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COM dean addresses faculty for 2007 Editor’s note: On Jan. 30, College of Medicine Dean Jerry Reves, M.D., presented his State of the College speech to COM faculty and staff. Following is his speech. Welcome to the sixth annual address to the College of Medicine. I will report on our performance during the past year, accomplishments within the College, selected individual achievements of our faculty, major initiatives of this year, and my own focus for the coming year.  In terms of the Dean’s report card for 2006, we developed a plan to assist the University solve financial issues and this plan has been implemented. We worked with Dr. Brady to create a Clinical and Translational Sciences Award planning proposal and developed the infrastructure to make this effort successful. We are in the final stages of recruiting a new director for the Digestive Disease Center. We have been planning for the opening of the new hospital and that has gone well, though there are still some unsettled issues regarding the allocation of backfill space. We have assisted faculty and Drs. Wong and Hannun with implementation of the College’s strategic plans for education and research. Given the emerging challenges in this arena, Dr. Hannun has proposed further revisions to our strategic plan for research, and I support his efforts. We have been working closely with the Veterans Administration and have determined a model of partnership around a phase two hospital; what remains to be seen is whether that plan is feasible and can be enacted in a timely way. We continue to explore ways to find new revenues to support our critical missions. It is clear that one of the foremost means to this end will be through philanthropy, though we are ever optimistic that there will be intellectual property revenues to assist us as well. As always, with your support, we have successfully remained focused on our primary projects. There have been other notable accomplishments within the College this year.  Both the ENT and Pathology departments had excellent external reviews.  As a College, we finally reached our goal of being in the upper quartile of National Institutes of Health (NIH) funding among free standing medical schools. Five departments are ranked in the top twenty nationally for NIH funding. We were successful in naming Dr. Scott Reeves as chair of Anesthesiology. John Schaefer has played a vital and leading role throughout the State through the Health Sciences South Carolina Center on Clinical Effectiveness and Patient Safety. Our medical students’ scores on the United States Medical Licensure Examinations are continuing to rise. We have also achieved records in patient care volume and research funding.  We have made a strong commitment to closing the gap in health care disparities.  One of our strategies is to further diversify our College so that we can optimize communications and reduce barriers to care for our citizens. To this end, we have increased the number of our underrepresented minority (URM) faculty by 6%, and we now have a total of 57 URM attendings in our ranks.  64% of our College departments have one or more minority faculty members, and we have increased the number of our URM house staff by 24%, from 29 to 36. We continue to attract prominent minority leaders for our Grand Rounds and other educational conferences. 21% of the College’s undergraduates are URM students, and we are especially pleased that in this year’s entering class there are 14 URM male students, 11 of whom are African-American.  We have been successful in our attempts to diversify our faculty, house staff and student body, and we will continue in these vitally important efforts.  I am confident that this will play a role in minimizing the health disparities that we have in South Carolina. Although our NIH funding increased through fiscal year 2005, our national standing is 52nd of 125 medical schools, and this is a slight drop from the previous fiscal year.  We remain quite strong in our region, ranking 13th of 43, and we have five departments who are nationally prominent and are regionally ranked within the top five.  We would certainly like to see these numbers trend upward and have more of our departments join this elite group. I am very pleased that for the first time the College of Medicine ranks in the upper quartile in NIH funding among the 34 free standing medical schools.  We stand at number eight and are only $4 million behind the Medical College of Wisconsin, which is ranked six higher than us.  As a College we have set as an ultimate goal to be in the upper quartile of all medical schools which would be at number 31, mid-way between Oregon and UT Galveston.  However we are forecasting, for the first time in a very long while, that in fiscal year 2007 our research funding may not grow. This is, of course, a factor of the flattened NIH budget. Also, last year we included endowed chair funding in this total.  We have not brought down the State’s matching funds for our Centers of Economic Excellence this year, and so it is still possible that we will close the gap to a degree, though possibly not entirely.  If we are to achieve continuing growth in research, it is likely that we will have to look to industry and other non-federal sources of funding to accomplish this important aspect of our academic mission.  One strategy we are using to enhance our potential for research is through the South Carolina Research Centers of Economic Excellence. The Chairs already awarded and those expected in 2007 through the Health Sciences South Carolina initiative will enable us to continue to identify talent from around the country and recruit new faculty to our campus, with the goal of improving not only our science, but also our economy and the health and welfare of the population of our State.             This is the part of the annual address that I enjoy the most, because I get to single out a few of the many faculty members who are doing wonderful things for our College. First I want to congratulate John Raymond for recruiting Steve Lanier back to our campus as the Associate Provost for Research.  In addition to his mentoring program in cardiovascular biology, Steve brings to us a strong interest in enhancing campus-wide mentoring efforts that will greatly assist us with faculty development and will ultimately impact all of our research endeavors. Wanda Gonsalves received the University of Kentucky’s Community Service Award for creating the MUSC Medical Student CARES (Community Aid, Relief, Education, and Support) Clinic through the department of Family Medicine.  Roger Newman is President of the Society for Maternal-Fetal Medicine. Ron See is principal investigator of the first methamphetamine research center in the country with clinical and translational research programs. Joe Schoepf received the Vezina Award for Innovation and Excellence from the French-Canadian Society of Radiology. Bruce Thiers served as vice president of the American Academy of Dermatology. Jim Oates is president-elect of the American Federation for Medical Research. Buddy Jenrette’s department ranked 3rd of 74 in pass rates for the radiation oncology boards, highlighting their superb teaching.            Bill Hueston served as president of the South Carolina Academy of Family Physicians and chaired their annual meeting.  Kathy Laber of Comparative Medicine was the first woman to serve as vice president of AAALAC (the Association for the Assessment and Accreditation of Laboratory Animal Care). We held a triumvirate with Drs. Osguthorpe, Day and Lambert, who served on the 12 person American Academy of Otolaryngology-Head and Neck Surgery Board of Governors, giving MUSC a solid voting block of 25%. Ray Anton is president-elect of the Research Society on Alcoholism of the American Psychiatric Association.  Mike Schmidt serves MUSC as director of the Office of Special Programs for the Department of Energy. Yuko Palesch is the principal investigator for the Stroke Treatment Trials Network, heading the Statistical and Data Management Center.              Julius Sagel received the Leonard Tow 2006 Humanism in Medicine Award for exemplary compassion, competence, and respect in the delivery of care. Carolyn Reed is president of the Southern Thoracic Surgical Association. Bob Sade is chair of the AMA Council on Ethical and Judicial Affairs. Inderjit Singh created a new spin off company with support from the Foundation for Research Development that will develop a new line of drugs. David Ploth is editor of the American Journal of the Medical Sciences. Dean Kilpatrick served as president of the International Society of Traumatic Stress Studies and as a member of the Institute of Medicine Veterans’ Compensation for PTSD Committee. There are many others doing incredible things within our College and I commend you all for your outstanding achievements.              A word about finance in the College: Though our total expenditures have grown steadily from fiscal year 02 through 06, it is important to note that the relative proportion of State support for all that we do has steadily declined by about one-third during this interval, from 15.3% to 9.6%.  This trend indicates that everyone is being more efficient while maintaining effectiveness, which is to be congratulated. In light of this financial trend and others, we need to maintain an ultimate goal of self-reliance.            As the first medical school in the South, our proper place among U.S. medical schools has yet to be achieved. Over this long haul we have continued to strengthen our programs and are arguably right around the tenth best in the South. However, we are not yet where we need to be, which is among the top quarter nationally and within the top five in the South. We have developed lofty but attainable goals in response to the question, “How do we get there from here?”  Accordingly, I will spend the remainder of our time talking about five major initiatives of the College this year: our commitment to excellence, the CTSA grant submission, opening the new hospital with service lines, formation of a teaching academy, and achieving MUSC accreditation with a focus on interdisciplinary education.              The hospital has introduced us to a process entitled “Commitment to Excellence” which follows a blueprint by Quint Studer, author of Hardwiring Excellence.  We are embarking on a two year journey to achieve lasting excellence within the crucial domains of service, people, quality, finance, and growth.  This road to success will make all of us increasingly cognizant of our fundamental purposes in doing worthwhile work while making a difference to South Carolina and our nation.  Prominent health centers such the Cleveland Clinic and Vanderbilt have already embraced this methodology to achieve measurable markers of excellence. You will be hearing a great deal about this effort as we further assess our interactions with people, the quality of our services, our mechanisms for growth, and our plans for financial stability.  Though it may be difficult at times, this process will be exciting, and it will give us the tools needed to make the transformation that we must undergo in order to achieve our lofty ambitions for national prominence and overall excellence.             Our second major initiative is the submission of a competitive Clinical and Translational Sciences Award (CTSA) application to the NIH.  I showed this slide last year to illustrate the key performance areas for the CTSA: novel methodology, biomedical informatics, design and biostatistics, research training and career development, translational technology and resources, and community engagement.  These are the areas in which we will have to prove our abilities.  We received a planning grant for $120,000 and Kathleen Brady is our principal investigator. There will be requests for applications until 2012, by which time there will be a total of 60 CTSAs nationally.  Our next steps are to find out if our GCRC renewal grant has been funded, and we should hear about this soon.  We are already conducting pilot projects, and we will apply on our red letter day of Oct. 24, 2007.  The CTSA must be transformative, novel and integrative. We are focusing on novel research aimed at health disparities in our region. We will be integrative in that all Colleges will be invited to participate, in order to foster research within multidisciplinary teams. Because diseases such as stroke do not recognize institutional or geographic boundaries, we will also be working with two independent universities, the Medical College of Georgia and the University of South Carolina, using a novel telemedicine-enabled hub and spoke system. Since we are located in the heart of the Southeastern stroke belt, we believe that the CTSA can help solve this regional health problem and others, translating promising research from the bench to the bedside.              Focusing now on clinical care, it is important to note that our State is one of the tenth fastest growing in the nation, and that most of the fastest growing areas are in the lowcountry that we serve. To address this remarkable growth, we are building a new hospital with new methods that will enable it to be hardwired for excellence from the start.  It will have an information system that will be virtually paperless.  We are building service line management throughout our clinical enterprise, and this effort will begin in the new hospital. Service lines will be overseen by a chief medical officer and an advisory committee, with service line management by a physician leader and an administrative leader, who will be responsible for operations, business and nursing.              Educational initiatives in the College of Medicine include a revised curriculum core, a patient safety and clinical effectiveness core, an extra-curricular core, and a teaching scholars academy. A central component of the teaching scholars academy is the supra-departmental organizational infrastructure designed to reward the educational efforts of outstanding teachers, develop and nurture the improvement of faculty teachers, support the administrative efforts of course coordination and evaluation, and enhance the academic scholarship of education. We will be working with the University to see that MUSC achieves re-affirmation of the Southern Association of Colleges and Schools’ (SACS) institutional approval when we have our site visit in March 2007.  We are monitoring our educational programs’ adherence to the institutional standards outlined by the Commission on Colleges, and are implementing MUSC’s Quality Enhancement Plan (QEP), which is entitled Creating Collaborative Care.  With your help, we are also working on curricular reform, updating and improving curricular structure to train future physicians effectively.  Overall, the goals are to promote clinical thinking and de-emphasize rote memorization, maximize clinical pertinence and eliminate unnecessary redundancy, and create opportunities for customizing educational experiences through clinical exposures provided earlier in the curriculum. Steps that are already underway under Jeff Wong’s leadership are: coordination and integration of the basic science curriculum across rather than within traditional departmental lines, enhanced emphasis on clinically relevant subject content, developing new methods for teaching content and concepts (less lecture, more “hands on”), and encouragement of academic and scientific inquiry through exposure to researchers and their work.  I am particularly excited about our opportunity to promote translational and clinical science in our educational curriculum. The blueprint for this was outlined in September by a task force of the Association of American Medical Colleges. In this report there are several recommendations, but two of them are foremost: One is that every future physician should receive a thorough education in the basic principles of translational and clinical research, both in medical school and during residency. The second recommendation is that the Liaison Committee on Medical Education should add education in translational and clinical research to requirements for medical school accreditation, as should the Accreditation Council for Graduate Medical Education, in order to be certain that our medical students and residents are taught the fundamentals of clinical investigation.  My question to you is this: Can MUSC be one of the first schools to fully implement these recommendations?              A work group consisting of Drs. Wong, Tilley, Hannun, and other leaders has listed the key elements that should be formalized within the educational continuum, from the first year of medical school through the last year of residency. The elements are: how to perform a literature search and review, critical appraisal of the literature, fundamentals of epidemiology and biostatistics, common themes in basic sciences and clinical research, how to work in multidisciplinary research teams, the ethics of research, how institutional review boards work, how to form and pose a research question, and what is involved in answering research questions.  If we can imbue our students with this understanding, we will have created a foundation for life long learning and a profound appreciation for the critical role of research in advancing clinical medicine.  Goals for the coming year include the recruitment of chairs for the departments of Surgery and Psychiatry. We will also fill key service line leadership positions and begin implementation of service lines. We will establish curricular reforms, adopt and implement the road to excellence process, and determine if we can jointly build phase two of the hospital with the Veterans Administration. We will implement a medical information system that fully integrates the clinics and hospital.  Dr. Feussner is taking the lead in our effort to establish greater clinical outreach in the north area, and we will be adding 50 to 100 new clinicians, about a 10 – 20% increase, to accomplish this goal. We will also support the CTSA application and assist the Hollings Cancer Center in preparing for their National Cancer Institute core grant submission in 2008. We will strive to increase NIH funding and other extramural support at a rate of growth that exceeds the national average. We will build the endowment of the College of Medicine and we will support the Health Sciences South Carolina commitments made on behalf of MUSC, continuing in our efforts to make this a national model. We will allocate appropriate space costs to users and require accountability for allocated space. We will also increase our underrepresented minority students, residents and faculty, and we will work collaboratively on the inter-professional curriculum with other Colleges. It promises to be a busy but rewarding year. In representing you, I am working to accomplish your goals and fulfill your ambitions on behalf of our College. It is a tremendous privilege for me to do so. Thank you for your attention and support.             Friday, Feb. 16, 2007 Catalyst Online is published weekly, updated as needed and improved from time to time by the MUSC Office of Public Relations for the faculty, employees and students of the Medical University of South Carolina. Catalyst Online editor, Kim Draughn, can be reached at 792-4107 or by email, catalyst@musc.edu. Editorial copy can be submitted to Catalyst Online and to The Catalyst in print by fax, 792-6723, or by email to catalyst@musc.edu. To place an ad in The Catalyst hardcopy, call Island Publications at 849-1778, ext. 201.