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Harvard Medical School BostonコミュのMessage from Dean Flier - The Year in Review

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Dear Colleagues,

As the 2008-2009 academic year and my second year as dean come to a close, I invite you to join me in reflecting on the many accomplishments at HMS during the past 12 months. Although the past year has brought some unexpected events, it has been an extraordinary honor to lead this great School during this period, and I look forward to sharing some of our progress with you.

A new financial context. Achievements across the Harvard Medical community occurred during a year of global economic crisis, which had an unprecedented effect on the finances of Harvard University and Harvard Medical School. The projected loss in the value of the University’s endowment and related declines in future endowment payouts, coupled with preexisting fiscal trends, caused us to project ballooning and unsustainable annual operating deficits. These new financial challenges coincided with the completion of our strategic plan for HMS and our planning for the initial phases of implementation. Not surprisingly, the financial circumstances have had several major consequences. Expected funding for new initiatives became limited, both from University sources and our own funds; attention had to be paid to existing programs due to unanticipated loss of funds required to sustain them; and the delay in construction of the Harvard Allston Science Complex, to which HMS Systems Biology was planning to move, restricted our future research space capacity.

As a result, we initiated a fundamental review of the School’s academic programs and policies as well as our operating and financial models in order to identify a strategic, effective path forward. Through aggressive management and shared sacrifice over the past five months, our projected deficits in unrestricted funding are beginning to move in the right direction. However, there is much more that must be done if we are to continue to make progress in key areas. Among our toughest decisions has been a small number of staff layoffs, which have taken a great toll on the affected individuals and our entire community. Next year will see further efforts to reduce costs and increase revenues, and these will require your creative input and cooperation.

However, it would be unacceptable to allow these new problems to put us into a prolonged and ultimately defensive crouch. HMS is an impressive institution with tremendous potential, and our challenge at this particular time in history is to reevaluate our organization and our traditional ways of doing business to identify the most effective means of advancing human health through education, research and engagement with the world. I am happy to report to you that, remarkably, despite the new financial realities, we have made meaningful progress toward attainment of the major goals set forth in our strategic plan (http://hms.harvard.edu/public/strategy).

Preclinical basic science. The preclinical basic science departments at HMS comprise an extraordinary group of world-class faculty at the leading edge of fundamental biological science. One of our most important goals is to maintain the excellence of this distinguished community in a constantly changing world of science. One approach is to recruit new faculty in areas of great promise. This year, in addition to the recruitment of Michael Greenberg as chair of Neurobiology, we have recruited six new Quad faculty, two in Pathology (Diane Mathis and Christoph Benoist), one in Neurobiology (Bob Datta), one in Systems Biology (Michael Springer), one in Genetics (Steve McCarroll) and one in Cell Biology (Gaudenz Danuser). To highlight only one of these distinguished faculty members, Dr. Danuser, recruited as a professor of cell biology from Scripps, is a dynamic young leader in developing approaches to cellular imaging, including new computational approaches. His recruitment was inspired by the strategic plan that encouraged recruitment of faculty who would push the envelope in developing new methodologies fundamental to biological science.

In addition to these wonderful recruitments, I have been working with HMS academic leadership to consider potential changes to our preclinical scientific programs that will align them even more effectively with evolving strategic goals and opportunities while also allowing us to manage and repair our facilities. The initial outline of a series of actions is just now emerging and is described here. These steps represent only the most immediate course of action. With your help, I hope to continue to support and improve the research community in all departments and to create new opportunities in the basic sciences.

First, neurobiology was a major priority in the strategic plan, and I was thrilled to recruit Michael Greenberg to be chair of the Neurobiology Department. Working closely with Mike, we have decided to move Neurobiology from the Goldenson Building, which is in major need of renovation, to the New Research Building, where our basic scientists will have proximity to many outstanding HMS neuroscientists in our affiliated hospitals. This will allow us to pursue the vision detailed in the strategic plan for a more integrated and powerful HMS neuroscience community.

This move will take place over several years and will permit Goldenson to be fully renovated. In the newly configured space, several exciting initiatives are being planned. First, in concert with the move of Neurobiology, members of the Pathology Department will relocate to renovated labs in Goldenson. This move will help create a community of microbiologists and immunologists that will not only allow the continued pursuit of fundamental science in those critical and far-reaching disciplines but will also encourage new focus and strength at the interface of these fields. A major goal will be to identify principles underlying susceptibility and host defense and to develop future therapies deriving from this knowledge. In parallel, we will take additional steps to enhance our broad effort in fundamental and translational immunology and inflammatory biology, which underlie so many prevalent human diseases. The same space in Goldenson will also house the expected growth of our exciting Systems Biology Department and the development of a nascent HMS Initiative in Therapeutics, discussion of which generated great enthusiasm during a two-day retreat last October. This initiative will span many departments, including Biological Chemistry and Molecular Pharmacology, Systems Biology, and Microbiology and Molecular Genetics, among others, and will allow HMS to establish a leadership role in this area, which is so critical for the future of the School.

It is likely that during the next few years, as these moves take place and initiatives become established, the face of microbiology, immunology and pathology on the Quad will evolve to best meet the needs of our extraordinary faculty and new scientific opportunities. The precise nature of these changes will be formulated over the next several months, with input from faculty and advice to me from a senior advisory group of HMS and external scientific leaders, in close consultation with the preclinical chairs.

These changes will require the input, energy and ideas of many in our community. It is worth remembering that, in response to changing scientific opportunities, HMS has evolved the identity and organization of its preclinical departments very successfully over the past 20 years. I believe that realignment of some of our efforts will also position us well for external funding, both from granting agencies and philanthropic sources.

Genetics. Genetics is fundamental to modern biology, and the Department of Genetics has targeted a number of critical areas for future development in order to remain at the forefront of this vital field. One of the most important is human genetics, motivated by our rapidly evolving understanding of the role of inheritance in human disease. The Genetics Department recruited an outstanding new faculty member in this field, Steve McCarroll, and the department is reorganizing the space for human genetics faculty to better reflect its aspirations.

Major support for genetics at HMS comes from the great generosity of Philip Leder, founding chair of the department, who has agreed to dedicate a substantial HMS fund, developed under his leadership, for recruitment and innovation in the department. One of the first fruits of this generosity will be a new chair for a professor of genetics in cancer biology on the Quad, a position for which a search has been started.

Importantly, human genetics, with its implications for both individual human health and society, is of broad interest and has become a major focus of scientific effort across Harvard, including the Faculty of Arts and Sciences, the School of Public Health, the Harvard hospitals and the Broad Institute. A plan for a Harvard-wide human genetics initiative was presented to and approved by the Harvard University Science and Engineering Committee, or HUSEC, last fall before the financial crisis, and it is now beginning to take form in a manner consistent with the current financial situation and aligned with the rest of the University’s science planning. To be launched in academic year 2010 under the leadership of David Altshuler, a professor of genetics at HMS and MGH, and in close collaboration with Cliff Tabin, HMS chair of the Genetics Department, and a University-wide executive committee, the Human Genetics Initiative will pursue four primary aims during the next two years: (1) to continue to build and coalesce the human genetics teaching and research communities across Harvard’s schools and teaching hospitals; (2) to provide a forum in which to develop and share effective educational resources―including new courses―to advance the teaching and training of students, researchers and clinicians; (3) to engage Harvard’s leaders in the field to develop a research framework of important scientific, social and policy questions to be examined in future efforts; and (4) to begin a longer-term effort to secure resources to propel research and teaching in human genetics across Harvard. By pursuing these aims, we can build momentum in human genetics research and lay the groundwork for addressing longer-term goals, including the advancement of a broader research agenda, as resources are developed.

Bioengineering. Bioengineering is another priority area for HMS and Harvard University. Fueled by a $125-million gift to Harvard University, the Wyss Institute for Biologically Inspired Engineering was launched this January (http://hibie.harvard.edu), led by Don Ingber, an HMS professor of pathology at Children’s Hospital. Located now in the Harvard Institutes of Medicine but soon to be situated in the Center for Life Sciences, this Institute brings together scientists from across the University and from the School’s affiliated hospitals. The Wyss Institute is actively establishing advanced technology cores and is focusing on fundamental science-driven technology development in the newly emerging fields of synthetic biology, biological control and living materials. A new faculty search in the field of synthetic biology, conducted jointly with HMS Systems Biology, is under way.

Social science and global health. The Department of Global Health and Social Medicine is experiencing major change as a result of the departure of its department chair, Jim Kim, on July 1 to become president of Dartmouth College. Happily for the department and the HMS community, I was able to name Paul Farmer to succeed him in this role. Our aspirations for this department and broad area will thrive under Paul’s visionary leadership. We have additional opportunities to extend the impact of HMS research and education to complementary venues in the world. In May, we announced that HMS and the Portuguese Ministry of Science, Technology and Higher Education made a formal agreement, signed in Lisbon, creating a collaboration between HMS and Portugal and its universities and medical schools that emphasizes translational research and training. We are also taking responsibility for providing health care information that will be translated into Portuguese and disseminated throughout the country, taking advantage of Harvard Health Publications, a unique and valuable part of our School. We are currently formulating plans for additional collaborations in research and education around the world. In addition, the HMS Department of Health Care Policy is fully engaged in the national debate on health care reform with our faculty in the forefront of the discussion.

Population medicine. Another department experiencing change is the Department of Ambulatory Care and Prevention, which underwent a thorough academic review this year that strongly validated its leadership and programs. We recently announced our decision to rename this department as the Department of Population Medicine, to more accurately reflect its mission. Going forward, the department, which is chaired by Richard Platt, will be linked even more strongly to Harvard Pilgrim Health Care, an HMS affiliate.

Harvard Catalyst. Perhaps the most far-reaching accomplishment of the past year in terms of its breadth and depth is the establishment of the Harvard Catalyst, a pan-Harvard initiative based at HMS and involving all its affiliated hospitals. Under the leadership of Lee Nadler, HMS took the lead in securing a $117-million grant from the National Institutes of Health to establish this center for clinical and translational science, supplemented by $75 million committed by the University, HMS and our affiliated hospitals. The infrastructure we are establishing as part of the center supports multidisciplinary programs in research, education and technology development and links groups across the University, HMS and the various hospitals. There were many highlights during Harvard Catalyst’s maiden year, including successful efforts to transform four separate clinical research centers into a unified human research laboratory, a transformative and still evolving web portal, the awarding of 60 collaborative pilot grants and the implementation of an IRB institutional reliance agreement that facilitates the launch of IRB-approved clinical trials across our independent institutions, an outcome until recently viewed by many as beyond our collective grasp. Transformative approaches to education and cross-institutional interactions are planned for the next year.

Education. Under the leadership of education deans Thomas Michel, Jules Dienstag and David Golan, medical and graduate education at HMS continue to advance. This past year, a major pillar of curriculum reform was consolidated. For the first time, all of our students spent their entire third-year clerkship at a single HMS affiliate, allowing them to engage deeply in the workings and unique culture of one complex health care organization while at the same timing gaining exposure to a longitudinal curriculum and mentoring experience. We continue to work on HMS-PRIME, which will eventually involve a fifth year of research for a group of students who will graduate with both an MD and a master’s degree in medical science. In a major step toward relieving students’ burdens of debt, last fall we increased scholarship funding by $3 million, a nearly 40 percent increase over the previous year, and we will maintain funding in the future. HMS leadership is committed to ensuring that financial constraints will not bar the most qualified students from joining our community.

Faculty. Across Harvard medicine, our faculty are making impressive progress. Between September 2008 and June 2009, 211 faculty were promoted to assistant professor, 122 to associate professor and 50 to professor through the efforts of our Office of Faculty Affairs. Of the 50 new professors, 10 were women, one was an underrepresented minority and nine have joined the School as new recruits.

The awards to and recognition of our faculty are quite remarkable, and I offer here only a few examples. Gary Ruvkun, a member of the HMS Department of Genetics and the Molecular Biology Department at MGH, has shared both the Gairdner Foundation International Award and the Albert Lasker Basic Medical Research Award for fundamental genetic studies uncovering a type of small RNA that regulates gene activity. George Church, a longstanding member of our Genetics Department, earned the 2009 Promega Biotechnology Research Award from the American Society of Microbiology for his critical discoveries leading to the fields of bioinformatics and synthetic biology, which are transforming DNA sequencing for faster, better approaches to personal genome sequencing. In another exciting moment for HMS, five members of the HMS faculty were among the 50 scientists selected by the Howard Hughes Medical Institute in March for early-career awards. A less traditional but no less notable recognition came from an initiative called Stand Up to Cancer, funded by the entertainment industry to establish and support multidisciplinary “dream teams” to attack questions in cancer research. When the panel announced its choice of five teams, two were headed by HMS faculty: Lewis Cantley of Beth Israel Deaconess Medical Center and the HMS Systems Biology Department, and Daniel Haber of MGH. These are just a small representation of the honors garnered by our illustrious faculty.

Conflict of interest. This year, I asked a committee of faculty, staff and students to begin a comprehensive review of the School’s Policy on Conflicts of Interest and Commitment. Their work should conclude in the fall, which will mark the sixth time the policy has been revised and updated since its inception in 1990. Committee members bring divergent views to the table, ensuring that deliberations are open and robust. To engage the HMS community fully in this conversation, we have created an interactive HMS Integrity in Academic Medicine website: http://hms.harvard.edu/public/coi. This site includes a white paper I wrote recently to clarify my own views on this complex issue (http://hms.harvard.edu/public/coi/dean). Please visit the site and include your thoughts and observations in the comment section.

In Memoriam: Dean Tosteson. In May we lost a beloved member of our community, former HMS Dean Daniel C. Tosteson. During his twenty-year tenure, Dan Tosteson had an extraordinary impact on the identity of HMS as an educational and research institution productively engaged with the larger world. In expressing deep gratitude for his vision and leadership, I know I speak for all who knew and worked closely with him. A memorial service is being planned for September.

In closing, I hope I have captured some sense of the excitement and progress that we have experienced across the HMS community during the past year. The steady progress that we are making reflects the spirit and determination of our remarkable community of faculty, staff and students. I am deeply grateful for your advice, your patience and your partnership.

Sincerely,

Jeffrey S. Flier
Dean of the Faculty of Medicine

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