2006 State of the School Address (May 10, 2006)
Arthur S. Levine, M.D.
Senior Vice Chancellor
for the Health Sciences
Dean of the
“Strengths,
Threats, and Opportunities: Strategies
for Dealing with Tough Times in Academic Medicine”
This is my first “State of the School” address to the Faculty of the University of Pittsburgh School of Medicine, but it is my intention to offer such a talk yearly going forward. At the same time, we will discontinue the quarterly faculty meetings that we have had in the past, given the great pressures on time that all of us confront. I have divided my talk into comments on education, research, and health care -- the classic three missions of any academic medical center -- with a few notes on what is emerging as a fourth mission, entrepreneurship. By the last, I mean the efforts that we are making to translate our research-based discoveries and inventions into economic development, thereby benefiting the economic health of our community and our School’s economic health as well. I shall also discuss our relation to UPMC, several recent and especially notable faculty recruits, and a miscellany of other issues that bear on our strengths, threats, and opportunities.
I.
Education
This year we
will educate 584 students who are working for the medical degree, of whom 47%
are women and 53% men; 12% of our students come from under-represented minority
populations and my goal is to strive for a higher representation of these
students. Twenty-nine percent of our
M.D. students are residents of
For the medical student class entering in 2005, we had 5,244 applications, of whom 1,122 were invited for an interview. Approximately 450 applicants were accepted for admission and of this number, 148 matriculated. Among the matriculants, the mean Medical College Admission Test (MCAT) score was 11.3, placing us in the top decile of American medical schools with respect to this metric. Twenty-nine merit-based, full-tuition scholarships were awarded to this class, comprising students in the MSTP (Medical Scientist Training Program), PSTP (Physician-Scientist Training Program), and CSTP (Clinical Scientist Training Program). For the class that will enter in September 2006, we have had approximately 5,300 applications and interviewed 994. We are offering two new full-tuition scholarships this year for students who have an exceptional potential for leadership at a time when the profession of medicine and the nation demand such skill and commitment.
With respect to the M.D. curriculum, our School has been in the forefront of curricular innovations, regarding the curriculum as having an “evolutionary biology” of its own. Our rapidly changing curriculum reflects the extraordinary advances that have been made in the science of medicine just within the past decade, as well as the increasing societal and cultural demands inherent in the practice of medicine. The first two years of the new curriculum have been extremely successful. The “Methods and Logic in Medicine” course has been extremely well received by students and faculty, and the students also are profiting from the earlier introduction of the clinical elements of the curriculum. Last year’s class was the first to be exposed to the “Scholarly Project,” now a mandatory element of the curriculum in which all of our students will be required to demonstrate the independent and creative practice of the scientific method. Students can meet this requirement by engaging in a long-term research project based in the laboratory or the clinic or in epidemiology, health care outcomes, health care services or other areas that depend upon the creation of a hypothesis, methods to test that hypothesis, and a presentation of the results of such studies, with interpretative conclusions. Most of the students will choose their project and their faculty mentors for these projects in their first year, and spend the summer between the first and second year with their projects, sustaining this work throughout the four years. Students in the MSTP, PSTP, and CSTP programs will meet the mandatory “Scholarly Project” requirement in their respected programs. It is critical that we recruit able and willing faculty not only as mentors for the students’ projects, but for the small group learning and clinical skills instruction that remain critical to the success of our curriculum. With this in mind, we have also renewed our focus on evaluation – students evaluating their courses and teachers, teachers evaluating the curriculum and their students, and decanal evaluation of both. Finally, we have also developed a series of innovative electives, especially for first and second-year students. For example, this year we established a formal collaboration with the Carnegie Museum of Natural History; museum curators now offer our students an elective in paleobiology which can also serve as the basis for scholarly projects. This program is directed by Dr. Christopher Beard, a MacArthur “Genius” awardee and one of the world’s leading paleobiologists.
Why is research important in medical education and for the practice of state-of-the-art medicine? First, there continues to be a decline in the number of young physicians embarking upon substantive careers as medical scientists. More than a decade ago, Leon Rosenberg, in a landmark but disheartening report, called this the “death of the physician-scientist.” It goes without saying that the pressure for grant support, the increasing pressure on physicians to generate more clinical revenue, shifts in the career aspirations of the current generation of young Americans, and the debt with which most students graduate from medical school have all conspired to reduce dramatically the ranks of the physician-scientist. With this in mind, our goal is to expose all of our students to the scientific method such that they gain confidence in their ability to think creatively, analytically, and independently – in the hope that an increasing number of our own graduates, despite these extraordinary challenges, will become “hooked” on the kind of career that many of us have enjoyed. Second, and with equal importance as to the role of research in medical education, it is my belief that the independent and creative application of the scientific method, as opposed to the usual rote learning and memorization of medical studentship, will yield independent and creative physicians who think analytically and whose clinical decisions are based on solid evidence. In a word, if I am ill with a combination of symptoms and signs not commonly reported as such in the medical literature, I want to be in the hands of a physician who “thinks out of the box,” and it is my belief that an exposure to research during medical school will yield a richer population of such physicians.
As I have
already mentioned, medical student debt remains a looming issue across the
country. Eighty-five percent of the 2005
graduates were in debt, with an average of $138,093. Seventy-two percent of the graduating class
had a debt greater than $100,000, and 19% greater than $200,000. Interest on these debts compounds during
residency and fellowship training, such that the final repayment of a $120,000
loan means that we are now establishing a generation of physicians in this
country who will confront a total debt of
$226,000 just as they are completing their training, ready to start an
independent career, and at the same time, attempting to build a home and raise
a family. In
One of the metrics on which our stature as a school is based relates to the further training of our graduates and where this training is undertaken. In 2006, 58% of our graduates matched to residencies in one of the country’s 15 most highly ranked academic medical centers (including UPMC). This is the greatest success that our school has ever had. In 2006, 40% of our graduates chose primary care specialties, 33% surgical specialties, and 22% hospital-based specialties.
We also have a
vibrant graduate program in our medical school, with 320 students currently
working toward the Ph.D., 87 of whom are in the MSTP program. Dr. Horn has performed masterfully in his
first year as Associate Dean for Graduate Studies, and both the quality of our
new graduate programs and the quality of the students admitted to those
programs are beginning to reflect his early success. Of the class entering in 2006, three students
will work toward the Ph.D. in bi
All three new
training programs are state-of-the-art, and although these are still early
days, they are attracting an exceptionally talented student population. The Computational Biology Graduate Program is
jointly directed by our School and
Here, I want to turn to faculty matters and comment especially on issues of tenure among our 1,900 full-time faculty members. When this school was beginning its extraordinary ascent from a good but essentially regional institution to the top decile among American medical schools, there was a great emphasis, of need, on NIH-funded research as a condition of tenure – not only an R01 grant, but a renewed R01 grant – given that the School’s ascendancy was to be based upon its research excellence and recognition. We are now firmly established in that top decile and can readily afford to broaden our reach: More than pure laboratory-based research is critical for our continued success, and this is reflected in our current criteria for tenure. Thus, the pathways for placement in the tenure track or the bestowal of tenure include investigator-educators, clinician-investigators and clinician-educators (slide 1). The three tracks have equal merit, in my view and that of the Tenure and Promotions Committee. With respect to academic rank within these three tracks, one can move from instructor to full professor. The typical R01-funded faculty member is, of course, the investigator-educator. However, we have a rising number of master clinician-educators who are tenured, as well as a substantial number of clinicians who participate in and facilitate research (clinician-investigators) but who are not necessarily principal investigators. With respect to academic non-tenure tracks, the faculty pathways include investigator-educators, clinician-investigators, and clinician-educators as well as clinicians who teach students and/or residents but who are primarily engaged in clinical practice. Nonetheless, the engagement of this last group in teaching is substantive. Clinicians who are employed outside of an academic unit of the university, including “UPP only,” receive no university salary or benefits and while they may participate in collaborative projects within the university setting, their academic prefix is “adjunct” or “volunteer.” Finally, faculty members in the non-tenure track who have minimal teaching responsibilities and who spend almost all of their time in primary research activities, wherein they usually have a collaborative and/or supportive role in research projects, have the “research” prefix before their faculty titles, e.g., research assistant professor. In summary, then, we currently recognize and reward a broad spectrum of academic “behavior” both with respect to tenure and non-tenure pathways, noting that this broad spectrum of interests, skills and activities is critical to our continued success as a medical school.
Slide 1:
Pathways in the Tenure and Non-Tenure Tracks
II.
Research
The Biomedical Science Tower-3 is only now being occupied will and not be fully occupied until this coming autumn (slide 2). Clearly, this cutting-edge research building is a gem. We were fortunate in having one of the country’s leading architectural firms and leading laboratory planners design this structure, and while we have the usual operational challenges in settling into a new building as large and complex as this one, the building’s early occupants are pleased indeed with their venue. I am fond of describing BST-3 as a “percolator,” with our most basic science at ground level where the structural and computational biologists are located, and with their data and habit of mind “percolating” upward and informing the work of the more applied drug discovery and vaccine development researchers on the top floors. In the middle of the building, we have a wealth of neuroscience research focused on basic biologic mechanisms, systems neurobiology, and research on neurodegenerative diseases. We also have a substantial amount of developmental biology research with 11,000 zebrafish tanks – one of the largest, if not the largest, zebrafish facilities in the world. This animal is now a favored model among developmental biologists since it is a vertebrate, as we are, but one that has the facile genetics of drosophila. With this facility, we are exquisitely well positioned to create models of human congenital anomalies and heritable diseases. For example, Dr. Burton, in the Department of Neurology, is attempting to construct a zebrafish model of Parkinson’s disease, and Dr. Bahary, in Molecular Genetics and Biochemistry, models of congenital anomalies of the gastrointestional tract as well as malignancies of those organs. The Center for Vaccine Research includes one of the nation’s Regional Biocontainment Laboratories, allowing us to develop vaccines under biosafety level-3 conditions.
Slide 2:
Biomedical
Slide 3
illustrates the new Children’s Hospital and its associated research tower, now
under construction in Lawrenceville. I
would draw your attention, in particular, to the fact that there will be at
least twice as much research space available on the Lawrenceville campus as has
been present in the
Slide 3:
Children’s
Slide 4 is a very
preliminary image of the research building that is planned in
Slide 4:
Biomedical Research and
Here I would like to offer a few examples of current research efforts in the medical school which I believe hold particular promise. Slide 5 simply demonstrates some of the fruits of structural biology -- the powerful methods of x-ray crystallography (Dr. Yeh), NMR spectroscopy, (Dr. Gronenborn), and cryo-electron microscopy (Dr. Conway), with which we can now image much larger and more complex molecular and macromolecular structures than was possible even a few years ago.
Slide 5:
Visualizing the Complex Structures Associated with Replication,
Transcription, and Translation
Slide 6 demonstrates an important concomitant of structural biologic strategies, i.e., the application of new trends in computational structural biology. Here, Dr. Bahar has been at the cutting edge in demonstrating that we must go beyond static structural analyses of proteins to calculate the dynamics with which proteins fold, unfold, and gyrate -- the dynamics of real time protein structures and protein interactions. Thus, Bahar et al., have moved from sequence to structure to structural dynamics.
Slide 6:
The Contemporary Computational Biology Focus
Slide 7 demonstrates that our computational biologists are exploring not only the dynamics of molecular structure, i.e., the conformation of a molecule in real time in a given cell, but also the extraordinary complexity with which proteins and other molecules interact on the cellular scale.
Slide 7:
The Complexity of Signal Transduction Pathways
Slide 8 describes the “molecular libraries paradigm,” which captures the application not only of structural and computational biology to drug development, but also the power of high-throughput candidate drug synthesis and cell-based screening of drug efficacy and toxicity. This new paradigm illustrates our progress in moving from the “needle-in-a-haystack” approach to drug development of the past to the contemporary, platform-based rationale of knowing the molecular anatomy of the genome, and being increasingly aware of the function of each of our genes and how this knowledge will lead to far more effective and efficient drug development, and ultimately to the production of new drugs, than has been the case in the past. This is the paradigm which motivates the work of our new Drug Discovery Institute, jointly directed by Dr. John Lazo from the Department of Pharmacology, Dr. Barry Gold from the School of Pharmacy, and Dr. Peter Wipf from the Department of Chemistry.
Slide 8: Increasing the Yield of Safe
and Effective Drugs
Slide 9 illustrates the utility of the zebrafish. Note that the fish in the lower portion of the slide is missing its posterior third, and slide 10 demonstrates why this has happened: The mutant fish called, “gridlock,” examined by cardiac catheterization (quite a challenge in an animal less than an inch long!), has a constriction in its aorta which prevents blood flow to the animal’s posterior third and eventuates in the lack of its development. This is a good example of the use of the fish as a model for human developmental anomalies since this one is tantamount to coarctation of the aorta in infants. Slide 11 shows the tanks in which the zebrafish are maintained. Because mutation is a rare event, many thousands of fish must be bred such that a very small number of mutants, useful for study, emerge.
Slide 9:
A Mutant Fish Phenotype
Slide 10: Cardiac Catheterization of the Zebrafish
Slide 11: Zebrafish tanks
Slide 12 describes an example of our rapidly expanding research program on the recognition of DNA damage and its repair or misrepair. Here, Dr. Laura Neidernhofer, a member of the Molecular Oncology Program faculty in the Hillman Cancer Center, has “knocked out” a gene which encodes one of the enzymes required for nucleotide excision repair (this is the pathway which repairs our skin DNA when it is damaged by the sun’s ultraviolet rays, but which, when elements of the pathway are defective, is associated with xeroderma pigmentosum, a heritable sun-sensitive disorder of the skin which eventuates in early skin cancer). Dr. Neidernhofer has created this knockout model in a dose-dependent manner and the slide demonstrates that when the protein, ERCC1, is undetectable, a mouse with this defect ages very rapidly. When ERCC1 expression is reduced by 75%, the animal ages much more slowly, but a diversity of solid tumors emerge, given that sufficient time has elapsed for the mutations to be formed that underlie oncogenesis. In the case of the mouse with no detectable ERCC1 expression, transcription is so compromised by unrepaired or misrepaired lesions in the DNA that early and severe aging is the consequence, with no time for the slower mutagenic process that eventuates in cancer to occur.
Slide 12: Aging, Cancer, and DNA Damage
Slide 13 demonstrates the work of Drs. Chet Mathis and Bill Klunk who are widely recognized for having developed a thioflavinoid, “Pittsburgh Compound B,” that binds to beta amyloid in the brains of patients with Alzheimer’s disease and which can thereby be detected using PET scanning. The slide demonstrates that with conventional MRI one cannot distinguish the brains of normal volunteers and patients with Alzheimer’s disease, but with Pittsburgh Compound B and PET scanning, the difference is dramatic. This is the first non-invasive diagnostic test for Alzheimer’s disease (especially in its earliest stages), and the overall safety and efficacy of Pittsburgh Compound B is now being assessed in clinical trials.
Slide 13: “
Slide 14 describes the work of Dr. Andrew Schwartz in the Department of Neurobiology. Dr. Schwartz is at the cutting edge of research which is focused on capturing the electrical activity of cortical motor neurons using microelectrode implants, and transducing this activity into software which controls the motion of a prosthetic limb.
Slide 14: Motor Cortex Activity and Anthro-Robotic
Control
The following link (15) to a video demonstrates that a primate with its natural limb strapped down and wearing a robotic prosthesis, is able to move the prosthesis in concordance with the activity of the motor neurons that are normally engaged when the animal plans a voluntary motor activity.
Video 15: (Click Here if you do not see a video directly below)
Slide 16 reveals the tip of a patient’s finger that has been accidentally amputated. In the following slide (17), the work of Dr. Stephen Badylak in the Department of Surgery and the McGowan Institute for Regenerative Medicine demonstrates how this finger has been “made whole,” using a biodegradable matrix on which stem cells, stimulated by growth factors, can accumulate and achieve appropriate cell connections and tissue morphology.
Slide 16: An Amputated Distal Digit
Slide 17: Results of “Tissue Engineering”
Slide (18) is
simply a reminder of the important work to be carried out by our new Center for
Vaccine Research in BST-3. We are
fortunate indeed to have recruited Dr. Donald Burke from Johns Hopkins, who
will have three jobs beginning this summer:
Dean of the Graduate School of Public Health, Associate Vice Chancellor
for Global Health, and Director of the Center for Vaccine Research. The latter two are new positions. He will also hold a Professorship in the
Slide 18: Avian Influenza: A Potential Pandemic
Slide 19 speaks to the work of Dr. Joanne Yeh, recently recruited by Dr. Gronenborn to lead X-ray crystallography research. Joanne’s research interests are novel in that she is applying her knowledge of protein conformation, and changes induced in conformation by the cellular environment, to the development of nanosensors and nanomotors. Here the general idea is to employ a protein that senses an environmental change, e.g., a change in redox potential or the presence of a toxin, and to use that conformational change to instruct a metalized peptide/nanoelectrode to direct the activity of a nanosensor, pump, or motor – all within a single cell.
Slide 19: Nanoscience in our
Slide 20 moves to clinical research, describing the advances in surgical strategy of Dr. Amin Kassam (Neurosurgery) and Dr. Carl Snyderman (Otolaryngology). They have perfected techniques whereby skull-based tumors can be excised using access through the nostril. In the past, such tumors have only been approachable via craniotomy and surgical manipulation through the brain substance until the base of the skull was reached. As one might imagine, these new techniques developed by Kassam and Snyderman greatly reduce the incidence and duration of morbidity.
Slide 20: Endonasal Approach
to Skull-based Lesions
Although I have
selected just this one example of clinical research in our School, I want to
note that clinical research here enjoys an enormous portfolio. Health services research is captured both in
the School and in GSPH’s Center for Research in
Health Care. Both schools are also a major provenance of epidemiological
research. Between 4,000 to 6,000
IRB-approved clinical trials and protocols are in force at any one time, and we
have one of the nation’s leading clinical trials program involving the medical
school as a whole, UPCI, the GCRC, GSPH, the
Despite these
extraordinary research advances, there are potential major barriers to
answering key questions in bi
Slide 21 shows
preliminary NIH award data for fiscal 2005.
(The NIH is late this year and will not post its final rankings until
later in the summer.) Currently,
however, our rank remains 7th among all American educational
institutions with their hospital affiliates, and we have experienced the
fastest and the largest increase in Federal support for bi
Slide 21: FY 05 Preliminary NIH Awards Data
Nonetheless, the
news is far from good: It is now clear
that if the NIH appropriation continues to be constrained, as it has been since
2003, we will have lost 20% to 30% of the NIH’s
value, expressed in constant dollars, by 2010.
Although in current dollars it appears that the NIH appropriation is
simply flat, the fact is that in every year since 2003, the NIH has failed to
keep up with the inflationary cost of bi
Slide 22: The NIH Appropriation: Recent History
There is more bad
news: The unfunded Social Security and
Medicare liabilities continue to mount, with the unfunded Medicare liability at
least five-fold greater than the unfunded Social Security liability. These entitlements compete head to head with
the NIH appropriation. Thus, it is hard
to be optimistic about the future of NIH’s monies (at
least until 2010, as slide 23 shows.)
In the best of circumstances, these economic constraints would be very
worrisome over the long term, but the worry is compounded by the current lack
of advocacy on Capitol Hill and the weakening of the intramural research
program in Bethesda, which historically has been the provenance of the most
visionary and creative NIH Institute directors.
That weakening has been occasioned by the end of the “doctors’ draft”
which, between the wars in
Slide 23: National Debt Projections
III.
Healthcare
Slide 24 captures the notion that we have learned more about human biology in the past 10 to 20 years than we have known heretofore in the entire history of science, and despite the challenges at the NIH, we continue to witness research breakthroughs by the day. Nonetheless, our country has never been in worse shape with respect to the delivery of health care and its economics.
Slide 24: The Dysynchrony
between Science and Health Care
Slide 25 relates
that we spend, on average, nearly $6,000, per year per person for health care –
more than twice as much as the next ranked industrialized nation. This slide demonstrates some of the drivers
of this cost. Even with this average
expenditure, we now have 46.5 million people living in this country with no
health insurance, getting sicker than they need to get and staying sicker
longer (notably, 50% of the indigent care in the U.S. is provided by the 6% of
hospitals that are academic). Moreover,
we are 26th among industrialized countries with respect to health
care outcomes and life span, and second from the bottom among industrialized
nations with respect to neonatal mortality (which is a revealing benchmark for
the health of society in general). Thus,
two “translational blocks” have been identified by the
Slide 25: Reasons for the High Cost of Health Care
IV.
UPMC
Despite these
threats to academic medicine, we are almost uniquely advantaged in our own
School by the strengths resident in this academic medical center and the
opportunities afforded us by these strengths.
Slide 26 shows the
Slide 26:
I have mentioned UPMC’s striking financial and operating performance
success, well reflected in slide 27, and redounding to our great benefit. Without this largesse, we would fail as an
institution since I noted earlier how poorly we and other
Slide 27: UPMC: Vital Signs
Slide 28: Commonwealth Support
V.
Recent Recruits to Senior Faculty Leadership
Positions
Slides 29-37
describe the careers and positions here of Drs. Amara,
Gronenborn, Shapiro, Freeman, Greenamyre,
Lakkis, Gittes, Gebhardt, and Burke – all recruited recently. We have had great success in recruiting these
leading figures in academic medicine and bi
Slides 29-37: New Faculty in Major Leadership Positions
VI.
Benchmarks of Success and Threats
Commonly accepted
benchmarks of success for any medical school, and ours in particular, are shown
in slide 38. Clearly, we have had huge success
with respect to funding from the NIH, including success in obtaining NIH
Roadmap funds; in the quality of the students and faculty that we have
recruited; in almost doubling our amount of research space in recent years; and
in beginning to address student debt, with about 20% of our students now paying
no tuition throughout their medical school years (we have moved from the bottom
of the “Thirteen School Consortium” in this regard to the upper third). We have also been successful, as noted
earlier, in continuously innovating elements of the curriculum and in the
quality of teaching (reflected in our new “
We have also been successful in fostering collaboration across departments, institutes, and centers, not only within the medical school but across the schools of the Health Sciences and, in fact, the University as a whole as well as Carnegie Mellon University. Indeed, Oakland is one of the few sites nationally where the whole parent University, a complementary university, and the hospital system all enjoy the same extended campus, and this geography offers a wonderful suite of collaborative opportunities. The final benchmark noted in slide 38, entrepreneurship, is valuable for a number of reasons: Without regulated technology transfer and the protection of licenses and patents, there is no incentive for industry to commercialize anything that we discover or develop, thereby robbing the public of our research advances. Further, when we are successful in entrepreneurship, we generate further revenue in support of our academic mission, not unlike the clinical and research paradigm I described previously.
Slide 38: Benchmarks of Success
Nonetheless, there are challenges to the kind of interdisciplinary research most apt to lead to commercializing our discoveries and developments. These challenges are shown in slide 39, but I am pleased to report that our very powerful tradition of collaboration across departments, institutes and centers speaks to these challenges, as does what I consider to be one of the nation’s more enlightened academic advancement policies, which I discussed earlier.
Slide 39: Challenges to Interdisciplinary Research
Another challenge has to do with conflict of interest and this is described in slide 40. The important point is that we must be aware that whenever our research holds the promise of increasing our own personal wealth, even if we have no conscious recognition of that possibility, the potential for conflict must be managed. The challenge is not to avoid the conflict altogether, because nothing could be more stultifying for institutional goals, but to manage it. Transparency should motivate all that we do in this arena: Others with appropriate expertise, but no possible financial conflict of interest, must have the same access to the same research data as that of the investigator who may have such a conflict.
Slide 40: Conflict of Interest
Finally, with respect
to “tough times in academic medicine,” I draw your attention to slide 41, which
describes the source of research published in the New England Journal of
Medicine between 1960 and 2005. The
slide shows that almost 100% of all such research was reported from a
Slide 41: Origin of Research Reports
VII. Other Issues
I will conclude my talk with brief comments on other matters of current concern to the faculty.
·
Mice: There is no question but that we have been
slow to develop state-of-the-art mouse facilities with respect both to quantity
of cage space and the adequacy of animal husbandry. None of us anticipated the explosive growth
we have had in our mouse-dependent research portfolio, and the animal care and
use program was not designed for such an expansive portfolio. Now, however, we are beginning to catch up:
This is costing a great deal of money, but as quickly as possible we are adding
high-density, ultra-filtration mouse caging, expanding the veterinary and
husbandry staffs, improving training and standard operating procedures, and
planning new facilities. For example, we
will soon begin construction of an “in-only” facility in BST-South to maintain
our most valuable animals in infection-free circumstances. We also are exploring the possibility of
contracting for some of our animal care needs, whereby a company, e.g.,
· Scientific Misconduct: We have learned a great deal from the stem cell contretemps that involved one of our senior faculty members during the past year. This has been a sad story indeed, but emphasizes the great care that we all must take in vouchsafing for the integrity of our reported research. This is especially true in an era of interdisciplinary, multidisciplinary -- and in this case, global – research collaborations, where we, as individual investigators, are often dependent on technologies and their interpretation that are remote from our own expertise and experience. Clearly, we must make as much of an effort to gain comfort with the work of our collaborators as we do with our own work.
· Bridge Funds: Because of the declining NIH appropriation (the first decrease in the past 30 years), I am making available a substantial amount of bridge funding, and have established an intramural “study section” to advise me on researchers and their projects that merit bridge funding. In most cases, funds will be awarded to investigators who have had excellent track records for peer-reviewed funding in the past, who currently have excellent priority scores and percentiles but are short of the funding threshold, and who may need some time before their funding is renewed. We will also use bridge funding for investigators who have changed their research direction and who will require support until that new direction is funded competitively. Finally, we will use bridge funding for new investigators who are not yet funded competitively but whose research achievements to date suggest great promise. The internal committee is now in place, and I expect that we will soon be awarding our first tronch of bridge funds. Needless to say, I have been able to create this fund only by moving dollars from other high-priority obligations, but I do not want to see any research effort of promise be compromised or aborted, and I especially want to be sure that funding continues for the graduate students, postdoctoral fellows, and laboratory staff of merit. Please note that funds from my office will only be available when Department funds are not available.
·
“BST-4":
UPMC has articulated its interest in building the next
· CTSA (Clinical and Translational Science Awards): We have been among the institutions to compete in the first round for the new NIH CTSA mechanism, and we should know the results of the competition within the year. However, I want to note that whether or not we receive funding in this highly competitive mechanism, I am committed to a Clinical and Translational Science Institute, a special focus of Dr. Steven Reis for the research per se, and Dr. Wishwa Kapoor for clinical research training.
· Ownership of Intellectual Property: As some of you know, there has been some ambiguity about the ownership of intellectual property arising in the medical school and UPMC’s interest in commercializing such property. Mr. Cindrich and others representing UPMC, and Provost Maher and others representing the University, have recently held a series of meetings that have put this ambiguity to rest, and I believe that we have now achieved definition and clarity on the part of both the University and UPMC with respect to who will be responsible for commercializing discoveries and inventions and how both entities will profit from that commercialization.
· “Glacial Speed”: Here I refer to the plethora of unfunded regulatory mandates that affect out ability to accomplish any of our missions, but especially animal and human subjects research. We are very close to having all of this regulation carried out electronically in a truly paperless academic community. We are also investing heavily in adequate staffing and high quality processes of the regulatory bodies, e.g., the IRB committees and the IACUC, both at the level of people and technology, and it is my goal to overcome what has been perceived as the “glacial speed” of regulation.
·
Intel and RAND: I want to call your attention to the Intel
University Lab of Pittsburgh and the RAND Corporation’s expanded quarters in
· Renewal of the University-UPMC Affiliation Agreement: This was a ten-year agreement, expiring at the end of FY 2008. However, both UPMC and the University are hopeful that the Agreement can be renewed earlier than its formal termination date, and I hope to have good news along these lines soon.
This concludes my first annual “State of the School” address, and, as I noted at the beginning of my talk, my hope is that this will become a durable medical school tradition. Notably, this talk does not replace what I enjoy most, which is speaking informally with faculty and students about the things that most concern and most interest them. As a physician, I have never met a patient who didn’t have at least one good story to tell me, nor have I ever met a person who didn’t have at least one good thing to teach me. This, of course, is especially true of my colleagues – both junior and senior. With this in mind, my door (and my e-mail) is always open, and I encourage one and all to seek me out whenever they want to share either their professional worry or their professional fun.
Thank you for coming to my talk in such large numbers; one of our faculty wags said that it was all because I used the word “threats” in my title. Next year, we’ll hold the talk in a larger space, and I hope that at least as many of you will come as has been the case now -- even absent the threats.