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Beyond Sterling Hall

Beyond Sterling Hall is a regular message from Dean Nancy J. Brown about ongoing initiatives at YSM.

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Yale School of Medicine should be an academic home where women and underrepresented in medicine (URiM) faculty, staff, and students thrive, and where diversity and excellence are inextricably linked.

Dean Nancy J. Brown
Any medical school dean will tell you that the white coat ceremony, “Match” day, and graduation are highlights of the academic year. Days of joy, these rituals enable us to take time out from the routine and appreciate the talent, excellence, and ideals of our students.
Even as our Yale School of Medicine community has modeled respect and civil discourse, we suffer when acts of hatred affect our larger community. When we bear witness to the darker aspects of humankind, we must pause to regain perspective and to live according to our highest values. As members of Yale School of Medicine, our commitment to the pursuit of discovery, as well as our student and professional oaths, require that we engage in inquiry, acknowledge each person’s humanity, and honor life. As a school, we will not tolerate any form of hatred.
In July 2023, we introduced a new funds flow model between the Yale New Haven Health System (YNHHS) and Yale School of Medicine (YSM).
On Jan. 17, 2024, Provost Strobel shared university-wide efforts “to explore and consider strategic opportunities for AI at Yale.” The provost invited deans to convene panels of faculty from diverse disciplines who are engaging in artificial intelligence (AI) to brainstorm on school-specific approaches to develop and harness new AI technologies to have an impact on discovery, education, and practice.
The last two months have highlighted the importance of tending to the well-being of our community. This Beyond Sterling Hall provides an update on recent progress in developing and supporting a culture of well-being at Yale School of Medicine (YSM).

We had planned this Beyond Sterling Hall as an update on several initiatives aimed to promote well-being among the members of our Yale School of Medicine. We will do so soon, but instead I feel compelled to pause and to consider how we support each other as a community in the wake of heinous acts by the terrorist group Hamas, even as we acknowledge that members of our community hold widely disparate views on the response to those acts. We share a common grief over the loss of innocent lives. 

I live in New Haven. One of the joys of returning to Yale in 2020 has been the unexpected pleasure of living in New Haven. I often walk to and from work or to after-work events. An evening constitutional clears the mind.
The last two years have seen dramatic progress in our alignment efforts. In January, Dr. Margaret McGovern assumed leadership of the Aligned Clinician Enterprise. Effective July 1, we launched a new, formulaic, and rational model for funds flow between Yale New Haven Health System (YNHHS) and Yale School of Medicine (YSM). Today, we write to provide an update on joint strategic planning efforts.

Department chairs, deputy deans, Yale New Haven Health System (YNHHS), and university leaders once again gathered in June to reflect on the direction of our school and academic health system.

I recently had the opportunity to speak with participants in the Advanced Emerging Leaders Program, a leadership program developed through a collaboration between Yale Medicine (YM) and the Yale School of Management.

During our recent Yale School of Medicine (YSM) department town halls, we have been discussing the progress on our journey to closer alignment between YSM and Yale New Haven Health System (YNHHS).

In the coming months, we will learn the Supreme Court decisions regarding race-conscious considerations in undergraduate admissions in the cases of Students for Fair Admissions v. President and Fellows of Harvard College, and Students for Fair Admissions v. University of North Carolina. We need not wait for these decisions to reaffirm the strong commitment of Yale School of Medicine (YSM) to diversity and inclusive excellence.

As I near my third anniversary as a member of the Yale School of Medicine community, I have been reflecting on all that we have accomplished, as well as all that we have yet to do. You–our students, faculty, and staff–amaze me every day with your intellect, your thoughtfulness, and your commitment to our missions.

In March, we articulated our commitment to align Yale New Haven Health (YNHHS) and Yale School of Medicine (YSM) to realize our full potential as one of the nation’s premier academic health systems. The imperative for increased alignment stems from our recognition that we must put the needs of our patients first, above all other considerations. Today, our patients struggle to access our services and to understand and navigate our complex organizational structures. They deserve the best from us, and we are focused on creating and delivering this patient experience.

As Thanksgiving approaches, I cannot help but reflect on how grateful I am to be part of Yale School of Medicine. We are surrounded by extraordinary people who come together to advance the most compelling mission of caring for people while advancing knowledge and health.

Last week, Jewish members of our community marked Yom Kippur, the Day of Atonement. As someone who was raised in another faith and came to Judaism as an adult, I have often been struck by the power of the communal acknowledgement of shortcomings on Yom Kippur. Acknowledging one’s flaws together is intended to lead to a renewed commitment to repairing ourselves and our community. It is in this spirit that I share with you the results of a recent survey conducted at the medical school related to faculty, student, and staff engagement, inclusion, and belonging. The university will soon share the results of a university-wide faculty survey conducted in the fall of 2021.

Academic medicine is sometimes described as a three-legged stool, balanced on the legs of three missions–education, research, and clinical care. I would make the case that our stool has four legs, with the fourth being people development, encompassing not only the education of our students and trainees but also the career development of our faculty and staff. People development is about creating an environment where all can thrive, and it is the underpinning of our strategic plan for diversity, equity, and inclusion. 

It’s been a quiet month in Lake Wobegon… not so much in Yale School of Medicine (YSM). Nevertheless, in the third week of June, department chairs, deputy deans, Yale New Haven Health System (YNHHS), and university leaders gathered off campus to reflect on the direction of our school and academic health system. Although we have convened before during the pandemic, this retreat felt different—like a homecoming and a new beginning at once.

As we anticipate (and even preview) the Supreme Court's decision on Dobbs v. Jackson Women’s Health Organization, I want to take a moment to articulate the communication guidelines of the Yale School of Medicine (YSM) dean’s office and the rationale behind them.

Today, as we mark a leadership transition at Yale New Haven Health System (YNHHS), we write as dean of Yale School of Medicine (YSM) and chief executive officer of YNHHS, to affirm our shared commitment to align further our two institutions to realize our full potential as one of the nation’s top academic health systems.

Earlier today, President Salovey, Provost Strobel, and I met with the faculty, students, and staff of Yale School of Public Health (YSPH) to share the plans for the search for a new dean and the decision to transition YSPH to become an independent, self-supporting school. We anticipate this transition will occur within a year of the appointment of the new dean.

February 1 marks my second anniversary at Yale. Two years ago, we published the first Beyond Sterling Hall, “Listening.” Since then, I have been buoyed by our listening sessions and continue to learn from you. I am humbled by your excellence and your commitment to your work. I am also continually reminded how difficult it is to communicate effectively

The SARS-CoV-2 pandemic has reminded us of the power of rigorous observation, critical thinking, and scientific discovery. We have witnessed how the application of basic discoveries made over many decades can culminate in the rapid development of vaccine technology. Lessons we have learned about the immune response to SARS-CoV-2 have shifted our understanding of chronic diseases such as diabetes, obesity, and hypertension.

During this month of Thanksgiving 2021, I am drawn to reflect on the meaning of philanthropy. On October 2, Yale University unveiled the public phase of a $7 billion capital campaign. The title of the campaign, For Humanity, may seem like hubris to some. Rather it is meant to convey that the work we do here must have impact far beyond Yale. It captures the meaning of the word philanthropy, from the Greek “phil,” love, and “anthro,” human.

A couple of weekends ago, several people sent me this column by our faculty member and NY Times writer Lisa Sanders. There is so much to love about this story. In its telling, Dr. Sanders captures what it means to be a teaching hospital and academic health system. She celebrates the commitment of our faculty, staff, and trainees to the value of human life and the tenacity with which they ask questions and apply their diagnostic acumen in the pursuit of saving lives.

This story further reminds us of the centrality of our clinical work to the realization of all our missions. I do not simply mean that revenue from the clinical enterprise supports our education and research missions, although this is true. Rather, the story highlights the critical role of the hospital and clinic in teaching analytical thinking as well as diagnostic and therapeutic strategies to our undergraduate and graduate medical trainees. Clinical observations inform discovery, and the partnership between Yale School of Medicine and Yale New Haven Health System enables us to offer our patients access to cutting edge diagnostics and therapies made possible by research.

Each year when I was chair of a Department of Medicine, the residency program director and I would shake our heads when we reviewed the resident survey and came to the question regarding how often residents received mid-rotation feedback. Whatever we tried, we struggled to increase the proportion of residents who answered positively. We developed courses in evaluation for core faculty. We conducted our own surveys, and there we discovered a disconnect. When surveyed, 80% of faculty said they provided feedback mid-rotation. Twenty percent of residents said they received feedback mid-rotation.
Last week the graduating Class of 2021 took an oath as they became physicians. They expressed the conviction that “all humans are deserving of our highest degree of care,” regardless of “ability, age, beliefs, ethnicity, gender, nationality, race, religion, sexual orientation, or socioeconomic status.” They vowed “to respect all patients, including those who hold beliefs that contradict our own.” Each day the members of our community live that oath, whether they care for patients, educate students, advance discovery, or create and maintain the infrastructure that makes this work possible. For this reason, it saddens me when an event appears to undermine our values.
A little over a year ago we faced an uncertain financial future. In the fiscal year ending June 30, 2020 (FY20), Yale School of Medicine had suffered a significant decline in clinical revenues, as we decreased the number of surgeries performed to create bed capacity for COVID-19 patients and reduced face-to-face outpatient visits due to a shortage of testing and masks. A year later, many of you have asked how we are doing. The short answer is, “We are okay.”
A recent conversation with colleagues in the Faculty of Arts and Sciences caused me to reflect on our education mission at Yale School of Medicine, and the significance that education and lifelong learning are embedded in all that we do, including our research and clinical missions.
In January, in a reflection on discipline, I shared that, “To hold ourselves accountable, we must also become comfortable with sharing data about our performance.” As I have been considering the many ways in which we measure ourselves, these lines from the Harold Ramus film, Caddyshack, came to mind (an occupational hazard of having raised three sons). In his glib response, Ty Webb (Chevy Chase) captures the pitfalls of comparisons, but also the absurdity of striving to improve without measuring progress.
Sometime during our training most physicians have experienced a “bad code.” Clinicians from four corners descend upon a room to resuscitate a patient, but it does not go as planned. Perhaps the leader does not communicate effectively. Others in the room deviate from their assigned tasks. Without coordination, despite their individual expertise and sense of purpose, the group never becomes a high-functioning team. In the research setting, an analogous lack of rigor or attention to detail, while not life threatening, can lead to wasted resources, irreproducible results, and misleading data that sets discovery back. In both cases, the culprit is a lack of discipline.
The SARS-CoV-2 pandemic serves to remind us of the importance of science. In the last week, clinicians and other health care workers began receiving mRNA vaccines against SARS-CoV-2. Such a strategy would not be possible without the basic science that defined the role of mRNA, elucidated the function of RNA polymerase, allowed for the isolation and sequencing of the viral genome, or identified modifications to make RNA less immunogenic.
As the days grow shorter and we face an increase in the number of SARS-CoV-2 (COVID-19)-positive patients in the hospital, our patience with this pandemic grows thin. Those who come to campus every day to care for patients, teach students, or conduct research may find some solace in human contact and witness progress in the environment around them. For our staff and faculty who are working remotely, however, it may be hard to appreciate how your efforts are contributing to the ongoing evolution of our school.
The fall is upon us and in less than two weeks the general election. In a time of uncertainty, anticipation of various potential outcomes can create anxiety. Some may feel that they do not have control over their future.
I hesitated to write about something this personal in Beyond Sterling Hall, but the value and importance of letting our faculty know that they are not alone and that they will succeed as they juggle work with child care or elder care through the COVID-19 pandemic compelled me to share my personal experience.
Today I would like to review the research strategic planning process ongoing at Yale School of Medicine.
Yale School of Medicine should be an academic home where women and underrepresented in medicine (URiM) faculty, staff, and students thrive, and where diversity and excellence are inextricably linked.
This week we have been confronted by the image of a white police officer holding his knee on the neck of a fellow human being, a Black man named George Floyd. The image invokes the most visceral of emotions, sickness, shock, anger, and for many in our community fear for themselves and for their loved ones. It follows on a series of disturbing events, including the shootings of Ahmaud Arbery and Breonna Taylor.
“Whan that Aprille with his shoures soote the droghte of Marche hath perced to the roote ... .” So wrote Geoffrey Chaucer in the prologue to The Canterbury Tales nearly 700 years ago. Spring has amazed and comforted us since the beginning of humankind. Yet, somehow the sight of daffodils and trees in bud has never seemed more startling and welcome than this year, as we experience the first downturn in the number of COVID-19 cases and anticipate our emergence from this long winter.
Pride, humility, gratitude—these are a few of the emotions I have been feeling lately as I witness the response of our faculty, staff, and students.
We named this monthly missive “Beyond Sterling Hall,” to convey that YSM extends far beyond an administrative building or our laboratories. Today I would like to convey the ways in which our faculty, staff, and students are rising above COVID-19 and share the work that is continuing to move us forward as a school of medicine.
The months leading up to my arrival and my first six weeks as dean of Yale School of Medicine (YSM) have been both exciting and eventful. The many meetings I have had with leadership, faculty, staff, and students—including a series of ongoing small group listening sessions with these groups—have given me a unique perspective on what makes the school so special, as well as some of the opportunities we have to excel even further.
As outlined in the three climate committee reports posted on January 23, 2020, the Academic Leadership Committee proposed that effective leaders are guided by the values of integrity, reflection, and communication; diversity and inclusion; generativity; discovery, innovation, and scholarship; and building an engaged and productive community.
Sixty-five meetings and 42,000 steps. Thank you to all who have welcomed me to your departments and offices over the last few months as I have begun to learn about Yale School of Medicine (YSM) prior to my arrival this week.
Sixty-five meetings and 42,000 steps. I have had the opportunity to meet with many faculty members over the last few months as I have begun to learn about Yale School of Medicine (YSM) prior to my arrival this week. I am grateful to Dean Alpern for his leadership and graciousness during our transition.