Building Boom

Visitors who take a stroll through the University of Louisville Health Sciences Center today often are overheard making the same one-word comment.

"Wow."

Guests to campus wind through twin state-of-the-art biomedical research buildings encompassing more than 200,000 square feet of research space. They visit the Alumni Center for Medical Education, which boasts a comprehensive standardized patient clinic and one of the largest academic medical simulation centers in the nation.

Some stop by the molecular imaging research center and tomotherapy wing that have made the university's James Graham Brown Cancer Center one of the region's best-equipped oncology research and treatment facilities.

Most are surprised to find a federally designated bioterrorism preparedness center housed in UofL's School of Public Health and Information Sciences.

But what visitors seem to find most remarkable is that few of these facilities or programs were here in 1998.

"The Louisville Medical Center and the Health Sciences Center were impressive even then," says Joel Kaplan, M.D., recalling his initial feelings about the campus six years ago. "I remember thinking, 'Where did this huge medical center come from and why haven't I heard of it?' "

A New York native, Kaplan brought with him a long and successful career in academic medicine when he arrived at UofL in 1998. His appointments at Emory University Hospital, Hospital of the University of Pennsylvania and the University of Texas Medical School instilled in Kaplan a strong respect for the three-tiered foundation of education, research and care.

Before moving to Louisville, he served for 15 years as chair of the department of anesthesiology at Mount Sinai School of Medicine in New York City.

Having announced his intention to step down as UofL's executive vice president for health affairs in August, he was looking forward to completing the fifth edition of his textbook, "Cardiac Anesthesia," and making the transition of his publication, Journal of Cardiothoracic and Vascular Anesthesia, from a print- to an electronic-submission format.

But Kaplan admits that he will miss the challenges, team spirit and boundless potential that marked his time as chief executive of UofL's downtown campus.

Converging Resources

The explosive growth at the HSC during Kaplan's tenure stemmed from many converging factors.

In fact he remembers wondering, when he was first considering the position, if he would be the obvious choice for the three-part role of dean of the School of Medicine, vice president for health affairs and senior vice provost for academic affairs.

"The university wanted to build a world-class research program and I wasn't known primarily as a researcher. My management and administration skills were a fit, however, and I was given the opportunity to design and plan programs with the considerable resources available at the time."

Those resources came from an inspired period in higher education in Kentucky.

In 1997 the Kentucky legislature approved House Bill I, a bold plan to reform the state's higher education system. When the law mandated that UofL move toward becoming a preeminent metropolitan research institution, the university responded with a 10-year plan called "The Challenge for Excellence" identifying the health sciences as a critical growth area.

The next year, research support for the health sciences and other key areas grew by leaps and bounds when the legislature developed the Research Challenge Trust Fund, commonly known as "Bucks for Brains." The program uses state funds to attract and match private donations to universities, effectively doubling the investment to support research in defined areas key to the state.

"The strategic plan was completed and the tools were in place to make it work. My job was to make it happen," recalls Kaplan. "The university leadership agreed that focused growth in translational research would the key to our success, and we set about implementing the plan."

Building Research

As soon as Kaplan arrived, he began focusing his efforts on drafting a research growth plan in cooperation with HSC leadership and the university's research office.

"I'm a strong believer that is there is no 'us' or 'them' when it comes to teaching and research," he says. "Research is a crucial part of the academic mission, and it makes us better teachers."

Armed with Bucks for Brains funding and a mandate to rapidly develop nine high-potential areas in the health sciences, Kaplan launched the most aggressive phase of health sciences recruitment in university history.

Today, more than 20 new research teams led by endowed chair recruits are working with established researchers to produce findings more efficiently than ever.

"Although 'translational' wasn't the buzz word in 1998 that it is now, the focus was to recruit clinical faculty who would be serious researchers -- something the school critically needed," says Russell Prough, Ph.D., a professor of biochemistry and molecular biology who served as associate vice president and vice dean for research under Kaplan.

"Dr. Kaplan recruited a lot of great new faculty who expanded the potential of the academic work of those of us who were already here," Prough adds._UofL's growing number of patents, licenses and clinical trials document the gains, but the most telling proof of success may come from the National Institutes of Health.

In 1998, UofL's School of Medicine ranked 96th among all U.S. medical schools receiving NIH support. By 2003, it had climber more than 20 ranks with total NIH support exceeding $35 million annually.

Growth at the schools of dentistry and nursing in the same period has been just as dramatic, with both achieving widespread recognition for their research prowess.

"We have increased our research support from $1 million to more than $4 million in just the last fiscal year," says John Williams, D.M.D., dean of the School of Dentistry. "Joel's support coupled with our outstanding faculty allowed us to grow and exceed expectations."

Prough agrees.

"Dr. Kaplan's partnership with the vice president for research to provide the funds necessary to recruit strong faculty was the real strength of his time. We'll be in a great position once the economy picks up to continue our growth and move even higher in the national rankings."

Shaping the Infrastructure

Logic dictates that hundreds of scientists, lab support workers and administrative staff pouring into campus cannot work effectively without the benefit of premier laboratories and equipment.

"The Donald E. Baxter Biomedical Research Building was near completion when I arrived," Kaplan says. "It was an honor to participate in its dedication and see the investment begin to pay off so quickly by the work being performed there."

Kaplan led the charge from its earliest stages for the next major research facility at HSC, the Delia B. Baxter research building. The second Baxter building was dedicated in 2003.

"Having state-of-the-art research space in the Baxter buildings as well as in the cancer center can make or break efforts to recruit the best and brightest to Louisville," he says.

Kaplan and the university leadership are well aware that the status quo will not suffice for long. A third HSC research building has been planned and is considered crucial to maintaining the current research and recruitment momentum.

"Space is the currency by which we will grow future programs," Williams said. "Joel and the president's office have appropriately worked very hard to keep a third research building on the radar screen."

Patients First

Although Kaplan devoted a great deal of his time and attention during his years at UofL toward building research programs, he also cast a critical eye on the university's clinical programs.

"I was impressed by our faculty's reputation for providing excellent leading-edge care," Kaplan remembers. "In fact, my first decision as the new dean was to approve the final stage of research that led to the AbioCor artificial heart implants by our faculty members at Jewish Hospital."

Ongoing collaboration with Louisville Medical Center partners has produced groundbreaking programs like the UofL Kosair Charities Pediatric Research Unit at Norton Healthcare's Kosair Children's Hospital and a rapidly developing Cardiovascular Innovation Institute in partnership with Jewish Hospital.

Despite the high-level of care offered by UofL faculty at partner hospitals and throughout the city, Kaplan was concerned about the future of University Hospital in his early days as dean and vice president.

"The hospital was stable after the transition to UMC but it was still half empty. We had a strong hospital CEO, but needed a new clinical vice dean," he recalls. He appointed Mark Pfeifer to that role, which was "one of the best moves I made."

"Mark and I worked closely with the department chairs and University Hospital president James Taylor to increase the mix of private patients, improve signature services, and, with Don Miller's arrival as director of the James Graham Brown Cancer Center, realize the incredible growth potential of the cancer center."

Ultimately, "Joel created an environment of confident progressiveness that brought out the best in a hardworking talented faculty who felt supported and optimistic," Pfeifer says.

Innovations in Instruction

Of all his accomplishments, Kaplan seems proudest of the innovations he brought about in education.

"My wife says that the days I came home smiling are the days she knew I was working with students," he says. "Our six spring graduation celebrations here were the six most meaningful days of my career."

Over the last six years, the health sciences curricula at UofL have experienced a period of review and improvement second only perhaps to the nationwide educational revolution that followed Louisvillian Abraham Flexner's scathing 1910 report on the state of medical education in America.

"The genesis of the educational revolution at UofL was simply a nice conversation with John Paris, M.D., a UofL alumnus who wanted to do something positive for his alma mater," Kaplan says. Paris, who died in 2004, helped fund the project through a generous donation to the school.

From that conversation and the gifts that followed, the Alumni Center for Medical Education emerged, offering students a new opportunity for frequent, hands-on, risk-free instruction.

Recognizing the potential, Kaplan encouraged all four HSC schools to study the effectiveness of their teaching methods. All of the schools incorporated the computerized patient simulators and standardized patients into their coursework, and the schools of dentistry and medicine added hand-held technologies like Palm Pilots.

First-year medical students now enter the simulation lab during their first week of school and begin applying classroom learning right away._The experience clearly is paying off. The medical school's most recent graduates earned a 100 percent pass rate on the U.S. Medical Licensing Examination.

"Dr. Kaplan recognized the importance of developing strong and innovative programs to support the education of the next generation of health professionals," says Mary Mundt, Ph.D., R.N., dean of the School of Nursing. "Our students, like all health sciences students, have benefited from experiences in the simulation center and standardized patient center."

Critical Leadership

UofL President James Ramsey, Ph.D., says Kaplan's leadership was critical in the university's recent achievements in the health sciences.

"Joel implemented plans and realized the goals for research growth in key areas of our long-range plan, The Challenge of Excellence, including cancer, cardiology, birth defects and spinal cord injury," he says.

"It's no coincidence that our medical school has been the fastest growing school for National Institutes of Health funding for the last six years."_As Kaplan turns his eye to the future, he has high confidence in his colleagues at HSC.

"The whole team gets credit for building the campus into what it is today," he says. "Our Wednesday morning staff meetings were especially valuable to me.

"Having all of the health sciences deans and key decision makers from across the campus come together once a week to work through challenges has been critical to our success.

"I focused my thinking all week around seeking feedback from and discussing issues with this group of outstanding professionals."

Kaplan is leaving the HSC "in great shape and poised to grow qualitatively and quantitatively to new heights," says Pfeifer.

"He created an environment that has everyone feeling they can succeed."