History of the Department

by  David J. Mokler, PhD (Professor Emeritus), Carol A. Brenner, PhD (Associate Dean for Research and Scholarship) and Barabara J. Winterson, PhD (Professor Emeritus)

Introduction

Since the founding of osteopathic medicine in the late 19th century, the profession has gained national acceptance. There are now over 35 accredited osteopathic schools at 55 sites located in 32 states. These colleges are educating more than 30,000 future physicians—25 percent of all U.S. medical students. The Accreditation Council for Graduate Medical Education (ACGME), the American Osteopathic Association (AOA), and the American Association of Colleges of Osteopathic Medicine (AACOM) approved an agreement in 2014, to transition to a single accreditation system for graduate medical education (GME) starting 2020. There were 35,185 medical students that submitted applications to match to ACGME residency programs in 2019. The 2019 National Resident Matching Program® (NRMP) match rate for US Allopathic Seniors was 93.9%, while that for US Osteopathic Seniors was 84.6%. The shortage of residency positions is exacerbated by the fact that Medicare has not increased the number of resident positions they fund since 1997 [1]. Many of our medical students are competing for highly subspecialty residency programs which place high value on candidates’ research activity and productivity for selection.

 It is imperative that medical schools offer research and scholarship opportunities to their medical students in order to enhance their ability to place in residencies of their choice.  A significant difference has been found for the number of research accomplishments between osteopathic and allopathic medical students. The mean number of research accomplishments and experiences was 5.91 for allopathic medical schools compared to 2.6 for the osteopathic medical schools [2]. Research accomplishments include abstracts, presentations, and publications.  Osteopathic medical schools have not traditionally been a rich source for such opportunities as they have largely focused on the education and service traditions of the profession.  The University of New England College of Osteopathic Medicine has been able to make the transition from the mission focused primarily on teaching, training and professional service to a mission that includes an increasingly rich environment of research and scholarship.

The Beginnings:

The New England College of Osteopathic Medicine (NECOM) was started by a group of physicians in the early 1970s that wanted to preserve the practice of osteopathic medicine in New England. A partnership was initiated between the leaders of NECOM and St. Francis College in Biddeford, Maine, which led to the formation of the first medical school in Maine. NECOM opened its doors in the fall of 1978 with 36 medical students, seven on-campus basic science faculty, Associate Dean for Basic Sciences Gene Yonuschot, Ph.D. with Dean William Strong, D.O. at the helm.  NECOM was housed in the partially remodeled Stella Maris Hall that included classrooms and teaching laboratories. Faculty and staff offices would be completed the next year.  There were no dedicated research laboratories or animal facilities for bench researchers.

The Filling-Out Years: 1980 – 1995

The next fifteen years brought in a full complement of basic science faculty bringing the total to 16.  The founding faculty were advised that their principal duty was providing a quality education to the osteopathic medical students in their charge.  The administration recognized that the teaching load for faculty in UNE COM would be significantly higher than the teaching loads at traditional medical schools, and thus the annual budget for the Department of Basic Sciences included support for lab supplies, animal care cost, and travel.  Thus, the research and scholarship efforts did not need to have external funding.  In addition, teaching assignments were made such that the basic science faculty could devote as much as 50% of their time to service and scholarship.  This generous time allotment would prove crucial in the future developments for research and scholarship. While all were dedicated to the teaching mission of the College, some came with interest and capacity for research.  Some of the unfinished spaces in Stella Maris Hall were fitted out for research albeit furnished from auctions of defunct scientific and medical laboratories in the New England region.  In addition, the teaching laboratories for anatomy, histology and microbiology were used for small research projects when not used for teaching.  UNE COM faculty promotion and tenure processes included research and scholarship as one of the three cornerstones of faculty work from the beginning.  How did research evolve and become an integral part of UNE COM? 

Some of the founding faculty of UNE COM shared a commitment to the goal of developing a strong research mission. The initial cluster of neuroscience researchers included John Earnhardt, M.S.W., Ph.D., Carl Spirito, Ph.D. and Barbara Winterson, Ph.D. in the Department of Physiology and Pharmacology and Alan Bell, Ph.D., Neal Cross, Ph.D., David Koester, Ph.D. and Frank Willard, Ph.D. in Anatomy. Strong interest in non-neuroscience research came from Michael Roper, Ph.D. in Biochemistry and Michael Newburg,  Ph.D. in Microbiology.  Barbara Winterson had the first NIH RO1 grant at NECOM in 1980, funding her research on eye movements in rabbits. She was also awarded two subsequent AOA grants in the late 1980s and early 1990s to study a model of spinal fixation in rats [3].  John Earnhardt who became Department Chairman of Pharmacology received a three-year NIH with co-investigator Peter Morgane, Ph.D. in 1987 [4].  The grant funded cardiovascular research on biological mechanisms of nutrients (proteins) and their effect on cardiovascular autonomic physiology. Peter Morgane, a neuroscientist with a distinguished career that spanned the neuroanatomy of the cetacean brain, sleep and the effects of malnutrition on the developing brain was looking to transition from his role as senior scientist at the Worcester Foundation for Experimental Biology.  He joined NECOM’s Department of Pharmacology as an adjunct professor and retired from Worcester Foundation in 1985.  David Mokler, Ph.D. joined the faculty in 1986 and was attracted to the small size of the school and the focus on neuroscience research. He received a small grant from the NIH in 1988 to study hallucinogenic drugs.   Peter Morgane invited David Mokler to join the research group at Boston University investigating the effects of prenatal protein malnutrition on the brain of rats in 1987  [5]. David Mokler has been involved with this research since that time, first as part of a program project at BU and then as the PI of a subcontract under a 5- year RO1 at UNE (Mokler, 2019 and other papers). 

The initial research infrastructure for research at UNE was minimal.  Labs were all in the back of Stella Maris Hall.  A vivarium originally designed to house rabbits and rats was created in two office rooms on the 4th floor. David Mokler was in charge of the animal facility for a few years, hiring undergraduates to feed and water animals and wash cages.  The Institutional Animal Care and Use Committee (IACUC) consisted of the few faculty who were using animals in research. The College covered the cost of animal care until 2010 with the formation of a University wide Office of Research and Scholarship (at this time no undergraduate faculty used animals).  Lab equipment was frequently bought from auctions of scientific equipment from other colleges that were closing.  Faculty continued to make road trips to collect used donated scientific equipment. From time to time, larger purchases of equipment were made if they utilized by several faculty.

Peter Morgane was increasing his involvement at UNE.  He became a tireless advocate for research at UNECOM.  He felt that all faculty should be involved in some aspect of research. Peter Morgane published extensively in peer-reviewed journals, with more than 240 peer reviewed full papers. He underscored this with a million- dollar donation to the Pickus Building which was built in 2008.  This established the Cecile Morgane Research Labs in Pickus.  He followed this with another million- dollar donation for the Morgane Hall, the science classroom and research building for the College of Arts and Sciences. 

This small but committed group of UNE COM biomedical faculty also were among the faculty leaders who, together with undergraduate faculty committed to scholarship and research, convinced the University Faculty Assembly to recognize the importance of research and scholarship among the faculty.  In the late 1980’s, the UNE Faculty Handbook was amended for promotion and tenure to include substantive accomplishments in research that would ultimately be reviewed by a University Reappointment and Promotion Committee.  This new accountability for faculty would, within a few years, significantly increase the quality and quantity of scholarly activity and research productivity from the University and UNE COM.

In addition to interest in faculty research, there was an awareness that UNE COM students could benefit from involvement in research projects.  This was strongly articulated by Dean J. Jerry Rodos, D.O. who in 1981 initiated the Dean’s Research Summer Fellowship Program.  Initially, there were five research summer fellowships awarded to medical students. In addition to these in–house fellowships, medical students have been awarded fellowships from external entities; Glaxo – Welcome Fellowships, AOA Student Fellowships, and others (David, Amy can you think of others).  The Dean’s Summer Research Fellowship program was later renamed the Peter Morgane Research Fellowship and now funds over 20 student fellowships each year. During this period, another student research fellowship program was initiated by a donation from a founding osteopathic physician, Carmen Pettapiece. Although originally designated for osteopathic or clinical research, it now supports all areas of medically oriented research – osteopathic manipulative medicine, clinical, biomedical, or public health and it is administered by the UNE COM Student Government Association. It currently supports two to four fellowships annually. 

Strategic Planning and Critical Mass: 1995 – 2010

The next fifteen years proved pivotal in the development of a small but nationally competitive research program for UNE COM.  Steven Shannon, M.P.H, D.O. was appointed interim Dean of UNE COM in 1995 and Dean in 1996. Dean Shannon had been an UNE COM medical student between 1982 and 1986. He was interested in medications for the elderly and applied for, and received a Deans Summer Research Fellowship and small grant funding from Southern Maine Agency on Aging to devise and implement a questionnaire about the lives of the elderly.  He interviewed about 100 elderly residents of Biddeford and Saco visiting them either in their own homes or their nursing homes facilities.  He compiled the information, wrote it up, turned it into a presentation, and gave numerous seminars.  This was a great experience for him;  Dean Shannon recognized that something like it should be more available to other medical students.  It should be noted that he also was witness to the importance of bench research as his wife was Barbara Winterson (one of the founding faculty) and saw first-hand the value of scholarship to the advance of medical science.  

Many events and milestones helped to prioritize research, and the development of a basic science research culture during these years that Dean Shannon was the Dean at UNE COM.  A 1998 strategic plan adopted by UNE COM that increased support for research and researchers beamong the priorities that should be implemented. It was stipulated that recruitment of basic science faculty in the College of Osteopathic Medicine with significant extramurally funded research programs was important to grow research at UNE COM. Participation of clinical faculty in clinical research activities became an accreditation requirements for research activities for the College of Osteopathic Medicine, the Northeast Osteopathic Medical Education Network (UNE’s Osteopathic Postgraduate Training Institute), and for residents in our own programs. At the request of the University of New England (UNE), the Research Competitiveness Service of the American Association for the Advancement of Science (AAAS) convened a senior advisory panel in 2002 to provide expert guidance to the strategic plan for research at the University of New England [6, 7].  UNE COM had a small core of successful researchers on the faculty and these researchers were spearheading the move to expand research both in the College and the University. The panel felt that it was realistic at this time to devote significant effort towards the recruitment of talented junior and mid-level investigators. There was sufficient space in existing facilities to provide interim research space for at least two new hires, with the understanding that, in time, their laboratories would move into the new building.  Assembling a critical mass  should not be delayed until the new facilities were completed.

Amy Davidoff, Ph.D. was the first biomedical faculty to be hired under the new initiative to expand research faculty. She joined UNE COM in 1997. She had been awarded a R01 grant from NIH entitled “Calcium regulation in the diabetic heart” which covered most of her salary and benefits, salary/benefits for a technician, research supply costs and indirect costs for the institution ([8] and others). Dean Shannon recognized that the basic science faculty came from a culture of research (and a number continued with their research), therefore it made sense to first focus on developing biomedical research capacity.  There was an incentive for UNE COM to hire Amy Davidoff because of this initiative and incentive to help further build research. This would allow her to continue her research program. It was a challenging time, but because there were few institutional research traditions, the school defrayed costs that were typically charged to individual Principal Investigators (PI); such as animal per diem costs,  administrative costs, and  lab space costs.  This allowed more grant funds to be dedicated to the research and research personnel (i.e., hiring technicians and students), and allowed unfunded investigators to continue their research efforts.  Dean Shannon developed a policy to provide a large portion of a grant’s institutional allotment (aka ‘Indirects’) to be funneled back to the PI to defray costs of research.  The College also had  developed a generous budget for large instrument service contracts and small equipment purchase (even if researchers are unfunded). These policies helped recruit junior and mid-level investigators with less institutional investment.  The hiring of additional research intensive faculty followed within the next few years including Edward Bilsky, Ph.D. in 2001, who through research grants and contracts, was investigating the mechanisms of action of newly developed drugs targeting the opioid receptors, to  identifying a pain drug without serious side effect [9].  Ian Meng, Ph.D. in 2003 who brought NIH funding to study the mechanisms of cannabinoid analgesia in the trigeminal system [10], and Ling Cao, M.D., Ph.D. in 2007 who, shortly after her arrival, was awarded a KO1 award to study the role of neuroimmunologic mechanisms in neuropathic pain [11].

Critical support also came from the University leadership.  Dean Shannon and Douglas Wood, D.O., Ph.D., who at that time was President of AACOM, presented to the University of New England (UNE) Board of Trustees (BOT) the importance of growing research expectations at osteopathic medical schools. The UNE BOT supported adopting the UNE COM strategic research plan, and also supported expanding research more widely with the whole university.

Additionally, Dean Shannon saw the need for state and regional support.  He became involved in a state-wide effort to develop funding for biomedical research, through an organization entitled the Maine Biomedical Research Coalition (MBRC) to plan building a research building. The Pickus Center for Biomedical Research was built in 2008 with funds from MBRC, a state bond, UNE fundraising and million-dollar donations from Owen Pickus, D.O., J.D., and from Peter Morgane, thus establishing the Cecile Morgane Research Laboratories within the Pickus Center.  Edward Bilsky led the application to Maine Technology to fund the vivarium in Pickus. President Sandra Featherman established the Office of Research and Scholarship in the early 2000s.  In 2005, UNE hired its first grants administrator, Nick Gere. Timothy Ford, Ph.D. was the first Vice President for Research and Scholarship and served from 2009 until 2011 and Edward Bilsky took over this position in 2011 until 2017, when Karen Houseknecht, Ph.D., another UNE COM biomedical sciences faculty member, was appointed to replace Dr. Bilsky.

The growth of neuroscience at UNE COM

UNE COM initial research endeavors were already heavily weighted towards pain/neuroscience.  Many of the founding faculty of Bell, Cross, Johnson, Mokler, Morgane, Spirito, Willard, and Winterson were trained and published in the fields of neurosciences and some, as we have seen, enjoyed continuing funding. The hiring of Edward Bilsky in 2001 increased the focus of neuroscience research at UNE COM and brought significantly increased efforts in pain research.  This enabled UNE COM to recruit more pain investigators such as Ian Meng and Ling Cao.  As the programs grew, Edward Bilsky took over as the VP for Research and Scholarship and further increased the focus of neuroscience research.  Drs. Meng and Bilsky were central to the establishment of The Center of Excellence in Neuroscience (CEN), which was established in 2008 and was supported by President Ripich with an initial investment of $100,000 per year for three years.  The mission of CEN was to foster creativity and collaboration among people who had a passion for understanding the complexities of the nervous system and in applying this knowledge to improve human health and quality of life. 

Also, at this time, most of the research-intensive UNE COM faculty joined the Graduate School in Biomedical Sciences and Engineering (GSBSE) at the University of Maine at Orono, in order to open up the possibility of have PhD students. The establishment of an undergraduate major in neuroscience allowed the UNE COM/CEN faculty the ability to attract undergraduate students, technicians and master’s students in their laboratories. Another midlevel pain and neuroscience investigator was hired during this time period. Geoffrey Bove, D.C., Ph.D.  joined the faculty in 2009 and brought significant and continuous funding to UNE COM to study the neurological mechanisms of neuropathic pain and mechanisms underlying manual medicine [12].

With the growth of the pain research at UNE COM, it was felt that there was a critical mass for research in this area to allow UNE COM to be competitive in applying for an NIH Center of Biomedical Research and Excellence (COBRE) grant. In 2012, a 10-million dollar grant by the National Institute of Health was awarded to establish the UNE Center of Biomedical Research and Excellence (COBRE) for the Study of Pain and Sensory Function. The grant was led by the principal investigators Ian Meng and Ed Bilsky. The COBRE grant was the largest research grant in the UNE’s history and an important indication that UNE had matured as a research institution to the point of national prominence 

Recent Expansion of Research Endeavors at UNE COM 2010 – present

Parallel to the growth of the neuroscience research, the class expansion and addition of the College of Dental Medicine, allowed for significant increase in the biomedical sciences faculty – some of whom were hired for their significant promise in research.  They included individuals with expertise in neuroscience but also other disciplines. Included were Tamara King, Ph.D. in 2011 [13, 14], Derek Molliver, Ph.D. in 2014 [15], Benjamin Harrison, Ph.D. in 2016 [16], Christoph Straub, Ph.D. in 2018 [17] and Diane Goode, Ph.D. in 2019 [15] to support neuroscience research and the COBRE.  In 2017 the COBRE received its phase II funding with an additional $10 million to continue to fund sensory and pain research.

Additional areas of research expertise of our UNE COM’s faculty have been the addition of Meghan May, Ph.D. in 2013 [18], whose current research focuses on the evolution of virulence, not only to determine how new diseases appear and where they come from but also how to predict what new disease might arise next — pathogen forecasting.  Kerry Tucker, Ph.D. was also hired in 2013 and whose research was concerned with developmental biology and the role of the primary cilia[19]. Karen Houseknecht, Ph.D. joined UNE COM in 2015, and whose current research focuses on identifying mechanisms underlying endocrine and metabolic side effects of antipsychotic medications and the implications of off-label prescribing of these medications to vulnerable populations such as children and the elders[20]. Karen’s NIH funded research collaboration with COBRE in Mesenchymal and Neural Regulation of Metabolic Networks with Maine Medical Center Research Institute directed by Cliff Rosen. She now also holds the position of Associate Provost for Research and Scholarship but retained her faculty position in UNE COM. Katie Becker, Ph.D. (2019) is a recent faculty addition who studies bone metabolism. With the addition of Becker to the faculty, UNE COM now has a group focusing on bone metabolism.

Activity towards expanding research initiatives for UNE COM associated with osteopathic manual therapy (OMT) to help reduce pain and improved function in both acute and chronic pain patients. These research efforts will be led by Jodie Herman, D.O. and Tamara King.  Chronic pain patients are often challenging to treat successfully, thus it would be to their advantage to have an osteopathic component in their assessment and treatment as a viable alternative to opioids for treating chronic pain. In addition, we are presently increasing UNE COMs clinical research capabilities in partnership with Maine Medical Center Research Institute. 

Every year our medical students have the opportunity to participate in three research symposia. In 2019, our Fall Research Forum attracted 400 medical students, faculty and guests and 64 medical students involved in either oral or poster presentations The Maine Osteopathic Association Midwinter Symposium located in Portland preserves the practice of osteopathic medicine in Maine. Every year it hosts a Research Forum with support from UNE COM. The number of medical students presenting poster presentations has been exponentially increasing in size. The Northeast Osteopathic Medical Education Network (NEOMEN) also has an Annual Research and Scholarship Forum supporting UNE COM’s 17 Clerkships and our osteopathic postdoctoral training Residency Programs and has grown to 150 research posters. These opportunities are critical for osteopathic medical students to present their research and be recognized for their work [21, 22].

The Present

UNE COM has celebrated 40 years since the entrance of its first class.  It has grown substantially during that time.  It started with a small core faculty of full -time faculty.  It has now grown to include over 75 part-time and full-time faculty in Departments of Biomedical Sciences, Primary Care, and Osteopathic Manipulative Medicine,  including the Offices of Clinical Affairs and Academic Affairs. This year UNE COM boasts an exceptionally high residency match rate of 99 percent. This is higher than the national averages for all allopathic medical schools (93.9 percent) and osteopathic medical schools (84.6 percent). The residencies where graduates will train also reflects UNE COM’s mission to educate primary care physicians. More than 60 percent of the class matched to primary care residencies such as family medicine, internal medicine, pediatrics and obstetrics. The College has been a boon to Maine financially as well, with 1,650 primary care jobs filled by UNE COM alumni that collectively boast a $100 million economic impact on the state. UNE COM’s 40th Anniversary Gala on the Biddeford campus on June 29th celebrated all of our alumni, faculty, professional staff, founders, trustees, and clinical partners which have all played an important role in the development of our basic and clinical research.

The growth in research, bolstered largely by UNE COM, resulted in UNE being reclassified as a Research 2 institution by the Carnegie Foundation 2018.  An R2 institute is a doctoral university with high research activity (Carnegie Classification of Institutions 2019 [23]). This reclassification is a major advance for research at UNE and UNE COM. Also, in 2018, UNE COM was granted a 10-year reaccreditation, a new designation from the AOA’s Commission on Osteopathic College of Accreditation.  This is a new accreditation status that is called Accreditation with Exceptional Status which includes fulfillment of all Standards including Standard 8 for research [24].

References

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2. Matthews, C.N., et al., Evaluating the Influence of Research on Match Success for Osteopathic and Allopathic Applicants to Residency Programs. JAOA, 2019. 119(9): p. 588-596.

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18. May, M., et al., The antipsychotic medication, risperidone, causes global immunosuppression in healthy mice. PLoS One, 2019. 14(6): p. e0218937.

19. Gazea, M., et al., Primary cilia are critical for Sonic hedgehog-mediated dopaminergic neurogenesis in the embryonic midbrain. Developmental Biology, 2016. 409(1): p. 55-71.

20. Motyl, K.J., et al., A novel role for dopamine signaling in the pathogenesis of bone loss from the atypical antipsychotic drug risperidone in female mice. Bone, 2017. 103: p. 168-176.

21. Brannan, G.D., Growing Research Among Osteopathic Residents and Medical Students: A Consortium-Based Research Education Continuum Model. J Am Osteopath Assoc, 2016. 116(5): p. 310-5.

22. Clark, B.C. and J. Blazyk, Research in the osteopathic medical profession: roadmap to recovery. J Am Osteopath Assoc, 2014. 114(8): p. 608-14.

23. The Carnegie Classification of Institutions of Higher Education. 2019 [cited 2019; Available from: http://carnegieclassifications.iu.edu/.

24. Commission on Osteopathic College Accreditation (COCA). 2019 [cited 2019; Available from: https://osteopathic.org/2018/05/10/accreditation-decisions-for-colleges-of-osteopathic-medicine-8/.