Well aware of the cutthroat competition for federal research grants, and the temptation for rising stars to head to the coasts, the Department of Medicine (DOM) has launched a unique-in-the-nation Outstanding Early Career Scholars Program aimed at funding scholarly activity of stand-out young faculty and keeping them in Colorado.
“With the economy the way it is, and the cuts in government budgets, it has become more and more difficult for young people to find funding for their research,” says Sean Colgan, PhD, the department’s vice chair of research. “We want to know who the young stars are and we want to hang on to them.”
The OECSP, announced in December 2011, provides each recipient with a generous $75,000 annually for up to five years to support research, or other forms of career development. At a time when many young faculty members are stretched thin seeing patients, teaching, writing papers, and hunkering down in the lab, it also assures recipients can devote 75 percent of their time to their chosen scholarly activities.
It’s open to medical doctors, doctors of osteopathic medicine or veterinary medicine, and scientists who hold a PhD. Open exclusively to DOM assistant professors with fewer than four years in that position, it targets a group with the creativity and ambition to have a big impact in the medical research world, but that also tends to be passed over for National Institutes of Health grants.
Obama’s proposed budget for fiscal year 2013 keeps funding for NIH at $30.86 billion, the same as 2012, with research funding for its 27 institutes flat, as they have been for years. Meanwhile, inflation has pushed research costs up, and the number of applications has risen. Whereas 20-30 percent of grant applications used to be funded, that number today is as low as 1 in 10.
“It’s hard enough for senior people,” says Colgan. “It’s even harder for younger people without a long track record.”
Using funding from the School of Medicine’s Academic Enrichment Fund, the DOM hopes to support 10 or more scholars in the coming years.
“We are hoping this program will not only enhance the DOM but also help garner important new discoveries and bring forth a new generation of physician scientists on the national level,” says Colgan. “Nothing like it exists elsewhere.”
Here’s a closer look at how Allen and Santiago will use their award:
In search of an AIDS vaccine: Mario Santiago, PhD
As a grad student arriving at the University of Alabama Birmingham in 1997, then-23-year-old Mario Santiago jumped into his research career with a lofty and controversial question in mind: Where did the AIDS virus originate? Within just a few years, under the guidance of famed HIV researcher Beatrice Hahn, he’d published some of the first papers to identify an AIDS-like virus in wild chimpanzees in sub-Saharan Africa.
Fifteen years later, the Phillipine-born microbiologist has moved on to other, equally pivotal questions: Why do some people and animals exposed to the HIV virus resist it? And can we somehow replicate their early immune response to the infection to help develop an AIDS vaccine?
“One of the most mysterious aspects of HIV disease is the very early stages of infection, right after transmission,” says Santiago, 38, an assistant professor who joined the division of infectious diseases in 2009. “There is a big gap of knowledge there.”
He notes that it takes a few weeks for the virus to show up in the blood, and before that, a host of little understood events occur, impacting just how the host’s immune system reacts. Few people develop antibodies to neutralize it, but a small percentage of people – even when repeatedly exposed – escape infection.
Santiago and others suspect a group of “immunity genes” are at play, and his seven-person lab intends to use both genetically altered mouse models and DNA samples from HIV-resistant humans to zero in on those genes.
One they’ll pay close attention to is the Apobec3 gene. According to Santiago’s previous research with Dr. Warner Greene at the San Francisco-based Gladstone Institute, it has already been shown to help mice develop antibodies against an HIV-like retrovirus.
Meanwhile, Santiago has been working with investigators gathering DNA samples from couples in Zambia, in which one partner has HIV and the other, despite repeated exposure, has not been infected.
Could variations in the Apobec3 gene be playing a role?
Using funding from the new Outstanding Early Career Scholars program, Santiago plans to develop new mouse models, with certain genes missing or augmented, to get a clearer picture of how Apobec3 and other genes influencing immune response interact in those early days after transmission of a retrovirus. The money will also help his team develop novel gene sequencing techniques to map large chunks of those DNA samples.
“Different animals express Apobec3 at high levels or low levels, and we think that happens in people too, but we don’t know the molecular basis for it,” he says. “If we can figure out the molecular basis for that differential expression, that might be the mechanism we want to target. Ultimately, that’s what we are after. We want a vaccine, or a cure.”
Improving the odds for heart failure patients: Larry Allen, M.D.
With roughly one in five heart failure patients returning to the hospital within 30 days, many efforts to improve health care quality and reduce costs have focused on heart failure. Such cases are complex and expensive, with preventable readmissions estimated to cost more than $1 billion annually. And some health care reformers believe hospitals should be penalized when their readmission rates run high.
“You spend thousands of dollars on a patient and within 30 days many of them are back again,” explains Larry Allen, MD, an assistant professor who joined the CU-DOM faculty in 2008. “It’s a huge topic of discussion among not only clinicians but hospital administrators right now.”
Using data gleaned from electronic medical records, and personal interviews with patients and clinicians, Allen is working to better understand what’s bringing those patients back to the hospital, and develop interventions to keep them healthy instead. Are they following their doctor’s advice about diet and lifestyle changes? Are they being prescribed the proper medication? If so, are they picking it up? If not, why not?
As a member of the Colorado Cardiovascular Outcomes Research Consortium and the broader Health Maintenance Organization Research Network, the 40-year-old physician scientist has already published 25 scientific papers and 15 reviews or editorials exploring such questions. He’s also worked with the American Heart Association and the American College of Cardiology on initiatives to curb readmission rates.
“He is doing world class epidemiology in heart failure research and has, at this very young age, already developed a reputation as a national leader,” says Colgan.
In September, Allen was awarded a K23, early career development award from the NIH, providing a salary and allowing him to devote much of his time over the next five years to research. But the $650,000 grant offers little funding for project support. The new OECSP grant will help “fill that gap”, he says, enabling him to hire experts to carry out complex statistical analysis, and manage and analyze patient interviews.
Once problems are identified – perhaps patients are getting the right prescription but, for some reason, not filling it – he’ll implement pilot programs to help address them.
For instance, some research has shown that hypertension patients do better when they receive automated calls reminding them to fill their prescriptions. Allen would like to test a similar program for heart failure patients.
“We can now move on to the next level at a quicker pace, in terms of figuring out how to improve care delivery for these sick patients,” he says.
As a Colorado native and CU-Boulder undergraduate who attended medical school at Harvard, moved to Ghana for a stint in the Peace Corps, and did his cardiology fellowship at Duke, Allen said he long wanted to return to his home state. Now, he says, he’s not going anywhere.
“I am incredibly appreciative of this program,” he says. “My hope is that I accomplish what they had in mind: to rapidly establish myself in the field and move the science along quickly with the University of Colorado’s name on it.”