Building Our Future Together
March 11, 2000
Thank you for that
kind introduction. It is a pleasure to welcome you back to the Medical
University. Some of you, I am sure, have been on campus recently. For
others, however, it may be some time since you were last at the Medical
University. Those in the audience whose memories of this institution go
back many years, will find it a different place today — grown much larger
in numbers of faculty, students, programs, and physical plant.
Why has the Medical
University experienced such growth? All of this expansion may seem ironic
at a time of constraint in the health care delivery system. Indeed, the
financial pressures on this institution have never been greater. In the
past few years, we have had to absorb the combined effects of the Balanced
Budget Act of 1997, deeply discounted fee-for-service reimbursements from
private payers, and a rising number of medically uninsured patients. Cumulatively,
these factors are responsible for the loss of substantial revenue to the
institution, with a concurrent rise in demand for services. Support from
the State, meanwhile, has been relatively flat. Today, State appropriations
account for less than 17 percent of all funding to the Medical University.
We are forced to rely increasingly on the entrepreneurial abilities of
our faculty to survive. Are we up to the challenge?
That question cannot
be answered with certainty, but let us consider the early indicators.
One such indicator is that extramurally funded research on this campus
has grown at a remarkable pace. A decade ago, the annual research funding
on this campus was about $20 million. Last year, we were the first university
in South Carolina to exceed $100 million per year in research support.
About 60 percent of
our research support derives from the federal government and about a quarter
of it comes from private sources, with the remainder from the State and
foundations. The National Institutes of Health accounts for most of our
federal research funding. The College of Medicine now ranks in the top
half of all medical schools in NIH funding.
The growth of research
on this campus is a direct result of investments made for that purpose.
Perhaps most importantly, Dean McCurdy has recruited strong research-oriented
department chairs. An example of this strategy was the hiring of Dr. Roger
Markwald as Chair of Cell Biology and Anatomy. Dr. Markwald is an established
investigator himself, and he has recruited a highly successful faculty
who have propelled the department into the first quartile of NIH funding
for anatomy departments. We are hoping that we can replicate the success
that Dr. Markwald has achieved in Cell Biology and Anatomy with two recent
leadership recruitments in Physiology and Biochemistry.
About 18 months ago,
Dr. Peter Kalivas was recruited to chair the Department of Physiology.
Dr. Kalivas' research focuses on the mechanisms of cellular recognition
and response to cocaine. Not only does he provide a strong basic science
component to our already nationally recognized clinical research on substance
abuse, he also has been charged with responsibility for helping to develop
the neurosciences on campus.
In Biochemistry, Dr.
Yusuf Hannun was recruited from Duke University about 18 months ago. Dr.
Hannun is a medical oncologist by training and his research focuses on
the topic of programmed cell death, or apoptosis. In addition to providing
leadership in Biochemistry, Dr. Hannun has been asked to coordinate the
development of structural biology on campus. Research in this area is
focused on the elucidation of the three dimensional structures of biological
molecules and relating these structures to functions. Among other applications,
this type of investigation is critical to understanding how receptors
work, thereby allowing the design of pharmacological agents to either
enhance or diminish biological responses.
In addition to recruiting
strong research leaders, we have improved our research facilities. Over
the past few years, we have completed new laboratory space in the Hollings
Cancer Center, the Storm Eye Institute, and the Thurmond/Gazes Research
Building. We have also renovated most of the laboratories in the Basic
Sciences Building and the College of Pharmacy. Plans for new facilities
include doubling the research space in the Hollings Cancer Center, building
a Children's Research Institute, and constructing an additional laboratory
building. As aggressive as this building program may appear, it will be
barely sufficient to accommodate the estimated 300,000 net square feet
of research space required on this campus in less than five years.
A third component
of enhancing research at the Medical University has been the development
of organizational units to enhance capacity. We created a Foundation for
Research Development to facilitate technology transfer of inventions arising
from the work of university investigators. Since its creation, two and
one half years ago, disclosures have been filed on 125 inventions, with
filings on 35 patents. Six new start-up companies have been formed as
spin-offs of research at the Medical University. An example of one of
these new companies is a Mount Pleasant-based firm that is developing
a new fast and inexpensive test to detect drug resistance among patients
with HIV infection. Should this technology prove to be successful, it
obviously would have huge commercial potential and even more importantly,
a dramatic impact on the management of patients with this disease.
The Foundation serves
as a bridge between the faculty and the private sector. Funding from private
interests, in the form of venture capital, contractual agreements, and
equity is becoming an increasingly important source of revenue for university-related
research. The synergy between university research and private enterprise
is well demonstrated in other parts of the country, such as the Research
Triangle in North Carolina. Unfortunately, South Carolina has been a relatively
new arrival to the appreciation of the role that research universities
can play in economic development. In our respective areas of expertise,
Clemson, USC and the Medical University each can contribute to helping
South Carolina compete successfully for technology-oriented business.
Within the Foundation
for Research Development, we also have created a subsidiary titled the
Clinical Innovation Group. This entity serves as a coordinating center
for national and international clinical trials. Through the efforts of
the Clinical Innovation Group, the Medical University can emerge as a
leader in the development and oversight of clinical studies. Several multicenter
trials are underway, including assessments of medical devices and pharmacological
agents. The initial areas of application have been gastroenterology, surgical
oncology, and psychiatry, with expansion planned in other areas. At present,
we are exploring the extent to which the Clinical Innovation Group can
work with private practitioners in South Carolina to enroll patients in
these studies. There are several benefits that private practitioners might
derive from such participation, including access to new and emerging treatments,
an additional revenue stream, and the stimulation of participating in
research.
Finally, the Medical
University is positioning itself for greater research capacity by augmenting
research training. For example, this year we obtained approval from the
Commission on Higher Education for a new degree program entitled the Master
of Science in Clinical Research. The goal of this program is to prepare
more clinicians for research careers, with focused coursework on the design,
conduct, analysis and interpretation of patient-oriented studies. The
target audience will be fellows and junior faculty in the clinical departments
of the College of Medicine, as well as advanced clinical trainees in other
colleges. This program is being coordinated by the Department of Biometry
and Epidemiology, whose new chair, Dr. Barbara Tilley, is a nationally
recognized investigator in clinical trials of cerebrovascular disease.
To summarize then,
the Medical University is engaged in a multi-pronged effort to build its
research capacity. We have invested in the recruitment of outstanding
research-oriented departmental chairs. We have expanded and upgraded our
laboratory facilities. We have created organizational resources to assist
faculty in securing and conducting funded research. And, we are developing
new training programs to assist trainees and junior faculty who want to
enter scientific careers.
All of this is well
and good, but why am I focusing on this in my first presidential address
to the College of Medicine Alumni Association? After all, this audience
is comprised largely, if not entirely, of clinical practitioners. As graduates
of our medical school, your attachment to us primarily derives from your
educational experiences here. To the extent that you have ongoing contact
with us, it is probably centered on patient referrals to clinical specialists
here, or alternatively around continuing medical education courses. It
would, therefore, seem far more appropriate for me to focus on our educational
or clinical programs.
It is exactly for
that reason that I have chosen to concentrate on the research dimensions
of this institution. You know us for the other components of our mission„education
and clinical service. For many of you, the fact that research is conducted
on this campus may seem at best a non-essential activity, and at worst,
an actual diversion of attention from the real purposes of this university.
Perhaps I am overstating the case, but I trust that you will forgive me
if I am exaggerating to make a point.
As you might guess
from the preceding comments, I am, without apology, an enthusiastic proponent
of research at the Medical University. Why am I such a strong proponent
of this aspect of our enterprise? In essence, I believe that a university
cannot be first class without a vital commitment to discovery and scholarship.
The great universities are all recognized for their contributions to understanding
the worlds within and around us. They have talented faculty and students
whose intellectual curiosity drives them to the frontiers of new knowledge.
As institutions, they set high standards of achievement, and more often
than not, they exceed those benchmarks.
There is a widely
held misperception that a heavy emphasis on research at a university will
come at the cost of the educational and clinical service functions. This
belief is predicated upon the assumption that it is a zero-sum game. That
is to say, there is a fixed resource available, and whatever faculty effort
is devoted to scientific investigation must necessarily be subtracted
from either teaching or clinical practice. That model, I would contend,
is completely wrong. In fact, research is the friend, not the enemy, of
both educational and clinical excellence. More often than not, the best
teachers are those who are active investigators, who can translate to
their students the excitement of an emerging field of inquiry. There is
a fundamental difference between the insight of a professor who is living
and breathing science from one who is learning about new findings from
perusing journals and textbooks. Similarly, the most advanced clinical
care is likely to be provided by faculty members who are at the forefront
of innovation in diagnosis and treatment.
If one reflects for
a moment on the leading biomedical research universities in our region,
the synergy of research to educational and clinical achievement becomes
evident. I suspect that we would all rate Duke, Emory, Vanderbilt, North
Carolina, and Alabama-Birmingham among the leaders in our region from
a research perspective. I have had the good fortune of attending two of
these institutions as a student and working as a faculty member at a third.
So, I speak about them with some personal knowledge. In each instance,
my experience tells me that their commitment to science augments their
educational and clinical excellence.
In drawing comparisons
to these cited institutions, some of our constituents, perhaps some in
this room, may feel that our aspirations are misdirected. After all, we
are located in a small and relatively poor state that has not historically
supported higher education as have our neighboring states. Unlike all
five of these institutions, we are not a component of a comprehensive
university campus, thereby lacking relevant collaborating disciplines
such as chemistry, physics, and information sciences. We also do not have
a long-standing tradition of excellence in science. Indeed, there is ample
reason to question whether the Medical University can compete with the
first tier biomedical research institutions. If we do not set that as
a goal, however, it is my firm belief that we will condemn your alma mater
to mediocrity. In order to attract the best students and faculty, we must
provide them with an environment that promotes discovery, values excellence
and rewards achievement.
It is an article of
faith with me that the Medical University can and must strive to be a
thought leader. Our greatest resource in that regard is a natural resource — it
is the intellectual capital of South Carolinians. Our first charge is
to make this institution attractive to the brightest sons and daughters
of South Carolina. We must also invest in attracting the most talented
faculty possible to this campus. My experience over the past five years
tells me that this is not only possible, it is happening. More often than
not, when we have stood toe-to-toe with other institutions, we have won
the recruiting battles.
Whatever success
we have achieved to date, moving to the next level will not be easy. It
will not happen overnight in single bold strides. It will occur incrementally
over a period of years. It is a long-term goal that will extend well beyond
my tenure in office. My task is to assure that we are headed in the right
direction and that we stay the course. You can be sure that I will approach
this task with vigor and enthusiasm.
To be successful,
however, the faculty and I will need your help. As alumni, you have a
vested interest in the reputation and well being of the Medical University.
You are our most influential ambassadors throughout the State of South
Carolina. Many of you have close personal relationships with the elected
officials who determine our levels of appropriation. If you believe in
our cause and are willing to advocate on our behalf, you can be a powerful
voice in shaping public opinion. An immediate opportunity exists in that
regard. As you know, the General Assembly presently is considering how
to spend the tobacco settlement funds. I would hope that everybody in
this room would support the notion that the vast majority of these funds
should be devoted to health care, especially to assuring services to the
medically underserved. If you agree with that suggestion, then by all
means, advocate for it with our elected officials.
Let me make a second
request of you. Consider your personal level of financial support to the
Medical University. As I indicated earlier, public funding has not been,
and will not be, sufficient to operate this institution. Our alumni, as
direct beneficiaries of our efforts, are an essential source of support.
If we share a common goal to build and sustain excellence on this campus,
it will come at a cost. Whether you choose to support scholarship assistance,
a professorship, or some other purpose, I hope that you will reassess
the maximal level at which you can give and support your alma mater generously.
In conclusion, the
Medical University is poised to move to a whole new level of achievement.
I have challenged our faculty to build an academic health center here
that will be the rival of any in the country. Our success will be measured
in incremental steps over many years. If we do not make a commitment today
toward that end, however, we will never get there. Moreover, this vision
cannot be realized without your support and encouragement. I look forward
to building that future with you. Thank you very much.
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