in the incoming residents.

The AAMC defines URM as “those racial and ethnic populations that are underrepresented in the medical profession relative to their numbers in the general population.” In recent years, residents who are URM have made up 7 percent of residencies nationwide. UVA usually follows that trend, matching 7 or 8 percent. Last year, however, UVA matched 10 percent URM to our program; and this year 15 percent! Looking at data from the Department of Medicine, our biggest department, the numbers went from 3 percent historically to 15 percent this year. These are outstanding increases.

This change did not happen by accident.

Great Change … But How Did We Do It??
Undergraduate medical education (UME) tackled this problem more than a decade ago and made astounding advances. Because of efforts made in the School of Medicine, we are now proud to say we have one of the most diverse student populations in the country. We wanted to do the same for our residency trainees, but we also wanted to broaden the AAMC definition of URM to be more inclusive.

As a first step, we conducted meetings to hear how minorities fared at UVA and in Charlottesville. These meetings were with the School, the Diversity Consortium, and the Medical Center, and with leaders in the institution like Dean David Wilkes, Dr. Gregory Townsend, and Dr. Michael Williams. While we had good information about our medical students, we lacked a grasp on how our minority trainees felt. After listening and receiving input from many groups, the Graduate Medical Education Committee task force (co-chaired by Dr. Kristen Atkins and Dr. Gerald Donowitz), working closely with Dr. Susan Kirk, Associate Dean for Graduate Medical Education, realized that there was a real need for us to do better.

Every program director was interested in making a change, however there were no mechanisms in place to make a broad, cohesive, and intentional impact. The GMEC task force assisted in creating these mechanisms by bridging the many groups who were already working on this subject.

The program directors started talking openly with applicants about diversity and what it means (and how it feels) to be an underrepresented minority. We created Diversity Days wherein we announced that several of our interview days would be extended for applicants interested in talking about diversity. While these days were sponsored by the Department of Medicine, they were open to all applicants and departments. Our message to the applicants was that UVA wants every trainee at UVA to thrive. The feedback we received from the applicants was eye-opening. Many had never had interviewers discuss diversity with them before. They appreciated it and recognized we wanted a change and that they could be a part of that change. For some, it was the first time they realized how important it was to belong to a place that was interested in their success.

Additionally, the task force educated program directors at monthly GMEC meetings about what was learned from speaking with GME trainees and applicants. We learned (and taught!) how to talk about diversity to an applicant, how to broach the subject, and how to openly discuss where UVA was with regard to diversity, but also where we wanted it to be. We kept the topic on everyone’s radar.

We also decided we couldn’t wait for the applicants to come to us. Like reaching out to high-school students before applying to college, we are now contacting third- and fourth-year medical students and giving them information about UVA Health System. We are going to regional and national meetings such as the Student National Medical Association (SNMA), the largest student-run organization focused on supporting underrepresented minority medical students.

Great Success and Momentum
All of this work is so that we may best serve our patients. A diverse group of trainees who reflect the community we serve leads to better patient care. And we are working on creating the best, most diverse resident teams. The past year has just been a pilot. We are moving forward with plans to propose new programs, create brochures for all programs for outreach, include more representation at SNMA meetings, and work with faculty across Grounds who conduct research on microaggressions. (There is much training and awareness we need to work on in this area.) We are also going to continue to tap into the underrepresented minority trainees who are already here and continue to solicit their help in recruitment and culture change. We will continue to take the pulse of our current trainees and institute activities and sessions that foster a culture of inclusion among all trainees, regardless of race, ethnicity, religion, gender, or sexual orientation.

Other ideas coming down the road: We are proposing formal training for all faculty in handling microaggressions and providing better access to our UVA Ombuds, Brad Holland, with scheduled on-site office hours. New signage has been implemented at the entrance to the Claude Moore Medical Education Building and the hospital lobby to let trainees (and everyone!) know that UVA is a welcoming place.

What we are doing for graduate medical education is a small component of what the whole community is doing — here at the hospital, in Charlottesville, and in Albemarle County. But we want the community to know that this is an important issue. We have learned much this year, and many of the needed connections are now in place. It was a good year. But it is just the first step in a longer process.

The success of initiatives such as this relies upon the willingness of all to participate. We would like to thank Dean Wilkes, Dr. Susan Kirk, the program directors, the task force, and the GMEC for their efforts in making this happen.

R.J. Canterbury, MD, MS, DLFAPA
Wilford W. Spradlin Professor
Senior Associate Dean for Education

Susan M. Pollart, MD, MS
Ruth E. Murdaugh Professor of Family Medicine
Senior Associate Dean for Faculty Affairs and Faculty Development

Getting Ready for One Patient, One Record

The goal of “one patient, one record” has been a glimmer in the eyes of UVA Health System administrators and clinicians for years. With the launch of Epic Phase 2 on July 1, our toolbox will finally include a completely integrated electronic medical record system that providers across our continuum of care will use.

Getting ready for this big change requires extensive preparation. Groups across the Health System are preparing to use the nine new applications to go live during Epic Phase 2, and thousands of team members are now engaged in online, classroom and personalized training.

As Senior Associate Dean for Clinical Affairs and Chief Medical Officer, Chris Ghaemmaghami, MD, reminds in this month’s special video message on UVA Connect, clinical teams are playing a crucial role in defining new workflows, and it is important for them to work hand-in-hand with operations and the Epic team. Such collaboration is essential to making our push toward one patient, one record a success. Acknowledging that change is disruptive, Dr. Ghaemmaghami notes that it has a positive purpose: “It is how we stay at the forefront of care and continue delivering our best for our patients.”

[Note: Video is internal-only. Access while on the Health System network.]

Slides: Spring General Faculty Meeting

If you missed the April 20 General Faculty Meeting — or if you attended and just want to review! — you can find a PDF of the presentation slides here.

Highlights: April MAC Meeting

som-bldg_NEW_12122014New World Order in Hospitals … and Academic Medical Centers

  • Dean David Wilkes discussed that, given the degree of uncertainty with the healthcare landscape, we need to be conservative about new clinical hires until we understand how possible changes will affect us. Other institutions are performing workforce lay-offs — that is not a position in which we want to find ourselves.
  • Given the precarious nature of the budget at the National Institutes of Health, Dean Wilkes said that we should pursue only funded, mid-level or senior investigators.
  • Dean Wilkes reiterated that while we will be fine, we need to exercise caution in our hiring. Clarity on these issues will surface in the coming months.

March Board of Visitors Update

  • Background: In the fall of 2016, Dr. Chhabra was appointed as faculty representative to the Medical Center Operating Board (MCOB) of the Board of Visitors. As standard practice going forward, Dr. Chhabra will report to the MAC highlights from the MCOB meetings.
  • From the March MCOB meeting:
    • Health System Dashboard update
      • Positive changes include success in Be Well Phase 2, an increase in referral patterns, and the recruitment of 5 new physician-scientists.
    • Finance update
      • Positive operating margin was reviewed and explained.
    • Epic Phase 2 update
      • Reviewed timeline and implementation plan. The Health System is on track for a summer launch.
    • Be Safe Approach and Outcomes
      • Reviewed service line accountability and provided an example of heart and vascular center success for STEMI patients, a significant improvement when compared to our peers.
    • Strategy update
      • Dr. Richard Shannon provided updates on why patients want to see clinical outcomes that matter, sharing publicly available clinical data, our progress in the Joint Operating Agreement (JOC) with Novant, developing a statewide pediatric care network, and progress on the developing academic relationship with Inova.

The next meeting will be Tuesday, May 9, 2016, in the BIMS classroom.