Annual economic impact study

ANNUAL ECONOMIC IMPACT

BUILDING ON 100 YEARS

UNIVERSITY OF ALBERTA

FACULTY OF MEDICINE & DENTISTRY

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TABLE OF CONTENTS

EXECUTIVE REPORT

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Introduction Teaching Mission and Accomplishments Research Mission and Accomplishments Clinical Relationships and Achievements Project Overview Methodology Employed in the FoMD Economic Contribution Analysis

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INTEGRAL TO THE PROVINCE’S ECONOMIC SUCCESS

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FoMD SUSTAINS JOBS

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FoMD RESEARCH ENTERPRISE

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BENEFITING THE PROVINCE BEYOND OPERATIONS

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Educating the Future Workforce FoMD Alumni Play a Vital Role in the Alberta Economy FoMD Provides Support to the Community

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APPENDICIES

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Appendix A: Definition of Terms Appendix B: Economic Contribution in Western Canada Appendix C: FoMD Research Awards and Distinctions Appendix D: FoMD Accomplishments Appendix E: Methodology Appendix F: FAQs Regarding Economic Contribution Analysis Appendix G: Acknowledgements

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FOR ITS WORK, THE FOMD IS RECOGNIZED AS ONE OF THE TOP 50 ‘CLINICAL AND PRE-CLINICAL HEALTH’ SCHOOLS WORLDWIDE1 AND IS THIRD IN CANADA IN TERMS OF MEDICAL RESEARCH INTENSITY. 2

Faculty member Justin Ezekowitz working with patient Ali Shawwa

EXECUTIVE REPORT

Introduction The Faculty of Medicine & Dentistry (FoMD) at the University of Alberta (U of A) fuels a powerful health and economic engine for the province of Alberta. Building a knowledge-based economy through education and research and the delivery of comprehensive health care underpins a healthy population and a healthy economy.

The purposeful linkage of the three pillars of academic medicine: education, research and patient care – creates an iterative system whereby researchers develop the evidence base, physicians apply and refine the evidence base, and faculty educators teach best practices for care and prevention. This concentration of academic faculty, community physicians, learners and staff strengthens a shared goal in developing new knowledge and applying it to patient care.

For its work, the FoMD is recognized as one of the top 50 ‘Clinical and Pre-Clinical Health’ schools worldwide1 and is third in Canada in terms of medical research intensity.2 Established in 1913, the Faculty’s history includes research discoveries and accomplishments in the fields of diabetes, virology, cardiology, cancer, spinal cord injury and many others. Today, the FoMD offers six undergraduate degrees, three diplomas, 55 medical residencies, 17 PhD and 13 master’s programs. It is home to more than 2,500 learners, more than 700 full-time and more than 1,300 part-time faculty members, and more than 1,200 support staff.

Key to the FoMD’s success is the integrated relationship with its affiliated clinical partners within Alberta Health Services (AHS): the University of Alberta Hospital, the Stollery Children’s Hospital, the Royal Alexandra Hospital, the Misericordia Hospital, and the Grey Nuns Hospital – plus the many other hospitals and clinics throughout Alberta that contribute to the educational and clinical experiences of the learners.

1 Times Higher Education World Rankings (2012) 2 RE$EARCH Infosource Inc. 2012

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Teaching Mission and Accomplishments The FoMD trains physicians, dentists, dental hygienists, medical laboratory technologists, and researchers in the clinical and basic sciences.

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Key teaching accomplishments of the FoMD include: ◆ The MD classes rank first in the country on the Medical Council of Canada licensing examinations. ◆ The MD program is one of the most competitive in Canada with eight applicants for every position. ◆ The Faculty is home to 577 MSc/PhD students and graduates 6 per cent of all health and biomedical PhDs in Canada.

FoMD researchers are among the most competitive in the country in terms of funding from the major federal granting councils and other sources and the FoMD ranks third in Canada for total sponsored research income (2012).3

FoMD graduates comprise: ◆ 28 per cent of all the current practising family physicians and specialists in Alberta. ◆ 52 per cent of dentists working in Alberta. ◆ 25 per cent of all medical laboratory technologists working in Alberta. ◆ 40 per cent of dental hygienists caring for Albertans.

Research Mission and Accomplishments Researchers in the FoMD explore the full range of health, from discerning disease events at the molecular level, to evidence-based orthodontics, to pediatric pathology, to issues in public policy. FoMD researchers are among the most competitive in the country in terms of funding from the major federal granting councils and other sources and the FoMD ranks third in Canada for total sponsored research income (2012).3 The FoMD generated $131.5 million in research dollars in FY 11/12, making up approximately 40 per cent of the university’s total.

Many Faculty research groups are recognized globally thus contributing to the FoMD’s ranking as one of the top 50 ‘Clinical and Pre-Clinical Health’ schools worldwide.4

3 RE$EARCH Infosource Inc. 2012 4 Times Higher Education World Rankings (2012)

RESPONDING TO A COMMUNITY’S NEEDS 5

The hope was to make young people feel When medical students go to

comfortable accessing health care, with

small communities for part

the ultimate goal of encouraging them

of their medical training, the communities often benefit as much as the students.

In 2011, then third-year medical students Samantha Stasiuk and Cameron Sklar (above) started a new youth clinic in Whitecourt to serve patients between the

to reach out for preventative health care instead of waiting until things become serious. The young medical students were more approachable, especially on topics of particular concern for youth such as contraception, unplanned pregnancy and STI (sexually transmitted infection) screening.

ages of 13 and 25. The students saw the need

Stasiuk and Sklar were in Whitecourt as

for this initiative because in small towns it

part of the Rural Integrated Community

can be difficult for youth to go to the local

Clerkship, which places third-year medical

hospital for confidential medical advice due

students in rural communities to help

to a lack of anonymity.

promote the practice of medicine in these

The clinic ran Tuesdays between 4 and 7

underserved areas.

p.m., the perfect time for students to get

The clinic was continued until the winter of

there after school. With the help of their

2013 by other medical students who did their

preceptor, Tahmeena Ali, Stasiuk and Sklar

ICC placements in Whitecourt. Today, while

treated about five patients per session, an

the youth clinic is no longer in operation, the

increase from the three a week before the

clinic where it was located has extended its

clinic was established.

hours to 5 p.m. during weekdays to be more accessible to youth.

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PROVIDING SPECIALIZED CARE TO ALBERTANS Four-year old Adelaide Radbourne received a heart transplant at six months. Faculty member Lori West helped prepare her for transplant.

The excellence of the Faculty of Medicine & Dentistry’s research and clinical programs attracts many medical experts to Edmonton who provide specialized care to Albertans.

The new program builds on the U of A’s reputation for transplant research excellence. The Alberta

Case in point: Faculty researcher and renowned

Transplant Institute (ATI), in close partnership with

pediatric transplant cardiologist Lori West who was

Alberta Health Services, brings together all of the

recruited to the University of Alberta from Toronto.

university’s clinical transplant programs and its

West now leads the Canadian National Transplant

multiple research strengths under one umbrella.

Research Program (CNTRP), which is designed to

The Edmonton Zone multi-organ transplant

increase organ and tissue donation in Canada and to

program is one of the most comprehensive clinical

enhance the survival and quality of life of Canadians

programs in Canada and is a leader in both the

who receive transplants. The CNTRP will transform

numbers of transplant procedures performed

the field of transplantation by addressing the barriers

and success rates in adults and children.

to donation, therefore increasing the number of available organs, improving the quality and viability of donated organs and grafts, and improving long-term survival and quality of life of transplant patients. It is the first program in the world to unite and integrate the solid organ transplant, bone marrow transplant, and the donation and critical care research communities together in a ground-breaking national research endeavour.

The ATI is also home to the world’s largest islet transplant program to treat Type 1 diabetes.

The science behind this treatment, the Edmonton Protocol, was also developed at the U of A more than 10 years ago. Faculty member James Shapiro, a surgeon and director of the clinical islet transplant program, also leads a research project as part of the CNTRP.

Key research accomplishments of the FoMD include: ◆ The Faculty garnered about 75 per cent of total Canadian Institutes of Health Research (CIHR) funding brought in to the University of Alberta.5 ◆ The FoMD played a critical role in launching 21 Alberta-based spin-off companies over recent years.

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Clinical Relationships and Achievements The partnership between the FoMD and Alberta Health Services (AHS) has allowed the two organizations to attract top clinicians, researchers and educators from all over the world to provide a rich clinical, research and teaching environment.

Key clinical accomplishments include: ◆ The Edmonton Zone multi-organ transplant program is one of the most comprehensive clinical programs in Canada. It leads in both the numbers of transplant procedures performed and success rates in adults and children. Building on this success, the FoMD now provides leadership for the new Canadian National Transplant Research Program. ◆ Almost 2,300 clinical trials are currently running through the combined efforts of the FoMD and AHS. These trials provide stateof-the-art clinical care and medications to almost 14,000 Albertans and bring in about $17.5 million dollars annually from industry that thus helps to support clinical care. Medications provided in clinical trials are free to the patient and the province; in the cancer field alone, medications provided to patients in clinical trials save the province almost $5 million in drug costs annually.6 ◆ Faculty clinician-researchers have developed and implemented new and innovative clinical protocols that allow for earlier pre-hospital intervention in acute myocardial infarct patients. This has led to dramatic reductions in hospital mortality rates. ◆ Using advanced gene chip technologies to decipher the molecular events occurring in transplant organs injury and rejection, a team of FoMD clinician-researchers and scientists have developed a ‘molecular microscope’ that can be used to read biopsies and to predict patient outcomes.

5 FoMD received $28,578,501 in CIHR funding out of $38,526,348 in total CIHR funding awarded to the University of Alberta.

6 Source: Northern Alberta Clinical Trial Research Centre (NACTRC); Cross Cancer Institute Clinical Trials Unit (CCI CTU)

The FoMD played a critical role in launching 21 Alberta-based spin-off companies over recent years.

Project Overview

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In November 2012, Tripp Umbach was retained by the University of Alberta’s Faculty of Medicine & Dentistry to measure the economic, employment and government revenue impacts of the FoMD’s operations and research. The goals of the FoMD economic impact study included the following: ◆ To quantify the economic and employment impacts of the FoMD on Alberta. ◆ To quantify the economic and employment impacts of the FoMD on Western Canada. ◆ To better articulate the benefits of a strong clinical, academic and teaching faculty and the FoMD’s partnership with the community, citizens and the province.

Methodology Employed in the FoMD Economic Contribution Analysis This economic impact analysis measures the effect of direct and indirect/induced business volume and government revenue impacts for all of the FoMD’s operations throughout Alberta.

The methodology employed in the calculation of these impacts is linear cash flow modelling (see Appendix E) with data provided by Statistics Canada. Primary data utilized to conduct the analysis was collected from the STUDY OVERVIEW FoMD. Data included: capital expenditures, operational expenditures, jobs, payroll and benefits, and taxes STUDY PERIOD: and encompasses the fiscal year of 2011/2012 (FY Fiscal Year 2011/2012 11/12). The approach taken on this study was decidedly conservative and adheres to industry standards for THIS STUDY INCLUDES: University of Alberta Faculty economic impact. of Medicine & Dentistry

STUDY GEOGRAPHY: Alberta and Western Canada METHODOLOGY: Ace-based Linear Cash Flow Models with Data from Statistics Canada

Economic impact begins when an organization spends money. Economic impact studies measure the direct economic impact of an organization’s spending, plus additional indirect and induced spending in the economy as a result of direct spending. Economic impact is not a measurement of revenue or dollars collected by institutions.

Total economic impact measures the dollars that are generated within Alberta due to the presence of the FoMD. This includes not only spending on goods and services with a variety of vendors within the province, and the spending of FoMD staff and visitors, but also the volume generated by businesses within Alberta that benefit from the FoMD’s spending. It is important to remember that not all dollars spent by a university remain in its home province. Dollars that “leak” out of the province in the form of purchases from out-of-province vendors are not included in the FoMD’s economic impact. The multipliers utilized in this study are derived from the data provided by Statistics Canada.

Key economic impact findings presented within the summary include the total current (FY 11/12) economic, employment, and provincial and local government revenue impact of the FoMD’s operations (see Figure 1).

FIGURE 1: COMPONENTS OF ECONOMIC IMPACT

What is included in the economic impact?

What is not included in the economic impact?

• Research Commercialization • In-Province Alumni Impact

• Operational Spending • FoMD Clinical Operations at AHS Attributable to the FoMD • Capital Spending • Research Spending • Salaries & Benefits • Visitor Spending • Student Spending

• Attraction Power • Knowledge & Expertise

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INTEGRAL TO THE PROVINCE’S ECONOMIC SUCCESS The FoMD is an integral piece of the province’s economic success, and FoMD operations directly or indirectly impact many Albertans every day – either through operational spending, research or provision of clinical care. The FoMD affects business volume in Alberta in two ways:

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1

Direct expenditures for goods and services by the FoMD, employees, learners and visitors.

This spending supports local businesses, which in turn employ local individuals to sell the goods and provide the services that FoMD constituencies need.

2

Indirect or induced spending within Alberta.

The businesses and individuals that receive direct payments re-spend this money within the province, thus creating the need for even more jobs.

$1,218.0 Million

TOTAL

FoMD (Academic)

ALBERTA HEALTH SERVICES (FoMD Clinical Only)

FIGURE 2: ANNUAL ECONOMIC IMPACT OF FACULTY OF MEDICINE & DENTISTRY (Academic and Clinical Components)

$739.7 Million

$ 1,957.5 Million

The overall economic impact of all the FoMD’s operations on Alberta in FY 11/12 was $2.0 billion ($1.2 billion direct impact and $0.7 billion indirect) (see Figure 2, Table 1).

TABLE 1: ANNUAL ECONOMIC IMPACT OF FACULTY OF MEDICINE & DENTISTRY (Academic and Clinical Components)

FoMD (Academic)

ALBERTA HEALTH SERVICES (FoMD Clinical Only)

DIRECT

$529.5 Million

$321.6 Million

$851.1 Million

INDIRECT

$688.4 Million

$418.1 Million

$1,106.4 Million

$1,218.0 Million

$739.7 Million

$1,957.5 Million

TOTAL

TOTAL

The $1.2 billion in direct impact is comparable to the economic impact of a number of American medical schools7 (see Table 2).

TABLE 2: PEER MEDICAL SCHOOL COMPARISONS PEER MEDICAL SCHOOL University of Alberta Faculty of Medicine & Dentistry

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TOTAL ECONOMIC IMPACT

SOURCE/YEAR

$1.2 Billion

Tripp Umbach, 2012

University of Arizona $1.2 Billion School of Medicine (Tucson)

Tripp Umbach, AAMC* 2011

University of Minnesota $1.2 Billion Medical School (Twin Cities)

Tripp Umbach, AAMC 2011

University of Washington $2.0 Billion School of Medicine (Seattle)

Tripp Umbach, AAMC 2011

University of Wisconsin School of $1.5 Billion Medicine and Public Health (Madison)

Tripp Umbach, AAMC 2011 *Association of American Medical Colleges

FOMD SUSTAINS JOBS

4,641 FTEs

7 Note: At the time of publication, comparative data for Canadian medical schools was not available.

TOTAL JOBS

ALBERTA HEALTH SERVICES (FoMD Clinical Only)

FIGURE 3: ANNUAL EMPLOYMENT IMPACT OF FACULTY OF MEDICINE & DENTISTRY (Academic and Clinical Components)

FoMD (Academic)

The FoMD supported 13,517 jobs in Alberta. These jobs include not only direct employment by the Faculty, but also indirect and induced jobs created for supply and equipment vendors, contractors and labourers for the construction and renovation of university facilities, and jobs created in the community at hotels, restaurants and retail stores in support of the FoMD’s workforce and visitors (see Figure 3, Table 3).

8,876 FTEs

13,517 FTEs

To complete its teaching, research and clinical mission, the Faculty has 643 tenure-track faculty members and about 1,200 support staff, and partners with more than 1,688 clinical academic colleagues – community physicians and dentists who teach FoMD learners in hospitals, clinics and private practices.

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The Faculty directly employed 2,210 full-time faculty members and staff in FY 11/12.8 The Faculty also supports hundreds of jobs annually province-wide in many sectors of the Alberta economy, such as construction, business and professional services, restaurants and hotels, information technology, security and temporary employment companies. These indirect jobs (2,431) support the 2,210 Albertans who are employed directly by the Faculty. The impact of the FoMD spreads to other sectors of the economy including the health-care sector (hospitals and physician and dental offices), nursing and residential care facilities, real estate establishments and non-residential commercial construction, restaurants, retail and wholesale trade businesses.

Additional employment and impact is generated by medical residents (750 people) at AHS, and clinical fellows and post-docs (178 people).

These employees do not receive a direct payment from the FoMD but their economic impact totals an estimated $8.5 million in the Alberta economy.

TABLE 3: ANNUAL EMPLOYMENT IMPACT OF FACULTY OF MEDICINE & DENTISTRY (Academic and Clinical Components)

FoMD (Academic)

ALBERTA HEALTH SERVICES (FoMD Clinical Only)

TOTAL

DIRECT

2,210 FTEs

4,227 FTEs

6,437 FTEs

INDIRECT

2,431 FTEs

4,650 FTEs

7,081 FTEs

4,641 FTEs

8,876 FTEs

13,517 FTEs

TOTAL

8 Includes full-time and part-time employees combined into full-time exemptions.

Faculty member Brian Rowe examines a young patient

TO COMPLETE ITS TEACHING, RESEARCH AND CLINICAL MISSION, THE FACULTY HAS 643 TENURE-TRACK FACULTY MEMBERS AND ABOUT 1,200 SUPPORT STAFF, AND PARTNERS WITH MORE THAN 1,688 CLINICAL ACADEMIC COLLEAGUES – COMMUNITY PHYSICIANS AND DENTISTS WHO TEACH FOMD LEARNERS IN HOSPITALS, CLINICS AND PRIVATE PRACTICES.

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FAST-TRACKING FACULTY VIROLOGY DISCOVERIES TO MARKET The University of Alberta’s Faculty of Medicine & Dentistry is world renowned for research advances in understanding how viruses work and for discoveries leading to treatments for viruses like hepatitis B and hepatitis C. A research team led by Michael Houghton (left) recently developed a vaccine that could fight all strains of hepatitis C, and Lorne Tyrrell and his colleagues are renowned for their work with an antiviral treatment for hepatitis B that is commonly used today.

The federal government recently recognized that excellence in advancing scientific and clinical research with an investment of $3 million in the U of A’s Li Ka Shing Applied Virology Institute. The money from Western Economic Diversification Canada is earmarked for commercialization efforts — offering financial support for the transition of research discoveries to the marketplace.

These discoveries will impact Albertans, Canadians and people around the world, providing treatments for serious illnesses.

The investment will go toward the institute’s purchase of specialized equipment to conduct pre-commercialization activities for developing and testing new vaccines and therapies. These activities are expected to attract commercial investments that will help bring new medical products to market. The institute’s resources will increase the number of vaccines that are developed and commercialized in the Edmonton area, with the long-term goal of establishing a competitive virology cluster in Alberta.

FOMD RESEARCH ENTERPRISE

In FY 11/12, the FoMD was awarded $131.5 million in sponsored research funds. These research dollars enter the Alberta economy from a wide variety of agencies including the Canadian Institutes of Health Research, the Natural Sciences and Engineering Research Council of Canada, the Canada Foundation for Innovation, Alberta Innovates - Health Solutions, private corporations/businesses and other municipal, provincial and foreign government sources.

$142.8 Million

The FoMD’s $131.5 million dollars in sponsored research translates into significant economic impact. Research expenditures totalled $142.8 million in FY 11/12. As a result of the strong research programs, the combined direct and indirect economic impact of the FoMD research enterprise is $328.4 million. As the FoMD’s research grants and contracts grow as a result of increased research funding, the impact of research will also continue to grow (see Figure 4).

The Faculty’s research operations make tangible and quantifiable economic contributions. Along with creating jobs for research staff and support personnel, FoMD scientists are contributing to new product development and technology commercialization. Knowledge and technology transfers have helped to start commercial ventures that promote entrepreneurship, economic development and job creation.

$185.6 Million

TOTAL

INDIRECT

FIGURE 4: ECONOMIC IMPACT OF FACULTY OF MEDICINE & DENTISTRY RESEARCH EXPENDITURES

DIRECT

The impact of research spending is already included in the $1.2 billion economic impact of the FoMD (academic only). It is critical to note that the research dollars the FoMD brings into the province are mainly “fresh” dollars for the province of Alberta – meaning that the quality of the faculty and strength of the programs is attracting out-ofprovince dollars to Alberta. The FoMD competes nationally for these dollars against its peer institutions to fund the research enterprise. The $131.5 million in research funds is a tribute to the exceptional quality of the diverse and innovative faculty, learners and staff, and the power of the FoMD intellectual community.

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$ 328.4 Million

FoMD Research Creates High-Quality Jobs

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In FY 11/12, the FoMD’s operational expenditures for sponsored research and other sponsored programs supported 1,251 jobs.

These research employment numbers represent 27 per cent of the total FoMD job impact.

These jobs include not only direct employment of research professionals, but also indirect jobs created for supply and equipment vendors, contractors and labourers for the construction and renovation of laboratory facilities, administrators and managers who support the research infrastructure, and jobs created in the community by the disposable income of the scientific workforce.

If the Faculty can maintain its strong base, it will continue to attract, and consequently spend, increasingly higher levels of research dollars, and the number of jobs supported will continue to grow.

If the Faculty can maintain its strong base, it will continue to attract, and consequently spend, increasingly higher levels of research dollars, and the number of jobs supported will continue to grow. With continued high levels of research funding and consequent expenditures, the FoMD will remain a source of support for more than 2,000 local jobs based on research funding alone.

Not included is the impact of commercialization activities such as patents, licensing, royalties and business spin-off companies.

Comprehensive data on research commercialization activity are difficult to obtain as some of this occurs independent of the university. Data from TEC Edmonton reflects only those commercialization activities where the university is involved and shows that over the past five years, discoveries and inventions by the FoMD brought an additional $3.5 million ($1.5 million direct impact) into Alberta.9

9 Source: Data on patents, licensing, royalties, and business spin-off companies was provided by TEC Edmonton.

◆ Since 2002, the FoMD has filed 28 licenses (exclusive and non-exclusive); 22 of which are still active. ◆ The FoMD has filed 303 patent applications since 2002.

• Nineteen were issued in the United States, two in Canada and 25 were issued in other jurisdictions.

• Three trademarks and one copyright have been issued. ◆ As a result of work conducted at the FoMD, 21 Alberta-based spin-off companies have formed over recent years (see Table 4).

TABLE 4: FACULTY OF MEDICINE & DENTISTRY BUSINESS SPIN-OFF COMPANIES LOCATED IN ALBERTA COMPANY

TYPE OF PRODUCT OR SERVICE

AcuVector Group Inc.

Genetic therapy products

Arch Biopartners Inc.

Technology holding & development company

ATGCell Inc.

Tailored recombinant protein expression

Biomech Designs Ltd.

Development of prosthetics

Biomotion Ltd.

Medical devices

DNA-Arts Inc.

DNA library services

HistoBest Inc.

Histological slide preparation: custom and pre-prepared

ImMed Biotechnologies Ltd.

Anti-infective therapies

Isotechnika, Inc.

Immunosuppressives and diagnostic breath test kits

KMT Hepatech, Inc.

In vivo models, development of Hep C, Hep B and malaria therapeutics and vaccines

Metabolomic Technologies Inc.

Colorectal cancer diagnostics

Metabolic Modulators Research Ltd.

R&D in energy-producing cellular fuels, fatty acids, and carbohydrate metabolism

Neurokinetics Inc.

Limb rigidity analyzer for neurological assessment

Prev Biotech

Technology for pressure ulcers

Progress Scientific Inc.

Neurophysiology consulting and research (particularly breathing)

(formerly Neurochemical Modulation Inc.)

RadTag Technologies Inc.

Radiation exposure/measuring devices for medical and agricultural uses

Regional Data Management Inc.

Data collection and data flow software solutions

Rehabtronics Inc.

Rehabilitation devices and diagnostics

Respirlyte Inc.

Metabolomic-based diagnostic for asthma and COPD

SmileSonica Inc.

Non-invasive dental repair technologies

TheraCarb Inc.

Carbohydrate-based vaccine and therapeutics for infectious and neurodegenerative diseases

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BENEFITING THE PROVINCE BEYOND OPERATIONS 18

The FoMD’s total impact on Alberta goes beyond the annual operational impacts detailed in this report. Economic impact studies often only capture what can be assigned an actual number, but the value of the FoMD goes far beyond the annual $2.0 billion economic impact. The FoMD educates future leaders and innovators. The FoMD provides access to expert faculty, top-tier medical care and education and the future workforce. It is challenging to assign a dollar amount to the outreach and community activities of the Faculty, but on a daily basis, the lives of Albertans are enhanced by the presence of the FoMD.

Educating the Future Workforce

By educating learners, the FoMD adds to the talent pool of human capital in Alberta. The learners are thus able to earn more in the job market because they are more valuable and productive.

The FoMD educates the workforce that Alberta needs to succeed in the 21st century. The learners who graduate every year from the FoMD are essential to the province’s human capital and workforce needs.

Graduates of the program go on to complete residency training and research throughout the province and country. About 80 per cent of graduates and 50 per cent of medical students will stay in Alberta upon graduation and contribute to the provincial economy.

FoMD Alumni Play a Vital Role in the Alberta Economy FoMD alumni are integral to the Alberta economy. By educating learners, the FoMD adds to the talent pool of human capital in Alberta.

The learners are thus able to earn more in the job market because they are more valuable and productive. The FoMD awarded 304 degrees and diplomas in academic year 2011/2012. This amounts to the creation of $925.0 million of future value (only counting the graduates from a single academic year) assuming that 50 per cent of the graduates stay and work in Alberta over the course of their careers. Even if the total is adjusted by 15 per cent to allow for periods of unemployment, time out of the labour force for child rearing and other life events, the value creation is still $786.3 million over the course of the careers for a single graduating class.

FoMD Provides Support to the Community Tripp Umbach estimates that FoMD staff, faculty, physicians and learners generate more than $27.7 million annually in charitable donations, volunteer services and provision of care through clinical trials. These benefits are in addition to the $2.0 billion annual impact and include the following:

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◆ $17.5 million in clinical care provided to patients through clinical trials. ◆ $6.4 million donated to local charitable organizations

by FoMD faculty, staff and learners.10 ◆ Nearly $3.8 million in value of volunteer time provided to area communities by FoMD faculty, staff and learners.

Tripp Umbach estimates that FoMD staff, faculty, physicians and learners generate more than $27.7 million annually in charitable donations, volunteer services and provision of care through clinical trials.

10 Source: Tripp Umbach has conducted survey research where students (primary), staff and faculty (secondary) provide estimates on spending patterns, including information on the number of volunteer hours and charitable donations they provide. Tripp Umbach used a conservative assumption of $20.10 per hour to calculate the value of volunteer services.

This amount was originally calculated independently by the Points of Light Foundation.

FACULTY MEMBERS HAVE RECEIVED NUMEROUS AWARDS AND DISTINCTIONS FOR THEIR RESEARCH ACTIVITIES.

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Faculty member Vivian Mushahwar gathers information from spinal cord injury patient Callum Duncan

APPENDIX A: DEFINITION OF TERMS 21

STUDY YEAR

FISCAL YEAR 2011/2012 (FY 11/12)

TOTAL ECONOMIC

CONTRIBUTION

The total economic contribution of an institution includes both the direct impact and the indirect impact generated in the economy as a result of the institution. Direct impact includes items such as institutional spending, employee spending, and spending by visitors to the institution. Indirect impact, also known as the multiplier effect, includes the re-spending of dollars within the local economy.

MULTIPLIER EFFECT

The multiplier effect is the additional economic impact created as a result of the institution’s direct economic impact. Local companies that provide goods and services to an institution increase their purchasing by creating a multiplier.

DIRECT EMPLOYMENT

INDIRECT EMPLOYMENT

Total employees based on total FTEs. Indirect employment is the additional jobs created as a result of the institution’s economic impact. Local companies that provide goods and services to an institution increase their numbers of employees as purchasing increases thus creating an employment multiplier.

APPENDIX B: ECONOMIC CONTRIBUTION IN WESTERN CANADA 22

Tripp Umbach also completed analysis on the FoMD’s economic contribution in Western Canada.11 Analysis shows the following: ◆ The FoMD has an overall economic impact on Western Canada of $952.9 million ($529.4 million direct). ◆ The FoMD has an overall employment impact on Western Canada of 4,640 jobs (2,210 direct jobs).

WESTERN CANADA

ECONOMIC CONTRIBUTION

EMPLOYMENT IMPACT

$952.9 Million

4,640 Jobs

Source: Tripp Umbach, using results obtained from data provided by the FoMD and Statistics Canada

11 Western Canada includes: British Columbia, Alberta, Saskatchewan and Manitoba.

APPENDIX C: FOMD RESEARCH AWARDS AND DISTINCTIONS 23

Faculty members have received numerous awards and distinctions for their research activities. The figure below profiles the recent research achievements of the FoMD.

FACULTY OF MEDICINE & DENTISTRY RESEARCH AWARDS AND DISTINCTIONS

INTERNATIONAL Fellows of the Royal Society (UK)

2

Members of the American Society of Clinical Investigation

2

NATIONAL Canada Excellence Research Chairs

NUMBER OF AWARDS 1

Canada Research Chairs

12 (Tier 1)

Canada Research Chairs

19 (Tier 2)

CIHR New Investigators

11

CIHR Clinician Scientists

1

Canadian Academy of Health Sciences Fellowships

5

Royal Society of Canada Fellows

24

PROVINCIAL Alberta Innovates – Health Solutions Awards

NUMBER OF AWARDS

UNIVERSITY Distinguished University Professorships

NUMBER OF AWARDS 75

NUMBER OF AWARDS 15

APPENDIX D: FOMD ACCOMPLISHMENTS 24

The stories below highlight some of the numerous teaching, research and clinical accomplishments of the FoMD.

Clinical trial aims to stop heart disease before it starts in breast cancer patients

Using special blood tests and imaging tests like MRI and echocardiograms, Paterson and his colleague are working to improve detection of heart disease and its risk factors in cancer patients.

Faculty of Medicine & Dentistry researcher Ian Paterson teamed up with a colleague in the Faculty of Rehabilitation Medicine to start a new clinical trial called MANTICORE that aims to prevent cardiovascular disease in breast cancer patients. Cancer treatment is hard on the body, particularly the heart, thus cancer patients and cancer survivors are at risk of developing cardiovascular disease. Using special blood tests and imaging tests like MRI and echocardiograms, Paterson and his colleague are working to improve detection of heart disease and its risk factors in cancer patients. They then want to aggressively treat those patients at risk with the goal to prevent heart disease not only during cancer treatment, but also after the cancer treatment concludes.

The duo decided to start with breast cancer patients, a leading cause of cancer death and the most common cancer in women. Treatments have improved drastically over the years, including one drug in particular: Herceptin. This drug improves survival rates for some types of breast cancer, but can damage the heart in up to 20 per cent of women.

Patients were happy to take part in the trial, saying it could improve their prognosis.

Faculty member and award-winning teacher Sarah Forgie

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NATIONAL TEACHING AWARD FOR FoMD PEDIATRICS PROFESSOR University of Alberta pediatrics associate

memories on – so I just try to come up with different

professor Sarah Forgie is the winner of a 2012 3M

ways to do that,” says Forgie.

National Teaching Fellowship, a prestigious award recognizing exceptional contributions to teaching and learning at Canadian universities.

From reciting beatnik poetry describing peritonitis or writing bug bios, to creating lecture podcasts or tasking students with creating rap to explain medical conditions, Forgie goes to great lengths to be inventive in the classroom – all with the goal of helping aspiring doctors remember the vital information they need.

“It falls back to the need to ensure that people have a memory hanger – something to hang those

Forgie isn’t happy resting on her creative laurels.

Her inventive nature drove her, for example, to learn to play a ukulele and rewrite a pop song to teach students about strep pharyngitis (strep throat).

“I like to think of it as my own little epidemic of making teaching fun in medical education,” says Forgie. “Whenever I have a student doing a project with me, I do my best to make sure they work as my emissaries, spreading the ‘bug.’”

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Above: FoMD graduate and family medicine resident Imran Raghavji with patient

Research on MRI use U of A Faculty of Medicine & Dentistry researchers and their Ontario colleagues recently published findings showing that many lowerback MRIs performed at two Canadian hospitals were possibly not warranted. The findings are important because in some parts of the country, MRI tests for the lower back account for about one-third of all MRI requests. Across the country, wait times for MRIs are long and patient access is limited.

Lead author and clinical scientist Derek Emery and his colleagues found more than 50 per cent of the lumbar spine or lower-back MRIs had questionable value or were deemed inappropriate. However, the study found requests for head MRIs in patients with headaches were appropriate 83 per cent of the time. MRIs for the back are usually to determine the cause of back pain, while head MRIs in this study were to identify the cause of headaches.

Emery said the study results indicate MRIs for the lower back may need to be reined in since the requests for these tests have rocketed in recent years. And if the number of inappropriate MRIs can be reduced, there will be more capacity to perform MRIs on patients who really need them – which will help improve patient care.

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FoMD oncology professor recognized nationally Scott North is another of the Faculty’s nationally recognized professors – winner of a prestigious 3M National Teaching Fellowship in 2011.

Each year, North teaches a four-week block on oncology. The course introduces medical students to common cancers and their general principles, symptoms to watch for and how to diagnose the disease and develop patient treatment strategies. North emphasizes palliative care, pain management, psycho-social support and complementary medicine in his teaching.

Instead of giving students paper-based cases, North brings in alternative-medicine practitioners or patients who are using alternative therapies. He once brought a patient dying of cancer and his wife to talk to the students about their grief process. Actors also visit the class to act out different scenarios as patients with varying types of cancer-like symptoms. In one exercise, North has the students practise breaking bad news to patients who have terminal cancer.

North knows he’s making a difference when he meets oncologists who say his course inspired them to become cancer specialists, or when students tell him the course gave them the confidence to deal with terminally ill cancer patients.

North knows he’s making a difference when he meets oncologists who say his course inspired them to become cancer specialists, or when students tell him the course gave them the confidence to deal with terminally ill cancer patients.

Cancer treatment breakthrough

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The Cross Cancer Institute and a research team led by Gino Fallone from the Faculty of Medicine & Dentistry have developed a new technology that will give oncologists far more accurate 3-D images of abdominal tumours and in ‘real-time’ as tumours are blasted with cancer-eradicating radiation. The Magnetic Resonance Real-time Guided Radiation Therapy (MRrtgRT) technology opens the door to radiation treatment on certain internal organ cancerous tumours, not previously possible due to minute patient movement. MRrtgRT technology also ensures pinpoint accuracy in hitting cancer cells with radiation, thus minimizing the impact on surrounding healthy tissue.

Identification of non-reactor based medical isotope

by FoMD Team A University of Alberta team has made an important breakthrough in the race to find a viable replacement supply for technetium-99m, an important isotope produced by Canada’s Chalk River reactor.

The research has proven that this medical isotope – used in nuclear medicine imaging for about 250,000 Alberta patients each year – can be created in a device known as a cyclotron and is as safe to use and provides as reliable an image as reactor-based isotopes. Their results are a promising first step in responding to an impending global need for an alternative supply. Sandy McEwan, a researcher in the Faculty of Medicine & Dentistry, says that the team has produced viable quantities of high-quality technetium-99m using a 19-mega-electron-volt cyclotron, a circular particle accelerator that propels charged particles using a constant magnetic field. Currently, technetium-99m is used in 85 per cent of all nuclear medicine procedures globally every year. Such procedures are used to diagnose patients with cancer, cardiac illness, neurological diseases and other diseases and are critical in identifying the presence or progression of disease and determining best treatment options.

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Faculty member Sandy McEwan working with the hot cell in the cyclotron facility

THE RESEARCH HAS PROVEN THAT THIS MEDICAL ISOTOPE – USED IN NUCLEAR MEDICINE IMAGING FOR ABOUT 250,000 ALBERTA PATIENTS EACH YEAR – CAN BE CREATED IN A DEVICE KNOWN AS A CYCLOTRON AND IS AS SAFE TO USE AND PROVIDES AS RELIABLE AN IMAGE AS REACTOR-BASED ISOTOPES.

APPENDIX E: METHODOLOGY 30

Businesses operating within Alberta in the wholesale, retail, service, and manufacturing sectors benefit from the direct expenditures of the institutions and their faculty, staff, learners and visitors on goods and services.

Impact on Provincial Business Volume The FoMD is an important employer in the province and, as such, a significant generator of personal income for residents of the province.

Businesses operating within Alberta in the wholesale, retail, service, and manufacturing sectors benefit from the direct expenditures of the institutions and their faculty, staff, learners and visitors on goods and services. In addition, many of these “direct” expenditures are recirculated in the economy as recipients of the first-round of income re-spend a portion of this income with other businesses and individuals within the province.

Methodology and data utilized for the estimation of the economic impact of the Faculty of Medicine & Dentistry This economic impact analysis measures the effect of both direct and indirect business volume and government revenue impacts. The methodology employed in the calculation of these impacts is derived from the standard set of impact research tools developed by the American Council on Education (ACE) for the measurement of college and university economic impact.12 The ACE-based methodology is well established, having been used in hundreds of impact studies including for the American Association of Medical Colleges. The ACE methodology employs linear cash-flow modelling to track the flow of institution-originated funds through a delineated spatial area. For the FoMD impact analysis, models were developed for the entire Faculty, with the models measuring impact on the provincial economy.

12 Caffrey, John and Isaacs, Herbert, “Estimating the Impact of a College or University on the Local Economy,” American Council on Education, 1971.

Faculty member Monica Gorassini (right) with rehabilitation medicine researcher Jaynie Yang and a young patient

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Model Inputs and Data Sources Model inputs included actual FY 11/12 expenditures provided by the Faculty of Medicine & Dentistry, and research throughout Alberta and Western Canada. Statistics Canada provided data to populate the models.

For the FoMD impact analysis, models were developed for the entire Faculty, with the models measuring impact on the provincial economy.

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INNOVATION IN VIRTUAL-REALITY RESEARCH HELPS AMPUTEES LEARN TO WALK AGAIN Amputees learning to walk again on prosthetic legs are regaining the skills to do so safely and confidently thanks to virtual-reality research led by Faculty of Medicine & Dentistry clinical scientist Jacqueline Hebert (left). Through sessions at the Glenrose Hospital on the CAREN (Computer-Assisted Rehabilitation Environment) — the only clinical virtual reality simulator of its kind in Western Canada — researchers are working to better understand the balance needs of amputees and to devise new approaches to therapy.

As versatile as an aircraft simulator, CAREN’s twin-treadmill platform, motion hydraulics and circular surround screen can be programmed by therapists to create virtually any scenario or game imaginable as it delivers a rehab program precisely tailored to each amputee’s needs. As well, sensors placed on patients are tracked by overhead cameras to give objective feedback and measure progress on gait, stride, speed, weight-shift, balance and more. Patients become part of the simulated environment, interact with it and change it through their body movements. Patients walk through virtual-reality scenarios to build skill and confidence.

To date, 16 single-limb amputees have taken part in the national study, with more sessions and subjects expected. Helping amputees with lower-limb trauma also promises better rehabilitation for military veterans wounded in action.

The CAREN at the Glenrose is the result of the hospital’s partnership with the Department of National Defence.

APPENDIX F: FAQS REGARDING ECONOMIC CONTRIBUTION ANALYSIS 33

What is economic impact?

Economic impact begins when an organization spends money.

Economic impact studies measure the direct economic impact of an organization’s spending, plus additional indirect spending in the economy as a result of direct spending. Economic impact has nothing to do with dollars collected by institutions, their profitability or even their sustainability, since all operating organizations have a positive economic impact when they spend money and attract spending from outside sources.

Direct economic impact measures the dollars that are generated within Alberta and Western Canada due to the presence of the FoMD. This includes not only spending on goods and services with a variety of vendors within the province, and the spending of its staff and visitors, but also the business volume generated by businesses within Alberta that benefit from the FoMD’s spending. It is important to remember that not all dollars spent by the Faculty remain in its home province.

Dollars that “leak” out of the province in the form of purchases from out-of-province vendors are not included in the Faculty’s economic impact on the province.

The total economic impact includes the “multiplier” of spending from companies that do business with the FoMD. Support businesses may include lodging establishments, restaurants, construction firms, vendors, temporary agencies, etc. Spending multipliers attempt to estimate the ripple effect in the provincial economy where the spending occurs. For example: spending by the FoMD with local vendors provides these vendors with additional dollars that they re-spend in the local economy, causing a “multiplier effect.”

Economic impact studies measure the direct economic impact of an organization’s spending, plus additional indirect spending in the economy as a result of direct spending.

What is the multiplier effect?

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Multipliers are a numeric way of describing the secondary impacts stemming from the operations of an organization. For example, an employment multiplier of 1.8 would suggest that for every 10 employees hired in the given industry, eight additional jobs would be created in other industries, such that 18 total jobs would be added to the given economic region.

What methodology was used in this study?

Multipliers are a numeric way of describing the secondary impacts stemming from the operations of an organization.

The methodology employed in the calculation of the impact of the FoMD was derived from the standard set of impact research tools developed by the American Council on Education (ACE) for the measurement of college and university economic impact. The ACE-based methodology is well-established, having been used in hundreds of impact studies. The ACE methodology employs linear cash-flow modelling to track the flow of institution-originated funds through a delineated spatial area.

What is employment impact?

Employment impact measures the direct employment (staff, faculty, administration) plus additional employment created in the economy as a result of the operations of the FoMD. Indirect and induced employment impact refers to other employees throughout the province that exist because of the FoMD’s economic impact. In other words, jobs related to the population – city services (police, fire), employees at local hotels and restaurants, clerks at local retail establishments, residents employed by vendors used by FoMD.

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Faculty member Karim Damji with patient

EMPLOYMENT IMPACT MEASURES THE DIRECT EMPLOYMENT (STAFF, FACULTY, ADMINISTRATION) PLUS ADDITIONAL EMPLOYMENT CREATED IN THE ECONOMY AS A RESULT OF THE OPERATIONS OF THE FOMD.

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FACULTY RESEARCH LEADS TO BETTER CONCUSSION AWARENESS AND CARE

Faculty of Medicine & Dentistry researcher Dhiren Naidu is the team physician with the Edmonton Eskimos, the head physician for the Edmonton Oilers and a specialist in concussions.

One of his recent studies looked at how CFL

from blows to any part of the body, and MRI or CT imaging doesn’t always detect concussions.

athletes fared against their university-level peers

Last season the CFL implemented annual

when it came to concussion knowledge, and

concussion education sessions for athletes.

whether a one-hour concussion education

These results confirm the effectiveness of the

program improved the two groups’ awareness.

education sessions and underscore the importance

The study involved players answering a questionnaire before and after a one-hour

of continuing to educate athletes on the topic of concussion.

education session on concussions. Results showed

Naidu is the author of the CFL’s player education

most players knew how to manage concussions and

session and was part of the CFL medical advisory

what the hallmark symptoms were. And after the

panel that wrote the league’s new concussion

session, players were more apt to understand two

guidelines.

key pieces of information: concussions can stem

Is this a one-time impact or does the economic contribution repeat each year?

The results presented in the FoMD economic impact study are generated for FY 11/12. The economic impact in future years may either increase or decrease based on number of learners, capital expansion, increases in external research and research grants and provincial appropriations.

What are Tripp Umbach’s qualifications to perform an economic contribution analysis for the Faculty of Medicine & Dentistry?

Tripp Umbach is the leader in providing economic impact analysis to leading health-care organizations, universities and academic health centres. Tripp Umbach has completed more than 150 economic impact studies over the past 20 years for clients such as The Association for American Medical Colleges, The University of Minnesota, Indiana University and IU Health, The Ohio State University, The University of Washington, The University of Iowa, UAB, Cleveland Clinic, University of Florida Shands HealthCare, the University of North Carolina Hospitals, the University of Pennsylvania Medical Center, the University of Pittsburgh Medical Center, and the Ohio State University Medical Center. Tripp Umbach’s current international economic impact projects include Capital Health in Nova Scotia, and Edith Cowan University in Perth, Australia.

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APPENDIX G: ACKNOWLEDGEMENTS 38

The Faculty of Medicine & Dentistry graciously acknowledges the many individuals and organizations that have contributed to the preparation of this report. The efforts and perspectives of numerous people have gone in to this project and the Faculty extends a special ‘thank you’ to all that have devoted time and energy to this important study.

Key groups and people are cited below.

◆ Faculty of Medicine & Dentistry ‘Economic Impact Study Advisory Committee’ • D Douglas Miller, Dean (Committee Chair) • Deborah James, Director, Dean’s initiatives • Fraser Brenneis, Vice-Dean Education • Dennis Kunimoto, Vice-Dean Faculty Affairs • Marek Michalak, Vice-Dean Research • Vivien Wulff, Chief Operating Officer • Randall Yatscoff, Executive Vice President, Business Development, TEC Edmonton ◆ Faculty of Medicine & Dentistry Office of the Dean Administrative Staff – in particular Carol Rogan for providing robust data collection and fact-checking services to the consultants ◆ Faculty of Medicine & Dentistry Office of Research Administrative Staff ◆ The ‘Northern Alberta Clinical Trial Research Centre’ and the ‘Cross Cancer Clinical Trials Unit’

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◆ TEC Edmonton – in particular Brenda Service and Joanna Preston, for providing robust data regarding the Faculty’s commercialization activities ◆ Tripp Umbach, Inc. – for providing essential service throughout the study, and in particular to Nichole Parker who led data analysis and report development ◆ Our host of stakeholders and advisors that provided valuable guidance, perspective and input to the study and the report throughout its development – including many university officials and academic faculty members, TEC Edmonton executives, government officials, and members of the general public

Building a knowledge-based economy through education and research and the delivery of comprehensive health care underpins a healthy population and a healthy economy.

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www.med.ualberta.ca