To the YSM Community:
“If you build it, they will come.” So is the line from the 1989 movie, “Field of Dreams” often misquoted. In the film, the character Ray Kinsella, played by Kevin Costner, hears a voice whispering, “If you build it, he will come,” referring to the baseball player “Shoeless” Joe Jackson. In any case, the line speaks to the necessity of believing and taking risks to accomplish something worthwhile. When faced with adversity or obstacles it can be easy to give in to negativism. Yet, as one of my former chairs used to say to faculty when we were feeling daunted about designing a new clinical or educational program or achieving a fundable score on a grant, “You have to plan for success.”
Each year in the spring, we create a budget for the coming academic year. Each fall, we prepare a long-range, 10-year financial projection in which we forecast expected trends in revenue as well as expected expenses in the context of our strategic goals and investments. As part of this exercise, we project our revenues over the next 10 years based on historical growth rates, the impact of changes such as funds flow, and environmental factors. We also model expenses based on recent investments and anticipated rates of growth in our academic missions, as well as continual efforts to enhance efficiency. Lastly, we model a crisis scenario and potential mitigation strategies—imagine planning for the financial consequences of the next pandemic. We present this projection to the provost and a faculty budget committee and review it with the Yale Corporation’s School of Medicine Committee in an annual presentation of strategy.
It was during the preparation of the long-range plan this month that the expression, “If you build it, they will come,” came to mind. Over the last several years we have made significant investments in physician-scientist development; supporting time for educators; supporting graduate students and postdoctoral fellows; recruiting rising stars and leading clinicians and scientists; revamping the Master of Health Sciences; creating a new department of Biomedical Informatics and Data Science; building resources in imaging (small- and large-scale), core technologies, clinical research infrastructure, and tools for artificial intelligence; and creating an aligned clinician enterprise, to name a few. We have much more to do as we realize our strategic plans in education, research, clinical care, and DEI, and we anticipate even bigger investments as we engage in the master space planning process, build out 101 College, and receive approval to solicit designs for a possible new Yale School of Public Health and Yale School of Medicine building at 35 College Place.
Each of these investments involves risk, yet we are already starting to see the return on these investments. YSM clinical revenues grew by 11.6% in FY24 (and those of Yale New Haven Health System by 8.8%) under the new funds flow model. Thirteen of 20 clinical departments realized an increase in clinical margin over the prior funds flow model or year-over-year, and we expect the remaining departments to thrive based on adjustments to the model. Growth in clinical volumes reflects enhanced access for patients and yields increased academic program support. In addition, income from grants and contracts grew 13.2% year-over-year in FY24, and faculty garnered support from exciting new sources, such as the Advanced Research Projects Agency for Health (ARPA-H) and the Chan Zuckerberg Biohub NYC. Support from the Starr Foundation, alumni, and other donors enabled the school to increase the number of medical students eligible for financial aid and the capping of their annual unit loan of $10,000, and the quality and diversity of our enrolling class remains high while applications have increased 12% this year.
We have great aspirations for the future. In addition to the initiatives above and as described in the July Beyond Sterling Hall, we are working to garner increased endowment funding for graduate students and postdoctoral fellow positions, expanding support for clinician-scientist development to incorporate proceduralist scientists, and enhancing the clinical practice environment to restore the joy in caring for patients. As we continue to build, it is gratifying to see our school come (together). No doubt there will be unexpected hurdles, but we will continue to plan for success.
Sincerely,
Nancy J. Brown, MD
Jean and David W. Wallace Dean of Medicine
C.N.H. Long Professor of Internal Medicine