Chair's Column: Striving to be Better than the Sum of our Parts in Research
The University of Toronto and Temerty Faculty of Medicine within it is truly a remarkable place to launch one’s career in academic medicine as a Clinician Investigator or Scientist. There are myriad opportunities for collaboration across the Toronto Academic Health Sciences Network (TAHSN) – seek and you shall find! We enjoy incredible philanthropy that has helped to build unique research resources. Our department is full of world-class researchers across the breadth of research disciplines, and I am delighted to witness the keen spirit of collaboration across sites and disciplines.
In this issue of DoM Matters, we have highlighted our research portfolio – the Clinician Scientist Training Program, under the leadership of Dr. Mamatha Bhat, and the city-wide engine that is the Interdepartmental Division of Critical Care Medicine, led by Dr. Laurent Brochard. We have over 400 faculty members in the department working as Clinician Investigators or Scientists. Sustaining and amplifying our research impact - ensuring that research findings find their way into new therapies, clinical practice, and health policy - is a priority for the DoM. As resources shrink, clinical pressures grow, and our health care system lurches from crisis to crisis, we must do everything in our power to ensure the continued success of our research mandate. Thus, as we launch the search for the next DoM Vice Chair, Research, with Mike Farkouh’s departure, we are taking stock of what is working well, and what could be working better to maximize our impact in research.
Within the department, an important focus of our current work is on comparing and contrasting various pathways to academic research careers for physicians, from identifying individuals with potential at the undergraduate and MD student levels through introduction to formal research training in our Clinician Scientist Training Program. We are carefully evaluating the successes and challenges of our current approach to research training as well as to recruitment and career support, and with respect to our goal of continuing to expand our research diversity. As some question the value of the physician versus PhD scientist, we must also advocate for the unique contributions of physician scientists to the basic sciences.
At a university or system level, we are advocating for changes to hospital research structures and policies to reduce the barriers to research collaboration. Our structures and policies were not designed to enable us to work as one. It is frustratingly difficult to obtain research ethics board (REB) approval for a multi-centre study at U of T much less successfully launch a project that requires sharing of data, money, and perhaps even tissue samples, across sites. Philanthropy has become critical to keep the lights on within our hospital research institutes; this has enhanced competition across sites. Many, if not all, DoM researchers have been affected by these issues. It is not uncommon to hear the lament “It’s easier to collaborate with colleagues in another country than with colleagues across the street”. Not only is this situation immensely frustrating, but it negatively impacts our faculty members’ and trainees’ career progression and wellbeing. Change is sorely needed to address these issues.
The TAHSN network is comprised of the University and its partner teaching hospitals. Detailed affiliation agreements between the University and each teaching hospital lay out our dual relationships as physicians and academics – to the hospital and to the University. There is a TAHSN-Research Committee, co-chaired by a hospital Vice President, Research (currently Brad Wouters PhD from UHN) and the Temerty Vice-Dean for Research (Justin Nodwell PhD), which brings together research leadership across sites. While efforts have been made for years now to address the above noted issues through TAHSN-R, recent conversations with TAHSN-R members have led me to feel more encouraged than ever before.
In conversation last week with Brad Wouters, I learned that the TAHSN-Research Committee members are also fed up! With the overarching goal to strengthen the collective ‘Toronto’ research and innovation identity, TAHSN-R has committed to addressing these issues once and for all. Brad shared with me TAHSN-R’s goals for the 2022-23 academic year and gave me permission to share them with you. Their top priority is the “dismantling barriers to collaboration across TAHSN”. Brad pointed out that there are currently no formal affiliation agreements across the hospitals within TAHSN. As a result, attempts to collaborate across sites is indeed the same as collaborating across countries.
Ongoing work is focused on moving towards “…creating the conditions, structures, and processes for seamless collaboration in research and innovation… by:
Reducing administrative barriers
Establishing TAHSN-wide core facilities and operations
Strengthening collaborative approaches to clinical research and trials, and
Improving resources for data sharing.
These changes are overdue, but most welcome. Already, the TAHSN organizations have signed on to use of a harmonized Data/Material Transfer and Use Agreement (D/MTA) template to promote the efficient and timely exchange of research data and materials across TAHSN institutions and researchers.
I am also hopeful that Temerty Medicine’s creation of a new Director of Clinical Research leadership position will augment the likelihood of success. This individual will be a physician scientist; their focus will be exclusively on optimizing the experiences and success of clinician researchers across TAHSN. This will enhance attention to and progress towards addressing the issues noted above.
As the premier research department of medicine in the country, it behooves us all to advocate for and support a fundamental shift in how we function as a whole at the Temerty Faculty of Medicine and our affiliated hospitals. We will need this to sustain and enhance our research impact. Importantly, such change has potential to reduce the workload and stress associated with conducting research here at U of T.
