Dean's State of the School Alumni Update

Transcript

• 00:04In February,
• 00:05we were delighted to learn
• 00:07from president McMenace and provost
• 00:10Strobel
• 00:11that Nancy j Brown, MD,
• 00:14this Jean and David w
• 00:17Wallace,
• 00:18Dean of Medicine,
• 00:20and the c h n
• 00:21h Long Professor of Internal
• 00:23Medicine
• 00:24have been reappointed
• 00:25for a second term as
• 00:27the Dean of the Yale
• 00:28School of Medicine.
• 00:30You supposed to clap, yo.
• 00:33Okay.
• 00:35Thank you, family.
• 00:37The announcement
• 00:38emphasized
• 00:40that, quote, Yale is fortunate
• 00:43to have brought on such
• 00:44a distinguished leader,
• 00:47scientist, and clinician in March
• 00:49of twenty twenty
• 00:51just moments before the onset
• 00:53of a global health crisis,
• 00:55the COVID nineteen
• 00:57pandemic.
• 00:58We are grateful to Nancy's
• 01:00leadership and guidance in helping
• 01:02the school and the university
• 01:04and the medical community
• 01:05navigate
• 01:07this complex time.
• 01:09In this period of change
• 01:12and challenge,
• 01:13Dean Brown has encouraged us
• 01:15to focus on our work,
• 01:17to support each other, and
• 01:18to act with discipline.
• 01:20And she has reminded us
• 01:22of the resilience of our
• 01:23community and the importance of
• 01:25not just surviving challenging moments,
• 01:28but thriving through them.
• 01:30As she embarks on her
• 01:32second term at Yale,
• 01:34Dean Brown has highlighted the
• 01:35impact of the work we
• 01:37do at the Yale School
• 01:38of Medicine,
• 01:39and she has addressed gaps
• 01:40in knowledge and patient care
• 01:43by diversifying
• 01:44funding for our work with
• 01:46renewed emphasis on development and
• 01:48novel partnerships.
• 01:50She has prioritized support for
• 01:52research and clinical programs,
• 01:55especially for early career
• 01:56professionals.
• 01:58Dean Brown has urged us
• 02:00to tighten our belts and
• 02:01our backbones
• 02:03while prioritizing
• 02:04our values and decision making,
• 02:06and Yale School of Medicine
• 02:08remains committed to creating an
• 02:10environment of inclusive excellence
• 02:12where all members of our
• 02:14community can thrive
• 02:15and where we can continue
• 02:16to recruit the best
• 02:18talent in the world.
• 02:21It is always an honor
• 02:23to introduce Dean Brown, but
• 02:25especially now when we need
• 02:27courageous and principled leadership.
• 02:30Are you ready, Dean Brown?
• 02:32I'm ready. Okay.
• 02:41Can you write the next
• 02:42Beyond Sterling Hall, Anne?
• 02:45So thank you. It's really
• 02:46great to be here and
• 02:47to see the room packed
• 02:48at nine o'clock on a
• 02:49Saturday morning.
• 02:51And I am gonna talk
• 02:53I'm gonna present a state
• 02:55of the school, and I'm
• 02:56doing that so I hope
• 02:57you will see
• 02:59how strong we are at
• 03:00this moment,
• 03:02going into a fairly difficult
• 03:03period and also get a
• 03:05sense of
• 03:06that the values
• 03:08of the school that you
• 03:09so love are very much
• 03:11intact.
• 03:13So
• 03:14this is our mission statement.
• 03:16We wrote it in
• 03:18twenty twenty,
• 03:20which was an interesting time
• 03:22to do this because we
• 03:23had
• 03:25a number of focus groups
• 03:26by Zoom, and it turned
• 03:27out that Zoom was actually
• 03:29a very good media to
• 03:30do with which to do
• 03:31this.
• 03:32And included not just our
• 03:34students, faculty, and staff, but
• 03:36members of the New Haven
• 03:38community who were very engaged
• 03:39with the school.
• 03:40And,
• 03:41I think it really captures
• 03:42who we are. Yale School
• 03:43of Medicine educates and nurtures
• 03:45creative leaders in medicine and
• 03:47science,
• 03:48promoting curiosity and critical inquiry
• 03:50in an inclusive environment enriched
• 03:52by diversity.
• 03:54This I think this curiosity
• 03:56and critical inquiry really captures
• 03:58the heart of the Yale
• 03:59system and, which I liken
• 04:01to the the liberal arts
• 04:03of a medical education, I
• 04:04think, is, how I think
• 04:06about our system.
• 04:07We advance discovery and innovation
• 04:09fostered by partnerships across the
• 04:10university, our local community, and
• 04:12the world, and I think
• 04:13that's really critical.
• 04:15We sit on a wonderful
• 04:16campus where we can go
• 04:17across campus and engage with
• 04:19our engineers or our,
• 04:21historians,
• 04:22and that's even more important
• 04:24than the current environment.
• 04:26And then we care for
• 04:27our patients with compassion,
• 04:29but also commit to improving
• 04:30the health of all people.
• 04:32So I'm gonna talk first
• 04:33a little bit about leadership.
• 04:35I'm now in my sixth
• 04:37year, and,
• 04:38we have been able to
• 04:39recruit amazing
• 04:42talent.
• 04:43And this is this is
• 04:45a large picture of this
• 04:47is how many departments we
• 04:48have between clinical and basic
• 04:49science.
• 04:50I'll highlight that about twenty
• 04:52five percent of our chairs
• 04:54are currently women. That is
• 04:55an increase from about fifteen
• 04:57percent,
• 04:58and that's simply by selecting
• 05:00the best people for these
• 05:01jobs. And the the three
• 05:02that are highlighted are our
• 05:04most recent,
• 05:05recruits.
• 05:06Puja Khatri,
• 05:08became our chair of neurology
• 05:09in April.
• 05:11She comes to us from
• 05:12University of Cincinnati. She is
• 05:14the
• 05:15director of the National Stroke
• 05:17Net
• 05:20network
• 05:21and,
• 05:22really a leader in,
• 05:25bringing together institutions across the
• 05:27country to address,
• 05:29neurologic diseases. And this is
• 05:31at a time when we're
• 05:32investing significantly in neuroscience and
• 05:35in,
• 05:36treating neurologic diseases. And so
• 05:38we'll talk a little bit
• 05:39more about that.
• 05:41Jillian Griffiths, we recruited from
• 05:43University of Cambridge,
• 05:44where she was a an
• 05:46institute director.
• 05:48She's a member of the
• 05:48Royal Society, and we were
• 05:50very fortunate to recruit her
• 05:51as chair of cell biology.
• 05:53Her own work,
• 05:55focuses on the,
• 05:57the cell biology of the
• 05:58t cell, and you can
• 05:59understand and appreciate
• 06:01the synergy between that and
• 06:03our very,
• 06:04strengths in immunobiology.
• 06:07And then Wolfram,
• 06:08Gosling will be joining us
• 06:10as the chair of medicine,
• 06:12in September.
• 06:13And I'm really excited,
• 06:15when you think about the,
• 06:17incredible
• 06:20history of that department.
• 06:21Wolfram is currently at Mass
• 06:23General. He is,
• 06:25both an oncologist and a
• 06:27gastroenterologist.
• 06:29He's currently the head of
• 06:30the section of gastroenterology
• 06:31in MGH, but he's also
• 06:33the director of the HST
• 06:34program, the health sciences and
• 06:35technology program, which is a
• 06:37joint Harvard MIT program,
• 06:40and
• 06:41very committed to,
• 06:43education and to faculty development,
• 06:45and I think will be
• 06:46just an outstanding chair.
• 06:48When we did we interviewed
• 06:50people about him,
• 06:52they said, I would like
• 06:52to say he's a triple
• 06:53threat, but he's really a
• 06:54quad threat because he's also
• 06:56an incredibly,
• 06:57kind and generous human being.
• 06:59So that's the kind of
• 07:00person I think we want
• 07:01as our chairs.
• 07:03And then our deputy deans,
• 07:04I think you'll be hearing
• 07:05from some of these.
• 07:06I I would like to
• 07:07point out Peg McGovern, who's
• 07:09currently our deputy dean for
• 07:10clinical affairs
• 07:12and has been instrumental in
• 07:13the alignment work that we're
• 07:14doing with the health system,
• 07:15and I'll talk about that,
• 07:17as well. And then, of
• 07:18course, Jessica Luzi, who's our
• 07:20current, deputy dean for education.
• 07:23So, let me talk a
• 07:25little bit about education
• 07:27and,
• 07:28let's see if I can
• 07:29go back here.
• 07:31So this is our current
• 07:32class. You looked like this
• 07:34at one time.
• 07:38And this this is the
• 07:39class by statistics, and,
• 07:42what I'd point out is,
• 07:44that I don't think I
• 07:45could get into the Yale
• 07:46School of Medicine,
• 07:47today.
• 07:49These are incredibly talented students.
• 07:51They're very committed,
• 07:54to the mission of the
• 07:55school.
• 07:56About twenty eight percent of
• 07:57our students are underrepresented
• 07:59in medicine,
• 08:00and we are, as as
• 08:02I've said, very committed to
• 08:04our mission,
• 08:06of having an intellectual environment
• 08:08that's enriched by diversity of
• 08:10all kinds.
• 08:11And that means diversity of
• 08:13experience. It means diversity of
• 08:15ideas.
• 08:16And this should be a
• 08:17safe place where people can,
• 08:19wrestle with difficult questions.
• 08:21And I think,
• 08:23it's a remarkable place in
• 08:24that regard, and I'll give
• 08:25the example of,
• 08:28how our students responded following
• 08:31October seventh in,
• 08:33two years ago.
• 08:35This was a an incredibly
• 08:37disturbing,
• 08:38time,
• 08:39and our students met, and
• 08:41I give credit to Don
• 08:42Francis and to, Jessica Iluzzi,
• 08:45in small groups
• 08:46with various deputy deans
• 08:49almost daily
• 08:50to wrestle with the things
• 08:51that they were feeling.
• 08:53And initially, when that started,
• 08:56that was primarily
• 08:58our Jewish and Israeli students
• 09:00meeting.
• 09:01And then separately, we had
• 09:03students who were from Palestine
• 09:04who had family members in
• 09:06Palestine who were meeting in
• 09:07small groups.
• 09:09By the time our students
• 09:10went home for break,
• 09:12they were meeting together
• 09:15and
• 09:16had discovered that some of
• 09:18the fears and things that
• 09:19they were wrestling with
• 09:21were fundamental human
• 09:23concerns
• 09:24and that they could find
• 09:26common ground and and have
• 09:28those conversations together. That's very
• 09:30different from what happened on
• 09:31many campuses, and I have
• 09:32to credit, again,
• 09:35our our faculty and staff
• 09:36and our students
• 09:38for showing us how we
• 09:39should act.
• 09:44How do we manage to
• 09:45recruit such amazing students?
• 09:48Anne has been in her
• 09:49role for about two years,
• 09:50and this has been the
• 09:52secret weapon you
• 09:53have been the secret weapon
• 09:54we have,
• 09:56rolled out. And that is
• 09:57we are now having,
• 09:59when we have alumni dinners
• 10:01across the country,
• 10:02we're inviting our prospective students,
• 10:05and we're sitting them
• 10:07at tables with you because
• 10:09it turns out you are
• 10:10the best recruiters we have.
• 10:13And I always tell the
• 10:14students just
• 10:16start the conversation with
• 10:19what did you do your
• 10:20thesis on?
• 10:21And then you don't have
• 10:22to talk at all.
• 10:25And you'll hear the life
• 10:26story of the person with
• 10:27whom you're sitting, and it's
• 10:28really wonderful. And, I think
• 10:30these have been great and
• 10:31really the the the,
• 10:33work of Evian and Amanda
• 10:35and others.
• 10:36The other critical thing is
• 10:38making an education at Yale
• 10:40School of Medicine accessible, and
• 10:41this is another area where
• 10:43you've contributed tremendously,
• 10:45in that we were able
• 10:47to meet the match of,
• 10:49fifty million dollars set by
• 10:51the provost.
• 10:53We have been able through
• 10:54that and through a generous
• 10:55gift from the Star Foundation
• 10:57to be able to reduce
• 10:59the annual debt for our
• 11:00students down who are students
• 11:02who have financial aid down
• 11:03to ten thousand dollars a
• 11:04year.
• 11:05So graduating with you know,
• 11:07and there's there's schools that
• 11:08are tuition free,
• 11:10but still have lots of
• 11:11those students have lots of
• 11:12debt because it doesn't cover
• 11:13room and board. It doesn't
• 11:14cover we cover the whole
• 11:15package.
• 11:17And this allows our students
• 11:18to make choices based on
• 11:20their passions and not on,
• 11:23financial concerns, and that's really
• 11:25critical.
• 11:26Our students, not only do
• 11:28we attract incredible students, but
• 11:30we also they go on
• 11:31to do great things.
• 11:34And as you are aware,
• 11:35under the prior
• 11:36administration, both the head of
• 11:38the CDC and the and
• 11:39the, surgeon general were our
• 11:41alums, fairly recent alums.
• 11:44You'll see this year's graduating
• 11:45class,
• 11:46we we retained about a
• 11:48quarter at Yale New Haven,
• 11:49and another quarter went to
• 11:50the Harvard,
• 11:52schools.
• 11:56Let's see here.
• 11:58I I did wanna share,
• 12:00some quotes from our students,
• 12:02just to
• 12:03share with you their view
• 12:04of the Yale system. This
• 12:06is very much alive and
• 12:07well,
• 12:09and,
• 12:10our one of the reasons
• 12:11that our students go on
• 12:12to be great leaders is
• 12:13that we treat them like
• 12:15adults,
• 12:16and we allow them to
• 12:17pursue their passions,
• 12:19and we facilitate that. And,
• 12:22I think you I'm delighted
• 12:24that you've had chance, and
• 12:25I see one of our
• 12:26students in the room right
• 12:27now. You will have chance
• 12:28to hear from them, and
• 12:29some of you have have
• 12:30interacted with them on various
• 12:33tours. It is a big
• 12:34place. It's it's much bigger
• 12:36than it was, say, fifty
• 12:37years ago. And for some
• 12:39students coming in and,
• 12:41and are just saying, you
• 12:43know, here's the candy store.
• 12:44Just have at it. Can
• 12:46be a little daunting at
• 12:47first. And so we've embellished
• 12:49on our advisory groups to
• 12:51create advisory houses.
• 12:53These integrate the students a
• 12:55little bit more with other
• 12:56classes as well as with
• 12:57residents and faculty. So,
• 13:00and we this year, after
• 13:01having these been simply color
• 13:03named, have now
• 13:05named them after many of
• 13:07our heroes. And this was
• 13:08another amazing experience where people
• 13:10came together
• 13:13to think about
• 13:14how we do that. And
• 13:15there was there were some
• 13:16who advised you should never
• 13:17name them because you're gonna
• 13:18miss somebody, and, of course,
• 13:20we missed a gazillion people.
• 13:22I came away from this
• 13:23thinking
• 13:24we need to name more
• 13:25things because we have so
• 13:27many heroes in our past.
• 13:28But,
• 13:29there there's as with all
• 13:31things, there's a little competition
• 13:32between these houses. This takes
• 13:34place on the athletic field
• 13:36in the spring. It's hard
• 13:37to imagine Yale School of
• 13:38Medicine students as athletes, but
• 13:41but they feel very strongly
• 13:42about this. And this year,
• 13:44there was a tie, and
• 13:45I don't remember which houses,
• 13:46but which two?
• 13:48Orange and yellow orange. Yeah.
• 13:50So Pilate and ham Hamburg.
• 13:51Yep. There we go. Okay.
• 13:53I should, you know, I
• 13:54should know that.
• 13:55I wanna talk a little
• 13:56bit about culture and climate,
• 13:58and we will have lots
• 13:59of time to talk at
• 14:00the end about the current
• 14:01environment,
• 14:02but just to walk through
• 14:04some of the things that
• 14:05we are,
• 14:06doing.
• 14:07When I came in two
• 14:09thousand,
• 14:10there I would say the
• 14:11thing that was most on
• 14:13people's mind related to
• 14:16treatment of women in the
• 14:18school of medicine and the,
• 14:21there had been some high
• 14:22profile events.
• 14:24And then that summer, of
• 14:26course, was the summer of
• 14:27George Floyd, and there was
• 14:28concern about,
• 14:31racism
• 14:31in the country and in
• 14:33the school.
• 14:34We have taken a very
• 14:35fundamental approach,
• 14:38to thinking about professionalism and
• 14:40addressing these issues. And one
• 14:42of the things I realized
• 14:43was,
• 14:44with respect to sexual harassment,
• 14:46for example, is that there
• 14:47we did not have more
• 14:48of that than any other
• 14:50institution, but we handled it
• 14:51very badly.
• 14:52And we hadn't given our
• 14:53leaders the tools
• 14:55to recognize things early,
• 14:57to make interventions,
• 14:59before things came to a
• 15:00head. So we've done a
• 15:02a number of things. We
• 15:04modified our office of faculty
• 15:05affairs. We've spent a lot
• 15:07of time
• 15:08on leadership training. So when
• 15:09because when people become section
• 15:11chiefs and chairs, they have
• 15:13excellence in research or clinical
• 15:14work. They don't always have
• 15:16the leadership skills that we're
• 15:18asking them to have. So
• 15:19we've invested in a lot
• 15:20of leadership training.
• 15:22We also are spending a
• 15:24lot of time
• 15:26in terms of developing our
• 15:27faculty, and this gets to
• 15:29diversity
• 15:30in paying attention
• 15:32to retention and mentorship.
• 15:35So I think people have
• 15:36overemphasized
• 15:38recruitment,
• 15:39and then we don't pay
• 15:40any attention.
• 15:41But we have got to
• 15:43mentor faculty. We've got to
• 15:44sponsor them.
• 15:46And in my mind, that's
• 15:47a proactive form of retention.
• 15:49And so one of the
• 15:50other things we did was,
• 15:52create
• 15:53a
• 15:54process
• 15:55to ensure
• 15:56that our faculty actually meet
• 15:58with their chair or section
• 15:59chief.
• 16:00This may seem
• 16:01rudimentary,
• 16:02but I can tell you
• 16:03when I first came and
• 16:04we were having listening groups
• 16:05that the thing I most
• 16:06commonly heard from faculty was
• 16:09some version of, I'm not
• 16:11sure that my
• 16:12section chief
• 16:14chair knows what I do.
• 16:16And then when I would
• 16:17speak to
• 16:19the chairs at our weekly
• 16:20meeting, they would say, oh,
• 16:22no. We have, you know,
• 16:22we have this meeting. We
• 16:23do this. We do that.
• 16:25Now we have a little
• 16:26bit of a forcing function.
• 16:27And what I can tell
• 16:28you is that we require
• 16:30this even of our senior
• 16:31faculty.
• 16:32And faculty who had not
• 16:35been meeting with their chair
• 16:36for a long, long time
• 16:37actually are having very meaningful
• 16:38conversations about the direction of
• 16:41their work, how they can
• 16:42contribute,
• 16:43and so, you know and
• 16:44we're measuring that, which is
• 16:45what all the graphs are
• 16:46and whatnot.
• 16:49So those are some of
• 16:50the things that we're doing
• 16:51to change culture here. They're
• 16:54not addressed
• 16:55on a specific group or
• 16:57a specific,
• 16:58ideology,
• 16:59but on our community as
• 17:01a whole. The other thing
• 17:02that we're doing, which we
• 17:03did during COVID and we've
• 17:05revamped,
• 17:06is the idea of
• 17:10just how we support each
• 17:11other.
• 17:13And,
• 17:14these are tough times. And
• 17:15so we have revamped something
• 17:18we did during COVID, which
• 17:19were which is offered by
• 17:21our
• 17:21colleagues in psychiatry, which is
• 17:23just a place to come
• 17:25and talk about what's on
• 17:26your mind. And you can
• 17:27imagine
• 17:28that that differs for different
• 17:29people. If you're a young
• 17:30investigator and your grant has
• 17:32just been canceled,
• 17:34that's different than perhaps than
• 17:35if you're somebody who's worried
• 17:36about your visa status. But
• 17:38this is a safe place
• 17:39to come and talk with
• 17:40others about that.
• 17:42The the environment around us
• 17:44and encouraging the creativity of
• 17:45our faculty and, this summer,
• 17:48we're doing these pop up
• 17:49concerts, which are great fun.
• 17:51These are just members of
• 17:52our community who are
• 17:55every couple weeks appearing, and
• 17:57we send out a note,
• 17:58and playing music gratis for
• 18:00our community. And it's a
• 18:01place that people gather at
• 18:03different times of day just
• 18:04to be together.
• 18:06Let me talk a little
• 18:07bit about our research,
• 18:09and I'll frame this in
• 18:10terms of the metrics we
• 18:12have used in the past,
• 18:14and that, you know, is
• 18:16always a measure a leading
• 18:17indicator which is how much
• 18:18funding do you have.
• 18:20I'm not sure how to
• 18:21interpret this today
• 18:23but,
• 18:24we,
• 18:25this year have been third
• 18:26in the country in NIH
• 18:27funding
• 18:29and that I think,
• 18:31reflects the quality of the
• 18:33research that our faculty are
• 18:34doing and a number of
• 18:36departments of our,
• 18:37number one in the country.
• 18:39And more importantly
• 18:41is the the are the
• 18:42lagging indicators and the types
• 18:44of
• 18:45research that our faculty,
• 18:47are producing. And I I've
• 18:48focused here on clinical,
• 18:51studies,
• 18:52but the I can tell
• 18:53you that we have a
• 18:55startling number of publications in
• 18:56journals like Nature and Science,
• 18:59at this institution. But
• 19:01to give you some examples
• 19:02of recent,
• 19:04publications,
• 19:05you know, the work of
• 19:06Kevin Harold,
• 19:07over thirty years identifying
• 19:09the immune response to islet
• 19:11cells
• 19:12and then developing antibodies to
• 19:14protect those islet cells and
• 19:15delay the onset of type
• 19:16one diabetes is is really
• 19:18just remarkable.
• 19:19Anya Jastrebrath's work,
• 19:21leading trials of the GLP
• 19:23one and GIP,
• 19:26agonists.
• 19:27You know, ketamine as an
• 19:29antidepressant
• 19:30is something that John Crystal
• 19:32developed, but we're now discovering
• 19:34many more, uses for ketamine
• 19:36as well as,
• 19:38some of the psychedelics as
• 19:39well. The list goes on
• 19:40and on, but these are
• 19:42just a few examples.
• 19:43I don't know if you
• 19:44can read this. It's more
• 19:45of a prompt for me
• 19:46to tell you a little
• 19:47bit about the kinds of
• 19:48things in which we're investing.
• 19:51We as you know, the
• 19:52university,
• 19:53developed a science strategic plan,
• 19:56now about seven years ago,
• 19:58And it's very well aligned
• 19:59with the strategic,
• 20:01research initiatives or I should
• 20:03say the strategic research initiatives
• 20:05in the school are very
• 20:05well aligned with this.
• 20:07You can see the top
• 20:08priority areas, data.
• 20:10I would say quantum, we're
• 20:11not directly aligned with, but,
• 20:13of course, we need that
• 20:14for our data science.
• 20:15Neuroscience,
• 20:17inflammation,
• 20:18maybe indirectly planetary solutions, and
• 20:20then cancer.
• 20:22Some of the work going
• 20:23on, for example, in neuroscience,
• 20:25through a gift from, Steve
• 20:27and Denise Adams.
• 20:28We have now the Adams
• 20:30Center for Parkinson's Research.
• 20:32This has provided a NIDIS
• 20:34for a number of other
• 20:36really important,
• 20:37gifts. We have
• 20:39more ASAP grants in Parkinson's
• 20:41than any other institution in
• 20:42the country.
• 20:44We're,
• 20:45we,
• 20:48are,
• 20:49now the beneficiaries
• 20:51of funding,
• 20:52which we haven't officially announced.
• 20:54So I won't say the
• 20:54foundation of a twenty seven
• 20:56and, half million dollar grant
• 20:58to look at,
• 21:00autism,
• 21:01using a very multidisciplinary
• 21:04approach that includes mapping of
• 21:06the brain and creating digital
• 21:07twins.
• 21:08The health system is building
• 21:09a neuroscience tower, so our
• 21:11vision is that,
• 21:13we take the very strong
• 21:15basic science and neuroscience and
• 21:16we translate that into our
• 21:18patients and that every patient
• 21:20who's admitted
• 21:22to Yale New Haven Health
• 21:23System should with a neurologic
• 21:25disorder should be enrolled in
• 21:26a clinical trial if he
• 21:27or she desires just as
• 21:29we do with cancer patients,
• 21:30for example.
• 21:32Inflammation science,
• 21:34we are one of three
• 21:36members of the now
• 21:38year and a half ish
• 21:39old,
• 21:40Chan Zuckerberg
• 21:41New York City Biohub,
• 21:44focused on inflammation.
• 21:45That work here is led
• 21:46by John Tsang. I like
• 21:48to joke that New Haven
• 21:49is the northernmost suburb of
• 21:51New York now.
• 21:53But I think we need
• 21:54to be doing more of
• 21:55those kinds of things
• 21:56and significant investments in data
• 21:58science. And I'll just show
• 21:59you that,
• 22:01a few years ago now,
• 22:03we recruited Lucila Onomashado, a
• 22:05member of the National Academy
• 22:06of Medicine from San Diego,
• 22:09to create what was then
• 22:10a freestanding
• 22:11section of
• 22:13biomedical informatics and data science.
• 22:15And in record time,
• 22:17literally a year,
• 22:19she built the department sufficiently
• 22:20that the corporation
• 22:22approved its,
• 22:23moving from a freestanding section
• 22:25to a department.
• 22:27This has been critical in
• 22:28our work in AI,
• 22:30and our work in
• 22:32really capitalizing on the huge
• 22:34amount of data that we
• 22:34have both in our electronic
• 22:36health record, and in other
• 22:37sources.
• 22:39Another significant,
• 22:40investment, and recruitment was George
• 22:42L. Fakhry
• 22:43who was initially recruited to
• 22:45run our pet center,
• 22:47and we have now created
• 22:48a new, institute for biomedical
• 22:50imaging because, of course, we've
• 22:52had centers for MRI and
• 22:54PET, but now it's all
• 22:55multimodality. Right? People do these
• 22:57things together, so another investment.
• 23:00On the basic science side,
• 23:01investments in imaging at a
• 23:03very small level,
• 23:05using this technology,
• 23:07FibCEM,
• 23:08and you can see the
• 23:09resolution
• 23:10of, the cell biology that
• 23:12we can achieve with this
• 23:12led by, Seanju,
• 23:15and Song Peng.
• 23:17We've,
• 23:18again, believe very strongly that
• 23:20we need to translate this
• 23:21work in the clinic,
• 23:23and,
• 23:24we just resubmitted our CTSA,
• 23:26the the clinical trial,
• 23:29clinical translational science award.
• 23:32This work,
• 23:33has been led most recently
• 23:35by Dave Coleman,
• 23:36and he now, in addition
• 23:37to being the director of
• 23:38our Yale Center for Clinical
• 23:40Investigation, has a dual role
• 23:42in the health system,
• 23:43and is doing the work
• 23:45to make sure that we
• 23:46can offer research to every
• 23:47patient in the health system.
• 23:48This is our Yale IRB
• 23:50is now the IRB for
• 23:52the entire health system.
• 23:53It's simplifying,
• 23:54you know,
• 23:57clinical billing and some mundane
• 23:58things,
• 23:59but it's also giving nurses
• 24:02and staff within the health
• 24:03system,
• 24:05the inspiration to be engaged
• 24:06in this work and to
• 24:07feel pride in enrolling patients
• 24:09in these studies.
• 24:12Lots of investments in physician
• 24:13scientist development,
• 24:15and we'll talk about how
• 24:16we're supporting people in the
• 24:17current time,
• 24:19probably during question and answer,
• 24:21as well as, some,
• 24:24some cluster hires
• 24:26focusing on bringing in the
• 24:28best possible postdocs
• 24:30and really changing the model
• 24:32and offering them the opportunity
• 24:34to be retained on faculty
• 24:36after their postdoc based on
• 24:37the strength of their,
• 24:39their work.
• 24:41And this work is led
• 24:41by Ifat Levy and Kristen
• 24:43Brennan.
• 24:44I mentioned AI.
• 24:47About
• 24:49eighteen months ago, the provost,
• 24:51organized a field trip for
• 24:52the deans and the office
• 24:54of the provost to the
• 24:55Bay Area. And we spent
• 24:57about three days meeting with
• 24:59all of the companies engaged
• 25:01in AI,
• 25:02who very generously opened their
• 25:04doors. And the conversation is
• 25:05was what's the role for
• 25:07academia
• 25:08versus the role for industry,
• 25:09and how do we partner?
• 25:11When we came back to
• 25:12campus, he stood up this
• 25:14task force on artificial intelligence,
• 25:16and three of our faculty
• 25:17members
• 25:18were on this task force.
• 25:20But we also set up
• 25:22faculty panels,
• 25:23in each of the schools.
• 25:24And in the school of
• 25:25medicine, we had two, one
• 25:27focused on basic science, one
• 25:29focused on clinical research.
• 25:31There was also an overarching
• 25:33panel focus two that are
• 25:35relevant, one focused on clinical
• 25:37care,
• 25:38and one focused on education
• 25:41across the campus.
• 25:43I,
• 25:44had the treat of sitting
• 25:46in with these panels as
• 25:47they were preparing their work
• 25:49and realizing
• 25:50that
• 25:52we were
• 25:53really quite far ahead in
• 25:54AI
• 25:55through the work of innovative
• 25:57young scientists who weren't waiting
• 25:58for anybody to do strategic
• 26:00planning. They'd already done this,
• 26:02and we were catching up
• 26:03with them.
• 26:04And so to give you
• 26:05some examples,
• 26:06Rohan Cara
• 26:08is a cardiologist.
• 26:09He has now an FDA
• 26:10approved application
• 26:12where he can take the
• 26:13EKG off your,
• 26:15if you have an iWatch
• 26:17and can diagnose structural heart
• 26:19disease
• 26:20with better sensitivity
• 26:21than an echo.
• 26:24That's pretty amazing, and so
• 26:25we're thinking about how we
• 26:26what we do with that.
• 26:29Sanjay Anidra
• 26:30is,
• 26:31can look at
• 26:33a CT
• 26:34of the chest in somebody
• 26:35with lung cancer and using
• 26:37AI, enhance the prognostic
• 26:39value of their genetic the
• 26:41genetics of their tumor.
• 26:43The list goes on and
• 26:44on.
• 26:45You know, in terms of
• 26:46developing drug targets, our basic
• 26:48scientists are using all sorts
• 26:49of credit critical,
• 26:50tools.
• 26:52Out of those panels came
• 26:55a thought about what we
• 26:56needed here on campus. And
• 26:57the biggest thing we needed,
• 26:59as everybody does, if you
• 27:00ask anybody engaged in computational
• 27:02work, is I need more
• 27:04compute.
• 27:05And so the the,
• 27:07provost has made a significant
• 27:08investment in computational power. We're
• 27:11also thinking about how we
• 27:12train people differently. We understand
• 27:13that someone who does a
• 27:15PhD in biology also has
• 27:17to understand enough compute to
• 27:18be able to be bilingual.
• 27:20And conversely, somebody who's here
• 27:21to do a p a
• 27:22PhD in in computer science
• 27:24needs to be side by
• 27:25side with biologists to understand
• 27:27what the questions are and
• 27:28how to answer them.
• 27:30The,
• 27:32the last
• 27:33thing I'll say about research
• 27:35is that,
• 27:36we are pretty space constrained
• 27:38in terms of our NIH
• 27:39funding, and you may not
• 27:40believe that when you look
• 27:41and see the buildings that
• 27:42are here
• 27:43compared to when you were
• 27:44here.
• 27:45Several of these buildings, the
• 27:47tall glass ish buildings, one
• 27:49hundred College and one zero
• 27:51one College, are not owned
• 27:52by the university. They're built
• 27:54by developers, which allows them
• 27:56to stay on the New
• 27:56Haven tax rolls
• 27:58where we lease space in
• 28:00those buildings. So we are
• 28:01side by side with some
• 28:03start ups. That's actually not
• 28:05a bad arrangement because when
• 28:06our faculty
• 28:07innovate and and do a
• 28:08startup, they can be on
• 28:10different floors of the same
• 28:11building,
• 28:12and it creates a collaboration
• 28:13with industry in a in
• 28:14a biotech
• 28:16environment here in New Haven,
• 28:18which we badly needed.
• 28:20But
• 28:21it's still fairly limited, and,
• 28:24we have been engaged
• 28:26in a master,
• 28:27space plan.
• 28:29We have,
• 28:30high aspirations. We are building
• 28:32out space in this,
• 28:34commercially built building one zero
• 28:35one college.
• 28:36We have aspirations to build
• 28:38a new building,
• 28:39which would serve both as
• 28:41it's actually would be two
• 28:43connected building to serve as,
• 28:45a a new home for
• 28:46the newly independent school of
• 28:48public
• 28:49health, but also significant wet
• 28:50lab space for the school
• 28:52of medicine.
• 28:53And,
• 28:54we'll have to see what
• 28:55happens financially,
• 28:57given what's going on with
• 28:58NIH funding, what the timing
• 29:00of this is, but, it
• 29:01is an aspiration.
• 29:03And, and just to say
• 29:05that we have,
• 29:06recruited a fantastic scientific advisory
• 29:09board,
• 29:10who meets with us once
• 29:11a year and advises us
• 29:13on the decisions that we're
• 29:14making and,
• 29:15our strategic thinking and,
• 29:17several alums on this board.
• 29:19In fact,
• 29:20the majority of people on
• 29:22this board have some connection
• 29:23to Yale School of Medicine,
• 29:25which we didn't always know
• 29:26when we first invited them.
• 29:27So, that's been really fun.
• 29:30Let me talk about our
• 29:31clinical mission and just the
• 29:32alignment work that we are,
• 29:34doing.
• 29:35Those of you who
• 29:38have been here over many
• 29:39different years understand that
• 29:42the relationship between the Yale
• 29:44New Haven Health System and
• 29:45the Yale School of Medicine
• 29:46has been bumpy over the
• 29:48years,
• 29:49but has been getting consistently
• 29:51better.
• 29:53When I came in
• 29:55in two thousand and then
• 29:56subsequently,
• 29:57Chris O'Connor became CEO of
• 29:59the Yale New Haven Health
• 30:00System,
• 30:01we really,
• 30:03committed to working on making
• 30:05this a much more aligned
• 30:07relationship,
• 30:08understanding that we were interdependent.
• 30:12And so we,
• 30:14created our first
• 30:15joint strategic plan.
• 30:17And,
• 30:18much of what we're doing
• 30:20there is focused on the,
• 30:22clinical
• 30:23programs, building our destination services,
• 30:26but also,
• 30:27that work that that Dave
• 30:29Coleman is doing to,
• 30:31create
• 30:31infrastructure for clinical research,
• 30:34comes out of the strategic
• 30:35plan.
• 30:36So does a lot of
• 30:37the educational work and ensuring
• 30:39that the education in the
• 30:40clinical setting is all that
• 30:41it can be.
• 30:42So these are things that
• 30:43we're now working toward together.
• 30:46We also
• 30:49restructured
• 30:50our,
• 30:52our clinical program.
• 30:54So we have, as you
• 30:55know, a faculty practice plan,
• 30:57and we,
• 30:59and it's very important that
• 31:00that is the practice plan
• 31:02of the school owned and
• 31:03operated by the school.
• 31:05The health system had developed
• 31:07Northeast Medical Group as an
• 31:08employed practice plan
• 31:10initially to fill the gap
• 31:12with primary care. But as
• 31:14time had passed,
• 31:16we were finding that there
• 31:17were often
• 31:19there was competition
• 31:21in recruiting whether to recruit
• 31:22to faculty or to NEMG.
• 31:24And to be recruiting within
• 31:27our own academic health network
• 31:29just didn't make sense. So
• 31:31we've created an aligned clinician
• 31:33enterprise, which is led by
• 31:34Peg McGovern.
• 31:36And in that role, she
• 31:37has dual reporting to me
• 31:38and to Chris O'Connor
• 31:40that brings these two groups
• 31:42together still with separate employment
• 31:44structure,
• 31:45but where we've defined
• 31:47what you know, the obvious
• 31:48thing is when should come
• 31:49somebody join the faculty practice
• 31:50plan. It's when they're engaged
• 31:52in education and they're engaged
• 31:54or they're engaged in research,
• 31:55etcetera.
• 31:56And where there's now
• 31:59the chairs are truly chiefs
• 32:00across the health system and
• 32:02have line of sight
• 32:03over quality of clinical care,
• 32:05whether physicians are within the
• 32:07faculty practice plan or in
• 32:09other practice plans.
• 32:10It's not linear. You know,
• 32:12we are every day,
• 32:14doing this better, and every
• 32:16once in a while, there's
• 32:17a gap and we realize
• 32:18we got something wrong. But
• 32:19it is really,
• 32:20I I think surpassing
• 32:22certainly my expectations at this
• 32:24point.
• 32:25We also revised our funds
• 32:26flow. We had had a
• 32:28series of
• 32:30one off
• 32:32negotiation, sometimes down to the
• 32:33physician level,
• 32:35that had perverse incentives in
• 32:37it. So, for example, during
• 32:39COVID,
• 32:40the health system paid us
• 32:41more,
• 32:44because, because they were obligated
• 32:46by the deficit funding agreements
• 32:48we have. We now have
• 32:49aligned incentives.
• 32:50It's very predictable.
• 32:52And both,
• 32:54our
• 32:56numbers and the health system
• 32:57numbers have have increased. And
• 32:59so
• 33:00the departments now have more
• 33:01revenue to use on academic
• 33:04mission like research and education.
• 33:06And I'm not gonna go
• 33:07through all the details.
• 33:09I do wanna say a
• 33:10little bit about funding the
• 33:11future.
• 33:13You know, we have
• 33:16if you think about an
• 33:17academic school of medicine and
• 33:18an academic health system, a
• 33:20very large proportion of our
• 33:21funding comes from the federal
• 33:23government.
• 33:24About fifty five percent of
• 33:25our clinical revenue of our
• 33:26revenue is from the clinical
• 33:28practice.
• 33:29About two thirds of that
• 33:30is Medicaid or Medicare.
• 33:31Thirty five percent of our
• 33:33revenue comes from the endowment,
• 33:34which may be taxed at
• 33:35a very high,
• 33:37I'm sorry, comes from our
• 33:38research, which in which indirects
• 33:40are may be cut significantly.
• 33:43And then, about eight percent
• 33:44come for the school of
• 33:45medicine comes from endowment, which
• 33:46may have a high, increase
• 33:48in tax.
• 33:49We have to diversify our
• 33:51funding portfolio,
• 33:52and we have to work
• 33:53differently. There's there's no way
• 33:55to make up the difference
• 33:56if if federal funding is
• 33:58significantly cut other than by
• 34:00working differently.
• 34:01But to that end, you
• 34:03know, I think I'm really
• 34:04delighted that Megan Fay joined
• 34:05us as
• 34:07our, associate VP for,
• 34:09development and alumni affairs
• 34:11just seven months ago. And,
• 34:13we are seeing people really
• 34:15step up to support our
• 34:16research mission, our young faculty,
• 34:19very, very proud of that.
• 34:21Of course, we're in the
• 34:22midst of a campaign, and,
• 34:25I would encourage you, if
• 34:26you haven't, to look at
• 34:27these web pages and the
• 34:29wonderful materials about the work
• 34:30that we are doing in
• 34:31each of these areas.
• 34:33And then I will just
• 34:35highlight again, as I did
• 34:36last night,
• 34:37the generosity of this group,
• 34:40and,
• 34:40I think so much so
• 34:41that,
• 34:42at the national double AMC
• 34:44meeting, this was featured as
• 34:46a standout for,
• 34:48our the generosity of our
• 34:49alumni. And so,
• 34:51our alumni this year have
• 34:52raised you've raised eleven point
• 34:53seven million and and, really,
• 34:56it's quite amazing. And as
• 34:57I said, we've been able
• 34:58to to match our
• 35:04our provost's generous fifty million,
• 35:07gift. So
• 35:08I am gonna stop there.
• 35:10The elephant in the room,
• 35:11of course, is the current
• 35:12environment, but I'm gonna ask
• 35:14that you ask questions. I
• 35:15will be very open and
• 35:17honest in any answers, but
• 35:18I I wanna hear what's
• 35:19on your mind.
• 35:35And please introduce yourself and
• 35:37your class here. Hi. Hi.
• 35:39Alan Astrow, class of nineteen
• 35:41eighty. Very happy
• 35:42to reconnect with my,
• 35:44fellow classmates here. So, I
• 35:46remember at my graduation,
• 35:48our graduation,
• 35:50I remember our associate dean,
• 35:51Howard Levin, the nephrologist,
• 35:54he talked about the three
• 35:55A's of medical practice,
• 35:57ability, affability,
• 35:58availability.
• 36:00And I remember some of
• 36:01our outstanding clinician teachers Yep.
• 36:04Howard Spiro,
• 36:05Tom Duffy,
• 36:07Alf Einstein.
• 36:09Would you talk a little
• 36:10bit about the humanistic,
• 36:11interpersonal dimension, the clinical aspect
• 36:13to education, and and what
• 36:15you've been doing as dean
• 36:16to Yeah. Reinforce that aspect
• 36:17of the Yale experience? Yeah.
• 36:19Thank you, Alan.
• 36:20It starts with day one.
• 36:22All of our students,
• 36:24take a two week course
• 36:25in the beginning, called the
• 36:27introduction to the profession.
• 36:29And those very basic concepts
• 36:31of professionalism
• 36:33and commitment to patients are
• 36:34introduced
• 36:36early on,
• 36:37in many different examples and
• 36:38with many different speakers so
• 36:40that that then informs everything
• 36:42else that comes,
• 36:44after that.
• 36:45Our,
• 36:47faculty
• 36:48are remain incredibly
• 36:50committed.
• 36:52We just had graduation and
• 36:54awarded
• 36:56a number of teaching awards
• 36:58to to the and it's
• 36:59it's a different set of
• 37:00names,
• 37:01but, for the same kinds
• 37:03of things. And it's
• 37:05teaching our students how to,
• 37:08behave and,
• 37:10respect the personal dignity of
• 37:12our patients.
• 37:14The,
• 37:16we do a lot as
• 37:17our students go more formally
• 37:19into the clinical setting in
• 37:21terms of, before each
• 37:23clerkship
• 37:25having a day to reflect,
• 37:27and a lot at the
• 37:28end of the clerkship,
• 37:30again, asking people to reflect,
• 37:33because we find that
• 37:35while
• 37:36ninety eight percent of what
• 37:38they experience
• 37:39lives up to that ideal,
• 37:42there's a there's a few
• 37:43percent that doesn't. And it
• 37:44may not even be related
• 37:45to to faculty. It may
• 37:47be that we have residents
• 37:48we need to coach.
• 37:49It may be staff, you
• 37:51know, and,
• 37:52so we spend a lot
• 37:53of time,
• 37:56working with those people to
• 37:57make sure that there's
• 37:58that that we
• 38:00remediate
• 38:01any issues. And we sometimes
• 38:03take people out of teaching
• 38:05if we don't feel that
• 38:06they have the if they
• 38:06don't exemplify the values that
• 38:08we have.
• 38:11Yes.
• 38:15Hi. Barbara Stoll, nineteen seventy
• 38:17five.
• 38:18You touched on the growing
• 38:20storm
• 38:22of lack of inter indirects,
• 38:25taxing endowments. You didn't mention
• 38:27Medicaid cuts,
• 38:28and you talked about working
• 38:30differently. How will you deal
• 38:31with that, and what do
• 38:32you mean by working differently?
• 38:34Thank you. So,
• 38:36I'll describe a little bit
• 38:38how we've been
• 38:39addressing this and thinking about
• 38:40this, and and I,
• 38:43put this in several buckets.
• 38:44So there are the immediate
• 38:45things that are happening. We've
• 38:46had about thirty seven grants
• 38:49that have had stop work
• 38:50orders.
• 38:51Nine of those have been
• 38:52reinstated because we're appealing
• 38:55all of those.
• 38:56They focus primarily on HIV
• 38:58work, on diversity,
• 39:00particularly diversity supplements.
• 39:02Initially, there were several related
• 39:04to long COVID. Those are
• 39:05some of the ones that
• 39:06have been reinstated.
• 39:08The first thing that we
• 39:09are doing there
• 39:10is we've developed what I
• 39:11call pivot funding. So it's
• 39:13not quite bridge funding because
• 39:14you're not just
• 39:16bridging somebody until they apply
• 39:17for the next grant. We're
• 39:18actually the only requirement for
• 39:20the funding is that people
• 39:22meet with a mentorship group
• 39:23or a faculty group if
• 39:24they're senior faculty
• 39:26to discuss how they will
• 39:28pivot their work. So you
• 39:29may be studying HIV
• 39:31in
• 39:32a specific,
• 39:34gender identity group. You can
• 39:36still address those questions
• 39:38differently using different funders, all
• 39:40those sorts of things. So
• 39:40it's helping people think prospectively
• 39:43and positively about what they're
• 39:44gonna do. That's the very
• 39:46immediate.
• 39:47We have, when we submitted
• 39:49our budget this year, we
• 39:50submitted the regular budget,
• 39:52but we then did a
• 39:53contingency plan. And the contingency
• 39:55plan was based on, the
• 39:57assumption of a fifteen percent
• 39:59indirect rate, which was what
• 40:01the executive order had which
• 40:03is now has a has
• 40:04a restraining order. Now it
• 40:06has an injunction on it.
• 40:07But that has to be
• 40:08solved in Congress, and we
• 40:10know we expect that Congress
• 40:12is gonna decrease indirect rates.
• 40:14I would love to see
• 40:15them uncap salaries and do
• 40:17other things to compensate for
• 40:18that, but but nevertheless,
• 40:22and assumed a fourteen percent
• 40:24tax on endowment. Now the
• 40:26bill the reconciliation bill that
• 40:27just came out of Congress
• 40:28has a twenty one percent,
• 40:30tax on endowment.
• 40:32We don't know where that
• 40:33will land after senate has
• 40:35after it's been through senate,
• 40:36but that was our contingency
• 40:38plan.
• 40:39That indicated
• 40:40that we needed to take
• 40:42in the next fiscal year
• 40:43about a hundred and fifty
• 40:44five million dollars out of
• 40:45our budget. By fiscal year
• 40:46thirty, it's about two hundred
• 40:48million.
• 40:49But that's on a budget
• 40:50of three billion.
• 40:51So when you start to
• 40:52look at it as a
• 40:53percent, you can start to
• 40:54wrap your hands around it.
• 40:56And what we did was
• 40:57we said,
• 40:59what are our levers to
• 41:00take that expense? Now I'll
• 41:02remind you that when COVID
• 41:03happened and we,
• 41:06shut down operating rooms
• 41:09So a month and a
• 41:09half after I was here,
• 41:11we were suddenly looking at
• 41:12an eighty million dollar deficit
• 41:14just based on COVID. So
• 41:15it's and it's not something
• 41:16that we haven't faced before.
• 41:18But the first thing we
• 41:19did was we defined a
• 41:21set of values by which
• 41:22we would make decisions.
• 41:24We're gonna support the careers
• 41:25of our young people. We're
• 41:26gonna we're gonna prioritize
• 41:28the strategic investments that we've
• 41:30made. We're gonna sunset unproductive
• 41:32programs. Sounds good. Very hard
• 41:34to do. There's a reason
• 41:35people haven't done that. Right?
• 41:37We're gonna look
• 41:38for inefficiencies
• 41:39and
• 41:40and deal with them. And
• 41:42there, I would say, for
• 41:43good or bad, we have
• 41:44a lot of those. Right?
• 41:45And I think many academic
• 41:46institutions do,
• 41:49etcetera, etcetera. So we agreed
• 41:50on those principles as a
• 41:51leadership group, and then we
• 41:53identified the levers. Some come
• 41:55from the university. You know,
• 41:56decisions about
• 41:58what next year's merit increase
• 41:59will be is a university
• 42:00wide decision, not a school
• 42:02decision.
• 42:03Those have an impact. But
• 42:05then there are some that
• 42:06are unique to the to
• 42:07the school of medicine,
• 42:09and we had them vote
• 42:10and rank those things. Now
• 42:13it might surprise you that
• 42:15one of the things that
• 42:15we had in there was,
• 42:16you know, we were gonna
• 42:17increase development by ten million
• 42:19dollars. This is on a
• 42:19base of about a hundred
• 42:20and sixty million this year.
• 42:22They all put that number
• 42:23one.
• 42:24Right? Like, yeah, let's do
• 42:25that.
• 42:26We're gonna cut travel and
• 42:27entertainment. Right? You know? So
• 42:29during COVID, we had almost
• 42:31a zero travel and entertainment
• 42:32budget. We're now back up,
• 42:34you know, and we have
• 42:35really nice events, but maybe
• 42:37we can't have nice events
• 42:38going forward. We can have
• 42:41okay events. Right?
• 42:42We can have potluck. So,
• 42:43you know, next time you
• 42:45come for reunion, we're gonna
• 42:46no. But,
• 42:48you know, so it was
• 42:48a list of those kinds
• 42:49of things.
• 42:50We and so we've now
• 42:52gone through that, and we've
• 42:53actually started to enact some
• 42:54of those things in preparation,
• 42:56for what's coming.
• 42:58The next chunk is
• 43:00in the president's
• 43:02skinny budget.
• 43:04NIH has cut forty percent.
• 43:07What does that look like?
• 43:08Now
• 43:10some of the cuts that
• 43:11we modeled in indirect goes
• 43:12into that, so it's it's
• 43:14less than that that we
• 43:14have to find. But that's
• 43:15about a total of about
• 43:17two hundred fifty million that
• 43:18we would have to find,
• 43:19and we've started that exercise
• 43:21of what we would need
• 43:22to do.
• 43:24And some of it is,
• 43:25again, diversifying our funding portfolio.
• 43:27And there are many conversations
• 43:29going on around the country
• 43:31with foundations,
• 43:32with others.
• 43:33That's not gonna make up
• 43:34the whole difference. So when
• 43:35I say we have to
• 43:36work differently,
• 43:38we have to think about,
• 43:40you know, again,
• 43:42how do we
• 43:45we have
• 43:46multiple
• 43:48cores, multiple things where we've
• 43:50tried to apply discipline to
• 43:51it, but we can still
• 43:52do better.
• 43:53And maybe everyone doesn't need
• 43:56one of these in every
• 43:57section or every department. Right?
• 43:59Those kinds of decisions.
• 44:01In the health care realm,
• 44:03you know, we have to
• 44:04become less dependent on federal
• 44:05dollars.
• 44:06We have opportunities
• 44:08to do,
• 44:09teleconsults.
• 44:10We have some incredible brain
• 44:11trust of faculty here.
• 44:14And, you know, there are
• 44:15things like that that we
• 44:16need to do and that
• 44:17we're working on. We have
• 44:19AI that can make us
• 44:20much more efficient in some
• 44:22areas.
• 44:23I would say one of
• 44:24the tough things there is
• 44:25that we are in a
• 44:26highly unionized environment, and so
• 44:28we're not agile. Right? You
• 44:29can't pivot quickly. There's a
• 44:31lot that you have to
• 44:32do to make sure that
• 44:33you're preserving
• 44:34commitments to the unions, but
• 44:36those are some of the
• 44:37things. Now the the the
• 44:39most extreme
• 44:40is
• 44:41we
• 44:43is the Harvard situation. Right?
• 44:45For the school of medicine,
• 44:46if somebody
• 44:48said all of your federal
• 44:49funding is going away,
• 44:51it's about a billion dollars.
• 44:54That's a different
• 44:56piece. That's a different bucket.
• 44:57I will say that with
• 44:58our current fund slow arrangement
• 45:00with the health system, there's
• 45:01some buffering there
• 45:03in terms of Medicaid,
• 45:05cuts. So
• 45:07so those those are the
• 45:08things that we're thinking about.
• 45:12That's sobering,
• 45:18On a different point, Tino
• 45:20Pena from Miami, class of
• 45:21ninety four. On a different
• 45:22point, I think we all,
• 45:23aside from the Yale system,
• 45:25felt
• 45:26the sense of,
• 45:29kind of a camaraderie
• 45:31Yeah. Being in hardness and
• 45:32being all together, going to
• 45:33class together.
• 45:35Obviously, things have changed. Is
• 45:36that something just that will
• 45:38always be this way where
• 45:39students won't go to class,
• 45:40they do stuff
• 45:42outside of class and won't
• 45:43be in Harkness,
• 45:44and we should think of
• 45:45it as that was old
• 45:46school and this is new
• 45:47school? Or is there any
• 45:48sign up that that you
• 45:49got? Community has not gone
• 45:51away at all.
• 45:53It's
• 45:54different.
• 45:55So one of the differences,
• 45:56our students don't live in
• 45:57Harkness.
• 45:59Harkness was built in the
• 46:00sixties. We, you know, we
• 46:02sprung for, like, air conditioning
• 46:03on two floors a couple
• 46:05years ago.
• 46:08The developers have built all
• 46:09these towers
• 46:11all around the school of
• 46:12medicine. They all live in
• 46:13the same building.
• 46:15It's not a university building.
• 46:17So I'll I'll give you
• 46:19some,
• 46:21anecdote that addresses your question.
• 46:24I have two sets of
• 46:25dinners for the students at
• 46:27my house. I have dinners
• 46:28for them by advisory group
• 46:30when they first get here.
• 46:32They all walk over from
• 46:33the towers.
• 46:35So, you know, it's not
• 46:36Harkness, but it's the same
• 46:38community.
• 46:39I then have the fourth
• 46:40years over
• 46:41right around right after match
• 46:43day.
• 46:45I can't get them out
• 46:46of the house.
• 46:48Like, they are
• 46:50they they just love each
• 46:51other, and,
• 46:53they want that time together.
• 46:55They they have created those
• 46:56relationships. That has not changed
• 46:58at all.
• 47:04Tom Deering from the class
• 47:05of eighty. Thank you for
• 47:06the update, Nancy. A quick
• 47:08question. Most of the people
• 47:09here, we all have diverse
• 47:10careers, but I think one
• 47:12thing that's characteristic is most
• 47:13of the folks here
• 47:15live now in different geographies.
• 47:17Many in the clinical arena
• 47:18are engaged in clinical outcomes
• 47:20research and
• 47:22program
• 47:23clinical improvement.
• 47:24And we do that with
• 47:25institutions
• 47:26across the globe, and certainly
• 47:27in the states. Is there
• 47:29any interest do you think,
• 47:30because all of us are
• 47:31truly committed to Yale, feel
• 47:32a fondness for Yale, it
• 47:34made us who we are,
• 47:35to extend, develop, and grow
• 47:37those programs so that clinical
• 47:39outcomes research and, you know,
• 47:40clinical programmatic improvement that can
• 47:43actually result in better clinical
• 47:45care everywhere
• 47:46can be driven by our
• 47:47institution. Is that something on
• 47:48the plate or is it
• 47:50operationally too difficult to enact?
• 47:52I think it's,
• 47:53the more that we can
• 47:54share ideas and borrow from
• 47:56others' success,
• 47:58we're fine with that. I
• 47:59think the point of contact
• 48:01for that should be the
• 48:02folks here who are engaged
• 48:04in implementation science and quality
• 48:06work,
• 48:07and creating that community that
• 48:09that draws on that universal
• 48:12talent.
• 48:17Yes. Good morning. I'm from
• 48:19the class of nineteen sixty
• 48:21five,
• 48:21and you've
• 48:23addressed some of this in
• 48:24part, but can you be
• 48:25a little bit more specific
• 48:26on the Harvard Yale comparison?
• 48:29Obviously, just by looking at
• 48:30the newspaper,
• 48:31Yale is being treated
• 48:33or not being treated, but
• 48:34it's being handled very differently
• 48:36than Harvard.
• 48:37Why is that and,
• 48:39and what is the proactive
• 48:40approach to make sure that,
• 48:42Yale is still viewed in
• 48:44the proper perspective?
• 48:48So,
• 48:51you know, I have three
• 48:52sons and one of the
• 48:53things I learned early on
• 48:54is you never comment on
• 48:55somebody else's parenting.
• 48:59So,
• 49:04I I can't I can't
• 49:05say why.
• 49:06I don't wanna speculate.
• 49:08What I can say is
• 49:12what is happening on the
• 49:13Yale campus.
• 49:15And, you know, for example,
• 49:16in the spring
• 49:17last year,
• 49:19we were very quiet compared
• 49:20to
• 49:22other campuses. We did have,
• 49:25you know, we did have
• 49:27a couple of protests.
• 49:28The I have to credit,
• 49:30provost Strobel,
• 49:32dean of the college, Pericles
• 49:34Lewis,
• 49:35and many, many people who
• 49:36worked hard on several things.
• 49:38One was on communication with
• 49:39the students.
• 49:40So there was constant communication.
• 49:43The second was on setting
• 49:44a set of rules and
• 49:45adhering to them.
• 49:47So that was
• 49:49freedom of speech. You can
• 49:50say whatever you want. You
• 49:51cannot interrupt a class. You
• 49:53cannot interfere with the ability
• 49:54of others to learn, drawing
• 49:56frankly on the Woodward report.
• 49:59And, that took a lot
• 50:00of courage at the time.
• 50:01And I think that,
• 50:03although
• 50:05the media sometimes wants to
• 50:06conflate all IVs or all
• 50:09institutions of our kind, I
• 50:10don't think we were the
• 50:11the same,
• 50:13very frankly.
• 50:15There we prior to
• 50:17that period of time,
• 50:19we had been engaged in
• 50:20a lot of self reflection
• 50:21about
• 50:25the feeling, particularly among our
• 50:27undergraduates,
• 50:28that they could not always
• 50:29speak their mind, particularly if
• 50:31they if they were from
• 50:32a conservative background,
• 50:34and a lot of work
• 50:35on civil discourse and how
• 50:37we made that possible.
• 50:39In the school of medicine,
• 50:42I have emphasized
• 50:43since I got here that
• 50:46we care for patients.
• 50:48And
• 50:49as such, we have to
• 50:50view every individual
• 50:52as the human being that
• 50:53they are, and we cannot
• 50:57be writing off a group
• 51:00because they believe differently from
• 51:01us. And we need to
• 51:02be careful even about what
• 51:04we say in public. And
• 51:05that was a,
• 51:07I would say, not always
• 51:08a popular stance, but I
• 51:10believe very strongly,
• 51:11that we've made a commitment
• 51:13to a profession that requires
• 51:14that of us.
• 51:15And,
• 51:16so,
• 51:18you know, I I
• 51:20it would be hubris to
• 51:21say that we may not
• 51:22see that,
• 51:24and,
• 51:25we have to, again, make
• 51:27decisions based on values and
• 51:29and the law. Right? And
• 51:31I feel that we have,
• 51:32and we can defend our
• 51:33decisions.
• 51:40Hi. Good morning. Joe Rojas,
• 51:42class of twenty ten.
• 51:44I think a lot of
• 51:44us,
• 51:45are, you know, working in,
• 51:48academic centers still and have
• 51:50a lot of trainees, medical
• 51:51students,
• 51:53residents from different systems.
• 51:55And I think a lot
• 51:57of us have seen,
• 51:59in the past few years,
• 52:00a pretty
• 52:01rapid and dramatic
• 52:03change in the way that
• 52:04trainees view professionalism.
• 52:07And I think probably a
• 52:09lot of us feel not
• 52:10necessarily in a good way.
• 52:13And
• 52:14I'm wondering specifically for
• 52:17Yale and the Yale system,
• 52:18which has always been,
• 52:21you know, focused on
• 52:23adult learners, independent learners,
• 52:25but
• 52:27also
• 52:28kind of
• 52:29putting a strong emphasis on
• 52:31we always have to show
• 52:32up for the patients.
• 52:33And when it comes to
• 52:34patient care,
• 52:36that trumps anything else.
• 52:38So I'm just kind of
• 52:39curious how Yale is navigating
• 52:42this change and trying to
• 52:44impart, you know, on a
• 52:46new generation of learners who
• 52:47have a slightly different relationship
• 52:49with work that
• 52:53and that's good and bad.
• 52:54That's I mean let's be
• 52:56real, that's good and bad.
• 52:57That's good and bad. I,
• 52:58you know, I don't expect
• 52:59anyone to die on the
• 53:00altar of medicine
• 53:02but,
• 53:03you know, how do we
• 53:05prepare them for a profession
• 53:08that is about giving to
• 53:10people in their
• 53:12most desperate hour,
• 53:13most vulnerable hour,
• 53:16and,
• 53:17you know, recruit for for
• 53:19students who are who are
• 53:20prepared to do that. So
• 53:21I I would say that's
• 53:22the that what you just
• 53:23said is really important. It
• 53:24starts with the students we
• 53:26select,
• 53:28and,
• 53:30I have been clear to
• 53:31the admissions committee that we
• 53:33and and I I don't
• 53:34it wasn't like the admissions
• 53:36committee didn't believe this, but
• 53:37that we have to select
• 53:38for
• 53:40students who I particularly who
• 53:42demonstrate
• 53:43resilience, which means that they
• 53:45have experienced defeat and worked
• 53:47hard to recover from that,
• 53:51in whatever form it's been
• 53:53in their lives, but and
• 53:54who have that professional identity
• 53:56that they're coming here to
• 53:57serve, and this is a
• 53:58profession, not a job. So
• 54:00that's that's number one.
• 54:02And I think as you
• 54:03see students over this weekend,
• 54:05you will
• 54:06you will see that.
• 54:07The second is we have
• 54:08to model it,
• 54:10and,
• 54:11the third is we have
• 54:12to hold people accountable.
• 54:14Both our faculty
• 54:16and our,
• 54:17students. And
• 54:19one of the things we
• 54:20realized is we have to
• 54:21celebrate when people do it
• 54:22well.
• 54:23And so we, you know,
• 54:25we have a weekly news
• 54:26and recognition,
• 54:27and occasionally, we'll publish something
• 54:29in that that is
• 54:31about a fellow who went
• 54:32the extra mile for,
• 54:35a patient, those sorts of
• 54:36things. So by saying this
• 54:38is something we value,
• 54:39I think it sends a
• 54:40message.
• 54:43Yes.
• 54:49One other question based on
• 54:51the resilience
• 54:52Yeah. Focus.
• 54:54How do you prepare young
• 54:55doctors to enter the environment,
• 54:57you know, that we now
• 54:58have
• 54:59where you have the administrative
• 55:00burdens of the computerized medical
• 55:02record? You have the administrative
• 55:04burdens of the health care
• 55:06system
• 55:06who employs you. I'm employed
• 55:08by I'm class of seventy
• 55:10five. I'm employed by a
• 55:11big health care system in
• 55:12Cincinnati.
• 55:14So the administrative
• 55:15burden there in terms of
• 55:17hours and hours and hours
• 55:18every year and then the
• 55:20administrative burdens for continuing
• 55:22recertification,
• 55:25by the professional societies.
• 55:27And if you start to
• 55:28add those all up and
• 55:29they seem to go up
• 55:30every year Yeah.
• 55:32It can be a devastatingly
• 55:35exhausting thing over and above
• 55:36clinical work. Right. It's not
• 55:38direct clinical work, and I
• 55:40find that women are more
• 55:42vulnerable.
• 55:44And I know that the
• 55:46site the suicide rate among
• 55:47women physicians is substantially higher
• 55:49than male. Right. So I
• 55:51think this is all all
• 55:52linked.
• 55:56So, this is about physician
• 55:58well-being much larger than preparing
• 56:00the students. This is about
• 56:01our own faculty,
• 56:03and it is
• 56:05very hard not to crack.
• 56:07I would say
• 56:08some of it we're we're
• 56:10using technology. So we're now
• 56:11using ambient AI
• 56:13to write notes for our
• 56:14faculty.
• 56:16It's really quite remarkable.
• 56:19We can have a conversation,
• 56:21and as you're walking out
• 56:22the door, you say,
• 56:24you know, by the way,
• 56:24I had chest pain on
• 56:26Friday. I was at my
• 56:27mother-in-law. Boy, does she drive
• 56:28me crazy, you know, blah
• 56:29blah blah. And what and
• 56:31what comes out of that
• 56:32is a very coherent note
• 56:34written in a in a
• 56:35rigorous structure.
• 56:37And it works better for,
• 56:41the so called cognitive
• 56:43disciplines than, you know, for
• 56:45these very quick,
• 56:47follow ups post op or
• 56:48something like that. But,
• 56:50we we've got to solve
• 56:52for that. We we also
• 56:54have to you know, people
• 56:55say this a lot and
• 56:56talk about people working at
• 56:58the top of their license.
• 57:00We have,
• 57:02we have nurse practitioners doing
• 57:04what RNs could be doing.
• 57:05We have physicians doing what,
• 57:07you know, clerks could be
• 57:08doing.
• 57:09We've got to put the
• 57:10right support people in place
• 57:12for everyone,
• 57:13and,
• 57:15I think you can make
• 57:16the the case for that
• 57:18on an economic basis if
• 57:19you work closely.
• 57:22In terms of our students,
• 57:24it gets back to how
• 57:25we teach. Right? We
• 57:27are we certainly don't spend
• 57:28time on I should say,
• 57:30we spend time on how
• 57:31to use AI critically
• 57:33now, which is something,
• 57:35and and how to read
• 57:37the literature critically still, which
• 57:38may come to you as
• 57:39a compendium of AI generated,
• 57:41you know, things.
• 57:44But
• 57:45in the same way that
• 57:47the diseases
• 57:48and therapies that they have
• 57:50thirty years from now will
• 57:51be completely different from
• 57:54what they're have now. There's
• 57:55no point in having them
• 57:58learn by memorization. Right? We
• 57:59want them to learn how
• 58:00to think, and we want
• 58:01them to learn how to
• 58:02think critically,
• 58:03whether it's about
• 58:05the mechanism of a disease
• 58:06or how we operate in
• 58:08health because they're gonna be
• 58:09the leaders who change the
• 58:10health systems.
• 58:15Is this our last one?
• 58:17I'm getting the I'm getting
• 58:17the hook
• 58:18here.
• 58:27Hi. Jerry Wu, class of
• 58:29two thousand. I actually graduated
• 58:30in o one because I
• 58:31was on the five year
• 58:32plan. Yep. And I think
• 58:33around half of my classmates
• 58:35did this thing. So I
• 58:35was kinda curious what's the
• 58:36current dynamic in terms of
• 58:41percent. It's confusing at graduation.
• 58:43I have to I have
• 58:44to remember who's
• 58:45who was here for what.
• 58:48K.
• 58:51I'm I'm getting I'm getting
• 58:53the this.
• 58:55Thank you.