Welcome, to all of you!  It is heart-warming to look out at so many Harvard Medical alumni, knowing how much impact you are all having across the country and around the world — in clinical settings, patient care, research, and in leadership capacities in hospitals, academia, industry, and government. As I have said in the past two days to the new graduates and to the Alumni Council, I am deeply honored and exhilarated to find myself at the helm of such a distinguished institution, with a truly august history, and with all of you to its credit. 

Today I’d like to talk a bit about the School’s future by highlighting some of the major milestones of the past year —all of which point to an exciting and vital path for Harvard Medical School and for medical education and innovation more generally.

I am extremely energized to be in this place at this time: we are in the midst of a true revolution in biomedical research and discovery, and we are making great strides in accelerating the translation of our discoveries and insights into basic science in meaningful clinical advancements in patient care.

In this invigorating environment, we are also deeply focused on providing our MD students the best possible experience. 

I am thus thrilled to be able to share with you some of our recent accomplishments so that you will have a sense of the excitement we feel, our priorities as we chart our course, and our hopes for an ever-more-meaningful impact in education and research, our two core missions. 

I will bring you up to date on three things in general:

The results of the curriculum reform that Jules Dienstag and a team from across the School initiated several years ago, and additional developments in our efforts to make medical education, and graduate education here, even better.

The strategic planning process that many of you have been hearing about, I hope, and the priorities that are emerging from this important  planning process will be discussed.

Curriculum
First, to say a few more words about the curriculum. As you probably know, we are now in the second year of our New Integrated Curriculum, and the two classes that have entered since the summer of 2006 have enjoyed many exciting innovations, including training courses at the outset that help them make the transition from “civilian student” to professional and physician-in-training.

We have more integrated basic science courses, and a series of completely new course offerings in areas of social medicine, health care policy, human development, and clinical epidemiology and population health.

In addition, we have created an entirely new paradigm of core clerkships, in which students spend a full year at one of our teaching hospital sites. You might be viewing that as somewhat different from what you remember, and it would be different. After four years of pilots, this Principal Clinical Experience is now adding valuable and valued longitudinal mentorship and advising to our already excellent clerkships — and it’s really that longitudinal mentoring and advising that plays a central role  in this new program.

This experience integrates the multidisciplinary, problem-based curriculum while also reinforcing  basic and population sciences; it provides a single-preceptor ambulatory experience; and, more subtly but  more palpably, a longitudinal identification with a group of committed faculty and the hospital itself. The Principal Clinical Experience is now fully implemented, enthusiastically embraced, by students and faculty alike, and highly visible as a model for other schools. 

We have reengineered the fourth year to begin earlier, during the spring of the third year. This extra time will to give students opportunities for sub-internships  or other clinical experiences at hospitals other than their Principal Clinical Experience sites, and will provide both more guidance and more structure to the year.   

We’re also planning a capstone course  just prior to graduation, which will reinforce concepts of professionalism, review important basic science concepts that underlie the practice of medicine, and provide practical preparation for our students’ imminent residencies.

Another pillar of educational reform at HMS has been the recommendation that all students participate in an in-depth scholarly project.  This has been challenging to implement because of structural and financial barriers, but we are now hoping to implement this new requirement for the class entering in 2009. 

The consensus amongst our faculty is strong that stimulating our students to pursue a problem in depth — whether it be basic science, patient-oriented investigation, or any one of a broad range of choices that relate to medicine in society — with a close faculty mentor will serve several purposes: to model the inquisitive physician; to embed the discipline of inquiry as a continuous and seamless part of medical education and practice; to provide students with an experience in how to address unanswered questions; and to yield graduates capable of deep reflection, one of the cornerstones of future leadership.  Again, this project enjoys tremendous enthusiasm from students and faculty.  

Overall, the changes have helped integrate courses and clerkships across the curriculum; have brought together clinical medicine with basic sciences and population sciences such as health policy, social medicine, and global health; and have helped reenergize the faculty. These initiatives, plus our innovations in faculty development and compensation and our important work to reduce student debt – which I’ll mention again in a moment -- are helping transform “business as usual” in medical education at HMS!

Strategic Planning
Business hasn’t been as usual in other major aspects of the School, either. Last fall we embarked on a major strategic planning initiative with the goal of taking an honest look at where we stand as a medical school today and comparing this against our highest aspirations for our School some 10 to 15 years down the road. Although HMS has engaged in strategic planning processes in the past, I felt that now the time was particularly favorable for a broad and deep effort.

To this end, one of the first decisions I made upon becoming dean was to freeze all faculty recruitments on the Quad until we had a better handle on how to move forward together strategically. I then assembled an impressive group of deeply dedicated and creative faculty and staff who have been engaged in an amazing process of brainstorming for the past seven months.

Actually, I received my one standing ovation when I announced to the faculty group that we would not be doing this with consultants. In fact, I’m quite glad that we made that decision. Not only did we save about $3 million, but we really got the help of our faculty and staff in a way that might not have happened otherwise. Their charge was to think expansively about what the School might do better, where we could best make our mark and be ahead of the curve in innovation and discovery. [And my apologies to the consultants among our alumni here – we do use you quite a bit.]

We have distributed the work of strategic planning across four advisory teams: Education, Biomedical Research, Tools and Technology, and Social Sciences and Global Health. In addition, we created a steering committee made up of the chairs of the advisory teams and other thought leaders from the school and across Harvard University. This group has been very active and of enormous assistance to me in guiding our thinking about the process.

So far, more than 100 faculty from across the University and hospital communities have participated in this planning process. Harvard President Drew Faust has been extremely supportive of this endeavor and recently attended one of our steering committee meetings. I am happy to report that she was as impressed with the extraordinary energy and level of engagement as I have been throughout the process! Based on her interim assessment, President Faust has provided an initial and substantial investment of University funds in support of our planning efforts, and has promised that this was just an initial down payment.

Since the goals of our strategic planning process have been to be broad, inclusive, transparent, and forward thinking, we have kept the community involved at every step. One aspect of this inclusion has been our strategic planning website, which contains all of the white papers that have been produced from the advisory groups, including articles on neuroscience, human genetics, immunology, therapeutics, imaging, microbial science, culture and community, and others. The site also has an active section for questions and suggestions and has received more than 10,000 unique hits. I invite you all to visit it and send in your own comments. And also feel free to send them directly to me.

Among the many excellent ideas from this process, I would like to share a few of the priorities and give you a preview of where I believe our greatest energies will lie in the months ahead.

Education
In the area of education, I would like to make four brief points. One of my greatest desires as dean has been to address the serious problem of student indebtedness.  To that end, earlier this year we announced a major financial aid initiative that eliminates the parent contribution for families with a total income of $120,000 or less.  The initiative affects approximately one-third of the total student population and marks a 33 percent increase in financial aid spending by  Harvard Medical  School. I hope and expect that this will be the beginning of an even more ambitious effort in the arena, and I am extremely grateful for the support of the alumni fund in helping us accomplish our most ambitious goals to reduce student debt.

To produce global leaders with top-quality credentials who have expertise beyond a strictly medical education, we are seeking to broaden the MD curriculum with joint degree programs with other Harvard schools, including the Business School, the Kennedy School of Government, and the School of Public Health. Our first graduate from the MD/MBA program has just received his degrees in the last couple of days.

To promote more scholarly research, we will be instituting a New Pathways Investigator Program, which will allow students to spend an additional year doing in-depth research.  Students accepted into this program will also be eligible, if they meet certain requirements, for  Master of Medical Science degree. 

I should also mention that students will not be charged tuition during this year, but rather will receive a living stipend. Even at this moment, 50% of our students take a fifth year to expand their horizons and test potential career paths. This new program will provide greater school support, on all levels, for them to succeed at the highest level. As I discuss this with some of our current students, they want it to be instituted so they can take advantage of it.

Finally, to help reinvigorate the culture of great teaching at HMS, the School’s promotion criteria now include teaching as one possible area of central excellence. The Education advisory group also encourages enhancing an Academy Center for Teaching, Learning, and Assessment that will focus not only on medical education, but also on graduate and postgraduate training.

Research
In research, I would like to mention three areas in which I believe HMS is poised to have tremendous impact.These are among the top priorities emerging from our strategic planning process: human genetics, neuroscience, and therapeutics. 

HMS is at a tipping point with regard to human-centered research; we have energy and momentum behind some of the most brilliant scholars whose research will improve human well-being. I am actively engaged right now in discussions about the design of an Initiative in Human Genetics. Harvard-wide in scope, but anchored at HMS, the initiative will bring faculty from across the hospitals and the University together to build a world-class curriculum in human genetics, which right now is lacking, and to provide leadership, focus, and resources that will aid in drawing top talent in the area of human genetics to the Harvard Medical Community. This is an area where we already lead, but we are much less than we could be.

We are recruiting a new chair of Neurobiology, whose directive will be not only to focus on the outstanding Quad Neurobiology Department, but to foster greater collaboration – really in an unprecedented way -- in this field and to build a broad and deep initiative in neuroscience across Harvard. 

And we are taking steps to strengthen our program in pharmacology, therapeutics, and chemical biology. This recent effort has given me the privilege and pleasure of working with Bill Chin, vice president at Eli Lilly and president of the HMS Alumni Council, who has been an active member of the strategic planning steering committee. 

We currently envision holding an intensive off-site think tank in the early fall to further brainstorm how best to build therapeutics at HMS. The white paper on the web goes over much of the background as to why we think we need to do this. There is much therapeutically relevant research going on in our community, remarkable amount, but all agree that the opportunity to do more, and do it better, is huge at this moment, and we intend to make Harvard the world leader in this critical area.

To support the wide range of research that we are planning, we must ensure that the School has access to cutting-edge technologies and computational support. That isn’t always the case, unless you focus on that as a specific goal, it will not occur.

A Tools and Technologies advisory group is being created and will lead  the way to provide more coordinated and strategic investments in this area—including new faculty innovators in technology that often drives modern science, support for technology infrastructure and equipment, and support for career paths for technology specialists, who are so important these days to the research enterprise, much more than ever before.  Cutting-edge imaging, going from atoms to human beings, and computational biology are two of the areas most cited by our faculty as needing new investment and new strength.

Health Policy and Social Medicine
In the areas of health policy and social medicine, HMS is taking a leading role in cross-university efforts to improve health through better understanding of social, economic, and delivery-systems factors that affect health care, both in the U.S. and abroad. We all recognize that some of the greatest challenges facing us not only as a School, but also a nation, will be in addressing areas of Medicare reform, rising health care costs, access to care, and disparities in care. These certainly cannot be addressed in isolation at HMS —although we must engage in them at HMS — and that’s why a new Social Science advisory group has advocated for a University-wide approach to studying these areas.

As the School moves forward in preparing our students to become leaders in global health and supporting our faculty as they develop innovative solutions for global health policy and delivery questions, we are making some changes to more accurately reflect the realities of the world and of the work at HMS.

One of these changes has been just in the last couple of weeks to rename the Department of Social Medicine the Department of Social Medicine and Global Health. More than just a name change, this new nomenclature gives notice that there is way more to HMS than just on the Quad. In addition, both the Education and Global Health advisory groups have made strong recommendations to increase options for global health education and mentorship of our students in this area.

Environment
Finally, another area for change that all of our strategic planning advisory groups have highlighted is the need to make our environment more inclusive and supportive, with special attention paid to improving the diversity and gender balance of our faculty.

Since this is an area of deep personal interest for me as well, I intend to work closely with the department chairs to develop an effective strategy for creating a more diverse and inclusive environment. I also plan to establish a task force on faculty development and diversity that I will personally oversee. Creating a more unified and actively supportive community for our researchers, teachers, and trainees may be the single largest contribution I could make to the future of Harvard Medical School and to the success of the goals in education and research that have been articulated, and continue to be articulated, in the planning process.

As the exhaustive brainstorming and development phase of our strategic planning process nears its close, the Initiative now moves into the implementation phase, in which we must decide our priorities and focus on the next steps in carrying out the various recommendations. 

Harvard Clinical & Translational Science Center
An exciting next step that is not a formal part of the HMS strategic planning process, but one which addresses many of our strategic needs and goals and has major implications for Harvard biomedical enterprise as a whole, is the creation that has just taken place of the Harvard Clinical and Translational Science Center — made possible by a major grant from the National Institutes of Health, formally announced 2 weeks ago.

And Lee Nadler, who is the Principal Investigator on that grant and new Dean for Clinical and Translational Research, and a Harvard alumnus, was spectacular in making this grant happen. It is now supplying $120 million over the next 5 years, and this will be supplemented by $75 million over this period contributed by Harvard University, HMS, HSPH, and our major Harvard Hospitals – so essentially, $200 million to support a completely new program, building on our existing research currently at our hospitals.

In our current world of boundary-defying scientific discovery, researchers are finding that the old “silo” mentality of isolated research labs creates barriers to achieving the most meaningful results that we might wish to have.

It is becoming increasingly clear that major gains are made when researchers collaborate and bring the best of each others’ work to bear for the common good in searching for better ways to alleviate human suffering caused by disease. It is in this vein that I am thrilled to report to you about the establishment of this paradigm-shifting Center, which will transform patient-oriented medical research and create an unprecedented level of unity and communication across the University’s schools and affiliated medical centers.

Through automated information exchange, simplified regulatory details, shared core technologies, and grants to support innovation, the Center will integrate clinical and translational research, accelerating the delivery of scientific discovery into clinical settings by allowing researchers to tackle disease more quickly and effectively.

With this major achievement, we are witnessing the beginning of a new era of collaboration and unity across our community. While this collaboration is designed to support Harvard researchers as they pursue their work to improve human health, its primary beneficiaries will be the patients who look to Harvard for the highest-quality and most cutting-edge research to help them face the burdens of their disease.

By focusing on the individual development of clinical and translational researchers, we are opening up a new world of progress on patient-centered research and bringing laboratory discoveries to the bedside at  critical—and exhilarating—times in the history of medical innovation. I hope you will share my enthusiasm for this Center and its role in securing Harvard’s place as the world’s leading medical research institution.

These are some of the ways in which the School is continuing its commitment to its students and enhancing its impact in the world.

You all are a highly valued part of this broad HMS community. It is your active participation in the alumni life of the school, and your financial generosity now and over the years, that help the school realize its loftiest ambitions, such as some of those that I have outlined today.

I’d like to offer my personal thanks to Bill Chin, outgoing President, and Steve Weinberger, incoming President of the Alumni Association. Their friendship over many years, long before I had any idea that I would serve as Dean of Harvard Medical School, makes this interaction with them on behalf of HMS especially rewarding for me.

I’d also like to thank Howard and Jeannette Corwin - Class of 1958 David Oakes - Class of 1968, and Jayne Finkowski-Riviera and Carlos Riviera - Class of 1983, for their efforts, and the work of their classes, in support of HMS.

Yesterday I had the truly moving experience of looking out at the new graduates and their families, who were filled with the joy of the occasion, proud of their accomplishments, and looking forward to the adventures ahead. I shook a lot of hands and every one of them was a great experience for me to feel that these were people leaving the podium and going forth to great careers. It was wonderful to share their happiness and to meet so many of them and their families. 

I was also struck by the palpable sense of their class unity — how much they had experienced together, both difficult and happy times, and how obviously close they are to each other. These are friendships that will last a lifetime. 

These important friendships are what you are all rekindling during your reunions, and I wish for you all that you will enjoy your time here together, remembering some good old days spent in this place. 

We are very happy to have you back.