Individually and collectively we are all trying to understand and react to the financial crisis gripping the United States and global economies. The implications of the rapidly unfolding events and proposed remedies on personal savings, investments, and retirement plans, as well as the solvency of our institutions, workplaces and communities leave much uncertainty. As noted in recent issues of the Chronicle for Higher Education and in the October 4th Boston Globe, colleges and universities are assessing the impact of the current crisis and how it may affect current and future plans. Some have chosen to freeze new hiring or to defer on-going or planned construction projects, and all anticipate a downturn in endowment returns and other sources of funding.
We are also assessing our current and future plans, and I want to share an update with you with the understanding that any forecasts we make now may change, even dramatically, depending on how the local and broader economic conditions evolve (or really devolve). As I have shared in previous communications, the sources of the Medical Schools revenues are predominantly sponsored research awards and contracts (from public and private entities), clinical income, income from endowment, tuition and gifts. Of our three major missions, education and research are both "cost centers" and require other sources of institutional support to make them whole. Historically these sources have been largely clinical income, endowment and gifts.
I have written numerous times about the challenges we and other academic medical centers and research institutes are facing as a result of the declining federal support for biomedical research. As you know, the flat funding for the NIH (which has not kept place with inflation and thus has led to a serious loss of purchasing power) that has occurred since 2003 is already impacting most medical centers and universities. Stanford is not an exception to this downturn, as we have experienced declines in our NIH funding in the third and fourth quarters of 2008 (we are finalizing the data now). As you also know, we have been hoping that the increasing bi-partisan support of the NIH for biomedical research — as well as for the NSF and other federal agencies supporting the physical and engineering sciences — might herald at least inflation level funding for sponsored research in the next several years.
However, we now need to anticipate that almost regardless of the level of commitment of the next Administration to basic and translational research, the serious economic crisis that is unfolding may make this difficult to accomplish not only in the next couple of years, but possibly for many more to come. That would clearly be bad news since our faculty are so dependent on sponsored research funding for their research as well as for portions of their personal compensation and are already feeling the strains of the past 5 years of reduced support. While funding from the California Institute of Regenerative Medicine will partially compensate for this reduction in NIH support, this support impacts only those who are working in stem cell biology — and this source of funding will end when Proposition 71 terminates in 2014.
Notably, we have already been working on how to develop a more diversified funding portfolio that would support our investments in research and education at a time of constraint in federal support for research. Indeed, this was an important initiative emanating from our 2008 Strategic Planning Retreat, and a number of ideas and plans are being put together. However, some of the most important options and opportunities — namely, creating more professorships to help support our research faculty and raising more philanthropic support for graduate student education, while still among my highest priorities, will surely be more difficult to accomplish given the current financial landscape.
Clinical income is another important source of support for faculty who have patient care as part of their responsibilities and is also a traditional source for investing in the academic missions of medical center. It is hard to predict what will happen on this front, although we are all well aware that the Medicare Trust Fund is already in jeopardy. It is likely that there will be efforts to address Medicare in the next several years, although some of the solutions likely to be proposed will include reduced support for graduate medical education by Medicare — which would also have serious implications for academic medical centers.
And despite the outstanding achievements of the Stanford Management Company in overseeing the university’s endowment (which includes the School of Medicine’s endowment) it is obvious that the value of the endowment will decline, although how much that will be is uncertain. Regardless, that will impact another important source for supporting faculty, education programs, research and facilities. Further, unless the crisis in credit resolves soon, the cost of borrowing and even using debt financing may be impacted.
We completed the plans for our FY09 budget in August, and we have been assessing whether we need to make changes in the funding allocations. At this time we have decided that we will stay the current course, but we recognize that this may well change as the economic picture becomes clearer in the next months and year(s). That said, we anticipate that our revenue sources (especially sponsored research, income from endowment, gifts) will almost certainly be more challenged in the next year(s) and that this will require modifications. As you know, we have been continuing to invest in the sequential phases of our Strategic Plan, Translating Discoveries, and, while we have made considerable progress to date, we will obviously be assessing the pace of future investments.
As you also know and see every day, we have considerable construction going on — in fact nearly $350 million for the Connectivity Project (new loading dock, tunnels and infrastructure to support the future of the medical school), the Li Ka Shing Center for Learning and Knowledge and Stanford Institutes of Medicine. Of these, the Connectivity Project is scheduled for completion in November of this year and both the LKSC and SIM1 will be completed in 2010. Based on our financial planning models, we do not anticipate a change in the completion of these buildings. But we will obviously be examining the pace and timeline for future construction projects — since these are so sensitive to philanthropic support as well as institutional resources. And of course we must give priority to the funding for the new Stanford Hospital, which is so critical to our future as an academic medical center.
In sum, we face many challenges but I remain optimistic. We have made a lot of progress, and we have incredible students, faculty and staff and a great story to tell. We benefit from a strategic plan that has been well thought out and that helps chart our future course. And while we will certainly need to make adaptations, I feel confident that, barring a true economic meltdown that is uncorrectable, we can succeed, even if it takes longer than we would like to accomplish all of our goals. But we will need to work together, communicate often and do all we can to preserve what we have accomplished and seek creative ways to continue to move Stanford forward.
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Welcoming New Biosciences Students and Preparing for Careers in Academics
On September 22nd Dr. John Pringle, Senior Associate Dean for Graduate Education and Postdoctoral Affairs, and I welcomed the incoming Stanford Bioscience Graduate Students. Once again we are so fortunate to have a wonderfully talented group of students who will be pursuing PhD (as well as Masters) degrees in the Biosciences and Bioengineering. It is our deep felt hope that many of these students will successfully pursue careers in academics and research, although we are aware that a number will choose other career pathways. I take note of the interesting Science Focus article "And Then There Was One" that appeared in the September 19th issue of Science (see: http://www.sciencemag.org/cgi/content/full/321/5896/1622). This article reviewed the individual career pathways of the 30 students who entered the program in molecular biophysics and biochemistry (MB&B) at Yale in 1991. Of the 26 who completed their PhD, the startling conclusion is that only one is a tenured faculty member today, although one other graduate of the program is in a tenure track position, four are in academic research positions, and one each is in academic teaching or administrative positions. Of the 18 students who did not pursue or stay in academia, 11 are in bio-industry and four are in other career paths.
On Thursday October 2nd I gave a seminar presentation and led a discussion with current graduate students and postdocs about the pathways for career development in academia. I polled the students before beginning my comments to query how many were interested in pursuing academic careers. Of the approximately 75 participants, slightly more than half indicated that they aspired to an academic career. This is higher than the numbers presented from Yale (see above), but of course this reflects aspiration and not reality. While I presented an honest assessment of the issues that help define successful entry as well as advancement in an academic center like Stanford, we must all be concerned about whether we are truly preparing our current students for the careers they desire. This, of course, must include preparation for careers not only in academia, but also in industry and other domains. This was one of the reasons for establishing the Career Center a few years ago.
Separately, but in a related way, we are focusing on the career development of junior and mid-career faculty and will be coming forth with additional recommendations on how to do a better job to support our faculty. Clearly these recommendations will have relevance to our graduate students since the challenges they face are part of a continuum of events and hurdles that impact pre-doctoral students, post-doctoral trainees and faculty members. Career development across the span of academic careers will also be a topic for our Strategic Planning Retreat in February 2009. While I think we have made strides in these areas, the data we are currently gathering suggests that we have much work to do and that improvement will require individual, local and systemic changes. But given the importance of our students to the future of science and the investments we make in recruiting faculty to Stanford, it is imperative that we do all we can to better support successful pathways. I fully understand that the breadth, diversity and complexity of a university environment make this challenging, but we need better success. While I do not make a value judgment about the percent of entering Yale PhD students who succeed in academia, I do believe that we must be true to our mission. To that regard I would hope that our yield and success in promoting academic careers is higher and that if students choose a different pathway it is because they proactively sought it and not because we didn’t equip or prepare them for the one they really desired.
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SIM1: Now The Lorry I. Lokey Stem Cell Research Building
On February 27, 2007 we were pleased to announce that Lorry Lokey made a $33 million gift for the construction of the Stanford Institutes of Medicine I building. I am truly thrilled to announce today that Mr. Lokey has now increased his gift to $75 million and that we will be naming the facility the Lorry I Lokey Stem Cell Research Building (http://med.stanford.edu/news_releases/2008/october/lokey.html and http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2008/10/06/BA0M13BU4V.DTL&tsp=1 ). This is wonderful news indeed.
Over the years that I have had the pleasure of getting to know Lorry Lokey I have been deeply impressed by his intelligence and personal commitment to using his personal financial resources to truly impact the world and make it better. He has been focused in particular on education at the high school and university level and on research — in the USA and in Israel. His decision to provide the initial core funding for SIM1 enabled us to gather additional support for this exciting building from other private donors as well as from the California Institute of Regenerative Medicine. Indeed our incredible success with CIRM funding was aided considerably by Lorry’s seminal gift. His more recent decision to increase his funding commitment speaks to his personal conviction that stem cell research is incredibly important and that he wants to do all he can to help support its development — at both a basic and an applied level. Accordingly, it is with heartfelt pleasure that we can now name SIM1 in honor of Lorry Lokey.
Quite amazingly, as I have (over and over again) offered my personal thanks and those of our colleagues to Lorry Lokey for his incredible generosity, he has both humbly and in remarkably touching manner thanked us for giving him the opportunity to make this gift. What an incredible individual. Even though human cloning is (and should remain) anathema, the world would be a much better place if it had more Lorry Lokeys in it.
We will be officially celebrating the groundbreaking of SIM1 — now the Lorry Lokey Stem Cell Research Building — on Monday, October 27th.
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AAMC Board Meets with Senator Grassley
On Thursday September 25th, the Administrative Board of the Association of American Medical Colleges (AAMC), of which I am a member, visited Capitol Hill for a meeting with Senator Charles Grassley (R-Iowa). As you know from prior communications, Dr. Grassley has been investigating a number of issues that impact universities and non-profit organizations. A major focus of his investigations has been on individual and institutional conflict of interest. He is also the author of the Physician’s Sunshine Legislation, which would compel the pharmaceutical and device industries to publicly list any payments to doctors as a means of comparing that information to what doctors and faculty list in their annual conflict of interest disclosures. He noted that he is investigating some 30 high profile faculty at 20 medical centers. One of these investigations was revealed in articles the October 3rd Wall Street Journal and the October 4 New York Times (http://www.nytimes.com/2008/10/04/health/policy/04drug.html?em). At this point it is important to view the claims made in these articles as allegations, since institutional reviews are underway. That said, this is another example of the increased attention being focused on conflict of interest issues and a reminder to faculty across the USA to be completely transparent and accurate on their annual (and transactional) conflict of interest disclosures.
Over the years Stanford has developed important policies for conflicts of interest related to research, education and patient care. Stanford is also one of a minority of universities with a written "Institutional Conflict of Interest Policy." But based on recent observations and the changing landscape in academia, revisions of our institutional conflict of interest policy are in progress to assure that principles and procedures are in place to ensure that research involving human subjects is conducted without untoward influence from either University investments or from the personal interests or holdings of key institutional leaders. The President of the University is leading this revision process, and further details will be forthcoming in the next months.
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Dr. Sherry Wren Named Associate Dean for Academic Affairs
I am pleased to join Dr. David Stevenson, Vice Dean and Senior Associate Dean for Academic Affairs, in announcing that Dr. Sherry Wren, Professor of Surgery, has been appointed Associate Dean for Academic Affairs, effective August 1, 2008. She will join Dr. Maurice Druzin (Obstetrics and Gynecology) Dr. Lucy Tompkins (Medicine), who will be continuing in their roles as Associate Deans for Academic Affairs during the 2008-09 academic year.
Dr. Wren has had a distinguished career since she joined Stanford in 1997. She has served as Chief of General Surgery and Associate Chief of Surgical Services at the Palo Alto Veterans Affairs Health Care System and since her arrival, the surgical service has grown and improved dramatically thanks to her strong and excellent leadership. Her research interests are primarily in surgical oncology, especially gastrointestinal cancers, and she has an active program in research that focuses on colorectal cancer screening strategies. She has published nearly 70 peer-reviewed journal articles, has served on two editorial boards and is a site reviewer for the National Fellowship Council. She has extended her interest in access to care into volunteering for Doctors Without Borders and, as in previous summers, will be spending the next six weeks on a surgical mission for that organization. I recently attended a seminar she gave about her experience in the Congo this past summer (see: http://med.stanford.edu/mcr/2008/wren-1001/ ) and came away with tremendous respect for her personal and professional courage and humanism.
Dr. Wren's research and patient care activities are complemented by award-winning teaching. Among numerous honors was her selection by the Association of Education for the National Outstanding Teacher Award for Excellence in Surgical Education. She has also been an exemplary citizen of the School. Since 2000, she has been deeply involved through extensive committee work on the evaluation, design, and implementation of the new curriculum for the School of Medicine and, for the past two years she served with distinction as the elected Chair of the School of Medicine Faculty Senate.
As Associate Dean, Dr. Wren will be responsible (in collaboration with Ellen Waxman, Director of Faculty Relations) for handling faculty complaints and sensitive issues that have the potential to turn into formal grievances. In addition, working with Dr. Stevenson and senior members of his staff, she will develop and implement School-wide policy initiatives and she will serve as an ad hoc member of the School's Appointments and Promotions Committee.
Please join Dr. Stevenson and me in welcoming Dr. Wren to her new role in the Office of Academic Affairs.
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At the October 3rd Executive Committee meeting, Michael Halaas, Associate Chief Information Officer, and Jane Volk-Brew, Office of Academic Affairs Business Owner Representative for the FAST|FAC project, provided an update and demonstration of this project. FAST|FAC is a system for managing the faculty appointments and promotions processes. It has its origins in 2005, when I appointed a Faculty Task Force, chaired by Dr. Robert Jackler, Professor and Chair of Otolaryngology, together with Dr. Kathy Gillam, Senior Advisor to the Dean, to develop policies that might streamline our academic appointment and promotion system and that would result in an electronic system for filing, managing and monitoring faculty academic actions. In 2006 the Task Force recommended the creation of a web-based system to improve the speed and accuracy of long form assembly and review.
The resulting Faculty A&P System Tracking File Assembly Completion system (FAST|FAC) was initiated in 2007 through a collaborative effort between Information Resources and Technology (IRT) and the Office of Academic Affairs (OAA). The project is advised by an implementation committee comprised of Dr. David Stevenson, Dr. Jackler, Dr. Gillam, Judith Cain, and Jason Irwin. The advice and feedback of department and division faculty affairs administrators has been instrumental in the development process. The development team is led by Michael Halaas and includes, in addition to Jane Volk-Brew, Don Mitchell, Sharon Seliga, Devi Meyyappan and Rose Barone.
FAST|FAC was launched in March 2008 for use in all professorial promotions and reappointments in the School of Medicine. The process to appoint and promote faculty requires a complex and rigorous series of steps to gather and review evidence about an individual's performance, achievements and potential. FAST|FAC has translated this process from paper to the web and provides a highly secure environment to track each step of the process, collect documents and data, assemble review committees, notify participants about status, and report metrics on the efficiency of the overall process. The system incorporates University and School policies and procedures to increase the quality of the information collected and a greater degree of transparency to individuals involved in managing the review actions of their faculty to enable timely process completion.
New functionality is being released in phases. In the coming year the system will enable departments to process appointments for new members of the professoriate and offer an interface for prospective candidates to apply online. If you would like more information about FAST|FAC please contact Jane Volk-Brew in the Office of Academic Affairs (volkbrew@stanford.edu). Thanks to the development team and departmental faculty affairs staff who have brought FAST|FAC to its current level of functionality. I look forward to seeing its further progress in the months ahead.
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Fall Forum on Community Health & Public Service
Wednesday, October 22nd
5:00 pm - 7:30 pm
Frances Arrillaga Alumni Center
The Fall Forum on Community Health & Public Services will be held on Wednesday, October 22, at the Frances Arrillaga Alumni Center, from 5:00 pm to 7:30 pm, to celebrate student contributions to community health through public service and community partnership research. Dr. Lisa Pratt, a dedicated community leader and currently the medical director for San Quentin State Prison, will be the keynote speaker. The event is free and open to the public. For information please contact the Fall Forum Coordinators Ruo Peng Zhu (rzhu@stanford.edu) or Alisa Mueller (alisamueller@stanford.edu).
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Stanford Health Policy Forum: "How War is Changing Medicine"
Wednesday, October 29th
11:00 am — 12:00 pm
Clark Center Auditorium
Thanks to the leadership of Dr. Keith Humphreys, Professor (Research) of Psychiatry and Behavioral Sciences, and Ryan Adesnik, Director of Federal Relations, the 1st Stanford Health Policy Forum will be held on October 29th from 11:00 am to 12:00 pm in the Clark Center Auditorium. The first session is entitled "How War is Changing Medicine" and features Dr. Kenneth Kizer, Former Under Secretary of Health in the Department of Veterans Affairs, as the Keynote speaker. The panelists will be Dr. Craig Rosen, Assistant Professor of Psychiatry and Dr. Eugene Carragee, Professor of Surgery. Space is limited, so if you are interested in attending please RSVP to:Lucy.Wicks@Stanford.edu.
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Skills Building Workshop: "Negotiating"
Thursday, November 20
5:30 — 8:30 pm
Always Building, Room M-112
On Thursday, November 20th the Office of Diversity & Leadership will continue the Skills Building Workshop series with "Negotiating." Back by popular demand, Margaret A. Neale, Professor in the Graduate School of Business, will present information on negotiating and will moderate a highly interactive session covering the following topics: misconceptions of negotiating, barriers in social interaction, and costs of negotiating vs. not negotiating. The purpose of this workshop is to provide participants with a set of negotiation tools that can enhance the quality and rationality of their agreements.
Registration for this workshop is open to all faculty, including CE's and Instructors. Please visit the ODL website at http://med.stanford.edu/diversity/ for details on registration and location as well as other events offered by the Office of Diversity and Leadership.
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- Dr. Ben Barres (http://med.stanford.edu/profiles/Ben_Barres/), Professor and Chair of Neurobiology and Professor of Developmental Biology and of Neurology and Neurological Sciences, has been selected by the Society for Neuroscience as the winner of the 9th annual Mika Salpeter Lifetime Achievement Award, which is given to a scientist to has "sustained exceptional achievement in neuroscience" and who has "exhibited an unusual dedication to facilitating the mentoring and entry of young women into neuroscience or to the advancement of women in neuroscience". Dr. Barres is not only a superb scientist but his commitment to diversity and career development — particularly for women — is nonpareil. This award is a wonderful and richly deserved recognition of his contributions as a neuroscientist and career advocate. Congratulations to Dr. Barres
- Dr. Atul Butte (http://med.stanford.edu/profiles/Atul_Butte/), Assistant Professor Medicine and of Pediatrics, and by courtesy, of Computer Science, has been selected as the 2008 recipient of the American Medical Informatics Award (AMIA) New Investigator Award. This award recognizes an individual for early informatics contributions and significant scholarly contributions on the basis of scientific merit and research excellence. The criteria for nomination include significant scientific productivity in informatics prior to reaching eligibility for fellowship in the American College of Medical Informatics; multiple significant scientific publications and demonstrated commitment to AMIA. This is a wonderful award and recognition of Dr. Butte’s major accomplishments and contributions. Please join me in congratulating Dr. Butte.
- Dr. Ron Levy (http://med.stanford.edu/profiles/Ronald_Levy/), Robert K and Helen K Summy Professor of Medicine, has been named the winner of the American-Italian Cancer Foundation Award for Scientific Excellence in Medicine for his work (along with Dr. Lee Nadler) that led to the successful development of monoclonal antibodies for the treatment of lymphomas. I am also particularly pleased to recognize Dr. Levy’s award since I am a past recipient (1991) of this award. Congratulations to Dr. Levy on another important recognition of his contributions to cancer research.
- Dr. Gary Schoolnik (http://med.stanford.edu/profiles/Gary_Schoolnik/), Professor of Medicine and of Microbiology and Immunology, informed me that he has received a major (nearly $20 million over 5 years) award from the NIH for his project entitled "A Systems Biology Approach to Infectious Disease" which is focused exclusively on tuberculosis. Dr. Schoolnik is an outstanding physician-scientist and this peer-reviewed award is another affirmation of his excellent work
- Dr. Fenando Mendoza (http://med.stanford.edu/profiles/Fernando_Mendoza/), Professor of Pediatrics at the Lucile Salter Packard Children’s Hospital, was honored on September 27th at the Gardner Family Health Services 40th year Gala Event. As one of Gardner’s founding members, Dr. Mendoza’s commitment and visionary work has added to Gardner’s mission of providing high quality comprehensive health and behavioral care nationally. Congratulations, Dr. Mendoza.
- Dr. Eugene J. Carragee (http://med.stanford.edu/profiles/Eugene_Carragee/), Professor of Orthopaedic Surgery, has been selected by the North American Spine Society to receive the 2008 Leon Wiltse Award for excellence in leadership and/or clinical research in spine care. He will be recognized at the Annual Meeting and the 2008 award winners in an upcoming issue of SpineLine. Congratulations to Dr. Carragee.
- Dr. Harry Greenberg (http://med.stanford.edu/profiles/Harry_Greenberg/), Joseph D. Grant Professor and Senior Associate Dean of Research, is the recipient of the Albion Walter Hewlett Award, designed to honor an exceptional physician with ties to Stanford. As part of the award, he will be the speaker at Medicine Grand Rounds on Wednesday, November 12th at 8:00 am in the Braun Auditorium, and will be honored at the Hewlett Award Dinner event that same day. Congratulations to Dr. Greenberg.
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- W. Scott Lock has been promoted to Adjunct Clinical Assistant Professor of Obstetrics and Gynecology, effective 10/8/08.
- Cynthia F. Woo has been promoted to Adjunct Clinical Assistant Professor of Obstetrics and Gynecology, effective 10/8/08.
- Steven Chang (http://med.stanford.edu/profiles/Steven_Chang/) has been promoted to Professor of Neurosurgery at the Stanford University Medical Center, effective 10/01/08.
- Loretta Chou (http://med.stanford.edu/profiles/Loretta_Chou/) has been promoted to Professor of Orthopaedic Surgery at the Stanford University Medical Center, effective 10/01/08.
- Mark C. Genovese (http://med.stanford.edu/profiles/Mark_Genovese/) has been promoted to Professor of Medicine (Immunology and Rheumatology) at the Stanford University Medical Center, effective 10/01/08.
- Graham H. Creasey (http://med.stanford.edu/profiles/Graham_Creasey/) has been appointed to Professor of Neurosurgery at the Veterans Affairs Palo Alto Health Care System, effective 10/01/08.
- Mike Yao (http://med.stanford.edu/profiles/Mike_Yao/) has been appointed to Associate Professor of Otolaryngology — Head and Neck Surgery at the Stanford University Medical Center and the Veterans Affairs Palo Alto Health Care System, effective 10/01/08.
- Brian Rutt has been appointed to Professor of Radiology, effective 10/01/08.
- Elisabetta Viani-Puglisi (http://med.stanford.edu/profiles/Elisabetta_Puglisi/) has been appointed to Assistant Professor (Research) of Structural Biology, effective 09/01/08.
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