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Assessing the Markey General Organizational Grants Program To assess the Trust's General Organizational Grants program the Committee examined separately those programs that provided (1) clinical research exposure to Ph.D.s trained in basic biomedical research and (2) training in basic research to medical school students or . . young p. ayslclans. The training of Ph.D.s was the more innovative of the two approaches in terms of translational research; the Committee thus decided to concen- trate on these training models. A workshop of program directors titled "Training Programs in Patient-Oriented Pathobiology for Basic Scientists" was convened to learn more about the successes and problems of these programs. This workshop, conducted in October 1999, brought together program directors from six institutions: Johns Hopkins University; Harvard University; University of California, San Diego; Washington University; University of Virginia; and University of Chicago. Irwin Arias of Tufts University made the keynote presentation (Arias, 2003~. A description of all programs for training Ph.D.s is in a subsequent section of this report. In addition, the Committee conducted a series of site visits to grant recipients who provided training in basic research to young physicians. These sites were selected because they represented a wide range of the types of programs that introduced physicians to basic research. The insti- tutions~ollege of Physicians and Surgeons of Columbia University, Children's Hospital of Boston/Harvard University, and the University of California San Francisco highlight the rich variation in approaches 19

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20 taken by the i: BRIDGING THE BED-BENCH GAP nstitutions funded by Markey. A description of all programs for training physician-scientists is in a subsequent section of this report. This report is based on information that emerged from the workshop and site visits as well as other sources. The Committee obtained detailed information on nine of the General Organizational Grants programs. Ex- tant data were used for the remaining programs. The full range of sources includes a review of extant data on General Organizational Grants pro- grams provided by the Markey Trust; a review of the literature (see References); the Workshop on Training Programs on Patient-Oriented Patho- biology for Basic Scientists; site visits to programs that provide training in basic research to . . . pnys~c~ans; oral history interviews of Markey trustees and executive staff; a commissioned paper, "Bridge Building Between Medicine and Basic Science," by Irwin Arias; and a commissioned paper, "The Endangered Physician-Scientists: Op- portunities for Revitalization Emerge," by Leon E. Rosenberg and Timo- thy J. Ley. Detailed information on the workshop and site visits, the two com- missioned papers, and the membership of the Markey Committee is pre- sented in the appendixes to this report. LIMITATIONS TO THIS ASSESSMENT This report does not attempt to evaluate the programs of the 22 Gen- eral Organizational Grant recipients. First, the goals of the General Orga- nizational Grants program remained relatively broad; for example, there was no request for application against which program activities could be judged. Second, the Trust allowed considerable latitude for funded insti- tutions to modify program activities. Because many of the grants ended well before the beginning of this assessment and key training personnel had moved to other institutions, it was difficult to track these changes and their implications for expected outcomes. Third, because no explicit re- quirements were systematically imposed by the Trust for evaluation, the outcome data collected by grantees were limited and not systematically collected; in addition, for more recently funded programs an insufficient amount of time had passed for expected outcomes to occur. Fourth, insti- tutions were selected for General Organizational Grants partially because of their track record in biomedical research and training. These institu-

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ASSESSING THE MARKEY GENERAL ORGANIZATIONAL GRANTS PROGRAMS 21 lions already had substantial extramural funding in biomedical research at Me time of the Markey award. Therefore, it was difficult if not impos- sible to differentiate the impact of the Markey award from other funding. Not surprisingly these limitations helped to preclude the use of those evaluation designs needed to confidently link outcomes to the General Organizational Grants program (e.g., the appropriate use of comparison groups). The Committee considered the possibility of identifying all students who participated in Markey-funded training programs and contacting them in order to monitor their careers. The Committee ultimately decided against that strategy for a number of reasons. The student selection criteria varied among the programs as did the goals of each of the programs. Consequently aggregating these data was not appropriate. Record keeping at host institutions was uneven, in some cases spotty and in other cases almost nonexistent, making it difficult if not impossible to identify and contact a significant number of trainees. No appropriate comparison group could be identified. Consequently the Committee concluded that trying to identify train- ees would tax resources and would not be productive. It decided that a general programmatic estimation by experts would be the only feasible approach to the assessment of the General Organizational Grants pro- gram. The one program funded by the Markey Trust that lends itself to a data-driven evaluation is the Markey Scholars program. This program had a clear goal that was defined by the Markey Trust in advance, so that a proactive outcome assessment of seven cohorts of Markey scholars with an appropriate comparison group is possible. The scholars were selected through a consistent, transparent system and were all at the same career stage at the time of funding. The Committee believes intensive tracking, monitoring, and data collection and analysis for the Scholars program is both feasible and the best use of the Committee's limited resources. This report does provide an explanation of the Markey Trust's fund- ing mechanism for the General Organizational Grants, a description of some of the best practices of the recipient organizations, and a summary of Committee insights to help guide other philanthropic funders.