Dean Browns Alumni Address Annual Meeting of the Association of Yale Alumni in Medicine

July 06, 2023

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Nancy J. Brown, Jean and David W. Wallace Dean of the Yale School of Medicine and C.N.H. Long Professor of Internal Medicine, shares the latest news from YSM and her vision for the future. Her address will be followed by a Q&A, and then the AYAM Annual Meeting. AYAM president, Dr. J. McLeod (Mac) Griffiss ’66, will present the 2023 Distinguished Alumni Service Award and the slate of nominees for open positions on the AYAM Executive Committee.

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00:04Started. I want
00:06to welcome all of you to the
00:08annual meeting of the Association
00:10of Yale Alumni and Medicine.
00:12I'm Matt Griffiths.
00:13I'm the president of the association.
00:15We have a good crowd here today,
00:18and I'm glad to see that and
00:20particularly welcome those of
00:21you in the 50th reunion class.
00:25We're going to start today by having Dean.
00:28Brown give us a an update on
00:30the school have been a lot of
00:33changes since she arrived,
00:34all of them positive and I think
00:36you'll enjoy hearing how the school
00:38is doing now as maybe it wasn't
00:41so many months ago or years ago.
00:44So Dean Brown.
00:53Thank you and good morning.
00:54It's really great to see you.
00:55I'm going to give you in some
00:57sense a little bit of a preview
00:58of my state of the school,
00:59which comes in a week,
01:00but with a few, a
01:03few extras because I assume you may
01:06not have been watching all of these.
01:08Let's start with the mission statement.
01:11We I arrived February 1st,
01:132020 and the mission statement had not been
01:17updated in many years and it focused on.
01:23They used a lot of words like
01:26premier and excellent and there
01:28was no mention of diversity.
01:30And it turned out that COVID was
01:32actually a great time to do redo a
01:35mission statement because we could we
01:37surveyed everybody on the old statement
01:39and then did a did a detailed survey.
01:42But we could have focus groups by
01:45zoom and reach various groups,
01:46but some of you participated in those,
01:48some of our community leaders.
01:50And this is where we landed.
01:51And I I'm not a mission statement
01:53kind of person,
01:54but I feel pretty proud of this
01:56as representative of the school
01:58and capturing the Yale system.
02:00So the first sentence,
02:01Yale School of Medicine educates and
02:03nurture creative leaders in medicine,
02:04promoting curiosity and critical inquiry.
02:06And I think that's really the
02:08essence of the Yale system.
02:10In an inclusive environment
02:11enriched by diversity,
02:12we advanced discovery and innovation.
02:15Importantly through our partnerships.
02:17It's we're not just in a silo.
02:20And we care for patients with compassion,
02:21but also commit to improving
02:23the health of all people.
02:24I I show a picture here of
02:26I asked a Fernando,
02:27who was our director of admissions at the
02:31time and emceed all of these focus groups,
02:34was amazing human being.
02:36And he tragically died about
02:38six months later of cancer.
02:39And so I always associate the mission
02:42statement with him as I talked today,
02:45they're really sort of forced.
02:47Crosscutting themes to what we're I think,
02:50trying to accomplish in the school,
02:52one is creating this environment of
02:55inclusive excellence where we not
02:57only recruit outstanding people,
02:58but we create an environment
03:00in which they can thrive.
03:01A second is breaking down silos.
03:03You know,
03:04we have many silos of excellence,
03:06but if we can cross those silos,
03:09we can really accomplish a lot,
03:12continuing to build and steward the resources
03:14that we need for discovery and then.
03:17Something that will may resonate with you,
03:20which is actually building our
03:22partnership with the Yale New Haven
03:23Health System and that's been an iffy
03:25partnership over 200 years and I'll
03:27talk a little bit more about that.
03:30So leadership,
03:31these are just leadership
03:33appointments in the last year,
03:36I'll highlight we've created a a new
03:39now freestanding section of biomedical
03:42informatics and data science.
03:44And recruited Lucilla Ona Machado from UCSD,
03:47member of the National Academy,
03:49to lead that that will become
03:51a new department.
03:52She also has the role of Deputy Dean
03:54over informatics as we realize the
03:58impact of all of the informatics that we
04:01have and partnerships with computer science.
04:05Keith trained here and actually
04:07all three of these recent chair
04:09selections were from internal
04:11candidates just reflecting the
04:13quality of our own faculty.
04:15Also highlight like Peg McGovern who
04:18is now our Deputy Dean for Clinical
04:20Affairs and CEO of Yale Medicine,
04:23our faculty practice plan.
04:24Really an extraordinary person for
04:27this role because Peg is a pediatric
04:29geneticist who was a chair of
04:32Pediatrics for about 10 years before
04:34she became someone involved in running
04:37clinical operations at at SUNY.
04:40And we've been very fortunate
04:42to recruit somebody who both can
04:44get things done and has also
04:46garnered the trust of the chairs.
04:48So and then Karina joining our Office
04:51of Diversity Equity Inclusion.
04:54There are leadership changes going
04:55on across the university and I wanted
04:57to highlight a couple of things.
04:59One is that our school of Engineering and
05:04Applied Sciences is becoming independent
05:06under the leadership of Jeff Brock.
05:09And Jeff has been a terrific partner
05:12beginning in the early days of COVID
05:14as we were bringing people together
05:16from across the university to solve
05:19many issues in the early days.
05:22And we are building many collaborations
05:25in biomedical engineering imaging
05:27and he's really great to work with.
05:29And I mentioned computer science
05:31and data science.
05:32You are also probably aware that
05:34our school of public health,
05:35which has always been in this
05:37tweener state where it's both a fully
05:39accredited school but also a department
05:41within the School of Medicine,
05:43will become completely independent in a year.
05:46The new Dean,
05:47Megan Rainey is coming from Brown July 1.
05:50She and I are working very closely.
05:52I was saying to Matt to make sure
05:54that as we separate,
05:55we developed a longterm relationship
05:57between the School of Medicine and the
05:59school of public health that is positive,
06:02not like the relationship to in some
06:05of the schools to the north of here.
06:10And then Azita Mommy,
06:13a world traveler, really trained.
06:18At the Karolinska as our new Dean
06:20of Nursing and so we're looking to
06:23forward to collaborating there.
06:24Our faculty do amazing things.
06:27This is a list of some of this
06:30year's elections to honor
06:32societies and achievements.
06:33You'll see 3.
06:35Appointed to ASCII the the
06:37so-called Young Turks couple to the
06:40Association of American Physicians
06:41to the National Academy members.
06:44One Jorge Galan to the American
06:47Academy of Arts and Sciences on
06:50a pile is shares appointments
06:53across the school and FAS and is
06:56National Academy of Sciences.
06:58Other outstanding awards.
07:00If you ever opened a newspaper during COVID,
07:03you've read of Akiko Iwasaki's
07:06work on the Immune Response,
07:08but I'll point out that Emily Wong.
07:11Was recently named a MacArthur
07:13Fellow for her work looking at
07:15the impact of incarceration on not
07:17only the health of the patient,
07:19but on the health of families.
07:22NIH Directors New Innovator Awards
07:243 is outstanding and I'll highlight
07:27at the bottom.
07:28The HHMI has a new Freeman Scholar
07:32Program for Junior Investigators,
07:3431 selected in the country and
07:36one of them was Trevor Sorrells.
07:39Trevor is working on.
07:43Mosquito borne and tick borne
07:45diseases and he's applying
07:49evolutionary genetics to understand
07:51how the blood feeding behavior
07:53of mosquitoes evolved to develop
07:56genetic targets for new drugs.
07:59We have lots of faculty who are involved
08:01in national leadership, but this is
08:03when I think that is extraordinary.
08:05In in a period in 2023,
08:07there will be a time when Eric Weiner,
08:09our new director of the Yale Cancer Center,
08:13will at once be president of ASCO,
08:15American Society of Clinical Investigation,
08:17and Pat Larusso will be president of the
08:19American Association for Cancer Research,
08:21so the two major cancer organizations
08:24in the country.
08:25Eric came to us from Dana Farber,
08:27he is a Triple Y.
08:29He was an undergraduate medical
08:31student and resident.
08:32Some of you may know him and
08:34doing an outstanding job in the
08:36Cancer Center and of course our
08:38faculty that we just had graduation
08:40garnering lots of teaching awards.
08:42And one of the efforts that we're making
08:44is to you know include all of our
08:48staff as well as we acknowledge
08:50awards and our staff are outstanding
08:53and contribute to our work.
08:55I want to talk a little bit
08:57about culture and climate.
08:58You know, these are interesting times.
09:00And when I arrived in 2020,
09:04there was a fair amount of concern related
09:08to some well publicized cases of sexual
09:11harassment and how they had been handled.
09:13And one of the first things that we did
09:17was revamp our office of Faculty Affairs.
09:22One of the other things that we've done now
09:25is develop a strategic plan around diversity,
09:28equity and inclusion.
09:29These are posted on the website.
09:31Are there 3 pieces of it,
09:33one around faculty, one around students,
09:36and one around staff?
09:38The the foundation of this
09:40plan is not only recruitment,
09:43but retention and really thinking
09:46about how we mentor faculty.
09:49And how we sponsor faculty and
09:51I'll show you our outcomes,
09:53which also involves measuring
09:55and looking at how we're doing.
09:58And so we've done probably too many
10:02surveys between the university
10:04and the school,
10:05but I'll highlight some outcomes of that.
10:09This is the AA MC Diversity
10:11Engagement survey.
10:12It allows us to compare our
10:14climate to that of other schools
10:16of medicine and and to other.
10:18About 80,000 other people have filled it out,
10:23and the striking thing to me
10:26was that we scored lower than
10:29our peers in the area of trust.
10:32And since I've been here,
10:34I've I've heard from faculty concerns about.
10:38If I say something about
10:40behavior that I observe,
10:42I'm I I'm fearful that there will be
10:44retaliation or that nothing will be done.
10:46And so again,
10:47this is something that we've
10:50worked to change the culture.
10:52I think we're making progress.
10:53So one of the things we did was we
10:55revised our Office of Faculty Affairs
10:57to create an Office of Academic
10:59and Professional Development.
11:01And really made it easy for people to
11:04express concern without making it a big deal.
11:07You know, I would say most of
11:10what we see is people struggling.
11:13They may have something going on at home,
11:15they may have mental illness, you know,
11:19and if we've intervene early,
11:21we can prevent a lot of things
11:23from happening and.
11:25And so the other thing we need to
11:27do is we need to train leaders.
11:29To hold people accountable.
11:30And this doesn't necessarily
11:32come naturally to everybody.
11:34So we've developed some leadership
11:36training led by the people you see
11:38here and particularly Bob Rohrbaugh,
11:39who's the deputy Dean for Professional
11:43and Leadership Development.
11:45And so we're tracking what this looks like.
11:47And this is an example of 1 year's kind
11:51of things that have risen to that office.
11:54And you'll see that the vast
11:57majority of them around what we
11:59would call professionalism,
12:00some around work unit culture,
12:02where sometimes a new chair or
12:04sometimes an old chair is struggling
12:06with how to communicate effectively.
12:08And there's and we can help that
12:11group by doing group culture,
12:14group coaching
12:15and when you look at those
12:18professionalism issues.
12:19You know some of it happens in the hospital,
12:21things aren't going well in the OR
12:24and someone reacts badly and you
12:27know that again noticing patterns,
12:29you know most of it is a one off
12:31but when you see somebody where
12:33that's happening very frequently
12:34you might be able to help them and
12:36and avoid those kinds of behaviors.
12:39The other survey that I would feature is a
12:43universitywide survey of our faculty and.
12:46And this was several years ago now.
12:47But it was striking to me that
12:50our faculty didn't feel like
12:52they were adequately mentored.
12:54And when I would have listening
12:56meetings with the faculty,
12:59our junior faculty all had
13:02mentorship committees.
13:03But our midlevel faculty would
13:04say things like, I'm not sure my
13:07chair knows what it is I'm doing.
13:10And then I talked to the chairs
13:11and the chairs would say, Oh yes,
13:12I meet with my faculty every year.
13:15It's, you know,
13:16we and there was a disconnect.
13:18And so we got a group together and we
13:20developed something called a faculty
13:22development annual questionnaire.
13:23Very simple.
13:25They can do it in a little red
13:28cap survey And it it's designed
13:30to be a little bit of a forcing
13:32function for that conversation
13:34where the faculty member reflects
13:36on what their goals are and.
13:39The
13:42and we coach the chairs a
13:44little bit about how you,
13:45how you have a meaningful conversation
13:47with someone about what those goals are.
13:49We've we piloted it last year.
13:51We've rolled it out this year.
13:53And the response I'll read you a couple
13:55of the comments which I I think are
13:57amazing and and we're continuing to
14:00iterate this so that it's not a burden
14:03for people either the faculty or the chairs.
14:06I appreciate the multiple layers
14:07of mentorship and support.
14:09Invaluable.
14:09I really appreciate that this is formalized.
14:12It helped me think concretely
14:13about steps toward ensuring
14:15that I'm on track for promotion,
14:19move forward to foster faculty
14:21engagement and and value.
14:23My chair spent almost 1 1/2 hours
14:24with me and gave me helpful advice
14:26and support of a calibre I could
14:29not possibly have found anywhere.
14:31In my long association with YSM,
14:32I've never had a proper appraisal.
14:34FDAC is a wonderful way to
14:36democratize faculty evaluation.
14:37So you know it's a work in
14:39progress and will iterate,
14:40but I think I think it's moving along.
14:43Another group of faculty in
14:46particular that I think we neglect
14:48is are our research track faculty.
14:50These are the non ladder
14:53faculty who are particularly.
14:55Important to our research mission.
14:56And so last year a task force suggested
14:59some things that we needed to do and
15:02and these I'm highlighting those
15:03that have been done in the last year.
15:06This seems pretty basic,
15:07but standardizing the offer letter,
15:09when somebody joins the research track,
15:11they're sometimes joining it as a
15:12bridge to a tenure track appointment.
15:15They're sometimes joining it
15:16because they have no desire to be
15:18an independent investigator and
15:19they want to be part of a team.
15:22And we need to make sure that
15:24there's clear understanding of
15:25which that is when somebody joins.
15:27There are multiple pathways.
15:29We've developed those.
15:30And then when we started the F DAC,
15:33we didn't have one for the research
15:34track faculty, which is, you know,
15:36maybe a little bit insulting.
15:37So we've added that.
15:39So we are measuring what we're doing.
15:42This is a slide that I show every year
15:44at the state of the school just to show.
15:47You know,
15:48doing these very simple things are
15:50what is what are we succeeding?
15:53And you can see that we are growing
15:55the proportion of our faculty who
15:58are underrepresented in medicine more
16:00at the assistant professor level.
16:02But we're now starting to see the same
16:03trend in the associate professor.
16:05And with time,
16:06I'm hoping in the professor level
16:08this is what our proportion of
16:11faculty who are women look like.
16:13We've been at 50% now in our
16:15assistant professors for some time.
16:17And we even show things like, you know,
16:20of our endowed professorships,
16:22what's the proportion of people
16:23who who hold them.
16:25And and as part of our
16:27efforts at transparency,
16:28all of this is available to
16:30our faculty at any time.
16:31They can go on our website and look at it.
16:36So let me turn to education and we,
16:40first of all, I want to highlight a couple of
16:44leadership changes in the last three years.
16:47When I arrived, Richard Belitzky had been
16:49in his role for 15 years and and I think
16:52within about two months came and said,
16:54you know, I've talked,
16:55I'd talked to Bob and I'm,
16:58I'm ready to step down from this role.
17:00And Missy and Goff did as well.
17:03So we had a national search and we
17:06recruited Jessica Aluzzi from within to
17:08become our new deputy Dean for education.
17:10She took that role in January 2021.
17:13She in turn recruited John Francis,
17:15I think some of you met John
17:18yesterday to succeed Nancy and Goff.
17:21John had been here in infectious diseases,
17:24had and had been one of
17:26our academic advisors.
17:27He had left to be a
17:30associate Dean for student affairs elsewhere.
17:32And so we were able to recruit
17:33him back and some other leaders
17:35in our student diversity office.
17:37And I'll point out the recruitment
17:40of a licensed social worker.
17:44To support our students
17:46in terms of mental health,
17:4840% of our students have seek
17:52some sort of mental health support
17:55during the time that they're here.
17:56And this is nationally true.
17:59For our students who are located
18:01here doing their clerkships.
18:03The burden of getting over to Yale Health
18:05in the middle of the day can be tough.
18:08And so we've created a satellite here.
18:10It also helps triage people
18:11if they need help.
18:13And this has been,
18:14I think really important to our students.
18:17So this is a profile of the class
18:20that entered this past August.
18:22We will completely codify our incoming
18:26class in in the middle of June.
18:30But this is pretty typical of what
18:31where we've been in the last few
18:33years with 24 to 28% of our students.
18:37Coming from groups that are
18:39traditionally underrepresented,
18:40about 15% of our students being
18:43first generation students coming
18:45from really top notch places and
18:48GPA's and MCAT scores that I don't
18:51think I could have gotten into Yale
18:54and and I'll tell you that next year's
18:57class looks even more fantastic
19:01and so. That's what comes in the door.
19:04And you know when you want to
19:06think about how you're doing,
19:07you also want to look at where
19:09they go when they leave here.
19:10And I just wanted to share with you our
19:13match this year because it was a really
19:16good day on match day and phenomenal.
19:18We we always send a lot of
19:21people to the Harvard programs.
19:24Last year was the first year in a long time.
19:26We actually retained more at
19:28Yale than we sent to Boston.
19:30But you'll see we sent something like
19:3430 some odd students to California.
19:36Most had come from California,
19:38but 15 to UCSFI mean it's So
19:43what? What allows us to attract such
19:46incredible students and why do they do well?
19:48And I believe and I think everybody in
19:51this room would would say the same,
19:53that it's our Yale system,
19:55we attract people who are curious.
19:59Who are fundamentally motivated and we put
20:03them in an environment where they can guide
20:07their own learning and we are really I
20:10think selling this to the incoming students.
20:13These are some quotations
20:14that appear on our web pages.
20:16There are many, many more.
20:18And so our current students value
20:21this just as much as you did,
20:24I would say as we look to.
20:28Recruit the best and brightest.
20:29One of the other important things is
20:31that we make medical education debt free.
20:35Several places have made medical
20:36education tuition free.
20:38But when you do that,
20:39there's still a fair amount of debt
20:41burden because of the cost of living.
20:43You know,
20:44room and board and all those sorts of things.
20:46The way we do our financial packages,
20:48we calculate the total cost.
20:51We calculate the ability of
20:53the family to contribute.
20:55We expect students to work one summer.
20:58Potentially very little money.
21:00And then they have a unit loan.
21:02And Bob Alpern had started to
21:05cap that unit loan and had gotten
21:08it down to $15,000 a year.
21:10And I'm very excited that this year
21:13through a $25 million gift from the
21:16STAR Foundation and Hank Greenberg,
21:18we've now reduced the unit loan to $10,000.
21:21Which means a student with financial
21:24aid who graduates would have a
21:26maximum debt from medical school
21:28of 40,000 after four years.
21:30And you know, the question is,
21:33do we take that all the way down to 0 next?
21:36My inclination is that we need to
21:38expand the the number of students who
21:41are eligible for financial aid first,
21:43because I think we have a bit of
21:45a donut hole where we have some
21:47students who are on the border
21:49and graduate with some debt.
21:52But you can see where we are compared
21:54to our peers and this is last year.
21:56We don't have this year's other
21:58everybody else's data for this year,
22:00but we're roughly half of
22:03the national average.
22:05I also want to highlight your
22:08role in helping us and I want to
22:10thank you for the work that you're
22:13already doing creating mentorship
22:15programs for our current students.
22:17But one of the things that I
22:21think we should be doing is really
22:25leveraging you in your community
22:27to reach out to our students.
22:30And so we're starting to do
22:32more dinners around the country
22:34to reach alumni where you are.
22:37And this is a sample of some of
22:39them that we've done in the last
22:41year and I'm really delighted.
22:43To share,
22:43I think some of you met Anne yesterday.
22:45She was the person sitting with your
22:48class wearing a class of 90 badge,
22:50and you were trying to figure out why.
22:52But Anne is a was a brown undergraduate,
22:56Yale medical alum,
22:58practicing ophthalmologist in New York.
23:01And we've convinced her to spend
23:03a little bit of her time as the
23:07new Director of Alumni engagement.
23:10And one of our visions is that we will.
23:13That that Ann will create a program that,
23:17as we admit students will be able
23:19to create outreach so that you can
23:22reach them if if they're from your
23:25city and talk to them about the
23:27Yale system and your experience.
23:28And I think that this will even
23:31further enhance the quality of
23:33students were able to recruit.
23:35I want to mention that we've been involved
23:37in strategic planning around education,
23:40and I think Jessica Lucy has
23:42shared some of this with you.
23:44A
23:46lot of this is around improving and
23:50innovating in medical education.
23:53You know, we, like so many schools,
23:54had these courses where our faculty would
23:59lecture with a PowerPoint like this okay.
24:03And it was pretty passive and with COVID,
24:06you know we did zoom but we learned that we
24:08need to do things a little bit differently.
24:10You saw the SIM center very
24:12handson way of learning that.
24:15We have a lot of people working on new
24:20technology based ways to to learn anatomy,
24:23to think in 3D.
24:26We also hear from our students that
24:29although they don't want you know.
24:31Grades and tests,
24:32they do want ways to assess themselves,
24:34they want ways when they're
24:35thinking about it.
24:36So we have some of the country's
24:38experts in that kind of self-directed
24:40assessment and so we're working on
24:43that and then expanding our advisor
24:45program into a a coaching program.
24:47So we had a gazillion applicants
24:50for 16 coaching positions and we
24:54will launch that program in June.
24:56Work in supporting our own faculty.
24:59We've revised our tracks in the faculty
25:04handbook to really reward teaching.
25:07We've developed educational leaders in each
25:11department beyond what we had previously.
25:13We've done work to improve our what used
25:15to be the teaching and Learning Center
25:18to to make that even more effective
25:20as a Center for medical education,
25:22offering people advanced degrees
25:24in medical education.
25:26And we've made sure that when
25:27we when someone is committing
25:29significant effort to education,
25:31we're paying them for that time and
25:34so they can protect their time.
25:36And then lastly, you know,
25:39I think some of this is an effect of COVID,
25:41but our students are hungry for
25:44more opportunities to meet people
25:47outside their own class and so.
25:49You'll you,
25:50I think you got an e-mail,
25:52we're standing up some advising
25:53colleges that will allow sort
25:55of for vertical integration.
25:56So first year students will be
25:59in dinners with 4th year students
26:01and senior folks we are,
26:04we are working with faculty to
26:08make sure that they understand the
26:11sensitivities of our students much more.
26:15Communication about the learning
26:16environment and again you know in in
26:19the hospital as well as in the school
26:21and then increase community engagement.
26:23We have a wonderful relationship with the
26:27pastors of our AM E Zion churches here.
26:30They are very engaged in our
26:32clinical research programs and more,
26:34more and more
26:37engaging them in things like in
26:40fact our mission statement but
26:42in sharing with our students.
26:44What the community's interests are, and
26:47the students are not always aware of that.
26:50They think they have the best and
26:52brightest idea in the community,
26:54says, you know, no,
26:54that's actually not what we're interested in.
26:56What we really need is this.
26:57So it's a very useful working relationship.
27:00And this is just, you know,
27:02we've got an LCMD site visit
27:04for accreditation coming up.
27:06I think it's something like preparing for
27:08a colonoscopy and that's where we are, so.
27:12So talk a little bit about research
27:15and we are sitting right now at
27:18#7 in the country and NIH funding,
27:21you can see that there's a cluster,
27:23they are all in the middle within you
27:25know a couple of millions of of dollars.
27:27And when you look at the departments,
27:30you know obviously internal
27:32medicine and and here psychiatry are
27:36biggest departments with funding.
27:38And psychiatry here is of course
27:41extraordinary typically a #1.
27:42Comparative medicine is a unique
27:45department here and then public health
27:47and public health is that's the
27:49ranking among public health departments
27:52and then it will move to becoming
27:55ranked among public health schools.
27:57The basic science here is extraordinary.
27:59What I didn't appreciate when I came
28:01is that the clinical and translational
28:04science is also extraordinary And
28:06to highlight a few things,
28:08the new therapies to prevent type
28:10one diabetes.
28:11Were developed here,
28:13starting with basic science and
28:15understanding how the T cell
28:16attacks the islet.
28:17But now all the way through the
28:20development of antibodies that can
28:21be given to children who are at high
28:24risk for type one diabetes trazepatide.
28:25And I forget the brand name,
28:28but it's the one that's now $1000 a month.
28:31But for the treatment of obesity.
28:33That trial was led here the,
28:36you know,
28:37some of the Sentinel trials in Alzheimer's.
28:40Obviously the COVID work ketamine
28:43for refractory antidepressants
28:45and for refractory depression.
28:48We, Yale University,
28:51developed a universitywide scientific
28:54strategic plan and I highlight here
28:56that much of that strategic plan is
28:59very well aligned with what we're
29:01doing in the School of Medicine.
29:03Tony Koleski and Brian Smith,
29:05our Deputy Deans for Research,
29:06led a school focused strategic
29:09planning exercise in late 2020 to say
29:12what do we need to develop that's
29:15compatible with the university wide,
29:17but focuses on our own gaps.
29:20One of those things is physician
29:22scientist development,
29:23creating an infrastructure so that
29:25we provide salary support for our
29:28starting faculty before they have
29:30that first career development award.
29:32And infrastructure to support
29:33people in making the transition
29:35from the career development award
29:37to the first independent funding,
29:39the RO one that includes oversight
29:42of mentorship,
29:43includes access to a repository
29:46of successful grants,
29:48a internal mock study section where
29:51people can see their grants reviewed and
29:53realize that they need to make a change.
29:55And then the creation of a Janeway society,
29:57which includes all of our junior faculty,
29:59whether they're in the basic science
30:01departments or the clinical departments.
30:03They just had their second
30:04second annual retreat.
30:05Jean Bennett,
30:06one of our alumna came
30:08and and spoke and Jean's,
30:10you know,
30:10only curing blindness and and so you know,
30:13she's a pretty compelling speaker.
30:16We've also developed this year
30:20was our inaugural year something
30:22called the Science Fellows Program.
30:25Which is I would say analogous to
30:28the Whitehead in that the intention
30:30is that we will recruit postdocs
30:32of such caliber that we anticipate
30:34we will invite them to stay
30:36on the faculty. And that's a very
30:38different model for basic science.
30:40And we're particularly interested
30:42in using this as a mechanism to
30:44increase the diversity both in terms
30:46of the types of science and the.
30:49And the applicants.
30:50And so this year there were the first
30:53year 134 applications, 11 finalists,
30:564 offers and three have accepted.
31:00And you can see that the applicants
31:01were very diverse and all
31:03three who accepted were women.
31:06That's unusual in our
31:08basic science departments,
31:09not yet any underrepresented medicine,
31:11but some significant improvements there.
31:15To mention that we're, you know,
31:17really focused on making sure
31:19that the technology or faculty
31:21have access to is cutting edge.
31:23We recruited Shan Ju and Song
31:26Penn a year ago to build Fib SEM,
31:29which is a technology they
31:30came from Januia Farm,
31:31a technology that allows incredible
31:34resolution to solve structures,
31:36things like building a murphish core.
31:39With some other crosscutting resources,
31:43we've created a a centralized
31:46biorepository for those of you who
31:48were here for any period of time.
31:49You know that many of our faculty
31:52have small biorepositories related
31:54to the disease of interest for them.
31:57But if you can, if you can,
32:00collect those samples in a way
32:02that they can be used for other
32:04things and you can collate them
32:06so that others can use them.
32:08This is a very powerful tool and
32:10it allows you to to search for new
32:13drug targets and and other things.
32:16I mentioned data science and
32:18the recruitment of Lucilla.
32:20Lucilla has brought with her all of us.
32:24So we are now at Yale engaged of
32:26the All of Us program in the all
32:29of Us program which is an NIH
32:31funded program to collect DNA and
32:34medical information from.
32:36It's a million people and we are
32:39focused here in Connecticut and in
32:41Puerto Rico and then we've stood
32:43up some centers in the last year.
32:45Anya Josheroff was the author who
32:47has led some of those incredin based
32:51pharmacologic trials for obesity.
32:55Mitochondrial biology is something
32:57that we're growing in our psychiatry.
33:01Department, a lot of interest in the
33:04effects of cannabinoids. You know,
33:06marijuana has been legalized in many,
33:08many States and yet we really don't
33:10understand the impact of that.
33:12And we believe we're seeing a
33:14significant impact in mental health.
33:16And then John Sang who was recruited
33:19recently doing Systems immunology
33:21and you'll be hearing more about that
33:24with an announcement in the fall.
33:27We are very space constrained and
33:29you may not appreciate this just
33:31walking around and because you've seen
33:33new buildings just to Orient you.
33:35This is College Street here, here, Cedar St.
33:38and of course Sterling Hall.
33:40We are over here in tack and we
33:44have two new buildings going up,
33:47100 College St.
33:48which has bridges to three 3300
33:51George Street and then back to
33:53the School of Public Health.
33:54And across the street a new building
33:57101 College we will that will
33:59give us more space but the space
34:02that we call West of Cedar,
34:04the old hospital that has been
34:06lab space is some of that will
34:08need to be decommissioned is the
34:10cost of renovating it now exceeds
34:12the cost of new space.
34:14You get into asbestos mitigation
34:15even when you renovate it,
34:17it's often still kind of rabbit
34:19worn looking labs and so.
34:22We,
34:23we are have plans after these
34:25two to build a new building.
34:28All of this is much slower
34:29than we would like it to be.
34:31We probably should have built a
34:33building about 10 years ago and it's
34:35slow because of Labor shortages and
34:40supply chain and all those kinds of things,
34:42but we will get there.
34:44We're trying to be very
34:46creative in our use of space.
34:47Last on research, we did convene our
34:51first scientific Advisory Board.
34:52You'll recognize many of these people.
34:55This wasn't intentional, but all,
34:57all but one have a Yale association
35:01and and that's kind of fun.
35:03So Nobel laureates,
35:04Lasker Prize winners,
35:06editor of science, you know,
35:07really a very energetic and
35:10enthusiastic group,
35:11very helpful to us.
35:13So the clinical mission
35:16I don't think for you
35:18know for many of you St.
35:20Raves was part of Yale New Haven Hospital,
35:23but it is now and that means
35:25that we currently have one of the
35:27largest academic health centers
35:29here in town with 1541 beds and
35:33this is just what's in New Haven.
35:36We have of course now a network
35:38that ranges from Greenwich to
35:40the South all the way up to.
35:43Westerly RI, most of the affiliated
35:45work that we do is here, but we have
35:49a fairly big footprint in Greenwich,
35:51Bridgeport and in New London.
35:56And again, you know,
36:00we have a 200 year relationship
36:02with first New New Haven Hospital,
36:05Grace New Haven Hospital,
36:07now you know,
36:08New Haven health system and
36:10it's been bumpy at times.
36:12And I think we are at a bit of a
36:16turning .1 because we have new leaders,
36:19relatively new leadership both in
36:21the school and as of March a year
36:23ago in the in the health system.
36:25But also because I think COVID
36:27has been helpful.
36:27We had to come together in
36:29ways that we never had before.
36:33And because of the way we came together,
36:36we actually had one of the lowest
36:38mortality rates in the country for COVID.
36:40And that is very different from
36:42how we do day-to-day because we're
36:45tripping over ourselves often.
36:48And so Chris and I have just said we're,
36:52we're going to do this and we're
36:54going to kind of, you know,
36:55step out over the ravine and hope
36:57we make it to the other side.
36:59But we have to do this.
37:01And So what is this?
37:02Well,
37:03we are working on a joint strategic plan.
37:05It's the first time we've ever had
37:07a joint strategic plan between
37:09our two institutions.
37:10I'm gratified that when we addressed
37:13this to the leadership of the
37:15hospital and our chairs 201,
37:17they identified leading clinical
37:19and translational research as what
37:21differentiates us and one of the
37:23things we needed to invest in.
37:25But it's everything from our
37:26learning environment to providing
37:28better access to our patients,
37:31better value for our patients and
37:32you know just the business aspects of
37:35what are our destination programs,
37:38one of the things that I think we didn't.
37:40Think we would get done as quickly
37:42as we did was an alignment of
37:44our physician practice.
37:45So Yale Medicine is our faculty
37:48practice plan.
37:49There's also a unit Yale New Haven
37:51Health System employed practice plan,
37:53Northeast Medical Group and the
37:56two sometimes competed, you know,
37:58whether we were recruiting
37:59physicians or competed for patients,
38:01which is crazy.
38:03And so we've now aligned them
38:05under a single group.
38:07We haven't changed employment status.
38:09So our faculty are still employed
38:11by the university and New NEMG is
38:13still employed by the health system.
38:15But it's led by a single chief
38:17physician executive who is Peg McGovern,
38:19who's also our deputy Dean for
38:22clinical affairs and she is
38:23somebody who's up to the task,
38:25which is really exciting.
38:27Reporting to Peg is
38:29Richard Goldstein, who oversees NEMG.
38:33This will allow us to get to a
38:36single access center. We now have 3.
38:39It will allow us to get rid of duplication
38:42in billing and all sorts of things.
38:45That will also reduce expense on both sides,
38:48which is critical to the success
38:51of hospitals post COVID.
38:53So we're huge amount of work that needs to
38:57be done And then the last thing because
39:02you don't really get into fund change
39:04management until you move people's money.
39:08Is we've gotten into funds flow and so
39:13we have our funds flow traditionally
39:16is a series of oneoff negotiations
39:19typically between chairs and a leader
39:22in the hospital and in our agreements
39:26look something like this no to alike.
39:29They are written down and huge amounts
39:33of wasted time and wasted personnel
39:35tracking everything that's in these.
39:38We needed to have something
39:39that was rational, transparent,
39:41aligned incentives so that we
39:44got the behavior that we wanted.
39:47And you know,
39:48we did what everybody has done and
39:50I and and many academic institutions
39:53have done this most, you know,
39:55as early as 10 or 10 to 8 years ago.
40:00And we brought in a consultant who's
40:02done this with most of our academic
40:04partners and we've changed how
40:05funds will flow in a ration.
40:07So we pulled out academic program support.
40:10We've created a criteria
40:12for the clinical payments.
40:13We continue to have things like GME payments,
40:16all those sorts of things.
40:17Not important to get into the details,
40:19but we go live July 1 and this is a
40:24huge exercise and change management is
40:26and it's going to require that people.
40:29Learn to lead differently.
40:30We are running our new and our old
40:33systems in parallel for a year
40:35and holding people harmless,
40:37but it's a big, big lift.
40:42Lastly, we're in the midst of a
40:44capital campaign. Universitywide.
40:45These are the pillars of the capital
40:48campaign and just tying to that
40:51what we're doing in the school.
40:53So obviously the the university
40:56science strategic plan.
40:58Our own interest in research and
40:59innovation such as in dead data science,
41:02our own interest in faculty development
41:04and in cross campus collaborations and
41:07then I think well aligned with leaders
41:09for a better award world is our efforts,
41:12our efforts in financial aid.
41:14You have been big contributors
41:17and I mentioned last yesterday
41:20afternoon before our our panel.
41:22That our alumni since July 2018
41:27have given $4.6 million many
41:31of you give to financial aid.
41:32For those of you who we have,
41:36a match is not the right term but
41:39a commitment from the Provost that
41:42for every gift of $1,000,000 or more
41:45to financial aid he is matching or
41:49unlocking funds that is matching this.
41:52And so for example,
41:53that gift from the Star Foundation,
41:55we're able to,
41:56we were able to unlock another 25 million.
41:59So thank you for this.
42:00Thank you for the outreach that
42:02you're doing to our residents and
42:05students and just ending again with a
42:07reminder of those crosscutting themes.
42:09And I hope you've seen what ties to that.
42:12And I think we have a little
42:14bit of time now for questions.
42:15Yes.
42:30Yes,
42:33question for that.
42:34I just I thought that there is a
42:37study in cannabis and I was thinking
42:39that very specific because there are
42:41coding here they all expect for the
42:43study how artificial involvement,
42:47yes there's. There's a fair amount
42:49of artificial intelligence work going
42:51on in the School of Medicine already
42:54particularly in imaging pathology the
42:56obvious places where you might use it.
42:58There is a a robust dialogue university
43:02wide and and obviously in computer science
43:05in those places a lot going on in a I.
43:07But one of the biggest issues
43:11particularly for the undergraduate
43:14campus is how even to handle.
43:16Tests and all of those kinds of things,
43:19and whether something is generated by chat,
43:21GB T and how you,
43:23how you annotate that and all those
43:25kinds of things. But yes,
43:30follow up to the cannabis Center.
43:32There's some interesting neuroscience
43:35that is moving forward slowly
43:37because of the bands going back to
43:40the legalization of psychedelics.
43:42Is that happening at Yale too?
43:45Yes. So we're doing a lot of
43:48work in and and I get I was
43:50showing new centers this year,
43:51but we're doing a lot of work
43:53in the psychedelics in a number
43:56of conditions, including PTSD.
43:57We probably have the strongest PTSD
44:00work going on in psychiatry here and in
44:04affiliation with our VA and that's yeah.
44:11Great things that this year for students,
44:13was the relationship still very strong. the
44:20VA, you know, is critical to I
44:21think to a School of Medicine,
44:23both for that educational piece
44:25for students and residents,
44:27but also for another opportunity
44:30for junior faculty in terms of
44:33grant funding and it it the VA has.
44:37Even more difficult wet lab space
44:40problems right now because it's
44:42physical plant is so old that
44:45we're actually in conversations
44:48about whether they would take some
44:50bioincubator space in New Haven for
44:52a while that those kinds of things.
44:56Yes,
45:01question about in terms of the development
45:05of physician scientists dental.
45:07I'm wondering how you do with respect
45:09to the kids that are transition. Yes.
45:13How are you doing to respect recruiting
45:17position scientists and keeping them? Yes.
45:22So you may not know this.
45:23This is one of my particular passions and.
45:27And when I arrived,
45:29we did appoint Keith Chote in this
45:32role and and the our statistics for
45:34the K to R conversion were not bad.
45:36They were you know they're still above
45:39the national average and of course,
45:41but in my experience if you get
45:43the right infrastructure in place,
45:45you can get that that K to R
45:47conversion up to the 70% range.
45:49And so the just to review
45:52some of the elements of this.
45:54We have a competitive program.
45:57So we we have lots of K12 awards.
45:59These are institutional career
46:02development awards along fields, right.
46:06But we also now haven't truly institutional.
46:09So it's from the Dean's office several
46:13slots and it's competitive so that
46:16people submit their science and
46:19their mentorship plan internally.
46:22Get funding.
46:22Most of them flip off because they're
46:25submitting their K award at the same time,
46:27so we're actually recycling this.
46:30We also created
46:33a T32 equivalent for our foreign
46:38trained fellows because that's a
46:40group as many of you know is not
46:43eligible for career development
46:45funding and some of our best folks.
46:47So we have 4 new people this year.
46:51So we're investing a fair
46:52amount of this. Yeah, yes.
46:59So the West Campus is used as cross
47:05university space for several institutes
47:07and we have a number of faculty out there.
47:13It my sense of it is that it is
47:16underutilized and I would like
47:18to put more things out there.
47:20It's, it's interesting that even
47:21post COVID when everybody was
47:23meeting by Zoom and whatnot,
47:25faculty are reluctant to move there.
47:28But we are trying to leverage
47:30that certainly for swing space
47:32as we build other things.
47:34Yeah, yes,
47:38you're doing a great job
47:39turning out leaders in medicine
47:42globally in the United States.
47:45Bravo on having a Surgeon General upcoming.
47:50Head of the CDC you have a
47:54lot of interdisciplinary How
47:57are you pulling this off?
47:58It's pretty amazing.
48:02I can't take
48:02credit for Rebecca or Mandy
48:04because they were here before.
48:06But I do think the Yale system
48:08makes a huge difference, right?
48:10You you develop people who go deeply and.
48:19Develop a passion
48:23and who maybe struggle a little bit.
48:25They have that experience of,
48:26you know, having to figure it out.
48:30There's no point in having medical
48:33students just memorizing a bunch of
48:35stuff because the stuff you memorize now
48:37is not the same stuff you need to know.
48:39And I mean, you know,
48:42so I think it's selection, no doubt,
48:44but I think the culture as well.
48:49Yes,
48:57yeah.
49:23Yes,
49:25a couple of things although
49:28it may not look different.
49:30I would point out the residential,
49:32the the numbers of towers of
49:34apartment buildings within a block
49:36or two of the School of Medicine.
49:39Most of our students do not
49:40live in Harkers Hall anymore.
49:42So, so that that fact that
49:45there's that residential is huge
49:46if you go several blocks away.
49:51Particularly on the other
49:52side of the hospital, it,
49:53it is a big concern.
49:55There's a lot of renovation going
49:58from here to Long Wharf and the mayor
50:02has announced a plan around that and
50:05we're very much partners in that.
50:07These buildings that are going
50:09up that are being built by
50:11developers have city support,
50:12but they are able to go up
50:14because the university and the
50:15School of Medicine in particular
50:16is leasing floors in them.
50:22Fundamentally, we have to we have
50:24to change the economics of the
50:26city and we have to address the
50:28addiction issues in the city.
50:29We have a lot of work going
50:32on around addiction.
50:33Our residents spend all of their
50:35primary care time in an FQHC,
50:39so we have a lot more work to do.
50:42But I it's one of the things
50:44that attracted me here was that
50:46we are in a community where we
50:48can make a difference.
50:50Yes, you
50:53must not sleep much at night. My
50:57question is what do you see
51:00the role of primary care.
51:04So it's interesting we have,
51:05you know, never produced a lot
51:08of primary care physicians.
51:09We do have of course our PA
51:13program on the other hand are.
51:14Our primary care residency program in
51:17internal medicine produces more primary
51:20care residents than anybody else.
51:22They don't stay at Yale.
51:25And with Peg's arrival,
51:28one of the conversations we're
51:30having is how do we keep them,
51:33if not on faculty in the Yale
51:35community through this aligned
51:36physician enterprise And we will
51:38within the next year stand up a.
51:41Clinically integrated network that
51:42allows us to then and you know
51:45spread the tent even further so
51:47are we have to build primary care.
51:51I'm an internist you know we
51:54will do that and again maybe not
51:56through having a gazillion faculty
51:58members but affiliated yes,
52:04so piggyback off that question both of
52:07us were went into family medicine and.
52:10When we graduated almost 20 years,
52:11it was such a challenge trying to
52:13navigate our way into family medicine.
52:15It was uncharted waters and and in
52:17respect to now with primary care
52:20still having that emphasis in regards
52:22to internal medicine and met peace.
52:23I was just wondering whether the
52:25conversation in terms of family
52:27medicine supporting students who
52:28are interested in it having some
52:30kind of track or encouragement.
52:34We have had the conversation
52:36and we particularly had a
52:38conversation about putting a family
52:41medicine residency in in L&amp;M,
52:44our hospital in New London.
52:47There were some funny GME things
52:50that they had had one fellow there,
52:53so they were capped at the as being
52:56able to have one GME person there.
52:58That's going to change with a new law.
53:01And so when that happens,
53:03we will revisit that as a possibility.
53:07Yes. In the 1960s,
53:10the highways that came in off
53:12of 95 were known as the Oak St.
53:15connectors and we were in the
53:17middle of the Oak St. slums.
53:18I I fighting the environment
53:21of New Haven is as old as
53:24the school way it is. Yeah,
53:26No, I have a. Son who was an urban
53:30planning undergrad and I was an
53:32architect and you know this is
53:34New Haven is the case study for
53:36effects of bad urban planning.
53:42I will say he loves, he loves the
53:45School of Public Health building as
53:47a as a perfect example of brutalism.
53:55Steve Brown, we have a question
53:57actually from a class member 72.
53:59In the past you've talked about the
54:01need to improve access to care.
54:02How is that going? I live in the community.
54:05So this work that PEG is doing to,
54:11you know again get us from three
54:14access centers to a single access
54:16center will make a huge difference.
54:18We we also need to change how
54:20we work as faculty, physicians,
54:23there's a tendency to.
54:25You know, you have a four hour.
54:27I mean you've all been through this, right.
54:28You have a four hour clinic and
54:30and that goes from 8:00 till noon,
54:32but you're you show up at 9:00 and you,
54:35you know, so we have to change
54:37our culture a little bit about
54:38our commitment to our patients.
54:40It doesn't mean that we are asking
54:42faculty to have more than 1/2 day
54:44clinic if they're a physician scientist,
54:46but to commit to that time
54:47when they're there.
54:48So yeah.
54:52Any other questions? There's one more more
54:57than married. So as clinicians,
55:00we deal with people, which
55:01is a humanistic effort.
55:04And I'm wondering what opportunities
55:06there are for the medical students
55:10to engage in the arts and humanities to
55:12help improve their humanistic endeavor.
55:14Yes, we have a wonderful.
55:19Program in humanism in medicine
55:22that offers regular events.
55:26We have, as you probably recall,
55:29the Yale Symphony,
55:30the Yale School of Medicine Symphony,
55:33and many of our students participate in that.
55:37The there's engagement with
55:39the art museums as well.
55:42So I think all of that's
55:43quite alive and well here.
55:53Can you tell us a little bit
55:55about the educational curriculum
55:56for the medical students and how that's
55:58changed over the last couple of years?
56:01So over the last couple of years,
56:02not a lot basically since I've
56:06been here it is as you know as
56:08but as many places now they do 18
56:11months before they go into their
56:15into their clinical clerkships,
56:17their preclinical time is.
56:22By you know, things are grouped together
56:26logically by not by basic science,
56:30but by related basic science material.
56:35And those blocks run from four weeks
56:38to 8 weeks, typically around 4 weeks.
56:42So they start with something called
56:44Introduction to the profession,
56:46which is a very brief block.
56:47It's about a two week block. They have.
56:50The next one is on you know hematology
56:52and genomics and those kinds of things.
56:55They have a large Physiology block which is
56:59one of our highest rate is rated blocks.
57:02There's that.
57:03There are many threads that
57:04run across that period of time,
57:06pharmacology being an example
57:07where it's better if it's
57:11integrated as you're learning
57:14the basic science as well.
57:17During their clinical clerkships they have
57:254-12 week blocks, but then they have
57:27an extended period of what we call
57:30advanced training period and there
57:33they have very few requirements
57:35and you know, so they do some.
57:38Occasional subinternships and electives,
57:40but they can also take that time to work on
57:44their thesis for extended periods of time.
57:47And still a majority of our
57:50students take a fifth year as well.
57:54So that's just a brief overview
57:56of the curriculum, yes.
58:07Medical school here years ago,
58:09one of the best lectures I
58:11ever attended was been Scully
58:16giving a lecture on the architecture
58:18of The Cave, and particularly
58:20he did the nice of longest.
58:23Whatever. Yeah, yeah, so do I.
58:29This is just amazing.
58:31So I'm wondering in light
58:33of the question of humanism,
58:34are there opportunities,
58:36structured opportunities without
58:37having too much effort to where
58:40medical students can take advantage
58:42of this amazing university? Yes,
58:46again, particularly elective time.
58:48You know, they have so much elective
58:50time they can they can take courses.
58:52One of the reasons we want this
58:54coaching program is to make sure
58:56they have awareness of, you know,
58:57to facilitate those kinds of things.
59:04Several of our MDPHD students are
59:06doing PHD's in the humanities.
59:10We have, as you were aware,
59:12a very strong history of Medicine
59:14Department and the History of
59:16Medicine folks spend a lot of
59:18time teaching undergraduates,
59:19but also in degraded into
59:21our curriculum as well,
59:25yes. I'm just not familiar
59:27with the way the fact they
59:29set up in terms of teaching.
59:31But when we were here we had
59:32exposure to private practitioners.
59:34Is everybody now Yale affiliated or
59:38under the faculty or do they have,
59:41you know we had the moral unit within the VA
59:45Is there that kind of exposure
59:48or is everybody Yale back to
59:50be one way or the other? No
59:53Yale New Haven health system
59:55is one of the. Rare academic
59:58health systems that is not closed
01:00:05and you know I would say so there are
01:00:09three types of physicians in our own
01:00:11just across the street, it's faculty,
01:00:13it's Northeast Medical Group that
01:00:15will that are more affiliated now and
01:00:19then it's community missions, yes.
01:00:26Changed over
01:00:31the years. Nora Wong has written a very nice
01:00:35article on this. Since I wasn't
01:00:39around in 1932, I can't.
01:00:44What I can say is that
01:00:48the fundamentals have not changed at all.
01:00:50You know, I think there are interesting
01:00:54writings about. What winter?
01:00:56And it's really what he really did, you know.
01:00:59So including getting rid of,
01:01:00you know classes in the sense of first,
01:01:02second, third, year, 4th, right.
01:01:04He really had a vision ahead of his time for
01:01:07competency based progression in medicine.
01:01:11I think if you came back and sat in
01:01:16on courses or didn't sit on a courses
01:01:19you would have a very you would you
01:01:21would recognize the place very much.
01:01:26Yes, So has
01:01:30created, yeah, that's important
01:01:35to have people who can remember
01:01:38a lot of stuff and it it's
01:01:41effectively measurable too.
01:01:42So that allows us to do some selection.
01:01:45So the alternative would would be to
01:01:46find people who are more compassionate
01:01:48and who can translate that more.
01:01:49And I'm wondering A,
01:01:50if you think that that's really the case.
01:01:53And secondly, are you aware of any
01:01:55data that we can measure compassion,
01:02:00I know it when I see it
01:02:08we do our admissions process includes
01:02:14some standardized interviewing,
01:02:16some cases and things that.
01:02:19I'm not a psychologist,
01:02:21but I understand help reveal
01:02:23those characteristics of people.
01:02:27But it's very judged.
01:02:29I I think it's very subjective and I
01:02:32I would say we do a pretty good job in
01:02:34our students of landing those people.
01:02:37We do something in residency,
01:02:39not we yell, but as a country we do
01:02:42something in residency that blunts that
01:02:46and I think that's where
01:02:48we ought to be focusing.
01:02:49And and some of that is us, right?
01:02:51I mean, I think some of it is what
01:02:53they see and this is what people
01:02:56refer to as the hidden curriculum.
01:03:02Yes, thank you. Has Yale done anything
01:03:07recently to address the workforce
01:03:09needs with respect to behavioral health
01:03:12issues that are so prominent now we.
01:03:17We have a huge department of psychiatry.
01:03:18Our students, you know,
01:03:21we're very engaged in.
01:03:23We have, we produce a significant proportion
01:03:26of people engaged in mental health.
01:03:29What we're doing clinically is much
01:03:31more embedding people in primary
01:03:35care because there's so much mental
01:03:39health issues across medicine now.
01:03:41I mean I will say for example we're seeing.
01:03:46Post COVID, we're seeing a surge in
01:03:49anger among patients and there's real
01:03:51concern about safety and you know,
01:03:52you've seen the stories nationally
01:03:54and and that's something we're
01:03:56thinking a lot about.
01:03:57Yes, a number
01:04:00of universities that are programmed
01:04:03on doctors, right, Learning how
01:04:06to find the general population.
01:04:10Does Yale have a kind of a
01:04:12program like that? We do.
01:04:13It's not just physicians.
01:04:15It's a universityled program,
01:04:16but we put about five or six
01:04:19people through it each year,
01:04:21typically rising early faculty, early mid.
01:04:26Faculty who have developed a career,
01:04:30have expertise,
01:04:31are passionate about something,
01:04:33and they learn how to write
01:04:34oped pieces and how to how
01:04:36to communicate effectively.
01:04:40You briefly mentioned the challenge
01:04:42of having to memorize things.
01:04:44I've been in practice surgery in the
01:04:46Boston area for 35 years and have taught
01:04:48it all through the medical school.
01:04:50And I've learned with my colleagues that
01:04:52as we're teaching nurturing students,
01:04:54we teach them that they need to learn how
01:04:56to recognize disease patterns and solve
01:04:58problems and not minimalize anything.
01:05:00They can't remember the name of the syndrome.
01:05:03Who cares as long as they understand
01:05:04what it is. Yeah. That's great.
01:05:07I I volunteer at the Haven
01:05:09clinic and I'm so glad that like,
01:05:11I don't need to remember
01:05:13the names of current drugs.
01:05:15You know, I what I and.
01:05:16And you're exactly right.
01:05:18What I add is that when I walk
01:05:20into a room I can recognize when
01:05:22someone's sick and I can examine
01:05:24them and and I can make a judgment,
01:05:26a triage that the students know all their
01:05:28antibiotics and all that, you know.
01:05:33I'm getting we're getting the signal here.
01:05:36Thanks very much.
01:05:43I think it's all of you
01:05:44can appreciate it spend a
01:05:46breath of fresh air to have Dean Brown here.
01:05:48And I have enjoyed very much
01:05:50my interactions with her,
01:05:51with my the last year plus as the president
01:05:55of the organization when she first came.
01:05:58On to the in February,
01:06:00I guess of 2020 was it? Yeah.
01:06:02Dora Wong, one of our active members
01:06:06in the Association had written up a
01:06:09a chapter on Dean Vindernet's and
01:06:13the 100 year anniversary of the Yale
01:06:16system and I gave a a copy of it.
01:06:18It was still nearly finished
01:06:21draft to Dean Brown.
01:06:23And she read it
01:06:27and and that began conversations about
01:06:30the Yale system and the resurrection
01:06:33of the system which had fallen
01:06:35in disrepair before she arrived.
01:06:38So thank you personally and
01:06:41for all of us alarms Okay.
01:06:43It's time to start the business meeting.
01:06:46I'm told here was a my overly
01:06:49scripted list of things to do. So
01:06:54we have a good group this
01:06:56coming to the reunion.
01:06:57Not all here in the room with us,
01:06:59but there are more than 300 guests
01:07:03who have registered for the reunion.
01:07:07The class of 1973 which is celebrating
01:07:11his 50th reunion has 62 alums
01:07:13and and guests in the class of
01:07:161988 celebrating 25th has 55 so.
01:07:20A large turnout and we appreciate
01:07:23that very much.
01:07:28I wanted to give you a brief update on
01:07:31the association and what it's up to.
01:07:35Our primary goal is to assist
01:07:40the school and and Dean Brown in
01:07:43the development of the school.
01:07:46In in in ways that we can not always in
01:07:51agreement but always in collaboration.
01:07:57We during this last year have
01:07:59instituted a couple of new things
01:08:01one is we are have a an amendment
01:08:04to our constitution which you're
01:08:06been asked to vote on which creates
01:08:09an America emeritus America status.
01:08:11For the leadership of the AY AM who
01:08:16rotate off and and you know what do they
01:08:19do then I mean you know in a in a in
01:08:21a year I'll no longer be the president.
01:08:23And we we we needed to have a way to have
01:08:28the insights and experience of our past
01:08:32leaders available to us as we move forward.
01:08:35And so we created that's the automatic
01:08:38status of America's America.
01:08:40Which will allow them to participate
01:08:42in the work of the association,
01:08:45everything except membership of
01:08:48the executive committee.
01:08:50But they come to the meetings and
01:08:52I tasked them with jobs to do and
01:08:56it's really been very helpful.
01:08:58So you you've been asked to vote for that,
01:09:01but I don't imagine anybody would have
01:09:03a great deal of opposition to it,
01:09:06our vice President.
01:09:07Paul Leong has started a program of
01:09:12engagement of alumni in various specialties,
01:09:17the first one being Neurosurgery,
01:09:20who will come together for a zoom meeting,
01:09:25six of them a panel,
01:09:27and the students who are interested
01:09:30in that particular specialty.
01:09:32Will have a chance to hear from them
01:09:35and to ask questions and get advice
01:09:39on how to become a neurosurgeon if
01:09:42that's just something that they
01:09:43think they might be interested in.
01:09:45So we're in that first meeting which
01:09:48I think is going to be next month,
01:09:50although I could be off by a bit.
01:09:53The we will have the chairs of certain
01:09:57departments and from from different
01:09:59medical schools all of them Yale graduates.
01:10:03He plans then the next one would be on
01:10:06Pediatrics and he plans to go through
01:10:09these just through all the specialties,
01:10:11so that that's an important new initiative.
01:10:15Another one is that we're still in the
01:10:17development stages of it's twofold.
01:10:21One is financial literacy.
01:10:24So that the students when they,
01:10:27you know they,
01:10:28I mean they've been taking money from
01:10:30the from the school and all of a sudden
01:10:33one day they have a job and what do they do,
01:10:37how do they manage that?
01:10:38One of the things that that that
01:10:40the theme that would probably be the
01:10:42first one that we present as a Zoom
01:10:45meeting is on disability insurance.
01:10:47Now this is something that nobody
01:10:48ever talked to me about when I
01:10:49was in medical school,
01:10:50but let's say you become a plastic surgeon.
01:10:53And develop a carpal tunnel syndrome.
01:10:57Then what?
01:10:59So it's not too early when you
01:11:01graduate because it's cheaper than
01:11:03when you're young to get disability
01:11:05insurance that will cover you
01:11:07for these certain disabilities.
01:11:10And another one is the ergonomics.
01:11:16I'm not a surgeon, but I.
01:11:18Remember with horror,
01:11:20standing behind a bunch of blue backs,
01:11:23holding, holding a retractor and
01:11:26wishing I had some place to sit?
01:11:31So so that that whole thing of of
01:11:35ergonomics and its effect on burnout,
01:11:38how they wearing out of the human body.
01:11:41Because we don't take care of it.
01:11:42We're too busy doing what
01:11:44we're trained to do, ends up.
01:11:47Causing burnout and A and a loss
01:11:49of of the physician workforce.
01:11:52So those are the initiatives
01:11:54that we have underway,
01:11:55all directed by the executive
01:11:57committee that you're going to
01:11:59be voting for members of in the
01:12:02moment or we'll be voting on them.
01:12:05So we welcome all of your input.
01:12:09You know your membership in the
01:12:11AY AM comes with your diploma.
01:12:14So you're all members and you're all
01:12:18welcome and you're welcome to come to
01:12:20the meetings and you're very welcome
01:12:22to participate and to let me know or
01:12:25the alumni office know if you have
01:12:27an interest in serving either as a
01:12:29leader of the AYM or to to one of
01:12:33these adventures that I've spoken of.
01:12:35And then the the last one is to
01:12:38support Dean Brown when she goes
01:12:40across the country and visits places.
01:12:42And we've I think we've we in
01:12:44Minneapolis we did a good job of that and
01:12:47probably I think in the San Francisco.
01:12:49So we're we're trying to develop in in
01:12:53the major cities where most of our our,
01:12:56our students end up and we have a lot
01:13:00of alums groups of alums who are who
01:13:03who get together at least by text message.
01:13:06And are prepared to welcome the Dean
01:13:08when she comes to visit those cities.
01:13:11Which reminds me of one other thing
01:13:13that we've done is that as you saw,
01:13:15there were a lot of our students
01:13:18who are going up to our our sister
01:13:21institution to the north and
01:13:23where they'll become lost.
01:13:25But
01:13:29but in an effort to help them,
01:13:31there's they're having a meeting.
01:13:34Of all of them are being gathered there by
01:13:37one of our alums who's who's who set this up,
01:13:40who will have a social gathering,
01:13:43which will also have Yale alums
01:13:45who are on the faculty there
01:13:48at the various institutions.
01:13:50You know that Yale doesn't have it.
01:13:52A real medical school,
01:13:53it's just a bunch of hospitals.
01:13:55I mean Harvard I meant.
01:13:57And the joke about when I
01:13:59was there at the Brigham,
01:14:00the joke was that.
01:14:01The only job the Dean of Harvard
01:14:03Medical School had was to make
01:14:05sure the heating system worked.
01:14:12So there will be a social gathering
01:14:14of of our recent graduates who are
01:14:16just starting in their careers up
01:14:19there in Boston to gather together.
01:14:21We planning one for our Yale
01:14:23graduates here in in in in Milford,
01:14:25but it kind of they they weren't
01:14:27terribly interested in it,
01:14:28I guess because they don't.
01:14:30They're not worried about culture shock,
01:14:32but anyway that's that's so
01:14:38that's what we've been up to.
01:14:40The next thing is that you've been
01:14:44asked to vote for new members of the
01:14:49executive committee and I want to
01:14:52thank the the expiring members who now
01:14:55become emeritus and America members.
01:14:59So you're being asked for them,
01:15:00the, the nominees.
01:15:03And this year, I think probably
01:15:06for the first time your ballot has
01:15:08had some information about them.
01:15:09Before it was just a series of names.
01:15:13So now you have some information about
01:15:14them and and hopefully some pictures.
01:15:16I think we got pictures from everyone.
01:15:19Linda Armstrong is works for Novartis
01:15:24and New York and is in the class of 88.
01:15:29Miriam Askari in the class of 97,
01:15:32she's a has already served two
01:15:35years as a executive committee
01:15:39member and she's up for reelection.
01:15:42Elizabeth Quatraki is a psychiatrist
01:15:46in at in Boston class of 94.
01:15:53Amaya Kulkarni is a someone
01:15:57coming up for a reelection.
01:16:00It's in the O6M D and Jill
01:16:04Silverman of class of 79 in New
01:16:08York is coming up for reelection.
01:16:11She to the associate to
01:16:14the executive committee.
01:16:16We have two nominees for the
01:16:21YAA, the alumni association.
01:16:23We get delegates to that.
01:16:26And we we have two delegate
01:16:28nominees that are on the ballot.
01:16:31Jennifer Troy is a dermatologist in
01:16:34Chicago from a class of of O3 who
01:16:38was one of the people who who there
01:16:42is a website where you can go on
01:16:44and and express your interest in
01:16:47serving in a leadership position in
01:16:49a Y AM and she did that and she's now
01:16:52going to be a delegate to the YAA.
01:16:56And Wilhemina Covar in the past of 77,
01:17:01is a pain specialist in Florida
01:17:04and Central Florida.
01:17:05And so she is the other nominee
01:17:07for the YAA delegates.
01:17:10If you want to serve in any of those roles.
01:17:14Again, there is a website and
01:17:16I forget what it is,
01:17:18but it's the alumni office
01:17:22or you can contact.
01:17:23The the Just a Y AM at Al dot
01:17:27Edu and let us know We're always
01:17:31looking for able bodied souls.
01:17:34All right now time and a real
01:17:38pleasure for me to award the 2023
01:17:41Distinguished Alumni Service Award.
01:17:44So Dean Brown, you'll need to come up here.
01:17:48It's nice to be able to
01:17:49tell the Dean what to do,
01:17:56so it's a great honor this year,
01:17:59a particular honor to to present this
01:18:02to a member of their alumni class,
01:18:06and the reward recognizes the alumni service.
01:18:09And this year it goes to Harold Mancus,
01:18:12Mancusi, Ungaro Junior.
01:18:27You, you come over here.
01:18:34It's a real pleasure because Harold was
01:18:36the president of the association when I
01:18:38first joined the executive Committee,
01:18:40and so I've known him all these years.
01:18:43So the Ale School of Medicine
01:18:45is proud to count you Harold,
01:18:47among its graduates and bestow upon you
01:18:50the Distinguished Alumni Service Award.
01:18:54As Secretary, Vice President,
01:18:55and President of the Way, AY AM,
01:18:59you provided consistent leadership and
01:19:02unstinting support for the best and
01:19:05most beloved traditions at the school,
01:19:08your service continued as a delegate
01:19:10to the Yale Alumni Association on the
01:19:1350th anniversary of your graduation.
01:19:15Those traditions remain strong
01:19:16because of the work you and your
01:19:19colleagues have done to shine a light
01:19:21on the Yale system enduring value.
01:19:24Dean Veternets once said in in
01:19:27laying out his vision for what
01:19:29would become the Yale System,
01:19:31every effort must be made not to stifle
01:19:34the opportunities for learning by
01:19:36building up a great machine for teaching.
01:19:39As a first year medical student,
01:19:42you authored Michelangelo,
01:19:43the Bruges, Madonna,
01:19:45and the Pickle the Themini Altar,
01:19:48a volume that grew out of your
01:19:51undergraduate thesis at Yale College.
01:19:53And combined art history with detective work,
01:19:56You realize that that this achievement
01:19:59would have been impossible in
01:20:01the traditional medical school
01:20:03environment that regulated how
01:20:05students spent every waking minute.
01:20:08You also recognize that when students
01:20:11take responsibility for their own
01:20:13education and learning and have the
01:20:15freedom to pursue their own passions,
01:20:17the result is an extraordinary
01:20:19line of leaders who.
01:20:21Push the boundaries of medicine
01:20:23to better serve humanity.
01:20:25A lifelong learner,
01:20:26you have always welcomed opportunities to
01:20:30explore the work going on at the school.
01:20:33Living in Texas and then California,
01:20:35you frequently returned to New Haven
01:20:38to be of service to the association.
01:20:41You knew that if your fellow alumni
01:20:43could become similarly involved
01:20:44with the ongoing work of the
01:20:46school that they would like you.
01:20:48Be strong voices for the Yale system.
01:20:51While serving on the AY
01:20:53AM Executive Committee,
01:20:54you promoted reunion programming
01:20:58that highlighted the achievements
01:21:00of outstanding School of Medicine
01:21:02graduates and illuminated how
01:21:04their unique experience at Yale
01:21:06contributed to their success.
01:21:08Beyond reunion programming,
01:21:10AY AM recorded oral histories of
01:21:13returning alumni who reflected on
01:21:15how the Yale system affected their
01:21:17personal and professional lives.
01:21:20This serves as a perpetual tribute
01:21:22to and case for the Yale System.
01:21:25This system system shaped you,
01:21:27and in a real way,
01:21:28you've had a profound impact on it.
01:21:33Today, your friends, family,
01:21:35classmates salute you for your
01:21:37service to the Yale School of
01:21:39Medicine and its ideals.
01:21:40You're our true son of Yale.
01:22:00I just like to say a couple of words.
01:22:05I really appreciate this.
01:22:07I've always said that contributing
01:22:11here was sort of payback for what,
01:22:13Yeah, was giving me.
01:22:15And as I was listening to the Dean
01:22:18and looking around, I realized that.
01:22:22You're all here because we're paying it
01:22:25forward to the next group of graduates
01:22:28and having stood where Mac is and
01:22:33bestowing the award and and realizing
01:22:36how important Yale is to some of us,
01:22:40I'll just say it's it's as good
01:22:42to receive as to give right here.
01:22:52I guess add one thing not not came
01:22:57through in that citation that this
01:23:00the association has an archive of
01:23:04these talks that were given by by
01:23:08graduates talking about how the Yale
01:23:11system had influenced their lives.
01:23:13It's it's a real unfortunately we
01:23:16the association not being abused
01:23:18collecting association doesn't have
01:23:20the the the money to to make this
01:23:23available but it hopefully someday
01:23:25it will become available and some of
01:23:27the people that are there were Deans
01:23:29of of other medical schools 1 Nobel
01:23:33laureate etcetera so and and some just
01:23:36practitioners who gave their time to
01:23:38talk about how the Yale system Justice
01:23:41Harold has said had shaped them.
01:23:43And made their their
01:23:46successful lives possible.
01:23:48So I just want you to know that that exists.
01:23:51Maybe someday we'll have a way of getting
01:23:54it available to the to all of the alums.
01:24:03Oh, is this on YouTube? Oh.
01:24:06It tells you how old I am.
01:24:07I don't have a future.
01:24:12I mean, what?