HMS State of the School

[SIDE CONVERSATION] Good afternoon. Good afternoon. Good afternoon and welcome. I’m no longer a new dean. I know the novelty has worn off. So I think it’s a testament
to your commitment to Harvard Medical
School that you’ve all taken the time out of your
busy schedules to be here, or it could be that we’re going
to hold the Green Dragon pub right after. Some of you will remember that
at my installation, I said, never underestimate the
convening power of free food and beer. [LAUGHTER] So I also want to welcome
the folks who are actually following along on Livestream. I’m particularly
thankful for them because I know that their
participation is not contingent on the appeal
of the Green Dragon pub. [LAUGHTER] So this afternoon,
I’d like to share some of the remarkable
progress that we’ve made over the past year and
to also talk about our plans for 2020. First, I’m going to
provide an update on the school’s finances. Then next, I’ll
highlight the investments that we’re making in our
research infrastructure that is going to benefit the
entire HMS community, and then finally, I’ll
speak about our improvements in our educational enterprise. And after my remarks, I’ll
take a few questions, and then of course, we can
continue our conversations at the Green Dragon pub. But before the updates, please
allow me a quick reflection. Sometimes, events
in the outside world feel confusing, depressing,
even infuriating. But my spirits are lifted
by the earnest work that you all do here
at HMS, and indeed, it is the accomplishments of
the Harvard Medical School that give me cause for
optimism on a daily basis. You are an
extraordinary community. Your remarkable dedication, your
excellence, and your service remind me that Harvard Medical
School drives meaningful change in science and
across our society. And thank you for that. Now, I was particularly inspired
by our celebration last October of a critically
important milestone in the history of
Harvard Medical School, the launch of diversity
inclusion efforts 50 years ago. Galvanized by the
civil rights movement and moved by the assassination
of Dr. King, in 1968, a group of Harvard faculty
came together to advocate for bringing more
African-American students to the school, which at that
time had virtually none. Now, these forward-looking
faculty successfully campaigned for the
creation of 15 scholarships for students from
minority backgrounds. And since that time, HMS
and the Harvard School of Dental Medicine have
graduated more than 1,350 students from backgrounds that
have been long underrepresented in medicine. Now, these graduates
in turn have gone on to distinguished careers– nine medical school deans, six
hospital presidents or CEOs, 32 department chairs or vice
chairs, 34 division chiefs. Last October, hundreds of
these alumni and members of the Harvard Medical
School community filled the TMEC
auditorium to overflowing to celebrate HMS’s five decades
of diversity and inclusion efforts and particularly
to pay tribute to Dr. Alvin Poussaint’s
leadership and legacy. Alumni came from
across the country. For many, it was
the first time they had returned to Harvard Medical
School since they graduated. I was not alone in
being deeply moved by the testimonials
shared by these alumni. It was clear they had faced
significant obstacles, but it was equally
clear they had not let those obstacles deter them. They shared that their
lives had been enriched by being part of the Harvard
Medical School community, and in turn, they have
enriched our community and countless others through
their work as clinicians, scientists, and leaders in
academia, medicine, government, business, and industry. Let me say, this community
regularly makes me proud, but I have never
felt prouder than I did that day last October. Now, I’m happy to report that
since 1969, our diversity and inclusion efforts have
grown stronger every year. Indeed, our entering
MD class this year is our most diverse in history. 25% percent of our
new medical students are from populations
underrepresented in medicine, and 15% self-identify as LGBTQ. At Harvard Medical School,
we champion diversity because it fosters a richer
educational environment for all students who learn so
much from each other’s lives. We champion inclusion
because varied perspectives contribute to better decision
making and drive innovation. We champion belonging because
our greatest achievements occur when every individual
is empowered to perform at their highest potential. We aspire to be a community that
reflects the broad diversity of the patients we serve. Now, an update on our finances– I am delighted to
tell you that today, Harvard Medical School is
in a much better position to deliver on our vision of
enabling greater impact than we were even a year ago. When I think of where we’ve
been and where we are going, I’m reminded of and I
conjure the image of rounding the mark in a sailboat race. Now, when I was in
graduate school, my older brother
taught me how to sail. And my wife and I
recently have taken up competitive sailboat
racing, a small sailboat we share with some friends. So those of you who sail
will get this metaphor. But sailboat races
typically start upwind. You fight a stiff breeze. You’ve got freezing cold
spray coming over the bow. And I’m on the foredeck. I get hit with a
lot of cold water. So just getting to the
first mark, it’s a struggle. But when you’ve rounded
that first mark, a major change happens. The wind is now at your back,
and you feel that wind power behind you, filling the
sails, pushing you ahead. It’s exhilarating. Right now, that’s how I feel
about Harvard Medical School. For the past three
years, we’ve been fighting financial headwinds. We’ve been struggling to balance
our budget while continuing to advance our
educational, research, and clinical missions. Now, after a lot of diligence
by our administrative and financial teams
working in concert with departmental and
university leadership, I believe we have
rounded the mark. We have wind in our sails, and
I am excited and cautiously optimistic that the wind will
be with us from here on out. Through a combination
of efficient management, greater success in
obtaining NIH grants, the sale of the 4
Blackfan Circle building, and countless other
smaller but still meaningful belt-tightening
moves by many of you, we have succeeded in
largely eliminating what had been a recurring,
year after year deficit. Now, through the
collective efforts of Executive Dean for
Administration Lisa Muto, our Chief
Financial Officer Mike White, and their teams,
we’ve decreased our deficit from $49 million in fiscal
year ’16 to $32 million in FY ’17, $21 million in FY
’18, $10 million in FY ’19. Now, we’ve projected a small
$4 million deficit in FY ’20, but we are already doing
better than anticipated. And we’re predicting cash
flow break even either this year or next. This is all before considering
the increased philanthropy that we’ve achieved
under the leadership of Lisa Boudreau, our dean for
alumni affairs and development. Let me emphasize this. We have balanced our books
on our own without depending on a university bailout or the
Blavatnik Family Foundation gift to cover our losses. In fact, the Blavatnik gift
was predicated on our first remedying our financial deficit. Now, I manage with a
watchful eye on cash flow, but Harvard as an
institution uses a full funds generally
accepted accounting principles, or GAAP, accounting method. By this method, after
receiving the first installment of the historic $200 million
Blavatnik Family Foundation gift, we are in fact reporting
a $52 million surplus in FY ’19. It is the first black ink we
have seen at Harvard Medical School in over a decade. Now, the Blavatnik gift
enables us to invest now in transformative ways here at
HMS, but I want to remind you, we must remain prudent
stewards of our resources. We’re facing uncertainty
in financial markets. There is a political
climate that is going to continue
to put pressure on our financial model. Complacency or a
lack of discipline will invariably lead us
back to structural deficits. Building financial strength
in an institution– it’s akin to building trust. It takes prudence and
fairness to build, and it can be quickly lost. I’m hopeful, however, that
through collaboration, shared decision making,
wise fiscal discipline, we can advance our
academic priorities while continuing to reinforce
our long-term financial stability. So with solid financial and
now intellectual foundations in place, strong
philanthropy behind us, it’s time for us to seize the
enormous opportunities that lie ahead. We are now poised to deliver
more than ever on the promise of this amazing institution. Now, one of my deeply
held convictions is that collaboration
breeds innovation. As the distinguished former
Dean of Harvard Medical School Oliver Wendell Holmes noted
more than 160 years ago, many ideas grow better when
transplanted into another mind than in the one
where they sprang up. And I strongly agree. I’m committed to a strategy that
maximizes collaborative efforts across Harvard Medical School
and, wherever possible, leverages the broader
Boston biomedical ecosystem. A primary vehicle for catalyzing
collaborative research has been the Dean’s
Innovations Awards. Now, to date, we have
granted more than $29 million to 92 collaborative projects
involving 169 investigators across our community,
and the vast majority is supporting fundamental
curiosity-driven research. Some 25% of these grants
involve co-investigators in our affiliated hospitals
and research centers and thus draw us together. Now, our outstanding
communications team led by Laura DeCoste has
prepared a short video highlighting just a few of
the people and projects, and let’s just take a look. [VIDEO PLAYBACK] [MUSIC PLAYING] [END PLAYBACK] So I think you’ll
see, this is, I think, a wonderful way to
catalyze community. It really highlights
just a small sampling of consequential new projects
that have been launched. To fill in a little
bit more, another way that we’re fostering
contributions from across our community is
through the Dean’s Innovation Awards for education,
administrative efficiencies, and diversity inclusion. Now, I’m thrilled that our
requests for applications in these areas was met
with tremendous enthusiasm by staff, by educators,
and by administrators. We received 79 applications
proposing a very broad spectrum of projects. I learned, actually, that one
staff member was motivated just by applying and
actually launched her project before
learning about the funding. Now, we’ve selected the
inaugural recipients of these awards. We’re going to be distributing
grants totaling more than $3 million to support 33 projects
involving 98 individuals. And I’m pleased to
announce them here, and I should note that the
project submitted by that staff member has, in
fact, been funded. So here are several
projects in education. I’ll give you a moment
to look quickly. You can see the range of
individuals and subjects supported. Awards in administrative
efficiencies and then awards to support efforts in
diversity and inclusion– I want to congratulate
all of you, and thanks to all who
submitted proposals. If you didn’t get funded this
round, please stay engaged. We’re going to have more calls
for projects in the future. As briefly mentioned
in the video, another tactic for bolstering
the research productivity of our community is investing
in shared research platform, particularly the 30 or so
so-called core facilities around the quadrangle. So this past year,
we solicited ideas for either upgrading the
existing research course as well as proposals
for entirely new ones through our Foundry program. We received 27 applications. Ultimately, we’re providing
more than $11 million to enhance and expand 14
existing core facilities and to support the
development of seven entirely new technologies. Through these cores and
these technology platforms, the Harvard Medical
School community then accesses highly specialized
equipment and expertise, much of which would be too
expensive for any one lab or one department or
even one institution to support on its own. And the cores have talented
directors and technicians, so they provide
expertise and training to make full use of
these technologies. Think about our cryo
electron microscopy center for structural biology. This is a joint effort
by Harvard University, Boston Children’s Hospital, the
Dana Farber Cancer Institute, and the Mass General. It makes this transformative
and very expensive technology readily accessible. Under the direction
of Stephen Harrison, the cryo EM facility has
been a spectacular success. Over the past year, HMS
structural biologists have used cryo EM to understand
the molecular anatomy of proteins that play
critical roles in human health and disease. These include the cancer driver
BRAF, the inflammatory protein NLRP3, the doublet
microtubules that drive the function of cilia,
and the CRISPR-Cas3 gene-editing system. The addition of cryo EM to
the structural biology toolbox has opened our eyes to
a breathtaking new level of structural complexity. We are also investing
very heavily in data science and
computational biology. These investments impact every
department– genetics, systems, health care policy. The heart of our data
science infrastructure is our new center for
computational biomedicine, which is led right now by
a steering committee that is comprised of faculty
from every quad department. It is currently chaired by
Zak Kohane and Steve Blacklow. The center working
groups are currently focusing on three
primary areas– single cell analytics,
novel imaging modalities, and data science and analytical
support for the community. The center has already
launched several pilot projects that are designed to illustrate
the value of aligning patient data and advanced
computational resources. These include a collaboration
with the Brigham to develop a scalable
genome-analysis engine, with Mass General to develop
a suicide risk prevention app, and with the Beth
Israel Deaconess to develop an app for
precision post-surgical opioid prescribing. Now, this wide range of projects
demonstrates the many ways that data science can lead to
discoveries with the potential to improve patient lives. We continue to advance our
therapeutics initiative. This is another highly
collaborative endeavor. It’s supported by
the Blavatnik gift. It’s engaging
scientists, entrepreneurs from across Harvard Medical
School and the broader Boston biomedical ecosystem. Now, a central tenet
of that initiative is that efforts to develop
novel and effective therapeutics must be grounded in the
deepest understanding of biological mechanisms
of disease, knowledge that originates in
our basic research. Breakthroughs in research
can best impact society when they impact
patients, and that typically involves collaboration
with biotech and industry. As revealed by the
community-wide survey that we conducted during my
first year as dean, the current system for
translating discovery into therapy faces
several barriers– insufficient funding for
therapeutics projects, inadequate support for
enabling technologies, and a fundamental
cultural divide between academia and industry. The therapeutics
initiative is designed to overcome these barriers. We’re providing grants
targeted towards therapeutic development. We’re investing
in, as you’ve seen, augmenting our core
platforms, and we’re fostering educational programs
for students and faculty alike to learn from
industry colleagues. The strategy entails leveraging
our traditional strengths in basic science with
added infrastructure to advance
therapeutics projects. Now, critically, we’re not
going to be making decisions about what to support based
on whether the projects will generate income. No, we are going to
greenlight the projects that have the greatest potential
to generate impact. Now, to anchor the
therapeutics initiative, I’m delighted to
announce we’ve hired an extraordinary
executive director of therapeutics translation,
Dr. Mark Namchuk. Now, Mark was trained as
a chemist, a biochemist. He spent the last couple
of decades in industry. He ultimately rose to direct
research at Vertex and most recently at Alkermes. And we are enormously
privileged and fortunate to recruit someone with
the depth and breadth of Mark’s industry experience. His expertise will
invigorate our community’s therapeutics research efforts. And Mark joined us just at
the beginning of the month. He’s doing his
listening tour, and I’d like to welcome Mark to
the Harvard Medical School community. [APPLAUSE] So as the leader of this
very ambitious therapeutics initiative, Mark is going
to be executing a vision for therapeutics
education, research, and infrastructure that will
integrate and unify the various components of the initiative,
so the Ideation Hub, which is led by Tim
Mitchison; the Foundry, led by Caroline Shamu; the
existing laboratory of systems pharmacology and the Center
for Regulatory Science, anchored by Peter Sorger; and
the soon-to-be-built Blavatnik Harvard Life Lab
here in Longwood, which is going to be located on
refurbished space in Building C. We’ve been reviewing
architectural drawings for the significant
renovations there, which also include extensive
renovations of the West Quad, and we will be optimizing
research for several departments. Now, the Life Lab’s
shared research space is going to house a
function that we’re dubbing “the translator.” This is going to
be the actual work to advance late-stage projects
with promise for therapeutics. The Life Lab will also have
the flexibility, if we wish, to incubate early-stage
high-potential biotech and life sciences startups that
are founded by Harvard students, faculty, and alumni. Now, while scientific
discovery is absolutely core to our mission at HMS,
so too is the education of our medical students
and our graduate students pursuing their doctoral
and master’s degrees. As I mentioned in a recent
letter to the community, the Liaison Committee
on Medical Education has awarded the school
full accreditation for another eight-year term. Now, among its
observations, the LCME praised our pioneering
pathways medical curriculum. The committee did identify
a small number of areas where we can do better,
and many of them were actually already
institutional priorities. Now, we are already
striving to improve. We’re always working,
and we’ve strengthened what is a continuous
quality improvement, CQI, a process that’s being
overseen by the dean’s Leadership Council. I want to just say
thank you again to the many, many people
across this community who came together in a massive
effort to prepare for the LCME, to issue the report, and to have
a very successful site visit. It was enormously satisfying
to see those efforts succeed. Now, in other
educational news, we plan to reform the structure
of the core clinical clerkship year and as well to introduce
reform into our health sciences and technology curriculum. The HST program marks its
50th anniversary this year, and as a proud
alum, I’m very much looking forward to celebrating
this golden anniversary come November. For our graduate programs, we
have an inspiring new leader in Ros Segal. She was named dean for
graduate education in August, and she’s leading the strategy,
oversight, and coordination of our PhD and
master’s programs. Our PhD programs have been
our traditional strength. Graduates of the division
of medical sciences and the biological and
biomedical sciences programs are leading academic
investigators here at Harvard and across the globe. However, an increasing
proportion are actually pursuing alternative
careers, many of them in the biopharmaceutical
industry, and Ros is currently
focused on revising the administrative structure to
optimize advising and mentoring so that all students receive a
personalized education designed to prepare them for
their chosen career. Over the past few
years, we’ve also grown our master’s programs. We now have extraordinarily
successful masters in biomedical
informatics, bioethics, clinical investigation,
medical education, immunology, clinical service operations,
health care quality and safety, and global health delivery. These programs
serve a remarkably diverse and international
community of learners. Many of them are
physicians who are seeking to augment their
skill sets and who become integral
members of our research and clinical communities. I am committed as part of
the mission of this school that our master’s
programs indeed serve our goals of teaching
and learning, scholarship and discovery, and
service and leadership. And we expect the
master’s programs to expand, however
modestly, in the future. Our office for
external education, which is headed by our
Dean David Roberts, continues to be a
pioneer in making the latest insights in
science and medicine accessible to an ever-growing
range of learners worldwide. New external ed offerings
include accredited continuing education units for nurses,
the HMX Pro online courses on topics that include cancer
genomics, immuno-oncology. Last fall, the office hosted
an inaugural global symposium that explored
trends, developments, and best practices for leaders
of medical institutions worldwide. Now, while our educational
programs justly make us proud, I remain deeply concerned
about student debt. More than 70% of
our medical students receive need-based financial
aid and yet still graduate with considerable debt. This is a source of
increasing stress. It may pressure
students to choose higher-paying specialties rather
than following their ideals to serve communities,
say, through primary care or global health. And we continue to
seek financial support, philanthropic support
for financial aid. It’s critical. It’s important to ensuring that
the best and brightest students can attend Harvard
Medical School regardless of their ability to pay. Now, a major success story
has been the REACH program, which provides additional
scholarship funds for students from disadvantaged backgrounds,
including many historically underrepresented in medicine. Since the program’s
inception three years ago, 52 students have benefited
from those scholarships, and a considerable
number of those who might not have
chosen Harvard are here, bringing their
extraordinary talents and drive to our community. I also want to say that to
support our doctoral programs, fundraising for graduate
student fellowships is now a university-wide
priority. One of our core commitments
as an institution is service to humanity,
which includes expanding our impact across the globe. A year ago, I had the
extraordinary privilege to accompany Paul
Farmer to Rwanda to celebrate the opening of
the University of Global Health Equity. That institution,
through the work of many HMS faculty,
students, and staff, gives me hope the promise
of modern medicine biomedical science will
reach those who need it most, wherever they might live. Here at Harvard
Medical School, we stand for excellence, passion,
dedication, and service. Last year, in recognition
of these qualities, members of our community
received an awe-inspiring array of honors and accolades
for advances in everything from molecular mechanisms
to mobile medicine. I am sorry. I wish I could cover and
recognize more individuals, but let me just point out two
particularly proud examples. In October, Bill Kaelin,
the Sidney Farber professor of medicine at HMS
and Dana-Farber, senior physician in
medicine at the Brigham, and who many of you know as a
revered and much beloved member of our community was awarded
the Nobel Prize in medicine. He awarded with two
other scientists for their discoveries of
how cells sense and adapt to oxygen. Now, when Bill was a
young investigator, his lab focused on probing
the molecular mechanisms that underlie the rare,
hereditary von Hippel-Lindau. It’s a tumor
predisposition syndrome. As is often the case with
fundamental scientific inquiry, Bill could not have predicted
the future impact of his work, but his discoveries
have rewritten textbooks and paved the way for
new treatment strategies for a host of diseases– cancer, heart disease, anemia,
macular degeneration, and more. But Nobel-quality
research is not the only way we have impact. We also encourage
those who may well become the world’s
future Nobel laureates, and that is just what Lash
Nolen did last Halloween. As president of the Harvard
Medical School class of 2023, Lash organized 75 of her
fellow first-year classmates to host a fall fest here
at TMEC for students from the nearby
Mission Grammar School. The medical students led
third- to sixth-graders in interactive games
and connected with them through discussions
about careers in science and medicine. And Lash, who is
here with us, hopes to make this an
annual fall fest. Lash, thank you very
much for your leadership. [APPLAUSE] These two leaders, Bill
Kaelin and Lash Nolen, represent but a tiny fraction of
the exceptional work being done by members of this community. So let me just close with
a few personal thoughts. As I round my own
third-year mark as dean, I’m reminded of the old
Peace Corps’ tagline. It’s the toughest
job you’ll ever love. Funny, in the last
three years, I’ve been asked countless times,
how do you like your new role? And I have always struggled
to answer that question, to formulate the right response. [LAUGHTER] I’ve been inspired
by so many of you, by your stories, your
aspirations, your achievements. I mean, that’s the
part of the role that I find
tremendously satisfying. But serving as dean, I feel
the weight of my responsibility to this institution
and to all of you. In so many ways, I
feel like I’m back in the first year
of medical school all over again,
feeling overwhelmed by the enormity of the task and
feeling that I will never ever master all that I need to know. But please know
that I am striving to become a better listener,
a more perceptive observer, a more judicious arbiter,
and a more effective leader, administrator, and manager. This job can be exhausting, but
it is also fundamentally very exhilarating. And please know that it’s
your energy, your drive, your achievements that
compel me to work harder and to strive to do better. Know that I endeavor
every day to justify your faith in me
and your commitment to Harvard Medical School. So because it’s your success
that gives me great joy, now when I’m asked, do
you like your new role, I can answer with
great confidence that I am indeed inspired
every day by the momentous privilege of serving this
institution and all of you. So as we set out
for 2020 together with the wind at our backs, I am
excited to see what this coming year will bring. So thank you for your
attention this afternoon. I’ll take a few questions,
and then we will all head out to the Green Dragon pub. Thank you very much. [APPLAUSE] Question. Questions. We can start the pub early. [LAUGHTER] No problem with that. All right. Usually don’t
[INAUDIBLE],, but I’m happy to stand here
after and take some more individual questions. And thanks for your attention. [APPLAUSE] [SIDE CONVERSATION]

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