School of Medicine struggles for success

By Gus Bode

Editor’s Note:This is the second part in an occasional series taking a closer look at the University one year after a national science consulting firm visited SIUC to measure its research strengths, weaknesses and ability to achieve the goals of “Southern at 150.”

The SIU School of Medicine is faced with the expectation of conducting more research with less funding, and it echoes a similar cry that is heard from the College of Science – more funding is needed to ultimately be successful.

“The question is:how do we get bigger on a smaller amount of money?” said Medical School Dean Kevin Dorsey, referring to state budget cuts that have sliced the school’s budget by 15 percent in the last three years.


Despite these shortcomings, Dorsey has plans to improve the school that are in line with the University’s “Southern at 150” plan.

“Southern at 150” is Chancellor Walter Wendler’s plan to push SIUC into the top 75 public research institutions by its 150th birthday in 2019. To help evaluate its research strengths and weaknesses, the University brought in a national science consulting firm, the Washington Advisory Group, last year.

The group has refused to comment because of client-consultant privilege.

According to the Washington Advisory Group’s report, which came out in July 2003, the School of Medicine’s small faculty is a contributor to its low research dollars.

“There is no research culture on the Springfield campus, or even much feeling that research should be a significant part of the School’s mission, particularly in the clinical departments,” the report stated.

Dorsey said while he agreed with most of the report, for the group to say there is little or no research culture in the school is all relative to the rest of the University. In 2002, the School of Medicine contributed nearly two-thirds, or $16 million, of SIUC’s $53.6 million in total research and development expenditures.

The school was created during a national outcry for more doctors in 1970. The community-based medical schools’ main purpose was to feed the doctor demand.


Thus, they were created on shoestring budgets and primarily expected to supply service, not perform research, Dorsey said.

This is the same reason that these community-based schools sit firmly in the last quintile of the nation’s 85 medical schools, he said.

Kim Espy, an associate professor in behavioral social sciences, said medical schools have incredibly diverse missions.

“Inevitably, there is always going to be a difference in how you balance those different demands,” Espy said. “It’s very rare to find someone who can find the time of day to do research 100 percent, teach 100 percent and do service 100 percent.”

According to the report, the SIU Medical School was ranked 13th out of 17 community-based schools in 2002. Dorsey said he believes the school is at about the same rank today. Its research numbers have been historically low because research was not in its mission until 1983, he said.

One of his goals is to be the top community-based medical school in research support in the nation, Dorsey said. However, it is more of a transitioning period for the school, as it looks to increase its research profile.

“Frankly, what I’m trying to do is to get away from a focus on us as a community-based medical school,” Dorsey said.

To make this move into the top rank would “require a real change in culture and much effort on the part of the dean and other members of the administration and faculty,” the report stated.

But the SIU Medical School’s reputation as a service institution will not evaporate either, Dorsey said. The trick now is to change the school’s emphasis while not detracting from its current abilities, he said

“I’ve told the faculty and chairs that I don’t want to sacrifice our successes,” he said. “I don’t want to fail where we’ve been good in order to be good where we haven’t existed before.”

The school is split between the Carbondale and Springfield campuses. Medical students spend their first year in Carbondale and then transfer to Springfield. Although the school wants to become more research-oriented, Dorsey said SIU would still depend on the Carbondale Memorial Hospital and two hospitals in Springfield.

Most large medical schools have their own university hospital.

The report said research lacks the most in clinical sciences. The National Institutes of Health, the largest provider for medical research dollars, awards the most money to research in the clinical sciences – such as neuroscience – rather than in basic science research, like microbiology or physiology.

Dorsey said the school is beginning to turn that around by focusing on pediatrics, child healthcare, geriatrics and neuroscience.

“To have people doing research in all areas makes us incredibly wide but incredibly thin,” Dorsey said. “You need to synergize. Then the whole becomes bigger than the sum of its parts.

“The whole thing is predicated on adequate funds to grow the institution.”

The Washington group also reported low faculty numbers throughout the school, particularly evident in its clinical departments, and also in “in subspecialty divisions, which would normally be expected to take the lead in clinical research.”

The newly formed Cancer Institute, which is designed to boost clinical research, has helped the school add to its meager faculty size. The institute is expected to dramatically increase the research expenditures for the school as well as increase its services to all of Southern Illinois.

“We are small – there is no doubt about it,” Dorsey said. “In order to improve our ranking and increase the amount of research dollars we get, we will have to have more faculty.”

The Cancer Institute began its services in 2002, but is still waiting to be housed under the same roof. Institute workers are spread throughout the Springfield campus. The Illinois Legislature approved money for an addition to the Combined Springfield Laboratory in 2000. However, now that it is built, Dorsey said, there is no money coming from the state for heat, water and electricity.

“Things are tough all over,” Dorsey said. “We don’t have the guarantee that the money will be there, but I’m sure everyone sees the logic in building a building and then let it collect mothballs and deteriorate.”

When the money becomes available, part of the institute will be housed in the combined laboratory, but the institute is also in the process of drawing up plans for its own building, which would accommodate its clinical cancer researchers.

Thomas Robbins, interim director of the institute, said even though it is not consolidated within one building, it is developing many programs, including an organ site working group and other clinical research programs.

Another way the institute hopes to stimulate outreach is by providing cancer services to Southern Illinois, he said.

“Downstate Illinois does not have a comprehensive cancer institute, and we will be the first,” Robbins said. “We want to have our effects go out and help people in rural areas.”

While the institute is still getting off the ground, Robbins said the future looks bright. Once the clinical side of the institute moves into one building, he hopes to build a core group of cancer researchers and create a nucleus of 10 to 12 independent research laboratories.

Another developing center for the school is the Center for Integrative Research in Cognitive and Neural Sciences. Espy said the idea for the center was a result of the Washington group’s report.

The report stated neurological science is a particularly lucrative research field and because SIU’s neurology department is strong, it could make a future center possible.

“If the school were to establish an institute of neurosciences, that might stimulate interaction among individuals in a variety of departments and colleges on both campuses, help build a critical mass in each location and involve leadership on both campuses,” the report stated.

Espy said once the report came out last year, the faculty began to talk about the possibility of such a center. The center would focus on interdisciplinary research between departments like psychology. She said a proposal was drawn up and awaiting approval from the Graduate Council, which could come up for a vote during its November meeting. If approved, Espy would be the center’s director.

“There was significant interest in building an umbrella organization to provide a mechanism to get people who are working at very ends of the spectrum at SIU,” Espy said.

Dorsey said he is hoping the Cancer Institute and neurological sciences center will increase communication between the Springfield and Carbondale campuses, something the report said was lacking.

The report suggested a possible merge of the two campuses for cost-saving purposes, a move that was suggested by the school’s first dean in the 1970s. But the report stated that “based on what we heard during the course of all of our visits, it appears that this is not now a practical possibility.”

Espy, who teaches on the Carbondale campus, said the current structure works well and many faculty communicate with each other through video conferencing, e-mail and trips to the respective campus.

Robbins teaches on the Springfield campus, and although he has only been with the school for a little more than a year, he acknowledges that having two campuses split is unusual.

“It’s not normal for medical schools to be in two places, but it happens that for SIU, that’s the way it evolved, and that’s ok. We’re working with that,” Robbins said.

Dorsey said the school’s future is only looking up from here. Just last year, the school cared for 100,000 individual patients, he said.

Espy said realizing the potential of the school and reaching the goals of “Southern at 150” is not easy because it takes a precarious balance of clinical service, educational studies and research.

“It’s a very exciting time. I have every anticipation that through good faculty effort and strong administrative support we can really make some progress,” Espy said. “Where will we end up? We’ll see. But you have to make a goal, and then hopefully you will work hard and try to get there as much as you can.”