 So I'll be talking today. Can everybody hear me okay? Okay. I'll be talking today about some proposed initiatives we have to kind of restructure and reorganize the current NHGRI training and career initiatives. A few things I want to note before I get started. This is actually a two-part presentation. Part two will be tomorrow during the closed session by my colleague Tina Gatlin. We'll be discussing more details about the budget. And one last note is in this particular presentation I will not be covering any of the training grants covered by the LC program that might be discussed at a future council presentation. So a little bit of background. Eric touched upon this in the director's report. We had a workshop back in April of this year. It was co-chaired by Gail Jarvik and Bob Waterston. And we wanted to ask this group of experts in genomics, academic medicine and training to provide guidance on how we can realign our research training and career development programs with the 2011 strategic plan. So we've all seen this slide a couple times today. But some of the overarching recommendations that came out to align with the strategic plan include we really want to maintain our investment in genomic science. We don't want to cut back and actually we want to expand into the realms of informatics. We also want to expand training into genomic medicine, going to the right of the diagram. And we also want to make sure that our training investment is on par with other NIH ICs. And at this April meeting, we actually invited training coordinators from other institutes across the NIH to find out what are they doing in their programs and how much of their extramural dollars are going towards these initiatives. So some of the general recommendations that came out of the meeting in regards to the institutional training grants is that we would like to expand the postdoc training to encompass areas of genomic medicine and to continue training in the areas of genomic sciences. In regards to the career awards, we want to expand these awards into the areas of genomic medicine and again continue training in genomic sciences. Some of the specific recommendations that came out of the workshop, we want to develop leaders in genomic medicine and genomic science. We would like to train comprehensively in more than one discipline. So we're really training a generation of multidisciplinary scientists. We want to make sure trainees have access to large and complex datasets. We want to continue support of the diversity action plans. And we would like to consider developing a professional network of trainees and the K or career wardees. The person that came to visit us from the National Library of Medicine, they've had a lot of success with putting together this network and they have a big symposium every year. And it's a nice way for all the trainees to get to know each other and network and figure out where they can go along the training pipeline. And again, they suggested that we fund more training and career development activities, which is what I'm going to discuss in more detail. So our proposed implementation plan. So coming out of these recommendations, we came back to staff and came up with these four areas that we would like to focus on. The first being an institutional postdoc and clinician training program in genomic medicine using the T32 mechanism. This would be new. Continuing our T32 program in genomic medicine that focuses on graduate students and postdoc fellows. And then looking at the career awards, the individual mentored career development award in genomics or the K01 mechanism. And then the K08 mechanism, which would be new for HG, which is an individual mentored clinical scientist career development award in genomic medicine. And I'm going to walk through each of these. The first one being the T32 in genomic medicine. Again, we really want to develop leaders in genomic medicine. And this is focusing on postdoc fellows and clinicians. We want programs that may include training genomic medicine researchers and providing comprehensive training for in genomics for clinicians. Eligible appointees would include postdoc fellows with an MD or a clinical PhD. And when I say clinical PhD, we're talking about folks who have a PharmD, clinical psychology, those kind of areas. Course requirements would be flexible, but we would require training in the quantitative sciences and LC. Individual appointments can vary anywhere between two to three years. And we propose the number of training slots per application somewhere between four and six. So what's new compared to the existing T32 program that we have now? We want to expand the current T32 program to support training in the area of genomic medicine. The program, like I mentioned before, is targeted to MDs or clinical PhD postdocs. And again, this broad training in medicine and genomics. And we're hoping that going through this training, individuals that come out of this T32 will really have a high potential to serve as a mentor in genomics. And we'll be able to work in clinics and be that expert in genomic medicine that individuals can go to to ask for this kind of information. Now, switching back to the T32 and genomic sciences, again, we want these leaders. And we want them to have a comprehensive knowledge base and skill set in the informational and quantitative sciences. Cross training, the group really felt that this was important to possibly include things like clinical discovery work and technology development. And we would like the new programs that come in for the Genomic Science T32 to be limited to 10 training slots. And the existing programs that are under the T32 umbrella that are on the larger side, there were recommendations to reduce these gradually over time. So again, what's new is we want to have a greater emphasis on training in the quantitative sciences, informatics, and biostatistics. So moving on to the K awards or the career awards, NHGRI is currently signed on to three NIH parent awards, the K01, the K25 and the K99ROO. On that last bullet, we are proposing no changes to the current K99 program. Our proposal is that we would like to issue a NHGRI specific K08 program announcement. And we would also like to have an NHGRI specific K01 program announcement that will replace the parent one that we're currently signed on to. And like I said before, no changes to the K99. So starting with the K01, which is the Individual Mentored Career Award in Genomic Sciences, we really want to cross-train investigators that are proficient in one genomic discipline and another scientific discipline that's related to genomic science. Eligible applicants would be individuals with a PhD or equivalent and with a demonstrated competency in one specific discipline related to genomic sciences. And again, what's new, we want to expand opportunities to individuals with a biological degree who wish to cross-train. And these K-Awards are really, really unique because what they provide is they provide anywhere from three to five years of support of having really dedicated time to be able to have the training and get the experience needed to be able to facilitate this. And then the K08s in genomic medicine, this is to provide a mentored research experience to clinically trained individuals to become those independent investigators and practitioners of genomic medicine. Eligible appointees could be individuals with a medical degree and course requirements. We really want this to be a defined curriculum in order to really complement their existing clinical expertise and to receive training in the areas of LC. And we would also think it would be nice for individuals to be able to pursue a research project that would provide some kind of preliminary data for an independent research project. And again, what's new is we want to expand the existing Mentored Career Award program to support clinicians in genomic medicine. This is my last slide. I wanted to provide a quick snapshot of the past five years of NHGRI funding for these individual programs. So starting with the T32s are the institutional NRSAs. We currently spend 1.8% of our extramural budget on this, which equates to about $6.9 million. And that's in comparison to the NIH average, which is about 2.39%. Looking at the individual fellowships, obviously for the F30s, we do not currently support anybody in the F30s because NHGRI just signed on to that program announcement. And there's two tracks for the F30s. One is a diversity and then one is kind of clear geared towards graduate students as well. The pre-doc fellowship, the F31, currently we support, you know, 0.04% of our budget towards this compared to the NIH budget of 0.17. For the postdocs in the F32, again, it's on the low side compared to the NIH. And for the F30s, which are the senior fellows, we're really low on that compared to the NIH. Moving on to the Research Scientist Career Development Award for the KO-1s, obviously this is an area we'd like to move into and we're seeing we would we're not going to be on par with the NIH, but we want to start moving in that direction. Same thing with the KO-8. We currently don't fund any KO-8. So this would be a new area for us to move into. So there's more to this table and that will be discussed in tomorrow's presentation by Tina, who will talk about what are the projections that we see going forward to increase our investment in these programs. But this is where we currently sit. So at this point, I want to open it up for discussions. We did have a pre-council call with three council members, Jim Evans, Lucila, and Howard Jacob. I don't know if you three want to start. And there's also a question document in the Electronic Council book for kind of questions to prime the conversation. How about I call on Howard? So I think the plan is a good plan. I think we can talk some more about this in some more detail. But before I talk a little bit more about it, I just made me wonder in thinking about this. So in genetic counseling, the terminal degree is a master's degree. Is there any chance to do something with any of these programs around that? Because when we think about genomic medicine, I mean, often they're going to be the tip of the spear in the clinical environment. So is there any prospects around, I mean, would any of those programs qualify? I know we haven't talked about it here, but or do they have to be terminal degree, have to be an MD or a PhD? I think I like your idea of the genetic counseling, and I think that would change the paradigm here at NIH of moving towards training people with a terminal master's degree. But at this point, Betty, if I'm right, most of the programs are geared. So this is more like allied health or something like that. So these programs don't support that. Okay, I'll come back to the rest of my question then or comments. And so I think I think we're moving in the right direction. And I think we can have some more conversations about trying to balance us out. But I'm going to come back to what Bob brought up is that when you think about genomic medicine, and you think about the number of places where this needs to go, I mean, this is a big challenge well beyond just the NHGRI. I mean, we're talking about looking at a relative handful of people. We still have to keep advancing the genomic science levels. That's not going away. It's not like we're at a point where we can say, okay, we can decrease that. So I think there's an interesting challenge that the Institute is facing around this, but is well beyond just NHGRI. So I think the fact that you're moving in that direction, I'm fully supportive of that. That's great, because we're really excited about it, because before we put together this workshop, I had, we had pulled all of the other training coordinators and other ICs, and there's definitely no other Institute looking into expanding training into genomic medicine. So we feel we can start a contribution in that part, and we feel that other ICs, as this technology and as the pace of science continues to move, maybe other ICs will sign on with us, and this will become a bigger training program. Jim? I think that, you know, looking at the oh, I'm sorry. I think, thank you. I think that looking at the questions for the open session and kind of ticking through those, I do think that the emphasis on biostatistics, computational biology, quantitative things is appropriate. I think that those are really going to be the rate limiting step for some time to come in the genomic sciences area. I think as far as the precise number, you know, frankly, you kind of take a guess and you go for it, and that seems like as good a guess to me as any. I don't really know how to refine it better. I think that the more interesting question is, is what the ratio of genomic science to genomic medicine should be, and it seems to me that that's about right. I think that genomic sciences has to be broader. I think that that's where it's a more established field, if anything, in this arena can be felt to be established. I think we have to kind of wait and see to some extent where genomic medicine goes. So I think starting with a significant preponderance of genomic science makes sense. As far as the duration of the K awards, I prefer the five years as opposed to four years. Obviously you could get a few more slots if you did four years, but my own feeling is that with the climate of funding and what you're trying to accomplish to have people really ready to go out there and contribute and make a living and be funded, etc., that the five years is probably worth it, putting that on balance with what you're sacrificing to do that. This is for the case? Yeah, for the individual career awards, right. And then as far as the K awards being below the NIH average, I don't really know how to answer that. I think that the NIH average is simply the NIH average and doesn't necessarily represent an aspirational goal, right? It is what it is. I think we have to, I think this, these numbers are a good place to start and I think that it's going to be a matter of seeing how things go over the next few years with regards to demand and how the field evolves. So I don't know of a way to really, I would just say I don't think the NIH average should necessarily be the aspirational goal. Okay, thank you. I just wanted to add that it's kind of a chicken and egg problem of being a handful of institutions because if you don't expand the training, they will always be in the same place. And as you expand the genomic medicine portfolio on grants, who is going to staff those grants? It's got to have a training component associated with it. Thank you. I'm wondering if you could talk a little bit more about the rationale for limiting the KO8s to clinicians with PhDs, to clinical psychologists in particular and not sort of thinking about the other types of PhDs who play a role in genomic medicine. So do you mean the KO8 or the T32 in genomic medicine? Let me back up. So for the KO8, we're specifically looking for, you meant the T32, okay. There we go. I think what we were thinking with when we were with this workshop group and I think talking programmatically, we were looking at individuals who are already working in the realm of genomics and want to move into the areas of genomic science, of genomic medicine. This might be a way to go down that road where you catch people early in the pipeline who realize that this is something they want to pursue. As for the clinical PhD degree, I mean I just gave a few examples but it's definitely not limited by the NIH definitions. I mean I just gave examples of the PharmD, a clinical psychologist but anybody who does have a clinical PhD degree could definitely be eligible to apply for this because we do know that there are a lot of people in the clinical arena who are working in genomic medicine now or are interested in moving into that field. Does that answer your question? It does. I would just be careful because I think that, you know, clinical PhD implies something very specific and I don't know that. I mean if I saw this and thought about myself I wouldn't think that I would be eligible for it. Okay. And so I think that there is, you know, that's something to consider. Okay, thank you. So for the most part I like this and I just have a question on slide 11 on the K01. How are you defining another scientific discipline relevant to genomic science? So I think for instance for this program we were thinking that biologists who might be interested in going to the field of informatics. People who are like genetic biologists where you're working in the lab, you're looking, say you're looking at evolutionary type of things and you want to move into the realm of genomics and informatics, this might be the right fit for you. But more broadly defined, you're still including things like engineering and other disciplines and others that want to train in genomic sciences? Originally the program was for people with degrees in bioinformatics, engineering, computer science, math, and physics. Those were the only ones. Now we're going to open it up so that you will have that group will also be included but we're expanding it to include people who may have degrees in genetics but who want to be trained in the quantitative sciences. So we're looking at basically two tracks. So we're not excluding the original group, we're just expanding. That's good. I just, I don't, I didn't understand that from the way this is all worded here on this slide. It didn't come across. Yeah, so it's expanding it to other disciplines other than bioinformatics. Okay. Great, thank you very much. So is there an opportunity here, you know, we've talked a lot about NHGRI as a wedge that drives genomic medicine into all of NIH. It seems to me that, you know, there might be an opportunity to partner with NIGMS, for example, right? They run most of the big MSTP programs or with NCI or even NHLBI on some of these applications. Is that something that's relatively easy to do or not so much? I think it depends. I mean I think it's we've talked to liaisons across the NIH but I mean no one has exactly jumped on the bandwagon and said I want to sign on with us but maybe now post this discussion that's something we can bring back to other ICs and see if they'd be interested in getting on board or people might want to take a wait-and-see approach see what kind of success we're getting out of these initiatives and at some point when they feel they're ready to sign on but I mean I agree that we can't do this alone and I think other ICs will start to have interest. So I would point out a couple things first of all I'm quite convinced that in fact I know for fact that when we have this upcoming retreat with NIGMS as part of John Lortz really look I mean he like I am looking at lots of things to learn about the Institute and you're right they have a very substantial training component that I know he wants to look at without question this that will be one of the areas we have a discussion about on that retreat day no question GMS. I think in case of the other institutes as you said is it something easy to do if budgetary times are great the conversations will go much different so I mean I think in the current climate I think it's a little hard I think until we get a little momentum and put something down and start doing it and demonstrate that you know what how effective this might be I think it's going to just sort of ring hollow I think once we get something out of the gates one could imagine either when we get applications and that are clearly cancer oriented or that are clearly heart, lung and blood oriented will go to the men or as they see some of these start to percolate we will go and talk to them I predict this kind of thing will spread among some of the other institutes but not until we get it out of the gates is my prediction. I wanted to circle back to the comment Dr. Hughes-Halbert made from the description of the T32 it looks like people could get training in how to practice genomic medicine I mean I know there was one element that was research but you start with people that have clinical degrees and then train them in genomic medicine didn't look to me like there was any requirement that you were actually training people who were going to be doing research I mean research was possible and this I think would be a quite a departure for NIH to train people to practice something. I think that's very come to microphone understanding is it's this is about research not so the recommendation was to have two tracks with that postdoc program one track would be to really train traditional genomic researchers the other track would be to train clinicians who would be very well versed in genomics research and who could be more in the clinic than they are in the laboratory that was the recommendation they'd be doing clinical research in the clinic yes that slides not clear I mean I look at that slide and I read that that could be somebody who would then go out and hang up a shingle and say I'm going to practice genomic medicine and I'll be trained in it on that t3 that's all right that's how I read no they would be clinical researchers but they would be a resource in the clinic so that's helpful Bob I mean clearly these will be flushed out in a much deeper language but let's make sure that gets noted it was not clear I guess it's a related point then that the t32 genomic medicine currently lists a requirement for either an MD or a clinical PhD as as an entry point and I think you're pointing out and you're pointing out as well that that is going to greatly restrict the scope of your genomic medicine post doctoral trainees to to to clinician as opposed to if you open it up to also people who had PhDs in a variety of fields some of which may not be clinical then your definition of t32 genomic medicine may draw on more disciplines for people who want to move into medical applications of their of their previous training I think your point was well taken and that was one of the things that Gail Jarvik made as as part of our workshop and that most of the well her experience was with NIGMS in which only clinicians were involved and she was making a very strong pitch to include people with PhDs just clinical PhDs are also PhD so I think that's the problem with the slide the slide says MDs or clinical PhDs is the requirement for entry and I think you should include PhDs straight PhDs non clinical PhDs that have come from a variety of different backgrounds and maybe interested in genomic medicine so I think there might be a little little confusion here I think when we say MDs we are also talking about there there are lots of comparable clinical degrees other than an MD there are pharmacology degrees nursing degrees things like that so that's one group of people but then we're also talking about traditional PhDs so for the T32s we would be looking at traditional PhDs as well as clinical types to genomic medicine slide right right there that the confusion is eligible appointees are postdoctoral fellows with MD or clinical PhD degree that should be expanded to just PhDs and clinical MDs. It could add this similar to the sorts of training that PhDs who are then becoming laboratory clinicians for the American Board of Genetics they have to do something they have to have clinical exposure they have to go to the clinic to see how the tests that they're running are used and so one could imagine that if you were a straight research oriented PhD you might want to build that into the training program. Bob it's actually funny because I think the phraseology clinical PhD was exactly to capture those individuals but I think what you're pointing out is that the stage they may make that transition they may not be considered clinical PhD I mean that's sort of a funny word when you think about it so but that's exactly the people we imagine capturing even more likely than super basic oriented PhDs who really hadn't necessarily shown much interest in clinical research so I think we can fix this is all very good input. David. So then just one other response because you do have this set of questions on the open session questions for council to consider so I just like to back up to the very first one that's listed there and that is not for the genomic medicine T32s but for the genomic science T32s you have this question should the primary training focus of genomic science T32s be biostatistics computational biology the quantitative sciences and technology development. I think all of those areas are absolutely key areas but I also think that a key component of the genomic science T32 program is going to have to continue to be a really solid foundation in genetics and biochemistry and molecular biology because that's also foundational for the effort to apply genome to medicine or to apply new drugs and drug targets to things that that may make it into the clinic. So I see those additional terms as key areas of interest but you can't throw out the the other basic aspects of training if you're going to have the kind of people that I think we want working in genomic medicine. Right and that was not the intention and we can definitely include that language back in. Yeah maybe just changing the article to a primary training focus but I agree. Any other questions. Okay thank you Heather. Thank you everyone good input.