September 19, 2019

Announcement of NIH+, a New Dept of Medicine Program to Support our Research Community

Dear Colleagues:

I write to describe a new program to support our research faculty, called NIH+. We announced the program at a fabulous research symposium last week, but not everyone could make it so it seemed worth sharing the details of the program. 

Before describing NIH+, the research symposium highlighted the extraordinary productivity and creativity of our community of DOM researchers, and the remarkable breadth of their activities. As examples of major new programs, Margot Kushel described the new Benioff Homelessness and Housing Initiative, Julia Adler-Milstein described the Center for Clinical Informatics and Improvement Research, Alex Marson described the Innovative Genomics Institute (a joint program between UCSF and UC Berkeley), and Sue Lynch described the just-launched Benioff Center for Microbiome Medicine. We could have easily highlighted scores of other world-class programs, programs focusing on everything from fundamental immunology to health disparities. 

We also reviewed the Department’s extraordinary success in research. Of the approximately 800 paid faculty in our department, 277 are funded >50% on grants and contracts. In addition to our faculty, we have 219 post-docs and 117 non-faculty academic researchers and specialists, and approximately 500 research-related staff. Together, this group received 336 grants last year, for a total of $294 million in direct costs. The $203 million of this from the NIH again made our department tops in the nation. We have fourteen T32 grants, supporting more than 70 trainees, and 48 NIH early K awards (training grants), also the most of any institution in the U.S. Our molecular medicine residency track, led by Neil Shah, has grown from four residents in 2014 to 10 today. 

Under the direction of our wonderful Associate Chairs for Research, David Erle (Biomedical) and Diane Havlir (Clinical and Translational), we have launched several programs to support our research enterprise. We now publish a monthly newsletter for our research community. We have a support group for pre-independent bench scientists (organized by Rachel Rutishauser and Renuka Nayak), a College of Bench Scientists (led by David Erle), and a Physician-Scientist Pipeline Task Force, led by Cathy Smith and Kamran Atabai. Our new Diversity in Bench Science (DiBS) program provides significant support to trainees who add diversity to our research community. The Department supports two research cohort grants each year (we have funded 14 in total; many have catalyzed significant new programs and grants). At last week’s Research Forum, we described three new initiatives to support our research community: a team-science planning grant (led by Courtney Lyles and Tien Peng), a Pre-Application Proposal Review program (PREPARE, led by Larry Fong and Judy Hahn), and the Chan-Zuckerberg Biohub Physician-Scientist Fellowship Program (led by Ethan Weiss). Each of these programs is described in detail on the DOM Research Program website.

We also know that space is a huge challenge, and are enthusiastic about new space at all of our sites, including a new research building at ZSFG and significant new research space at Parnassus – with a commitment to build a large new research building to replace the U building at the west end of Parnassus Avenue in 5-6 years. And we have been partnering with the Office of Clinical Trials Activation (OCTA) to address another big problem: an underperforming clinical trials infrastructure. This effort is being led by Diane Havlir, Jon Rueter, our Director of Research Administration, and several DOM faculty with leadership positions in campus research administration: Lindsey Criswell, Vice Chancellor of Research; Hal Collard, Associate Vice Chancellor of Clinical Research and Director of the UCSF CTSI; and Payam Nahid, who recently became Associate Director of Clinical Trial Operations in the Office of Research.

Now onto the biggest news, the NIH+ program:

Based on the feedback that David and Diane received last year during their “listening tour,” the biggest issue among our research community was the NIH “cap gap”. (NIH bases all its awards on a salary maximum of $192,300, so for faculty with salaries higher than that, having, say, 80% support from the NIH creates a gap between the dollars flowing from Bethesda and the faculty member’s actual salary.) We spent the better part of this year thinking about how best to address the cap gap in a way that is financially responsible, fair, and sustainable. We also wanted a program that was relatively easy to understand and administer, and provided the appropriate incentives.

The program we’ve created in response to these issues is NIH+ (pronounced “NIH Plus”). We’ll commit to it for the next three years and then evaluate its effectiveness and sustainability. In a nutshell, NIH+ works like this:

  • All associate and full professors will be eligible for NIH+ support, with the exception of In Residence associate professors (they already receive iRAPS support, a 3-year old program that supports Associate Professors in the In Residence series; at $50,000/year plus benefits, the iRAPS program is more generous than the maximum NIH+ benefit), and recall or visiting faculty. Importantly, Clin X, Adjunct, Ladder Rank and HS Clinical faculty are eligible, as are In Residence full professors.
  • The benefit will be 20% of the faculty member’s NIH (or other capped) salary support, excluding benefits. The dollars will be given as discretionary funds.
    • So, as a simple example, a faculty member who had $100,000 of salary support from NIH grants last year will receive an NIH+ benefit of $20,000 this year
    • By “NIH and other capped support,” we mean all government grants and contracts that have a salary cap (private and foundation funding is not eligible)
    • By salary support, we mean monies from these sources applied to the faculty member’s salary – it is not necessary to be principal investigator
  • There are a few situations that will attenuate the benefits – largely because the need for NIH+ support should be somewhat lower for faculty with significant resources or pre-existing hard money support. Each dollar that faculty receive for salary support from the sources below will decrease their NIH+ benefit by 50 cents. The situations are:
    • FTEs, including FTE equivalents and VA research FTEs
    • Annual income from endowed chairs or distinguished professorships
    • Discretionary funds owned by the faculty member >$500,000
  • In contrast to the shared model of central DOM/divisional funding that we use to pay for iRAPS, NIH+ will be funded solely with central DOM dollars. The year one outlay from the department is approximately $2 million.

Detailed program rules, with examples, are posted here. This year (2019-20), 137 of our faculty will receive some support through NIH+, with 101 faculty receiving benefits of at least $3,000, and 16 receiving more than $30,000.

Over the last several years, we have made significant investments across all of our missions, including investments to improve faculty and staff satisfaction and engagement, investments that support educational programs such as the medical school’s Bridges program and our residency, investments in mentorship for clinician-educators, and investments in programs to improve diversity, family friendliness, and our sense of community. In addition, we have advocated, often successfully, to other parts of the university and our partner health systems for the resources we need to succeed, including new space, improved infrastructure, and clinical support (such as in increased clinical payments per RVU and scribes at UCSF Health, improved IT, and video conferencing). The NIH+ program, a major new investment in our research community, reflects the fact that the NIH’s salary cap creates a distinctive hardship for our researchers that leads to undue stress and perverse incentives. 

Thank you for all you do to make this department such an extraordinary and unique enterprise.