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Welcome to the the Office of the President

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.