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I Introduction Assessment and evaluation in the world of philanthropy often take a back seat to ongoing programs. Funders may argue that money spent on evaluation is money taken from grants that could be distributed. Indeed, philanthropic and charitable organizations can main- tain the status quo quite comfortably because in the eyes of their trustees current operations appear to be working well, and there is no need to fix something that is not broken. On the other hand, when programs and award structures of philanthropy are evaluated, useful information can be generated to guide future decision making. The Markey Trust distributed over $500 million in support of basic biomedical research in just 15 years. At the end of its existence the Trust has asked whether its grants were well spent and whether its mode of philanthropy could be an effective model for other organizations. The Markey trustees asked the National Research Council of the National Academies for such an evaluation. The Committee for the Evaluation of the Lucille P. Markey Charitable Trust Programs in Biomedical Science, with the assistance of the staff of the Board on Higher Education and Workforce, is evaluating the results of Me Trust's philanthropy: General Organizational Grants, Markey Scholars and Visidng Fellows Awards iThe Committee for the Evaluation of the Lucille P. Markey Program in Biomedical Sci- ences is the proper name of the NRC committee that will assess me Markey Trust's activi- ties. Hereafter it will be referred to as the "Markey Committee" or the "Committee." 6

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INTRODUCTION 7 program, and Research Program Grants. To do this the Committee used multiple approaches that varied according to the program being exam- ined. For example, the Markey Scholars program lends itself to in-depth evaluation, but other programs could not be rigorously studied because of the lack of outcome data, the variety and differences of programs sup- ported, and the long-term horizon for basic research. This is the first of a series of reports that will document Me activities of the Markey Trust. Additional reports will assess the Markey Scholars and Visiting Fellows Awards programs and Research Program Grants. Just as each of the Markey programs varied in terms of goals and focus, so will the Committee's approach to assessment and evaluation. For ex- ample, the evaluation of the Markey Scholars program will be prospec- tive and will be conducted with greater methodological rigor than this assessment of the General Organizational Grants programs and the Re- search Program Grants. This report on General Organizational Grants programs (as well as the future report on Research Program Grants) relies on expert judgments and the information gathered in site visits and a workshop, which do not allow for analytical approaches. This report is organized into several sections and a set of appendixes, beginning with a history of the Markey Trust and its grant programs. It continues with a discussion of the methodological issues related to evaluating the Markey Trust programs as a whole and its General Organizational Grants in par- ticular. It presents descriptions of the 22 General Organizational Grants programs. The report concludes with potential lessons-learned for fund- ing organizations and individual philanthropists. Two appendixes con- tain commissioned papers on the biomedical research environment, de- scriptions of training programs in clinical research sites visited by the Committee, descriptions of the training programs in translational research at six universities invited to the Workshop on Training Programs on Pa- tient-Oriented Pathobiology for Basic Scientists, and the workshop agenda and associated materials.