When Robert A. Winn was named director of the University of Illinois Cancer Center in 2015, he knew that the skills required to be a successful cancer center director were very different from the skills he drew upon to be a successful scientist. So, he formed an informal, personal mentorship team.
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“I know they got tired of me, but I called them almost once a month,” Winn said.
In this episode of The Cancer Letter Podcast, Winn spoke with Paul Goldberg, editor and publisher of The Cancer Letter, about the program Winn started to address this gap: the Executive Leadership Academy for Cancer Centers.
“Not every cancer center director even has [a personal mentorship team] or even is knowledgeable that they should do that,” Winn said. “By having this ELAC program, it will not only give them leadership skills about having a network, how do you do it, how do you run your finances? Not just how do you do your own science, but how do you now transition to figure out how to create science themes for an institution i.e., a cancer center, and how to actually be familiar with the CCSG? I think that it just makes all the sense in the world.”
Winn established the Executive Leadership Academy for Cancer Centers in order to set cancer center leaders up for success.
“Cancer center leadership has really been done by apprenticeship, meaning that you find someone who’s a good scientist and you say, ‘Yeah. Of course, they’re going to have good administrative skills,’” Winn said. “And then, we put them in roles like program leaders or we put them in roles like associate directors and deputy directors. And when they struggle, we sort of scratch our head, like, ‘Why are they struggling?’”
Cancer center leaders have unique responsibilities—including preparation and submission of Cancer Center Support Grant applications.
“[I realized] there was not really any single training specific to the CCSG aspects, the cancer center support grant, as well as the cancer center that we actually had in the United States. And so, I had a big bold idea and an ‘Aha!’ moment that, why not actually fill in that gap with an actual leadership academy that focuses, not on just leadership, but actually on CCSG knowledge and content, and start with a good solid foundation of that pool of future leaders?”
This episode was transcribed using AI transcription services. It has been reviewed by our editorial staff, but the transcript may be imperfect.
The following is a transcript of this week’s In the Headlines, a weekly series on The Cancer Letter podcast:
Jacquelyn Cobb: This week on The Cancer Letter Podcast…
Robert A. Winn: You know, it’s like having a baseball player. Yeah, he just has natural talent. It’s just natural. We should stop relying on the natural talent and start understanding that many cancer center directors, and deputies, and ADs, and program leaders would literally benefit from a program in which we were, from day one, telling them the importance of CCSG and building up their CCSG knowledge more so than many of us have had, and paying attention to the soft, and what I would say, the hard skills of being a leader.
Paul Goldberg: You’re listening to The Cancer Letter Podcast. The Cancer Letter is a weekly independent magazine covering oncology since 1973. I’m your host, Paul Goldberg, editor and publisher of The Cancer Letter.
Jacquelyn Cobb: And I’m your host, Jacquelyn Cobb, associate editor of The Cancer Letter. We’ll be bringing you the latest stories, groundbreaking research, and critical conversations shaping oncology.
Paul Goldberg: So, let’s get going.
Dr. Winn, thank you for finding the time to talk with me. I hope you had a great summer.
Robert A. Winn: Summer has been going too quickly, but it’s been a good one.
Paul Goldberg: That’s fantastic. So, we are here to talk about something that you started, which is called the Executive Leadership Academy for Cancer Centers. I should say it much faster. Executive Leadership Academy for Cancer Centers. What’s fascinating about this is that for years, well, really for decades, cancer centers have been run by people who kind of rose through the ranks without any specific training to run the cancer centers, and you’ve set up a different approach.
Robert A. Winn: Yeah. I’ll say that like all things, right, it evolves over time. And cancer center leadership has really been done by apprenticeship, meaning that you find someone who’s a good scientist and you say, “Yeah. Of course, they’re going to have good administrative skills.” And then, we put them in roles like program leaders or we put them in roles like associate directors and deputy directors. And when they struggle, we sort of scratch our head, like, “Why are they struggling?”
Not recognizing that the reality is that with cancer center leadership, that there’s specific roles and duties of program leaders. There’s specific relationships of how the program leaders relate to the associate director. What are the associate director’s responsibilities, and how they interact with, not only their program leaders, but with the deputy director, and the director, and the rest of the team in a cancer center?
So, I think what I recognized was just that while there were lots of leadership training specifically for leaders to become deans, for the AAMC leaders to become chairs, there was not really any single training specific to the CCSG aspects, the cancer center science grant, as well as the cancer center that we actually had in the United States. And so, I had a big bold idea and an ‘Aha!’ moment, “Why not actually fill in that gap with an actual leadership academy that focuses, not on just leadership, but actually on CCSG knowledge and content, and start with a good solid foundation of that pool of future leaders?”
Paul Goldberg: Yeah. Well, let’s do some history. From what I gather, it was an outgrowth of Karen Knutson’s study that she started as AACI president. And then, Caryn Lerman continued it. And then, you became the AACI president. That was when your ‘Aha!’ moment occurred. Is that correct?
Robert A. Winn: Absolutely. All I’ll say is that it has certainly been an influence of Karen’s and your work, by the way, the publication that you had in The Cancer Letter, during our period of COVID. As the ELAC, probably the first iteration of this came about somewhere probably ’22. It took over a year. It took over a year plus to then get it fluffed up enough that it would be more than a concept and we had a curriculum.
And I have to give a thanks to Anita Harrison, who is one of my associate directors for scientific strategies. Her and her team spent significant time fluffing up the curriculum for this program. But you’re absolutely right. I think Caryn Lerman’s run when she was at the AACI, I think Karen’s run when she was at the AACI, both—you can see elements of how that certainly has influenced this ELAC program.
Paul Goldberg: Oh, fascinating. But you started it within your institution; right?
Robert A. Winn: Yeah, the funny part about how this all started was that I literally was thinking that, as we talk about what I now am calling, having a person to look at my shop as the AD for leadership and professional development, that we say leadership and professional development, and we conflated all the time with our education and training. They’re not the same.
In fact, when I think of SEER Tech or the education and training component, it really is training the next generation of scientists, training the next generation of clinicians, clinical trialists. But inherent in that is not the training of professional development as it relates to leaders.
And so in ’22, I had the bright idea that we were doing—certainly training lots of people to go out and be successful scientists, and successful academics, and successful clinical trialists. But there wasn’t really a focused rigorous program, literally, around leadership.
And as you think about most cancer centers in the United States, leadership actually does matter. And so, not to actually have as much focus on the leadership component had me sort of saying we needed to address that.
And so, I came up with the program with my team, with Anita, and lots of other people involved. But we came up with this concept of the ELAC program for leadership, executive leadership, that was supposed to be specific to just VCU Massey. I didn’t even have any other thoughts other than VCU Massey at the time when this program was created.
Paul Goldberg: I like the way you kind of worked in Simone Maxim, Joe Simone’s line, “leadership does matter.” It’s very nice, very artful the way you did it. He would probably approve of this idea. But you’re really setting it up for your own institution, but I think you’ve also got other institutions involved. Can you actually can it, so other cancer centers could join this? Is there a curriculum? How does it work?
Robert A. Winn: It’s an interesting question that you have, and the answer is Yes. There is a nine-month curriculum literally focused on everything CCSG. What’s a table for? What’s CTEP? How many pages in a grant? How do you finance a grant? How much money comes from CCSG? So, we have a whole nine-month training of young leaders, potential leaders who are probably more well versed in CCSG than even, I would say, most of their senior leaders in their institution. Number one. The second nine-month is structured so that we are teaching three things. The soft skills of being a leader, the hard skills of being a leader, and the financial skills that are actually, I mean, absolutely necessary to learn how to manage a budget within a cancer center, whether you’re a deputy director, or a director, or an AD, or a program leader.
So with an 18-month program, it’s funded by us, the cancer center. We essentially will allow people to have… We’ll pay for 10% FTE. To answer your question specifically, you’re right, we couldn’t do it alone. We figured out that we were trying to do this with just us, and it became quite apparent that we probably needed to actually have another partner to really have a robust cohort around 12 or 13 people. And so to do that, it was suggested by Anita Harrison, who’s on our team, that we partner up with a similarly like institution. So we went with The Hollings Cancer Center in South Carolina, with Ray DuBois, who actually has been nothing but an amazing partner, and Ben Toll who’s been down there. I mean, both those guys have just been dynamite.
Paul Goldberg: Can you bring in more people? Can you bring in more institutions? Can you make it into sort of a national program?
Robert A. Winn: We’re at a program right now where I never thought I would say this, but this program in its inception was kind of a cool idea. But now since we’re really going through the program itself, we’re bringing in some of the best national leaders from both the NIH, the NCI from the business world. But we’re also bringing in top people from the world of cancer, particularly ADs or program leaders that will come in and say, “I never knew what a program leader was. I was just put in this position. And here’s what happened positively, and here’s what happened negatively, and here’s what I wished I would learn.”
Almost everybody that’s interacted with this very first cohort says the following, “I wish I had this when I was at your stage.” I mean, universal. So, as a result of that success, and we are now collecting the data and putting it together, collecting it with an evaluation process. So, we’re hoping to also have a paper that comes out of this. We now think that what was supposed to be just a local effort, we think we can actually be able to effectively and efficiently, through a governance structure, be able to accommodate more cancer centers for more of a national sort of movement and flavor to this. And we would welcome other cancer centers to the table, to be quite honest with you.
Paul Goldberg: But there’s no money involved, meaning you don’t have to spend money to join it. You don’t have to put in money to enroll. It’s a revenue neutral thing. It’s something you do kind of in your spare time.
Robert A. Winn: Yeah. Right, exactly. You know what the wonderful part about this is that every institution that participates, we would ask, they would be at least willing to pay for 10% FTE for the individual participating in the programs. We thought that the ideal cohort, and this is why we partnered, and let’s give credit where credit is due. We also watch other amazing programs like the ELAM program, the Executive Leadership Academy of Medicine, which is a program geared towards creating the next generation of women who would become chairs and deans.
We actually are very broad. We don’t have any sort of restrictions on who can be other than they need to be young, aspiring junior faculty that have a track record and a desire to, in their future, potentially want to be program leaders or ADs or deputies or directors. That’s the only requirement. The second requirement is that the institution itself would release them for 10% FTE time because it’s important that they’re getting, I mean, top-notch incredibly valuable information through our workshops that we have with them virtually. Physically, they get together only twice a year, so we’ve made it, so that it is not very cumbersome for any institution to participate.
There are two physical meetings a year, and we’re hoping that in the future that we bring everybody together at an AACI meeting annually at some point. But the cost is fairly minimal. If you can cover 10% of the cost of the FTEs of your participant getting in, that would be great. By the way, it is a competition. We decided that we had a committee that picked out for us the six most, what we believe at at the time, to be the most effective junior faculty with the most potential to be administrators or leaders in their cancer centers, both at Hollings and at VCU.
So, we think that cohorts of anywhere between 12 and 15 would work. We’re thinking about, if we do this nationally, having regional cohorts, so that the time issue of doing virtual meetings would not be hindered so much.
Paul Goldberg: Well, you know there’s always this, having covered this field for many years, I’ve seen this nightmare scenario where a very, very smart person, either a clinician or a scientist, you know where I’m going, becomes a cancer center director, and the whole thing flops like you would not believe, that it takes a while, and a lot of people are dragged down. Or the other thing could be where a cancer center director does pretty well having learned the stuff by osmosis or whatever, and then ends up becoming kind of a traveling show.
Robert A. Winn: Yeah. Oh, my God. I’m being polite about this. But you just hit on something that I think has always been unfair to the cancer center directors. There are certain cancer center directors that have been incredibly effective, I mean, clinical physician scientists or PhD scientists. And all of a sudden, there’s science. You now put them in an academic realm with lots of administrative duties of understanding how do you finesse things? How do you take care of conflicts? How do you actually deal with getting everything from learning how to negotiate, not just your salary or just your research, but to negotiate for the cancer center with a health system and with deans?
You have people who… We don’t teach this stuff, and yet we expect them to be ready on day one. In fact, some cancer center directors are familiar with a CCSG, but not knowledgeable of all things that are in CCSG, so you really have to understand how do you work with a team. And the funny part about why this program happened in part is because, I use my own self as an example; right? I wound up being a cancer center director both at UIC and then at VCU, but I did one thing that’s very different. I actually had three people that were very important in my life. It was Michelle Le Beau, it was George Wiener, and Pat Loehrer, who was at Indiana. I called those three. I know they got tired of me, but I called them almost once a month.
And then, I recognized that my transition to doing my job was becoming a little easier, because I actually had a mentorship team. But not every cancer center director even has that or even is knowledgeable that they should do that. So I think by having this ELAC program, it will not only give them leadership skills about having a network, how do you do it, how do you run your finances? Not just how do you do your own science, but how do you now transition to figure out how to create science themes for an institution i.e., a cancer center, and how to actually be familiar with the CCSG? I think that it just makes all the sense in the world.
Paul Goldberg: Also, dealing with NCI is not the easiest thing.
Robert A. Winn: Oh, my God. Dealing with NCI, and dealing with your state, dealing with philanthropy. These are things that they throw you in the deep end and either you swim or you don’t. And then what happens is the people who can’t swim in the deep end, we blame them as opposed to sort of saying, “You know, had we probably had a program in which they had this training, they may have had a better opportunity of being successful.”
Paul Goldberg: And the people who enrolled, are they early in career or are they kind of—
Robert A. Winn: Yeah, that’s the only restriction we had is that, at this point, we were thinking that, not only for capacity, but that you have to draw the line somewhere. So, at this point, we’ve drawn the line that they needed to be earlier stage investigators with the propensity of wanting to be and developing to being program leaders at some point. We may change that as a program matures. But at this point, we are really happy that we made that decision. By the way, each of these trainees in this program, they also have to have a capstone. So I have now six folks who are doing special projects within the cancer center that actually directly benefit the cancer center.
And it gives them their first taste of administrative roles of doing things within the cancer center. In addition to their research or their development of clinical trials, they’re working with both mentors that are actually internal. And they have an external group, which I really like, of sponsors and mentors. And so, there’s a mix of external and internal people who are actually helping to guide them as individuals as well as their projects. And making sure that they continue to write papers, that they continue to get grants, they continue to do all the things that are important for their promotion at their university and within their cancer centers. So we’ve thought a lot about that.
Paul Goldberg: Well, cancer centers as a culture are incredibly collaborative, but it doesn’t happen at their lower levels, right? Faculty levels. Because you have in the EAB, for example, that’s going to help you. You better listen to what they say all the time.
Robert A. Winn: You better listen to what they say. That’s right.
Paul Goldberg: Yeah, the EAB is really crucial. So you have consultants. I mean, actual consultants that you pay as well, but that also is not at a starting investigator, young investigator level either. You will never see those people, right?
Robert A. Winn: That’s right.
Paul Goldberg: So, basically, you get that culture that actually exists at later levels and get it going a little bit, get people acclimated to it a lot sooner. That’s genius.
Robert A. Winn: Yeah. And you know what I think the fun part about this, is that we always talk about how can we improve cancer centers? And so, we always take the money and we make the money work because it ought to work in investments in clinical trials. It ought to be in funding the best science. But over the years, what I recognize is that if you have senior leadership that understand science, that understand clinical trials, but that really understand CCSG, how to build teams, how to negotiate on behalf of cancer centers, how to understand which money to invest, how to prioritize, how to actually do something as simple as create a strategic plan, and how do you get that with the team to help you create strategic plan. Cancer center directors are incredibly busy, and so sometimes what happens is we create this generation of managers as opposed to leaders, right?
With the vision and understanding how to build teams, how to actually support the teams that you build, how to advocate for them when necessary, how to actually go up to the NIH and NCI, and be able to advocate effectively. Those things aren’t just inherently you’re born with, some people maybe, but those are actual traits and skill sets that can be learned. And what I was struggling with is that, in most cancer centers, many of our cancer center directors, it’s not that they couldn’t do that, they just didn’t have the exposure to that. Tongue in cheek. You caught me. Because actually when I read Joe Simone’s Maxims a lot, and I have to say that in addition to Karen, and in addition to both Karen’s, Caryn Lerman and Karen Knutson, and the work that you’ve done in The Cancer Letter that talk about leadership during that period of time.
In the context of who was leading cancer centers, it happened upon, true story, that every once in a while, I have my Maxims out, I pull them. And when you got to the point that leadership matters, I was like, “You’re right. Leadership matters.” And yet when it comes to our program leaders, our associate directors, our deputy directors, and our directors, unlike a dean, which we now say that IN cancer centers and some cancer centers, they’re at the level of deans. Well, the AAMC has an actual leadership program to actually tell you, “Here’s what a dean is. This is the job. Here are the things that are going to be the struggles for you. Here are the things that should be simple for you. Here are the things you’re going to look out for.”
And actually, we’re still in the medieval ages where we’re essentially passing this on as apprenticeship or some of us by actually forming a group around us. And it seemed that that should become much more standard. So what I think the program has done successfully is that it is now… It’s not perfect. And it’s still evolving. But the program is the first bite at really putting together rigor and some type of standardization, if you will, for lack of a better term, around what are the challenges and what’s the job of senior leadership within the cancer center? What’s the purpose? And the purpose isn’t only, although it’s to get CCSG, to get a better score, to get more papers, it’s to get more clinical trials. Definitely. It’s to do better science. It’s to do better recruitment and retention. Definitely.
But there are other things that are not absolutely within the CCSG guidelines that actually are also important for becoming an outstanding cancer center, so that we’re ultimately having, at the end of the day, the largest impact on the science, on the greatest number of people for the best possible outcome. And so, you can’t do that with just having, in my mind, only good science with no type of framework of leadership. And I think that the time has come for us to treat cancer centers the same way deans and chairs are being treated across the country, and that is to develop a program in which we actually have our best and our brightest people exposed to what it’s like, and what is the purpose, and how do you do your job of being a senior leader within a cancer center. That’s the part that I’m super excited about. And leadership does matter. Joe was right.
Paul Goldberg: Joe was definitely right. But it’s interesting that the era during which he wrote the Maxims was not the era when most cancer centers were multi-billion dollar health systems.
Robert A. Winn: That’s right.
Paul Goldberg: That alone should justify several people holding a job, right?
Robert A. Winn: That’s right. By the way, it has become much more complicated to be a cancer center director. And so to leave us with what they would’ve done in the ’70s, ’80s, and ’90s as the same basic goals without any additional training around the skill sets, the challenges. How do you circumvent those challenges? How do you deal with those challenges? What are the new challenges? Come on. I mean, as the NOFO and other things change within the NIH and the NCI, it’ll be important to have a program in which, not only are we keeping up, but we’re passing on the fact that things do change. How do you deal with change from a cancer-centered senior leader’s perspective? I think those things are not something that should just happen to us.
You know, it’s like having a baseball player. Yeah, he just has natural talent. It’s just natural. We should stop relying on the natural talent, and start understanding that many cancer center directors, and deputies, and ADs, and program leaders would literally benefit from a program in which we were, from day one, telling them the importance of CCSG and building up their CCSG knowledge more so than many of us have had and paying attention to the soft, and what I would say, the hard skills of being a leader. Most leadership programs just teach you leadership programs, but they’re not CCSG specific. They’re not specific to cancer centers. And they think that most of what they teach you is translatable. Much of what people do in these various leadership efforts that people go to, they go to places.
They pay people to put them in workshops, to learn how to be leaders, how to manage conflict. Yeah, yeah, yeah. That’s stuff’s important, but that stuff doesn’t always completely translate into saying, “That’s great.” But if you don’t know how that applies within a CCSG program or what are the requirements really, other than you’ve written your section as a program leader, and now all of a sudden you become the AD or you become the deputy director. It doesn’t help. I actually think we need to get rid of that mindset and start learning that these are teachable skills. And in fact, we’ll be able to teach better and produce better leaders, much better than I am, and much more knowledgeable than I am in the future if we start paying attention to leadership now.
Paul Goldberg: I’ll accept that maybe much more knowledgeable than you were when you started this. Right now, you obviously are seeing the flaws in the entire system, and they’re figuring out a way to fix the entire system. So I would respectfully disagree with this self-criticism or self, whatever, flagellation.
Robert A. Winn: But to your point though, Paul, I’ve now gone from thinking that this would only be good just for VCU to… It would be now great for VCU and Hollings as a group to be able to have more people at the table with us, so that we can expand this program, and hopefully even have it as a national program where it’s a touchstone, like the ELAM program, where to be cancer center directors or ADs or program leaders, you go through a program in which you have training on how to be a leader. And then, you get picked as a program leader and you come to this program, or something like that. But we’re working out the details.
But I will tell you that this first pancake, this first cohort, they’re tremendously amazing. And at some point in the future, I hope you’ll be able to cover the people who help create the curriculum like Anita Harrison and others. But I also really am hoping that at some point that Ray DuBois and some of the participants in the program, you’ll have an opportunity to sort of see exactly what I’m talking about, they went in a certain way. They’re coming out much more knowledgeable, much more confident, I think, than I was when I started the whole process of being a cancer center senior leader.
Paul Goldberg: Well, you were humble, but you’re pretty confident. You did the things that needed to be done. And I say that as a friend because we were having dinners at that Polish restaurant in Chicago.
Robert A. Winn: It’s true.
Paul Goldberg: Let’s just be truthful, okay?
Robert A. Winn: It’s true. That’s true.
Paul Goldberg: The restaurant is called Staropolska, and they’re not one of our sponsors. But if they want to be, you’ve got my phone number.
Robert A. Winn: It’s true though. But you know, I will say the importance of sponsorship and mentorship, I think that I look smarter than I am, because I did have people like Michelle Le Beau, people like George Wiener, Pat Loehrer. Yeah. I mean, and Leon. Leon, who’s over at Northwestern, Platanias. I mean, I’ve had many of these guys, and Jennifer Pietenpol. I had no fear of reaching out and getting information. And I think that any success that I’ve had, I also have to give credit to those folks and people like Otis Brawley who I really saw as being part of my team, of being able to help me guide the cancer center. So again, I want to make sure that I give credit where credit is due.
Paul Goldberg: But this is also a field that is so collaborative to a fault almost. Because you’ve just listed all of the competing institutions in University of Illinois in Chicago, right? As your friends and advisors. So that just gives you an idea of how this is not Coke versus Pepsi kind of thing.
Robert A. Winn: It’s true.
Paul Goldberg: It’s the opposite.
Robert A. Winn: Absolutely true. It’s the opposite.
Paul Goldberg: Yeah, it’s the opposite. The enemy is cancer, and not the cancer center down the street. Is there anything we forgot to cover, anything I forgot to ask?
Robert A. Winn: The only thing I would add is that, I do think that our young people have been calling for this for quite a long time. Sometimes when we get program leaders or people that we promote the program leaders, they’ll say, “Oh, I wish I knew some of this stuff.”
And the reality is, why do we keep talking about “I wish” when we have something that we can do about it? So, hopefully, there’ll be others who will want to join the cause of saying that leadership matters, and that we’re not just going to admire the problem, but we’re going to at least try to do something about it. And we may not be perfect in the beginning, but we’ll continue to try to perfect it over time.
Paul Goldberg: Well, there has to be a way to make it national. You’re working on the curriculum. And I think you could probably take on, once the curriculum is done, you would think you could take on thousands of people.
Robert A. Winn: Absolutely. And in fact, we can. And we’re looking forward to being able to expand the program, for sure.
Paul Goldberg: And the cost is, there’s no cost really.
Robert A. Winn: At this point, there’s no cost other than the 10% that you have to cover for the people who are chosen from your institution to participate in the program.
Paul Goldberg: Which is only fair. Well, thank you so much.
Robert A. Winn: Well, thank you. And as always, I appreciate the opportunity to talk about this. And thank you for your interest in leadership, as we’ve talked about over the years, and how leaders do matter. But I think that the training of leaders matters as much, and you can get really amazing leaders for the future by training them today and helping them to be better.
Jacquelyn Cobb: Thank you for joining us on The Cancer Letter Podcast, where we explore the stories shaping the future of oncology. For more in-depth reporting and analysis, visit us at cancerletter.com. With over 200 site license subscriptions, you may already have access through your workplace. If you found this episode valuable, don’t forget to subscribe, rate, and share. Together, we’ll keep the conversation going.
Paul Goldberg: Until next time. Stay informed, stay engaged. And thank you for listening.
