2007 Annual Report The University of Nevada School of Medicine, or How to grow a medical school with limited resources

1. 2007 Annual ReportThe University of Nevada School of Medicine, orHow to grow a medical school with limited resources

2. Overview • Where is UNSoM in comparison to peers? • What do we aspire to be? • What challenges do we face and how do we prepare ourselves? • Questions

3. UNSoM’s position in the universe of medical schools • 125 U.S. accredited M.D. granting schools of medicine in 2007 • No single objective measure of quality • Quality of education (board scores, surveys, graduate outcomes, etc). • NIH Ranking, citation index, productivity per investigator. • Reputation amongst public, peers, opinion leaders.

4. We fare well amongst our peers in undergraduate medical education

5. Undergraduate Medical Education • Strong student body with solid GPA and MCAT scores • Strong basic science education • Solid performance on national boards • Excellent success in securing positions in very competitive residencies • Good feedback on our student’s performance as residents

6. Undergraduate Medical Education Challenges

7. Research • Strong commitment to preclinical education • Nationally and internationally recognized investigators and research programs • Well funded on a per lab or per individual investigator basis But… • Limited scope • Antiquated and cramped facilities • Underrepresented translational research

9. To reach the bottom of the 2nd Quartile will require us to triple grant funding

10. Total Expenditures in 2007 of $14.3 million $3.73 million are generated by faculty over the age of 60

11. Research

12. Trends in medical education affect our programs • Medical school enrollments are projected to increase by 30% (increased 2.3% in 2007; several new schools planned) • Increased emphasis on structured education with measurable goals and objectives • Increased emphasis on multidisciplinary learning and simulation • Increasing popularity of certain specialties presents challenges filling primary care residencies

15. Graduate Medical Education

16. Accomplishments • Recruited new leaders • Expanded faculty and programs • Formed new relationships • Begun new research and educational facilities • Increased the class size • Begun to improve efficiency of administrative functions

17. Recruited new leadership Administration Chief of staff – Ann Mischissin Chief operating officer – Blain Claypool Chief financial officer – Jean Regan Chief counsel – Thomas J. Ray Associate Dean for GME – Miriam Bar-on Communications Director – Mark Levine Director Medical Library & IT Services – Jim Curtis Director of Clinical IT – Jon Goetz Director of Development – Stefanie Scoppettone

18. Recruited new leadership Clinical Chairman Obstetrics and Gynecology, Las Vegas – Paul Stumpf Internal Medicine, Las Vegas – Daniel M. Goodenberger Pediatrics, Reno – Nevin Wilson Emergency Medicine – Dale Carrison Family Medicine, Las Vegas – Elissa Palmer Family Medicine, Reno – Daniel Spogen Mojave Mental Health – Coni Kalinowski (Medical Director)

19. Growing clinical programs Pediatric Surgery, Las Vegas – Dr. John Gosche Endoscopic Bariatric Surgery, Las Vegas – Dr. James Lau Nevada Neurologic Consultants merger with UNSoM, Las Vegas Expanded subspecialty programs in internal medicine, Reno Sports medicine fellowship in family and community medicine in Reno and Las Vegas

20. Despite significant resource limitation, UNSoM has grown significantly over the past 5 years

22. Clinical practice revenue is an increasingly important revenue source

27. The Faculty Practice Plan is an economic engine driving our growth and sustains education and scholarship

28. Academic Medical Centers Face Difficult Times A two-part article in Tuesday's issue of The Oregonian reports that: “Oregon Health & Science University's losses on laboratory research and doctor education are growing far faster than anticipated and are projected to reach $50 million this year.” Those losses mean tough choices for the university, which has ambitious plans to treat more patients, expand its scientific research and build a world-class medical school that will train new doctors for Oregon. The article further reports that OHSU President Joe Robertson told the paper "that the university has sufficient resources for the next 20 months, but that its current financial course is 'not sustainable.' Robertson declined to speculate how the university might address the growing losses or say whether cost-cutting alone could close the gap."

29. Role of the Practice Plan • Ensures access to diverse patient population for students, residents, fellows and other health care providers in an educational environment with supervised increases in responsibility of learners • Generates 42% of total annual revenue to the school of medicine, supports other missions, and provides the majority of clinical faculty salary

30. Data from 2006 LCME Report

31. Practice Plan Organization Board of Regents University of Nevada, Reno Leadership UNSoM Leadership UNSoM Programs

32. Practice Plan Assets

33. Practice Plan Liabilities

34. Practice Plan Summary

36. What do we aspire to be? • A more complete medical school with the ability to educate the physician workforce for Nevada in Nevada • A vibrant center of research, service and learning that attracts a diverse group of the best and brightest faculty, staff and trainees • A valued partner for patients and other health care providers

37. What must we do to succeed? • Measure our performance against external benchmarks from peers • Streamline our procedures and administrative structure – “Faster, Better, Cheaper” • Identify and maximize revenue • Be focused and tenacious in pursuing our goals • Never sacrifice quality for speed or quantity