Dean's Report 2014-2015

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Dean’s Report 2014–2015

Dean’s Report 2014 I 2015 119

harvard medical school

Self-Portrait

120 Dean’s Report 2014 I 2015

Illuminating Discovery. Incubating Innovation. Inspiring Leadership.

1 Message from the Dean 4 Education 10 Discovery 16 Service and Leadership 22 Facts and Figures HMS Leadership Preclinical Department Chairs Fundraising Highlights By the Numbers Affiliated Hospitals and Institutions Collaborations Across Harvard Financial Report

At HMS, the spirit of collaboration sparks vital new discoveries and creative approaches to education and research. Together, we are combining our strengths and breaching all bound­aries to improve human health.

On the cover: Students from the Class of 2018 celebrate White Coat Day

Dean Jeffrey S. Flier

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The whole is greater than the sum of its parts is a maxim attributed to Aristotle, the Greek philosopher whose towering ideas influenced the fields of biology, medicine and ethics—core disciplines we explore and advance at Harvard Medical School today. n Individuals working together frequently achieve results that could not have been realized in isolation, and at HMS we have a long tradition of extraordinary partnerships—great minds working together to safeguard and improve the health of humankind. n These collaborations are increasingly important in a world in which biomedical insight is advancing with exceptional speed. Today, we continue to pool our knowledge for a better understanding of some of the world’s more intransigent diseases, such as cancer, Alz­heimer’s disease, diabetes and tuberculosis.

In the quest to alleviate suffering caused by disease, HMS has a singular ability to convene great thinkers and innovators, forging alliances across disciplines, departments and institutions. These individuals, working together, create a grand canvas of achievement, a picture, if you will, of what unity can accomplish.

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model of collaboration, the new Laboratory of Systems Pharmacology, which opened in 2014, is a scientific incubator where teams of basic and clinical scientists from diverse disciplines are seeking to reinvent the fundamental science underlying how new medicines are developed. The goal: to deliver therapeutics with greater efficacy and fewer safety concerns. In one instance, researchers are using intravital microscopy, advanced image analysis and mathematical modeling to analyze how tumors respond to anticancer drugs. They hope to learn how to tailor therapies to the properties of individual cancers.

As members of the larger Harvard Program in Therapeutic Science, or HiTS, these investigators are working with other academic institutions and HMS-affiliated teaching hospitals, as well as with pharmaceutical industry partners, to improve links between basic science and new drug discovery. Together they are stimulating the creation of new and more effective therapeutics.

Partnerships are fundamental to another exciting venture—the new Office for External Education, which is laying the groundwork necessary to bring our extraordinary educational expertise to learners both locally and globally. External Education combines the formidable assets of the Department of Continuing Education, Harvard Health Publications and the Office for Global Education with online learning programs to create educational opportunities that deliver sought-after knowledge. It will use a variety of platforms to reach larger and more diverse populations of learners.

Vital Research Partnerships

Creative partnerships are not new to HMS, but in an increasingly global community they are more necessary than ever before. At HMS, we link the research and creativity of more than 12,000 HMS faculty and more than 11,000 students and trainees on campus and at our 16 affiliated hospitals. From the creation of a powerful new gene-editing tool that promises to transform discovery and therapeutics, to the identification of a molecule that may help corneas regenerate from stem cells and potentially reverse blindness, the range of discovery at HMS continues

to reflect the talents of exceptional people who achieve remarkable results.

In 2014, several other promising collaborations will help ensure that we will continue to improve health and medical care for thousands of people far into the future. A $90 million Ludwig Cancer Research gift, for example, will facilitate new insights into the biology of cancer and accelerate the translation of basic research to improve patient outcomes.

Another initiative, the Undiagnosed Diseases Network, aims to reveal the origins of rare undiagnosed diseases so that novel treatments may be explored and established. The National Institutes of Health (NIH) chose HMS to serve as the coordinating center for this national network of clinical sites. The network will be overseen by the School’s Center for Biomedical Informatics.

Harvard Catalyst | The Harvard Clinical and Translational Science Center was awarded a second five-year NIH grant.

Harvard University, HMS and the Harvard School of Public Health, as well as Beth Israel Deaconess Medical Center, Brigham and Women’s Hospital, Boston Children’s Hospital, Dana-Farber Cancer Institute and Massachusetts General Hospital renewed their support for Harvard Catalyst’s work in accelerating cross-disciplinary and inter-institutional clinical and translational research partnerships.

We also formed and re-established promising international collaborations in 2014. The new Evergrande Center for Immunologic Diseases at HMS and Brigham and Women’s will lead the creation of a scholarly exchange program with institutions in China to probe the role of chronic inflammation in disease. The inaugural Evergrande Center Symposium at HMS drew experts from around the world.

The Bertarelli Foundation renewed the Bertarelli Program in Translational Neuroscience and Neuroengineering, extending the HMS partnership with the École Polytechnique Fédérale de Lausanne in Switzerland by initiating new programs in computational and statistical education. This work will help accelerate the translation of basic biomedical research into improved health for people with neurological disorders.

Funding from the NIH and the State of São Paulo Research Foundation

Below, the Partners In Health (PIH) Advance Ebola Response team consults with frontline health workers from Last Mile Health in southeastern Liberia.

teams HMS researchers with Brazilian scientists on an investigation of new antifungal agents. HMS physicians and researchers in Haiti, Mali and Rwanda continue to help those nations respond to health threats such as tuberculosis, cholera and malaria, while in the fall, HMS faculty traveled to West Africa to help plan a response to the Ebola epidemic.

Educating the Next Generation

Preparing the next generation of medical leaders and integrating them into these vital partnerships is fundamental to the HMS mission. In 2014, the School welcomed 164 students from 33 states and 16 other countries who had attended 66 col-

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leges and universities. Forty-nine percent of the Class of 2018 is made up of women, and 20 percent of entering students identify themselves as members of groups underrepresented in medicine.

To support these students as they acquire the skills they will need to be effective leaders in their profession, the Program in Medical Education is completing a redesign of the MD curriculum, working with more than 100 HMS faculty and staff to develop a new four-year program that more fully fuses basic sciences with clinical medicine. It will employ new pedagogical techniques and technology to better equip students for careers in an ever-shifting health care environment.

To facilitate these ambitious educational and curriculum redesign goals, we conducted an architectural programming study of the Medical Education Center (TMEC) this year, and we are now refining a 10-year campus master plan to help us determine long-term space and design needs.

We have established two new hospitalbased academic departments—the Department of Neurosurgery and the Department of Emergency Medicine—that will bring a host of benefits to hundreds of faculty members. We also have expanded our master’s programs to five. These active programs now include two launched in the fall of 2014: a Master of Medical Sciences in Medical Education and a Master

Pictured, Joia Mukherjee (far right), associate professor of global health and social medicine, and Paul Farmer (second from right), Kolokotrones University Professor of Global Health and Social Medicine, PIH co-founder and head of the Department of Global Health and Social Medicine.

of Medical Sciences in Immunology.

The Center for Primary Care also received generous support this year, allowing it to expand its flagship program, the Academic Innovations Collaborative. This program fosters safe and reliable systems in primary care and spurs innovation in education and care delivery at 20 HMSaffiliated primary care teaching practices that serve more than 275,000 patients.

Progress and Transitions

It takes extraordinary individuals to accomplish our many ambitious goals, and I am constantly inspired by the achievements of HMS community members. Our faculty continue to be recognized for their superlative work. Among the many who received awards and recognitions this year were five faculty who were admitted to the National Academy of Sciences, seven others who were elected to the Institute of Medicine and another five who were welcomed into the American Academy of Arts & Sciences. We also continued to make progress toward a more secure financial future for the School, aligning academic goals with resources in ways that will ensure academic excellence in the decades to come.

We recognize that such advances are critical to the success of the School, but we also know that it is our people who make it all possible—people such as Lanny Smith, founder of Doctors for Global Health, and Rafael Luna, an instructor in the Department of Biological Chemistry and Molecular Pharmacology, who oversees a Mission Hill Little League program in Boston.

They, like all of us at HMS, recognize that successfully addressing the health needs of a richly pluralistic world requires collaboration, diversity and inclusiveness. This year, I was pleased to launch a program to support the School’s LGBT (lesbian, gay, bisexual and transgender) community to ensure that all members of the HMS community can contribute to the fullest extent of their capabilities.

The whole, after all, is greater than the sum of its parts, and I am proud to share with you in this report some of the highlights of the past year’s accomplishments.

I am also grateful to have this opportunity to extend my heartfelt appreciation to every individual who contributes to the success of the HMS mission.

Education

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Dean for Students Nancy Oriol (front left) accompanies members of the Class of 2017 to their first clinical case presentation on White Coat Day.

A familiar face to generations of students, he is the Daniel D. Federman, M.D. Distinguished Professor of Medicine and Medical Education.

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G

eorge Washington Carver, the eminent scientist, educator and inventor, once said, “There is no shortcut to achievement.

Life requires thorough preparation—veneer isn’t worth anything.”

At Harvard Medical School, educators have set the standard for preparing the world’s foremost physicians and scientists for more than 230 years, training leaders known for finding new and better ways to ease suffering, promote health and cure disease.

In the early 1800s, HMS faculty member Benjamin Waterhouse became the first American practitioner to successfully vaccinate patients against smallpox. Today, HMS faculty continue to embrace innovation and to do so on an increasingly international scale, whether by experimenting with engineered gene drives to combat malaria and other insect-borne diseases, by transforming the practice of primary care within patient-centered medical homes, or by bringing clinical research skills to students in classrooms around the world.

External Education

The demand for medical knowledge and enhanced clinical skills has intensified as technologies and mobile communications bring the global community closer. Disease knows no borders, and at HMS, we recognize that our educational responsibilities and opportunities extend far beyond the Quad. For this reason, in 2014 we welcomed our first Dean for External Education David Roberts, who is defining and implementing a strategic vision to bring the School’s educational expertise to new and expanded categories of learners, both locally and globally. To support this vision, we are committed to producing a wide range of new educational programs that incorporate the latest technologies and to expanding and enhancing existing nondegree offerings and programs.

Continuing Medical Education. In order to share the latest medical treatments and procedures with physicians worldwide, HMS is undertaking an ambitious agenda that involves creating new content for wider audiences. Accredited courses are being redesigned to better assess what physicians are learning and to help them implement best practices so they may improve patient outcomes.

Online courses are being restructured to make use of the latest digital technology as we reach out to clinicians worldwide.

Harvard Health Publications. Over the past 50 years, this HMS media and publishing division has provided hundreds of thousands of subscribers and millions of online visitors with current, authoritative and accessible health and wellness information reviewed by HMS faculty. Formats have changed over time, moving from print to e-books and online learning, but the goal of delivering straightforward and relevant clinical information remains the same. HMS will further leverage digital and interactive technologies, such as mobile

Louise Xu (left) plays the guzheng and Jie (JJ) Sun plays the pipa as part of FABRIC, an annual talent show in which students celebrate their cultures.

apps and Web-based interactive tools and videos, to shape new directions in public education and to reach even wider audiences.

Global Education. HMS has developed a suite of programs for clinicians worldwide, beginning with the Global Clinical Scholars Research Training Program (GCSRT) that was launched by the Program in Graduate Education. The GCSRT is a one-year certificate program that has proven enormously successful. Last year nearly 150 physicians and physician-scientists from 30 countries in Africa, Asia, Europe and the Middle East, as well as Canada and the U.S., participated in a virtual global classroom. Designed for clinicians seeking advanced training in clinical research, the curriculum focuses on enhancing skills in epidemiology and biostatistics by using traditional teaching approaches as well as online lectures, webinars, in-person workshops and team-based learning. We are now offering or developing an array of courses in other high-interest areas, such as patient safety/clinical informatics/quality improvement, or global cancer care and emerging therapeutics.

Online Education. To prepare prospective students for the rigors of a medical school curriculum, HMS is developing novel educational material and an online platform that will engage and inspire while effectively teaching the fundamentals of complex medical and scientific principles. The aim is to make this series, which is appropriate for college-level students preparing for careers in a variety of health-related professions, available to students worldwide within the next year.

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KIM VAN SAVAGE

Associate director for human resources at the New England Primate Research Center, she has dedicated her career to fostering positive work environments.

Executive Education. For decision makers in fields aligned with medical science, such as executives in health care or biomedical companies, HMS is developing education programs designed to impart the information and insights these leaders need to be successful. We also are exploring courses for professionals in nonmedical fields, such as finance, law, intellectual property and patents, to help guide professionals in work that relates to medical science.

Program in Medical Education

Continuing our long tradition of preparing students to meet the challenges of the next era in medicine, the Program in Medical Education is in the final stages of redesigning the MD curriculum—to be known as the Pathways curriculum. Over the past three years more than 100 HMS faculty and staff, led originally

by Jules Dienstag, the Carl W. Walter Professor of Medicine and former dean for medical education, have participated in the redesign, which was overseen by a faculty task force. The Pathways curriculum will more fully integrate basic science with clinical medicine and will introduce curricular content in more developmentally appropriate time frames, employing new pedagogical techniques and incorporating educational technologies that enhance teaching and learning.

Beginning in August 2015, many concepts now presented in the first two years will be combined in a 14-month curriculum that begins with foundational courses addressing the basics of anatomy, cellular and molecular biology, genetics, immunology, pharmacol-

Above left, Barbara Fullerton (center), assistant professor of otology and laryngology, instructs clinical fellows (from left) Jennifer Fuller, Sid Puram, Deepa Galaiya and Anuraag Parikh in the Joseph B. Nadol, Jr., M.D. Otolaryngology Surgical Training Laboratory at Massachusetts Eye and Ear.

ogy, microbiology and pathology; it continues with an introductory course in social and population sciences and concludes with organ-system blocks that will allow students to study normal and abnormal processes within the context of organ systems. A longitudinal clinical skills course, the Practice of Medicine, will ultimately span all four years of the MD curriculum, and will begin in the first week of medical school, immediately following Introduction to the Profession. The second year will be devoted to the Principal Clinical Experience, which includes the core clerkships hosted at affiliated hospitals. In the final two years, informed by these clinical experiences, students will take advanced courses and electives more closely aligned with their career paths, and they will undertake mentored scholarly research projects relevant to their interests in the basic, clinical or social sciences.

Implementation of the new curriculum will be guided by the new dean for medical education, Edward Hundert, the Daniel D. Federman, M.D. Professor in Residence of Global Health and Social Medicine and Medical Education, a medical ethicist and former director of the HMS Academy’s Center for Teaching and Learning. Hundert previously served as dean of the University of Rochester School of Medicine and Dentistry and president of Case Western Reserve University. He assumed his new duties in the fall of 2014 when Dienstag stepped down to continue teaching. Dienstag trained more than 1,600 HMS students during his distinguished and visionary 10-year tenure.

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STUDENT REVIEW

The Harvard Medical Student Review was launched by co-founders (from left) Jay Kumar ’16, Omar Abudayyeh’16, Adam Frange, HMS teaching assistant, and Noor Beckwith ’16.

Supporting the New Curriculum

The Program in Medical Education has been fortunate to receive support from the Harvard Initiative on Learning and Teaching (HILT) for a number of initiatives in the development of the new curriculum. A HILT-funded grant supported the evaluation of new pedagogical approaches that have been piloted in current courses, such as Integrated Human Physiology. A HILT Cultivation Grant is funding an evaluation of the impact of the new curriculum and of team-based learning in newly designed classroom spaces. An earlier grant from HILT to support decanal priorities is supporting the development of faculty teaching skills in new pedagogical techniques, such as flipped classrooms and team-based learning.

The decanal grant has also made possible the creation of a production studio to create short videos that will present important concepts to students who are preparing to participate in flipped classroom sessions.

Master Planning Initiatives

To accommodate curriculum changes, HMS is wrapping up a master planning process. The goal of this strategic facilities plan is to understand the type and amount of space required to meet the future research, educational and administrative needs of the School. It will also inform decisions on the HMS real estate leasing portfolio. The HMS planning office and consultants have engaged numerous constituencies throughout the School in developing an inventory of existing space to understand the nature of future space requirements. Several alternative scenarios for

Above left, Ellen Beauchamp, a Harvard University PhD student in the Division of Medical Sciences, Graduate School of Arts and Sciences, studies in TMEC’s technology service center, a newly modernized computer lab.

development have been advanced with a goal of providing HMS leadership with a thoughtful road map for the future.

The comprehensive 10-year facility plan is guided by three operational concepts:

Reorganize: revitalize buildings for current and future medical education and research pursuits and renovate the Medical Education Center (TMEC) to align it with future curriculum needs

Improve: use research space more efficiently; improve the research infrastructure; improve core facilities; and upgrade housing, athletic facilities and physical accessibility Connect: find new ways to build a sense of community by linking campus elements and improving opportunities for social interaction and collaboration Rethinking the Admissions Process

Of the more than 5,000 applicants to HMS each year, up to 800 are invited for interviews. This year, a group of first-year students, working with Dean for Students Nancy Oriol and the HMS Admissions Committee, made recommendations to the Faculty Council on how to enhance interview experiences for applicants, including the addition of student-led tours, lunch panels with faculty and an evening gathering at Vanderbilt Hall.

In addition to retooling the admissions process, HMS students have helped develop programs to welcome each new class. Accepted candidates often return in the spring for the three-day Revisit event, which HMS students use as a way to highlight the

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School’s collegial spirit. For prematriculation week, two studentdesigned and student-led options are available: FEAT (First-year Education Adventure Trip), an outdoor experience, and FUNC (First-year Urban Neighborhood Camp), an immersion in community service opportunities available in Boston’s Longwood Medical Area.

Scholarship Aid Increases

HMS continues to provide generous assistance to students. In 2013-14, the average debt per graduating student was $103,900, about 10 percent lower than six years ago. Approximately 11 percent benefited from loan-forgiveness programs, receiving more than $460,000 in debt relief. Some were eligible for additional relief, including $80,000 after completing residency.

Need-based scholarships awarded by HMS totaled $16.6 million, an increase of 7 percent over the previous year. Contributions

by HMS alumni continue to be a vital source of scholarship aid, with ongoing efforts by the Office of Resource Development to increase support.

Graduate Education

WILLIAM MEEHAN

An assistant professor of pediatrics at HMS, he is director of The Micheli Center for Sports Injury Prevention and is involved in a major study probing the health of football players.

HMS graduate programs, led by Dean for Graduate Education David Golan, the George R. Minot Professor of Medicine, continue to expand their influence, shaping new knowledge and developing leaders in the basic sciences, biomedical research and global health delivery.

PhD Programs. Our PhD programs are thriving despite a challenging funding environment. This fall, the Division of Medical Sciences programs welcomed 101 new students to six disciplines, bringing total enrollment to 625. Another 38 new students enrolled in biophysics, chemical biology and systems biology, bringing the total enrollment in these three programs to 172.

Increasing numbers of students are embracing our enrichment programs to augment their PhD training. The new Therapeutics Graduate Program uses multidisciplinary themes to encourage new drug discovery and development, while the Leder Human Biology and Translational Medicine Program trains students to turn advances in basic research into new ways to prevent, diagnose and treat disease. The Program in Graduate Education launched the first in a planned annual series of symposia focused on emerging issues in graduate science education.

Master of Medical Sciences Programs. Two new master’s degree programs that provide advanced training for physicians and scientists were launched this year. The new Master of Medical Sciences (MMSc) in Medical Education, housed in the Academy Center for Teaching and Learning, is designed for those who lead or aspire to lead medical education programs. The new MMSc in Immunology is for current physicians and scientists as well as individuals with bachelor’s degrees who seek advanced training in immunology. It is the School’s first MMSc in the basic sciences.

These two new programs join the existing MMSc programs in biomedical informatics, clinical and translational investigation, and global health delivery. Enrollment for all MMSc programs at HMS totaled 84 students this year.

Global Research and Education

HMS–Portugal Program in Translational Research and Information.

This program is completing its first five-year term with funding from the government of Portugal. The largest activity in the program is the Portugal Clinical Scholars Research Training Certificate Program, a two-year blended learning program that leverages HMS expertise in training physicians in clinical research. Enrollment in this program now totals 60 physicians.

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HMS faculty offer workshops, online lectures and webinars that present participants with the key pathways of clinical research.

Other elements of the HMS–Portugal program include collaborative research projects and fellowships involving investigators and trainees at HMS and in Portugal.

Nathan Georgette ‘17 (right) performs an eye exam on Andy Nguyen ‘17 during the Patient-Doctor II course.

Evergrande: Supporting Inflammation Research. As a result of a partnership formed by Harvard University with the Evergrande Group, an integrated industry leader based in China, several major initiatives were launched this year, including the Evergrande Center for Immunologic Diseases at HMS and Brigham and Women’s Hospital. The center is focusing on cross-disciplinary core and translational research and on patient care that will lead to improved understanding of the role of inflammation in autoimmune, neurologic and metabolic diseases. It is also exploring the environmental factors that may trigger inflammation, as well as the development and evaluation of potential treatments.

The first Evergrande Center Symposium, titled “Immunity and Inflammation in Disease and Tissue,” took place in August, drawing experts from around the world.

Partnership for Health Advancement in Vietnam. Faculty at HMS, Beth Israel Deaconess Medical Center and Brigham and Women’s, in collaboration with the Vietnam Ministry of Health and with faculty at Hanoi Medical University and Ho Chi Minh City University of Medicine and Pharmacy, are working to strengthen health care in Vietnam by improving the country’s medical education programs, implementing a new postgraduate training process and developing a national system for continuing medical education.

To learn more about education at HMS, go to hms.harvard.edu/education.

Student Profiles

Colleen Farrell, MD 2016

Eduardo Hariton, MD-MBA 2015

Jennifer Cloutier, HST, MD-PhD 2021

David Duong, MD 2015

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Cloutier graduated from Harvard College in 2013 and matriculated directly to the Harvard-MIT Health Sciences and Technology (HST) program. After a childhood spinal cord injury, she became broadly interested in developmental and regenerative biology. Cloutier is looking forward to starting her PhD in the Reddien Lab at the MIT Whitehead Institute, which studies in vivo regeneration in the context of Planaria. She has also recently rejoined the Canadian Adapted National Water Ski Team and will be competing in the world championships in 2015.

She is interested in combining clinical medicine and research in her future career.

Duong came to the U.S. from his native Vietnam at age 5, eventually earning an MPH at the University of Michigan. Duong was chair of the 2011 Harvard Leadership Conference and served on the inaugural Student Leadership Committee for the HMS Center for Primary Care, where he designed Abundance Agents of Change Challenge Grants. For the 2014-2015 academic year, he received a Fulbright Research Grant for a fifth-year project at HMS to study noncommunicable diseases in Vietnam. He also drafted a successful World Bank grant to introduce curriculum changes at the largest medical university in Vietnam. Duong is currently on the Partnership for Health Advancement in Vietnam program steering committee and serves as a technical adviser to the program, which is a collaboration between HMS, Brigham and Women’s, Beth Israel Deaconess and the Vietnam Ministry of Health.

Farrell, a graduate of Williams College, spent two years at The Hastings Center, a public policy and bioethics initiative, before entering HMS. During that time she contributed to research on end-of-life care and assisted reproductive technologies, and she gave presentations around the country on bioethical issues related to HIV prevention. She is a classical violinist who performs with the Longwood Symphony Orchestra, which is made up of medical professionals in the Boston area. Farrell continues her scholarship in bioethics and is completing her Principal Clinical Experience clerkship at Beth Israel Deaconess. She recently served as editor of a theme issue of Virtual Mentor, the American Medical Association’s online ethics journal.

Hariton has shown outstanding leadership potential, exemplified by being awarded a Paul and Daisy Soros Fellowship for New Americans. He is also cofounder and leader of the Harvard Latino Student Alliance, the first campus-wide (and now the largest) Latino organization at Harvard. Hariton is simultaneously earning an MD and an MBA from Harvard and is planning to specialize in obstetrics and gynecology. He plans to use his medical and business acumen to find a way to improve access to care for underserved populations in local and international settings.

Discovery

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— Ralph Waldo Emerson

At Dana-Farber Cancer Institute, Jarrod Marto, associate professor of biological chemistry and molecular pharmacology, studies proteomics-based methods to analyze key molecular events in tumorigenesis.

Protein samples are passed through hollow silica tubes, alMERCEDES BECERRA lowing examination of amino acids to identify An associate professor oftargets in promising global health and social cancer treatment.

medicine, her research focuses on the treatment and epidemiology of drug-resistant tuberculosis.

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s medicine, health care and biomedical research continue to advance at exceptional speed, Harvard Medical School research programs remain at the forefront of discovery, from those that shape national health care policies to those that illuminate the secrets of the aging cell. In 2014, while some HMS researchers tested the limits of genetic reprogramming, others developed a new theory of cancer development using mathematical analysis, opening the door for research into new treatment targets.

This year, the combined research efforts of HMS and Harvard School of Dental Medicine resulted in $292.4 million in funding for sponsored programs, which represents 32 percent of Harvard University’s research portfolio and includes $226.5 million in federal awards. Of those grants, $210.2 million came from the National Institutes of Health (NIH).

Important breakthroughs in medicine and science require sophisticated synergies and the combined intellect of many. HMS

Laura Pontano Vaites, research fellow in the Department of Cell Biology, works with Barry Huang, a high school fellow in the Basic Science Partnership program. The program enhances science education for middle and high school students through a variety of internships that allow them to explore the world of biomedical research.

has an unparalleled ability to leverage powerful collaborations among academia, research, industry and government. This year, we were fortunate to forge several dynamic new partnerships.

The Harvard Ludwig Center, created with a $90 million gift from Ludwig Cancer Research, will help unite a diverse crosssection of cancer experts from throughout the Harvard community and encourage new insights into the biology of cancer, with the goal of integrating accumulated knowledge and accelerating the translation of basic research to improve patient outcomes.

Another key partnership, dedicated to identifying rare diseases and developing treatments, combines the resources of three of our affiliated hospitals within the Harvard Center for Integrated Approaches to Undiagnosed Diseases, one of six such centers in the U.S. established by the NIH to facilitate patient care and data sharing.

One of the more exciting new core facilities is the Laboratory of Systems Pharmacology, the cornerstone of the Harvard Program in Therapeutic Science, where bioscientists, software engineers and physicians are partnering to reinvent the science of drug development. Another facility, the Thermo Fisher Center for Multiplexed Proteomics, housed within the HMS Department of Cell Biology, is equipped with highly sophisticated capabilities for protein quantitation on a large scale to advance understanding of complex disease mechanisms and accelerate discovery of effective therapies.

Ushering in the era of big data, the School is leveraging digital technology to advance its educational and research programs.

In a major infrastructure transformation, the HMS Information Technology department is consolidating data centers and expanding the HMS technology network, including platforms for big science and storage solutions. A Big Data Center of Excellence, funded by an $8 million NIH grant, will focus on developing optimal methods to manage patient data.

HMS continued to wind down operations at the New England Primate Research Center, a decision based on a review of the long-term academic benefits and the financial costs of continuing to operate the center. Key faculty members are working closely with the NIH on this transition.

Harvard Catalyst | The Harvard Clinical and Translational Science Center

The NIH has awarded Harvard Catalyst a second five-year grant, the largest award of its kind in the U.S. This grant renews support for Harvard Catalyst’s work, which fosters transformative biomedical research. Advocating an open-source approach, Lee Nadler, the Virginia and D. K. Ludwig Professor of Medicine and dean for clinical and translational research, is leading a wide range of Harvard Catalyst initiatives that innovate and foster critical medical research across the nation.

Harvard Catalyst played a key role in uniting a diverse team of investigators to form the Scalable Collaborative Infrastructure for a Learning Health System, a far-reaching common data platform that will link more than 8 million patients with doctors in 10 U.S. health care centers, thus providing a valuable resource for researchers trying to better understand disease and to develop therapeutics. An interdisciplinary team convened by Harvard

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attacking. If ubiquitin binds using the K48-linked chain, RIG-I is recycled like any other protein. This system of checks and balances may keep the cell from launching inappropriate immune responses.

Cell Biology

Unmasking a Viral Invader. Healthy people who carry cytomegalovirus (CMV) often don’t know it, as it generally remains in check.

But if the immune system becomes compromised, the pathogen sometimes can be life-threatening. The lab of Steven Gygi, professor of cell biology, has discovered how to use mass spectrometry, a tool more commonly used in physics and chemistry, to decipher how CMV is able to evade the immune system.

In the new approach, proteolyzed protein lysates were vaporized, sprayed into a chamber, and then broken apart by collisions with helium, with mass spectrometry providing the specific sequence of amino acids in each peptide. Applying this technique to fibroblasts, or connective tissue cells, being invaded by CMV, the researchers deconstructed an initial three-day infection sequence in which the virus hijacks—but hasn’t yet destroyed—the cell. As published in Cell, this approach allowed study of approximately 8,000 proteins from both host and virus, identifying ways that CMV invades the cell and detecting potential therapeutic targets.

Genetics

Catalyst continues its work as part of the Football Players Health Study at Harvard University by launching player studies, a pilotstudies program and a law and ethics initiative.

Serving as another model for broad collaboration is the Advanced Microscopy Pilot Grants program, sponsored by Harvard Catalyst’s Reactor program. Working with the Harvard Center for Biological Imaging, 11 awardees received funding of $40,000 each for proposals that use state-of-the-art Zeiss microscopes for pathology research.

Recognizing that the future lies with our junior faculty, the Harvard Catalyst Grant Review and Support Program continues to achieve a high rate of success in helping promising scientists secure the R-level federal grants that provide independent funding to advance research.

Biological Chemistry and Molecular Pharmacology

Drawing a Ring Around Viral Immunity. A small regulatory protein called ubiquitin, known to tag damaged proteins for recycling, has another key role, as discovered by Sun Hur, assistant professor of biological chemistry and molecular pharmacology at Boston Children’s Hospital. As reported in Nature, her team used X-ray crystallography to show that ubiquitin forms ring structures with the protein RIG-I, part of a signaling pathway that detects viral RNA and triggers an immune response. The rings, which consist of four RIG-I proteins linked together by a chain of ubiquitins, serve as platforms on which other molecules gather, helping the cell know when to produce the antiviral protein interferon. If ubiquitin binds to RIG-I using the K63-linked chain, RIG-I signals that a virus is

Marie-Louise Jean-Baptiste (right), assistant professor of medicine at Massachusetts General Hospital and Cambridge Health Alliance, demonstrates how to check blood pressure on Stephen Pelletier, Program in Medical Education senior project manager, for student Michelle-Marie Peña ‘14.

Imparting a New Genetic Vocabulary. HMS researchers created the first entirely recoded genome in Escherichia coli by replacing all instances of one of the 64 codons—the three-letter “words” composed of the nucleotides adenine (A), cytosine (C), guanine (G) and thymine (T)—with a new word of identical meaning. This enabled the replacement word to be reprogrammed with a new amino acid, expanding E. coli’s vocabulary to make proteins that normally do not occur in nature and are resistant to viruses. In an expansion of that project, published in the same edition of Science, the researchers replaced every occurrence of not one but 13 of the 64 codons across 42 key E. coli genes. Principal investigator George Church, the Robert Winthrop Professor of Genetics and founding faculty core member of the Wyss Institute for Biologically Inspired Engineering, said the ability to recode genomes may open a powerful avenue for the production of therapeutic molecules and chemicals and may provide the ability to improve the safety, productivity and flexibility of biotechnology products.

Global Health and Social Medicine

TB’s Surprising Family Tree. For years, physicians have watched as strains of Mycobacterium tuberculosis developed resistance to drugs.

As published in Nature Genetics, a research team led by Megan Murray, professor of global health and social medicine, applied a new method of analyzing whole genome sequences to a massive set of M. tuberculosis strains collected from clinics around the world. The team discovered 39 new genes associated with elevated drug resistance. The findings suggest that acquisition of resistance is a multistep process. Also, some genes may confer “global” resistance traits, which help strains become resistant to an entire group of antibiotics, rather than just one drug. By further studying the molecular mechanisms involved, the researchers hope to develop more specific targets to discourage drug resistance.

Dean’s Report 2014 I 2015 13

JESSICA POLKA

A postdoctoral research fellow in systems biology, she studies intracellular organization in bacteria and is a co-founder of Future of Research, a Boston-based group for postdocs.

14 Dean’s Report 2014 I 2015

Health Care Policy

The Mammography Dilemma. Doctors and patients rely on the mammogram as a detection tool for breast cancer, the second-leading cause of cancer deaths among U.S. women. But it is not a perfect test, says Nancy Keating, associate professor of health care policy. As published in JAMA, the Journal of the American Medical Association, a comprehensive review of international studies published over the past 50 years revealed that the benefits of mammography are often overestimated while the harms are underestimated. Mammography screening is associated with a 19 percent overall relative risk reduction in breast cancer mortality, but because most women have a very low risk of dying of breast cancer, the absolute risk reduction is small. Women between the ages of 40 and 50 who get annual mammograms have a 61 percent cumulative risk of a false-positive reading over 10 years, potentially leading to unnecessary interventions. Moreover, 19 percent of breast cancers diagnosed during screening may reflect overdiagnosis—detecting cancers that would not have become clinically evident in a woman’s lifetime in the absence of screening—subjecting patients to the harms of treatment while offering no benefit. To maximize benefits, decisions need to be based on each patient’s risk profile and preferences, with more research needed to optimize risk models and decision-making tools.

Microbiology and Immunobiology

Cellular Cross Talk in Psoriasis. As reported in Nature, HMS researchers have discovered how specific nerve cells in the skin provoke the inflammation that is the hallmark of psoriasis. Working with a model of the disease in mice, they discovered the phenomenon of neuroimmune cross talk, in which nerves beneath the skin’s surface take control of the immune signal and tell nearby dendritic cells to mount a local immune response. The team, led by Ulrich von Andrian, the Edward Mallinckrodt Jr. Professor of Immunopathology, is now investigating the ways that this damaging signal can be interrupted without affecting the body’s overall immune function; this finding could potentially open new avenues to the treatment of inflammatory skin diseases.

GEORGE CHURCH

The Robert Winthrop Professor of Genetics, he helped initiate the Human Genome Project in 1984 and the Personal Genome Project in 2005.

Neurobiology

Breaking through the Barrier. In research that may improve methods for delivering beneficial drugs to the brain, HMS researchers have found a gene that encodes a protein that limits the brain’s permeability. Normally, the blood-brain barrier provides a protective mechanism that allows nutrients to pass from the vasculature to the brain while blocking pathogens and toxins. Most drugs, however, cannot cross the barrier, thwarting current treatment approaches. In a recent study led by Chenghua Gu, associate professor of neurobiology, and published in Nature, the authors describe a mouse gene, Mfsd2a, that produces a protein that appears to inhibit a barrier-crossing mechanism called transcytosis, in which substances are transported through barrier cells in bubbles called vesicles. By transiently blocking this inhibitor’s activity, doctors may be able to briefly open the blood-brain barrier, allowing the introduction of drugs that can treat life-threatening conditions such as brain tumors, infections and multiple neurologic conditions.

Stem Cell and Regenerative Biology

Reprogramming Blood. Marking a major advance toward one of the most sought-after goals of regenerative medicine, researchers have reprogrammed mature blood cells into blood-forming hematopoietic stem cells (HSCs). These “induced” HSCs have all the functional characteristics of naturally occurring HSCs and give rise to all cellular components of blood. As reported in Cell, the study was led by Derrick Rossi, associate professor of stem cell and regenerative biology and a principal faculty member of the Harvard Stem Cell Institute. Naturally occurring HSCs are used in stem-cell transplantation procedures to treat about 50,000 patients each year. HSCs are rare, however, and in some cases finding a matched donor can be difficult. Having the ability to generate HSCs from a patient’s own mature blood cells by reprogramming could transform stem cell-transplant medicine and extend the possibility of transplantation to patients for whom a histocompatible donor cannot be identified.

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Leslie Lehmann, an assistant professor of pediatrics at Dana-Farber/Boston Children’s Hospital, visits 8-year-old pediatric leukemia patient Emma Duffin on the stem cell transplant floor.

Systems Biology

Striking a Chord. Most drugs hit multiple targets at the same time, and it’s often unclear which targets are producing desired treatment outcomes or causing unwanted side effects. HMS researchers have turned the tables on this phenomenon, which is known as polypharmacology. This is particularly a problem for drugs that inhibit a family of proteins called protein kinases. Instead of trying to make drugs act more specifically, the researchers exploited the fact that every protein kinase inhibitor has multiple targets. The team, led by Marc Kirschner, the John Franklin Enders University Professor of Systems Biology and founding chair of the Department of Systems Biology, tested many different drugs to see which ones inhibit cell migration, a process that is important in cancer but remains poorly understood. Many of the drugs inhibit migration and therefore must also inhibit the protein kinase that helps trigger migration. As published in the Proceedings of the National Academy of Sciences, the team used a novel computational technique to analyze the differential patterns of inhibition by the different drugs and then inferred which of the many protein kinases inhibited by the drugs were responsible. They confirmed their findings in cell cultures. This study opens the door to using nonspecific inhibitors in an entirely new way to identify long sought-after disease mechanisms.

Harvard School of Dental Medicine

Competing Signals in Bone Formation. Osteoporosis, a disease of low bone-mineral density associated with increased risk of fracture, is a significant health problem and socioeconomic burden. New therapies are needed to reduce its incidence. Bone morphogenetic protein (BMP) signaling plays a prominent role in skeletal development and fracture repair, and increasing evidence links BMP signaling to bone formation in the adult skeleton. Vicki Rosen, professor and chair of the Department of Developmental Biology at Harvard School of Dental Medicine, is exploring two interrelated ideas that affect how we view the interaction of signaling by BMP and the growth factor activin. First, competition between BMP and activin for shared type 2 receptors is a physiological event that influences bone formation in vivo; and second, signaling antagonism between the BMP and activin pathways occurring downstream of receptor engagement also serves to regulate bone mass in adult skeletons. These studies may lead to future therapeutic approaches to treat osteoporosis. Also this year, in a first-of-its-kind event,

Below, Linda Powers (right), assistant professor of medicine at Mount Auburn Hospital, with Anastasia Avery in the newly renovated Mount Auburn Primary Care Center.

It is one of 20 HMS sites engaged in primary care practice transformation with the HMS Center for Primary Care Academic Innovations Collaborative.

HSDM hosted a two-day symposium that focused on the economic impacts of oral health and drew more than 200 attendees.

Office of Technology Development

To advance the development of HMS discoveries into commercial products that can benefit patients, the Harvard Office of Technology Development (OTD) helped HMS researchers secure an unprecedented number of industry-sponsored research projects this year, enabling many of them, for the first time, to access the types of funding and resources usually available only to industry.

Sixty-six projects are now running with approximately half of the labs on the Quad engaged in industry collaborations. OTD also supports startup formation, as it did for the recently launched Incro Pharmaceuticals, which focuses on treating inflammatory and neurodegenerative diseases with inhibitors of necroptosis, a form of cell death discovered by a scientist in the Department of Cell Biology. OTD also awarded nine Blavatnik Biomedical Accelerator grants, which will help HMS researchers design proof-ofconcept experiments to attract industry partners and investors. A previously funded project, led by a Department of Microbiology and Immunobiology team, is harnessing a modified form of the anthrax toxin to deliver drugs into cells to either kill cancer cells or replenish diseased cells with missing molecules. Finally, OTD continues to sponsor educational programs, including workshops in which industry experts share firsthand the processes for successful drug development, and to offer an interactive Pathways to Entrepreneurship series.

Learn more about the School’s unmatched impact on medical exploration at hms.harvard.edu/research.

Service and Leadership

Thelisma Heber (left) directs the Cholera Treatment Center near Mirebalais, Haiti. Partners In Health cofounder Paul Farmer, head of the Department of Global Health and Social Medicine, led a coalition of non-governmental, governmental, corporate, foundation and academic partners in opening a new hospital there.

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RAFAEL CAMPO

An associate professor of medicine at Beth Israel Deaconess – Medical Center, as well as a poet and essayist, he uses writing to explore questions of suffering, illness and identity.

Hippocrates

Dean’s Report 2014 I 2015 17

W

hen Harvard Medical School opened in 1782, three faculty members taught a small group of students in Cambridge.

Today, there are more than 12,000 faculty in several locations: on the Quad, in our affiliated hospitals, at research institutes and in classrooms around the world. To better serve our students, faculty, patients and the medical profession, the Office for Academic and Clinical Affairs, under Dean Nancy Tarbell, the C. C. Wang Professor of Radiation Oncology, works to ensure adherence to the highest academic standards while promoting collaboration among numerous academic constituencies. This work enables HMS to continue to recruit and develop a diverse group of highly talented practitioners of medicine, biomedical research and health care.

In 2014, HMS approved two new clinical academic departments, the Department of Neurosurgery and the Department of Emer­ gency Medicine, recognizing that each discipline involves distinct training programs, fellowships and specialty boards. This new status will allow for more direct oversight of faculty appointments and has the potential to impact faculty recruitment.

To ensure excellence in medical practice across the entire HMS community, the School and its affiliates together invite external distinguished faculty to our campus for a comprehensive review of each clinical department every eight years; more than 60 reviews have been conducted since the program began in 2000.

All HMS-affiliated initiatives, programs, centers and institutes also undergo regular, rigorous review. In recent years, the application process for new centers was revitalized to promote organizational structures that facilitate collaborative research and education enterprises among Quad and affiliate departments, or among the affiliates themselves. This year the Harvard Celiac Research Program, established to improve health care delivery, quality of life and support for patients with celiac disease and other glutenrelated disorders, became the first new HMS program approved in five years. This program encourages collaboration by connecting Quad faculty members interested in celiac disease with faculty and staff in gastroenterology, dermatology, endocrinology and pathology departments at Massachusetts General Hospital, Beth Israel Deaconess Medical Center and Boston Children’s Hospital.

The Division of Medical Ethics at HMS was transformed into the Center for Bioethics to raise the visibility of bioethics topics across Harvard University and HMS affiliates. The center will deepen connections with the Program in Medical Education, weaving medical ethics and professional training through all four years and engaging nationally and internationally in the public domain to increase understanding of ethical issues such as endof-life care, genomics and the uses of big data.

Over the past six years, the Task Force on Faculty Development and Diversity has worked to define new pathways for HMS faculty

Michael VanRooyen, professor of medicine at Brigham and Women’s Hospital and director of the Division of International Health and Humanitarian Programs, interviews patients in Darfur, Sudan.

to advance their careers. In a parallel effort, under the leadership of Dean for Faculty Affairs Maureen Connelly, the School this year implemented detailed and substantive policy changes that provide clearer guidance on faculty eligibility rules and appointment titles.

Mentoring requirements for junior faculty were strengthened, as were expectations for faculty, who are required to spend at least 50 hours per year in direct training of medical, graduate or postdoctoral students or residents, fellows or peers. Junior faculty members are also required to have regular HMS career conferences. The updated policies, featured in the forthcoming HMS Faculty Governance, Appointment and Promotion Handbook, also outline the School’s more streamlined process for promotions, which this academic year facilitated the promotions of 74 faculty members to professor, 141 to associate professor and 342 to assistant professor.

The Task Force on Faculty Recruitment also developed guidelines aimed at identifying exceptional junior and senior faculty for recruitment. The overall aim is to advance the HMS goal of diversity and inclusion and to ensure that every effort is made to recruit women and minorities underrepresented in medicine.

The task force recommendations will be reviewed by the dean and the Faculty Council this coming year.

Junior faculty also benefit from yearly orientation and leadership courses. The Eleanor and Miles Shore 50th Anniversary Fellowship Program for Scholars in Medicine annually provides approximately 80 fellows with stipends to support academic activities. The HMS Foundation Funds Program assists junior faculty and postdoctoral researchers in the critical early stages of their careers. In the past two award cycles, 17 HMS physician-scientists were awarded more than $7 million in funding from organizations such as the American Diabetes Association and the Burroughs Wellcome Fund.

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Supporting the work of the School is a dedicated staff of more than 1,693 individuals who provide administrative, technical and facilities services. Human resources initiatives include implementation of streamlined web and online platforms to facilitate reference searches, evaluate skills and performance, set goals and simplify reviews, thus improving the hiring and administrative experience for both employees and managers. An organizational workforce program launched this year offers supervisor training courses quarterly to new or newly promoted supervisors.

Diversity Inclusion and Community Partnership

Dean’s Postdoctoral Fellowship. To facilitate excellence and attract a broader, more diverse cohort of postdoctoral trainees, the Office for Diversity Inclusion and Community Partnership (DICP), headed by Dean for Diversity and Community Partnership and Associate Professor of Medicine Joan Reede, this year launched the Dean’s Postdoctoral Fellowship program, a product of the Task Force for Faculty Development and Diversity. Initial funding was created for two fellows, but the program proved so successful that Quad-based departments contributed funding to support additional fellows. Six fellows, each meeting stringent postdoctoral admissions standards, participated in fall 2014. Once selected by labs or departments, the fellows receive up to two years of training in basic or social science fields. In support of the fellowship, the Society for Translational and Academic Researchers (STARS) was established to provide career development and build community.

Pathways. Leveraging a $2 million NIH Pathfinder Award, DICP has implemented Pathways, a groundbreaking platform inspired by a Harvard Catalyst | The Harvard Clinical and Translational Science Center profile tool that analyzes data to better determine

LAURA RILEY

An associate professor of obstetrics, gynecology and reproductive biology at Massachusetts General Hospital, she is a national expert on reproductive health and an author of books on pregnancy.

Above left, a child in Santa Marta, El Salvador, who has been helped by Doctors for Global Health (DGH), a nonprofit organization promoting health and education around the world.

DGH was founded by Clyde Lanford (Lanny) Smith, an assistant professor of medicine at Beth Israel Deaconess Medical Center.

He was recognized with a Dean’s Community Service Lifetime Achievement Award.

how individuals work, network and advance within HMS. Through implementation of conceptual, methodological and analytical approaches, Pathways offers quantifiable evidence that medical schools nationwide can use to foster diversity and inclusion. The Pathways diversity inclusion logic model utilizes data extracted from individual profiles, promotion dynamics, discipline characteristics and other criteria to identify factors that facilitate or serve as obstacles to faculty career advancement, illuminating possible solutions. Included in this model are metrics and measures relevant in charting progress toward diversity inclusion.

Biomedical Science Careers Student Conference. One of the School’s many successful outreach programs for young people, this biennial conference, co-sponsored by DICP and the Biomedical Science Careers Program, attracted more than 1,000 students from more than 280 institutions in 36 states, Puerto Rico and Brazil. It provided them with opportunities to network and explore career paths in biomedical science.

Center for Primary Care

The HMS Center for Primary Care is working to solve a national crisis. Approximately 66 million people live in regions of the U.S. with a shortage of primary care physicians, a gap that needs to be filled by more than 17,000 doctors and primary care teams. To help make a difference, HMS has implemented a wide range of improvement strategies and leadership opportunities for HMS students, residents and practicing primary care physicians.

Academic Innovations Collaborative. A paper published in Academic Medicine demonstrated that the 20 primary care practices in this flagship program showed significant improvement across all identified areas of transformation, including team-based care, leadership, patient engagement, evidence-based practice, quality improvement, access and care coordination. More than 275,000 patients and 500 residents are benefiting from these service improvements.

Primary Care Master’s Scholars. This past year, the center began providing support to students seeking to earn a master’s degree in any area that will further their careers as leaders in primary care. By gaining this knowledge and experience, these emerging physicians will bring valuable insights to practice redesign, health policy and public health.

InciteHealth. In 2014, the center launched a program that provides project support to collaborators from diverse disciplines who are identifying and creating solutions to urgent primary care problems. InciteHealth is expected to inspire new technologies, care delivery solutions or diagnostic tools that will strengthen essential primary care functions.

Service Abroad

In resource-poor nations, health care needs are often critical, as was the case this year in several West African countries where thousands died in an epidemic of Ebola virus disease. Paul Farmer, the Kolokotrones University Professor of Global Health and Social Medicine and co-founder of Partners In Health (PIH), visited Liberia with a contingent of health care workers to determine what could be done to boost medical staff at local clinics and hospitals in the region. With the initial help of 100 volunteers, PIH planned to set up four treatment centers in rural areas in an effort to stop the outbreak. Farmer said it is imperative that the developed world work to strengthen public health systems in countries where there are very few doctors to care for hundreds of thousands of people and shortages of materials, space and systems to respond to deadly outbreaks. Listed below are a few of the global initiatives guided by HMS faculty.

Peru. HMS researchers continue to quantify the worldwide incidence of multidrug-resistant tuberculosis (MDR-TB). They have recently completed a cohort study on bacterial and host risk factors for MDR-TB that enrolled and followed more than 4,000 patients and 12,000 household contacts in Lima. In a newly funded study at the same site, researchers are working to create new diagnostic tools for the disease and to unmask the genetic factors involved.

Haiti. Responding to the Haitian Minister of Health’s request for help with a cholera outbreak that sickened 650,000 people and claimed 8,000 lives since 2010, an HMS team has administered an oral cholera vaccine to more than 45,000 people and is evaluating its efficacy. This team is also assessing

The Athletics, a Mission Hill Little League team in Boston, prepares to play ball.

League president Rafael Luna, an HMS instructor in biological chemistry and molecular pharmacology, was honored with a Dean’s Community Service Award for his eight years of volunteer service to the league.

the impact of nutritional support for HIV-infected adults on retroviral therapy.

Mali. In this West African nation, HMS is helping to improve child survival rates by implementing prevention strategies and providing early access to care. An analysis of health outcomes following a three-year intervention designed to strengthen a community-based health system found that the mortality rate for children under age 5 dropped to one-tenth of the baseline value, febrile illness dropped from 38 percent to 23 percent, and the percentage of children receiving antimalarial drugs within 24 hours of symptom onset nearly doubled.

Rwanda. In a collaborative program, HMS and Brigham and Women’s Hospital educators continue to train professionals in clinical medicine in this African nation and are making progress in initiatives such as malaria treatment and reducing the risk of postsurgical infection.

Global Surgery. Although developing countries are home to more than two-thirds of the globe’s population, fewer than onefourth of the world’s surgical procedures are performed in these countries. Guided by faculty in the Department of Global Health and Social Medicine, the Lancet Commission on Global Surgery is analyzing the state of surgical care in low- and middle-income countries, outlining what is needed for a properly functioning global surgical system.

20 Dean’s Report 2014 I 2015

Honors and Awards*

NATIONAL ACADEMY OF SCIENCES This year, five faculty members were elected to the academy in recognition of their distinguished and continuing achievements in original research: Bruce Bean, the Robert Winthrop Professor of Neurobiology, whose research is directed at understanding electrical signaling in the brain; Emery Brown, the Warren M. Zapol Professor of Anaesthesia at Mass General, who is developing statistical methods for neuroscience data analysis and characterizing the neurophysiology of how anesthetics work; Timothy Mitchison, the Hasib Sabbagh Professor of Systems Biology, whose research involves the fundamental mechanisms that cells use for physical organization and movement, primarily the dynamic organization of the microtubule cytoskeleton during cell division; Vamsi Mootha, professor of systems biology and of medicine at Mass General, whose work has led to the molecular discovery of more than one dozen Mendelian mitochondrial disease genes and to the discovery that mitochondrial dysfunction is associated with the common form of Type 2 diabetes and to the identification of the molecular components of the mitochondrial calcium uniporter; and Martin Pollak, professor of medicine at Beth Israel Deaconess, whose lab studies the genetic basis of human kidney disease and recently demonstrated that two common variants in the APOL1 gene that protect against certain forms of trypanosome infection explain the high rate of kidney disease in people of recent African ancestry.

INSTITUTE OF MEDICINE Seven HMS faculty were among the 70 new members elected in 2014 to the Institute of Medicine (IOM), the health arm of the National Academy of Sciences.

The appointments recognize individuals who have demonstrated outstanding professional achievement and dedication to service. The seven HMS faculty were: Elliot Chaikof, the Johnson and Johnson Professor of Surgery, surgeon-inchief and chair of the Roberta and Stephen R. Weiner Department of Surgery, Beth Israel Deaconess E. Antonio Chiocca, the Harvey W. Cushing Professor of Neurosurgery at HMS, neurosurgeon-in-chief and chair of the Department of Neurosurgery, co-director of the Institute for the Neurosciences at Brigham and Women’s/ Faulkner Hospital, and surgical director of the Center for Neuro-Oncology at Dana-Farber Cancer Institute Todd Golub, professor of pediatrics at Boston Children’s, Charles A. Dana Investigator at Dana-Farber, Howard Hughes Medical Institute (HHMI) investigator and chief scientific officer at the Broad Institute of Harvard and MIT Bradley Hyman, the John B. Penney, Jr. Professor of Neurology and Alzheimer’s unit director at the MassGeneral Institute for Neurodegenerative Disease Paula Johnson, professor of medicine, chief of the Division of Women’s Health and executive director of the Connors Center for Women’s Health and Gender Biology at Brigham and Women’s and professor of epidemiology at Harvard School of Public Health Margaret Shipp, professor of medicine at Dana-Farber and Brigham and Women’s and chief of the Division of Hematologic Neoplasia, Dana-Farber Bruce Spiegelman, the Stanley J. Korsmeyer Professor of Cell Biology and Medicine at Dana-Farber and the Department of Cell Biology AMERICAN ACADEMY OF ARTS & SCIENCES The American Academy of Arts & Sciences elected five HMS faculty to this year’s class of fellows: Bruce Bean, the Robert Winthrop Professor of Neurobiology; Elazer Edelman, professor of medicine and director of the Harvard-MIT Bio*as of 10.31.14

VINCENZO MAZZONE

Custodial supervisor, Campus Operations, he helped institute a biowaste program that eliminated the need for more than 11,000 cardboard boxes, which won him a Harvard University Green Carpet Award.

Dean’s Report 2014 I 2015 21

medical Engineering Center, senior attending physician in the coronary care unit at Brigham and Women’s and the Thomas D. and Virginia W. Cabot Professor of Health Sciences and Technology at MIT; Alvin Poussaint, professor of psychiatry and faculty associate dean for student affairs; Bernardo Sabatini, the Alice and Rodman W. Moorhead III Professor of Neurobiology and HHMI investigator; and Rachel Wilson, professor of neurobiology and HHMI investigator.

ROYAL SOCIETY In 2014, two HMS faculty members were elected foreign members of the Royal Society: Stephen Harrison, the Giovanni Armenise–Harvard Professor of Basic Biomedical Science in the Department of Biological Chemistry and Molecular Pharmacology, who determined the first structure of an intact virus particle as well as the mechanisms of viral entry and assembly; and Clifford Tabin, the George Jacob and Jacqueline Hazel Leder Professor of Genetics and chair of the Department of Genetics, who has made fundamental discoveries in embryonic development, identifying the first known secreted morphogen, Sonic hedgehog, and elucidating how morphogens orchestrate formation of the human embryo.

GAIRDNER AWARD Harold Dvorak, the Mallinckrodt Distinguished Professor of Pathology and senior investigator in the Center for Vascular Biology Research at Beth Israel Deaconess, was one of eight scientists honored with the 2014 Canada Gairdner International Award. His work included the landmark discovery of vascular endothelial growth factor (VEGF), a key molecular mediator of new blood vessel formation, and the development of effective anti-VEGF therapy for cancer and macular degeneration.

WOLF PRIZE, GRUBER GENETICS PRIZE AND BREAKTHROUGH PRIZE Gary Ruvkun, professor of genetics and investigator at Mass General, was named a co-recipient of the 2014 Wolf Prize in Medicine for his contributions to the discovery of microRNAs and small interfering RNAs. This work also led to his sharing the 2014 Gruber Genetics Prize and his receipt of a $3 million Breakthrough Prize in Life Sciences.

BLAVATNIK NATIONAL AWARDS Rachel Wilson, professor of neurobiology and an HHMI investigator, was recognized as an inaugural Blavatnik National Laureate for her groundbreaking research on sensory processing and neural circuitry in the fruit fly.

ENDOWED PROFESSORSHIPS The following newly established HMS professorships were celebrated this past year, recognizing the generosity of their respective benefactors and the accomplishments of their inaugural incumbents.

Michael E. Chernew, the Leonard D. Schaeffer Professor of Health Care Policy Dean Eliott, the Stelios Evangelos Gragoudas Associate Professor of Ophthalmology Marc B. Garnick, the Gorman Brothers Clinical Professor of Medicine Terrie E. Inder, the Mary Ellen Avery Professor of Pediatrics in the Field of Newborn Medicine John F. Kelly, the Elizabeth R. Spallin Associate Professor of Psychiatry in the Field of Addiction Medicine Martin A. Samuels, the Miriam Sydney Joseph Professor of Neurology Ron M. Walls, the Neskey Family Professor of Emergency Medicine Ralph Weissleder, the Thrall Family Professor of Radiology

Opposite page, the Harvard Program in Therapeutic Science (HiTS) is rethinking the basic and clinical science needed to discover, develop and deliver better drugs. Investigators from Harvard and other universities, HMS and HMS-affiliated hospitals combine experiments and computation in a systems approach to modeling therapeutic and toxic drug responses.

Cameron D. Wright, the Mathisen Family Professor of Surgery in the Field of Thoracic Surgery Ramnik Xavier, the Kurt J. Isselbacher Professor of Medicine in the Field of Gastroenterology AMERICAN ASSOCIATION FOR THE ADVANCEMENT OF SCIENCE This year, three HMS faculty were named fellows: Ole Isacson, HMS professor of neurology (neuroscience) at McLean Hospital and Mass General, for contributions to neuroscience and neurology, particularly for helping to elucidate the neurobiology of Parkinson’s disease and for innovations in applications of stem cells; Ali Khademhosseini, professor of medicine at Brigham and Women’s, for contributions at the interface of engineering, materials sciences and biology, particularly for the application of micro- and nano-engineered materials for regenerative medicine; and Timothy Alan Springer, the Latham Family Professor of Biological Chemistry and Molecular Pharmacology, for establishing the paradigm that the immune and vascular systems use adhesion molecules and for discovering how they regulate immune responses and the passage of blood cells through vessel walls and into tissues.

SUSAN G. KOMEN BRINKER AWARD FOR SCIENTIFIC DISTINCTION IN BASIC SCIENCE / BREAST CANCER ALLIANCE EXCEPTIONAL PROJECT GRANT Joan Brugge, the Louise Foote Pfeiffer Professor of Cell Biology and co-director of the Ludwig Center at Harvard, is this year’s recipient of the prestigious Susan G. Komen Brinker Award for Scientific Distinction in Basic Science. Brugge was also awarded the 2014 Breast Cancer Alliance Exceptional Project Grant.

BURROUGHS WELLCOME FUND CAREER AWARDS FOR MEDICAL SCIENTISTS Marcin Imielinski, clinical fellow in pathology at Mass General, was awarded a 2014 Burroughs Wellcome Fund Career Award for Medical Scientists.

FRANKLIN INSTITUTE AWARD Christopher T. Walsh, the Hamilton Kuhn Professor of Biological Chemistry and Molecular Pharmacology Emeritus, received the 2014 Benjamin Franklin Medal in Chemistry from The Franklin Institute for his research focusing on enzymes and enzyme inhibition.

AMERICAN SOCIETY FOR THERAPEUTIC RADIOLOGY AND ONCOLOGY Nancy Tarbell, the C.C. Wang Professor of Radiation Oncology and dean for academic and clinical affairs, received a 2014 ASTRO Gold Medal award. Tarbell has had a major influence on advances in pediatric oncology and radiation therapy and has worked to expand the presence of women faculty in radiation oncology and other disciplines.

PRESIDENTIAL EARLY CAREER AWARD Sandra McAllister, assistant professor of medicine at Brigham and Women’s, is one of 102 researchers named by President Barack Obama as a recipient of the Presidential Early Career Award for Scientists and Engineers. Her research in cancer biology focuses on identifying systemic factors that affect the course of metastatic cancer.

For more HMS awards, please visit: hms.harvard.edu/news/all-news?tid=16.

Facts and Figures

HM “Alone we can do so little; together we can do so much.”

– Helen Keller

MS

Dean’s Report 2014 I 2015 23

Jeffrey S. Flier, MD Dean of the Faculty of Medicine

ACADEMIC DEANS

Sanjiv Chopra, MB, BS Faculty Dean for Continuing Education (Nov 2001 – July 2014)

Maureen Connelly, MD, MPH Dean for Faculty Affairs Jules Dienstag, MD Dean for Medical Education (May 2005 – Oct 2014)

David Golan, MD, PhD Dean for Graduate Education

Edward Hundert, MD Dean for Medical Education (Oct 2014 – ) Lee Nadler, MD Dean for Clinical and Translational Research Nancy Oriol, MD Dean for Students

Joan Reede, MD, MS, MPH, MBA Dean for Diversity and Community Partnership

David Roberts, MD Dean for External Education Nancy Tarbell, MD Dean for Academic and Clinical Affairs

HARVARD SCHOOL OF DENTAL MEDICINE R. Bruce Donoff, DMD, MD Dean

ADMINISTRATIVE DEANS

Wesley Benbow Interim Executive Dean for Administration (July 2013 – May 2014) Chief Financial Officer (Feb 2010 – July 2014) Gretchen Brodnicki Dean for Faculty and Research Integrity Pamela Caudill Chief Research Operations Officer

John Czajkowski Executive Dean for Administration (June 2014 – )

Rainer Fuchs Chief Information Officer

Judith Glaven Associate Dean for Basic and Interdisciplinary Research Lisa Muto Associate Dean for ​ Institutional Planning and Policy Susan Rapple Dean of Resource Development

Richard Shea Associate Dean for Campus Planning and Facilities Julie Stanley Chief Human Resources Officer

Gina Vild Associate Dean for Communications and External Relations and Chief Communications Officer

PRECLINICAL DEPARTMENT CHAIRS

Stephen Blacklow, MD, PhD Gustavus Adolphus Pfeiffer Professor of Biological Chemistry and Molecular Pharmacology Chair, Biological Chemistry and Molecular Pharmacology Joan Brugge, PhD Louise Foote Pfeiffer Professor of Cell Biology Chair, Cell Biology (July 2004 – Nov 2014) Paul Farmer, MD, PhD Kolokotrones University Professor of Global Health and Social Medicine Chair, Global Health and Social Medicine

Michael Greenberg, PhD Nathan Marsh Pusey Professor of Neurobiology Chair, Neurobiology Wade Harper, PhD Bert and Natalie Vallee Professor of Molecular Pathology Chair, Cell Biology (Nov 2014 – )

Marc Kirschner, PhD John Franklin Enders University Professor of Systems Biology Chair, Systems Biology

Barbara McNeil, MD, PhD Ridley Watts Professor of Health Care Policy Chair, Health Care Policy

John Mekalanos, PhD Adele Lehman Professor of Microbiology and Molecular Genetics Chair, Microbiology and Immunobiology

Douglas Melton, PhD Xander University Professor of Stem Cell and Regenerative Biology Co-chair, Stem Cell and Regenerative Biology

David Scadden, MD Gerald and Darlene Jordan Professor of Medicine Co-chair, Stem Cell and Regenerative Biology Clifford Tabin, PhD George Jacob and Jacqueline Hazel Leder Professor of Genetics Chair, Genetics

24 Dean’s Report 2014 I 2015

FUNDRAISING HIGHLIGHTS

FY14 GIFTS AND PLEDGES BY PURPOSE

Harvard Medical School depends upon a generous philanthropic community whose members believe deeply in our mission to alleviate human suffering caused by disease. In fiscal year 2014, our circle of supporters—including nearly 4,200 alumni, friends, faculty, staff, foundations, corporations and leadership volunteers—gave nearly $135 million to support work in the School’s areas of highest priority: education, discovery, service and leadership.

In education, these gifts are helping to lift the debt burden for students and to create state-of-theart spaces for teaching and learning. In the area of discovery, these gifts propel the largest biomedical research engine in the world, supporting research in virtually every field, from gleaning new insights into the basic biology of cancer to probing the role of chronic inflammation in the origin and progression of disease. Our service initiatives are being amplified through gifts bolstering our commitment to transforming health care systems in the U.S. and abroad, such as supporting tuberculosis treatment, improving the delivery of surgical care worldwide, transforming primary care practice and education, addressing evolving ethical questions and shaping policies. And finally, in the area of leadership, discretionary gifts provide the dean with the flexibility to help incubate innovation and pilot change toward improved human health.

n

Research 60% Professorships and faculty support 24% n Unrestricted 8% n Other 5% n Financial aid 3% n

5%

3%

8%

24%

60%

Learn more about the impact of philanthropy through the School’s Honor Roll of Donors at: http://hms.harvard.edu/honor-roll.

BY THE NUMBERS Total faculty 12,426 I Tenured and tenure-track faculty on HMS campus, in nine preclinical departments 175 I Voting faculty, campus and affiliates 5,537 I Full-time faculty, campus and affiliates 9,673 Nobel Prizes (Physiology or Medicine, Peace) 9 prizes, 15 recipients (cumulative) I Howard Hughes Medical Institute investigators 36 I Institute of Medicine members 189 I National Academy of Sciences members 65 (current) Total MD students 726 I Total PhD students 803 I MD-PhD students 178: basic sciences 162, social sciences 16 (total included in MD and PhD counts) I Total DMD students 145 I Total MMSc students 127 I Total DMSc students 37 I Trainees (residents and postdoctoral fellows) 9,202

COLLABORATIONS ACROSS HARVARD Broad Institute of MIT and Harvard 3% 7%| The Harvard Clinical Harvard Catalyst 8% and Translational Science Center Harvard Stem Cell Institute Wyss Institute Inspired Engineering 13% for Biologically43%

Students entering in 2014: MD (includes 13 MD-PhD) 164 I Applicants 6,614, Admitted 231 (3.5%) I Matriculated (includes 13 MD-PhD students) 164 I Men 84 (51%) I Women 80 (49%) I Underrepresented in medicine (African-American, Native American, Hispanic, Mexican-American) 31 (19%) I Asian 56 (34%)

26%

Entering PhD, DMD, MMSc, DMSc students, 2014: PhD 139 I DMD 35 I MMSc 70 I DMSc 3 Additional joint degree programs: MD-MBA; MD-MPH; MD-MPP Medical school alumni 9,813 (MD and MMSc degrees)

7% 13%

AFFILIATED HOSPITALS AND INSTITUTIONS

39%

$87,107,000

$97,603,850

$113,763,436

Joslin Diabetes Center Judge Baker Children’s Center Massachusetts Eye and Ear/ Schepens Eye Research Institute Massachusetts General Hospital McLean Hospital Mount Auburn Hospital Spaulding Rehabilitation Hospital Veterans Affairs Boston Healthcare System $ 94,685,992

Beth Israel Deaconess Medical Center Boston Children’s Hospital Brigham and Women’s Hospital Cambridge Health Alliance Dana-Farber Cancer Institute Forsyth Institute (HSDM affiliate) Harvard Pilgrim Health Care Institute Hebrew SeniorLife

FY

FY

FY

FY

11

10

09

08

13%

28%

24%

60%

Dean’s Report 2014 I 2015 25

FY 2014 OPERATING REVENUE n Research grants and contracts n Endowment distribution for operations n Other revenues* n Rental income n Gifts for current use n Tuition (net)

Total

7%

$265,924,287 43% $159,556,535 26% $79,301,702 13% $50,165,361 8% $41,797,547 7% $20,391,928 3% $617,137,359

3%

8% 13%

43%

26%

* Includes continuing medical education, publications, service income and royalties

7%

$256,977,563 $186,679,133 $86,080,347 $85,280,974 $47,092,523 $662,110,540

39% 28% 13% 13% 7%

13% 39% 13%

$87,107,000

28%

$97,603,850

Harvard Medical School reports another year of remarkable progress, achieved while holding its finances steady in the face of continued pressures on funding for research and eduFY cation. HMS ended the 2014 fiscal year 11 (FY14) with a $45.0 million deficit, as compared with $44.7 million in 2013.

While we are pleased to have halted the growth of the deficit, we are not satisfied with the current fiscal position and have begun developing responsive new programs and strategies to lead the School toward an increasingly sustainable financial model.

$113,763,436

FINANCIAL REPORT

$ 94,685,992

FY 2014 OPERATING EXPENSES

n Personnel costs n Supplies and other expenses n Plant operations and interest n Research subcontracts and affiliates n Depreciation Total

In FY14, operating revenues totaled $617 million, an increase of $12.1 million, or 2.0 percent. Revenue from research grants decreased by 1 percent, yet the School benefited FY FY FY from greater distribution of the endow10 09 08 ment, generous current-use gifts, new graduate and continuing education course revenue and increased rents from leased properties.

Total operating expenses in FY14 increased by $12.4 million, or 1.9 percent, to $662 million. We limited most costs to an inflationary increase and began to benefit from our

efforts to generate operating efficiencies across the School. The nature of new research grants was collaborative and global, which resulted in more subcontracts and purchased services.

We also increased our budget to allow for the maintenance of our campus.

We have much to look forward to as we pursue key initiatives. Among our most promising ventures is the creation of the Office for External Education. We also are planning for a bold new curriculum redesign within our Program in Medical Education. As in the past, our HMS faculty remain in

the vanguard of biomedical research.

We are grateful for the partnerships that make this progress possible and that enable us to advance our mission to alleviate human suffering caused by disease.

Credits: Writing and editing by M.R.F. Buckley and Christine Paul; design and art direction by

Produced by the HMS Office of Communications and External Relations: Gina Vild, Associate

Paul DiMattia; photo editing by Angela Alberti; copyediting by Bobbie Collins, Susan Karcz and Ann Marie Menting; research assistance by Mary Commisso. Photography by Steve Lipofsky; Sam Ogden; John Soares and Steven Vote. Additional photos courtesy of Angela Alberti, Suzanne Camarata; Dana-Farber Cancer Institute; Doctors for Global Health; Florence Hariton; Justin Ide; Philip Kim; Rose Lincoln; Rebecca E. Rollins, Partners In Health; and Paul Spirn, Mission Hill Little League. Printed by Kirkwood Printing.

Dean of Communications and External Relations and Chief Communications Officer, 107 Avenue Louis Pasteur, Suite 111, Boston, MA 02115, (617) 432-0442, communications@hms.harvard.edu.

25 Shattuck Street Boston, Massachusetts 02115 www.hms.harvard.edu