Feature Article

Medical school to revive focus

VCU officials aim to return research and development to the forefront of efforts.

Virginia Commonwealth University officials plan to hire more than 80 new research faculty over the next six years and invest millions in a new laboratory building and other space.

Research in cancer, neuroscience, infectious diseases, immunology and microbiology, transplant medicine, and cardiology is expected to benefit from the move.

It is part of an effort to return the medical school to its research heyday when it ranked among the top tier in the nation for winning National Institutes of Health research dollars -- surpassing even the University of Virginia, which now easily outranks it.

"I think we were fairly successful in creating a tradition of scientific inquiry in the early years," said Dr. Sheldon M. Retchin, VCU vice president for health sciences.

"That carried over to the late 1980s and 1990s. By then, the die was cast. We really had no space for research."

In 2003, VCU's medical school ranked 60th among the 121 medical schools in terms of NIH research dollars awarded. That was a big drop from 1990, when the school ranked 34th.

In terms of actual NIH research dollars awarded, VCU's medical school grants grew from about $36 million in 1990 to about $60 million in 2003. But VCU's ranking fell because other medical schools' NIH grant amounts increased.

For instance, the University of Virginia saw its research grants increase from $31 million in 1990 to more than $122 million in 2003. U.Va.'s medical school was 33rd on the ranking list of the 121 medical schools in 2003, up from 40th place in 1990.

Dr. Steve Wasserman, assistant dean for research at the U.Va. School of Medicine, said researchers collaborated as multidisciplinary teams in such areas as diabetes, cardiovascular research and cell signaling, which put them in good position to win grants at a time when the NIH budget doubled.

The NIH dollars are only a part of the research dollars a medical school may receive. Grants also come from other federal agencies, private foundations and industry, such as pharmaceutical companies for drug studies.

The NIH dollars are important because they help build a medical school's reputation.

"The rankings reflect the amount of dollars that are around here," said Phillip B. Hylemon, a professor of microbiology and immunology in the VCU School of Medicine.

Hylemon is part of a team whose works studying lipids, or fats, is bringing in $2 million to $2.5 million a year in research dollars to VCU. One grant funds a study of why lifesaving drugs called protease inhibitors prescribed to HIV patients change those patients' fat metabolism, raising their heart-attack risk.

Hylemon said NIH grants are "an indirect indication of the viability of a school's research community."

"If we want to move up in the national ranking of research universities, we have to have good quality people in numbers," he said.

Research grants help to pay for laboratory space, he explained. "It helps pay my salary. It pays my light bill," Hylemon said.

About a third of VCU's $582 million budget for fiscal 2005 is from research and development dollars, school officials said. This fiscal year, research and development dollars across the university are expected to top $188 million, about half of which involves the medical school.

Retchin said the VCU medical school faced numerous issues in the past decade that affected its ability to win research grants and to attract researchers with big grants.

Those factors include the shortage of laboratory space and changes in the health economy. Managed care put pressure on faculty to see patients, and that cut into research time. State budget cuts also hurt, Retchin said.

In the past, some faculty have grumbled that university administrators focused too much on adding new bricks and mortar instead of developing and nurturing faculty. New buildings have been constructed on the Monroe and MCV campuses of VCU in the past decade.

"It's not a fair criticism," Retchin said. "There was some concentration on buildings. Those are not the same dollars being used for this."

Research did flatten, Retchin admitted.

"Everybody else grew. Then we started catching up in the 1990s by redoubling our efforts in the School of Medicine and other schools," he said.

Dr. Heber H. Newsome Jr., dean of the School of Medicine, said the impact of managed care cannot be overlooked.

The Richmond region, Newsome said, moved from an area with almost no managed care to one of the most consolidated markets in the country.

To survive, the medical school had to focus on patient care, Newsome said. "Given the fact that there are so many hours in a day, what suffered was research," he said.

Under the research growth plan recently approved by the VCU board of visitors, the medical school is aiming to move up to 45th place on the NIH rankings by the year 2011, which would mean being awarded about $102.4 million in research grants.

To reach that goal, Retchin estimates that VCU will have to invest about $112 million over the next six years. That includes:

This article was originally published March 8, 2005 in the Richmond Times-Dispatch. Re-published with permission.