The State of the School

Among the many items Dean Robert J. Alpern, M.D., discussed with alumni at this year’s reunion weekend were the School of Medicine’s insatiable need for laboratory space, innovations in medical education, a new trend in collaborations with drug companies, the implementation of an electronic medical record, the pending merger between New Haven’s two hospitals, and expansion of the clinical practice. The news and the state of the school, he said, are good.

“I think you’re going to like what you hear,” said Alpern, Ensign Professor of Medicine, in his State of the School address.

The School of Medicine, he said, continues to attract the best students, who move on to top residencies around the country. Despite the rising costs of medical education, the average debt of Yale graduates has held steady at about $110,000, below the average of about $160,000 for private medical schools. A strategic review of the curriculum is under way, with a focus on rewarding excellence in teaching. To that end the school recently opened the Teaching and Learning Center to provide faculty with resources. The center will offer workshops on pedagogy, curriculum, and assessment; create new assessment methods in line with the Yale system; develop instructional websites, interactive applications, and other digital technologies to support education; and train faculty in use of standardized patients or role plays.

The school also recently upgraded urology from a section to a department. “We felt it was a discipline that needed to be expanded so we decided to make urology a department,” Alpern said. Peter G. Schulam, M.D., Ph.D., a professor of urology and vice chair of the department at UCLA, was recruited as chair.

Alpern also offered a vision for the school’s clinical practice—to become a leading referral group known regionally and nationally for standard-setting care, access to cutting-edge clinical trials and treatments, and a broad state and regional network of physicians. The clinical practice is already growing in many areas. “When I got here we were doing three liver transplants a year. Now we’re doing 40. We’re the leading liver transplant program in the Northeast,” he said. “We have a great cancer program. The fastest part of the growth of the medical school is the clinical practice.”

Affecting that practice will be the impending acquisition of the Hospital of Saint Raphael by Yale-New Haven Hospital (YNHH). Various state and federal agencies have approved the merger, Alpern said. The expected benefits include increased patient capacity, economies of scale, and improved financial performance.

Both hospitals will share in Epic, an electronic medical record now being implemented at YNHH and at Yale, at a cost of $250 million. The first clinical practice went live in October 2011; YNHH and its affiliated hospitals will all be using the system by June 2013. “We feel this was the right decision,” Alpern said. “Every hospital in the health system, every doctor in the medical school, most of the doctors in the community, all will be on one electronic medical record. This will really improve care.”

Turning to basic science, Alpern noted the 2009 opening of the Yale Center for Genome Analysis, a core facility established jointly between the medical school and the university. “We are now able to sequence 15 trillion base pairs per month,” he said. The NIH, he added, recently funded the Center for Mendelian Genomics at Yale, one of only three in the country. “We feel that we have become a national leader in genomics.”

The medical school has also turned to alternative sources of research funding, given a flat NIH budget and uncertainty about the country’s economic and political direction. Last year Yale reached an agreement with Gilead Sciences, under which the drug company will provide up to $40 million over four years to fund research into cancer therapies. The collaboration could continue for 10 years, with funding of up to $100 million. Gilead has the right of first refusal to license findings for drug development, but Yale retains the intellectual property rights.

The school is increasing its ability to perform research by adding new laboratory space or renovating existing space. Since 1991 new buildings have added about 460,000 square feet of space to the medical campus. About a half-million square feet in existing buildings have already been renovated, with about 85,000 square feet in existing buildings awaiting renovation.

These advances in education, clinical practice, and basic research support the school’s three missions, Alpern noted. “We want to continue to be a school that seeks new knowledge in the service of humanity,” Alpern concluded. “That is what we do—we teach, we discover, and we care for patients.”