Earlier this year I was fortunate to publish a Viewpoint in the Journal of Clinical Investigation about collaborative science. I believe that my own experiences with it both as a young investigator and now as a slightly less young chair of Internal Medicine and as a director of a multidisciplinary research center have yielded multiple benefits. Like many, I started my academic career as a physician scientist with the mantra of becoming an independent PI, toiling away solo or with a small team at the bench, collaborating as needed. This has been the traditional model on which many careers were built. But, as I describe in the piece, I received valuable mentorship from a colleague who brought me along on a U01 grant application, which ultimately combined the talents and resources of six different institutions. “Collectively,” I wrote, “these efforts significantly advanced our understanding of diabetic complications to a much greater extent than could have been achieved on the basis of individual groups working in silos.”
Our Department of Internal Medicine has 150-plus years’ worth of stories to tell about individual breakthroughs or even those emerging from small teams, all of them focused on one or a few narrow questions. Just like when I was that young investigator, this has been the traditional method for performing science here and everywhere. But science has evolved to become increasingly interdisciplinary as complexity and knowledge continues to explode. Experiences like mine with that U01 at the University of Utah might have been a relatively novel concept in those days, but now, evidence is clear that collaborative science is faster, more efficient, and better at answering bigger questions.
When it comes to the single Principal Investigator model, with individual R01 grants from the NIH at the foundation, we have been extraordinarily successful at holding our own next to some institutions with much more robust support structures. Last year’s dramatic 13.2% increase in research funding over the previous year is in part evidence of that. But the fact is that our department’s research portfolio will not continue to grow, and certainly not at a pace like what we saw last year, unless we also adapt to more collaborative modes of research, both within and outside the University of Iowa. The question we have been grappling with in leadership meetings is how can we foster this activity? What are the activation barriers and how can we remove these so that we can pursue and compete for larger, programmatic grant awards? That is a question that our Vice Chair for Research Dr. Isabella Grumbach will be putting to you very soon, in addition to a few other questions that should help us to improve our support structures for this activity. Please watch your inboxes for that survey, but if you have ideas in this area, our doors are always open to any and all suggestions.
Here is why I am confident that we can do this: We already are. Although our department perhaps has many stories of the successful individual investigator, we are also surrounded every day by collaboration. The Fraternal Order of Eagles Diabetes Research Center, the Pappajohn Biomedical Institute, and the Iowa Neuroscience Institute represent examples of centers founded on the idea that if you connect people who think differently about problems, new ideas develop. The Holden Comprehensive Cancer Center seeks to attack the problems of cancer from as many directions as possible. These examples have all fostered inter-departmental collaborations and others exist. But I was curious about how we do within our department. I asked Thomas Callahan, our data analyst extraordinaire, to query PubMed on six months’ worth of publications with three or more Internal Medicine members as authors. The below visual represents just inter-divisional collaboration from January through June 2021, nearly 70 publications.
A few things become readily apparent. Our infection prevention and health services research teams are tremendously active and interactive. And although they have the heaviest lines, indicating the greatest number of publications in this six-month period, every division connects outside itself.
It is not just publications that show our ability to collaborate. In patient care for example, many faculty in General Internal Medicine, Infectious Diseases, and Pulmonary have been hand-in-glove since the pandemic began, whether in the ILI Clinic or the Post-COVID Clinic. Beyond COVID-19, Drs. Adeyinka Taiwo and Bill Sivitz are collaborating with Dr. Antonio Sanchez on a clinical research project exploring connections between non-alcoholic fatty liver disease and Type 1 Diabetes. Dr. Rich Hoffman is also working with GI on a colorectal cancer screening project. Endo’s Dr. Amal Rahhal is working with Nephrology’s Dr. Diana Jalal on a paper on bisphosphonates in renal failure patients and on another with Pulmonary on a project related to osteoporosis.
We have also been very good at mentoring the next generation of investigators, regardless of the subspecialty they call home. There are a wide variety of research opportunities available to fellows and postdocs on one of our many T32 grants, and we have effectively leveraged these to support trainees across multiple divisions. I regularly hear, for example, from fellowship program directors outside endocrinology looking to connect with scientists in the Diabetes Research Center. Collaboration is also exemplified by the many hands who make light work in their evaluation of our residents on their rotations each day and in special projects like those for our interns during our annual Objective Structured Clinical Evaluations. Those who invest in educating our trainees are truly a cross-section of the department.
All this is to say, we are far greater than the sum of our parts. Moreover, we have and will continue to demonstrate that we are more than capable of building the relationships that will unlock new ideas, new questions, new ways of doing science that will take our department’s research programs to a new level. We do it every day, driven by circumstance and need. We now need to be more strategic in this mission and we hope you will join us in understanding first, how these collaborations happen and second, what we can do collectively to build those new bridges.