10-31-24 Dean Nancy Brown State of the School - MSC Perspectives on Medicine

Transcript

• 00:03Alright.
• 00:04Alright, everyone. I think we
• 00:05can get started today.
• 00:06But hello, everyone. Thanks for
• 00:08coming.
• 00:09You maybe went to the
• 00:10first session of these, but
• 00:11these are this is the
• 00:12second of, four sessions that
• 00:14we're hosting as part of
• 00:15the medical school council perspective
• 00:17on, medicine lecture series.
• 00:19My name is Gabe Creo,
• 00:21and I recently finished serving
• 00:22my term as medical student
• 00:23council president this past year.
• 00:26Before we begin, I'd just
• 00:27like to take a moment
• 00:27and acknowledge the incredible efforts
• 00:29of those who made, this
• 00:30lecture series possible.
• 00:32Special thanks to Barbara Watts,
• 00:33and Dean Min and the
• 00:34former medical the former offer
• 00:36officers of medical student councilor
• 00:38from the twenty twenty three,
• 00:39twenty twenty four school year.
• 00:40So that is Jordan Shaqued,
• 00:41May Marion Berry, and Amanda
• 00:43Geraud, just for all the
• 00:44coordination that took to make
• 00:46this,
• 00:47this session possible and recruit
• 00:48the speakers as well.
• 00:50So today, I'm honored to
• 00:51introduce our speaker, doctor Nancy
• 00:53Brown. As I'm sure you
• 00:55all know, doctor Brown currently
• 00:56serves as the Jean and
• 00:57David w Wallace Dean of
• 00:58Yale School of Medicine.
• 01:00She has dedicated her career
• 01:01to advancing medicine through research
• 01:03and education,
• 01:04from her pioneering work in
• 01:05clinical pharmacology
• 01:07to her visionary leadership at
• 01:08Yale.
• 01:10Dean Brown's best interest in
• 01:11Yale dates back to her
• 01:12days as an undergraduate here,
• 01:13actually.
• 01:14She completed a bachelor of
• 01:15arts degree in molecular,
• 01:17biophysics and biochemistry at Yale
• 01:19before earning her degree from
• 01:21Harvard Medical School. She went
• 01:23on to specialize in internal
• 01:24medicine at Vanderbilt where she
• 01:25later pursued a research fellowship
• 01:27in clinical pharmacology
• 01:28and hypertension.
• 01:30Her previous research has focused
• 01:31on how the renin angiotensin
• 01:33aldosterone system interfaces with the
• 01:35calickerion, kyanin, and incretin systems
• 01:38to modulate inflammation, thrombosis, and
• 01:40cardiovascular risk.
• 01:42Doctor Brown brings a wealth
• 01:43of leadership experience to her
• 01:44current role.
• 01:45Not only was she the
• 01:46first woman is she the
• 01:47first woman to serve as
• 01:49the dean of Yale School
• 01:49of Medicine, but she also
• 01:51previously served as the first
• 01:52female chair of Vanderbilt's department
• 01:54of medicine.
• 01:55Her cofounding of Vanderbilt's master
• 01:57of science in clinical investigation,
• 01:59the program demonstrates her commitment
• 02:01to advancing medical education.
• 02:03I personally have also had
• 02:04the opportunity to work with
• 02:05team Brown this past year
• 02:06through medical student council, and
• 02:08I'm immensely grateful for the
• 02:09advocacy she has shown for
• 02:11students on topics such as
• 02:12financial aid and the Yale
• 02:14system.
• 02:15I've also had the privilege
• 02:16of working with her as
• 02:17a clinical volunteer at the
• 02:18Haven free clinic on Saturdays,
• 02:20and I'm grateful for the
• 02:21time she dedicates to supporting
• 02:23the local community as well.
• 02:25Today, Dean Brown will be
• 02:26presenting her talk on the
• 02:27state of the school where
• 02:28she will share updates and
• 02:29insights into the future of
• 02:30Yale School of Medicine. And
• 02:31at the end, we'll open
• 02:32up the floor for any
• 02:33questions. So at this time,
• 02:34please join me in welcoming
• 02:34Dean Brown. Thank you very
• 02:34much. And,
• 02:44for those of you who,
• 02:46have seen this talk in
• 02:48June, it's a bit of
• 02:49a reprise, but with some
• 02:51updates,
• 02:52as
• 02:53almost six months have progressed.
• 02:55And I always start this
• 02:56talk with oh,
• 02:58glad you're staying until the
• 03:00slides
• 03:02advance.
• 03:05Who's up there? Oh, there
• 03:07we go. Oh,
• 03:10okay.
• 03:11There's just a little bit
• 03:12of a lag. So,
• 03:14always talk about leadership changes.
• 03:16And in a school the
• 03:17size of ours,
• 03:18you know, we have roughly
• 03:20twenty nine departments and a
• 03:22lot of deputy deans, and
• 03:23we are
• 03:25always
• 03:26recruiting
• 03:28new talent. And it's really
• 03:30exciting. So sometimes that's from
• 03:32within.
• 03:33So for example,
• 03:34two of our new chairs,
• 03:36Andy Goodman and Valerie Reinke,
• 03:38in the basic sciences are
• 03:40from within.
• 03:41And then Jillian Griffiths,
• 03:43who will be joining us,
• 03:44in a few months as
• 03:46our new chair of cell
• 03:47biology is coming to us
• 03:49from,
• 03:49University of Cambridge, England, where,
• 03:52she's a member of the
• 03:53Royal Society, and we're very
• 03:54excited about that.
• 03:56Sambal, of course, now deputy
• 03:58dean for faculty affairs, and
• 03:59you all know, Eric Schwase,
• 04:01who's our director of admissions,
• 04:03and we're just really excited
• 04:05that he's here.
• 04:06There are other leaders that
• 04:07you may not
• 04:09see behind the scenes.
• 04:11So we are doing a
• 04:12lot of work around
• 04:14aligning
• 04:15our
• 04:16clinical enterprise with the Yale
• 04:17New Haven Health System
• 04:19and thinking about how we
• 04:20provide better care to our
• 04:22patients.
• 04:23You know, medicine today is
• 04:24fee for service, but it
• 04:26really needs to be value
• 04:27based in how do we
• 04:28prevent things rather than doing
• 04:29these heroic saves. And so,
• 04:32Raj Krishnamurthy
• 04:33is our new,
• 04:35associate dean for population health.
• 04:37Pat Kenny, who I noticed
• 04:39is sitting in the back,
• 04:40there, is leading ambulatory,
• 04:43as our executive and associate
• 04:45dean for clinical affairs, and,
• 04:47you'll you'll see the the
• 04:49work that he's doing.
• 04:50David Coleman is,
• 04:52really helping to revamp our,
• 04:56Yale Center for Clinical Investigation,
• 04:57but has a new role
• 04:59that we've never had before
• 05:00as director
• 05:02of clinical research across the
• 05:03health system so that a
• 05:04patient who comes in
• 05:07and is admitted, say, in
• 05:09Bridgeport
• 05:09can get access to the
• 05:11same clinical trials as someone
• 05:12who's admitted here at Yale
• 05:13New Haven. We've done that
• 05:15pretty well in cancer, but
• 05:16it should be in everything
• 05:17that we're doing.
• 05:19Bertha Risner is our new
• 05:20chief administrative officer. Know, there's
• 05:22a lot of work that
• 05:23goes into,
• 05:25running a clinic. I think
• 05:26you students who are here
• 05:27appreciate that in Haven
• 05:29and imagine multiplying that times,
• 05:32hundreds and thousands. And then
• 05:34Megan Fay, our associate VP
• 05:36for development,
• 05:38who helps us raise money
• 05:40for things like, making our
• 05:42our, medical education
• 05:45debt free.
• 05:46So,
• 05:48every year, we try to
• 05:49celebrate
• 05:50a few of the achievements
• 05:52of our faculty, and,
• 05:54I won't go through as
• 05:55many as I would normally
• 05:57in the,
• 05:59full state of the school.
• 06:00But, you know, there are
• 06:01a number of honor societies
• 06:02that really sort of are,
• 06:05steps along the way, like
• 06:06the American Society for Clinical
• 06:08Investigation that acknowledges physician scientists,
• 06:10the same with AAP, and
• 06:12then, of course, the National
• 06:13Academy of Medicine,
• 06:15and
• 06:17National Academy of Arts and
• 06:18Sciences or the American Academy
• 06:20of Arts and Sciences,
• 06:21etcetera, etcetera.
• 06:23Again, if you're a student
• 06:24sitting in this room, that
• 06:25seems very far away. I
• 06:27will tell you that for
• 06:28everyone who has achieved those
• 06:30awards, it's because someone put
• 06:33them forward,
• 06:34in their early days. So
• 06:35there was mentorship, but there
• 06:36was also sponsorship and someone
• 06:38who advocated for them. So
• 06:40the the person who's nominating
• 06:42you for,
• 06:43you know,
• 06:45a grant to do a
• 06:46small research project,
• 06:48that's the beginning of it.
• 06:49And,
• 06:50and then, of course, some
• 06:51of our faculty
• 06:52make the news, like,
• 06:54Akiko Uesaki, who's been recognized
• 06:57for her work
• 06:58in long COVID in particular,
• 07:00but I think who brings
• 07:02attention
• 07:03to the the importance
• 07:05of basic science in solving
• 07:07clinical,
• 07:08health problems,
• 07:10such as as long COVID
• 07:11and the strength of our
• 07:12immunobiology.
• 07:14Carolyn Missouri, who has been
• 07:15leading,
• 07:16so for twenty five years
• 07:18led our women's health research
• 07:20at Yale Center,
• 07:22now leading a White House
• 07:23initiative on women's health research
• 07:25and bringing national attention
• 07:28to often ignorance about what
• 07:30the effects of sex as
• 07:31a biological vary
• 07:33biological variable.
• 07:34And, of course, that has
• 07:36all sorts of implications as
• 07:37we now
• 07:39are often using treatments that
• 07:41change,
• 07:42that biological variable
• 07:45in in in
• 07:46patients.
• 07:47And I think some of
• 07:49the most
• 07:51important,
• 07:53awards that we give are
• 07:54for teaching. And, you know,
• 07:55we give these out typically
• 07:57at the end of the
• 07:58year around graduation, but I
• 08:00just want to give a
• 08:01shout out to to these
• 08:02people, many of whom you
• 08:04know because of the work
• 08:05that they're doing,
• 08:06with you.
• 08:09A school like ours,
• 08:11however, doesn't run without staff,
• 08:15and you know the staff
• 08:17with whom you interface in
• 08:19as students.
• 08:20But everything we do
• 08:23is accomplished
• 08:24because of hundreds and thousands
• 08:26of people who are committed
• 08:28to their work.
• 08:29And,
• 08:30every year that's acknowledged with
• 08:32a set of awards called
• 08:33the Linda Lorimer Awards. I
• 08:35I won't embarrass her, but
• 08:36there's one of the winners
• 08:37of the awards in the
• 08:38room here,
• 08:39and that's coming up again,
• 08:41this year.
• 08:43So
• 08:44let me talk about you
• 08:45know, normally, when we think
• 08:46about,
• 08:47medical education, we think about
• 08:49three
• 08:51missions. Right? We think education,
• 08:53clinical, and research.
• 08:54But I always like to
• 08:56start these,
• 08:57talks with a piece about
• 08:59our culture and our climate.
• 09:01It's who we are as
• 09:02a community. And
• 09:04when I came in twenty
• 09:06twenty,
• 09:07we had our first case
• 09:08of COVID about six weeks
• 09:09later, and we've had a
• 09:10pretty tumultuous
• 09:12climate
• 09:13in this country over the
• 09:15last,
• 09:17several years.
• 09:18Through that, I think we've
• 09:19learned a lot about how
• 09:20to support each other,
• 09:23and,
• 09:24and how to make sure
• 09:25that we are listening.
• 09:28And one of the things
• 09:29about a school of medicine
• 09:31is that we have a
• 09:32very specific mission, which is
• 09:34to,
• 09:35advance
• 09:37health and discovery, but to
• 09:38take care of patients.
• 09:40And our patients come from
• 09:42all sorts of different backgrounds,
• 09:43have all sorts of different
• 09:44beliefs,
• 09:45And so it's incumbent on
• 09:47us in particular to be
• 09:49able to listen
• 09:50and to be able to
• 09:51explain what we know scientifically
• 09:54versus what is opinion,
• 09:56to our patients. I think
• 09:57we start by learning to
• 09:59do that with each other
• 09:59and so highlighting some of
• 10:01the work. And I I
• 10:02have to say
• 10:03how grateful I have been
• 10:05for,
• 10:06Darren Lattimore and his team
• 10:08for his thoughtfulness
• 10:09around,
• 10:10leading us in this work.
• 10:13There are other aspects to
• 10:14culture.
• 10:16For those of you who
• 10:17are newer,
• 10:18if you haven't been to
• 10:19a Yale Medical Symphony
• 10:21concert, like, you just have
• 10:23to go. It's
• 10:25one of the best things
• 10:26here. But the art in
• 10:27in public places, the art
• 10:29on our walls, that's all
• 10:30part of of who we
• 10:31are.
• 10:33There are aspects around culture
• 10:35like,
• 10:36how do we move away
• 10:38from where medicine was
• 10:41not so long ago as
• 10:42a very homogeneous
• 10:44population
• 10:46to reflect the population of
• 10:47our country and to, really
• 10:49make it possible for everyone
• 10:51to thrive?
• 10:52And we are doing that
• 10:53in a number of ways.
• 10:54We have strategic plans around
• 10:55that. But one of the
• 10:57elements of that strategic plan
• 10:58is to be transparent
• 10:59and to show how we're
• 11:01doing. And so every year
• 11:02at the state of the
• 11:03school,
• 11:04I show a slide like
• 11:05this that shows
• 11:06the proportion of our faculty
• 11:08who identify as underrepresented in
• 11:10medicine by rank just to
• 11:12see if we're making progress.
• 11:13And you can see we
• 11:14continue to make progress with
• 11:16assistant professors.
• 11:17We had been making tremendous
• 11:18progress with associates professors that
• 11:20leveled off last year. We
• 11:22need to pay attention to
• 11:23that. And, of course, we
• 11:24have
• 11:25tremendous work to do in
• 11:26terms of retaining,
• 11:27and developing our faculty. And
• 11:29the same numbers for our
• 11:30women faculty.
• 11:32The very foundation
• 11:34of our work in making
• 11:36this a a place where
• 11:37all can thrive
• 11:38is mentorship and sponsorship. And,
• 11:43as you think about as
• 11:45students, how do I get
• 11:46feedback, our faculty also think
• 11:48about
• 11:49how do I
• 11:50know if I'm on track?
• 11:52How do I talk about
• 11:53the obstacles I'm facing? How
• 11:55do I learn to get
• 11:56better at what I'm doing?
• 11:58And the way this should
• 11:59happen is through conversations with
• 12:01their chairs or their section
• 12:03chiefs, but that wasn't always
• 12:04happening. And so we worked
• 12:06on we, a group of,
• 12:08faculty leaders,
• 12:11really brainstormed about what are
• 12:12the questions that you should
• 12:14discuss if you have a
• 12:15meeting with your chair, and
• 12:16how do we make sure
• 12:17that you're having a meeting
• 12:18with your chair or your
• 12:19section chief. And that resulted
• 12:20in this faculty development annual
• 12:23questionnaire.
• 12:24When you first start something
• 12:25like this, you know, the
• 12:27first concern is, god, are
• 12:28we just creating more work
• 12:29for people?
• 12:30But it's it's a red
• 12:31cap forum that rolls over
• 12:33year after year, and we're
• 12:35starting to get some numbers,
• 12:36and we're measuring whether this
• 12:38has an impact. And a
• 12:39lot of faculty are telling
• 12:40us that this does impact
• 12:42on their career development.
• 12:44Interestingly,
• 12:45we're having our senior faculty
• 12:47do this as well.
• 12:48And they are not saying
• 12:50that it impacts on their
• 12:51current development, but they're saying
• 12:52they love the opportunity to
• 12:53meet with their chair because
• 12:54they'd stopped doing that, and
• 12:56so they like those conversations.
• 12:59Getting back to transparency,
• 13:00we're measuring impact in
• 13:04in,
• 13:05objective surveys. And so this
• 13:07is one that has been
• 13:08repeated
• 13:09now,
• 13:10twice so we can start
• 13:11to see trends. This is
• 13:12just showing,
• 13:15whether people have perceived that
• 13:17they're receiving effective mentoring. And
• 13:19you can see that, overall,
• 13:20the trend is positive,
• 13:22and this is by specific
• 13:23groups so that we can
• 13:25now look and see, are
• 13:26there groups that don't feel
• 13:27this versus those who do?
• 13:29All of this is on
• 13:30our web page, and, I
• 13:32think, you know, web pages
• 13:33are maybe becoming somewhat obsolete,
• 13:35but,
• 13:36but it's still the right
• 13:38place to go. If you
• 13:39wanna see
• 13:41how we're doing in these
• 13:42areas, it's all there for
• 13:44you.
• 13:46So
• 13:46as as we think about
• 13:48where we wanna go,
• 13:51we still have work to
• 13:52do around the well-being
• 13:53of our
• 13:55faculty, particularly our clinical faculty.
• 13:57You know, we,
• 14:00I think there are several
• 14:01things that affect this. The
• 14:02introduction of the electronic health
• 14:04record
• 14:05now many years ago,
• 14:08created
• 14:09it it really took away
• 14:10some of the joy of
• 14:11seeing patients because now people
• 14:13were focused
• 14:14on getting the right forms
• 14:15filled out rather than
• 14:18seeing that patient. And we
• 14:19are using some AI to
• 14:21change that. I'll talk a
• 14:21little bit more about that.
• 14:23But there's a lot of
• 14:24work. We need to remove
• 14:25the barriers for people who
• 14:27are seeing patients.
• 14:29We're continuing this work on
• 14:30faculty annual questionnaires and how
• 14:32to coach people and how
• 14:34to have those conversations.
• 14:37We are also reviewing our
• 14:39search processes. I mentioned at
• 14:40the beginning, we're always recruiting
• 14:42new leaders. How do we
• 14:43do that in the way
• 14:44that makes sure we get
• 14:46people who are not just
• 14:47great scientists and clinicians and
• 14:49teachers, but are effective leaders
• 14:51who really will change the
• 14:52institution,
• 14:54continuing to streamline processes,
• 14:58and then, again, the transparency
• 15:00piece.
• 15:02So let me talk briefly
• 15:03about,
• 15:04education.
• 15:08We, have a relatively small
• 15:09class compared to our peers.
• 15:11Right? We have a hundred
• 15:12and four students,
• 15:13and we do that because
• 15:14we don't believe that we're
• 15:17trying to address the workforce
• 15:19needs of the country. What
• 15:20we want to do is
• 15:22create the leaders
• 15:24who, by virtue of your
• 15:26innovation and your leadership, will
• 15:27change medicine.
• 15:29And I think we can
• 15:30point to some alums. Right?
• 15:31Vivek Murthy,
• 15:33Mandy Cohen
• 15:34are just a couple of
• 15:35examples.
• 15:36So we very much value
• 15:38the white the, Yale system
• 15:40and this idea that we
• 15:43bring students here
• 15:45and teach treat you as
• 15:47adults
• 15:48and as future,
• 15:51as future peers
• 15:53and
• 15:54need to provide you with
• 15:55mentorship.
• 15:56Now
• 15:59last year, we had, roughly
• 16:01fifty seven hundred applicants for
• 16:03those a hundred and four
• 16:04positions. I will tell you,
• 16:06Laura's sitting in the back.
• 16:07It's over seven thousand
• 16:09this year.
• 16:11I
• 16:12I don't think I could
• 16:13get into Yale School of
• 16:14Medicine.
• 16:16But one of the things
• 16:17that I'm really excited about
• 16:19is
• 16:20this entering class, you first
• 16:22years who are here, was
• 16:24the first class that we
• 16:26enrolled after
• 16:27the Supreme Court decisions that
• 16:29affected our processes for admissions.
• 16:32And we continue to recruit
• 16:35a diverse as well as
• 16:36excellent class, and I'm really
• 16:37excited about that.
• 16:39One of the ways we
• 16:40do that is by,
• 16:43making
• 16:44an education here accessible.
• 16:47Some of you may have
• 16:48seen there was an article
• 16:48in The Atlantic,
• 16:50last week talking about,
• 16:52tuition free medical education
• 16:54and whether or not it
• 16:55works.
• 16:57We don't do tuition free
• 16:58medical education.
• 16:59We
• 17:00focus on
• 17:01our students who have need.
• 17:03And, of course, as you
• 17:04know, we're aiming to reduce
• 17:05debt.
• 17:07And we do that by
• 17:08calculating the total cost to
• 17:10you of attending school of
• 17:11medicine, which isn't just tuition,
• 17:13but it includes
• 17:14rent
• 17:15in New Haven or,
• 17:17the cost of food. And
• 17:18since I live in New
• 17:19Haven, I know how expensive
• 17:20food is in town if
• 17:22you don't have a car
• 17:23to get groceries.
• 17:25So we calculate that, and
• 17:27we cap your debt. And
• 17:29we have been very fortunate,
• 17:31to get a
• 17:33significant gift from the Star
• 17:35Foundation, but, also, I will
• 17:37tell you many gifts from
• 17:39our alumni
• 17:41and others.
• 17:43And,
• 17:44we really have to you
• 17:45know, if you if you
• 17:46hold one of those scholarships,
• 17:47we really you know, just
• 17:49saying thank you every once
• 17:50in a while is is
• 17:50an important thing to do.
• 17:52So that's allowed us to
• 17:53keep our this is a
• 17:54little bit out of date,
• 17:55but our debt much lower
• 17:57than the national average.
• 17:58And,
• 18:00that then gives you the
• 18:01choice of making a decision
• 18:03about what you wanna do
• 18:04in the future that's based
• 18:06on what your passion is
• 18:07and not based on how
• 18:08much debt you have and
• 18:09what whether you need to
• 18:10whether you can afford to
• 18:11do that thing.
• 18:13So,
• 18:14as part of raising that
• 18:15money, we've had a challenge
• 18:17over the last year where
• 18:18the provost said, if for
• 18:19every dollar you raise an
• 18:21endowment, I'll match it. And
• 18:23we said, we're gonna specifically
• 18:25say for every dollar related
• 18:27to education,
• 18:28we'll match because we wanted
• 18:30donors to understand how much
• 18:32how the import of education.
• 18:33So we've just reached that
• 18:35goal, so we've matched fifty
• 18:36million dollars of donations in
• 18:38support of medical education.
• 18:41The other way that we,
• 18:43I think, are
• 18:46maintaining
• 18:47the quality
• 18:48and breadth of our class
• 18:50is through outreach.
• 18:51It's the notion that you
• 18:53have to make sure that
• 18:55everybody in the country knows
• 18:56that Yale School of Medicine
• 18:58is accessible
• 19:00to you. And and and
• 19:02the person who's been doing
• 19:03a lot of that work
• 19:04is Anne Arthur, who's our
• 19:05new director, not so new
• 19:06now, over a year, of
• 19:08alumni engagement because we're leveraging
• 19:10our alums across the country
• 19:13to get to know students,
• 19:14and we're holding events as
• 19:15we travel around the country.
• 19:17And those are some pictures
• 19:18from some of the events.
• 19:19And so she, you know,
• 19:20got a group of alums
• 19:21to talk at second look
• 19:23about their careers. And those
• 19:25relationships, I think, are things
• 19:26that we would like to
• 19:27build so that you have
• 19:28alums to talk to even
• 19:30as you're advancing and thinking
• 19:31about your career choices.
• 19:34And I think the word
• 19:35gets out that our students
• 19:36match at really great places.
• 19:38So and this is a
• 19:39question that often comes up,
• 19:40and you probably had those
• 19:42questions when you're coming here.
• 19:44No grades.
• 19:45How will people know
• 19:47how good I am?
• 19:48And the answer is because
• 19:50of the letters that John
• 19:51Francis writes, because of the
• 19:54subjective comments that you get,
• 19:55and because of the track
• 19:57records of the people who
• 19:58came before you and went
• 19:59to those programs.
• 20:02Some of us
• 20:03around this time last year
• 20:05were just recuperating
• 20:07from the LCME site visit
• 20:08the week before,
• 20:10and I'm delighted to say
• 20:12we are reaccredited for eight
• 20:13years.
• 20:16But, you know, LCME site
• 20:18visit is
• 20:20it's it's a painful process,
• 20:23but it's also a forcing
• 20:25function to make us do
• 20:27strategic planning around education.
• 20:29And,
• 20:30we are now
• 20:32in the luxury period of
• 20:33executing on that strategic plans.
• 20:35One of the things that
• 20:36we heard loud and clear
• 20:37and that Jessica Luzi and
• 20:39others are working on is
• 20:40how we create
• 20:42that sense of community and
• 20:43make sure that you are
• 20:45not just interacting with your
• 20:46own class, but you are
• 20:47interacting with classes
• 20:49above and below you and
• 20:50also with residents and faculty
• 20:52and community members. And that,
• 20:54of course, led to the
• 20:55establishment
• 20:56of
• 20:57our advisory houses.
• 20:59And just a week ago,
• 21:00as you know, we announced
• 21:02finally
• 21:03the naming of our houses.
• 21:07This was about an eighteen
• 21:08month process,
• 21:09seventeen.
• 21:12There were a few people
• 21:13who said you shouldn't name
• 21:15the houses.
• 21:16But I actually think it
• 21:18was an incredible process where
• 21:19we learned a lot about
• 21:21our history
• 21:22and the fantastic
• 21:23role models we have.
• 21:25And it's a fluid process.
• 21:27Right? One of the things
• 21:28that we said is we
• 21:29won't select somebody who's still
• 21:32alive,
• 21:33because that can be awkward
• 21:34for that person. And,
• 21:37but,
• 21:38I think,
• 21:39I think if you haven't
• 21:40read the,
• 21:42the bios of these, incredible
• 21:44people, I would encourage you
• 21:45to do that. It's really
• 21:47inspiring. And there are a
• 21:48lot more inspiring people, in
• 21:50our history, and I think
• 21:51we need rather than say
• 21:52saying we're not gonna name
• 21:53anything, I think we need
• 21:54to think about how we
• 21:55broadly
• 21:56honor our our past.
• 22:01Whenever you introduce something like
• 22:02houses or colleges, you get
• 22:04competition. I don't know. I
• 22:05mean, it's
• 22:07get competition. So,
• 22:09I've already heard conversations about,
• 22:11you know, a little bit
• 22:12of,
• 22:13trash talk,
• 22:15at dinners at my house
• 22:16along the, you know, hill.
• 22:18Stay tuned for that.
• 22:20There are other educational programs.
• 22:23Obviously,
• 22:24we spent a lot of
• 22:25time thinking about our,
• 22:27PA program, and that is
• 22:28coming up for reaccreditation.
• 22:31You think of the master
• 22:32of health sciences program and
• 22:34and taking that during your
• 22:35year off, but it's also
• 22:37a program that our faculty
• 22:38take, and
• 22:40we have revised that to
• 22:41make it a little bit
• 22:42more structured
• 22:43so that degree has some
• 22:45meaning. And we've introduced a
• 22:46new track in that degree
• 22:47in clinical investigation.
• 22:50We also have a new
• 22:51relatively new masters in
• 22:54personalized medicine and applied engineering
• 22:56translation,
• 22:57three d printing for in
• 22:58medicine, and and device design.
• 23:02We also, of course, have
• 23:03an extensive,
• 23:04doctoral program,
• 23:06not just our MD PhD
• 23:07program, but hundreds of of,
• 23:10predoctoral students and a lot
• 23:11of postdocs.
• 23:12And,
• 23:14the cost of
• 23:16maintaining that program is going
• 23:18up substantially.
• 23:20It relates to the fact
• 23:21that the NIH is funding
• 23:22fewer slots.
• 23:24We, have fewer international students
• 23:27related to visa restrictions by
• 23:29the by the government.
• 23:30And so we are spending
• 23:32a lot of time investing
• 23:33in those programs as well.
• 23:35And so,
• 23:37always was one of our
• 23:38goals, we continue to raise
• 23:39fund for financial aid.
• 23:41We're continuing,
• 23:43to work on improving formative
• 23:44feedback, which is part of
• 23:46something that came out of
• 23:46the LCME and,
• 23:48very creative work around pedagogy
• 23:50so that you don't just
• 23:51sit and listen to
• 23:53PowerPoint,
• 23:54talks,
• 23:55developing curricular content, and we've
• 23:57had
• 23:58people interviewing for the the
• 24:00role of associate dean for
• 24:01curricular,
• 24:03development,
• 24:04continuing to expand the coaching
• 24:06program and, again, the advisory
• 24:08houses. And then, I mentioned
• 24:10some of these other things.
• 24:12So let me turn to
• 24:13research.
• 24:16Yale has always been an
• 24:17institution
• 24:18that that understands that,
• 24:22to advance health, you yes.
• 24:24We have to
• 24:26advance preventive medicine, but we
• 24:28made to need to make
• 24:29transformative changes in our understanding
• 24:31of disease
• 24:33that informs that work. And
• 24:34most of that is funded
• 24:36through the National Institutes of
• 24:37Health, and we track how
• 24:39we're doing in that. And
• 24:40you can see last year,
• 24:41we were fourth.
• 24:43We're projecting that we'll be
• 24:44third. That's not,
• 24:47so relevant, but it's what
• 24:48you should understand is that
• 24:50a big portion of our
• 24:52research is funded by the
• 24:53federal government,
• 24:55and that's something that we
• 24:57always have to be thinking
• 24:58about. We wanna diversify our
• 25:00funding somewhat.
• 25:02So this year, for the
• 25:03first time, we've
• 25:05received
• 25:06several ARPA h awards. I
• 25:07think we have three now.
• 25:08These are,
• 25:10much more
• 25:12project focused,
• 25:14but they diversify our funding.
• 25:15And then we have wonderful
• 25:17support from various foundations,
• 25:20and one of them,
• 25:21that,
• 25:22we launched this year is
• 25:24a new Chan Zuckerberg Biohub
• 25:26New York. We've learned that
• 25:28New Haven is the northernmost
• 25:30suburb of New York, so
• 25:31we are partnered with,
• 25:33Rockefeller, Columbia,
• 25:35and Yale.
• 25:36This is a fascinating
• 25:38project, which is based on
• 25:40engineering immune cells. When you
• 25:41think about immune cells, they
• 25:42hone to various tissues in
• 25:44your body in response to
• 25:46both normal physiology but to
• 25:47inflammation and disease.
• 25:49So they can provide information
• 25:51if you can track them
• 25:53as sensors, and they can
• 25:55also serve as carriers of
• 25:57cargo potentially. And so this
• 25:59is the thinking about this.
• 26:00And this work is being
• 26:01led at Yale by, John
• 26:03Tsang,
• 26:04opening the doors for many
• 26:05other,
• 26:06potential things in this area.
• 26:09Mister Lemn Blavatnik has supported,
• 26:13innovation, and many of our
• 26:15faculty,
• 26:17develop new technologies
• 26:19or new ideas that then
• 26:21become new drugs or new
• 26:23devices.
• 26:24And, these awards help our
• 26:26faculty transition,
• 26:29those into patients, right, through
• 26:31through commercial development. And so
• 26:33this is just an example
• 26:35of the the faculty within
• 26:37our own school who received
• 26:38these awards last year.
• 26:40And, of course,
• 26:42you know, in research, one
• 26:43publishes, and so really high
• 26:45impact papers
• 26:47that influence the fields
• 26:49of our faculty. And you,
• 26:51as students, who do thesis,
• 26:53may do your thesis in
• 26:54basic research. You may do
• 26:55your thesis on the other
• 26:56side of campus in
• 26:58literature, but it's the same
• 26:59sort of high quality
• 27:01impact on the field.
• 27:04So
• 27:05you probably don't think about
• 27:06how we invest in research,
• 27:07but there is a university
• 27:09wide science strategic plan, and
• 27:11we've done strategic planning within
• 27:13the school as well to
• 27:14think about
• 27:16what are the areas in
• 27:17which we wanna invest. And
• 27:18I don't suspect you can
• 27:19see all of this, but
• 27:20I'll I'll highlight a few
• 27:21of them. You know? So
• 27:22one is
• 27:23data science.
• 27:24Anybody who thinks you can
• 27:26have
• 27:27science and medicine without data,
• 27:29come talk to me afterwards.
• 27:31But,
• 27:32so
• 27:33now January in twenty twenty
• 27:35three, we set up a
• 27:36freestanding section of biomedical
• 27:38informatics and data science. That's
• 27:39now a department.
• 27:41A lot of our work
• 27:42in artificial intelligence,
• 27:44which has been led by,
• 27:45frankly, young faculty
• 27:47and students
• 27:48distributed throughout the institution is
• 27:50now,
• 27:51being collaborated through that department.
• 27:53Biomedical engineering. We have incredibly
• 27:56strong bio I'm sorry. Imaging.
• 27:58We have incredibly strong biomedical
• 28:00imaging in partnership
• 28:01with our biomedical engineers,
• 28:04PETCT,
• 28:05MR, SPECT,
• 28:07to allow us to advance
• 28:09other areas like neuroscience
• 28:11because we can see things
• 28:12and understand functionally how they
• 28:14work when we couldn't before.
• 28:17Neurodegeneration.
• 28:19We have a new,
• 28:20ADAM Center for Parkinson's research,
• 28:22and we recruited Clement Scherzer
• 28:24who's looking at the genetics
• 28:26of Parkinson's. What are the
• 28:27genetic factors that predict who
• 28:29will get Parkinson's, and what
• 28:30are the genetic factors that
• 28:32predict,
• 28:33once you have Parkinson's,
• 28:35how quickly it will advance
• 28:36and how you will respond
• 28:37to drugs. And it turns
• 28:38out those are different sets
• 28:39of genes.
• 28:41I mentioned the CZI Biohub
• 28:43and engineering.
• 28:44So specific areas, but then
• 28:46also cross cutting themes. Right?
• 28:48Investments in graduate students and
• 28:50postdocs.
• 28:52Investments in physician scientists.
• 28:54How do we enable people
• 28:56in their transition from
• 28:58their
• 28:59fellowship onto faculty
• 29:01to have
• 29:02protect so called protected time,
• 29:04but academic time to develop
• 29:06their careers
• 29:07and get their first grant.
• 29:09And how do we people
• 29:10how do we help people
• 29:12write those grants and,
• 29:14and get funding and become
• 29:16independent investigators?
• 29:18Work to increase the diversity
• 29:21of our,
• 29:22of our faculty and trainees.
• 29:26The,
• 29:28some of the just technology,
• 29:30the bleeding in technology that
• 29:32we need to make new
• 29:33discoveries,
• 29:34such as FIB SEM. And,
• 29:37it is so imaging not
• 29:39at the high level, but
• 29:40at the smallest possible level
• 29:42to see structures
• 29:44and make discoveries based on
• 29:45seeing those structures.
• 29:47And then,
• 29:48things like our center for
• 29:49clinical investigation. Any of you
• 29:51who are doing human studies
• 29:52knows there's a there are
• 29:53a lot of pieces to
• 29:54that, and we need to
• 29:55help facilitate that. And that
• 29:56had gotten kinda clunky, so
• 29:58we're really doing a work
• 29:59a lot of work to
• 30:00overhaul that.
• 30:05So I mentioned a couple
• 30:06of new centers. I mentioned
• 30:08the Adam Center, but another
• 30:09center in neurodegeneration
• 30:10is focused on the immune
• 30:12system and the effects of
• 30:13the immune system in the
• 30:14brain. So, of course, we
• 30:15know that multiple sclerosis is
• 30:17immune disease. Turns out Parkinson's
• 30:19is probably as well. And
• 30:20that, actually, there's a big
• 30:22relationship between what's going on
• 30:23in your gut
• 30:24and what immune cells go
• 30:26to your brain and affect
• 30:27risk of Parkinson's and and
• 30:28probably other neurodegeneration.
• 30:30I mentioned
• 30:32John Zhang, and the CZI
• 30:34Biohub. This is other work
• 30:36that he's doing,
• 30:37that's
• 30:38defining
• 30:39the phenotype of the immune
• 30:40system in individuals and how
• 30:42it develops over time.
• 30:44Again, the department of biomedical
• 30:45informatics, we recruited Lucila Onomashado
• 30:48from UCSD.
• 30:49She is a member of
• 30:50the National Academy,
• 30:51an expert in
• 30:53how you,
• 30:54analyze data while maintaining privacy
• 30:57using techniques like blockchain.
• 31:00Again, biomedical engineering, we recruited,
• 31:03George O'Fackery from,
• 31:05MGH,
• 31:06and then physician scientist development.
• 31:08I hope you appreciate that
• 31:09it takes it really does
• 31:10take a village to help
• 31:12everybody get where they need
• 31:13to go in terms of
• 31:14their career advancement.
• 31:16One of our other programs
• 31:17is the science fellows program
• 31:19where we
• 31:20recruit
• 31:22potential faculty as postdocs. So,
• 31:24traditionally, in academia, you go
• 31:26one place for your postdoc,
• 31:27you go someplace else for
• 31:29your faculty position if you're
• 31:30a basic scientist.
• 31:32Given the size of our
• 31:33institutions, that no longer makes
• 31:35as much sense. If you're
• 31:36succeeding,
• 31:37you can shift labs in
• 31:39the same
• 31:40place. And so this is
• 31:41an investment in people to
• 31:43say, we
• 31:44are so
• 31:45invested in you. We will
• 31:47guarantee you as you come
• 31:48on for your postdoc that
• 31:49we're gonna keep you on
• 31:50faculty, and so the departments
• 31:52are making an investment. That
• 31:53allows us to recruit people
• 31:55who might not otherwise
• 31:56think that this career in
• 31:58basic science is accessible to
• 32:00them.
• 32:01Again, developing our course and,
• 32:03again,
• 32:05you know, simple mundane things.
• 32:07If you're doing clinical trials,
• 32:08how long does it take
• 32:09you from the time of
• 32:10your idea to get the
• 32:11trial started?
• 32:12It used to be,
• 32:14you know, close to half
• 32:15a year. We're getting that
• 32:17down to ninety days, and
• 32:18and that's important.
• 32:22So,
• 32:23another area that was not
• 32:25in the original
• 32:26science strategic plan is artificial
• 32:28intelligence.
• 32:29And over the last year,
• 32:30the,
• 32:31deans and provost went out
• 32:33to the Bay Area and
• 32:34spent a lot of time
• 32:35with OpenAI and Google and,
• 32:38all the different companies out
• 32:39there and came back and
• 32:41did this strategic planning,
• 32:43led by a task force,
• 32:44the Yale task force on
• 32:46artificial intelligence. These are our
• 32:48faculty who were part of
• 32:49it.
• 32:50And we convened a couple
• 32:51of faculty panels, one in
• 32:53clinical research, one in basic
• 32:54science research.
• 32:56And,
• 32:57I actually sat in on
• 32:58these meetings while they were
• 32:59brainstorming. I think it was
• 33:00one of the high points
• 33:02of of the year for
• 33:03me to see
• 33:04how much our faculty were
• 33:06accomplishing even before we were
• 33:08making significant investments.
• 33:10You may have seen, an
• 33:12announcement from the provost talking
• 33:13about the investments we are
• 33:15making. Many of those are
• 33:16investments we've made in the
• 33:17school of medicine through that
• 33:18department of biomedical informatics.
• 33:21A lot of it is
• 33:21around training. You know, you
• 33:23no longer can get a
• 33:24PhD in one basic science
• 33:26field without understanding,
• 33:29how you use data science
• 33:30and and artificial intelligence.
• 33:32Similarly, for clinical research, we
• 33:34have this rich
• 33:37phenotype
• 33:38of patients in our electronic
• 33:40health record.
• 33:41We often now have genetics.
• 33:42How do we use that
• 33:44to say
• 33:45before you as a physician
• 33:46recognize it, this patient is
• 33:48going to get this disease,
• 33:49and you can intervene and
• 33:50prevent,
• 33:51prevent it or change the
• 33:53outcome.
• 33:54So
• 33:55lots going on there,
• 33:57and,
• 33:58some ideas about how we're
• 33:59gonna do that.
• 34:01Really getting into the weeds,
• 34:03faculty are very interested in
• 34:05this.
• 34:06You think about the educational
• 34:07space, but there's also research
• 34:09space, which has been very
• 34:11constrained. And so we are
• 34:12currently doing a master plan.
• 34:15I will only point out
• 34:16that if you look at
• 34:17this slide,
• 34:19some of the things that
• 34:20we're planning will not be
• 34:21completed for another eight years.
• 34:23It's a long range plan.
• 34:25And then we are advised
• 34:26by an external group of
• 34:28scientific advisers.
• 34:30So our goals here,
• 34:32a lot of it is
• 34:32around space,
• 34:35continuing to pursue now endowment
• 34:37for the other side of
• 34:39education, which is the graduate
• 34:41and postdoctoral fellows,
• 34:43developing our strategies to,
• 34:45support physician scientists,
• 34:48as well and and some
• 34:49other things that are probably,
• 34:51a little bit too mundane.
• 34:54So
• 34:55clinical.
• 34:57Some of you may be
• 34:57in your clinical clerkships.
• 35:00We have an interesting relationship
• 35:01with our health system. We
• 35:03don't own our health system.
• 35:04Every academic
• 35:06every school of medicine and
• 35:07academic health system is different
• 35:08and has a different relationship.
• 35:10But we've been working for
• 35:11the last three years to
• 35:13really make sure that we're
• 35:15rowing
• 35:17in this at same
• 35:18direction.
• 35:20And,
• 35:21that has included the first
• 35:22ever strategic plan about what
• 35:25is it we wanna grow
• 35:26in terms of our clinical
• 35:28programs,
• 35:29and how do we grow
• 35:30that, and how do we
• 35:31make sure that systems are
• 35:32working well rather than just
• 35:34pointing at the other person
• 35:35and saying, oh, that's broken,
• 35:37but not feeling any personal
• 35:38responsibility for that. So that
• 35:40strategic planning
• 35:42identified some things that you
• 35:44just need to do,
• 35:45like primary care.
• 35:47Those are the table states.
• 35:49And some things that are
• 35:50differentiators
• 35:51for us,
• 35:53like some of the things
• 35:54we do in neurosurgery and
• 35:56deciding then which of those
• 35:57things will develop.
• 35:59The other important work is
• 36:01making sure that we have
• 36:03the same
• 36:04standards of care,
• 36:06the same systems,
• 36:07the same call center, whether
• 36:09our patients are seeing one
• 36:11of our faculty
• 36:12or whether they're seeing one
• 36:14of the physicians employed by
• 36:15the health system.
• 36:16We actually used to compete,
• 36:18and a patient who was
• 36:19coming to see us might
• 36:20call three different numbers to
• 36:21try to get an appointment.
• 36:24And so we've now created
• 36:25this aligned clinician enterprise. It
• 36:27doesn't change how people are
• 36:29employed,
• 36:30but it says we're gonna
• 36:31have one system.
• 36:33People come into the clinic.
• 36:34They won't know,
• 36:36and our chairs will have
• 36:38oversight
• 36:39across the system in terms
• 36:41of quality,
• 36:42our standards,
• 36:44in what we do. And
• 36:45this is led by doctor
• 36:46McGovern, who is our deputy
• 36:47dean,
• 36:49for clinical affairs. Doctor McGovern
• 36:51brings a unique
• 36:52perspective to this work because
• 36:54she herself is a geneticist
• 36:56chain trained in rare disorders
• 36:58in children and was chair
• 36:59of pediatrics for about ten
• 37:00years before she took on
• 37:02this organizational work.
• 37:05So access, you know, you
• 37:06don't think about it, but,
• 37:09if you've tried to get
• 37:10an appointment,
• 37:12sometimes it's pretty hard.
• 37:14We have to fix that.
• 37:15And so this this structure
• 37:18allows us to do that.
• 37:19It also allows us to
• 37:21set up something called a
• 37:22clinically integrated network,
• 37:24which then brings community physicians
• 37:27in partnership with us. So
• 37:29a patient with diabetes who's
• 37:31seen by a community doc
• 37:32within this integrated network
• 37:34or a faculty member
• 37:35or a northeast medical group
• 37:38physician gets the same care,
• 37:40and we're measuring that quality
• 37:41and we're improving that quality.
• 37:45It also involves,
• 37:46again,
• 37:48changing the quality of life
• 37:49for those
• 37:51physicians who are practicing. And
• 37:52I mentioned earlier the electronic
• 37:54health record and how that
• 37:56has changed the patient
• 37:58physician interaction.
• 38:00We have been
• 38:01now piloting a program. Anybody
• 38:03here use a bridge?
• 38:06Okay. Anybody use a bridge
• 38:07in Haven? Probably not. So
• 38:09I I really would love
• 38:10to try that.
• 38:11So a bridge is an
• 38:13AI program
• 38:15that you download and you
• 38:17ask the patient if they're
• 38:18okay with you using it,
• 38:19and then you you take
• 38:21your history and
• 38:23it
• 38:24structures that as
• 38:26a perfect clinical note the
• 38:28way you've learned how to
• 38:29write a clinical note.
• 38:31And because it's got because
• 38:33it's AI, it's it's you
• 38:36know, you ask the patient
• 38:38whatever the questions. And on
• 38:39the way out the door,
• 38:40the patient says, oh, by
• 38:41the way, because it's always
• 38:42on the way out the
• 38:43door, I've been having chest
• 38:44tightness.
• 38:46You know? And it started
• 38:47when I was at my
• 38:48mother in law's, and now
• 38:49I can't my mother-in-law, you
• 38:50know, and and we were
• 38:51watching the football games, and
• 38:53you can can you believe
• 38:54that how badly the titans
• 38:55suck and you know, which
• 38:56they do. But
• 38:58and, you know, blah blah
• 38:59blah. And the note takes
• 39:01all that extraneous stuff out
• 39:03and writes the, you know,
• 39:05patient presents with the chief
• 39:06complaint of this. You said
• 39:08this. Here's the plan.
• 39:10And the we've we've started
• 39:11with a small pilot, but
• 39:13we're now extending it. And
• 39:14the faculty
• 39:15and clinicians who have used
• 39:17this have said it's a
• 39:18game changer.
• 39:20It's really improved the quality
• 39:21of their lives. They're not
• 39:23spending time at night writing
• 39:24notes.
• 39:25And so these are the
• 39:26kinds of things that we
• 39:27need to do,
• 39:29to to help our our,
• 39:31clinicians.
• 39:34We also change the way
• 39:35money flows
• 39:36between the health system and
• 39:38the school.
• 39:40That's really fun.
• 39:42If you wanna get people's
• 39:43attention,
• 39:45you change the way money
• 39:46flows. And it's I won't
• 39:47go into all the complex
• 39:49details, but I'll give you
• 39:50a little hint of what
• 39:52it was like.
• 39:54We used to have thousands
• 39:56of one off deals
• 39:57between
• 39:58the health system
• 40:00and the departments,
• 40:01often down to the physician
• 40:03level.
• 40:04I'm recruiting this person.
• 40:07They need this salary.
• 40:09They probably aren't gonna make
• 40:10this salary. They really wanna
• 40:11do this. Can you give
• 40:12me some of that?
• 40:14And
• 40:15they were at least written
• 40:16down.
• 40:19But
• 40:21they would make an agreement,
• 40:22and then maybe somebody would
• 40:23come behind and say,
• 40:25I don't think we can
• 40:26afford that. We're not gonna
• 40:28honor that agreement or whatever
• 40:29it was.
• 40:31And now we have a
• 40:32rational system, which very formulaic.
• 40:34It says, if you are
• 40:35this kind of physician,
• 40:37your your benchmark salary is
• 40:39this, your benchmark work product
• 40:41is that, and then we're
• 40:42gonna put in the academic
• 40:43pieces of it, the overhead,
• 40:45the whatever.
• 40:46And by the way, we're
• 40:47gonna give the school
• 40:49a percent of revenues to
• 40:50the health system
• 40:52to be used for academic
• 40:53program support.
• 40:55It's much more rational.
• 40:58It's changed. So, you know,
• 40:59it created a lot of
• 41:00anxiety because change is hard.
• 41:03But what we did last
• 41:04year was we ran that
• 41:05system
• 41:06and our old system in
• 41:07parallel,
• 41:09and we held departments harmless.
• 41:10We said, whichever in whichever
• 41:12system you come out better,
• 41:13we'll give you that you
• 41:14know, that's the amount your
• 41:15department will have this year.
• 41:17And what that allowed us
• 41:18to do is to see
• 41:19how test how the model
• 41:20worked and make a few
• 41:22tweaks, but it worked
• 41:24as expected. And, frankly, lots
• 41:26of people have done this
• 41:27before us.
• 41:29By doing that kind of
• 41:30model, you align
• 41:32goals.
• 41:33So now
• 41:35if you're a person seeing
• 41:36patients and the operating room
• 41:38isn't working,
• 41:40you don't have a perverse
• 41:41incentive where you're getting paid
• 41:43anyway even if it's not
• 41:44working and, you know, you're
• 41:45getting incentive anyway even if
• 41:47it's not working. You say,
• 41:50I really you know, I
• 41:51need to see patients.
• 41:52And the health system says,
• 41:55we really need to get
• 41:56patients in the door, and
• 41:58you're solving problems. So what
• 41:59we've seen is that we're
• 42:01seeing many more patients, and,
• 42:03and, actually,
• 42:05we're solving problems together because
• 42:06we've got those aligned,
• 42:08incentives.
• 42:09So that's been the success,
• 42:10I would say, is that
• 42:12it's functioning the way we
• 42:13predicted.
• 42:14We put processes in place
• 42:16to make it more transparent,
• 42:18and it's enhanced collaboration.
• 42:20But you learn things.
• 42:21One of the things we
• 42:22learned was our departments really
• 42:24didn't know how to do
• 42:24a budget
• 42:27because they just knew what
• 42:28their deals were,
• 42:30and they would say, I
• 42:32think I'll be able to
• 42:32negotiate for a little bit
• 42:33more next year. Let's see.
• 42:35I'll just add this much.
• 42:37And so now we're actually
• 42:38thinking about just as we
• 42:39do everywhere and you do,
• 42:42you know, at home, like,
• 42:43I have this amount, and
• 42:44I
• 42:45think I can increase
• 42:47the, you know,
• 42:49money that I'm bringing in
• 42:50by whatever. And here and
• 42:52here are our goals. Here
• 42:53are our priorities. Here's what
• 42:55we're gonna
• 42:56invest in. Something that the
• 42:57school has to do, the
• 42:58departments have to do. So
• 43:00we we need to learn
• 43:01how to do that better.
• 43:03Some of our,
• 43:06our departments had very archaic
• 43:08compensation plans,
• 43:10and they were they learned,
• 43:12like, wow. This is I'm
• 43:14not paying people fairly. I'm
• 43:16rewarding things that I don't
• 43:17wanna reward,
• 43:19and that was highlighted when
• 43:20the how the money came
• 43:21into them.
• 43:23It enhanced
• 43:24budgeting process, silly things that
• 43:26well, not silly things, but
• 43:27things that you don't need
• 43:28to, I think, at this
• 43:29point, really think about except
• 43:30to understand how complicated
• 43:32the world of health care,
• 43:34can be.
• 43:36So what are we doing?
• 43:37You know, I think we've
• 43:38finalized our strategic plan. We're
• 43:39now starting to build those,
• 43:41destination services.
• 43:43We have to make sure
• 43:44that patients can get in
• 43:45the door. If you advertise
• 43:46that you're doing this really
• 43:47cool thing and a patient
• 43:49calls and they can't be
• 43:49seen for six months, that's
• 43:51not gonna last very long.
• 43:53We're continuing to execute on
• 43:55population health, that clinically integrated
• 43:57network, and building primary care.
• 44:00We it may not be
• 44:02with faculty. It may be
• 44:03with those community docs or
• 44:05with Northeast Medical Group, but
• 44:06we are way underdeveloped
• 44:09in primary care in Yale
• 44:10New Haven Health System.
• 44:12Removing those barriers to operations,
• 44:14helping our clinicians
• 44:15feel better about themselves,
• 44:18getting the word out. And
• 44:19the things that we're doing
• 44:20in alignment,
• 44:21we can actually leverage in
• 44:24in other areas,
• 44:26including education.
• 44:27That aligned clinician enterprise has
• 44:29made
• 44:30primary care,
• 44:33clerkship
• 44:33or or clinical sites available
• 44:36that we didn't have before.
• 44:39The,
• 44:41in the past, our faculty
• 44:43had to do everything twice,
• 44:45get credentialed in the school,
• 44:46get credentialed in the health
• 44:47system. We can start to
• 44:49integrate that and take away
• 44:50some of the pain.
• 44:52So
• 44:53I went through all of
• 44:55the different areas, but coming
• 44:57back to this fundamentally,
• 44:58it all relates to this
• 45:00mission, right, which is, as
• 45:01we started,
• 45:03the school of medic of
• 45:04medicine educates and nurtures creative
• 45:06leaders,
• 45:07promoting curiosity and critical inquiry
• 45:09in an inclusive environment.
• 45:12The discovery and innovation piece
• 45:14that we talked about, that
• 45:15that's not done in isolation,
• 45:17but it involves
• 45:18our partners in the university,
• 45:20like in biomedical
• 45:22engineering to do, biomedical imaging,
• 45:24our local community who participate
• 45:26in the Yale Center for
• 45:27Clinical Investigation, and the world.
• 45:29And then, importantly, why this
• 45:29is a medical school and
• 45:30not a research institute?
• 45:32It's because we're all here
• 45:33fundamentally because we wanna make
• 45:38the health of individual patients
• 45:40and the health of our
• 45:41society better,
• 45:43and we need to do
• 45:44that locally as well as,
• 45:47broadly. And I think as
• 45:48we innovate in the health
• 45:50system,
• 45:51if we learn to do
• 45:52it well, we can export
• 45:54that to other academic health
• 45:55systems. So,
• 45:57I think we have pretty
• 45:58pretty good time for for
• 46:00questions, and I will stop
• 46:01talking and open it up.
• 46:15Okay. Thanks, Dean Brown. So,
• 46:17yeah, we can open it
• 46:18up to q and a.
• 46:19I'll just try to, like,
• 46:20pass the mic to whoever
• 46:21has questions so we can
• 46:22also get it on the
• 46:23people who might be on
• 46:24Zoom. So does anyone have
• 46:25any questions?
• 46:31I can go first as
• 46:32well. Takes a while, and
• 46:33then the damn breaks. Yeah.
• 46:35One of my questions was
• 46:36you talked about how, primary
• 46:38care is an opportunity for
• 46:40improvement for Yale.
• 46:41Just curious. Maybe you touched
• 46:43on it a little bit
• 46:43earlier, but,
• 46:44what sorts of things is
• 46:46Yale looking into to try
• 46:47to improve that? And, like,
• 46:48what are sort of some
• 46:49of the measures place to
• 46:50Yeah. Define that? You know,
• 46:51so, interestingly, we have in
• 46:51internal medicine a primary care
• 46:51program residency program. We graduate
• 46:51from that residency program more,
• 47:06physician trained in primary care
• 47:07than anywhere else in the
• 47:08country.
• 47:09We've never retained them.
• 47:11They're out in the community.
• 47:13And,
• 47:14I think it it was
• 47:15a
• 47:16a decision
• 47:17about the
• 47:21role of the medical school.
• 47:23And
• 47:24I think we again, the
• 47:26question of
• 47:28whether we build a huge
• 47:29primary care cadre within the
• 47:31school or as
• 47:33affiliates of the school is
• 47:34one we still need to
• 47:35think about. But we're graduating
• 47:37as people and just retaining
• 47:38them would go a long
• 47:39way.
• 47:40And most of the primary
• 47:41care providers in our community
• 47:42are our own graduates.
• 47:44So
• 47:46yeah,
• 47:53yes.
• 47:57Thank you.
• 47:59So you spoke about how
• 48:00we're doing a pretty good
• 48:01job at recruiting your IMs
• 48:03as associate or assistant professors,
• 48:05but, again, retaining them at
• 48:07the professor level.
• 48:09I'm curious if we have
• 48:10an idea of why that
• 48:12is,
• 48:13and what the strategies are
• 48:14to retain these faculty members.
• 48:17So,
• 48:18the the why there's attrition?
• 48:21Some of it is attrition.
• 48:22Some of it is just
• 48:23delay,
• 48:24so that
• 48:26we have to move people
• 48:27from assistant to associate to
• 48:28professor.
• 48:30I I would say
• 48:32a factor
• 48:33in general is that there
• 48:35is,
• 48:37unfortunately,
• 48:38competition among
• 48:40schools of medicine for the
• 48:41same small group of people.
• 48:43So we definitely have to
• 48:44continue
• 48:46at every point in the
• 48:47pipeline to retain. So even
• 48:49from high school to college
• 48:50and college to med school.
• 48:52Right? And then we're doing
• 48:53a lot of programs around
• 48:54that.
• 48:56One of the reasons that
• 48:57we did the faculty development
• 48:58annual questionnaire is the notion
• 49:00of what I call
• 49:02proactive retention.
• 49:04The academic model in the
• 49:06past has been
• 49:08you wait until somebody has
• 49:09got an offer from somewhere
• 49:10else,
• 49:11and then you rescue them
• 49:13back,
• 49:14which
• 49:15is crazy.
• 49:17Now sometimes you you you
• 49:19do that, but
• 49:20the reason that it happens
• 49:21that way is often we're
• 49:23not paying attention.
• 49:25And the idea of that
• 49:26faculty development annual questionnaire is
• 49:28that you're now having one
• 49:29on one meetings,
• 49:30and you're saying,
• 49:32this person is experiencing that
• 49:34obstacle. I didn't know about
• 49:35it. I need to invest
• 49:37now in removing that obstacle.
• 49:40And what happens is you
• 49:41show the person that you
• 49:42value them.
• 49:44You
• 49:45create also
• 49:46a a sense of,
• 49:49loyalty and pride in the
• 49:50institution.
• 49:51And so that is much
• 49:53more effective in and if,
• 49:54you you know, if you
• 49:55do that all along the
• 49:56way,
• 49:57it's probably still,
• 49:58you know, maybe the same
• 50:00amount of money, but it's
• 50:01much more effective than those
• 50:03throwing those huge packages when
• 50:04somebody's on their way out
• 50:05the door.
• 50:13I can ask another question.
• 50:15Yeah.
• 50:16So thanks for sharing the
• 50:17numbers on,
• 50:19the number of students that
• 50:20were from underrepresented backgrounds in
• 50:21medicine in the class of
• 50:22twenty twenty eight. So I
• 50:23was just curious,
• 50:24given the Supreme Court decision
• 50:26on affirmative action, what do
• 50:27you think about the Yale
• 50:29recruitment and admission process allowed
• 50:31us to still admit so
• 50:32many students or or present
• 50:34that as an emphasis. Really
• 50:35doubled down on that outreach
• 50:36piece,
• 50:37both before and after,
• 50:40the process. So
• 50:42making sure that the pool
• 50:43of applicants was diverse, and
• 50:45then
• 50:46once people had been admitted,
• 50:47making sure that they saw
• 50:50what was so special about
• 50:52Yale School of Medicine. So
• 50:53we had more people at
• 50:54second look, and many of
• 50:55you, thank you, participated in
• 50:56that.
• 50:58And,
• 50:59I think that's what we
• 51:00need to do. We've got
• 51:01a very good story to
• 51:02tell. You guys are fantastic,
• 51:03and we just need to
• 51:04let people
• 51:15see it.
• 51:18Thank you for your talk,
• 51:19and congratulations
• 51:20on the fifty million march.
• 51:22I was wondering,
• 51:24what the plans are for
• 51:25the newly found
• 51:27new money.
• 51:31So we have already
• 51:34some of that ability to
• 51:36reduce the
• 51:38debt this the the last
• 51:40two years to ten thousand
• 51:41dollars comes from that money.
• 51:44We are using it to
• 51:45support,
• 51:46as I said, the predoc
• 51:47and post the gaps in
• 51:49the predocs and the postdocs.
• 51:51Those are probably the two
• 51:53biggest,
• 51:54pieces.
• 51:58You never have as much
• 51:59money as you have good
• 52:00ideas.
• 52:07Yeah. Thank you for the
• 52:07presentation.
• 52:09So I see you,
• 52:11yield is trying to incorporate
• 52:14AI into
• 52:16medicine now. So is there
• 52:17gonna be
• 52:18an avenue in the future
• 52:19for medical students to or
• 52:21to incorporate,
• 52:23AI data science and
• 52:25medical education? Yes.
• 52:28And so so Jessica,
• 52:30there's a new role in
• 52:32technology,
• 52:34that we're recruiting for,
• 52:36because we have to we
• 52:37have to there are lots
• 52:38of things I think we
• 52:39need to do. There's the
• 52:43there's the how do you
• 52:44do AI, which I think
• 52:45is pretty simple.
• 52:47But there's the critical thinking
• 52:48aspect of it, which is
• 52:51how do I know if
• 52:52it's right?
• 52:53You know, we've spent a
• 52:54lot of time over the
• 52:55years teaching students how to
• 52:56read papers.
• 52:58We now we need to
• 52:59develop the science around how
• 53:01do I assess the accuracy
• 53:02of this,
• 53:03how do I know if
• 53:04it's biased, if it's been
• 53:05trained on a biased set.
• 53:08As you can imagine,
• 53:10you know,
• 53:12a a a a dataset
• 53:13trained on a very homogeneous
• 53:14population
• 53:15then applied in a very
• 53:17diverse population
• 53:18could actually cause harm.
• 53:20And so we need the
• 53:21science,
• 53:22which is mostly what I
• 53:23talked about of how you
• 53:24develop that, but as we
• 53:25need to help our students.
• 53:27And I think, like all
• 53:29good things in education,
• 53:32you are learning
• 53:33at a very fast rate
• 53:34and bringing different things than
• 53:37I think if the formal
• 53:38curriculum will will bring. But
• 53:40we need to make sure
• 53:40that we're,
• 53:42informing that with,
• 53:45principles.
• 53:47Thank you.
• 53:59Okay. If there's no other
• 54:00questions, we can thank Dean
• 54:01Brown.