Preparing for the next century of pediatric excellence

Yale School of Medicine's Department of Pediatrics has played an integral role in establishing and boosting the medical school’s culture of cooperation, diversity, and interdisciplinary research. Nancy J. Brown, MD, the Jean and David W. Wallace Dean of Yale School of Medicine and C.N.H. Long Professor of Internal Medicine, discusses the present and future of pediatrics.

What role does pediatrics play in driving interdisciplinary work and collaboration at Yale?

Increasingly, the medical community has focused on understanding the importance of early life in determining health outcomes across a person’s lifespan. That requires collaboration in terms of clinical care and in terms of research. From Ob/Gyn to pediatrics to adult medicine, our goal is to understand the genetic and environmental determinants of health. It all springs from a life’s beginning.

One of the keys to tracking health care is at the transition in care between pediatrics and adults. We’ve made impressive progress treating diseases, such as cardiac anomalies and cystic fibrosis, that were once fatal in children; now, those same children live into adulthood. How do we bridge that and care for those patients as they lead successful and fruitful lives?

It requires a great deal of collaboration between fields and physicians who in the past may not often have worked together.

Similarly, in mental health, many diseases become manifest in childhood. They reflect the environment and genetic factors. There’s a need to work with our community partners as well as with adult psychiatry. Those are a few examples.

Which research initiatives stand out as being areas of strength for Yale School of Medicine’s Department of Pediatrics?

The Department of Pediatrics has a robust history in the area of type 1 diabetes, both in understanding disease mechanisms and in developing new treatment paradigms, such as closed-loop insulin pumps. Pulmonary work around cystic fibrosis is a strong area. And the work we do with our Department of Genetics in terms of identifying rare disorders early, sometimes as early as in the neonatal intensive care unit, is quite robust.

What are your general thoughts about pediatrics at Yale and the arc of pediatrics in the United States?

Pediatrics as a specialty has always been about the whole human being. It’s about normal development as much as it is about disease—caring for our children in a way that maximizes their chance of leading a healthy, long life and succeeding; reaching their potential in school and eventually as fully formed adults. Pediatrics has a collaboration with Yale Child Study Center that is unique to Yale. That is a mission for pediatrics, and Yale has excelled at this. And, recently, in a more intentional way, the department is considering and promoting health equity.

What are some of the initiatives and plans the School of Medicine has for the Department of Pediatrics?

The Department of Pediatrics is adding to its academic excellence. Recruiting superb leaders in areas including immunology, oncology, neonatology, and neurology has been extremely important. Along with an emphasis on leadership, we have a commitment to grow the cadre of young physician-scientists in the department who are contributing to discoveries.