UAB School of Medicine Annual Report 15-16

UAB School of Medicine

Annual Report

2015/2016

Message from the Dean Welcome to the UAB School of Medicine Annual Report for the 2015/2016 academic year.

Thanks to the commitment of our faculty, staff, and leadership, we have continued to build on a strong foundation of excellence across all our mission areas: training the next generation of leaders in medicine and biomedical sciences; generating groundbreaking scientific discoveries to improve human health; providing world-class care to patients who come to us from across the city, the state, and beyond; meeting our social responsibility to enhance access to care and improve health care outcomes for all people; and advancing our role as an innovation incubator and economic engine for the city of Birmingham and the state of Alabama.

Much of our success is made possible by our ability to create connections—connections with local, regional, national, and international partner organizations, both public and private; connections between experts across the School of Medicine and the university; connections between what we’re learning about disease at the most fundamental level and the applications for the betterment of public health; and connections among students, trainees, and faculty in order to provide the most deeply immersive and dynamic training experience possible.

We have organized this report around some of our key strengths and focus areas, including:

Selwyn M. Vickers, MD, FACS

Senior Vice President for Medicine and Dean James C. Lee Endowed Chair

Leveraging Key Partnerships – embracing our trusted partners to help us advance our mission effectively and efficiently Multidisciplinary Collaboration – bringing great minds together to address the most complex challenges in patient care and biomedical research Precision Medicine and Population Health – viewing health problems at the genetic and population levels to get the broadest possible picture Infrastructure and Support – providing our students, trainees, and faculty with the skills and resources they need to succeed in the ever-changing health care and research landscape On the following pages, you’ll be introduced to a few of the people and programs that embody those strengths. Connecting innovators and fostering an environment in which their ideas can flourish has been one of our guiding aims since our earliest days. As the health care landscape continues to shift, we will continue to make bringing together the best people— and bringing out the best in them—an essential priority.

Sincerely,

Selwyn M. Vickers, MD, FACS Senior Vice President for Medicine and Dean James C. Lee Endowed Chair

Annual Report 2015/2016

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Table of

CONTENTS Leveraging Key Partnerships

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4 Confronting Kidney Disease 10 Partners in Medical Training

Multidisciplinary Collaboration

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UAB School of Medicine

14 Allies in the Fight Against Heart Disease 18 A Prescription for Better Health

Precision Medicine & Population Health 22 Unlocking Secrets in the Genes 26 Lighting the Path to Better Cancer Care 29 Students Take on Health Disparities

Infrastructure & Support 30 Preparing for Today’s Workforce 32 Alleviating Student Stress, Encouraging Teamwork 33 Philanthropy 34 Funding & Finance 36 Facts & Figures 38 Leadership & Organization

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LEVERAGING KEY PARTNERSHIPS

PARTNERSHIPS MAKE OUR PROGRESS POSSIBLE. THEY enable us to leverage our strengths while embracing the talents of our trusted partners in order to deliver excellence across all our mission areas. On the following pages, you’ll see how the power of partnerships—between transplant patients and donors, physicians and researchers, and philanthropists and the programs they support—are giving kidney disease and transplant patients a second chance at life. You’ll also meet some of our essential partners in medical training who help us deliver a uniquely diverse and exceptional learning experience.

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LEVERAGING KEY PARTNERSHIPS

Confronting Kidney Disease

Paying It Forward Chalice Howard is a preschool teacher living in Charleston, South Carolina. Levon Madison is a high school student from rural Pine Level, deep in the Alabama Black Belt. At first glance, they don’t seem to have much in common. However, a few minutes after they met, Madison’s mother, Elaine Madison, told Howard, “You’re part of our family now!”

That’s because Levon Madison and Howard do, in fact, share something: Howard donated a kidney to Levon Madison as part of the UAB Kidney Chain. “She gave my son a chance at a normal life,” says Elaine Madison.

“I feel like the lucky one,” Howard says. “It’s amazing to help press ‘reset’ for a kid who has suffered for all those years. And it’s crazy how much I have received from meeting Levon and his family and beginning a friendship that will last forever.”

Multiply their relationship by more than 100 and you sense the magnitude of the UAB Kidney Chain, a linked series of surgeries. After two years, it holds the record as the longest living-donor kidney transplant chain in the world. It now includes 67 donors and 67 recipients—a total of 134 men, women, and children from 12 states.

Facing page, left to right: Chalice Howard donated a kidney to Levon Madison as part of the UAB Kidney Chain. Howard says she donated in part because of her father, who received a life-saving bone marrow transplant. “My uncle ended up being a match, but otherwise we would have been at the mercy of a stranger willing to donate. That kind of caused me to think, ‘What could I give?’”

In a paired transplant chain like this one, the family or friends of recipients give a kidney to another person in need—often total strangers—on behalf of their loved ones. For example, Contessa Terry, of Moulton, Alabama, wasn’t a transplant match for her father, Glen Peebles, so she instead donated a kidney to Price Johnson, from Oxford, Mississippi.

Peebles, in turn, received his own new kidney from another donor.

The UAB Kidney Chain includes a number of donors who have no loved ones receiving transplants or connections to anyone in the chain. These altruistic donors—nine so far, including Howard—volunteered a kidney simply “because it was an opportunity to bring others along on this journey,” says chain coordinator Jayme E. Locke, MD, surgical director of the UAB School of Medicine’s Incompatible Kidney Transplant and Kidney Paired Donation programs. “That sacrifice showcases a sense of community here in the South that is different from anything I have experienced elsewhere. They have allowed us to keep this chain going.”

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LEVERAGING KEY PARTNERSHIPS

Above, left to right: UAB Kidney Chain recipient Price Johnson and his wife Vikki made a gift to support kidney transplant research; Dr. Jayme Locke is the surgical director of the UAB School of Medicine’s Incompatible Kidney Transplant and Kidney Paired Donation programs.

Called to Action Price Johnson was so impressed by his experience as a transplant recipient in the UAB Kidney Chain that, while still recovering from surgery in UAB Hospital, he asked how he could make a gift to support Dr. Locke’s research. “The idea of being able to do something to help made me feel like I was somehow getting on the team,” Johnson says. “And it was an impressive team.”

Johnson and his wife, Vikki Hughes Johnson, made a gift to establish the Living Donor Kidney Transplant Research Acceleration Fund. Johnson is particularly interested in Dr. Locke’s plan to conduct research on post-operative effects—medical as well as psychosocial and psychological—on donors. Dr. Locke says the study will give physicians vital insight into building the most effective infrastructure for post-donation care.

“I’m humbled by the fact that the Johnsons wanted to support what I’m doing,” says Dr. Locke. “They’ve had a profound impact on me and my career and, by virtue of that, the patients I take care of. It’s incredibly motivating and inspiring.”

UAB IS ONE

OF THE FOUR LARGEST KIDNEY

TRANSPLANT CENTERS IN THE NATION UAB HAS PERFORMED

MORE LIVING DONOR TRANSPLANTS THAN ANY OTHER PROGRAM IN THE U.S. SINCE 1987

ALMOST 50% OF THE PATIENTS WHO RECEIVE KIDNEY TRANSPLANTS AT UAB ARE AFRICAN-AMERICAN

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A Legacy of Excellence The Kidney Chain is just one example from UAB’s long history of innovation aimed at addressing a health problem that disproportionately affects our state and region. “Our rich history in nephrology and kidney transplantation reflects the interplay of several variables,” says Robert G. Gaston, MD, Robert G. Luke, MD, Endowed Chair in Transplant Nephrology and director of the UAB Comprehensive Transplant Institute. “First, the incidence and prevalence of kidney disease in the Southeast are among the highest in the country. Given our history and reputation, this means Alabama’s waiting list for transplantable kidneys (almost 3,000 patients) is among the nation’s longest” Dr. Gaston also notes surgeon Arnold G. Diethelm, MD, and nephrologist Thomas E. Andreoli, MD, were among the earliest arrivals to the School of Medicine in the late 1960s/ early 1970s. They both were committed to addressing the challenge of kidney disease in the rural South. “During a period when services remained limited in surrounding states, even into the past decade, Southerners with kidney disease flocked to UAB for state-ofthe-art care,” he says. “Because of a predilection among African-Americans to develop kidney disease, this meant UAB became the nation’s leader in research, addressing both risk factors and therapy for kidney disease in minority patients.”

LEVERAGING KEY PARTNERSHIPS

The UAB Kidney Chain team includes, from left, Drs. Devin Eckhoff, Jayme Locke, Vineeta Kumar, and Robert Gaston.

The Power of Networks UAB’s Kidney Chain and transplant program received special recognition last summer at the first White House Summit on Organ Donation. With this announcement, UAB’s Division of Transplantation will be part of two national efforts designed to increase access to organ transplants and reduce the number of patients awaiting kidney transplantation.

The Live Donor Champion model for African-Americans is part of a comprehensive program to teach patients how to leverage personal connections and social networks, to raise awareness about the need for organ donors, and to help identify potential live donor candidates. The UAB program will be known as the Living Donor Navigator Program.

“African-Americans face a significantly higher incidence of end-stage kidney disease and disproportionately low rates of live donor transplantation, so the need in this community is real and vital,” says Dr. Locke, who is overseeing the UAB program. “The Living Donor Navigator Program, which has been tested at Johns Hopkins University and other places, is associated with a more than fivefold increase in identification of potential live donor candidates. We hope we will see the same type of impact in the communities we serve.”

UAB also will collaborate with Johns Hopkins University on a program designed to help patients in need of live donor transplants leverage their social networks to find potential living kidney donors. Dr. Locke is co-principal investigator of the effort, which will teach transplant patients how to use a specially designed Facebook app to share their stories in hopes of increasing their odds of finding a living donor.

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LEVERAGING KEY PARTNERSHIPS

TELEHEALTH HOLDS WITH IT THE PROMISE TO ELIMINATE BARRIERS IN ACCESS TO HEALTH CARE IN OUR STATE. – Eric Wallace, MD.

Distance No Barrier to Care In another instance of new technology improving kidney care, Ellen McGowen, 63, settles into her chair at the Colbert County Health Department in Sheffield, Alabama, and looks at the TV in front of her. Looking back at her is UAB nephrologist Eric L. Wallace, MD. Using telehealth technology, Dr. Wallace gives a full checkup to McGowen, a home dialysis patient who lives 115 miles away.

With the use of a high-definition hand-held examination camera, he checks McGowen’s legs for swelling, her mouth for signs of dehydration, and her dialysis catheter for redness, drainage, or other signs of infection. He even listens to her heart and lungs with a Bluetooth-enabled stethoscope, and a nurse draws her blood to be sent to a central lab for testing. “My son who works for NASA is going to be amazed by this,” McGowen says.

In a first-of-its-kind program in the U.S., Dr. Wallace is using telehealth to replace comprehensive face-to-face visits for home dialysis patients. This two-way, real-time interactive communication between the patient and the physician is part of a pilot study in a UAB School of Medicine partnership with the Alabama Department of Public Health. The study is novel for the state, because telehealth is currently not used in any comprehensive capacity. It is also believed to be the first in the country to replace comprehensive face-to-face visits for home dialysis patients.

In April, the UAB School of Medicine announced a new, cutting-edge program that seeks to solve the shortage of available organs for transplant.

A five-year, $19.5 million grant from biotechnology leader United Therapeutics Corp. has enabled the launch of a pioneering xenotransplantation program, a development covered by The Wall Street Journal. Leaders of both organizations say they hope Dr. Joseph Tector this program will lead to genetically modified kidney transplants from pigs to humans by 2021.

“We want UAB to be the premier center for end-stage organ disease—whether it’s liver, heart or kidney,” says Devin E. Eckhoff, MD, Arnold G. Diethelm Endowed Chair for Transplantation Surgery, director of the UAB Division of Transplantation, and principal investigator of the grant. “There is no doubt that our list of those awaiting transplants—especially kidney transplants—is steep, and the cost of ongoing dialysis care is substantial. The average wait for someone with blood type O, the most common blood type, is six to eight years, so there is a real need.

Dr. David K.C. Cooper

Dr. Eric Wallace speaking at the Fifth Annual Alabama TeleHealth Summit.

“If I can provide a fully comprehensive telehealth visit for a home dialysis patient, which is one of the most complicated visits to do, then I can do this for any patient and any disease,” Dr. Wallace says. “It means the subspecialty and super-subspecialty care that may only be available in a university setting can now be extended to every corner of Alabama. Telehealth holds with it the promise to eliminate barriers in access to health care in our state.”

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Frontiers of Science

“Even if you were to get 100 percent consent from every possible deceased donor in America, you still wouldn’t have enough organs to fill the need,” Dr. Eckhoff continues. “And here in the South, we’re in the hotbed of organ failure—kidney failure, liver failure. People are dying waiting on organs. Xenotransplantation is a natural fit for us as a university and could potentially spur more biomedical opportunities in our region.”

Two prominent xenotransplant researchers have joined UAB as co-directors of the xenotransplantation program: Joseph A. Tector, MD, PhD, a leading U.S. liver transplant surgeon, was recruited from Indiana University; and David K.C. Cooper, MD, PhD, a pioneering heart transplant surgeon, came to UAB from the University of Pittsburgh Medical Center.

“The supply of human organs is insufficient to treat all the patients who present each year with organ failure and who could benefit

LEVERAGING KEY PARTNERSHIPS

if a compatible graft were available,” says Dr. Tector. “While substantial progress has been made toward harnessing the tremendous potential of stem cell biology and tissue engineering, most approaches based on these young technologies are far from clinical application. This provides a powerful impetus for preclinical translational research to develop clinical therapies using organ and islet xenografts, which I believe are close to making clinical impact.”

“More than 8,000 people either died waiting for a kidney transplant or became too sick to receive one in 2014,” says Selwyn Vickers, MD, senior vice president for medicine and dean of the UAB School of Medicine. “As a research and medical community, we have to do more to try and help those suffering. This gift from United Therapeutics gives us the chance to be the first in the world to transplant genetically engineered kidneys from nonhuman organs into human recipients within the next five years. This opportunity further defines our school and UAB Medicine as an outstanding destination for education, clinical care, and research.”

be daring work, and we are focused on bringing in the research and clinical talent necessary to discover if xenotransplantation will be a viable option for humans in the very near future,” says Herbert Chen, MD, Fay Fletcher Kerner Chair of Surgery in the UAB Department of Surgery. “We believe it will be.”

KIDNEY TRANSPLANTATION ORGAN SHORTAGE MORE THAN

Leveraging Promise, Avoiding Pitfalls While the need is undeniable, kidney transplantation has raised questions around bioethics since its inception more than a half century ago. Initially, debate centered around the propriety of transplanting organs from both deceased and living donors.

“These issues were largely decided, by society and the health care community, in favor of transplantation, and almost 200,000 Americans are now living with successful transplants,” says Dr. Gaston.

Current bioethical debate in kidney transplantation centers on the organ shortage, with more than 100,000 Americans—3,000 people in Alabama alone—competing for the approximately 10,000 transplantable kidneys that become available each year. “More people annually die on the waiting list than undergo transplantation,” says Dr. Gaston.

Against this backdrop, UAB’s new partnership with United Therapeutics offers the prospect of making many more organs available for transplant. Xenotransplantation is not entirely novel; for example, pig heart valves have been used in replacement surgeries for many years. But as with any biomedical advance, researchers must be prepared to carefully and thoughtfully confront bioethical questions that may arise. It is likely animals as sources of organs for transplantation will raise new bioethical issues: “How do you define safety? Who is the best recipient? What is the risk of transmissible diseases?” says Dr. Gaston. “I have no doubt these issues, which pale in light of the overwhelming human need, will be addressed responsibly in the oversight and consent processes as the field moves forward.”

120,000 AMERICANS ARE

ON THE ORGAN WAITING LIST

3,000 IN ALABAMA ALONE

THEY ARE COMPETING FOR APPROXIMATELY TRANSPLANTABLE KIDNEYS

10,000

AVAILABLE EACH YEAR

8,000

MORE THAN PEOPLE EITHER DIED WAITING FOR A KIDNEY TRANSPLANT OR BECAME TOO SICK TO RECEIVE ONE IN 2014

UAB scientists believe whole organ transplants from genetically modified animal models are possible in the near future if immunological and physiological barriers can be overcome. “This will

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LEVERAGING KEY PARTNERSHIPS

UAB medical student and Schweitzer Fellow Taylor Baskin says she formed meaningful bonds while working with students at the Glenwood Autism and Behavioral Health Center as part of her fellowship service project.

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LEVERAGING KEY PARTNERSHIPS

Partners in Medical Training Committed to Community When UAB launched the 13th U.S.-based Albert Schweitzer Fellowship’s (ASF) chapter in Alabama in 2016, medical student and Birmingham native Taylor Baskin found an ideal avenue for combining her training and personal goals.

“If you’re going to medical school for the right reasons, you want to help people,” says Baskin. “The Albert Schweitzer Fellowship provides an outlet to be involved in the community and is a reminder of why I came to medical school.”

Service is at the core of the ASF, which was founded in 1940. Today, the ASF is dedicated to improving the health of vulnerable populations at home and abroad by developing a corps of professionals skilled in creating positive change in their local communities, within the broader health and human service systems, and throughout the world. Approximately 250 graduate students from a variety of disciplines are selected as Albert Schweitzer Fellows each year.

They partner with community-based organizations to develop and conduct yearlong service projects. Six UAB medical students, including Baskin, were chosen for the inaugural class of Alabama Schweitzer Fellows last spring.

Drawing on her strong interest in helping people with autism, Baskin created a program to work with adults and children at the Glenwood Autism and Behavioral Health Center to improve their health and self-esteem through dance and exercise. “The bond I’ve created with these kids is very meaningful to me,” Baskin says.

Kristin Boggs, the ASF Alabama chapter director, concurs that creating lasting bonds within the community is a key goal of the ASF. “The mission is about preparing the next generation of professionals who will serve and empower vulnerable people to live healthier lives and create healthier communities,” she says. “We expect Fellows to define for themselves what type of change they want to see in the participants and the community at large. What defines success?”

For UAB medical student David Osula, success means enabling young people to actively pursue their career interests. The Jasper, Alabama, native is working with Carver High School’s Academy of Health Sciences to establish a mentoring program for students who are interested in careers in health care.

“We want to empower them to learn more about their career interests and pursue those interests—shepherd them through the process and just be friends and role models,” Osula says. “This type of service learning allows you to engage the community around you, and encourages you to reflect and really try to learn from the hands-on experiences you’re having.”

That is what service learning is all about: students applying classroom lessons to a cause they are passionate about to improve the world around them. “I think it’s an obligation that we, as the state’s top medical school, have to produce not only competent physicians but also ones who feel an obligation to benefit their communities in a meaningful way,” says Craig J. Hoesley, MD, senior associate dean for medical education.

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LEVERAGING KEY PARTNERSHIPS

Extending Medical Training Across the State Affiliated regional medical campuses in Montgomery, Huntsville, and Tuscaloosa enable the UAB School of Medicine to extend our reach far beyond Birmingham. These partnerships, both longstanding and new, are bringing exceptional training experiences and better health care solutions to communities across Alabama.

All UAB medical students spend their first two years of pre-doctoral medical training at the main campus in Birmingham. For their last two clinical years of training, they are placed at either the Birmingham campus or one of the school’s three regional medical campuses in Montgomery, Huntsville, and Tuscaloosa.

The first class of medical students to train at the Montgomery Regional Medical Campus, which opened in 2014 at Baptist Medical Center South, graduated last May. The inaugural class of five students agreed that being part a small class allowed for enhanced interpersonal bonding and a uniquely personalized, one-on-one learning environment.

“I never felt like I was lost in the shuffle,” says Adam Jones, who matched into the pathology residency at UAB. “Being able to work with the same doctors each day highlighted our strengths and weaknesses, and it always seemed like our teachers had a genuine interest in each of us as individuals.”

A driving motivation behind the creation of the Montgomery campus is an effort to increase the number of primary care physicians in Alabama and address the shortage of physicians in rural areas across the state. According to The New York Times, the U.S. is short approximately 9,000 primary care doctors, and experts predict the deficit will increase dramatically in the next 15 years.

The shortage is even greater in rural areas, and 55 of Alabama’s 67 counties are considered rural. Since opening two years ago, the Montgomery Regional Campus has grown in size and is now home to 20 third-year and 20 fourth-year medical students, some of whom it is hoped will alleviate the primary and rural care crisis in the state.

Passing the Baton

Dr. Roger Smalligan has been appointed dean of the Huntsville Regional Medical Campus beginning Jan. 15, 2017.

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In the northern part of the state, the Huntsville Regional Medical Campus is undergoing a changing of the guard.

Robert M. Centor, MD, has retired after serving 12 years as regional dean. “Dr. Centor is an outstanding clinician-educator,

investigator, and national leader in internal medicine,” says Selwyn M. Vickers, MD, FACS, senior vice president for medicine and dean of the School of Medicine. “Through his tireless efforts, he has restored our Huntsville campus to a level of prominence as an exceptional place for educators and training of students and residents.”

UA B S C H O O L O F M E D I C I N E REGIONAL MEDICAL CAMPUSES

Replacing Dr. Centor as the Huntsville regional dean is Roger D. Smalligan, MD, MPH. He comes to UAB and Huntsville from the Texas Tech University Health Sciences Center in Amarillo, Texas, where he was a regional chair and professor in the Department of Internal Medicine. Dr. Smalligan says he hopes to continue that tradition of excellence and help expand the ranks of health care providers in that part of the state. “I see UAB in Huntsville playing an integral role in that growth by training the next generation of physicians to care for the residents of north Alabama,” he says.

The Huntsville Regional Medical Campus is home to both the Family Medicine Residency and Internal Medicine Residency programs. It is also home to the Rural Medicine Program, a medical student training program aimed at developing physicians with the desire and skills to practice in rural areas and small towns. Each year, 72 third- and fourth-year students complete their clinical trainings at the Huntsville campus.

Longitudinal Learning In western Alabama, the Tuscaloosa campus is home to an innovative training program that promotes deeper connections with patients and stronger student-teacher relationships: the Tuscaloosa Longitudinal Community Curriculum (TLC2).

Through TLC2, third-year students and their physician mentors follow a group of patients during a nine-month period, through various specialties and diagnoses or diseases, continuously and often simultaneously, and in all settings—primary care and specialty clinics, hospitals, emergency rooms, and nursing homes.

Under the traditional model of medical education, third-year medical students receive their clinical education in weeks-long rotations through each specialty individually and usually in a hospital setting. “In an eight-week rotation, you might see a patient once, twice, three times if you’re lucky,” says Elizabeth Junkin, who participated in the inaugural year of TLC2 and who is now a first-year resident in The University of Alabama Family Medicine Residency. “I saw some patients six or seven times at least, and I got to see them develop over that period.”

LEVERAGING KEY PARTNERSHIPS

Joining forces in GME Watch UAB Gastroenterology Fellow David M. Fettig, MD, interact with Roy Hilton, and you’d think they’re old friends. From their genuine laughter to their good-natured digs at each other’s favorite football teams, they could be sharing a meal instead of meeting at the Birmingham Veterans Affairs Medical Center (BVAMC), where Dr. Fettig spent three years caring for Hilton as part of his fellowship.

“It was an honor caring for Mr. Hilton,” says Dr. Fettig. “What I liked most about him is he is an active patient with his medical problems. Mr. Hilton was an incredible patient, and I cherish the three years I cared for him.”

Dr. Fettig says he has always felt a strong connection to veterans.

His father was a lieutenant in the U.S. Army, one grandfather piloted missions for the U.S. Air Force during World War II, and the other grandfather served in Gen. George S. Patton’s famed 4th Armored Division. Dr. Fettig acknowledges he only applied to residency and fellowship programs that had partnerships with VA hospitals.

Centrally located within the heart of UAB’s campus, the 131-bed BVAMC provides acute tertiary medical and surgical care to veterans living in Alabama and surrounding states, and serves as a referral center for the surrounding area. A new clinic opened in January a few blocks away from campus to house primary care, mental health, women’s health, audiology, and a pharmacy. The BVAMC also operates seven outpatient clinics in North Alabama.

Most staff physicians have joint appointments with the VA and UAB. “UAB residents have an opportunity to rotate through the largest health care system in the U.S. at the VA,” says Susan J. Laing, PhD, associate chief of staff for education at the BVAMC. “And they have a chance to work with a lot of patients with medical conditions they might not see at other institutions.” For example, Dr. Fettig notes some Vietnam veterans were exposed to Agent Orange during their service. “The exposure has shown to cause many health consequences, including ischemic heart disease, Parkinson’s disease, and certain cancers,” he says.

School of Medicine Assistant Dean of Graduate Medical Education Gustavo R. Heudebert, MD, agrees that a powerful advantage of a UAB residency or fellowship is the uniquely diverse patient population trainees encounter. “UAB Hospital represents a microcosm of the city of Birmingham, which is very diverse and complements the types of cases residents encounter at the VA to provide a well-rounded residency,” Dr. Heudebert says. “Typically, at the VA they will see very complex patients who might have two, three, or four diseases together, so they have to learn to juggle those complexities.”

For Dr. Fettig, those words couldn’t be truer. “VA patients play an important role in trainees’ development,” he reiterates. “We form great relationships with them. I take pride in caring for veterans.

They are America’s heroes, and they deserve every bit of care we can give them.”

Dr. David Fettig (left) says it’s an honor to treat veterans like Roy Hilton (right) as part of his UAB fellowship training. In fact, Dr. Fettig says he only applied to fellowship programs that offer VA rotations.

UAB/VA GME PARTNERSHIP

BY THE NUMBERS OVER 120 UAB MEDICAL STUDENTS ROTATE AT THE BVAMC EACH ACADEMIC YEAR THE BVAMC HAS 147 PHYSICIAN RESIDENT POSITIONS THROUGH WHICH MULTIPLE RESIDENTS ROTATE

607 UAB PHYSICIAN RESIDENTS ROTATED THROUGH THESE POSITIONS AT THE BVAMC LAST YEAR

7,816 UAB RESIDENTS AND FELLOWS ROTATED AT THE BVAMC FROM 1999 THROUGH 2014

Contributing writers: Kendra Carter, Liann Cates. Jo Lynn Curry, Cary Estes, Brett Jaillet

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MULTIDISCIPLINARY COLLABORATION

Dr. Jay Zhang is collaborating with researchers at several universities to bioengineer a heart patch to replace diseased or damaged heart muscle.

THE AVERAGE HUMAN BRAIN EMITS ONLY ABOUT .085 WATTS of electricity, but when you combine the talents and creativity of a group of people working together to solve problems, the power they can generate is infinite. UAB is known as a place that values and promotes collaboration, a place where egos are set aside and ideas are refined and improved by the perspectives and expertise of a team. Read on to learn how experts in a variety of fields are coming together to propel research, provide cutting-edge clinical care, and even leverage their philanthropic giving to do the most good.

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MULTIDISCIPLINARY COLLABORATION

Allies in the Fight Against Heart Disease Mending a Broken Heart Progress in the battle against heart disease certainly doesn’t occur in a heartbeat. It requires patience and collaboration to develop new weapons against a disease that kills more than 600,000 people in the U.S. every year and is the No. 1 cause of death in Alabama.

However, sometimes major advances can take place in just a few years.

In summer 2015, Jianyi (Jay) Zhang, MD, PhD, was named the chair of the UAB Department of Biomedical Engineering, which became a joint department of the Schools of Medicine and Engineering that year. “Pairing a top academic medical center and a successful School of Engineering creates the potential for impactful discovery in the field of biomedical engineering, for patient care and for population health, all to benefit the people of Alabama and beyond,” he said when the appointment was announced.

Dr. Zhang, who now holds the T. Michael and Gillian Goodrich Endowed Chair of Engineering Leadership, is a national research leader in the field of myocardial bioenergetics, congestive heart failure, biomaterials, and stem cells for cardiac repair. His research aims to discover better diagnostic and therapeutic methods for patients with heart failure.

Within a year of his arrival at UAB, Dr. Zhang helped secure a seven-year, $8 million grant from the National Heart, Lung, and Blood Institute to create a bioengineered human heart tissue patch. Dr. Zhang is directing a consortium that includes researchers from the University of Wisconsin-Madison and Duke University.

Because the heart cannot regenerate muscle tissue after a heart attack has killed part of the muscle wall, the dead tissue can strain the surrounding muscle and lead to a lethal heart enlargement.

The goal of this research consortium is to engineer tissue that is composed of the several different types of cells that make up heart muscle, and use this engineered tissue to patch over diseased or damaged tissue.

The Wisconsin team will develop novel heart tissue progenitor cells with the ability to conduct electrical signals to create a smooth heartbeat. The Duke team will develop the heart tissue patch technology, using cells provided by Wisconsin and UAB. The UAB team will develop novel universal human-induced pluripotent stem cells lines, fabricate an engineered cardiac tissue patch, and create a heart attack model to study effectiveness of the cell therapy, using cells and tissues from UAB, Wisconsin, and Duke.

The UAB team includes Sumanth D. Prabhu, MD, Mary Gertrude Waters Chair of Cardiovascular Medicine and director of the Division of Cardiovascular Disease; Tim M. Townes, PhD, of the Department of Biochemistry and Molecular Genetics; Jack Rogers, PhD, professor in Biomedical Engineering; and Kelly Hillard, program director of the Department of Biomedical Engineering. Dr. Zhang anticipates the project should be ready for clinical trials by the end of the seven-year grant.

Pairing a top academic medical center and a successful engineering school creates the potential for impactful discovery in the field of biomedical engineering, for patient care and for population health, all to benefit the people of Alabama and beyond.

— Jay Zhang, MD, PhD

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MULTIDISCIPLINARY COLLABORATION

In July, Dr. Massoud Leesar implanted a patient with the world’s first FDA-approved dissolving heart stent for the first time in Alabama.

Disappearing Act This past summer, UAB Hospital became the first hospital in Alabama to offer a first-of-itskind dissolving heart stent to patients with coronary artery disease. Massoud A. Leesar, MD, holder of the Baker-Dean Endowed Professorship in Interventional Cardiology in the Division of Cardiovascular Disease, implanted a patient with the Absorb bioresorbable vascular coronary stent. Unlike traditional metal stents, which can clot and block the artery, the Absorb is made of a naturally dissolving material called polylactide. Therefore, the stent gradually disappears in a manner similar to that of dissolving stitches and sutures.

The stent is placed into the artery on a balloon at the end of a thin, flexible tube. The stent is expanded by inflating the balloon, which pushes the plaque against the artery wall and allows for greater blood flow. The balloon is then removed, leaving the stent to slowly release medication to the diseased area. Once blood flow is restored, the stent begins dissolving and allows the artery to operate naturally. The device dissolves completely within three years, at which point the vessel can remain open and pulsate on its own. All that remains in the artery are two pairs of tiny metallic markers that enable a physician to see where the device was placed.

“This may be a safer long-term option for patients,” Dr. Leesar says. “The risk of a metal stent suddenly clotting is a major issue long-term. Since the new stent dissolves over time, this risk can be eliminated, and the vessel has the potential to be open more than it was before with the stent.”

Optimizing Surgical Outcomes In 1966, university leaders recruited pioneering heart surgeon John W. Kirklin, MD, from the Mayo Clinic, one of UAB’s earliest recruiting successes. Dr. Kirklin had such an impact on the university and the Birmingham area that UAB Medicine’s outpatient facility, the I.M. Pei-designed Kirklin Clinic, bears his name.

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Contributing writers: Amy Bickers, Cary Estes, Bob Shepard

MULTIDISCIPLINARY COLLABORATION

Dr. John Kirklin’s son, James K. Kirklin, MD, became the director of cardiac transplantation at UAB in 1986 and took over as director of the Division of Cardiothoracic Surgery in 2006. He now holds the John W. Kirklin Chair of Cardiovascular Surgery, named for his father.

To honor both doctors’ contributions, UAB announced in 2016 the creation of the James and John Kirklin Institute for Research in Surgical Outcomes (KIRSO). Dr. John Kirklin began the first surgical outcomes studies at UAB in the 1980s, and now Dr. James Kirklin will continue his late father’s work as KIRSO’s inaugural director.

Outcomes research helps identify the best evidence to guide patient care and produce the most optimal outcomes. It critically appraises the results of a procedure, its global impact on patient health and well-being, satisfaction, functional status, lifespan, and the health care system. Outcomes researchers then translate the knowledge gained into practice and policy by working with surgeons, payers, and purchasers of health care.

From left, Drs. Robert Bourge and James Kirklin joined forces in 2013 to create an endowed research fund in mechanical circulatory support, which they elevated to a professorship this year.

Building on Success KIRSO follows another successful outcomes-focused effort, the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS). In 2005, Dr. James Kirklin became the principal investigator of this NHLBI-funded national registry that tracks patients who are receiving mechanical circulatory support device therapy to treat advanced heart failure. The registry has enhanced UAB’s national position in outcomes research and facilitates the introduction of novel devices, refinement of clinical practice, and improvements in outcomes for thousands of patients.

Dr. James Kirklin has helped establish a 35-person KIRSO research team that includes surgeons, biostatisticians, and scientists. This group is currently conducting nearly 100 different studies involving cardiovascular surgery at UAB and many other institutions across the country. KIRSO also has developed collaborations with other investigators within the Department of Surgery. The new institute offers investigators expert services in project management, data collection, database design, statistics, reporting results, regulatory affairs, informatics, and research consultation. The goal is to extend outcomes research expertise to nonsurgical disciplines across UAB. “We have decades of experience in how to construct, organize, and conduct outcomes studies,” Dr. Kirklin says. “We have unique expertise in evaluating results and performing analytics. We are poised to bring that experience to surgical and nonsurgical disciplines across UAB and to other universities and research institutions globally.

“I truly believe this institute will be a transformative step in our understanding of how to determine best outcomes. A critical component is disseminating that information around the world. I think this would have made my father smile.”

The Heart of Giving “Cats and dogs working together” is how Robert C. Bourge, MD, describes his three-decade professional relationship with James K. Kirklin, MD. Dr. Bourge, former director of the Division of Cardiovascular Disease and the E.A. and Abbie Drummond Endowed Chair in Cardiovascular Medicine, has a reputation for cutting up. Dr. Kirklin is more reserved; he is The Odd Couple’s Felix to Dr. Bourge’s Oscar. And like those famous characters, the pairing works.

“In 1986, Jim talked me into working with him in heart transplantation, and it turned out to be the best thing I ever did in my medical career,” Dr. Bourge says. “He’s largely responsible for kickstarting my academic career.”

“There were many people in those early days who said there’s no way these guys can work together,” says Dr. Kirklin. “This is cardiology and cardiac surgery, and one of the two of them is going to be too controlling.”

It turns out cats (cardiothoracic surgeons) and dogs (cardiovascular physicians) working together can lead to great things. In fall 2013, the two doctors established the Bourge-Kirklin Endowed Research Fund in Mechanical Circulatory Support in the Division of Cardiovascular Disease. Since then, the fund has provided support for a faculty member known as the Bourge-Kirklin Scholar.

In 2016, Dr. Bourge and Dr. Kirklin again joined forces to give additional funding to elevate the research fund to the level of a professorship. “Both of us share a commitment to recruiting the best faculty possible and to promoting scientific endeavors,” Dr. Kirklin says. “Philanthropy is an important way to facilitate that.”

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Dr. Marcas Bamman is one of the country’s leading exercise medicine researchers, and directs UAB’s Center for Exercise Medicine.

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A Prescription for Better Health Exercise Medicine Takes the Lead Marcas M. Bamman, PhD, foresees a day when a physician hands a patient a prescription that replaces or supplements medication—a prescription for exercise. “We’re learning more and more about the potent role of exercise in medicine,” says Dr. Bamman, professor in the Department of Cell, Developmental and Integrative Biology and director of the UAB Center for Exercise Medicine. “Exercise needs to be treated like any other medicine with an optimal dose prescribed founded on evidence-based research.”

This is not about exercise for weight loss or simply feeling better.

We are striving to understand the role of exercise as medicine at the molecular, cellular, and clinical levels.

— Marcas Bamman, PhD

Dr. Bamman was among a few of the world’s leading exercise medicine experts featured in a 2016 Time magazine cover story, “The Exercise Cure: The Surprising Science of a Life-Changing Workout,” which is an indication of the increasing interest in exercise medicine not only among biomedical researchers, but also in the public at large. There is no disputing exercise is beneficial to health, but Dr. Bamman says the key question the UAB Center for Exercise Medicine seeks to answer is how exercise can be dosed to best affect human health. “This is not about exercise for weight loss or simply feeling better,” he says. “We are striving to understand the role of exercise as medicine at the molecular, cellular, and clinical levels.

“It’s not enough to simply tell someone they should exercise more. We need to present precise exercise prescriptions to patients that include evidence-based dosing—frequency, intensity, and type of exercise—which will be most effective in helping that patient improve health, reduce disease burden, or recover from an event such as trauma or surgery.

We need to determine the optimal exercise prescription for a 70-year-old woman with osteoporosis versus a 30-year-old man with a traumatic brain injury. We don’t have all those answers yet, so it’s an exciting time for research.”

A New Concept of Care Dr. Bamman refers to exercise as regenerative medicine, often defined as the process of replacing or repairing human cells, tissues, or organs to restore or establish normal function. “We are learning that exercise affects every organ system in the body by activating stem cells and molecular pathways that serve as agents of change and recovery. Exercise can activate numerous internal mechanisms, which can then regenerate dysfunctional tissues.”

Exercise medicine as a distinct field of study came of age in 2007 with a joint initiative of the American College of Sports Medicine and the American Medical Association to create public awareness of the role of exercise. Dr. Bamman proposed the creation of the

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Center for Exercise Medicine within the School of Medicine in 2010.

Following approval from the University of Alabama Board of Trustees in February 2011, UAB became one of the first major academic medical centers to establish a center devoted to understanding the benefits of exercise. The center achieved university-wide status later that same year. In addition to conducting its own research, the center has rapidly become a national powerhouse in exercise medicine and serves as an expert resource frequently tapped by other institutions.

Partnerships in Health The center manages two national networks devoted to research in medical rehabilitation. One is the National Institutes of Health-funded Medical Rehabilitation Research Resource Network (MR3 Network), working to foster advances in medical rehabilitation research. UAB’s REACT Center—Rehabilitation Research Resource to Enhance Clinical Trials—is one of six partner centers making up the MR3 Network, and serves as the network’s coordinating center.

The center also founded and maintains NExTNet, the National Exercise Clinical Trials Network. NExTNet is a 70-member consortium of institutions involved in exercise research. Member institutions are looking at exercise in the context of nearly every major disease or condition, from heart disease and diabetes to aging and cancer.

Dr. Bamman also heads a clinical trial on aging and frailty to determine whether the addition of metformin, a drug typically used to treat Type 2 diabetes, will improve the effectiveness of strength training in older adults by reducing muscle inflammation. Other projects in development include studies on the role of exercise in patients with multiple sclerosis, HIV, or depression, and in women with pelvic pain syndrome.

Next Steps The center recently moved into a state-of-the-art Exercise Clinical Trials Facility with over 7,000 square feet of space, including an exercise training room, cardiorespiratory function and neuromuscular function laboratories, a clinic, and conference and office space.

It offers a full range of exercise equipment and staff with expertise to facilitate clinical testing invaluable to exercise researchers.

“Exercise is now getting the rigorous study we apply to any advance in medicine, be it drug development or new surgical techniques,” Dr. Bamman says. “It needs to follow the same consistent path from initial Phase 1 studies—which look at safety and tolerability—to large-scale, multiple-institution Phase 3 studies that can lead to translation of the knowledge learned to clinical practice. We’re doing this at the Center for Exercise Medicine.”

Prescribing Parks

At UAB, some of the center’s first clinical studies were in Parkinson’s disease, in collaboration with the School of Medicine’s leading researchers. Dr. Bamman and his colleagues first published the results of an exercise therapy trial in January 2014 in the Journal of Applied Physiology. In that study, high-intensity strength training produced significant improvements in quality of life, mood, motor function, and cellular improvements in skeletal muscle tissue in older patients with Parkinson’s disease.

Dr. Bamman’s dream of exercise medicine becoming a normally prescribed part of disease treatment is reflected in a pilot program that launched in September 2016. Led by the UAB Minority Health and Health Disparities Research Center, Parks Rx is modeled after successful national initiatives in which health care providers prescribe exercise for their patients and direct them to outdoor spaces to exercise.

William R. Carroll, MD, Department of Otolaryngology, and Sharon A. Spencer, MD, Department of Radiation Oncology, are also conducting a pilot study testing intensive strength training in head and neck cancer patients. “This study is a great example of how exercise can dovetail with therapy,” Dr. Bamman says. “Exercise is often recommended for cancer patients but is usually delayed until after their cancer therapies. This study is looking to see if exercise done concurrently with radiation and chemotherapy will reverse or mitigate some of the adverse effects on stem cells that are known to occur following radiation therapy.”

Parks Rx is a project of Birmingham REACH for Better Health, a Centers for Disease Control and Prevention-funded initiative to reduce the gap in chronic diseases between African-Americans and whites in Birmingham by improving access to fresh foods and increasing opportunities for physical activity in two underserved African-American communities in north Birmingham. A partnership among UAB, the Jefferson County Department of Health, United Way of Central Alabama, Freshwater Land Trust, Birmingham YMCA, REV Birmingham, and Safe Routes to School, Birmingham REACH for Better Health is expected to reach over 116,000 people.

UAB EXERCISE CLINICAL TRIALS FACILITY 4,200 SQ FT EXERCISE TRAINING SPACE 2,800 SQ FT ADMINISTRATIVE SPACE 2 LABORATORIES 1 EXAMINATION/PROCEDURE ROOM

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“Only 25 percent of American adults get the recommended amount of physical activity, and 29 percent don’t engage in any leisure time physical activity,” says Mona N. Fouad, MD, principal investigator for REACH, director of the UAB Division of Preventive Medicine, and director of the UAB Minority Health and Health Disparities Research Center. “This sedentary lifestyle contributes to an increased incidence of obesity that leads to chronic diseases such as high blood pressure, diabetes, heart disease, stroke, and some cancers.” Studies show access to the outdoors and green spaces reduces stress, promotes physical activity, and results in a nearly 50-percent increase in exercise.

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AMERICANS & EXERCISE FAST FACTS

ONLY 25%

OF ADULTS GET

THE RECOMMENDED AMOUNT OF PHYSICAL ACTIVITY

29% OF AMERICANS DON’T ENGAGE IN ANY LEISURE TIME PHYSICAL ACTIVITY LESS THAN 5% OF ADULTS PARTICIPATE IN 30 MINUTES OF

PHYSICAL ACTIVITY EACH DAY

ACCESS TO OUTDOOR GREEN SPACES RESULTS IN A NEARLY

50% INCREASE IN EXERCISE

Contributing writers: Adam Pope, Bob Shepard

UAB investigators Drs. Monica Baskin (left) and Mona Fouad (right) are searching for ways to reduce the gap in chronic diseases between African-Americans and whites in Birmingham through programs like Parks Rx.

After receiving a healthy living prescription from their health care providers, patients are directed to the Parks Rx website (www.reachforbetterhealth.com/parksrx) where they can search an interactive map for local parks and green spaces in their ZIP codes. The map pinpoints area parks and has links to park details such as amenities, safety, trail lengths, and hours of operation.

The Jefferson County Department of Health piloted Parks Rx in its pediatric clinics over the summer. According to Mark E. Wilson, MD, health officer for Jefferson County, the program has been well received by pediatric patients, their parents, and physicians.

“One parent said she would be placing the prescription on her refrigerator as a reminder to her family about daily exercise and healthy eating,” Dr. Wilson says.

“Another parent said she would use the prescription to increase her own physical activity.”

“We have the perfect recipe Visitors can enter their ZIP codes into the Parks Rx website for Parks Rx in Birmingham,” to see a map of Birmingham area parks where they can says Libba Vaughan, engage in outdoor activity. executive director at the Freshwater Land Trust. “Just in the city of Birmingham, we have more than 100 parks for people to enjoy and have one of the country’s leading universities working in preventive medicine, exercise medicine, and health disparities.”

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ANY CHALLENGE MUST BE VIEWED WITH BOTH A NARROW and a wide focus to get the full picture. That is why the UAB School of Medicine made precision medicine and population health two of our research priority areas: Learning all we can about how each individual’s genes affect his or her health and response to treatment will ultimately help us develop health promotion and disease prevention strategies for high-risk populations. In this section, you’ll meet pediatric researchers who are investigating how genetics can affect treatment outcomes in the youngest patients, and learn about programs geared toward improving accessibility and outcomes disparities in cancer care.

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Unlocking Secrets in the Genes Precision Medicine in Pediatrics Any parent will tell you that no two children are alike—they grow and move and develop at their own pace. However, there are also less obvious differences. Much as we each have a unique fingerprint, the rest of our bodies are unique, too, because we each have different DNA. The differences in our genetics can impact what diseases we develop, what drugs are most effective in our bodies, and what kind of medical attention we need throughout our lives. The field of precision medicine aims to understand just how doctors can optimize care for individuals by using knowledge about these genetic differences, among other factors including lifestyle, behavior, and environment.

Much of the research in precision medicine has been geared toward diseases in adults— cancers, heart disease, and diabetes, for instance. However, many UAB physicians and scientists are working to apply the promise of precision medicine to diseases that affect younger patients.

“When you talk about precision medicine, you’re really talking about minimizing risks and optimizing benefits for a person,” says Matthew A. Kutny, MD, assistant professor in the Department of Pediatrics. “That’s incredibly important for children because they have many more decades to live, so all the side effects and implications of treatment are going to be magnified.” As Dr. Kutny explains, personalizing treatment for a child rather than treating all children the same helps improve his or her future quality of life.

Personalizing Treatment Dr. Kutny is studying how to personalize treatment for children with cancer. In 2015, he and his colleagues discovered children with acute myeloid leukemia (AML) who have a certain version of a gene called TET2 had shorter survival times than AML patients with other versions of the gene.

Facing page, left to right: Drs. Randy Cron, Matthew Kutny, and Smita Bhatia are investigating the ways in which genetics contribute to therapy outcomes for the youngest patients.

“Patients with the risky version seemed to be more predisposed to dying from an infection,” says Dr. Kutny. Although the gene didn’t make their AML worse, it made them more sensitive to side effects and complications of the cancer drugs. If doctors know up front a patient has the risky version of TET2, they can take extra measures—such as prescribing preventive antibiotics or calling for mandatory nights in the hospital during the patients’ cancer treatments—to avoid infections in children at risk, Dr. Kutny says.

Smita Bhatia, MD, MPH, professor, vice chair of outcomes, and the Gay and Bew White Endowed Chair in Pediatric Oncology in the Department of Pediatrics, says she wants

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to use precision medicine to avoid complications when treating cancer. Anthracycline, a chemotherapy drug commonly used in children, can cause cardiomyopathy, a heart condition that may lead to heart failure. In a recent study, Dr. Bhatia found children with a variant in the gene CELF4 were 10 times more likely to develop cardiomyopathy when taking anthracycline. “We plan to replicate this finding to confirm the gene signature is associated with a personal risk of anthracycline-related cardiomyopathy,” says Dr. Bhatia. “We envision we could then take these findings to the clinic.”

Compared to studying cancer in adults, tackling the genetics of pediatric cancers can be especially challenging, Dr. Bhatia admits.

But institutions, including UAB, are teaming up to make strides in the field. “Project: Every Child,” for instance, is an initiative bringing together more than 200 research sites around the country to share genetic samples from children with cancer. Including more children in the studies allows researchers to better identify links among genes and outcomes, disease risks, or side effects.

Precision Medicine Beyond Cancer Just as two children with cancer might require different treatment strategies, have different risks of developing complications, and experience different outcomes depending on their genetic profiles, the same is true for countless other childhood diseases. Randy Q. Cron, MD, PhD, professor of pediatric rheumatology, studies a life-threatening condition called hemophagocytic lymphohistiocytosis (HLH), which results from the body’s immune system going into a dangerous overdrive. While some cases of HLH appear within a few years of birth, others are triggered by cancers, rheumatic conditions, and infections later in childhood or adulthood. “We all get exposed to various viruses, but very few of us end up in the hospital or die from them,” says Dr. Cron. “This research is asking, why is that?”

A study by Dr. Cron and his colleagues showed at least a third of patients with HLH associated with fatal cases of influenza virus infection (the cause of the flu) have certain genetic mutations that help explain the extreme nature of their disease. In the future, identifying these at-risk patients at birth using genetic tests might help their parents and doctors catch HLH early enough to treat it successfully.

“If someone with a known genetic risk came into the hospital with a fever, we could immediately assess for HLH and dampen critical components of the immune response with targeted therapies,” says Dr. Cron.

By spearheading research into how genetics puts children at risk for disease and how their DNA impact how they respond to treatment, UAB researchers are helping to revolutionize pediatrics through the application of precision medicine. “I think it’s definitely a new era,” says Dr. Kutny.

physicians across UAB are harnessing the power of individuals’ clinical, genetic, genomic, and environmental information in order to optimize care.

Since 2013, the School of Medicine has established the Hugh Kaul Personalized Medicine Institute, the UAB-HudsonAlpha Center for Genomic Medicine, and the UAB Informatics Institute.

All three programs have made significant strides in the last few years. Both the Personalized Medicine Institute and the Center for Genomic Medicine made their first research grants to UAB faculty for innovative investigations in ovarian cancer and heart disease, among others. The UAB Informatics Institute has welcomed a new director, James J. Cimino, MD, Endowed Professor in Informatics, who came to UAB from the National Institutes of Health. It also welcomed Associate Director Jake Y. Chen, PhD, who joined UAB from Indiana University. In April 2016, the institute celebrated the grand opening of its new home.

In the coming years, every field of medicine will be transformed by the increasing diagnostic and therapeutic precision offered by personalized medicine, the new knowledge we glean from genome sequencing, and the leveraging of vast caches of biomedical data through informatics. UAB is committed to staying at the forefront of that revolution through programs that push the boundaries of what is possible in precision medicine, both in the lab and in the clinic.

Unraveling Undiagnosed Diseases UAB’s Undiagnosed Diseases Program (UDP) was created to help patients suffering with medical mysteries that defy diagnosis.

Launched in October 2013, the program aims to unravel the most perplexing medical cases in which a diagnosis has not previously been made.

“Undiagnosed diseases present a critical unmet need, with patients often cycling through the medical system with no satisfactory treatment plan,” says Bruce R. Korf, MD, PhD, the Wayne H. and Sara Crews Finley Chair in Medical Genetics in the Department of Genetics and director of the UDP. “Some of these conditions may be so rare only a handful of people in the world have them. Others may be more common but have symptoms that present in an unusual way, making diagnosis difficult.”

The NIH’s Office of Rare Diseases Research notes there are about 500 diseases common enough to be in any physician’s repertoire for diagnosis, while another 6,500 are known but extremely rare.

For patients and their families trudging through the medical system with no answers and no plans, the UDP can be a ray of hope.

Offering Hope

The Future Is Now As the previous examples show, precision medicine is not the wave of the future; it’s already here, changing biomedical research and health care delivery in innumerable ways. Researchers and

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During its brief existence, the UDP has seen over 150 patients.

Of the patients whose evaluations are completed, over half have received a diagnosis. This includes several diagnoses described in the literature a handful of times anywhere in the world.

PRECISION MEDICINE & POPULATION HEALTH

Health Initiative, which has significant investment from the state of Alabama, will conduct genomic analysis, free of charge, for as many as 10,000 healthy individuals from across the state with the goal of integrating that information into their routine medical care.

“By creating one of the first statewide programs in America to incorporate genomic analysis into routine clinical care, we will be able to create a network that will facilitate the integration of genomics into routine medical care, positioning Alabama as a leader in the forefront of medicine for the 21st century,” says Dr. Korf, who is directing the initiative.

Dr. Bruce Korf heads UAB’s Undiagnosed Diseases Program.

Physicians make diagnoses based on a combination of cuttingedge technology allied with more traditional medical strategies, such as comprehensive review of records and history and time spent listening to the patient or the patient’s family. In many cases, the UDP partners with Huntsville’s HudsonAlpha Institute for Biotechnology to employ a cutting-edge technique called whole exome sequencing, which identifies variants that may be disease causing anywhere in the genome.

Doctors employed sequencing in the case of a child born with profound development issues. The child is blind and deaf, suffers from multiple seizures, and has never smiled or sat up. The results of sequencing revealed the child had two gene mutations, one associated with seizures and developmental abnormalities and the other involved with impaired cognitive development.

UAB researchers plan to recruit participants representing a variety of socioeconomic and racial/ethnic groups from each county in Alabama who agree to have their genomes analyzed. In return, the genomic findings that can impact their health will be returned to their primary care physicians. “We will work with physicians in their communities to develop appropriate management strategies for those found to be at risk of disease, and provide counseling to participants and their families to help them understand the findings,” says Dr. Korf. The program will help to familiarize physicians across the state with genomic data, creating a more informed health care workforce.

The initiative also will allow researchers to develop a regional biobank of DNA sequence data that can be used to identify new genetic factors associated with risk for diseases that are prevalent in Alabama. These include cancer, cardiovascular disease (especially arrhythmia, cardiomyopathy, and coronary artery disease), diabetes, obesity, carrier status for recessive disorders, and gene variants that predict adverse reactions to medications. It is hoped that this information will help researchers develop new approaches to disease prevention, diagnosis, and treatment.

“It would be extremely unlikely that this sort of condition would be recognized in a setting outside a program such as ours,” Dr. Korf says. The mutations were categorized as de novo, or new mutations, meaning they occurred spontaneously. While there is no cure for the child’s condition, the good news for the parents is the risk that such mutations would occur again if they have another child is very small. In addition, the risk to the family’s other children of one day having a child with these mutations and associated conditions is no greater than in the general population.

UAB GENETICS VITAL STATS

“Every new diagnosis broadens our understanding of rare diseases,” says Dr. Korf. “Every therapy we try, whether it works or not, tells us something of the mechanisms by which these diseases operate.

That’s the reason for the Undiagnosed Diseases Program: The more we learn about rare genetic conditions, the closer we are to unlocking treatments that have a meaningful impact on people’s lives.”

CONDUCTING RESEARCH IN GENETICS AND GENOMICS

OVER 150 PATIENTS SEEN BY THE UAB UNDIAGNOSED DISEASES PROGRAM TO DATE

20 UAB GENETICS SPECIALTY CLINICS 100 UAB FACULTY MEMBERS FROM 15 DEPARTMENTS AND 6 SCHOOLS ARE

A New Standard of Care Alabama will soon become one of the first states to create a statewide initiative that harnesses the power of genomic sequencing in routine medical practice. The Alabama Genomic

Contributing writers: Nancy Jackson, Bob Shepard, Sarah Williams

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Patient navigators like (clockwise from left) Myeisha Hutchinson, Ernest Grimes Jr., Chinara Dosse, and Ramona Colvin help underresourced patients navigate the health care system and manage their cancer care regimens more effectively.

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Lighting the Path to Better Cancer Care Equalizing Access, Improving Outcomes Inequities in access to health care for the poor, ethnic minorities, and people in rural areas is a well-documented problem with many causes. But for cancer patients, those disparities lead to disproportionately fatal outcomes. The UAB Comprehensive Cancer Center (CCC)—one of 47 National Cancer Institute-designated “comprehensive” cancer centers in the U.S. and the only one in the Deep South—is committed to providing research and outreach programs aimed at decreasing disparities and improving outcomes for underserved populations, decreasing suffering, and reducing costs across the health care system.

Ethnic disparities in cancer rates and outcomes are staggering: According to the National Cancer Institute (NCI), overall cancer rates in African-Americans are 10 percent higher than in Caucasians, and African-Americans’ death rates are double those of whites. For nearly every type of cancer, African-Americans have lower five-year relative survival rates than whites at each stage of diagnosis. African-American men have a 25-percent higher incidence and 43-percent higher mortality rate for all cancer sites combined compared to white men. Although African-American

WE HAVE TO FIGURE OUT HOW WE CAN MAKE USE OF LAY, NONPROFESSIONAL INDIVIDUALS TO ADDRESS LOGISTICAL ISSUES THAT OFTEN BOG DOWN SOCIAL WORKERS AND NURSE NAVIGATORS BUT DO NOT REQUIRE A PROFESSIONAL. – Edward Partridge, MD

women have lower incidence rates than white women for all cancer sites combined, they have a 20-percent higher mortality rate.

One reason for these grim outcomes is African-Americans are less likely than whites to be diagnosed while the cancer is still localized, before it has spread and might be treated effectively. Another factor is higher rates of other co-existing health conditions that can affect outcomes, such as diabetes and heart disease.

Research findings suggest African-Americans and Caucasians have similar outcomes when they receive similar cancer treatments and medical care. Equalizing access to and quality of care for underserved populations is a mission the UAB CCC is tackling head on, both in the clinic and in the community.

Overcoming Barriers Coming to terms with a cancer diagnosis and managing a treatment plan can be overwhelming for anybody at any socioeconiomic level. For poor people, minorities, and rural residents who have trouble getting to a doctor’s appointment, much less daily or weekly chemotherapy or radiation treatments, the obstacles are more than emotional.

The UAB CCC Patient Care Connect program is a free service for patients on Medicare. Approximately 40 non-social worker, non-nurse patient navigators are trained to guide patients through the physical, emotional, social, and financial barriers of receiving timely and effective cancer treatment within the 12 UAB Health System Cancer Community Network associate sites in Alabama, Florida, Georgia, and Mississippi.

Navigators assist patients and their families with details such as arranging transportation to and from appointments, finding nearby community services that provide assistance, and finding short-term housing where they and their family members can stay if they must travel to receive treatments. The program also trains navigators to help facilitate conversations between patients and their families about the patient’s preferences for end-of-life care. Patients feel comfortable calling navigators with any type of question or issue, and some patients say they feel more comfortable discussing certain issues with their navigators than their doctors.

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The program began in March 2013, and about 25 percent of eligible Medicare patients age 65 and older across the UAB Health System Cancer Community Network had enrolled by the end of 2014.

CCC researchers conducted an observational study of the program in October 2015. They found that overall with “navigated” patients there was a reduction in hospitalization Dr. Edward Partridge admission rates, emergency room visits, and intensive care unit admissions. The program also adopted earlier use of hospice care and reduced use of chemotherapy in the last two weeks of life.

“We’re not going to be able to train enough professionals to handle all of the work necessary to effectively navigate care,” says Edward E. Partridge, MD, Evalina B. Spencer Chair in Oncology and director of the UAB Comprehensive Cancer Center. “We have to figure out how we can make use of lay, nonprofessional individuals to address logistical issues that often bog down social workers and nurse navigators that do not require a professional.”

Making Research More Inclusive The patient navigation model also is being used to address a longstanding problem in cancer clinical trials research: the necessity of including participants from all population groups. Enrollment and retention are especially challenging among racial and ethnic minorities; currently, fewer than 10 percent of all trial participants are minorities.

The American Society of Clinical Oncology selected a study of minority participation in cancer clinical trials for inclusion in Clinical Care Advances 2016, an independent annual review of the year’s major achievements in cancer. The study, which was funded by the NCI and the National Institute of Minority Health and Health Disparities, was led by Mona N. Fouad, MD, MPH, director of the UAB Division of Preventive Medicine, director of the UAB Minority Health and Health Disparities Research Center, and senior adviser to the director at the UAB Comprehensive Cancer Center.

For the study, titled “Patient navigation as a model to increase minority participation in cancer clinical trials,” specially trained patient navigators met with African-American patients who were potentially eligible for clinical trials. The navigators informed them

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about current clinical trials and provided tailored support to those who decided to enroll in a trial.

Between 2007 and 2014, 378 African-Americans were eligible for a clinical trial. Of those, 304 enrolled in a clinical trial, and 272 opted to receive patient navigation support. Among trial participants receiving navigation support, 75 percent completed the trial compared to 38 percent of trial participants who did not receive navigation support. The difference in retention rates between the two groups was statistically significant, and African-Americans’ participation in cancer clinical trials increased from 9 percent to 16 percent.

“Personalized medicine is supposed to target medical treatments on the individual level,” says Dr. Fouad. “If we don’t include African-Americans and other minorities in clinical trials, the gap in health care is going to get even wider.”

Foundation for the Future After a rigorous peer review process, the UAB Comprehensive Cancer Center received a five-year, $29 million Cancer Center Support Grant renewal from the NCI in 2016 to continue its programs through 2021. The grant supports six research programs as well as 14 shared facilities and services, including programs to address cancer care disparities and higher mortality rates in the Deep South.

Along with the renewal of its core grant, the Cancer Center received an “outstanding” rating—its highest ever—and was recognized for growth and expertise in its “translational capabilities” (meaning its ability to move scientific discoveries from the lab to clinical use). A “comprehensive” designation also means patients have access to leading-edge treatments and clinical trials that may not be available at their local hospital or at smaller cancer centers.

These recent accolades and the NCI grant renewal are the latest in a string of milestones that have been achieved under the leadership of Dr. Partridge, who became director of the CCC in 2007. This past summer, Dr. Partridge announced he will retire in summer 2017, and a search for a new center director is under way. Replacing him will be no easy feat—Dr. Partridge is well known for his expertise as a clinician and researcher specializing in gynecological cancer. He is also widely respected for his deep personal commitment to improving cancer care for all, particularly in a region with so many health care disparities.

“UAB has an obligation to address the South’s cancer burden,” says Dr. Partridge. “It has been really interesting to understand how we can extend our health care delivery by using lay people. You don’t actually need a physician or clinician to keep a well person well, or a sick person as well as possible and out of the hospital.

You need someone coordinating their care.”

Contributing writers: Tara Hulen, Beena Thannickal

PRECISION MEDICINE & POPULATION HEALTH

Students Take on Health Disparities Confronting Social Determinants of Health Spenser Hayward admits he had only a surface understanding of the connections among poverty, environment, and health before he started medical school at UAB in August 2015.

Hayward and about 50 of his new classmates arrived on campus a few days before the start of medical school orientation to participate in the first-ever Health Disparities Boot Camp, which was sponsored by the School of Medicine’s Office of Diversity and Multicultural Affairs. The group learned about the profound impact income and environment have on a person’s health. “I wanted to become more culturally self-aware, and better able to understand the differences between my experience and those of my future patients,” Hayward says.

The Health Disparities Boot Camp was so well received that, starting in 2016, its content was incorporated into the “Patient, Doctor and Society” course as part of the regular orientation curriculum for all incoming medical students. “As the patient population becomes increasingly diverse, training is necessary for all physicians to effectively provide the best possible care for everyone they encounter,” says Carlton J. Young, MD, assistant dean for medical student diversity and inclusion. “A growing body of research continues to highlight that providing culturally incompetent health care actually contributes to the persistence of health disparities and, ultimately, poor health outcomes for underrepresented populations.”

In its first year, about 25 percent of the incoming class participated in the two-day Boot Camp that covered topics related to implicit bias, health disparities, social determinants of health, and culturally responsive care. Hayward says one element that stood out to him was a map of the Birmingham area superimposed with the life expectancies of residents of each area. “I was shocked to see the large variance between those who lived downtown, near UAB, having much shorter lifespans than those who lived in wealthier suburbs like Vestavia Hills and Mountain Brook,” he elaborates.

In the course, students also watch the documentary Unnatural Causes: In Sickness and in Wealth. The film explores the dichotomy between higher-income families who can, among other advantages, exercise outside in their neighborhoods after work versus lower-income families who tend to work shift or long hours and are often unable to find safe outdoor areas in their neighborhoods.

“That moment stays with me because it was an example of something I had always taken for granted: access to safe outdoor spaces, which many lower-income Americans don’t have,” says Hayward. “I think there are many of these subtle differences that affect health, and I’ll have difficulty appreciating them if I don’t become cognizant of them through programs like this.”

I wanted to become more culturally selfaware, and better able to understand the differences between my experience and those of my patients.

— Spenser Hayward

Contributing writer: Nancy Jackson

Annual Report 2015/2016 | 29

INFRASTRUCTURE & SUPPORT

THE ONLY CONSTANT IN MEDICINE IS CHANGE—THE PACE of scientific discovery and technology development accelerates continually, while the health care system is buffeted by pressures from regulators, payers, and consumers. As Alabama’s premier medical training and research institution, we must prepare trainees to succeed in a professional landscape where disruption has become the norm. That’s why we are developing new programs to expose our PhD trainees to career options outside of academia and to help our junior research faculty develop a strong foundation for future success. We have also modified our undergraduate medical education grading system to support student wellness and deepen learning. Risk is inherent in any change, but as President John F. Kennedy said, “Change is the law of life, and those who look only to the past or present are certain to miss the future.”

30| UAB School of Medicine

INFRASTRUCTURE & SUPPORT

Preparing for Today’s Workforce FEWER THAN 8 PERCENT OF TODAY’S PHD GRADUATES WILL EVER SEE A TENURE-TRACK POSITION, SO WE ARE WORKING TO PREPARE THEM TO USE THEIR SKILLS IN OTHER AREAS. – Dr. Lisa Schwiebert

Looking Beyond Academia Traditionally, doctoral students in scientific fields sought and found employment in academia. In recent years, those positions have become increasingly rare due to reduced federal research funding and a growing trend of university faculty members staying on the job past the typical retirement age. According to The Organisation for Economic Co-operation and Development, over 40,000 researchers graduate with advanced science and engineering degrees in the U.S. each year. Of those, only about 3,000 become faculty members at universities.

This new reality means thousands of trained researchers have to seek employment outside academia. “While most people come into the PhD program expecting to stay in academic research, they quickly find out that it’s an unlikely career path,” says Lisa M. Schwiebert, PhD, professor of cell, developmental, and integrative biology and associate dean for graduate and postdoctoral affairs for UAB. “Fewer than 8 percent of today’s PhD graduates will ever see a tenure-track position, so we are working to prepare them to use their skills in other areas.” In response to this changing landscape, UAB School of Medicine has created new programs to prepare trainees for careers on and off the bench.

Charting New Paths One way UAB is prepping PhDs for careers outside academia is through its Experiential Learning for Career Enhancement in the Sciences (EXPERIENCES) program, which began hosting a series of Career Summits in 2015. Approximately 70 to 90 trainees attended each Career Summit to learn more about the professional opportunities available to them.

The events provided information on five different career paths—public policy, teaching, business administration, research administration, and research communication—through workshops, boot camps, and immersion learning. “Trainees are learning that these career opportunities are not alternative career paths anymore; they are going to be the norm,” Dr. Schwiebert says.

Jami Armbrester, director of career development and outreach in the Graduate School/ Office of Postdoctoral Education, serves as the EXPERIENCES program career adviser and works with alumni and community partners to arrange opportunities for current trainees to participate in job shadowing, career immersion, and internships.

Scientist Support Networks

Facing page: Drs. Robin Lorenz (center) and Lisa Schwiebert (far right) with MERIT Scholars (starting far left) Oreoluwa “Ore” Adedoyin, Sparkle Williams, and Victoria Huang. The MERIT program provides PhD students with outstanding research and teaching experiences while improving the recruitment of underrepresented groups into biomedical research.

The School of Medicine’s Physician Scientist Development Office (PSDO) serves as a home base for MD and dual-degree physician scientists at the student, resident, fellow, and junior faculty levels who are in advanced scientific fields. In collaboration with the UAB Center for Clinical and Translational Science (CCTS), the PSDO provides a support network for physician scientists that connects them with UAB resources in areas of mentorship, seminars, and funding opportunities.

Along with the CCTS support network, the PSDO assists in grant creation and submission and continuing education opportunities, says Robin G. Lorenz, MD, PhD, associate dean for physician scientist development. “MDs and MD/PhDs who participate in our development programs have the perfect training for multiple career paths,” Dr. Lorenz says. “Academic physician scientists have the flexibility to combine careers in research, clinical care, education, and/or medical school leadership.”

Annual Report 2015/16 | 31

INFRASTRUCTURE & SUPPORT

GRADUATE BIOMEDICAL SCIENCES TRAINING 8 INTERDISCIPLINARY THEMES

INTEGRATING MORE THAN 33 DEPARTMENTS AND 20 RESEARCH CENTERS

329 GBS TRAINEES CURRENTLY PURSUING A PHD 1,520 DOCTORAL DEGREES HAVE BEEN AWARDED BY GBS AND AFFILIATED JOINT HEALTH SCIENCES DEPARTMENTS SINCE 1969

Helping Faculty Get a Funding Foothold The James A. Pittman Jr., MD, Scholars Program is another way the School of Medicine is working to support early-career researchers.

Launched in 2015, it recognizes junior faculty and helps them build a strong foundation for future contributions. Pittman Scholars are chosen based on their research achievements and their potentials for continued discovery in the basic or clinical sciences, and they receive funding to support their research or scholarly pursuits.

true understanding, as opposed to studying for the purposes of improving their class rank.”

“The Pittman award helped me start my own lab and has provided support for my research while I work to get my own NIH funding,” says Beatriz León-Ruiz, PhD, a 2015 Pittman Scholar and assistant professor in the Department of Microbiology whose research focuses on defining how T-helper immune cell responses are regulated. “Being a young scientist these days means being stressed about funding. It is very helpful to get some financial support to gather preliminary data for proposed research.”

In some preclinical courses, pass/fail grading consists of scores on two components: the knowledge component and the small group component. The knowledge component is typically assessed through examinations and quizzes, whereas the small group component is generally determined through skill-based activities, participation, professionalism, small group work, laboratory experiences, and projects. Students must pass both components in order to receive a passing grade for the course.

Alleviating Student Stress, Encouraging Teamwork

“Our curriculum increasingly emphasizes small group, team-based activities,” says Dr. Hoesley. “Therefore, it makes sense to promote a learning environment where students do not feel they need to undermine each other for personal benefit.”

For many students, being in medical school is the greatest challenge they have faced. And it is not just academic hurdles students must clear; successfully navigating medical school can also mean overcoming emotional and psychological challenges as well. According to a study published in 2014 in the Journal of the Association of American Medical Colleges, medical students have increased odds of developing depression or symptoms of depression. The highly competitive and demanding nature of medical school contributes to this alarming trend.

According to James H. Banos, PhD, assistant dean for student success, the old system ranked students by a P1-P4 quartile system, with P1 being the highest quartile. Students were ranked module by module. The new pass/fail system still allows students to achieve an honors designation without a module-by-module ranking.

“Students who have a weighted average of 92 for their module raw grades receive an honors designation for all their preclinical coursework,” explains Dr. Banos.

UAB recently implemented a new pass/fail grading system aimed at alleviating some of this pressure and helping medical students focus on actively learning the material instead of passively absorbing it to achieve a high grade or ranking. The Class of 2019 is the first class to experience this grading change.

Dr. Hoesley admits there are limitations to the new pass/fail grading system. “Some students could potentially ‘take their foot off the accelerator’ because they are not being ranked,” he says.

“However, when you look at reducing student stress and improving collaborative learning, the rationale for this change is sound and should reap real benefits for student wellness.”

“I believe the pass/fail grading system in the preclinical curriculum has benefited students,” says Craig J. Hoesley, MD, senior associate dean for medical education. “Specifically, it has reduced student stress and encouraged students to learn the material for

Contributing writers: Emily Henagan, Nancy Jackson

32| UAB School of Medicine

PHILANTHROPY Campaign for UAB Milestones $756,368,935

Campaign for UAB total*

$486,905,967

School of Medicine total*

92,641 Donors

made Campaign for UAB gifts*

25,714 Donors

made Campaign for UAB gifts to the School of Medicine*

64% of all

Campaign for UAB gifts were made to the School of Medicine * As of Nov. 30, 2016

Alumni Campaign for the School of Medicine

School of Medicine Endowed Faculty Positions $42,546,845 in gifts and pledges to endowed faculty positions since Campaign start

724 gifts and pledges

to endowed faculty positions since Campaign start

60 new endowed

faculty positions since Campaign start

School of Medicine Research Gifts $266,464,084 in gifts and pledges since Campaign start 27,565 gifts and pledges since Campaign start Philanthropic Endowments

$30,000,000 Goal

$93,383,014

$27,775,350 raised to date 3,042 SOM alumni donors * As of Nov. 30, 2016

5% 26% 32%

School of Medicine Scholarships $3,710,000 in scholarships distributed in

17%

AY2016/2017, an 11% increase over the previous year

281 students received a scholarship in AY2016/2017,

19%

1%

a 21% increase over the previous year

More than 35% of the medical student body received a scholarship in AY2016/2017

14 new scholarships were established in the School of Medicine for AY2016/2017 bringing the number of active scholarship funds to 117 $14,163,648 in gifts and pledges

Endowed Scholarships Endowed Faculty Chairs Endowed Faculty Scholars Endowed Professorships Endowed Research Other Endowments

$4,420,427 $29,999,117 $944,194 $18,202,411 $16,050,787 $23,766,078 * As of Oct. 30, 2016

to scholarships since Campaign start

3,471 gifts and pledges to scholarships since Campaign start

Annual Report 2015/2016 | 33

FINANCIALS & FUNDING Operating Revenues & Expenses FY2016 Total Revenues $698.2 million

$116.5M 17%

Federal Grants Direct

$182.8M 26%

Other Grants Direct

$40.2M

Clinical Enterprise (UH, HSF, HS)

6%

$82.2M

$50.3M

12%

7%

Indirect Expense Recovery Tuition State Appropriations incl. Earmarks

$168M

$21.9M

Philanthropy

24%

3%

Other

$35.9M 5%

Total Expenses $627.8 million

Campuses, Department, Centers

$233.1M

Grants

37%

Space SOM Infrastructure

$352.3M 56%

$31.1M 2%

34 | UAB School of Medicine

5%

Endowment Assets

Corpus Fund Balance

$163.8M FY14

Interest Earned

$12.1M

$176.2M FY15 $12.6M

$191.4M FY16 $14.8M

Grants & Contracts FY2016 NIH Grant Funding $186,002,658 Total Number of NIH Awards 424* D, 1 S, 1 T, 20

U, 44

G, 1

Active Grants & Contracts $241,998,660

Award Types

F, 23

F - Fellowship Programs K - Research Career Programs

K, 45

P - Research Program Projects and Centers R - Research Projects T - Training Programs

P, 23

U - Cooperative Agreements

R, 266

D - NIH Director’s Pioneer Award

G - Resource Programs

S - Research-Related Programs

* Includes supplements to existing awards

Annual Report 2015/2016 | 35

FACTS & FIGURES UAB Medicine Honors

3RD LARGEST

public academic medical center in the U.S.

NO. 1

UAB Hospital ranks in Birmingham and Alabama in U.S. News & World Report’s Best Hospitals report

10 SPECIALTIES rank in the nation’s top 50 in U.S. News & World Report’s Best Hospitals report

UAB Health System 86,643 total patient discharges & 1.3 million outpatient visits

4,123 babies delivered

2,262 total beds

1,319 medical faculty

18,000+ employees

$71 million in charity care provided annually

Medical Student Body 2015/2016

792 total enrollment

8,552 physicians trained to date

School of Medicine Entering Class 2015

186 students

54 undergraduate institutions represented

30.15 average MCAT score

82 104 women men

21-39 age range

36 | UAB School of Medicine

8 MD/PhD students

52 degrees of study 18 minority students 155 Alabama Residents 31Out-of-State Residents

School of Medicine Class of 2016 Match Day 99% UAB STUDENT match rate, matching into 78 institutions in 31 states

Top 5 matched specialties: INTERNAL

MEDICINE (29), PEDIATRICS (28), FAMILY MEDICINE (19), SURGERY (17), OBGYN (14)

206 NEW RESIDENTS, representing 56 U.S. AND 32 INTERNATIONAL UNIVERSITIES, matched into residencies at UAB

School of Medicine GME Profile 2015/2016

29 ACGME residency programs

54 ACGME fellowships 953 GME trainees

62 underrepresented minorities

UAB Centers & Cores 40+ UNIVERSITY-WIDE interdisciplinary research centers and cores

Since 2008, the UAB Center for Clinical and Translational Science has

invested $1,037,000 in 36 pilot projects; recipients have garnered

$33,722,309in new grants,

representing a return on investment of

32.5:1

Becker’s Hospital Review named the UAB Comprehensive Cancer Center one of the nation’s 100 HOSPITALS

AND HEALTH SYSTEMS WITH GREAT ONCOLOGY PROGRAMS in 2016

UAB Research & Innovation

15 U.S. patents issued per year* 509 U.S. patents issued 1991-2015 35 new patent applications filed per year* 1,713 patent applications filed 1991-2015 26 license agreements per year*

230 license agreements per year 1991-2015 49 startups 1991-2015 startup revenue $74,536,351 cumulative 1991-2015 89 intellectual property disclosures per year* 2,405 intellectual property disclosures 1991-2015 * Five-year average

Annual Report 2015/2016 | 37

LEADERSHIP

Selwyn M. Vickers, MD, FACS

Anupam Agarwal, MD

Etty “Tika� Benveniste, PhD

S. Dawn Bulgarella, MSHA, CPA

Senior Associate Dean for Administration and Finance, UAB School of Medicine Chief Financial Officer, UAB Health System

Mona N. Fouad MD, MPH

Senior Associate Dean for Research Administration and Development Charlene A. Jones Endowed Chair in Neuroimmunology

Craig J. Hoesley, MD

Robert P. Kimberly, MD

David A. Rogers, MD, MHPE

Senior Vice President for Medicine and Dean James C. Lee Endowed Chair

Senior Associate Dean for Medical Education Chair, Department of Medical Education

38 | UAB School of Medicine

Executive Vice Dean Marie S. Ingalls Endowed Chair in Nephrology Leadership

Senior Associate Dean for Clinical and Translational Research, Howard L. Holley Research Chair in Rheumatology

Senior Associate Dean for Diversity and Inclusion

Senior Associate Dean for Faculty Affairs and Professional Development

UAB MEDICINE PARTNERS UAB Health System Clinical Facilities on the UAB Medical Center Campus

UAB Hospital — The centerpiece of the UAB Health System, one of the largest and most advanced public hospitals in the nation with 1,157 licensed beds. Established in 1945 as the teaching hospital for what is now the UAB School of Medicine.

UAB Hospital-Highlands — A general acute care facility providing emergency care, orthopaedics, pain management, occupational medicine, and the region’s first coordinated care unit for geriatric patients.

UAB Women & Infants Center — World-class care for babies and mothers, including a Regional Neonatal Intensive Care Unit and a Continuing Care Nursery with 108 private rooms combined.

Hospitals and Clinics

UAB Callahan Eye Hospital — The only specialty hospital in Alabama focusing on eye care and the nation’s first Level 1 Ocular Trauma Center.

William Ferniany, PhD Chief Executive Officer, UAB Health System

The Kirklin Clinic of UAB Hospital — Nearly 600,000 outpatient visits annually with more than 33 specialties under one roof.

The Kirklin Clinic at Acton Road and Community Primary Care Centers — Offers comprehensive services for cancer, cardiovascular, and other conditions south of the city center.

UAB Urgent Care — A convenient office in Midtown Birmingham offering medical care seven days a week without an appointment.

Affiliates

Medical West Hospital, Bessemer — Offers 310 licensed beds and provides primary and specialty care, a 21-bed emergency room, and a professional office building with a surgical center. The 15-bed Medical West Freestanding Emergency Department opened May 2016.

The Baptist Health System, Montgomery — Composed of three hospitals with a combined 689 beds plus a behavioral health facility and an outpatient cancer center.

Valley Foundation, Huntsville — Assisting UAB Health System in conducting educational, training, and research programs, especially as they relate to the UAB School of Medicine campus in Huntsville.

University of Alabama Health Services Foundation A nonprofit, 1,100-member physician practice including The Kirklin Clinic and The Kirklin Clinic at Acton Road, and serving UAB Medicine through more than 30 centers of excellence.

James A. Bonner, MD

President of UAB Health Services Foundation

Annual Report 2015/2016 | 39

UAB School of Medicine Annual Report 2015/2016 Produced by the UAB School of Medicine Development Communications Office Executive Director of Development Jackie Wood

Senior Director of Communications Paige Dorman

Editor

Jane Longshore

Art Director Kristin Farmer

Associate Editor Emily Henagan

Contributing Writers Amy Bickers Charles Buchanan Kendra Carter Jo Lynn Curry Cary Estes Tyler Greer Jeff Hansen Brooke Hubner Tara Hulen Nancy Mann Jackson Brett Jaillet Adam Pope Bob Shepard Sarah C. P. Williams

Contributing Photographers Nik Layman Dustin Massey Arik Sokol Steve Wood UA Photography

All rights reserved. No part of this publication may be reproduced or transmitted in any way without written permission. Š 2016 by the Board of Trustees of the University of Alabama System for the University of Alabama at Birmingham.

UAB is an EEO/AA/Disability/Veteran Employer www.uab.edu/medicine

Office of Development FOT 1230, 1720 Second Avenue South Birmingham, AL 35294-3412 ADDRESS SERVICE REQUESTED