Q&A With CTSI Director Clay Johnston

Clay Johnston, MD, PhD
Clay Johnston, MD, PhD

CTSI Director Clay Johnston takes time out to offer his take on the big ideas, challenges, and opportunities influencing CTSI, as well as what he likes about his job and the trends he's expecting in the translational research realm.

Q: With CTSI now well into its 6th year, what do you think has been the Institute's biggest accomplishment or contribution so far?

A: I think we’ve seen a major shift in interest in research at UCSF. From the highest levels of leadership through the organization to our youngest trainees, there is a much clearer focus on research that improves health. Of course, we can’t take credit for all of that, but I do think we’ve been a catalyst for this change. 

Q: What are some of the big ideas and opportunities that you see influencing CTSI’s work over the next five years?

A: We need to focus squarely on the efficiency of the research process and, ultimately, need to address the rising costs that are becoming the most important barriers to innovative improvements in health. One little piece of this is open data. We’re just beginning a project in this area that could be transformative. It’s a very exciting time, thanks in part to rapid changes in informatics.

Q: What are some of the challenges facing CTSI?

I think we’ve seen a major shift in interest in research at UCSF.
Clay Johnston, MD, PhD

A: We are one of the best funded CTSAs and were the only one not to receive a significant budget cut at the time of our renewal. This has put a target on our backs, and we have been warned that we may suffer a major cut in the next renewal so that we’re more in line with other institutions. Given this, we need to transition to becoming more self-sustaining. This is both a challenge and an opportunity. It means that we need to provide services of high enough quality and value that people will pay for them. This has already happened in many of our offerings, but it needs to be universal across the Institute. We also need to work on identifying brand new funding streams.

Q: What do you like most, or what excites you, about your job?

A: This is a great job. I love being part of changing the landscape and helping highly motivated and visionary faculty become successful. And, every day I'm energized by the high caliber of staff at CTSI who ensure we keep advancing rapidly. Without them, we wouldn't be able to achieve our ambitious goals. Knowing that we are delivering on this mission to improve health, even when our role is not readily recognized or recognizable, is a great feeling.

Q: The NIH grant that supports CTSI has until recently been managed by the NIH’s National Center for Research Resources (NCRR). However, through a recent Act of Congress, the NIH dissolved NCRR and replaced it with the newly-created National Center for Advancing Translational Sciences (NCATS). Does this change have any implications for CTSI?

A: We don’t think so. We’ve been reassured over and over that this shouldn’t change our mission, though there has been concern that the charge of NCATS doesn’t include training or T2-type translational research. For now, we are working to become more independent from the NIH grant so that we can define our own mission rather than having it handed to us by NIH. Of course, NIH will pay for what interests it, which means we need to diversify our sources of support.

Q: Looking ahead, what trends are on the horizon for translational research?

A: I see five big trends to watch out for: 1) Heath IT being used across the spectrum to hasten research and its uptake in care; 2) Downward trends in traditional drug development due to costs and regulation; 3) A greater focus on cost saving from new technologies and population-focused health improvement; 4) Greater development and reliance on reliable metrics of research productivity; and 5) Public-private partnerships that push more early development back into academia.

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Read Clay Johnston's biography
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