I n t e r n a t i o n a l E v a l u a t i o n C o m m i t t e e

ResearchAssessmentAcademicMedicalCentre(AMC)Site-visit23-25October2017

Fall17

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Content

ReportAMCSite-visit(finalversion15January2018).........................................................4

1.Introduction....................................................................................................................4Scopeoftheassessment.............................................................................................................4

2.AssessmentoftheAMCresearch....................................................................................52.1Researchquality....................................................................................................................52.2Relevancetosociety..............................................................................................................52.3Viability.................................................................................................................................6

3.AMCthemes,GraduateschoolandCorefacilities.........................................................103.1Cardiovasculardiseases.......................................................................................................103.2GastrointestinalDiseasesandMetabolicDisorders..............................................................113.3InfectionandImmunity.......................................................................................................133.4Neurosciences.....................................................................................................................143.5Oncology.............................................................................................................................153.6PublicHealthandEpidemiology...........................................................................................163.7ReproductionandDevelopment..........................................................................................173.8MovementandMusculoskeletaldisorders..........................................................................183.9GraduateSchool..................................................................................................................193.10Corefacilities.....................................................................................................................20

4.ConclusionsandRecommendations..............................................................................23

Appendix1TheInternationalEvaluationCommitteeandthereviewprocedures.............27InformationprovidedtotheCommittee......................................................................................27ProceduresfollowedbytheCommittee.......................................................................................28

Appendix2Programmesite-visit......................................................................................29

Appendix3Parallelsessions.............................................................................................31

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ReportAMCSite-visit(finalversion15January2018)23-25October2017

1.IntroductionTheExecutiveBoardoftheAcademicMedicalCenter(AMC)invitedanInternationalEvaluationCommitteetoreviewitsresearchperformance,corefacilities,graduateschoolandresearchgovernance.Thisreviewispartofthe6-yearcycleofevaluationofresearchinallDutchuniversitiesandUniversityMedicalCenters(UMC’s).ItisguidedbytheStandardEvaluationProtocol(SEP)oftheRoyalAcademyofSciencesandArtsoftheNetherlands.ThepresentevaluationtakesplaceatatimewhentheAMCisintheprocessofsettingupanalliancewiththeVUUniversityMedicalCenter(VUmc)inAmsterdam.Thisstartedin2012andcollaborationinthefieldofscientificresearchisamajorelementoftheprocess.HarmonisationofresearchpoliciesbetweentheAMCandtheVUmcisacriticalpartoftheallianceplanning.InJanuary2016,fiveallianceresearchinstituteswerefounded,baseduponexistingAMCandVUmcresearchthemes,andinJanuary2017threeadditionalallianceresearchinstituteswereformed(www.amsterdamresearch.org).Althoughthecurrent2017evaluationfocusesontheAMCresearchprogrammeandformallynotonVUmcresearch,themergerwithVUmcobviouslyprofoundlyimpactsthefutureandviabilityofAMCresearch.ScopeoftheassessmentTheExecutiveBoardoftheAcademicMedicalCenter(AMC)hasaskedtheInternationalEvaluationCommittee(IEC,furtherreferredtoasthe‘Committee’,seeappendix1)toperformanassessmentofthequalityoftheresearchconductedattheAMCduringtheperiodof2011-2017.AccordingtothecriteriaoftheSEP2015-2021,alsothesocietalrelevanceoftheresearchandtheextenttowhichtheAMC(andititsindividualthemes)isequippedasawholetoachieveitsgoalsisincludedintheassessment.TheSEP2015–21allowsaninstitutetouseitsownobjectivesandstrategyasguidingprincipleswhenpreparingtheself-evaluationreportandthefocusoftheassessmentprocess.TheAMChaschosentopursueasimilarapproachasinpreviousevaluations.TheCommitteewasaskedtoassesstheStrengths,Weaknesses,OpportunitiesandThreats(SWOT)oftheAMCfromaninternationalperspective;andinadditiontoassesstheStrengths,Weaknesses,OpportunitiesandThreatsoftheindividualthemes,thecorefacilities,andtheAMCGraduateSchool.TheCommitteewasrequestedtotakeintoaccountthefollowingspecificquestions:• WhatarethestrengthsintheAMCresearchgovernancethatshouldbepreservedintheplanned

mergerwiththeVUmc?WhataretheopportunitiesthattheplannedmergerwithVUmcofferstofurtherstrengthenresearchgovernance?

• WhataretherecommendationstoreinforceinterdisciplinaryresearchandthecollaborationwithotherfacultiesoftheUniversityofAmsterdam?

• InwhichwayshouldAMCreinforceitscorefacilities?• Howandatwhatorganisationallevel(PIgroup,department,allianceresearchinstitute,division),

shouldtherelationbetweenperformanceandbudgetbeshapedinordertostimulateexcellence?

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ThecompositionoftheCommittee,thedocumentsprovidedtotheCommitteeandtheproceduresfollowedbytheCommitteearedescribedinmoredetailinAppendix1.Inchapter2,theCommitteeassessestheAMCresearchasawhole.Chapter3isspecificallyconcernedwitheachoftheeightAMCresearchthemes,thegraduateschoolandthecorefacilities.TheconclusionsandrecommendationsoftheCommitteetotheExecutiveBoardoftheAMCaresummarizedinchapter4.

2.AssessmentoftheAMCresearchTheAMCisauniversitymedicalcentreinwhichtheFacultyofMedicineoftheUniversityofAmsterdamisfullyintegrated.Itisaprominentresearchinstitution,aswellasauniversityhospital,witharound1000researchstaffincluding302PrincipalInvestigators(PI’s),150postdocsandmorethan1500PhDcandidates.TheAMCscientificmissionistopromoteexcellentbiomedicalandmedicalresearch(seeself-evaluationreport).Theself-evaluationreportdescribesanestablishedtraditionofresearch,coveringabroadspectrumfrombasicscience,translationalresearchandproofofconceptstudiestoappliedclinicalstudies,healthservicesresearchandmedicalinformatics.Manyresearcherscombinetheirscientificworkwithday-to-dayclinicalresponsibilities,teachingandtraining.TheAMChasninedivisions,headedbyadivisionchair,andencompasses72departmentsandsub-departments.Each(sub-)departmentheadhasintegralresponsibilityforpatientcare,educationandresearch,aswellasformanagementandfinances.TheExecutiveBoardconsistsofthreemembers,andisadvisedbytheResearchCouncil(26members)onmajorpolicyissuesregardingscientificresearch.TheResearchSupportOfficesupportsdevelopmentandexecutionofresearchpolicies,includingstrategicresearchplanning,careerdevelopment,internalbudgeting,andcorefacilities(see3.10).TheResearchCouncilandResearchSupportOfficeshareachairandsecretarytoalignneedsanddevelopments.

2.1ResearchqualityOverall,thebasic,translationalandclinicalresearchintheAMCvariesoverabroadrangefromgoodtoworldleading.TheCommitteewasimpressedbytheselectedscientifichighlightsthatwerepresentedduringthesite-visitandreportedintheself-evaluationdocument.Eachofthethemespresentedsuchhighlightsduringthesite-visit,andsomeofthesehighlightsreflectprominentinternationalresearchlines.TheCommitteeacknowledgesthattheAMC’spublicationoutputisatahighlevelandhasprogressivelyincreased.ThisincreaseparallelstheriseinnumberofPrincipalInvestigators.Intheperiodunderreview,theAMChasmadeanumberoflandmarkcontributionsto(bio)medicalandtranslationalresearch.Duringthevisit,theCommitteealsonotedthatseveralresearchthemesshowedasignificantleveloffragmentation,likelytohavearisenfromthelackofa‘topdown’overarchingresearchstrategy.ThisisevidencedbyaconsiderablenumberofPI’sinrelativelysmallteams,withwidelydifferentresearchinterests.InsomeinstancestheThemeshavebeencollatedfromresearchersworkingfromverydifferentdisciplines/departmentswithoutanagreedresearchstrategy.2.2RelevancetosocietyTheAMChasdevelopedaSocietalImpact(SI)scorebasedoncriteriasuchascontributiontoclinicalpracticeguidelines,healthpolicyreports,books,patentsetc.Asshownintheself-evaluationreport,theSIscoreisonaverage3(ona5-pointscale),showinganormaldistribution.Duringthesite-visit

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excellenthighlightsofsocietalimpactthattheAMChasachievedindefinedareaswerepresentedtotheCommittee.TheCommitteewasimpressedbythesocietalimpactofadiverseseriesofscientificachievementsacrossseveralthemes.Variousachievementshavesocietalormedicalpracticechangingimpact.Examplesofthesehighlightsareapparentincardiovascular(e.g.theMrCLEANtrial),neurological/psychiatric(e.g.DeepBrainStimulation),reproductive&women’shealth(e.g.thepreconceptioncarrierscreening),publichealth(e.g.ResearchonObesityandDiabetesamongAfricanMigrants),infection&immunity(e.g.meningitis),oncology(e.g.neuroblastomabioinformatics),gastroenterology&metabolism(e.g.theAMCbioartificialliver)andmovement&musculoskeletal(e.g.interdisciplinarytranslationalresearch)programmes.Thelattershortlistreflectsaselectionofillustrativeexamplesbutthereareothersthantheonesmentionedhere,indicatingthatthecontributionoftheAMCtosocietyisprofound.2.3ViabilityIncomparisontothepreviousevaluation,AMCfindsitselfatanimportantturningpointbecauseofthemergerwiththeVUmc.Toassesstheviability,theCommitteehasfocusedonthestrengthsandweaknessesoftheresearchgovernanceoftheAMCandconsideredthisaspectfromaninternationalperspective.ThisisofparticularrelevanceforthefuturealignmentofAMCandVUmcresearchlines.BelowtheCommitteepresentsitsconsiderationsforanumberofresearchgovernanceaspectsandaddressesthequestionsputforwardtotheCommitteebytheAMCBoard.1.Strategicresearchplanning-prioritiesTheAMC’sresearchpoliciesfocusonpeople(see2.),funding(see3.)andquality.Accordingtotheself-evaluationreport,strategicdecisionsaremadebytheExecutiveBoard,inparticularregardingtheappointmentofprofessors,majorresearchinvestments,andparticipationinnationalandinternationalinitiatives.Departmentheadsareresponsibleforcontentissues,suchasthedefinitionofnewandexistingresearchlinesandthenominationofcandidatesforPIappointmentsorprofessorships/associateprofessorships.TheResearchCouncilactsasanadvisorybody,butithasnoexecutivepower.Inordertostimulateinterdisciplinarycollaboration,theAMChasselectedbroadresearchthemesinwhichitaspirestoexcel.ThesethemesconstitutethebasisoftherecentestablishmentoftheallianceresearchinstitutesoftheAMCandVUmc.Thethemesdifferintheirdegreeofdevelopmentandorganization.SomeofthesestartedinJanuary2016,whereasotherswerelaunchedonlyveryrecently,i.e.inthecurrentyear2017.InthepreviousSEPevaluation(page17intheself-evaluationreport),oneoftherecommendationswastosetupstrategicplanningatathematiclevelandsupportjointprojectswithstrongresearchinstitutesintheregion.ThesubsequentactionsthathavebeentakeninthisregardhavebeenstimulatedgreatlybythealliancewiththeVUmc,andtheactualestablishmentofthenewallianceresearchinstitutes.Considerations:governanceofresearchdirections,profileandfocusUntilnow,theAMChasbenefittedfromitsdelegatedgovernanceprocesses:researchersaregenerallypositiveabouttheopportunitiesintheAMCandtheproductivityofresearchhasbeenverygoodinthelast6years.TheCommitteefeelsthatinacomprehensiveprocessasthemergerwiththeVUmc,morecentralgovernanceandsteeringisdesirableinordertoeffectivelyalignthemedevelopmentandresearchprioritydecisions.Inaddition,theCommitteeadvisesthatmanagement

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ofthestrategicoverview,cross-cuttingissues(suchascorefacilitiesandinterdisciplinaryresearch),anddeliberateprioritychoicesshouldbeforcefullyaddressedcentrally.TheResearchCouncilcouldplayaroleinthisprocessandoptimallysupportandenhancetheorganizationofcentralgovernancetasks.Atthethematiclevel,theCommitteewasimpressedbyvariouspositiveexamplesofjointAMCandVUmccollaboration.ResearchlinesusuallyseemtodevelopthroughabottomupprocessbycombiningexistingAMCandVUmcresearchlines.Thisisapositivedevelopmentbutinadditionanoverarchingdefinedresearchstrategycoupledtoanexplicitlystructuredgovernancemaybeuseful,particularlyatthistimeofupcomingsignificantchangesintheorganizationoftheAMC.AnincreasedfocusonthemostpromisingresearchlineswouldcontributetothefuturepositioningandprofilingoftheAMCresearchendeavour.Thiswouldenhancethevisibilityand(inter)nationalimpactoftheAMCanditscapacitytoattractexternaltalent.Theneedforenhancingandfocusingtheresearchorientationshouldbesupportedbyfinancialincentivestostrengthenthefurtherdirectionandoptimaldevelopmentofthemes.ItseemsappropriatethattheResearchCouncilandResearchSupporttakeupanactiveroleinsupportingthisprocessoffocusingonthemostpromisingresearchlines.TheCommitteeadvisestheAMCBoardtochargetheResearchCouncilwithaleadingroleinofferingadviceregardingtheframingandrestructuringoftheresearchpolicyandofgovernance.Inthiscontextsufficientfundsshouldbemadeavailableforimplementinghighprioritychanges.Thisisespeciallycrucialinviewoftheupcomingmerger/alliancebetweenAMCandVUmc.ThisprocessshouldobviouslybetunedwiththeAMC-VUmcallianceprocess.2.People/CareersThroughitsresearchpolicy,theAMCaimstostimulateexcellencebyputtingtheprofessionalinthelead.Baseduponpublicationoutput,fundingacquisitionandsupervisoractivities,thePrincipalInvestigator(PI)systemawardsresearchersandprovidesthemwiththeopportunitytocreatetheirowngroup,takeonleadershipandgainvisibility.DepartmentheadscannominateresearchersforaPIappointment,whichisaprerequisiteforpromotiontoassociateprofessor.FurthertalentpolicyincludestheannualAMC-fellowship(oneperyear)formid-careerlaureatesofprestigiousindividualgrants.Sincetheselaureatesareconsideredfutureleaders,theyaresupportedwithanextraPhDcandidateposition.OneoftheaimsofthePIsystemistokeeptalentintheAMCbyofferingthemtheoptiontodevelopintoanindependentresearcher.Currently302PI’shavebeenappointed,whereasintheoriginalplanaround200-220PI’swereforeseen.TheaveragePIscorehasincreasedfrom3.0(2011)to3.4(2017)outofamaximumscoreof5.PerformancebasedbudgetingfurthersupportsthePIsystem.Considerations:PIsystemTheCommitteeappreciatesthevalueofperformancebasedresearchbudgeting.Clearly,thelaunchofthePIsystemhasworkedasavaluabletooltostimulatetalent,althoughmanyresearchersexpressedconcernsaboutthefairnessandlackoftransparencyofthesystem.ThenumberofPI’sindicatesthattherearemanygoodresearchersattheAMC.However,whiletheaveragePIscoreisnow3.4,theCommitteealsoobservesalongtailoflowerscores.IncombinationwiththeincreasednumberofPI’s,andtheperformance-basedbudgetof€10,000perPI-pointthatmayinducedivision-

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levelincentivestonominatePI’s,theCommitteeconsidersthatinthefuturethissysteminitscurrentformwillnotbesustainableandserveasthebestmodeltostimulatehighqualityresearch.Itisalsounderstoodfromdiscussionswithindividualresearchers,thatthecriteriaofthePIscoresystemhaveremainedsubjectofanongoingbroaderdiscussion.TheCommitteelearnedthatpartofthePI’sfeelthatthevariabilityoftheposition,careerphase,andsciencefieldofPI’saffecttheirscores,e.g.betweencliniciansandnon-clinicians.ThePIscoreisnotuncommonlyperceivedtoencourageresearcherstofocusonthequantityofpublicationsratherthanonthequality.Moreover,thePIscoreseemstoenhancecompetitionbetweenPhDcandidatesandPI’sonauthorship,whenthePImayunfairlyclaimseniorauthorshipovermorejuniornon-PIstaff.This,astheCommitteenoted,isapotentialcauseofinappropriateincentiveandresentment,andcanadverselyinfluencecareerprogression.Overall,fromageneralperspectiveofresearchcareers,theCommitteenoticedlimitedattentionforcareerguidanceforpostdocs,andlimitedplanningformidcareerresearchers.Intermsofviabilityitisalsoessentialtobeabletoattractexternaltalent,whichonoccasionsseemeddifficult.Thus,theCommitteeendorsesthepolicyofsupportingtalentedresearchers,butitsuggeststhatthecurrentformatofthePIscoreasanincentivesystemshouldberevisedandtransformed.TheCommitteerecommendsthatthefundingshouldbereallocatedcompetitively.Ifindividualsareselectedonthebasisofmerit,budgetaryallocationshoulddirectlybenefitthem.Decisionstothisendshouldmoveawayfromdivisionsanddepartments,butinsteadalignwithstrategicresearchprioritiesoftheinstitutes.Thepoliciestoimplementalignmentandfundingofexcellenceshouldbeappliedatthecentralcorporatelevel.Inadditiontothis,theCommitteesuggeststorecognizeandrewardexcellencefordistinctcareerlevels(forinstance,PhD’s,postdocs,andjuniorfaculty)aswell.Thiscouldbeorganizedatthecentrallevel,andexecutedattheinstitutelevel.3.Funding/researchbudgetTheAMCincomingresearchbudgetconsistsofdirectgovernmentfunding(RijksbijdrageandAcademischeComponent)whichtotals~100M€(in2016);andacquisitionofexternalfunds(2nd,3rdand4thmoneystream),whichtotals~112M€(turnoverin2016).Theturnoveroftheexternallyacquiredfunding(includingNWOgrants,ECfundingandcharityfunding)hasprogressivelyincreasedeachyearfrom2011whenitwas76M€.Theyearlyacquisitionshowssomevariation,showingahighsuccessratein2012comparedtolateryears.Thefundingofresearchfromgovernmentfundsislargelyintegratedinthebudgetsofdivisions,whichisgrantedasanannuallumpsumtothedivisions,anditisnotearmarkedaccordingtocoretasks(education,clinicalcareandresearch).Onlypartofthebudgetisallocatedspecificallytoresearchandisconnectedtooutput.Thetotaldirectfundingforresearchis28.8M€andisusedforPI’s,PhD’s,ResearchSupportandCorefacilities,aswellasabudgetof2M€fortheAllianceInstitutes(0.25M€pertheme).Thismodel,wherebudgetallocationislargelyindependentofprioritiesandexcellenceistypicalformostDutchUMC’s.ConsiderationsTheCommitteenotesthattheconsequenceoftheaforementionedtypeofbudgetingisthatadirectlinkislackingbetweenfundingandscientificleadership,researchexcellenceorresearchstrategy.Therearecurrentlylimitedopportunitiesfordirectsteering.However,withintheselimitations,choicescanbemadethatrelatetoinvestmentingeneralorthematicstrategicpriorities,including

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corefacilitiesande.g.interdisciplinaryresearch.Oneoftheaspectsthatregularlyemergedasproblematicduringthesite-visitisthelackofprotectedresearchtimeofclinicians.Thishasmanyimplicationsincludingstressandpotentialbiasagainstresearcherswithyoungchildrenwhohavelimitedtimeoutsideworkinghours.TheNeurosciencetheme(see3.4)hasdevelopedastrategytothisendthatcouldserveasanattractiveprototypeexampletobeconsideredforbroaderapplicationintheAMC.4.ThefutureTheCommitteecongratulatestheAMCandVUmcwiththeachievementofthemerger,appreciatingthatitisachallengingprocessandrequiresaproactiveattitudealongtheway.Themergerduetotheenhanced“criticalmass”andthepotentialforsynergywillcreatenumerousopportunitiesforstrengtheningtheresearchportfolioandperformance.TheCommitteewaschargedonlywiththeunilateralAMCassessmentinthecurrentprocedure.WhiletheemergingbilateralrelationshipbetweenAMCandVUmcpresenteditselfasanobviousandrecurrentiteminthecurrentAMCresearchevaluationprocess,theCommitteewasunablenorrequestedtosystematicallyanalyzetheeffectsoftheupcomingallianceasitwasonlyprovidedwithdocumentationabouttheAMC-relatedresearchinthe2011-2016period.TheCommittee,however,considersthemergerasauniqueopportunityandanecessitytodevelopacommonandfocusedresearchstrategyintheAMC.RevisinganewlyupdatedandfocusedoverarchingresearchmissionandstrategywillbetimelyinthecontextoftheAMC-VUmcmerger.Inordertoreachthegoalsofthemerger,itwillalsobecrucialtomitigatetherisksandpotentialnegativesideeffects.ThatiswhytheCommitteeisrecommendinginparticularmoredirectcentralresearchgovernanceintheAMC.Themergerprocessrepresentsahugelydemandingeffortthatultimatelyinvolvesthemajorityofthescientificstaffformultipleyears.Itwillwithdrawtimeandattentionofresearchersfromtheircoreactivities.Thisneedstobemanageddeliberatelyinordertopreventadeclineinresearchperformanceduringtheyearsofimplementationofthemerger.

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3.AMCthemes,GraduateschoolandCorefacilitiesInthischapter,theCommitteedescribesandassessestheStrengths,Weaknesses,OpportunitiesandThreatsoftheAMCthemesfromaninternationalperspective.3.1CardiovasculardiseasesTheAMCCardiovascularthemehassince2016beenpartoftheAmsterdamCardiovascularSciences(ACS).ThisAMC/VUmcmergerinstitutefocusesonfivethemes:Heartfailureandarrhythmia;pulmonaryhypertensionandthrombosis;atherosclerosisandischemicsyndromes;diabetesandmetabolism;andamicrocirculationresearchcluster.Itsmissionistodesignknowledge-basedtreatmentstrategiestopreventandcurecardiovasculardisease.TheAMCcardiovascularresearchthemeissubstantialinsize,coveringmanydepartments.Thecardiovascularresearchismainlytranslationalinnaturewithastrongclinicalfocus(twothirdsofthePI’sareMD’sandonethirdisnon-MD).TheCommitteerecognizesareasofstrengthsinarrhythmia,heartfailure,lipidologyandcoagulation,vascularmedicineandcongenitalheartdiseases.Theinvestigatorshaveparticipatedinvariousinfluentialclinicaltrials.ResearchongeneticsofarrhythmiashasplacedtheAMCintooneoftheleadingcentersworldwideanditsphenotypic-genotypicapproachtounravelthegeneticbackgroundofrarebutalsomorecommonarrhythmiashasbeenadoptedbyothercenters.Someoftheresultsofthesetrialshavehadanapparentimpactonclinicalpractice.Asanexample,theMrCLEANtrialwhichwashighlightedduringthesite-visit,hasimpactedtheperceptionofstandardqualitycareworld-wide.TheCommitteenotesthatthesameworkisreportedasoneofthekeyachievementsinNeuroscienceaswell.Theclinicalresearchbuildsuponinternationalleadinggeneticsresearch,registries,biobanksandresearchfacilitiesininducedpluripotentstemcells(iPS).Publicationoutputissubstantial.Thegroupshaveattractedconsiderablelevelsofexternalfunding,bothfromprivateandpublicsources.AlargepartoftheacquiredpublicfundingischaracterizedbygrantsattractedbyindividualresearchersatdifferentlevelsofsenioritysuchasgrantsfromtheDutchNWO(Veni/Vidi/Vici)andERCgrantingsystem.ImpressiveistheleadingroleofthearrhythmiathemeinfourhighlyesteemedTransatlanticLeducqPartnerships,eachlastingforafive-yearperiod,assemblingprominentresearchersincardio-vascularmedicine.Whileallthesescientificactivitieshaveshownpositivedevelopments,itisatthesametimecleartotheCommitteethatACSmaybenefitfromagreaterfocusoftheoverallstrategyoftheentireresearchprogram.TheAMCandVUmcthemesintheACSarealignedtoincludealmostallexistinglines.TheCommitteewouldencouragetofurtherfocusresearcheffortsduringthetransitionperiod,andadditionallyinparticularpinpointanoverarchingprofileandstrategy.TheCommitteerecognizesthattheretirementofsomeoftheestablishedseniorleadersisimminentwhichwillposeachallengeforthefuture,especiallyinviewofthetransitionandoverallstrategy.Itmaybechallengingtomaintainthelegacyoftheseseniorresearchers.TheCommitteeacknowledgesthefactthatthesustainabilityofthecardiovascularresearchlinessignificantlydependsoncorefacilitiesandresearchinfrastructureatlarge,whichneedfurtherattention(seecorefacilities).Inthemerger,theVUmccardiologywillmovetotheAMC,bringingcardiovascularresearchandclinicalcaretogetherinonebuildingandstrengtheningthecriticalmassofbasic,translationalandclinicalresearchevenfurther.AMCresearchersaregenerallypositiveaboutthebenefitsofthemergerforresearch.WhiletheimagingfacilitiesremainattheVUmc

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location,someAMCresearchersexpresstheneedforaClinicalResearchUnit(CRU)toconduct,forinstance,in-housephase1and2investigatorinitiatedclinicalstudies.Inaddition,researchinfrastructureforbigdata,datamanagementandcouplingofelectronicpatientdata,tobiobankmaterialandclinicalresearchrequirescontinuoussupportandstaff.AccordingtotheCommittee,theplanningoftheorganisationofthesedevelopmentsshouldpreferablybepartofanoverallstrategyforthecorefacilitiesandamorefocusedcardiovascularprofileandpromisingresearchpriorities.Inthediscussionwiththerepresentativesofthecardiovasculartheme,theCommitteespecificallyaddressedthetopicofcareerdevelopment.Astrongcareerdevelopmentpolicywillbecriticalforthefuture.Withregardtocareerdevelopment,thecurrentsystemdoesnot(yet)providesufficienttoolstoattracttalentsfromabroad.ThePIsystemdoesn’tofferextrabudgetsforindividuals,andthemid-careeroptions(post-doc,juniorfaculty)withintheAMCcouldbeimproved,withextraincentivesfornon-MDPI’s.Atthesametime,PI’sfinditdifficulttoprotecttheirresearchtimefromotherdemandingtasksincludingclinicalduties.Theindividualizedsystemoffersgrantsforcollaborativeprojectstosupportsynergy,butingeneralthesteeringofresearchbudgetsdoesnotfollowthemostsuccessfulresearchprioritiesandopportunities.TheCommitteesuggeststhatPI’sstartworkingtogetheroncross-cuttingtopicsaroundsharedinfrastructure,combiningbasicandclinicalscienceinordertogoforgoodscience3.2GastrointestinalDiseasesandMetabolicDisordersTheAmsterdamInstituteforGastroenterology&MetabolicHealth(AG&M)unitestheresearchof65PIsattheAMCand28PIsattheVUmcpositionedattheintersectionofnutrition,microbiology,digestion,endocrinologyandmetabolism.ThemissionoftheAG&Mresearchinstituteistoperformresearchonhealthynutritionandmetabolism,preventorcuregastrointestinalandinheritedandacquiredmetabolicdiseaseandimprovethewellbeingofpatients.AG&Misorganizedin4differentresearchprogram:1)Regenerationandcancerofthedigestivesystem,2)digestiveimmunity,3)endocrinology,metabolismandnutrition,and4)inbornerrorsofmetabolism.AG&Msharesmultiplecommonalitiesandongoingcollaborationswiththeotherresearchthemes,inparticularcardiovascularsciences,oncology,infectionandimmunity,andreproductionanddevelopment.AG&Mcoversthecompleteresearch&developmenttrack,fromfundamentaltoclinicalresearch.AG&MincludesseveralexcellentPIsandresearchcenters(e.g.theworkattheTytgatcenter,whichwasselectedforpresentationduringthesite-visit).TheCommitteerecognizestheAG&IMpublicationquantity,althoughtheCommitteealsofeltthatpaperswithhigherscientificorclinicalimpactcouldhavebeenselectedfortheself-evaluationreport.Thescientifichighlightsthatwerepresentedatthesite-visitwerequiteofinterest,butthepresentationsalsosuggestedparticularstrategyweaknessesintheinstituteandintheAMCasawhole.Oneobservationisthatthereiscomparativelylittlefocusandcoherencemarkingthespecificresearchprofileoftheinstitute.Theresearchactivitiescoveratrulywiderangeofcollectedheterogeneousactivities.Inordertomeetthecharacteristicsofatrueinstituteratherthananetwork,theinstitutewouldneedtotakeanactiveleadindefiningaclearstrategyandfocus.ForthistheinstitutewillneedclearinsightsintothebudgettobeprovidedbytheAMCBoard.

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WithinAG&M,facilitiesareavailableforwholegenomesequencing,tandemmassspectrometryandmetabolomics.Eventhoughtheygeneratehigh-qualitydata,itisquestionablewhetherintheircurrentpositioningtheycanperformatacompetitivestate-of-theartlevelandbeabletosustainaninternationallyprominenttechnologicalinfrastructure.TheCommitteesuggeststofocusonthemostpromisingresearchlinesandassociatedinfrastructure,whichshouldthenbecomeeligibleforcentralfundingsupporttobeabletogrowintoaninternationallyleadingfacility.TheCommitteealsonoticedthatthelogisticandexpertisesupportofinvestigator-initiatedtrialsisinadequate,whichasamatteroffactappearsabroaderissuealsoinotherthemesintheAMC,whichiscomprehensivelyandmorespecificallyaddressedin3.10.StrengthofAG&Misthattheyinvestintalentedresearchersbyfundingprogramsforgoingabroadandforpostdocs.Thefundamentalresearchersandclinicalexpertscloselycollaborateinmultipleprojects,whichresultinresearchlineswithsocietalimpact.Forinstance,thecolorectalcancersurveillanceprogram(whichisanationalprogramme)ishighlyrelevantforsociety.ThePhDstudentindividualplanseemsquiteeffective,asistheconceptofselectingabuddyforyoungresearchersinordertomentorthemduringgrantapplications.AlthoughAG&MhasbeenactiveinstimulatingAMCandVUmcalignment(Annualretreat,PhDretreat,jointlecturesandsymposia),themergerofAMCwithVUmcwillhaveprofoundconsequencesforgastroenterologyandmetabolismresearch.Itwillbeamajorchallengetodefineajointresearchstrategy,toobtainsufficientcoherenceandtosetafocusforparticularresearchlines,mainlybecauseofthelargeleveloffragmentationwithintheinstitute.AnotherconcernoftheCommitteeisthatthegastroenterologypartwillmovetoVUmcandthemetabolismpartwillstayintheAMC.ItisimportanttoreiteratethattheCommitteerecognizedthevalueofindividualresearchersandtheirgroupsandtheconsistencyofperformanceofsomeoftheAG&Mgroupsoverthelastdecade.TheCommittee,however,wouldalsoliketocommendtheopenattitudeoftheleadershipinthediscussionsaboutthecurrentpositionandfutureoftheinstitute.Attheonsetofthemeetingwithseniorgroupleaders,theCommitteeaskedthequestion:‘’DoesthisThememakecompellingintellectualsenseordoyoufeelthatitismoreofanadministrativeexercisetolumptogetherquiteheterogeneousscientificgroups?’’TothecreditoftheAMCcolleagueswhowereveryfrankintheirresponseduringthemeeting,therewasanoverwhelmingvoteinfavorofthesecondsuggestioninspiteofthestillearlystageofdevelopmentofthisinstitutethatonlystartedin2017.IndependentofscientificqualityoftheAG&Mtheme,theexpertisecouldbereallocatedandreorganizedinviewofthegeographicalconditionsthatwillphysicallyseparatecomponentsofthetheme.Suchareconsiderationmayalsobeintheinterestofacohesivestrategybetweenthevariousparts,andtheappealingopportunitiestomergewithotherstrongAMCthemesintheinterestoftheresearchstrategy.Actually,theCommitteerecommendstheAMCleadershiptoreconsiderwhethertheAG&Mthemeinitscurrentformshouldbecontinuedorratherberepositioned.AbetterpositioningoftheexistinggroupsneedstobeexploredindiscussionwithDepartmentHeadsandtheotherthemeleaders.Forexample,theGastroenterologyoncologycouldbeintegratedintoOncology(CCA),thegroupsfocusingonmucosalimmunityandtheinflammatoryboweldiseaseresearchlinecouldfindahomeinAI&I;diabetesresearchcouldbeembeddedinthecardiovascularsciencesinstituteandtheinborn

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errorsofmetabolismresearchtotheReproduction&Developmenttheme.However,intheeventthatitisdecidedtokeepAG&Masaresearchinstitute,itwillbeessentialforitsviabilitythattheytakeupmoreactivedecisivepowerandauthoritytoalignAMCandVUmcresearchers,outlineaclearresearchstrategy&focusandmanageadedicatedresearchbudgetinaccordancewithandinsupportoftheoutlinedscientificAG&Mstrategy.3.3InfectionandImmunityTheresearchoftheinfectionandimmunitythemeoftheAMCandtheVUmcformallymergedsinceJanuary2017andcomprisesoneofthelargestallianceinstitutes:theAmsterdamInfection&Immunity(AI&I)Institute.Threeprogramsweredefined,namelyInflammatorydiseases,InfectiousdiseasesandCancerImmunology.ThemissionoftheAmsterdamInfection&ImmunityInstituteistodevelopknowledgeandexpertisefordecipheringmicrobiologicalandimmunologicalprinciplesanddesigninnovativetherapiestopreventortreatinfectiousdiseases,inflammatorydiseasesandcancer.Inordertoachievethis,AI&Iaimstoperformhigh-levelmultidisciplinaryfundamental,preclinicalandclinicalresearch,therebycoveringthecompleteresearch&developmenttrack.Sincetheinstituteisnotbasedonaparticulardisease,butratheronsharedunderlyingprinciples,AI&Ihasmultipleinteractionswithintheirthemesandlinkswithotherinstitutes,inparticulartheGastroenterology&MetabolismandtheOncologytheme.TheCommitteewaspleasedtoseeanenthusiasticgroupofambitiousresearchersandseveralresearchgroupswithagoodcriticalmassinbothinfectiousdiseasesandimmunology.Basedontheself-evaluationreportandthepresentedscientifichighlightsoftheworkonstemcelltransplantation,cancerimmunotherapy,HIVvaccinedevelopmentandHIVtransmissionelimination,theopinionoftheCommitteeisthatinfectionandimmunologyresearchrepresentsawell-developedresearchareaintheAMC.ThejointExperimentalImmunologygroupwithSanquinisanexampleoftheproductivecollaborationsthatareongoinginAMCinfectionandimmunologyresearch.TheresearchthemeswithinAI&Iaregenerallyoftranslationalandtransdisciplinarynature.Inordertobecomeanevenstrongerresearchinstitute,fragmentationshouldbereducedandtransversalthemesfurtherdeveloped,includingthosedealingwithneurologicalandpsychiatricdisorders.Forthatpurpose,acentralresearchstrategyshouldbedefined,whichrequiresaneffectivesteeringinstrumentandmoredirectivepowerwithintheresearchinstitute.Thisshouldalsodealwithearmarkedresearchbudgetsanddedicatedresearchtimeforclinicalexperts.Inadditionthismayleadtoagreatervisibilityofthemajorresearchlinestotheoutsideworld.Althoughthereissufficientawarenessoftheimportanceoftalentdevelopment,theavailablebudgettotrulysupporttalentinthedevelopmentoftheirresearchlineislimited.ThesameholdstrueforattractingtalentedPhDstudentsandPostdocsfromelsewhereintheNetherlandsandabroad.TheCommitteerecognizesthestrongimpactoftheInfectionandImmunitythemeonnationalandinternationalguidelinesforinfectiousdiseases,inflammatorydiseasesandcancer.Withinthetheme,thereisanevidentlinktobiotechnology.Furthermore,multiplecollaborationswithindustry,patientorganizationsandotherstakeholdersareongoing,whichcontributestosocietalimpact.Asregardstherecentmerger,theAMCandVUmcAI&Iarealreadywellalignedasaresultofeffortssuchasakick-offmeetingandaPhDretreat,butalsocommontalentdevelopmentandgrantprograms.ThelattermightbemoretargetedtowardsjointinitiativesofAMCandVUmcinthefuture.Inaddition,AI&Ialreadydevelopedcommonresearchthemes.AnopportunityforAMCisto

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profitfromthetumorimmunologygroupoftheVUmc.InordertostimulatemorecollaborationbetweenAMCandVUmcresearchers,theCommitteerecommendsdevelopingincentivesforthestartofjointresearchinitiatives.Corefacilitiessuchasclinicaltrialsupportandtheanimalfacilityrequiregreaterspecificattentionandearmarkedbudgets,becausetheyareessentialforthedevelopmentandmaintenanceofexcellentresearchlines.3.4NeurosciencesTheAMCNeurosciencethememergedwiththeVUmcNeurosciencein2016toformtheAmsterdamNeurosciencesInstitute(ANI).Inthisinstitute,researchisorganizedinamatrixcombiningfivedisease-orientatedprogrammes(neurodegeneration;neuroinfectionandneuroinflammation;neurovasculardisorders;compulsivity,impulsivityandattention;mood,anxietyandpsychosis)withfourmechanisticandtechnologyprogrammes(brainmechanisms,complextraitgenetics;neurotechnology;brainimaging).TheAMCthemeaimstoconductinternationallyrecognisedresearchinparallelwithcompassionateandinnovativepatientcareofthehighestquality.ManyPhDstudentswithintheinstitutefollowacombinedtrackofaPhDandmedicalspecialisttraining.Themedicalspecialisttrainingallows1yearofresearchtime.PhDcandidatesattendgraduateschoolcourses,organiseandattendregulareventsorseminars,butneurologyandpsychiatryaremostlynottogether.TheCommitteewasimpressedtoseethealreadyadvanceddevelopmentofthestructureofthemergedinstituteandtheroleitcouldserveasaparadigmforotheremergingAMC/VUmcinstitutes.Thestrategicthinkingwasinplacealreadyattwoyearspriortothemerger,andthishasresultedinathoughtfulapproachthatisbackedupbyup-to-datedataonstaff,budgetandoutputacrossthematrix.Thematictopicsarebaseduponstrongareasorresearch.Thegovernanceisinplace,withalignmentofthebudgetandpositions.Clearly,theinstituteleadersshareavisionaboutwheretheyaregoing.PartoftheAMCprogramsisworldleadinganditshowsthatdeliberatecoordinatedplanningpaysoff,asforinstanceisevidentfromalargenumberofjointpublicationsandfromclinicalcareadvancesatthesametime.TheCommitteenotedthatclinicianshaveprotectedresearchtime:60%isrequiredforclinicalpracticeandtheremainingpartisnegotiable,butoftenresultsin30%researchtime.TheseexperiencesmayserveasaprototypeexampleforotherdepartmentsthroughoutAMC.Whiletheclinicalcohortsandrandomisedclinicaltrialswithastrongtranslationallinktobasicscienceareamajorasset,theinadequacyofsomecorefacilitiesconstitutesaseriousproblemalsoforthistheme.Inparticular,therehavebeenproblemswiththeanimalhousingfacility,e.g.inrelationtoresearchwithrodentmodels.Asaresultoftheclosingdownoftheanimalcorefacility(ARIA),experimentalresearchhasbeencriticallyhampered.Withregardtothematrixstructure,thecurrentstrategymightbefurtherdevelopedtoincludebigdataapproaches,especiallythosearoundbehaviouralandmultimodaldata,bioinformaticsandmachine/deeplearning.TheCommitteebelievesthattherearepromisingopportunitieswithinthisareathatdeservetobeexploited,butthiswouldrequirepartnershipwithothergroups.Bymakingexplicitresearchchoicesratherthantryingtocovereverything,afocused,high-impactapproachhasbeencreated.TheCommitteestronglyendorsestheNeurosciencesInstitutetoproceedwithimplementingtheirstipulatedroadmap.Theirapproachshouldcontinuetoleave

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flexibilityandspacefornewdirections.TheCommitteesupportstheAmsterdamNeurosciencesInstitutestrategytowardsmoreintegrationwiththelocalexpertiseinotherinstitutesintheAmsterdamareanearAMC.Inparticular,theANItheaimstofurtherorganisecollaborationbyintegratingwiththeNetherlandsInstituteforNeuroscience(KNAW-NIN),SpinozaCentreforNeuroimaging,andtheUvA’sAmsterdamBrain&Cognition(ABC).TheCommitteeencouragestheseinitiatives.

3.5OncologyInJanuary2016,theoncologyresearchoftheAMCandVUmcmergedtoformtheCancerCenterAmsterdam(CCA),whichhasbeenorganizedin3programs:Cancerbiology&Immunology,Imaging&BiomarkersandTreatment&QualityofLife.TheCCAmissionistoimprovetreatment,lifeexpectancyandqualityoflifeforpatientswithcancerandtoreducetheimpactofcanceronhealthcareandsociety.Withintheinstitute,multidisciplinaryresearchisbeingperformed,rangingfromfundamentaltotranslationalandclinicalresearch.Forseveralcancertypes,theCCAiscoveringthecompleteresearchanddevelopmenttrack.Moreover,AMConcologicalresearchisconnectedtootherthemesoftheAMC,inparticulartotheImmunology,GastroenterologyandPublichealththemes.TheCommitteevaluedthescientifichighlightsthatwerepresentedduringthesite-visitandintheself-evaluationreport.Duringthesite-visit,productiveresearchlineswerepresentedoncolorectalcancerandlymphoma,whiletheCommitteeinadditiongreatlyappreciatedtheoncogenomicsplatform.However,duringthesite-visittheCommitteealsoobservedahighleveloffragmentation,indicatedbythefactthattheoncologyresearchwithintheAMCisacollectiveeffortofnolessthan62PIsfrom27departments.Inordertostimulatetheexcellenceofoncologyresearch,theCommitteefeelsthattheCCAshouldstrategicallydefinethemostexcellentresearchlinesandcross-cuttingthemes,whichshouldresultinthefocusonalimitednumberofresearchtopics/programsbybuildingcriticalmassandreallocationofbudgets.However,inthecurrentsituation,CCAlackstheauthoritytobeabletodefineandimplementaclearstrategyandtoreallocatebudgets.AnopportunityofferedbythemergeristotakeadvantageofthestrongimmunologygroupoftheVUmc,togetherwiththeexcellentimmunologyongoingwithintheinfectionandimmunologythemeoftheAMCitself.WiththeexceptionofLYMMCARE,intheOncologyThemesurprisinglylittlementionwasmadeofcellularorantibody-basedimmunotherapyatthistimeofbreak-throughinnovationincancerimmunologytherapeutics.TheCommitteewaspleasedtoseethatresearchersoftheoncologythemearesuccessfulinobtainingexternalfunding,includingseveralpersonalgrantsfromtheEuropeanResearchCouncil,theNWOVernieuwingsimpulsandtheDutchCancerSociety,butalsomultiple(inter)nationalcollaborativeprojectshavereceivedfunding.TheCommitteerecognizesthestrongsocietalrelevanceoftheoncologyresearchwithinthetheme,whichisindicatedbyitsfocusontranslationalresearch,butalsobyahighnumberofpublic-privatepartnerships.LYMMCAREisanexampleofamultidisciplinaryresearchgroupthatactivelycollaborateswithstakeholderslikeclinic,industryandpatientorganizationstofacilitaterapidimplementationoftheirfindings,resultinginhighsocietalrelevance.

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AlthoughtheAllianceinstituteCCAformallystartedinJanuary2016,theresearchinstitutehasalreadymadesignificanteffortstoaligntheinstitutes,forexamplebytheorganizationofacommonkick-offmeetingforalmost400researchersfromAMCandVUmc.TheimpressionoftheCommitteeisthatplanningandorganizingthemergerdemandsubstantialeffortsandtimeinvestmentsofmanypeople,whichshouldnotreducescientificperformanceandoutput.Inthefuture,alloncologyresearchandclinicalcarewilltransfertotheVUmclocation.However,beforetheactualtransfer,collaborationbetweenresearchersfromAMCandVUmclocationshouldbestimulatedtoovercomethephysicaldistance.Currently,fundsarebeingraisedtouniteallpreclinicalCCAresearchersfromAMCandVUmcinonebuilding.TheCommitteerecommendstomaximallyreducingthephysicaldistancebetweenpreclinicalresearchersandclinicalexpertsinordertostimulatetranslationalresearch.Toovercomethepotentialbarriertothedevelopmentofcross-cuttingthemesandmultidisciplinaryresearchbecauseofdifferentlocationsofresearchinstitutes,thecollaborationwithinandbetweenresearchinstitutesshouldbeactivelypromotedviaincentivesforjointgrants.ThePhDstudentsoftheoncologythemearegenerallypleasedwiththelevelofsupervisionbytheirsupervisor,althoughthereisvariability,asitseemsthatthisverymuchdependsontheindividualsupervisor.IntheopinionofPhDstudents,thegraduateschoolcouldimprovetheirvisibility.Regardingthemerger,thePhDstudentsfeelthatthecommunicationregardingjointeventscouldbemoreeffective.

3.6PublicHealthandEpidemiologyThetheme‘PublicHealthandEpidemiology’investigatesthehealthandwell-beingofboththegeneralandtheworkingpopulation,thequalityandeffectivenessoftheorganizationofhealthcare,thecourseofchronicphysicalandmentalhealthproblemsinpatients,andtheresultsofinterventions.TogetherwiththeVUmc,aprojectplanoftheAmsterdamPublicHealthresearchinstitutehasbeenestablished.Themissionofthisinstituteistoconducthighqualityresearchtoimprovepeople’shealth,reducehealthinequalities,transformhealthcareandempowerpeople.IntheopinionoftheCommitteethisprojectplanisclearandwelldefined.TheCommitteealsovaluesthemanagementstructuredescribedintheprojectplanwiththeexistenceofascientificqualityCommittee,aPhDCommitteeandtwoadvisoryboards(bothinternalandexternal).AfterimplementationoftheclosecollaborationwithVUmc,theresearchthemeconsistsofeightresearchprograms.AccordingtotheCommitteethisdivisionintoeightprogrammesmakessense,becauseofthesizeoftheresearchgroup.TheCommitteewaspleasedtonoticethattheAMCandVUmcpartstogetherhaveredefinedresearchprogramsthatarerelevantanduptodate.IntheopinionoftheCommittee,thecollaborationwithVUmccreatescriticalmassineachresearchprogramme(thesmallestprogrammeconsistsof100-120researchers)toenableanimportantroleinthepublichealthfield.Althoughtheresearchstrategyofthe‘PublicHealthandEpidemiologytheme’seemstoprovideasolidbasisforsuccessfulimplementationandcollaboration,ithasyettofullysaturatetheentirebodyofresearchersatalllevels.Forinstance,duringthesite-visit,theCommitteenotedthatthePhDstudentswerealmostunawareoftheexistenceoftheresearchtheme.Theymuchmoreidentifiedthemselveswiththedepartments.TheCommitteewasimpressedbythequalityoftheresearchassummarizedintheself-evaluationreportandvaluedthesocietalimpactoftheworkthatwaspresentedduringthesite-visit.Initsopinion,thethemeisfocusingonimportantgeneralhealthissueswithanactivetranslationof

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findingstopolicy.Partofthetheme’sresearchisbasedonseverallargelongitudinalcohortstudies.TheCommitteenoticedthatthemaintenanceoftheinfrastructureofthesecohorts,whicharealsoutilizedforresearchprojectsbyotherdepartmentsandthemes,isnotsecured,butlargelydependsonexternalfunding,whichplacestheircontinuanceatrisk.Becauseofthescientificvalueofthesecohorts,alsoforotherresearchAMCresearchthemes,theCommitteeadvisestocreatemoresustainabilitythroughcentralfunding.Duetobudgetcutsinthelastfewyears,manyjuniorfacultyontemporaryfundingleft.ThismakesitdifficulttomentorPhDstudents.Thethemewouldbenefitfromhavingastrongertalentpolicyandgoodmentoringsystem.AnotherconcernoftheCommitteeisthatthePIsystemdoesnotseemtoworkverywellforthisgroup,duetothelowerimpactofleadingjournalsinthistheme.3.7ReproductionandDevelopmentTheresearchthemeReproduction&Developmentaimstoimprovehealthbyperforminggroundbreakingpreclinicalandclinicalresearch.Theoverarchingconceptoftheresearchofthisthemeisthecircleoflife.TheCommitteenotedthatthethemebenefitsfromstrongleadership,organisationandcommendablevisionandthatconsiderableprogresshadbeenmadeincreatingaprogrammeofworkwiththeVUmc.TheCommitteevaluesthecollaborationwithotherthemesforinstanceinthefieldofclinicalgeneticsandpublichealth.Itwaspleasedtohearthatthethemeaimstobeinclusiveindefiningtheresearchstrategy.However,intheopinionoftheCommitteeitisimportantnottospreadouttoobroadlyanddiversely.Inthenearfuture,thethemeshouldconsidertofurtherworktowardsadetailedresearchstrategyfocusingontheexistingstrengthsoftheresearchprogramme,whilstrecognizinglinksbetweenthedifferentresearchtopicsofthethemeandcrossthematicinterconnections.ConnectingwiththegroupinMetabolismstudyingtheinbornerrorsofmetabolismisrecommended,withthepossibilitythattheacademicstrategyandgeographicallocationofthatgroupmightfitmoreappropriatelyintoReproductionandDevelopmentthaninGastroenterologyandMetabolism.Thealignmentliesinthesharedinterestingeneticsparticularlyinscreeningforgeneticdisorders.TheCommitteewaspositivelyimpressedbythequalityoftheresearchinthisthemeandtheproventranslationalandsocietalcapacity.WhilstlinkswithPublicHealtharestrong,considerationshouldbegiventothebestfitofPIswhomightbebetterplaced100%inthistheme.ThecommitteeconsideredthattheresearchgroupisleadinginobstetricsresearchintheNetherlands.TheCommitteevaluestheinternationallyrecognizedsuccessesofthetrialfacilityoftheNederlandseVerenigingvoorObstetrieenGynaecologie(NVOG)consortium,whichisledbythisgroup.However,withoutacentraltrialfacilityattheAMCprovidingoversightandinfrastructuralsupportfortrialsacrosstheAMC,theNVOGconsortiumtrialunitisisolatedandpotentiallyvulnerabletoriskwithregardtoprovidingadequatesupportofmanagement,trialdesign,statisticalsupportandotheraspectsoftrialplanningandtrialmanagement.ThisoversightshouldbeprovidedbyacoreClinicalTrialsUnitfacilityasitisinmostEuropeanuniversities.TheCommitteeagreeswiththethemeleadersthatatpresentthereisalackofbasicscienceinreproductivehealthandthatmorefocusisneeded.Thelaboratorybasedsciencespresentedshowedconsiderablebutisolatedstrengths,andcapacityforexpansion.ThelackofcorefacilitiesintheAMC

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(forgeneralcommentsseefurtherunder3.10)isanimpedimentforthisthemeaswell.Thisalsoconcernstheproblemswhichhavebeenincurredinrelationtotheanimalfacilities.SharedlaboratoryfacilitieswithVUmcshouldbeconsideredastheywouldbringtogethertheexistingbasicscienceandstrengthenthelaboratoryinfrastructure.Atwhichsitetheselaboratoriesshouldbelocatedshoulddependontheavailabilityofcorefacilitiestosupporttheresearch.TheCommitteealsosuggeststhatmorebasicresearchbeundertakeninassociationwiththeclinicaltrialsunit,forinstanceinthedevelopmentofbiobanksforstorageofhumantissuespecimens.CurrentleveloffundingwithintheNVOGmodelhasinsufficientlyenabledthis,leadingtoamajormissedopportunityandreducinginternationalcompetitiveness.Newfundingopportunitiesshouldbeexplored.IntheopinionoftheCommittee,societalrelevanceisexcellentinthistheme.TheCommitteewaspleasedtohearthattranslationalimpactofresearchresultsisanimportanttopicofdiscussion.TheCommitteeencouragesthethemeleaderstofurtherexpandtheimplementationoftrialresultsandconsiderinvestmentinimplementationscience.Beingsmallmakesthethemevulnerable.ThesharedthematicdevelopmentwithVUmcishamperedbythelackofadministrativesupport,whichisimportantatthisdevelopmentalstage.TheunitednesswithVUmcisalreadystrengtheningthetheme’scapacitytoattractresearchscientistsandexternalfundingbutthiswouldbeoptimisedwithadministrativehelp.Duringthesite-visit,itstrucktheCommitteethattherewasinsufficientawarenessamongstthethemeleadersofthetheme’sfinancialsituation,andtheCommitteewasreceptivetothestatedneedforfinancialtransparencyinthedivisions,especiallytheallocationoffundsforresearchstaff.Researchersappearedtohavenodataontheresearchfundingwithintheirdivision.TheCommitteealsorecognizedconsiderabledissatisfactionwiththecurrentPIincentivescheme.TheCommitteerecommendstoincorporateafundingplanintheresearchstrategy.IntheopinionoftheCommittee,adifferentandmoretransparentfinancialstructurewouldhelpthisvibranttheme.3.8MovementandMusculoskeletaldisordersTheresearchtheme‘Movementandmusculoskeletalmedicine’wasfoundedinJanuary2017.Althoughthethemejuststarted,itcanbuildupontheexistingVUmcresearchinstitute.AMC,VUmcandFreeUniversity(VU)togetherdevelopedaninstituteplan‘AmsterdamMovementSciences’,inwhichtheplansofthecomingperiodaredescribed.Theaimoftheinstituteisbecomingworldleadinginthefieldofinterdisciplinarytranslationalresearchonhumanmovementandphysicalperformance,andtodisseminateitsresultstoend-userssothatsocietybenefitsoptimallyfromtheresearchresults.TheCommitteehasspokentoanenthusiasticgroupofresearchers,whoallconsideredthealliancewithVUmcasanopportunityforthefieldofmovementsciences.Withtheestablishmentofthistheme,theyfeelthattheycanadvanceresearchinthistopicandbecomemorevisibleintheAMCandabroad.Intheself-evaluationreportandduringthesite-visit,theCommitteehasseensomegoodexamplesofhighqualityresearch,whichisalsorelevantforpracticalapplication.Someoftheresearchhasalong-standingbackground.TheCommitteewaspositivelysurprisedtoseehowwelltheallianceoftheresearchgroupsofAMCandVUmchasprogressed.Itnoticedthatrecentlygainedfundingis

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mostlyforjointprojects.TheCommitteealsovaluesthenumberofcollaborationswithotherpartners,suchastheTUDelftandTUEindhoven.AlthoughtheCommitteeispositiveabouttheresearchplans,italsoidentifiedpotentialthreatstothelong-termsustainabilityofthetheme.IntheopinionoftheCommittee,thethemeisvulnerable,becauseitisledbyasmallnumberofresearchers.Inaddition,thePIsystemdoesn’tworkwellforthistheme,becauseoftherelativelyyoungresearcherswithlowpublicationimpactandtherelativelylowpublicationimpactofthefieldincomparisontomainstreamareas.ThethemeisthereforelargelydependentonexternalfundingandwillreceivelessviathepresentPIscoresystem.TheCommitteerecognizesthatthethemecouldbepushedforwardbyaclinicalresearchunitandsharedmovementlabfacilities.3.9GraduateSchoolThemissionoftheAMCGraduateSchoolistoorganizethedoctoratelevelacademictrainingofAMCPhDcandidates.ActivitiesoftheGraduateSchoolare:• ToregisterAMCPhDcandidatesandtheirsupervisors;• ToinformcurrentandfuturePhDcandidates,supervisorsandothersabouttheAMCPhD

programme;• ToprovideaPhDcourseprogrammeforregisteredPhDcandidates;• TomonitorthePhDtrainingofAMCPhDcandidates;• TosupportPhDcandidatesincaseofquestionsanddifficulties;• TosupportPhDsupervisorsintheirrolesasactivementorsandtrainersofPhDcandidates;• Tofacilitateformalactivitiestowardsthethesisdefenseandceremony.TheGraduateSchoolhasover1600activePhDcandidateswhoaremainlyDutch(82%).AlthoughtheCommitteeunderstandsthatmedicalPhDstudentsneedtospeakDutchinordertocommunicatewithpatients,itencouragestheAMCtomakeeffortstoincreasethepercentageofinternationalstudents.AccordingtotheCommittee,theGraduateSchoolfunctionswell,contributingtoaveryhighcompletionrate.TheCommitteehadtheopportunitytospeakwithaselectednumberofPhDcandidateswhoweresatisfiedwiththeoperationoftheGraduateSchool.TheGraduateSchooloffers49coursesclassifiedintotransferableskills,scientificmethodsandadvancedscience.ParticipationisfreeofchargetoregisteredPhDstudents.TheCommitteewaspleasedwiththevarietyofcourses.TheCommitteewasespeciallypositivelyimpressedbytheAMCWorldofScienceintroductorycourse,inwhichalsothetopicofscientificintegrityisincluded.IntheopinionoftheCommittee,itwouldbebestifalsothematictrainingcourseswouldbeorganizedundertheauspicesoftheGraduateSchool.Thiswouldofferaplatformtothecoordinatorsofthesecoursestocommunicateandfacilitatetheexchangeofbestpractices.Arecommendationofthepastassessmentreportwastodevelopastandardizedmonitoringprocedure.Therefore,theGraduateSchoolhasintroducedanindividualTrainingandSupervisionAgreement(iTSA),inwhicharrangementsaremadewithregardtomodeandfrequencyofsupervisionaswellasthestructureandcontentsofcoursesandtraining.TheCommitteewasimpressedbythismonitoringprocedure.ItvaluestheattentiongiventotheindividualPhDcandidate

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throughthePhDcandidateadvisor,whoisveryaccessible.TheGraduateSchoolmonitorsandevaluatesPhDprojectsatthreepointsoftime,atthebeginning,halfwayandaftergraduation.Tostrengthentheprogramme,theCommitteewouldsuggesttoextendthemidtermevaluationtoyearlyevaluationsratherthanonlyonce(after2years).ItstrucktheCommitteethattakingcoursesandevenregistrationintheGraduateSchoolisnotobligatoryforAMCPhDcandidates.SincemostPhDcandidatesareregisteredintheGraduateSchool,fillouttheiriTSAandfollowWorldofSciencealready,itseemsarelativelysmallsteptomakethismandatory.TheGraduateSchoolalsoprovidessupporttoPhDsupervisorsthroughanumberofinstruments,includingguidelinesforgoodmentorshipandworkshopsonsupervisionofPhDcandidates.ThisnewlydevelopedtrainingprogrammeforsupervisorsisanimportantpositiveresponseoftheGraduateSchooltoexpressedneedsofPhDstudentsconsideringtherelativelyhighnumberofcomplaintsaboutsupervision.Unfortunately,thenumberofsupervisorsthatfollowthetrainingprogrammeislow.TheCommitteesuggeststhattheGraduateSchoolmakeseffortstofurtherstimulate,orbettereven,requirenewlyappointedsupervisorstofollowthiscourse.BasedoninterviewswithPhDcandidates,theCommitteenotedthatthecareerguidanceofPhDcandidatesisminimal.TheCommitteerecommendsastrongercareerdevelopmentprogrammeforbothPhDcandidateswithacademicandnon-academicambitions.Italsosuggestsincludingpostdocsinthiscareerdevelopmentprogramme.3.10CorefacilitiesIntheself-evaluationreporttheAMCpresents16corefacilities.Theorganisationalandfinancialstructuresofthecorefacilitiesvary.Mostcorefacilitiesareembeddedinadepartment,whereastheyaregovernedandvariablyfinancedthroughtheDivisionofLaboratorySpecialisms(DivisionG).Inthe2011evaluationandthesubsequent2014midtermevaluation,recommendationswerespecificallydirectedatthecorefacilities.However,theCommitteetakesnotethatintheselfevaluationreportitisconcludedthat“asharedvision,andpoliciesbasedonthatvision,shouldbeelaborated;andthatinvestmentsareneededtoreinforcecorefacilitieswithsufficientequipmentandexpertstafftoreachacceptableturn-aroundtimesandreasonableuserfees”,suggestingthattheearlierrecommendationshavenotsufficientlymaterialized.OneofthequestionsthattheAMCBoardhadformulatedfortheCommitteewas(again):InwhichwayshouldAMCreinforceitscorefacilities?TheCommitteewasconfrontedwiththeinsufficientlystructuredorganisationofthecorefacilitiesandacleardefinitionofcorefacilitywaslacking.TheCommitteewasleftwiththeimpressionthattheinfrastructuresidentifiedascorefacilitieswerearesultofhistoricallyestablishedfacilitiesthathavebeendevelopedfromabottom-upsystem.Whereasthismayprobeviabilityintheinitialphases,forsuchaconstructtodevelopandremainvital,guidancewillberequiredinordertoestablishsufficientgovernanceandsatisfyemergingneeds.Importantly,theorganizationofthecorefacilitiesneedstobepartofanoverarchingstrategy.Inaddition,theconversationswiththestaffwhoaredirectlyinvolvedincorefacilitiesrevealedthatthey(andtheirmanagement)demonstratedlittlesenseoftheneedtodevelopabusinessmodelwhereservicesareatleastpartiallyreimbursedona‘feeforservice’basis.Onlyinthisway,canasustainedcorefacilitymaintainitsqualityandservice.Aseparateconcernexpressedbyindividualmemberswasthatrecentinstitute-widebudgetcutshaddisproportionallyaffectedthecorefacilities.

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IntheinterestoftheAMCambitiontomaintain(andstrengthen)itspositionasaleadinginternationalresearchinstitute,theCommitteeadvisesthattheleadershipdevelopsasoundstrategyforasustainablecorefacilityinfrastructure.Thewordingchosenherereflectstheurgencyoftheneeds,acknowledgingthatsomepeoplededicatedtothefacilitieshavebeenpoorlysupportedinthelast6years.Giventhissituation,thoseinvolvedinthecorefacilitiesdealingwiththeday-to-daychallengeshavedoneagreatjob.TheCommitteeisimpressedthatundertheseconditionsindividualgroupsaredoingsomuchgoodresearch.Withregardtotheheterogeneoussetofcorefacilitiesthatarelisted,theCommitteewouldliketomakeadistinctionbetweenservices,specialistfacilitiesandfacilitiesnotlisted.CoreservicesarefundamentalneedsforallresearchersthroughouttheAMC,andneedtobeavailableatalltimes,havingstrongbackupsystemsandbuilt-insustainability.Theanimalhouse,radionuclidelab,andmedical-technologyaresuchservices.Theanimalhousingproblemshavecausedmajorsetbacksinresearch.SeveralresearchersacrossmostoftheAMCthemesexpressedtheirfrustrationsinthewayproblemshave(not)beenaddressed.High-techspecialistfacilitiesusuallydevelopwithinindividualdepartmentsandareassuchcriticalforsomeofthe“local”high-qualityresearch.Oncetheybecomeavailabletotheotherdepartmentsandturninto‘self-acclaimed’corefacilitiestheymaysufferfromabundanceofrequests,toolittlemoney,anddiffusemanagementstructure.Oncogenomics,theHISmousefacilityandcellularimagingareexamplesofsuchsophisticatedcorefacilitiesthataredirectlyrelatedtoresearch.Inthesefacilitiesbioinformaticssupportisunderstaffed,whichneedsfurtherattention.Inordertomaintainthem,theyareinneedofstructuredmanagement.Inthelistof16corefacilities,theCommitteenotedanimportantdeficiency,namelyabigdata/clinicalinformatics(patient,cohortsandresearchdata)infrastructure.Thelatteriscrucialformodernbiomedicalresearch,andrequiresplanningandstrategy.Partofthisresearchinfrastructureisavailableassupportforvariousaspectsofclinicalresearch.Yet,withinseveralresearchthemesclinicalresearchsupportandcoordinationseemtohavebeendevelopedwithlittlecoordinatedoverview,whichleavestheCommitteewonderingwhattheroleoftheClinicalResearchUnit(CRU)is.Moreover,regardlessoftheirquality,theexistenceofmultipleresearchthemespecificclinicaltrialgroups,e.g.inReproductionandCardiovascularthemes,complicatesoverallqualityassuranceoversightofclinicaltrialmanagementfortheAMCboard,withinherentrisks.ThereisanimmediateandunmetneedforanoverarchingClinicalTrialsUnittooverseeallaspectsofclinicaltrialmanagementandgovernance.AlsothebiobankingandmedicalimagingactivitiesoftheAMCshouldbeconsideredaspartofthebigdata/clinicalinformaticscorefacilityactivity.Insettingupastrategicdevelopmentforthecorefacilityportfolio,AMCshouldstriveforcommonrequirementsandstandardsforeachinitiativeconsideredasacorefacilityincludingauserCommitteestructure,abusinessplan,andadescriptionoftheactivitiesthatareintrinsictothedepartmentordivisionhostingthecorefacility.TheCommitteerecognizesthatlocatingsuchfacilitiesindepartmentswhichalsohavearesearchstakeinthecorrespondingtopic,requiresasustainablestrategyforcorefacilityservicesthatdistinguishbetweenthoseaspectsforpurposesofbudgetingandperformanceevaluation.

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TheCommitteeisofthefirmopinionthatsustainablebusinessmodelsforthecorefacilitiesmustincludeuserfeesthatarecompetitivebutsufficientforthefacilities’operations.TheCommitteehasseenexamplesoffacilitieswithveryloworabsentfeesthatarepredictablyoverwhelmedwithrequests.ThefactthatmanyresearchersoutsourcetheirworktocorefacilitiesexternaltotheAMCfacilitiesmustimplythatAMCinvestigatorsrecognisethattheuseoffacilitiesisnotforfree.Thefinancialsituationforthefacilitiesiscomplicatedbythefactthatclinicaldivisionsarebudgetholdersandresearchthemesarenotinthelead,whichiscommoninotherDutchUMC’s.TheupcomingmergerwiththeVUmcprovidesanexcellentopportunitytoreviseandreconsiderthepositionofthefacilities,theneeds,thebudget,andthemanagement.ThisshouldtakeintoaccountotherAmsterdambasedinstitutions,inordertocreateviableandsustainablefacilitiesthatmatchtheneedsoftheAMC/VUmcinstitutesaswellasoutsideuserneeds.Insuchajoinedeffort,thereismoreroomtomanoeuver.Theplanshouldalignwiththeoverallresearchstrategy,andshouldatleastincludeaseparatebudgetthatisclearlyvisiblewithinthedivisions,includingdivisionG.

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4.ConclusionsandRecommendationsAccordingtotheStandardEvaluationProtocol(SEP),qualitativeassessmentsaresupplementedbyassigningadiscretescore(1-4,1beinghighest)totheresearchunit(inthiscase,theAMC)foreachofthefollowingevaluationcriteria.• Researchquality:Asoutlinedinparagraph2.1,thebasic,translationalandclinicalresearchinthe

AMCvariesoverabroadrangefromgoodtoworldleading.TheCommitteewasimpressedbytheselectedscientifichighlightsthatwerepresentedduringthesite-visitandreportedintheself-evaluationdocument.Eachofthethemespresentedsuchhighlightsduringthesite-visit,andsomeofthesehighlightsreflectprominentinternationalresearchlines.Score#2(Theunitconductsverygood,internationallyrecognizedresearch)

• Relevancetosociety:Asdescribedinparagraph2.2,theCommitteewasimpressedbythesocietalimpactofadiverseseriesofscientificachievementsacrossseveralthemes.Variousachievementshavesocietalormedicalpracticechangingimpact.Score#1(Theunitmakesanoutstandingcontributiontosociety)

• Viability:Asstatedin3.3,theAMCfindsitselfatanimportantturningpointbecauseofthemergerwiththeVUmc.Thisisbothachallengeandanopportunity.TheCommitteeassessedtheviabilityagainstthisbackgroundandrankeditasGood(Score#3-Theunitisequippedforthefuture).TheCommitteewishestoemphasizethatitsconclusionisnotbasedonanymisgivingabouttheAMC.Aspectsofviabilitysuchasthefinancialbasisandacquisitionpowerreflecttheverygoodresearchquality.Andtheleadershipiswellawareofthefutureneedsandpotentialhickupsinthemergerprocess.InparticularbecauseofthemergerwiththeVUMcbutalsoinviewoftheneedtoalignwithinternationalbestpractices,theCommitteewishestosignalthatAMCshouldreinforceitscentralresearchgovernanceintermsofthematicprioritization,talentpolicy,andcorefacilities.ThisisofdirectrelevanceaswellforthefuturealignmentofAMCandVUmcresearchlines.Accordingly,anumberoffirmstrategicdecisionsmustbetakennow,theeffectofwhichisyetunknown.Atthispreciserelativelyearlypointintime,theCommitteelackssufficientinsightthateverythingwillunfoldunderabest-casescenario.WhiletheconclusionisthatAMChasworkedhardandpositivelyonthesoundnessofthefutureplansconcerningresearchinthemergerwithVUmc,thereisstillanenormoustaskaheadthatrequiresthefullpotentialofAMC’sleadership.

Fromthegeneralandthemedescriptions,andfromthequalitativeandquantitativeassessment,severalconclusionsandrecommendationsemerge:1.Strategy,leadershipandgovernance• TheCommitteeadvisestheboardofAMCtocontinueitsapproachofstimulatingtheresearch

agendawiththesamelevelofambitionbuttoconsideradditionalmeasurestostrengthenhighlypromisingresearchlinesandreconsidercriticalgovernancemechanisms(detailedbelow).

• TheCommitteeadvisestheExecutiveBoardoftheAMCto(re)defineanoverarchingresearchstrategyandthegovernanceneededtoimplementitinviewofcompetingprioritiesintheinstitutions.Thisshouldinvolveanexplicitlong-termvision,transparentproceduresofstrategicresearchplanningandchoicesofresearchprioritiesassociatedwithtransparentallocationoffunds.

• TheAMCBoardshouldconsiderchargingtheResearchCouncilwithaleadingroleinrestructuringtheoverallresearchpolicyandgovernance.

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• TheResearchCouncil,supportedbytheExecutiveBoard,couldmonitorandoffersupporttoreducethecurrentdisparityamongthethemesandenablepreparationforthemergerintermsofleadership,governancemodels,focus,andcoherence.Somethemesarealreadyadvancedandmayserveasrolemodelsinthisregard.

• Thereisaneedforstrengtheningtheorientationandfinancialincentivesthatsupportthefurtherdevelopmentofresearchstrategyandresearchthemes.TheResearchCouncilmayneedanallocatedbudgettoimplementchange.

• Oneoftheincentivestosupportexcellence,e.g.inclinicalresearch,istoorganizeprotectedresearchtimetotalentedindividuals.Inaddition,thePIsystemshouldbereconsideredandadecisionmadetoreallocatefundinginadifferentmodel.Theemphasisshouldbeonpersonalexcellence,butmovingawayfromdistributionthroughdivisionsanddepartments.Insteadtheseactivitiesshouldalignwithstrategicresearchprioritiesoftheinstitutes.

• InterdisciplinaryresearchcanbefurtherstimulatedbytheExecutiveBoard,followingre-framingoftheircorporateresearchvision,plansandincentivestodeliberatelyfocusoncross-cuttingandtransversalresearchthemes,alignmentofinterdisciplinaryprioritiesandstrategiccooperationwithexternalpartnersandoutreachtootherfacultiesoftheUniversityofAmsterdam,e.g.theScienceandSocialSciencefaculty.

2.Researchprioritieswithinthemes• Theresearchthemesneedtobeencouragedtoactivelyfocusonthemostpromisingresearch

lines.ThisrequiresprioritizationofselectedareasofscientificexcellenceandpromiseinwhichtheAMCcancontinuetocompeteinternationallyonahighlevel.Thisisnotonlyimportantforcontinuingtoattractcompetitiveexternalfunding,butitwillalsofurtherenhancethevisibilityoftheseactivitiesandincreasetheimpactoftheAMCintheoutsideworldaswellasitsabilitytoattractexternaltalent.

• Inordertoachievetheseobjectives,theCommitteerecommendsconstructingamanagerialmodelthatputsauthorityandexecutiveandadvisorydecisionmakingintothehandsoftheleadershipoftheAllianceInstitutes.Acriticalsteptoachievethisistoequiptheleadershipwithfinancialinsightandresponsibility,andtheabilitytomakestrategicappointments.Attheveryleast,thisshouldpermittheleadershiptoinfluencetheappointmentofnewProfessorsandtohaveanimportantroleinchoosingnewPI’s.TheadvisoryroleoftheResearchCouncilforfosteringcoherenceanddevelopmentofcross-cuttingthemesandassignmentofprioritiesshouldbeenhanced.Ideally,thiswouldpermitallocationoffundsbytheleadershiptosupportcapitalexpenditure,financestaffandprovideacareerdevelopmentpathwayforpromisingyoungresearchers.

• TheCommitteerecommendstoreconsiderthepositionoftheGastrointestinalDiseasesandMetabolicDisorderstheme(aspartoftheAmsterdamInstituteforGastroenterology&MetabolicHealth(AG&M)).Thisinstituteappearsinsufficientlyfoundedonacommoncoherentresearchtheme.Itseemstocoverawiderangeofheterogeneousscientificdisciplines;thereislimitedcohesivestrategyandrelativelylittleinteractivevalueacrosstheentiretheme.

3.Careerandtalentdevelopment• TheCommitteefeelsthatthecurrentPIsystemdeservestobereconsideredinviewofthe

mergerwiththeVUmcandsuggestsdevelopingitintoarevisedorevennewsystem.InanewPIsystem,thecrucialelementofpersonalmeritshouldbemaintained,andatthesametimetaking

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senioritylevelintoaccounttoavoidabiasawayfromsupportingmid-careerscientists(post-docsandjuniorfaculty).Thisnewsystemshouldfurtherbeblendedwithdecisionmakingbytheinstitutes.

• TheCommitteerecommendsdevelopingapolicyandprovidingappropriatesupportforcareerandtalentdevelopmentthatisfocusedonexcellenceandthatisspecificforeachcareerphase(PhDcandidates,postdoc/PI,juniorfaculty),andtoassignfundingcompetitively.Thisshouldbenefit“high-potential”individuals,acrossdivisions.Decisionsshouldmoveawayfromdivisionsanddepartments,butinsteadalignwithcorporatestrategicresearchpriorities.

• Especiallyfurtherattentionisneededformid-careeroptionsandextraincentivesfornon-MDPI’s.

WithregardtotheGraduateSchool• TheCommitteerecommendstomakeregistrationandtakingcoursesintheGraduateSchool

mandatoryforAMCPhDcandidates;thiswouldalignwithmostEuropeanPhDtrainingprogrammes.

• TheAMCBoardshouldmakeeffortstorequirenewlyappointedsupervisorstoattendacourseforsupervisorsandfurtherencouragecurrentsupervisorstodosoaswell.

• TheCommitteeadvisestodevelopapropercareerdevelopmentprogrammeforbothPhDcandidateswithacademicandnon-academicambitions.Moresystematicapproachesareneededtoexposethisgrouptonon-academiccareeroptions.Includepostdocsinthiscareerdevelopmentprogramme.

• TheGraduateSchoolisadvisedtofurtherdevelopitsmentoringsystem,makingitalsoeffectivewithrespecttomentalwellbeing.Amentoringsystemisextrausefulfornon-MDPhD’swhoexperiencemoreuncertaintyabouttheircareerperspectives.

4.Corefacilities• Asstateoftheartinfrastructureofequipmentandcorefacilitiesiscrucial,theCommittee

recommendsthattheExecutiveBoardoftheAMCdevelopsacomprehensiveplanforthecorefacilities.Inthepastyearstheperformanceofmanycorefacilitieshasbeensuboptimalbecauseoflackofcentralmanagementandassociatedlackofappropriatebudget.

• Acorefacilitystrategyshouldstartwithgeneralandappropriatedefinitionsandcriteriaforcorefacilitiesthatcoverallrelevantfacilitiesandinfrastructures.

• Thechoiceandsizeofcorefacilitiesshouldbereconsideredaccordingtotheresearchstrategy.Whilecorefacilitiesneedauserdrivengovernance,thisneedstobetranslatedintoabusinessplanandallocatedbudgettomakethemsustainable.Thecorefacilitiesplanneedstobesupportedbythecentralmanagement,inlinewiththeresearchstrategy.

• CorefacilitiesneedearmarkedcentralfundingandshouldbeaccessibleacrosstheentireAMCinstitution.Competitiveadditionalfundingmayberequiredaswell.

• TheAMCcorefacilitystrategyobviouslywillneedtobealignedwiththeVUmccorefacilityplanning,aswellaswithotherrelevantinstitutionsinAmsterdam,tocreatemaximumsynergy.Inthetransitionperiodfundingmaybeneededtobridgethisgap.

• TheCommitteeperceivesaneedforstrengtheningastate-of-the-artclinicaltrialsunitthatsupportsGoodClinicalPractice(GCP)andmethodology,governance,datamanagement,legalsponsorship,StandardOperatingProcedures(SOP),andregistrythatisinlinewithEuropeanregulation.Thequalityofsuchacorefacilityiscriticaltolaunchingclinicaltrials,asisindicatedby

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thefactthatallthemescurrentlyseemtodeveloptheirownclinicaltrialsunitofvariablemagnitude.However,thisdoesnotmeanthateverythinghastobeaccommodatedinonegeographicallylocatedunit.Ahubandspokemodelmayworkadequately.

• Regardingotherresearchinfrastructure,furtherattentionisnecessaryformaintenanceofcohorts,researchdatasharingpracticesandcouplingtoclinicaldata.

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Appendix1TheInternationalEvaluationCommitteeandthereviewproceduresTheInternationalEvaluationCommitteememberswere:• Prof.dr.BobLöwenberg,chairmanoftheCommittee

ProfessorofHematologyatErasmusUniversityMedicalCenterRotterdam,TheNetherlands.• Prof.em.dr.GünterBreithardt

DepartmentofCardiovascularMedicine,HospitaloftheUniversityofMünster,Germany.• Prof.dr.MarcBonten

DepartmentofMedicalMicrobiologyandJuliusCenterofHealthSciencesandPrimaryCareattheUniversityMedicalCenterUtrecht(UMCU),theNetherlands.

• Prof.dr.JohnCreemersCenterforHumanGenetics,KULeuven,Belgium.

• Prof.dr.DavidKerrProfessorofCancerMedicine,UniversityofOxford,UnitedKingdom.

• Prof.dr.GitteMoosKnudsenDepartmentofNeurologyandNeurobiologyResearchUnit,CopenhagenUniversityHospital,Rigshospitalet,Denmark.

• Prof.em.dr.KeesMeliefProfessorofImmunologyatLeidenUniversityMedicalCenter(LUMC),TheNetherlands.

• Prof.dr.AndreasMeyer-LindenbergDirectoroftheZentralinstitutfürSeelischeGesundheit,Mannheim,Germany.

• Prof.dr.LucillaPostonHeadoftheDepartmentofWomenandChildren’sHealth,Kings’College,London,UnitedKingdom.

• Prof.dr.JanetRich-EdwardsDirectorofDevelopmentalEpidemiologyatBrighamandWomen’sHospital,HarvardMedicalSchoolBoston,UnitedStates.

SecretariestotheCommitteewere:• Dr.IngeborgMeijer,PhD,IngeborgMeijerAdvies• Dr.JoycePutters,PhD,VUmc,Amsterdam• Dr.AnnemarieVenemans,PhD,DeOnderzoekerijInformationprovidedtotheCommitteeTheCommitteehasreceivedtheself-evaluationreport2011-2016oftheAMCascoredocumentation,includingtheinformationrequiredbytheStandardEvaluationProtocol(SEP).TheCommitteealsoreceivedthefollowingdocuments:• TheTermsofReference,includingthespecificquestions• TheSEPprotocol2015-2021• TheAMCevaluationreport2011

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• AlliantieAMC-VUmc;Opwegnaarexcellentie.Ambities,locatiesenplannen;May2014(strategicdocumentconcerningmerger,inDutch)

• FinancialreportsAcademicMedicalResearch(AMR)oftheAMC,years2011-2016• SpecificreportsoftheAMC-VUmcinstitutesProceduresfollowedbytheCommitteePriortothefirstCommitteemeeting,allCommitteemembersreceivedtheTermsofReferencefortheevaluationtogetherwiththeself-assessmentreportoftheAMC.Thefinalassessmentsarebasedonthesetwodocuments,thedocumentationprovidedbytheAMC-VUmcinstitutes,andtheinterviewswiththeboard,researchcouncil,andrepresentativesofAMCthemes,corefacilitiesandGraduateSchool.Thesite-visitoftheCommitteetookplaceon23,24and25October2017attheAMCinAmsterdam.Thefullagendaofthesite-visitreviewisattached(appendix2),andithadbeenpreparedbytheAMCitself.Atoccasions,theCommitteehasrequestedtodeviatefromthepreplannedagendainordertobeabletodiscussandaddressparticulartopicsingreaterdepth.TheevaluationofaninstitutionofthesizeofAMCintwodaysrequiredthattheCommitteememberssplitinparallelsubgroupstomeetwithrepresentativesfromthevariousthemes.ThelogisticalprocessfurtherrequiredintermittentfeedbackandharmonisationsessionsoftheCommitteeandopportunitiesforsharing,discussingandaligningfindingsandimpressions.Appendix3showswhichindividualCommitteemembersvisitedtheindividualAMCthemes,graduateschoolandcorefacilities.Priortothethemesessions,theCommitteepreparedanddiscussedtheinformationintheself-evaluationreport,exchangedfirstimpressions,andformulatedquestionsfortheAMCthemerepresentativesduringtheparallelsessions.Afterthesessions,theplenaryCommitteediscussedabouttheirobservations,commentsandrecommendationsforthereport.Beforethewrittendraftreportwasfinalized,aprefinalversionwaspresentedtoAMCforfactualcorrectionsandcomments.ThereportissubmittedtotheUniversityofAmsterdam,whichistheformalrecipientofthereport.

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Appendix2Programmesite-visit

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Appendix3Parallelsessions

DistributionofCommitteemembersoverpanels

Theme 1 2 3 4Oncology C.Melief D.Kerr B.Löwenberg Corefacilities M.Bonten G.MoosKnudsen L.Poston A.Meyer-

LindenbergGraduateschool J.Creemers J.Rich-Edwards G.Breithardt Muscoloskeletal J.Creemers J.Rich-Edwards G.Breithardt Cardiovascular G.Breithardt G.MoosKnudsen B.Löwenberg Infection&Immunity C.Melief A.Meyer-

LindenbergJ.Creemers M.Bonten

Reproduction L.Poston J.Rich-Edwards D.Kerr Neurosciences A.Meyer-

LindenbergG.MoosKnudsen G.Breithard

Gastroenetrology D.Kerr L.Poston J.Creemers PublicHealth J.Rich-Edwards M.Bonten C.Melief B.Löwenberg