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Daniel Mulrooney

Daniel Mulrooney examines two-time cancer survivor Nichole Wilson. Mulrooney is studying the late-effects of chemotherapy and radiation therapy on people who have been treated for cancer as children.

Beyond the basics

Innovative program helps junior faculty break into the world of clinical research

By Mary Hoff

From eNews, October 25, 2007

For Daniel Mulrooney, an assistant professor of pediatric oncology at the University of Minnesota, it's the classic Catch-22. To do biomedical research, you need time, funding, and know-how. To get time, funding, and know-how... you need research experience.

Mulrooney spends much of his time at the University of Minnesota Children's Hospital, Fairview, caring for young patients who have cancer. He's also very interested in studying the "late effects"--those that show up after years or even decades--of chemotherapy and radiation therapy on children, and learning what he and others can do to minimize them. But when he applied for federal funding to conduct research on the topic, Mulrooney discovered he lacked the track record needed to land a major grant.

Then he heard about the University of Minnesota's Career Advancement Program for Clinical Research Scholars (CAPS). Part of a nationwide National Institutes of Health (NIH) initiative, CAPS was established in 2005 to help early-career faculty in the health sciences break into clinical research. Mulrooney applied to the University's program and was accepted as one of seven inaugural scholars. Under the guidance of a multidisciplinary team of mentors, he has since begun recruiting survivors of Hodgkin's lymphoma for a preliminary study of biomarkers of inflammation and vascular injury.

"I think CAPS is a terrific program," he says. "This is just what a junior faculty member needs to navigate the waters and learn what you otherwise wouldn't know how to achieve."

Boosting clinical research

Clinical research has faced tough times in recent years. Traditionally, new treatments and cures emerge from a pipeline that extends from basic science (studying how living systems work) to translational research (studying how to apply new knowledge to human health) to clinical trials and, ultimately, patient care.

Basic scientists have been making great strides in understanding how molecules, cells, tissues, and organs function. But the translation of this new knowledge to new approaches to prevention, care, and cure has lagged. Although there are many reasons for this, two critically important ones are more competition for less federal money and the pressure on physician-researchers to produce revenue through patient care.

"Clinicians interested in doing research find themselves taking academic positions, and suddenly all of their time is taken up by clinical duties, system demands, and the need to generate income," says CAPS program director Russell Luepker. Without some type of support that allows them to reduce their clinical hours, Luepker says, even the most dedicated find it difficult to get the research experience they need to successfully compete for major grants.

CAPS offers three key types of support to clinical faculty launching their research careers in medicine, nursing, pharmacy, dentistry, and public health.

The first is funding. Scholars receive up to $25,000 in research support annually as well as travel money, graduate tuition, and textbook reimbursement. Even more valuable, CAPS supplies the dollars needed to cover 75 percent of its scholars' salaries for the three to five years it takes them to develop a research program solid enough to successfully compete for NIH grants and other support. That buys them "protected time"--a portion of their work week in which they are committed to doing research.

Kamakshi Lakshminarayan and Russell Luepker.
Kamakshi Lakshminarayan getting advice from Russell Luepker, one of her mentors in the CAPS program. She hopes her research will lead to better outcomes for stroke patients.

"Each [scholar] is doing a different project with a different team in a different department, yet they're all doing amazing things," says CAPS mentoring and evaluation director Carole Bland, assistant dean for faculty development and professor of family medicine and community health in the Medical School.

The second involves project management. In the past it was possible to learn the ropes by spending time in others' labs. But today's clinical science demands intensive training in everything from using sophisticated analytical technology to dealing with sensitive legal issues. The University's Office of Clinical Research, which works closely with CAPS, offers biweekly seminars on a variety of topics and periodically brings in distinguished visiting scholars who provide valuable insights and advice.

"How to write a grant, how to do a scientific presentation, how to work with industry... It's been so diverse, things I never would have thought of," Mulrooney says.

Multidisciplinary mentorship is the third component of the CAPS approach. Each CAPS scholar gathers a mentoring team of at least three people--two in fields directly related to his or her subject of study and the third, a biostatistician--which then works together to help guide the scholar.

"One of the roles of more senior faculty is the mentoring and development of more junior faculty--we're going to do that no matter what," says Joseph Neglia, interim head of pediatrics and Mulrooney's primary mentor. "But the CAPS program has allowed some additional resources for that."

To learn more about the CAPS program, visit the Academic Health Center.