State of the School

August 15, 2008

D. Douglas Miller, MD, CM, MBARegents’

Professor and Dean

First Things First: Focus

“The main thing is to keepthe main thing the main thing.”

– John Kanary

Miller’s Hierarchy of Needs

Faculty Engagement: Committees of the Faculty Senate

Executive CommitteeAdmissionsAppointments, Promotions and Tenure, Post-tenure ReviewStudent PromotionsStudent Affairs

Curriculum OversightRules and BylawsNominatingFaculty RecognitionDean’s Summer ResearchCommittee on Committees

Faculty Engagement: Faculty Senate Accomplishments

Engagement –

in successful LCME site visit and accreditation

–

in expansion (i.e., key searches MCG Athens campus dean, expansion planning, etc.)

By-laws revision–

significant progress towards completion

Regular standardized reporting to the faculty by–

School of Medicine Dean

–

Physicians Practice Group CEO–

MCGHealth CEO

Commitment to Accountability

Chair Charters–

A formal agreement between the Dean and the Chair to strive for excellence

–

Sharing of confidential Academic Council ‘360’

rating–

Tracks Chair responsibilities to department and faculty

Evolution of the Chair Charter–

10/2007: Prototype development

–

6/2008: 100% submission by departments–

7/2008: Implementation survey of all departments

Commitment to Accountability

Faculty developmentStudent performance as a surrogate for faculty performanceFaculty scholarshipPublications/impact factor

Sponsored research supportClinical service and outcomesBudgetary outcomesQuality of communications within the department

How do Chair Chartersmeasure departmental progress?

Faculty Development

AAMC survey in 2006 reported that 44 of 125 schools had formal faculty development programs–

No formal program at MCG at time of survey

SOM commitment to faculty development–

Associate Deans

Faculty Development and Educational AchievementLeadership Development

–

Faculty development as a formal component of Department Chair Charters

Model Program for Faculty Development: Psychiatry and Health Behavior

FACULTY CAREER DEVELOPMENT HANDBOOK

Department of Psychiatry and Health Behavior Medical College of Georgia

School of Medicine

Brian Kirkpatrick, MD Alex Mabe, PhD

Donna Londino, MD Erick Messias, MD, PhD

Sandra Sexson, MD Stewart Shevitz, MD. Lara Stepleman, PhD

MCG SOM Retention vs. AAMC Survey 7/1/07-6/30/08

96.9%

96.1%

90%

91%

92%

93%

94%

95%

96%

97%

AAMC FAMOUS database MCG SOM

MCG SOM Faculty Attrition Trend

9.4%

11.6%

6.7%

2.0%

9.1% 8.8%

10.9%

9.8%

13.6%

12.9%

19.2%

14.1%

0%

5%

10%

15%

20%

25%

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

DEAN 1DEAN 2

DEAN 3DEAN 4

DEAN 5

MCG SOM Faculty Census Trend

477

462

496

475

447

438

469

478

494495

474

461

425

435

445

455

465

475

485

495

19971998

19992000

20012002

20032004

20052006

20072008

Facu

lty C

ensu

s at

Jul

y 1

DEAN 1DEAN 2

DEAN 3DEAN 4

DEAN 5

Faculty Attrition: Pros/Cons A Negative ROI Event–

After years of investment (direct and indirect $)

–

Escalating costs of replacement (market forces)–

Negative economic impact (loss of $1M/physician/year)

An Opportunity for Organizational Improvement–

… in ‘fit’: new people for new needs

–

… in ‘reverse engineering’: of academic units–

… for ‘targeted re-investment’: tied to evolving mission, goals, etc.

MCG Platform for Educational Expansion

Academic excellence–

Applicant interest: 2,162 for 190 spots

–

Board exam test scores, pass rates, etc.Program accreditation–

By the LCME for 760 students: max. 8 years

–

By the ACGME for 419 residents: avg. 3.9lyears

Expansion Requires Accreditation

MCG site visit 1/08LCME decision 6/08Four-year MCG Athens campus limited site visit 4/09LCME decision 6/09–

MD/PhD class enters 8/09

–

Full class (40) enters 8/10

Major 2008 Achievements

“After reviewing the report of the survey team…the LCME voted to continue

accreditation of the educational program leading to the MD degree at the Medical

College of Georgia School of Medicine for an eight-year term. The program’s next full survey will take place during the 2015-2016

academic year.”

LCME Accreditation

www.trippumbach.com

Expanding Medical Education in Georgia

Roadmap forMedical College of Georgia School of Medicineand Statewide Partners

(2008–2020)

January 15, 2008

Education –

Workforce Axis

The State of Georgia ranks 40th among 50 states in terms of physicians per capitaGeorgia ranks 4th among 50 states in population growth–

MCG RespondsTo Board of Regents strategic initiative for a proposed four-year ‘MCG/UGA Medical Education Partnership’Athens campus by 2010

–

MCG RespondsBy establishing and maintaining statewide hospital partnerships and physician relationships to ensure excellence in clinical clerkships and electives

Future?

Albany30 Students

Savannah30 Students

Future?Athens

240 Students

Augusta900 Students

Medical College of Georgia Statewide Expansion Plan: 2020

“Vision needs management, electricity, and concrete.”

─

Reverend William J. RewakPast President, Santa Clara University

Future Site of the MCG/UGA Athens Partnership Campus (2009)

Recruiting for a Four-Year MCG Athens Campus

Campus DeanChair, Basic SciencesChair, Clinical SciencesAssistant Dean, Curriculum

Assistant Dean, Student and Multicultural AffairsCoordinator, Phase 1 Curriculum DevelopmentBasic science faculty–

8/08 “survey says”…

76 MCG faculty interested

Active Searches

Proposed Design for Medical Education and Research Building (2014?)

Education –

Workforce Axis

MCG Responds:–

Assumes accountability for statewide coordination of Graduate Medical Education (GME) for Georgia physician workforce management

GME Leadership SummitOctober 15-16, 2008

Atlanta, Georgia

Statewide GME Realities

UME and GME are a continuumExpansion of UME programs without a companion strategy for GME will not achieve the goal of increasing Georgia’s physician workforce–

+104 residents for MCG program

–

+200 residents for workforce impact–

+ 14 unused ‘cap’

at University Hospital

Expansion Challenges

Accelerating growth while maintaining qualityStatewide platform required for full implementation Faculty ‘engines’ are recruitment targets–

Peer public SOMs (AL, FL, SC, TN, etc.)

–

Private SOMs (Jefferson, Mayo, Pittsburgh, etc.)

Education

“The illiterate of the 21st century will not be those who cannot read and write, but those who cannot

learn, unlearn, and relearn.”

─

Alvin Toffler

The Era of ‘Edu-tainment’

Education: Focus Forward

1.

Excellence: “The Main Thing”2.

MCG statewide expansion to meet Georgia’s physician workforce needs

3.

MCG statewide leadership in GME to enable the medical education continuum in Georgia

Education Discovery Institute

MISSION

PromoteExcellence, Discovery, Innovation

and Translationin medical educationto enhance learning

and improve patient care

EDI ‘Translational’

Paradigm

Education: Rewarding Excellence

Celebrate our Educators–

Teachers

Exemplary Teaching Awards–

Educators

Academy of Medical Educators–

Scholarship and Research

Education Discovery Institute

Academy of Medical Educators Inaugural Members

Ralph Gillies, PhDHarmut Gross, MDValera Hudson, MDLisa Leggio, MDD. Scott Lind, MD

John Mellinger, MDWalter Moore, MDCarol Nichols, PhD

Andria Thomas, PhDPeggy Wagner, PhD

Induction Ceremony ♦

December 12, 2008

Mark Your Calendars

December 12, 2008:

Academy of Medical Educators

Inaugural Induction Ceremony

April 2009

Exemplary Teaching AwardsInaugural Presentation Ceremony

Education: Challenges

Clinical resources required for expansion–

Recruitment and development of clinical faculty

–

Development of clinical clerkshipsPartnerships–

Hospital and ambulatory

–

Augusta and out-state

Research: Engine of Economic Development

SOM Performance

During the period of 1998-2006* (*Most current NIH data):–

School of Medicine researchers grew the MCG NIH extramural research portfolio by 119%

–

NIH awards over the same period grew by 69%

Cumulative Growth in Research Portfolios NIH Extramural vs. MCG SOM: 1998-2007

118.9%115.2%115.5%

100.7%

69.7%

61.9%

45.3%

21.5%

68.7%69.0%67.1%60.9%

49.7%

25.8%

13.0%

37.8%

0%

20%

40%

60%

80%

100%

120%

140%

1998/99 1999/00 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06

Per

cent

Gro

wth

in T

otal

Cos

t Aw

ards

Medical College of Georgia SOM National Institutes of Health

Navigating the ‘Roadmap’The NIH Roadmap for Medical Research was launched by NIH Director Elias Zerhouni in October 2003Major Themes of the Roadmap–

New Pathways to Discovery

–

Research Teams of the Future–

Re-engineering the Clinical Research Enterprise

‘Discovery’

ROI Measures

“Although the sequencing of the human genome presents vast opportunities for researchers, it also creates a series of

challenges that will redefine the ways that medical research is conducted and,

ultimately, how research leads to improvements in health.”

─

Elias Zerhouni, MDScience 302:63 (10/3/03)

Recruiting Science Talent: The Brain Decoding Project

David Hess, MD Joe Tsien, PhD

MCG Discovery Institutes = Better Georgia Health

Brain & Behavior (BBDI): Brain HealthCardiovascular (CVDI): Heart HealthDiabetes & Obesity (DODI): Child HealthImmuno (IDI): Immune HealthVision (VDI): Eye Health

Discovery Institutes: Functional Model

Departments

DeanSchool of Medicine

Department Chairs

Centers and Institutes

CORES

INFRASTRUCTURE

TissueBio-

Repository

Clinical Research

Unit

Center for Outcomes Research

Clinicial-Scientist Training

Data Coordination

OperationsResearch Planning

Committee

POLICY

TRANSLATION

PhDCo-Director

MDCo-Director

Center/Institute Directors

Vision:

Immuno Discovery Institute Program Development

Nephrology & TransplantMedicine

(L. Mulloy)

Immunotherapy Center (ITC)Chronic inflammatory disease syndromes,

immune tolerance mechanisms, inflammation

(Mellor & Munn)

Department of Medicine(Madaio)

InfectiousDiseases/

Ryan White (HIV) Center

(Rissing)

Hematology/Oncology

(Jillela)

Cancer Immunotherapy

Program (Munn)

Cancer Center(Bhalla)

Immuno Discovery Institute (IDI)

(Madaio, Mellor, Munn, Rissing)

Future Immuno Discovery Institute Translational Research Programs

Endocrinology/Diabetes (A. Mulloy)Pulmonology/Allergy (Davis)

Rheumatology (Moore)GI (Schade)

Dermatology (Lesher)

Multiple Sclerosis(MS)

Clinical Center

(Hess)

Department ofNeurology

(Hess)

Autoimmunity

(L. Mulloy)

Ex: IDI Functional Model

Clinical Translational Cores

Tissue Bio-repositoryData CoordinationClinical Research UnitClinician-Scientist TrainingCenter for Outcomes Research (CORe)

Clinical Care: “Caught in the Competitive Crossfire”

(1)

1.

Caught in the Competitive Crossfire: Safety Net Providers Balance Margin and Mission in a Profit-Driven Health Care Market. Cunningham, PJ, et al. Health Affairs, Aug.12, 2009.

SOM Faculty = Best Care Anywhere

Nearly 25 percent of MCG SOM faculty physicians were recognized by their peers this year as experts in patient care–

America’s Top Doctors ®

(Castle Connolly Publishing)

21 SOM Faculty Physicians

–

Best Doctors ®72 SOM Faculty Physicians

Clinical Care: Challenges

Provider-based Care Model–

Staffing levels and staffed beds? (for PFCC)

–

Optimum for modern med-ed? (for LCME, RRC)Investment and reinvestment–

Multi-disciplinary clinical programs? (and EMR)

–

Catch-up and look-ahead capital projects? (and debt)Strategic and financial alignment of cooperative organizations–

of PPG with SOM? (via PPG Board)

–

of MCG Health and PPG/SOM? (via JV)

$217,991,539

$136,892,273

$168,888,885

$220,507,565$231,565,121

$237,939,181$241,393,674

$250,604,569

$-

$50,000,000

$100,000,000

$150,000,000

$200,000,000

$250,000,000

$300,000,000

FY 2002 FY 2003 FY 2004 FY 2005 FY 2006 FY 2007 FY 2008 FY 2009Budgeted

Clinical Departments Type A and B Charges: Growth?

Clinical Departments Type A and B Income: Growth?

$86,727,559$84,241,391

$81,610,401$80,545,065$78,635,566

$71,803,116

$56,863,489

$50,317,134

$-

$10,000,000

$20,000,000

$30,000,000

$40,000,000

$50,000,000

$60,000,000

$70,000,000

$80,000,000

$90,000,000

$100,000,000

FY 2002 FY 2003 FY 2004 FY 2005 FY 2006 FY 2007 FY 2008 FY 2009Budgeted

Enabling Growth: “2020 Vision”

Miller’s Hierarchy of Needs

“One doesn’t discover new lands without consenting to lose sight of the shore for a

very long time.”

─

Andre Gide

L’Envoi