People, Purpose, PRIDE: Celebrating the UCSF School of Medicine

People, Purpose, PRIDE. Celebrating the UCSF School of Medicine Highlights from Academic Year 2018-2019

UCSF PRIDE Values UCSF PRIDE values are the cornerstone for everything we do and unite our faculty, learners, researchers, caregivers, and staff in building a culture of collaboration that inspires us be our best today and in the future.

Described in more detail, UCSF’s PRIDE Values and how they can be enacted through our daily lives are: P - Professionalism: To be competent, accountable, reliable and responsible, interacting positively and collaboratively with all colleagues, students, patients, visitors and business partners.

R - Respect: To treat all others as you wish to be treated, being courteous and kind, acting with utmost consideration of others.

I - Integrity: To be honest, trustworthy and ethical, always doing the right thing, without compromising the truth, and being fair and sincere.

D - Diversity: To appreciate and celebrate differences in others, creating an environment of equity and inclusion with opportunities for everyone to reach their potential.

E - Excellence: To be dedicated, motivated, innovative and confident, giving your best every day, encouraging and supporting others to excel in everything they do.

Cover: Specialized signaling filopodia called cytonemes (blue) extend from the developing air sac primordium to the cells of the wing imaginal disc of Drosophila larva. Nuclei (orange) of all cells and membranes (blue) of air sac primordium cells are visualized with Structured Illumination Microscopy (SIM).

Signaling by touch is necessary for the air sac primordium and the imaginal wing disc to properly develop into the air sac and wing in the adult fruit fly. Photo by Brent Wood.

This page: Graduating class of 2019. Photo by Elisabeth Fall.

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CONTENTS 2 Greetings from Dean Talmadge King

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3 Education

On Advancing the Academic Mission: Vice Dean for Education, Catherine R. Lucey, MD, MACP 8 Research

On Bridging the Gap from Curiosity to Cure: Vice Dean for Research, David Morgan, PhD Research by-the-Numbers Research Highlights Takeaways from Our 2019 Leadership Retreat on Research 14 Patient Care

On the UCSF School of Medicine’s Role in Our Academic Health System: Vice Dean for Clinical Affairs, Josh Adler, MD

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Clinical Highlights Provider Satisfaction 18 Population Health

On the Importance of Understanding the Social Determinants of Health: Inaugural Vice Dean of Population Health and Health Equity, Kirsten Bibbins-Domingo, MD, PhD, MAS 21 Dean’s Priorities

Strategic Plan Diversity, Equity, and Inclusion Staff Engagement

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On Progress, Plans, and Space Management: Vice Dean for Space Strategy, Bruce Wintroub, MD Philanthropy 28 A Look Ahead

FROM THE DEAN

A remarkable year for the School of Medicine

D

ear Colleagues and Friends of the UCSF School of Medicine,

tI am pleased to share People, Purpose, PRIDE – highlighting some of this past academic year’s remarkable accomplishments.

This report, written in the spirit of transparency and open communication, is just one chapter in the continually evolving narrative of innovative and inclusive excellence at the UCSF School of Medicine (UCSF SOM). It is part of a much larger effort to ensure that all members of the UCSF community understand the mission, vision, values, and priorities of the School, appreciate how their contributions are critical to our success, and are aware of the wealth of resources that are available to them.

Talmadge E. King, Jr., MD Dean

The mission of UCSF is Advancing Health Worldwide. The UCSF SOM contributes to this mission through excellence in education, research, patient care, and public service. As Dean, my goal is to serve as a leader who creates an environment that unleashes the talent of our community to meet our goals of training the healthcare workforce for the future, providing the highest quality and most compassionate patient care, answering the most pressing questions in biomedical research, and meeting the needs of a dynamic scientific and health care landscape.

• Managing essential resources, such as funds technology, and space, to ensure faculty, staff, and learners can work and collaborate effectively, while accommodating continued growth and ensuring a sustainable future for the School.

• Increasing financial support for our students and faculty to sustain the next generation of leaders and provide them with the advanced tools and facilities to do their best work.

In all of these domains, I aspire to make the UCSF SOM the most diverse, equitable, and inclusive academic institution in the country. I strive every day to encourage and support a culture that celebrates our history, while evolving to address the unique challenges of today.

This year, we saw significant progress in each of our key mission areas, entered the implementation phase of our five-year strategic plan, and moved the needle on our diversity, equity, and inclusion goals through our Differences Matter Program. This report will take a closer look at the projects that continue to advance the UCSF SOM, and the people responsible for their success.

At UCSF, we are truly privileged. Our people have seats at the table in guiding health policy throughout the world. In that position, we have both the honor and the obligation to ensure the health of the communities we serve, by strengthSpecifically, I focus on: ening health systems and addressing health in• Advancing the academic mission by en- equities when and where we encounter them. couraging and supporting research and Now in my fifth year as Dean, reflecting on scholarly activities in the relevant disciplines that will improve our basic under- the past academic year fills me with more apstanding of the causes, mechanisms, treat- preciation than ever for the outstanding contriment and prevention of disease, and the butions of the UCSF SOM. I am inspired every social interactions related to human health. day by the talent, dedication, and collaborative nature of our community, and I look forward to • Empowering our faculty, staff, and learn- what the year ahead will bring. ers, by allocating the resources needed to foster a work environment in which Regards, patient care, teaching, and research can thrive.

• Recruiting and retaining talented individuals who possess both a deep commitment Talmadge E. King, Jr., MD to the academic mission and an under- Dean, UCSF School of Medicine standing of leadership and organizational operations, and providing these leaders with the professional development to excel in their roles.

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Education On Advancing the Academic Mission

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he UCSF School of Medicine is internationally recognized as a leader in evidence-based, innovative educational programs. We view medical education as a public good, responsible for preparing the workforce to improve the health of our communities and reduce suffering for our patients To that end, the school provides outstanding support to develop, innovate, and continually improve scholarship by offering high quality educational programs across the continuum, from pipeline programs to continuing medical education and faculty development. This work enables learners to work within complex systems to improve health care and advance science for future generations.

• Expanded work focusing on optimizing wellbeing in residents and fellows, including initiating work to address work hours concerns in residency programs.

• Launched a new unit, the Learning and Caring Ecosystem (LACE) unit to support effective, efficient faculty development for front-line clinical teachers.

Excellence in our education mission is only possible because of excellence in patient care, research, and all of UCSF’s mission areas. We are constantly inspired by the work of our faculty, staff, and learners, and feel lucky to be part of such a collaborative and helpful community.

Together, we are preparing physician-leaders to transform 21st century health care.

Like our students, we are continuously learn- With gratitude, ing and improving. Below are three of many exciting developments from the 2018-2019 academic year: • Received full accreditation by the Liaison Committee of Medical Education (LCME) Catherine R. Lucey, MD, MACP through 2026.

Executive Vice Dean and Vice Dean for Education • Welcomed the UCSF San Joaquin Valley Program in Medical Education, reaffirm- The Faustino and Martha Molina Bernadett ing our commitment to addressing the Presidential Chair in Medical Education needs of underserved populations in Cal- Professor of Medicine ifornia and establishing UCSF Fresno as a clinical regional branch campus of the UCSF School of Medicine.

• Activated Career Launch, the final phase of the innovative Bridges Curriculum, in which fourth-year medical students participate in clinical experiences and scholarly projects aligned with their career goals.

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E D U C AT I O N

School of Medicine Receives Full LCME Accreditation In 2018-2019, medical education leadership and staff successfully managed and led the School of Medicine’s LCME reaccreditation achieving full accreditation status until 2026.

The accreditation process culminated a twoyear process involving more than 200 faculty, staff and leaders and led to a variety of new quality initiatives, including the establishment of the School of Medicine’s strategic plan, new approaches to medical student grading, and the development of a medical student lounge at Mission Bay hospital.

The accreditation process required all of us from across the continuum of education to focus

on continuous quality improvement. While the majority of the last year’s reaccreditation process focused on our Undergraduate Medical Education programs, all aspects of our education mission were impacted. As with everything we do, we benefited from the collaborative spirit of UCSF and were driven by the principle that through this accreditation process we would improve our learning environment for all.

As a result of the LCME site visit, medical education will continue to focus on clerkship adherence to accreditation standards, improving clinical space for learners and enhancing our career advising program for students.

New Approach to Grading in Core Clerkships To promote fairness, equity and wellbeing early in students’ clinical training, the UCSF School of Medicine moved to a pass/fail grading system in core clerkships in January 2019. This decision, based on local evidence documenting persistent issues with equitable grading in clerkships and national and international published literature on best practices in assessment and learning, was informed by student, faculty, and department chair feedback. The new approach emphasizes students’ development of essential skills, and students’ own accountability for their learning by seeking feedback and setting goals.

“The decision to remove traditional tiered grading from the core clinical year creates a tremendous opportunity to support student learning in the clinical years,” said Karen Hauer, MD, PhD, Associate Dean for Assessment.

“We believe that this decision will help improve learning, equity, fairness, and student well-being during their first year of full-time clinical

immersion. Students will be able to focus on becoming the best physician they can be instead of competing against one another.” The rationale for this policy decision can be found here, and you can also watch a video describing the change in clerkship grading.

To help the school plan for this transition, Dr. Cees van der Vleuten, PhD, Scientific Director of the Department of Educational Development and Research at the Maastricht School of Health Professions, University of Maastricht, the Netherlands spent the last year working with a number of UCSF educational task forces to understand the culture of assessment, feedback and competency decisions at UCSF and rethink the approach to assessment in the clinical years. Dr. van der Vleuten’s work was paid for by UCSF Presidential chair funds through the Center for Faculty Educators.

“Eliminating grades in favor of competencybased assessment systems focused on assessment for learning holds promise to engage learners in the process of developing essential patient care and teamwork skills and foster their development of lifelong learning habits.”

Dr. Catherine Lucey

Career Launch: The Final, Individualized Phase of the Bridges Curriculum In March 2019, fourth-year medical students at UCSF began Career Launch, the final phase of the Bridges Curriculum. During this individualized component of their training, students participate in clinical experiences and scholarly projects aligned with their career goals.

UCSF medical students in clerkships.

A key component of the Career Launch phase, is that all medical students are now required to spend 12-20 weeks completing a scholarly project prior to graduation. Known as Inquiry Deep Explore, this is the capstone requirement for the Inquiry Curriculum, a four-

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year longitudinal program focused on teaching students how to develop scholarly ‘habits of mind.’ Through this curriculum, students advance from consumers of biomedical literature to producers of new knowledge and discoveries. The Inquiry Curriculum is directed by Rita Redberg, Professor of Medicine who was appointed to the position in the summer of 2019.

Read more about Career Launch at meded.ucsf.edu/career-launch.

E D U C AT I O N

Welcoming the First Cohort of Students in the UCSF San Joaquin Valley Program in Medical Education (SJV PRIME) The first cohort of students in the UCSF San Joaquin Valley Program in Medical Education (SJV PRIME) began their medical education in August of 2019. SJV PRIME is a tailored track at the UCSF School of Medicine that aims to train students who are passionate about engaging with the community and working with underserved populations in California’s San Joaquin Valley.

In 2018, the Liaison Committee on Medical Education, the national medical school accrediting body, approved the program transfer from the UC Davis School of Medicine to the UCSF School of Medicine. The program was fully redesigned from admissions through curriculum by a group headed by program director Loren Alving, MD from UCSF Fresno and Director of the Academy of Medical Educators, Ann Poncelet MD. The San Joaquin Valley has historically faced drastic shortages of physicians and other healthcare professionals. According to a 2018 report by the University of California Office of the President, the region has the lowest ratio of licensed physicians, nurses, nurse practitioners, therapists, counselors, and social workers per 100,000 population in the state. Research shows that where physicians are raised and where they complete residency are strong predictors of where they will eventually practice. Therefore,

to combat the provider shortage, SJV PRIME aims to train future physician leaders with ties to the Central Valley, in an effort to ensure that the region will have a sufficient physician workforce to meet its future health care needs.

With the combined expertise of UCSF, UCSF Fresno and UC Merced faculty, researchers, educators, and leaders, the six students in the first class of UCSF SJV PRIME will gain exposure to supplementary curriculum exploring the unique health care needs of the Central Valley. For example, students will spend the first 18 months of Foundations 1 in San Francisco, along with classmates in the MD program, and attend a seminar course similar in structure to that in the Program in Medical Education for the Urban Underserved (PRIME-US). They will then transfer to the Fresno campus to complete their Foundations 2 and Career Launch curriculum.

PROGRAM LE ADERSHIP Kenny Banh, MD Assistant Dean of Undergraduate Medical Education UCSF Fresno Undergraduate Medical Education Program

Loren Alving, MD Director SJV PRIME

Leticia Rolon, MD Associate Director SJV PRIME

The SJV PRIME seminar will explore social determinants of health and educate students on the San Joaquin 6, a curricular framework that captures pertinent issues of the Central Valley, which includes coccidioidomycosis, methamphetamine use, human trafficking, pre-term birth, diabesity, and immigrant health.

Learn more about the inaugural class of UCSF SJV PRIME students here.

New Faculty Co-Directors Offer New Vision for Career Advising Heather Whelan, MD Clinical Professor, Hospital Medicine

Brent Kobashi, MD Associate Clinical Professor, General Internal Medicine

In October 2018 Heather Whelan, MD and Brent Kobashi, MD began inaugural roles as Faculty Co-Directors of Career Advising for the School of Medicine. In this role, they recommend improvements to the School’s career advising programs for medical students, evaluate and implement best practices in career development and match advising, and more.

The School of Medicine’s Career Advising Program is a four-year initiative that spans from matriculation through graduation. The pro-

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gram includes a career exploration curriculum, counseling services, specialty and program data, and faculty career advisors.

With the implementation of this new role for Faculty Directors of Career Advising, the School of Medicine and its Student Experience Team (SET) have formalized their strong commitment to bringing additional support and resources to support our medical students at critical points during their journey through medical school.

E D U C AT I O N

Two New UCSF Graduate Medical Education Innovations Lead the Way in Quality, Safety, Equity, and Value Building on a long history of engaging residents and fellows in quality improvement and patient safety, UCSF graduate medical education (GME) has expanded its efforts with an enhanced resident-led quality improvement program called REFLECT (Residents and Fellows Leading Interprofessional Continuous Improvement Teams). Working closely with health system and specialty-specific QI leaders, residents and fellows use Lean methodology to design program-specific projects that impact the patients they care for. Each project is aligned with institutional goals, integrated with interprofessional Unit-Based Leadership Teams, and posted on local True North Boards. Residents and fellows present their ongoing work during Leadership Rounds three times per year.

REFLECT is led by Dr. Glenn Rosenbluth at UCSF Health; Dr. Esther Chen leads a similar

26% of our 2018 cohort of residents (not including fellows and nonMD trainees) were from the UC system: 48 hailed from

UCSF GME program at ZSFG. Virtually all residents and fellows now participate in these programs.

To support the increased resident and fellow learning in quality and safety, a new group of faculty are being trained as Learning Health System (LHS) Coaches to be experts in continuous improvement science in order to teach and coach these skills. The LHS Coaching Program currently includes two cohorts of 15 interprofessional faculty who work and learn together for two years to become Certified Lean Leaders and LHS Coaches. The program trains physicians, nurses, pharmacists, and other health professional leaders and is led by Drs. Lei Choi and Ralph Gonzales.

itive grant from the Accreditation Council for Graduate Medical Education called Pursuing Excellence in the Clinical Learning Environments. UCSF was one of 8 GME institutions selected out of over 800 eligible programs. These programs have grown and are being sustained

by UCSF to continue long after the grant is completed. “These programs will have a lasting impact on the role of residents and fellows in providing quality patient care and truly interprofessional clinical learning environments,” said Associate Dean for GME Bobby Baron, MD.

These programs began as part of a compet-

Kanbar Center Advances Scholarship on Simulation and Learning The UCSF Kanbar Center for Simulation and Learning, a state-of-the-art training facility, has two new Baum Faculty Scholars dedicated to advancing simulation at UCSF. Sneha Daya, MD, Assistant Professor of Internal Medicine, will focus on simulation-based assessment and Tushani Illangasekare, MD, Assistant Professor of Obstetrics and Gynecology, will use simulation to tackle inequity and bias. The Baum Faculty Scholars program is funded through the Baum Family Presidential Chair for Experiential Learning, a generous gift from John and Mindy Baum.

Mindy Ju, MD, Associate Professor of Pediatrics was appointed the Associate Education Director of the Kanbar Center. In this new position, Mindy will oversee quality assurance, American Heart Association Emergency Cardiac Care Courses and all evaluation and assessment data in the center. Mindy joins Kanbar after having served as the Kanbar Center’s first Simulation Fellow and completing the UCSFUC Berkeley Master of Health Professions Education program.

Post-baccalaureate students hone their techniques at the Kanbar Center. Activities at the center range from those that use actors (standardized patients), to activities with partial task trainers and/or mannequins. Photo by Mark Wooding.

the UCSF School of Medicine, and another 27 came from other UC medical schools.

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E D U C AT I O N

Graduate Medical Education at-a-Glance • The School of Medicine has over 1,600 residents and clinical fellows in approximately 170 accredited and non-accredited programs.

• Doximity, in partnership with US News & World Report, ranked US residency programs in 20 specialties. UCSF ranked in the top 20 in all 20 of the ranked specialties, and in the top 10 for 15 of the specialties.

• UCSF’s residency programs ranked 1st in anesthesiology, dermatology, neurological surgery, neurology and radiology.

Underrepresented in Medicine Residency and Fellowship Match 2017-2019 We have shown a steady increase in the number of residents from Underrepresented in Medicine (UIM) groups.

% UIM Residents

2017

2018

2019

18%

26%

28%

2018

GME Cohort

289 Residents

24

Non-MD Trainees

102

UIM Learners

100

ACGME Fellows

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18.8%

Non-ACGME Fellows

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Research On Bridging The Gap From Curiosity To Cure At the UCSF School of Medicine, our research mission spans all departments and disciplines, incorporating internal and external collaborations to forge new discoveries, drive technology, accelerate delivery of preventive interventions, and improve clinical care.

The UCSF health sciences continuum is vast, so it is imperative that we continue to bridge the gap between basic science, clinical, and translational research and implementation, while maintaining focus on our goal of achieving health equity and access.

We are working, teaching, learning, and discovering in an interesting time in health and health care. The UCSF SOM is one of the most research-intensive Schools in the U.S. The SOM is renowned for its pioneering work in early-stage biomedical discovery and translation.

We are deeply committed to a culture of data sharing, the exchange of creative ideas and the development of cross-sector, innovative collaborations.

This mix of diverse expertise, technology development, collaboration and entrepreneurial spirit, is leading the way in scientific breakthroughs, discovery and translation to therapies, and is transforming prevention and patient-centered care. By revealing the fundamental mechanisms of biology, SOM researchers unlock the secrets of health and disease, forging new paths of investigation and developing innovative technologies to better prevent, treat, and cure even the most intractable illnesses.

The explosion of data sources, data types, and analytic tools is resulting in major shifts in healthcare in the laboratory, in the clinic, and at home. As leaders, physicians, scientists, educators, and community partners, we recognize how much good can come from successfully harnessing these technological advances and new treatments.

My goal as the Vice Dean for Research is to do whatever I can to help sustain and build our wonderful research community and enable our scientists to make great discoveries.

One major goal in my work is to help basic science departments hire outstanding research scientists from diverse and underrepresented backgrounds.

Thanks to the strong advocacy of faculty members, and with the Dean’s support, we established a standing interdepartmental search committee for the purpose of identifying candidates who will enhance the diversity of our basic science faculty. The first candidate from this search process was just offered a position and we are very hopeful that he will be joining us soon.

One of the most important and complex aspects of my role centers on space. Clearly, we need to use our research lab space in the most effective way possible, and we must also ensure that our research faculty and programs have the space and infrastructure they need to do the best possible science.

This is a dynamic, evolving problem that is compounded by the rapid growth of the UCSF research faculty. In most cases, solving these space problems depends on close collaboration with Vice Dean Bruce Wintroub and the members of his space team, who have a deep understanding of how space is used in every UCSF building.

We must continue to find new opportunities and think about the next phase of discovery science at UCSF. UCSF is in a position of great strength, and we must continue to accelerate new discoveries and attract promising researchers to UCSF, so that we can continue as a leader in addressing the most challenging problems in healthcare.

Sincerely,

David O. Morgan PhD Professor, Department of Physiology Vice Dean for Research, UCSF School of Medicine

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2020 US News & World Report Rankings Rank

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RESEARCH

Department Internal Medicine

By-the-Numbers

Neurosurgery

• Over the last seven years, the UCSF SOM has ranked #1 in NIH funding.

Total awarded research funding from all sources increased to $1.45 billion in 2018.

• Evidence of the strength of our School can be found in the success of our individual departments. In FY18: • 24 of our 28 departments were ranked • 18 of our departments ranked in the top 10 for funding received from the NIH • 5 departments were ranked #1 • 12 were in the top 5 • 23 of our 24 ranked departments were ranked in the top 20 • UCSF faculty members published more than 6,000 articles in peer-reviewed journals in CY2018 and were named as key contributors on 6,101 extramural grants during this time. More than 90 of those publications and 40 of those extramural grants were related to educational scholarship.

Obstetrics & Gynecology Otolaryngology Urology Biochemistry and Biophysics

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Orthopaedic Surgery Radiology and Biomedical Imaging Dermatology

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Neurology Ophthalmology

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Surgery Epidemiology and Biostatistics Physiology Cellular and Molecular Pharmacology Anesthesia and Perioperative Care Family and Community Medicine

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Physical Therapy and Rehabilitation Science

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Pathology

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Psychiatry

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Anatomy

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Microbiology and Immunology Pediatrics

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Emergency Medicine

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RESEARCH

Chan Zuckerberg Biohub (CZ Biohub) In 2018, the CZ Biohub, a nonprofit medical research organization, announced that it was awarding $13.7 million over three years to support cutting-edge biomedical research from seven teams of scientists, physicians, and engineers, with each team including faculty members from UCSF, UC Berkeley, and Stanford University.

The awards will fund two new programs: the

CZ Biohub Microbiome Initiative and the CZ Biohub Intercampus Research Awards. There are now 19 CZ Biohub funded investigators at UCSF and CZ Biohub funds have contributed to the recruitment of several new research faculty in the SOM.

Scientist Carly Cheung shows Sandra Chipuka and Ernestine Dada Johnson tools used in the BSL-1 lab.

Photo courtesy CZ Biohub.

Basic Science Faculty Search Committee In 2019, a new interdepartmental search committee was formed for the purpose of enhancing the diversity of our basic science faculty. This initiative is spearheaded by Carol Gross, PhD, a Professor in the Departments of Microbiology & Immunology and Cell & Tissue Biology. The search process is guided by a large committee of

faculty from the eight basic science departments in the Schools of Medicine, Pharmacy, and Dentistry, and candidates selected by the committee can be hired into a position in any of those departments. Hiring in SOM departments will be supported by the SOM Dean’s Office.

Microbiome The past 15 years have seen a revolution in scientists’ appreciation for how deeply our health is tied to the microbes that reside in our gut and throughout our bodies. Now, a $25 million gift from Marc and Lynne Benioff will establish a new UCSF Benioff Center for Microbiome Medicine dedicated to predicting and developing next-generation therapies for a wide range of diseases – from asthma and allergies to inflammatory bowel disease and obesity. The new Center’s Director is UCSF professor of medicine, Susan Lynch, PhD. Faculty engaged in microbiome research across campus have previously shown that our microbiome plays a key role in defining human health. For example, microbial dysfunction in the infant gut – characterized by the enrichment of particular microbial genes and their products – drive immune dysfunction and can be used to predict the development of allergy and asthma in childhood. Perturbed microbial ecosystems across the human body have been linked to autoimmune disease, metabolic syndromes such as obesity and diabetes, skin diseases, and even multiple sclerosis. Gut microbes can even contribute to metabolizing drugs and influence how much enters the circulation.

Leveraging this expertise and collaborations with UCSF Benioff Children’s Hospitals in Oakland and San Francisco and institutions nationwide, the UCSF Benioff Center for Mi-

crobiome Medicine aims to develop a holistic understanding of our earliest interactions with microbes in utero, through birth, and in early life. These efforts aim to find ways of predicting and preventing not only asthma and allergy, but other childhood diseases – including dermatological, gastrointestinal, respiratory and neurological disorders.

The new center aims to drive these innovations in microbiome-based therapies through support for new faculty, expanded technological infrastructure, and translational collaborations between microbiome and clinical researchers across the university. Lynch says that the foundation of this effort will be UCSF’s existing clinical strengths, as well as the broad and diverse group of faculty across the University’s schools of medicine, dentistry, nursing and pharmacy already making important contributions to understanding the role of the microbiome in health and disease.

UCSF scientists are at the forefront of a scientific movement to advance our understanding of the myriad ways microbes in the human gut, on our skin, and throughout our bodies impact our health and contribute to disease. Below are a few of the leading UCSF researchers and clinician-scientists whose work will contribute to the success of the new Benioff Center for Microbiome Medicine.

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Staff research associates, from left, Clark Santee and Ariane Panzer, Susan Lynch, PhD, Associate Professor in the Division of Gastroenterology, and graduate student Ivan Vujkovic-Cvijin reflect on data from a Quantitative PCR system, a platform that permits quantification of genes and their expression. “A common bread and butter technique for a microbiology lab.” Photo by Susan Merrell.

RESEARCH

ImmunoX Launched in September of 2018, the Bakar ImmunoX Initiative, is an innovative research program that will promote collaborative, cutting-edge research and data sharing to catalyze discoveries about the central role of the immune system in human health and harness its power to treat a wide range of diseases.

The anchor gift from the Gerson Bakar Foundation will invest in the people, technologies, and research platforms needed to drive the ImmunoX vision of collaborative immunological research while also supporting a broader set of resources to promote collaborative research projects across the university.

Boosted by a significant new gift from the Gerson Bakar Foundation, ImmunoX aims to break down the barriers that traditionally separate immunology research by disease area, and instead organize the UCSF immunology community around a set of collaborative “CoProjects” that will tackle fundamental questions in the field.

The gift will initially support ImmunoX CoProjects focused on analyzing immune activity and identifying novel therapeutics in cancer, neurodegenerative diseases, and chronic viral infections. The Bakar gift will provide funds to jumpstart several CoLabs, including a new Disease to Biology CoLab to process tissue samples from clinical labs into their component cells; a Flow Cytometry CoLab to count, sort, and analyze the composition of these cells; a Genomics CoLab to perform single-cell analysis of gene activity and to develop innovative methods for analyzing and modifying gene function; a Biological Imaging Development CoLab for detailed microscopic analysis; and a new Data Sciences CoLab to develop bioinformatic frameworks for storing, analyzing, and sharing the data produced by the CoLabs pipeline.

These CoProjects will be conducted within the UCSF CoLabs, an integrated research platform currently in development. The CoLabs are a pillar of the University’s reimagining of its original campus at Parnassus Heights as a next-generation hub for research, education and patient care. The CoLabs will provide scientists across the University with access to a shared ecosystem of state-of-the-art research facilities for processing clinical tissue samples; performing single-cell genomic, proteomic, and imaging experiments; and analyzing and curating the resulting data.

Left: Matthew “Max” Krummel, PhD, is a UCSF professor of pathology and one of the leaders in developing ImmunoX. Photo by Maurice Ramirez.

Right: Qizhi Tang (second from left), PhD, of the Department of Surgery, is one of the developers of ImmunoX. Photo by Barbara Ries.

Using the UCSF CoLabs platform, ImmunoX will enable UCSF clinician-scientists, laboratory scientists, and data scientists to analyze the role of the immune system in diseases from cancer, where immunotherapies have already proven effective, to chronic viral infections or immune-mediated neurodegeneration. The resulting findings will also be made available to the broader UCSF community through a structured data library, enabling this unique and valuable data to be continuously mined by researchers and students with different questions and perspectives.

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ImmunoX also envisions creating an ImmunoX Data Library, a common repository for member research findings, enabling researchers and students across the university to mine the data to answer their own unique research questions.

In addition, the Bakar gift will support postdoctoral researchers and clinical fellowships, and enable the recruitment of top new immunology faculty. It will also support a number of other initiatives designed to advance an engaged, collaborative, and diverse immunology community, including career development program for technicians, and a career/life balance initiative that will provide research support for graduate students and postdoctoral researchers for a full year during childbearing leave.

RESEARCH Susan Lynch, PhD Director of UCSF Benioff Center for Microbiome Medicine Research in the Lynch lab focuses on how environmental exposures shape microbiomes in the human respiratory and gastrointestinal tracts, and the role of microbial metabolism in promotion of chronic inflammatory diseases.

For example, together with her clinical collaborators, Lynch’s team has identified specific gut microbiomes that relate to distinct features of inflammation in adult patients with chronic

sinusitis, HIV-infection or inflammatory bowel disease. Her early-life studies have identified a distinct neonatal gut microbiome associated with increased risk of allergy and asthma development in childhood and established a mechanism by which specific neonatal gut microbial metabolites may induce immune dysfunction in babies who go on to develop asthma.

Sergio Baranzini, PhD Professor of Neurology, UCSF Weill Institute for Neurosciences The Baranzini lab studies multiple sclerosis, boosting certain gut microbes could slow down an autoimmune disorder of the central nervous the course of the disease. In 2016, Baranzini system. The lab recently discovered that the mi- launched the international MS microbiome crobiomes of patients with MS differ from that study (iMSMS) to comprehensively map the of healthy individuals. In animal studies, the distinctive microbiomes of MS patients as a first lab has shown that these microbial differences step toward developing future microbe-based may influence the inflammatory destruction of therapies for the disorder. nerve fiber insulation that causes MS and that Katherine Pollard, PhD Professor of Epidemiology and Biostatistics, UCSF; Director of the Gladstone Institute of Data Science and Biotechnology Pollard’s team at the Gladstone Institutes – an independent research institution academically affiliated with UCSF – uses bioinformatics and computer modeling to study the human microbiome and its effects on conditions such as autoimmune disorders, obesity, and mental health. She and collaborators have previously shown that it is certain microbial genes, not dis-

tinct microbial species, that predict obesity, and investigated what makes certain microbes more likely to colonize the gut than others. More recently, Pollard’s team mined public datasets to computationally reconstruct the genomes of thousands of previously unknown microbial species living in the human gut.

Tiffany Scharschmidt, MD Associate Professor, Department of Dermatology The Scharschmidt lab focuses on under- microbes first colonize the skin in the days after standing the complex dialog between the birth. Understanding how the immune system skin’s microbiome and the immune system. privileges beneficial microbes over problematic Scharschmidt studies how the immune system ones may lead to better therapies for inflamlearns to distinguish “good” commensal mi- matory skin diseases while also contributing crobes from pernicious pathogens early in life by to a deeper understanding of the fundamental exploring how immune cells and skin microbes mechanisms underlying adaptive immunity. communicate with each other, particularly as Peter Turnbaugh, PhD Associate Professor, Department of Microbiology and Immunology The Turnbaugh lab studies how our diet protein impacts that ability of specific gut bactealters the composition of microbes in our guts ria to inactivate a commonly used cardiac drug. and how these microbial differences may im- Their current studies seek to apply this framepact our responses to important drugs. His team work to a much broader range of commonly has shown that a carnivorous or vegetarian diet used drugs with the aim to precisely engineer can dramatically alter gut microbial ecosystems the gut microbiome to improve drug response. within hours of consumption and that dietary

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Takeaways from Our 2019 Leadership Retreat on Research In January of 2019, more than 160 leaders The Day from across the UCSF SOM and UCSF gathered to discuss Bridging the Gap: From Curios• We inspired ity to Cure at UCSF. • We challenged The goals of this retreat were to: • We worked • Communicate the breadth of fundamental discovery programs active at UCSF and consider their potential to advance health What We Heard in the coming decade and beyond; • The best science happens when there is • Strategically plan to use the resources and freedom to explore and opportunities for programs at UCSF to accelerate new discollaboration, yet it still remains challengcoveries and attract promising discoveries ing to find those who care about the same to UCSF so that we can continue to adtypes of questions as you. dress challenging problems in healthcare; • Technology provides an opportunity to • Identify strategies to strengthen the conbetter make connections and facilitate colnections between basic science and clinical laborations, yet our existing technology departments and PhD and physician scientools are underutilized. tists; and • Trainees (PhD students and postdoctoral • Establish a sense of ownership and pride in fellows) are critical to our research success, existing and emerging scientific discoverand we must ensure adequate support for ies by faculty, staff, and learners in all misthese trainees. It’s important to examine all sion areas and at all geographic sites. elements of our research programs, including graduate program structure and trainWe chose this topic because we realize that ee funding mechanisms. in order to achieve our mission of advancing healthcare worldwide, we must understand the What We are Doing current landscape of scientific discovery and the potential disruptive discoveries that may lead • Conducting a comprehensive analysis of to dramatic changes in the ways we understand the size and funding of graduate programs; and treat disease.

• Sharing lightning talk videos across UCSF to help share the passion of our discovery mission; and • Working with IT to better harness our existing tools to facilitate connections among researchers.

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“In order to achieve our mission of advancing healthcare worldwide, we must understand the current landscape of scientific discovery and the potential disruptive discoveries that may lead to dramatic changes in the ways we understand and treat disease.”

Left: School of Medicine Faculty and Staff leaders gathered for a day-long discussion of research.

Photo by Mark Wooding.

Right: Anna Molofsky, MD, PhD, presents on her research around the mechanisms of synapse formation during brain development. Photo by Mark Wooding.

Patient Care

On the UCSF School of Medicine’s Role in Our Academic Health System

T

he UCSF School of Medicine is central to our academic health system.

Fulfilling our clinical mission requires us to successfully serve patients at four distinct health systems: UCSF Health, Zuckerberg San Francisco General Hospital and Trauma Center (ZSFG), San Francisco Veterans Affairs Health Care System (SFVAHCS), UCSF Fresno/Community Regional Medical Center (CRMC).

Each of these institutions enjoys strong local, regional, and national reputations. All sites are integral to our missions as each has a different mix of patient populations, which benefits our education and research missions.

During the 2018-19 academic year:

established health system and physician partnerships in Alameda, Contra Costa, Marin, San Mateo, Sonoma, and Santa Clara counties, and beyond.

• We continued to work to develop new models of physician employment to ensure alignment between our academic departments and growth in the UCSF Health system, and • Revenue for UCSF Health remained strong, providing important funding to increase faculty salaries and support other elements of our mission. Value improvement efforts continued to be a focus as we look for more ways to provide high-quality care more cost-effectively.

• UCSF Health’s clinical programs continued to grow and were busier than ever. We saw record numbers of patients as they, and referring providers, chose us as their provider of choice;

During the past year, School of Medicine faculty have contributed to shaping the future of UCSF Health as we develop our next five-year strategic plan. Three strategic themes and three core elements have been identified:

• We continued to improve and excel in most quality and safety metrics, and received the prestigious Press Ganey Pinnacle of Excellence Award for our three-year high-performance in-patient experience;

1. Complex Care Leadership - Fulfill UCSF Health’s unique role as the Bay Area’s leading complex care provider and destination for tertiary and quaternary care

• Bay Area organizations continued to partner with us, which is vital to our goal of expanding access to care for more patients closer to their homes. We now have

2. UCSF Health Network - Consistently deliver seamless, interconnected, high-quality care across UCSF Health and our affiliates

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3. Innovation at Scale - Spearhead and accelerate consumer-centric innovations to shape the future of healthcare UCSF is a great institution because of the strength of its components. The relationship between UCSF Health and the UCSF SOM requires careful cultivation and attention. We recognize the coming decades will present many opportunities and challenges that we can address together with a solid financial foundation, and there is a shared commitment to support the academic mission of the School, as a strong academic program adds great value to UCSF Health now and for its future.

Best,

Josh Adler, MD EVP, Physician Services, UCSF Health Vice Dean, Clinical Affairs, UCSF School of Medicine

PAT I E N T C A R E

Clinical Highlights For the 21st year, UCSF Health has been recognized among the nation’s elite hospitals in U.S. News & World Report’s 2019-2020 Best Hospitals survey.

UCSF Medical Center ranked among the top 10 centers nationwide in 10 specialty areas: diabetes and endocrinology, neurology and neurosurgery, and urology (all ranked 3rd nationwide), orthopedics (4th), geriatrics (5th), nephrology (6th), rheumatology (7th), pulmonology (8th), ophthalmology and psychiatry (both 9th). It was the highest-ranking hospital

in Northern California for cancer care (12th-tie) and gastroenterology and GI surgery (11th-tie), and was 13th (tie) in otolaryngology.

Additionally, UCSF received the highest possible ranking – high performing – in 8 of 9 common specialty procedures that were evaluated: abdominal aortic aneurysm repair, chronic obstructive pulmonary disease, colon cancer surgery, heart bypass surgery, heart failure, hip replacement, knee replacement, and lung cancer surgery. UCSF was recognized in all 15 categories for which it was assessed.

Provider Satisfaction The Physician Net Promoter Score (NPS) measures how likely our clinicians are to recommend UCSF as a place for work and care. It also seeks to identify concrete recommendations for improving clinician work experience.

For the first time, there was a unified survey for physicians and providers who work at our UCSF Health East and West Bay locations. This will enable us to better understand how we can improve as an integrated academic medical center.

To maximize the inclusivity of the survey, we implemented a number of changes in FY19 including expanding gender identity affiliations to meet best practice guidelines for transgender and non-binary options. Four new questions also were added related to physician burnout and finding meaning in/having influence over your work.

In the West Bay: • We continue to see steady improvement in “place to work” scores, with “place for clinical work” now at +7 (from +1 in FY18) and overall “place to work” at +8 (from +2 in FY18).

• Our “place to come for care” score (NPS +44) did not show statistically significant movement, but remains high (from NPS +46 in FY18).

• Our overall burnout rate is 37% (7% lower than the recently reported 2017 US National Burnout rate of 44%).

In the East Bay:

+16 and overall “place to work” score is NPS 0.

• Our “place to come for care” score is NPS +33.

• Our overall burnout rate is 41% (3% lower than the national rate of 44%).

We have implemented a series of approaches in an effort to transform UCSF SOM operations and reduce bureaucracy, thus hopefully improving engagement and employee satisfaction.

• Focus on developing meaningful metrics that drive academic excellence, as well as, efficiency.

• Realignment of department managers across “like” departments to better facilitate transfer of best practices.

• Forums for Chairs and Directors to leverage each department’s experiences (“avoid recreating the wheel”).

• Formalized job descriptions for department chairs and ORU directors.

• Implemented decision-making process to clarify opportunities for input and timing of decisions.

• Implemented leadership development program for SOM chairs and managers – increase self-awareness, promote lifelong learning, develop leadership skills to manage effectively in changing healthcare environment, foster deeper sense of professional fulfilment, and strengthen connection to UCSF.

• Our “place for clinical work” score is NPS PEOPLE, PURPOSE, PRIDE

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Dr. Lori Weichenthal, MD, FACEP, RYT works with resident Anthony Lim in the Emergency Department at Fresno Community Regional Medical Center. Photo by Barbara Ries.

PAT I E N T C A R E

Zuckerberg San Francisco General Hospital and Trauma Center (ZSFG)

107,521 Patients Served

582,114 Outpatient Visits

84,959

Medical & Psychiatric Emergency Visits

22,001

Urgent Care Visits

3,638

Trauma Activations

1,061 Babies Born

ZSFG, the safety net hospital for the residents of the City and County of San Francisco, is the only Level 1 trauma center in San Francisco and Northern San Mateo County. Considered one of the finest US public hospitals, ZSFG offers humanistic, cost-effective and culturally competent care to an international community of patients, regardless of their ability to pay.

ZSFG has partnered in public health with UCSF since 1873. All physicians at the hospital hold UCSF faculty appointments, provide patient-care treatment and services, conduct research, and teach. The ZSFG workforce includes over 2,000 UCSF employees. In addition, 900 residents, 400 medical students and 60 clinical fellows complete at least one third of their training rotations at ZSFG. In addition to working with the underserved, learners experience patient care specific to ZSFG’s population, such as services consistently recognized as Centers of Excellence in Neurotrauma, Stroke, and Orthopedics. ZSFG offers the city’s only 24/7 psychiatric emergency service, is a world leader in HIV/AIDS care and a W.H.O. “Baby Friendly” hospital. Other specialty services include Integrative Medicine and an ACE Unit.

Research at ZSFG impacts healthcare at a local, national and global level. Over 280 UCSF researchers and their teams conduct 850 studies at ZSFG with research budgets exceeding $150,000,000 annually. UCSF is building a stateof-the-art facility to house bench lab, desktop and patient-centered research and education space with an anticipated move-in date of 2022.

Other key inpatient, outpatient, emergency, diagnostic, and psychiatric services for adults and children include: • Internationally recognized global leader in HIV clinical care, research, and education.

POP-UP, Helping Homeless and Unstably Housed People with HIV (SF Board of Supervisors award Oct 2019).

• Surgery clinical research programs: Center for Global Surgical Studies, San Francisco Wraparound Project, San Francisco Injury Center (SFIC), Artificial Intelligence That Reads Chest X-Rays Is Approved by FDA. • Internationally recognized global leader in research, diagnosis and clinical care of Traumatic Brain Injury. TBI Certified.

Unique programs include the Traumatic Brain Injury Program, Orthopaedic Trauma Center.

• W.H.O. “Baby Friendly” hospital, ZSFG Family Birth Center, unique 24-hour mid-wifery service and training program, ZSFG to expand Clinton Foundation’s Too Small to Fail initiative’s “Talking is Teaching: Talk, Read, Sing” early literacy campaign at the hospital.

• Bay Area Perinatal AIDS Center, experts in caring for pregnant patients with HIV and/or Substance Use Disorder • Leaders in research in Global Women’s Reproductive Health: Bixby Center for Global Reproductive Health. Self-reported physical health of women who did and did not terminate pregnancy after seeking abortion services: a cohort study • Tuberculosis research and standards of care at a global level • ED Social Medicine Team receives CAPH/ SNI Quality Leaders Award • Primary Care Behavioral Health Team • Psychiatry programs include San Francisco’s only 24/7 dedicated psychiatric emergency service, Jail psychiatric and forensic focus services, Citywide Case Management Programs and the Trauma Recovery Center, mental health services for victims of violent crime Leader in research in diagnosis and care of Traumatic Brain Injury

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PAT I E N T C A R E

San Francisco Veterans Affairs Health Care System (SFVAHCS) SFVAHCS is owned by the US Department of Veterans Affairs (VISN 8) and provides primary through tertiary care to veterans in Northern California, SFVAHCS is a major regional and national referral center for specialized care.

The two institutions began their affiliation in 1968. More than 240 full- and part-time UCSF physicians are on staff at SFVAHCS and provide patient care. SFVAHCS serves as a major teaching hospital for UCSF residents and fellows. SFVAHCS funds 171 positions for UCSF residents who train there and provides clinical training for one-third of UCSF medical students. SFVAHCS has the largest research program in the VA system.

40% of SFVAHCS unique patients come from outside of our catchment area. These referrals mostly come from the western states and Hawaii, but also are spread across the entire country.

In 2019, SFVAHCS: • Enrolled its 5,000th volunteer research participant in the national VA Million Veteran Program (MVP), which is building a genetic database to help research and develop new treatments for Veterans and non-Veterans alike. SFVAHCS is one of 139 VA sites across the country where Veterans can enroll in MVP. Launched nationally in 2011, MVP is a landmark research effort aimed at better understanding how genes affect health. Data and genetic samples collected through the study are stored securely and made available for studies by authorized researchers, with stringent safeguards in place to protect Veterans’ private health information.

Dr. Bruce Ovbiagele was appointed Associate Dean of the San Francisco VA Healthcare System in August 2018. Photo by Noah Berger.

• Went smoke-free for patients, employees, visitors, volunteers, contractors and vendors on campus.

• Received “LGBTQ Health Care Equality Top Performer” designation from the Human Rights Campaign Foundation (HRC).

UCSF Fresno Fresno hospitals serve the residents of the San Joaquin Valley of California, yet another culturally diverse patient population with some unique conditions that complement the diverse case mix of the San Francisco institutions.

Ibironke Adelga, MD, Asst. Professor of Surgery, teaches medical students Shayan Salim (left) and Rebecca Barber in the Clinical Skills Lab. Photo by Barbara Ries.

UCSF Fresno was created as a regional graduate medical education campus of UCSF in 1975 to address the severe shortage of physicians in the region. In 2018, UCSF Fresno was recognized by the Liaison Committee on Medical Education as a branch campus of the UCSF School of Medicine. UCSF Fresno is the San Joaquin Valley’s largest physician-training program, providing high quality medical education – training more than 300 medical residents and fellows in eight medical specialties and 18 sub-specialties and more than 300 visiting medical students from around the United States on a rotating basis each year. Nearly 700 UCSF core and volunteer faculty at UCSF Fresno care for thousands of patients annually and train the next generation of outstanding clinicians and patient advocates. Approximately 50 percent of the physicians trained at UCSF Fresno stay in the Valley to provide UCSF care. In addition, UCSF Fresno helps prepare middle, high school, and college students for careers in health and medicine through a variety of pipeline programs.

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In 2019: • More than 100 medical residents and fellows, along with three oral and maxillofacial surgery dental residents and five physician assistants completed training at UCSF Fresno. Nearly 40% of UCSF Fresno family and community medicine residents, almost 50% of pediatrics residents and 44% of internal medicine residents remained in the Central Valley to care for patients, teach future physicians or continue their medical education.

• UCSF Fresno’s Mobile Health and Learning (HeaL) Clinic, led by Kenny Banh, MD, assistant dean for undergraduate medical education, expanded its outreach and services this year, holding Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ) friendly clinics in downtown Fresno, and traveling north to the small communities of Balico, Denair and Patterson in Stanislaus County. Mobile HeaL provided basic health screenings, vaccinations and medical care for over 400 residents who are most in need of access to health care. Health care services involve faculty physicians at UCSF Fresno, residents, medical students, regional college and university pre-health students and community partners.

Population Health

On the Importance of Understanding the Social Determinants of Health

I

n 2017, Dean King recognized the need for the School of Medicine to develop an organizational strategy for integrating population health and health equity (PHHE) into all facets of the academic mission and appointed me as the inaugural Vice-Dean of Population Health and Health Equity. Together with PHHE leaders and researchers at UCSF, we work to advance the science of population health and health equity and accelerate the translation of this science into improvements in health and health equity within UCSF, other health systems, and more broadly into communities, locally, nationally, and globally.

So, what is population health and health equity?

Population health and health equity investigators seek to understand how social, environmental, and behavioral factors influence the health of groups or populations. These groups can be defined in a number of ways - by where they live (the Bay Area for example), by where they work (UCSF), or by other demographic factors, such as socioeconomic status, race and ethnicity, or disability. Social determinants that influence the health of groups must be understood to design effective interventions.

UCSF Health and the Office of Population

Health and Accountable Care, as well as other health providers, use population health methods to identify opportunities for interventions to improve care and outcomes for their patients. Precision Population Health looks at how social determinants of health intersect with individual biology. Advancements in

data analysis and integration have made precision therapeutics possible and targeted preventive efforts more effective to specific populations.

phasizes that we need to understand what leads to poor health outcomes in those groups and then tailor interventions to improve health accordingly.

Improving the health of any population requires active engagement of diverse partners: academic researchers from many disciplines, health providers and systems, public health officials, local and state government, and, most importantly, community residents, and organizations that work with them.

We are already doing amazing work at UCSF related to population health and health equity, work that is nationally recognized but could be more broadly known in the community. As Vice Dean of Population Health and Health Equity, part of my position is to help shine a light on all that is being done here at UCSF already.

The ongoing partnership with the City and County of San Francisco, Department of Public Health (SFDPH) allows for joint work on population health interventions. SFDPH’s collaborations with other health providers to analyze medical record data across the City will provide a more detailed view of the health conditions of San Francisco residents and enable the design of interventions to improve health. Implementation of interventions informed by research findings in partnership with communities and stakeholders, will and bring people together to address local health disparities.

Health equity means that everyone has the oppor-

tunity to lead the healthiest life possible. To achieve this goal requires understanding and addressing obstacles to good health that affect different communities, including factors like poverty, discrimination, and access to healthy food and health care. Research into the patterns of health and disease in a population conclusively show that certain groups have worse health outcomes. The concept of health equity em-

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But I want to think bigger. I would like us to expand our work in population health and health equity across all of our missions at UCSF - in research, education, clinical care, and service. I want to identify areas of new opportunities, new synergies, and new partnerships, so that we can magnify our impact.

Many of our scientists, clinicians, and educators are interested in making their work more accessible. I want to make it easier for them to identify partners with the right expertise.

Best,

Kirsten Bibbins-Domingo, PhD, MD, MAS Professor and Chair, Department of Epidemiology

and Biostatistics Vice Dean for Population Health and Health Equity, UCSF School of Medicine

P O P U L AT I O N H E A LT H

Building Infrastructure We identified that our data infrastructure was essential to advancing the scholarship in population health and health equity. We launched the Population Health Data Initiative (PHDI) to address this infrastructure, with joint funding from the EVCP’s office strategic funding opportunity. The PHDI aims to catalyze this work by expanding research capacity, strengthening the network of UCSF researchers, and facilitating the use of “big data” from public and private sources.

Researchers can access the UCSF PHHE Research Datasets that was developed by PHDI and the UCSF Library, which, along with expert consultation, can help researchers select the best research dataset to use. Our efforts in this area continue to expand, making acquisition, sharing, linkage, and analysis of existing data resources in order to accelerate discovery and innovation in population health, health services, clinical epidemiology, and other areas of research.

We have also expanded the infrastructure for using clinical data at UCSF Health and ZSFG

for population health research questions. We have geocoded addresses in our clinical records and linked these to other data regarding social, environmental, and physical context in which our patients live. In order to develop scholarship exploring the influence of context on clinical conditions PHDI investigators developed clinical cohorts of UCSF patient populations with specific health conditions such as hypertension, diabetes, and conditions associated with aging.

These cohorts are currently being used to move forward numerous research projects. All UCSF researchers can leverage these cohorts for their own research projects.

(PHOTO)

A new website dedicated to Population Health news, events, and research tools launched in Fall 2019.

A new interactive website anticipated to launch in the late Spring will allow researchers to integrate population health data from many different sources and create visual tools and maps that represent the disparities in health.

These tools will help academic researchers, policy makers, and health providers easily see health conditions by location and intervene to improve the health of a population.

Expanding Capacity

Dean Talmadge King and Vice Dean for Population Health and Health Equity Kirsten Bibbins-Domingo with the inaugural class of PHHE Scholars.

Work in population health and health equity is funded by the NIH and other major foundations and philanthropic funders. However, the types of partnerships that are often essential to this work take time to develop and solidify which places a burden on junior investigators beginning in this field. Last year, we launched an award for junior investigators conducting research or developing programs in population health or health equity. The Population Health and Health Equity (PHHE) Scholars Pilot Award Program was established to support innovative research and programming of junior faculty in the early stage of their careers. The Inaugural Class of PHHE Scholars are studying cancer health disparities, the impacts of longterm immigration and stressors on population health, sexual and reproductive health inequities among marginalized populations, and subsidized housing’s impact on the implementation of smoke-free policies. The PHHE Scholars program will be expanded in this second year and importantly will provide support to outstanding scholars at all four professional schools through a strong collaboration with the deans of the schools of pharmacy, dentistry, and nursing.

In the Spring of 2020 we will launch a new program called Accelerating Impact that will build skills of researchers at UCSF to translate and communicate their scientific work in a way to effectively partner with policy makers to develop evidence-based policy.

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P O P U L AT I O N H E A LT H

Fostering Community

Students Katie Machado (left) and Henry Carter prepare supplies for the Multi-Service Center South’s Health Fair in June 2019. MSC-South is San Francisco’s largest homeless shelter.

Photo by Le Wen Chiu.

Population health research is carried out by researchers in many different departments, schools, and disciplines, and facilitating formal opportunities for collaboration and knowledge-sharing across the School is a clear priority.

A new website, Population Health and Health Equity, serves as the nexus for researchers to find collaborators, identify data resources, and learn about events related to population health and health equity.

New academic symposia were convened on topics such as A Population Health Science Approach: Guns, Obesity, and Opioids, a Joint UCSF-UC Berkeley Symposium: Data Science for Advancing Population Health, and Immigrant Health.

Nurturing Partnerships Critical to the work of the SOM in advancing population health and health equity is strong partnerships. We have worked closely with UCSF Health on two initiatives. The first is establishing a Health Equity Council for UCSF Health that seeks to enhance the culture, data, and quality improvement work to address healthcare disparities among UCSF Health patients. The Health Equity Council released its inaugural report to the UCSF Health Leadership in 2019 and devoted its Quality and Safety Symposium to the issues of healthcare disparities. The SOM was pleased to support similar work and shared learning for health equity councils that have also been formed at ZSFG and at Benioff Children’s Hospitals.

We have used our new initiatives in data to partner with the UCSF Health Office of Population Health and Accountable care to identify actionable opportunities to improve health by understanding our UCSF Health patient in their neighborhood context, as well as work closely with departments of public health in the region to identify opportunity where healthcare

information can be used to inform public health initiatives.

The ongoing partnership with the City and County of San Francisco, Department of Public Health (SFDPH) allows for joint work on population health interventions. SFDPH’s collaborations with other health providers to analyze medical record data across the City will provide a more detailed view of the health conditions of San Francisco residents and enable the design of interventions to improve health. Implementation of interventions informed by research findings in partnership with communities and stakeholders, will and bring people together to address local health disparities. The city and the state public health efforts increasing involve use of data to understand the needs of more marginalized communities – like the homeless, those with substance use disorders, and those with mental health diagnoses. The SOM has been playing an increasing role in providing the technical support and partnership for these important public health efforts.

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Eat SF Vouchers 4 Veggies provides healthy food vouchers to vulnerable residents through networks of community-based organizations and clinics, supporting health and wellness, fostering community, and reducing food deserts by sustaining local food vendors.

DEAN’S PRIORITIES

Strategic Plan

I

n October 2017, the UCSF SOM embarked on an inclusive and highly participatory strategic planning process that aimed to engage a diverse group of stakeholders across multiple geographies who, through their work together, set a bold vision for the coming years.

The strategic planning process was overseen by an Executive Committee of the school’s chairs and directors, a Steering Committee and five Working Groups. Our broader community also had a chance to share their input and recommendations.

We culminated this work with a Leadership Retreat, bringing together representatives from all groups who participated in the brainstorming, to arrive at the mission and vision for the strategic plan and five core pillars of focus support this transformation.

The five pillars aim to: • Develop and empower diverse talents, • Advance and harness technology • Lead innovation and Discovery • Establish and sustain meaningful, collaborative community partnerships, and • Transform communications and operations.

Through these five pillars, we want to do three things: 1. Transform the way faculty, staff, and learners work together at UCSF, 2. Enable the incredible people of UCSF to do their best work – to advance health worldwide through education, clinical care, research, and community engagement, and 3. Become the move diverse, equitable, and inclusive place to work in the country.

We spent the majority of 2018 determining how best to tackle the thoughtful ideas generated by our community. To support this effort, we announced Beth Harleman as our Dean’s Stra-

tegic Plan Implementation Leader. Beth’s deep UCSF experience and commitment to our faculty, staff, and learners has proven invaluable, as she works across the groups to amplify shared ideas and ensure connections between all of our constituents.

Partnering closely with Beth, we appointed Dean’s Strategic Plan Implementation Leaders to chair our five Implementation Teams. These teams have been tasked with thinking about the relevance of the strategic plan pillars in each of our unique ecosystems and environments, propose innovative interventions, and develop metrics to track our progress.

Timeline We are currently in the implementation phase of the plan, and have incredible leaders in five key areas: Basic Science, Education, Clinical Care, Clinical, Translational, and Population Health, and Community Partnerships. Each of these groups has a faculty and a staff leader, and we tried hard to construct working groups that are 50% faculty, 50% staff, and to pull in learners whenever possible, so that the groups that are thinking about implementation represent the people who will be experiencing the change.

Heading into 2020, we are in the experimental phase of our work. Our Implementation Teams have conducted landscape assessments, identifying gaps and pain points, and developing ideas for pilot interventions and/ or structural changes to be considered by the Dean’s Leadership Team for implementation.

Landscape Assessment Using the knowledge gained from the landscape assessment, the Teams will plan a series of experiments to: • amplify and extend the reach of existing exemplar programs and/or create new workplace structures, programs and communities that will advance our aims, and • identify structural changes (in processes, communications, allocation of resources and other areas) that should be addressed and suggest plans for how to address these areas of concern.

To learn more about the people leading our Strategic Plan implementation, and for updates on our process, click here.

Timeline 1/2019 Implementation Teams begin work

12/2022 end of 5-year initiative

2018

2019

PLANNING

ASSESSMENT

2020

2021

2022

IMPLEMENTATION PHASE 1

PHASE 2

PHASE 3

2019 IMPLEMENTATION LANDSCAPE ASSESSMENT

1/2019 Implementation Teams begin work

EXPERIMENTATION

6/2019 Landscape Assessment Complete

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WHITE PAPERS

10/2019 Experiments Complete

12/2019 Final Recommendations due to Dean’s Leadership Team

Strategic Plan

240 104 57 30 26 4 50+ 20 11 5 PEOPLE, PURPOSE, PRIDE

Retreat Participants (October and January)

Working Group Participants

Stakeholder Interviews

Working Group and Affinity Group Meetings

Steering Committee Members

Steering Committee Meetings

Enablers Provided Throughout the Process Additional Areas Developed by Retreat Participants Areas of Strategic Attention Developed

by Affinity and Working Groups Key Strategic Areas of Focus 22

DIVERSITY, EQUITY, AND INCLUSION

Differences Matter

U

CSF has made a commitment to Advancing Health Worldwide.

Fulfilling this commitment requires that we tackle and solve today’s most challenging problems in biomedical science and healthcare, for everyone. Diverse teams, including people from different backgrounds and with different life experiences, are better at solving complex problems.

UCSF’s success in improving the health of our patients and our communities depends on diversifying our disciplines and professions and creating an inclusive an equitable institution. It is time that we engineer our culture for equity and inclusion so that all may thrive.

4. Clinical Care: Identify and address health care disparities in the clinical environments, UCSF and UCSF affiliates and ensure that health care professionals are skilled in working with diverse communities.

5. Research: Increase the diversity of our scientific workforce and our clinical trials participants and work to ensure that our discovery engine provides better insights into the health and health care needs of our increasingly diverse population.

and Inclusion Champion Training for School of Medicine faculty and staff. This free full day training includes education on implicit biases and microagressions, coaching in skills related to addressing these issues, and training in how to apply thoughtful, active listening and empathy to support a more diverse, equitable, and inclusive environment. The program, which launched in 2017, has trained more than 1,500 faculty and staff to-date, with more than 800 in academic year 2018-19 alone.

6. Pipeline, Outreach and Pathways: Establish For more specific Differences Matter proUCSF as a destination for those who seek to grams and interventions, please view each Aceliminate opportunity disparities in our com- tion Group’s page. munities.

As part of the Climate and Recruitment Differences Matter is a multi-year, multi-faceted School of Medicine initiative designed to group’s work to ensure a diverse, equitable, and make UCSF the most diverse, equitable and in- inclusive environment for learners at UCSF, we clusive academic medical system in the country. developed and rolled out the Diversity, Equity, The initiative has six focus areas, each led by faculty and staff Dean’s Diversity Leaders: 1. Leadership: Develop an informed, committed and diverse leadership who are dedicated to advancing diversity, equity and inclusion in all mission areas and at all UCSF sites.

2. Climate and Recruitment: Increase the diversity of our faculty, residents and professional staff and increase the personal competencies of all our professionals in teaching, leading and managing a diverse community.

3. Education: Cultivate the highest quality, most inclusive learning environment for our medical students and residents.

Differences Matter Outcomes RECRUITMENT, RETENTION AND CLIMATE

• Created the Diversity, Equity and Inclusion (DEI) Champion Training for faculty designed to reduce microaggressions experienced by learners and improve the learning environment

•

Over 1400 faculty and staff trained as of October 2019

• Through our Holistic Review and Best Practices for Diversifying GME Handbook and our GME Diversity Second Look program, increased the number of UIM residents matching at UCSF from 18% to 30%

26%

28%

12%

2015

2018

LEADERSHIP

• Redesigned graduation milestones to include proficiency in structural competency and social justice • Integrated social justice curriculum throughout the 4-year curriculum • Revamped criteria for AOA and Honors to create more equity in the grading system • Launched an advisory committee to assist and provide feedback to educators developing curriculum that mentions racism, race and racial/ethnic health disparities • Published an Anti-Racism Primer and Toolkit devised to assist educators in the development and cultivation of deep competency and comfort addressing and discussing the topics of health disparities, social justice, bias and racism

17%

2012

LEARNING ENVIRONMENT

2019

RESEARCH ACTION GROUP FOR EQUITY

CLINICAL HEALTH EQUITY

• Designed process to annually track demographic data for faculty in leadership positions • Created toolkit for department chairs to incorporate transparent, inclusive best practices for leadership positions and springboard opportunities to promote diversity • Through Building Community through Professional Development (BCTPD) seminars, educated and engaged department chairs and leaders in issues of diversity, transparency, parity, equity

PIPELINE, OUTREACH AND PATHWAY PROGRAMS

• Successfully recruited two new UIM faculty in the basic sciences through the use of an inter-departmental hiring plan • Established Health Equity Councils at UCSF Health and San Francisco VA Health Care System (SFVAHCS) and helped author the 1st Annual UCSF Health Equity Report

Outcomes of Differences Matter, a 5-year initative that finished in 2019.

• Doubled the number of NIH Diversity Supplements at UCSF and brought in $1 million in funding for URM trainees and junior faculty

• Created equity toolkits for Oversight Departments and Patient Experience Departments

• Partnered with San Francisco State University to develop and implement a Clinical Research Coordinator (CRC) training program for URM students to enhance the diversity of CRCs at UCSF

• Led development of a derived race-ethnicity variable and other standardized variables for use by the UCSF Health community to better detect disparities in clinical quality, patient experience, access, and financial domains

• Obtained $250,000 from the Patient-Centered Outcomes Research Institute to conduct needs assessment and asset mapping for stakeholder research engagement

• Piloted one interpreted conversation per day with hospitalized LEP patients • Awarded “Leader” (UCSF Health) and “Top Performer” (SFVAHCS) in LGBTQ Healthcare Equality designation in Human Rights Campaign’s (HRC) Annual Healthcare Equality Index Survey

• Hosted ASPIRE Symposium bringing together over 100 researchers, patients, and community leaders to develop a plan to increase diverse patient and community engagement

• Created a Diverse eCohort Steering Committee with 4 community

organizations and UCSF researchers to increase diversity among participants in online or technology-based research and developed two multi-lingual research portals

10/2019

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23

• Created directory of UCSF-affiliated pathway, outreach, and pipeline programs • Developed a workshop series for pathway, outreach and pipeline program directors • Led inter-program collaboration funded by the National Science Foundation’s Inclusion across the Nation of Communities of Learners of Underrepresented Discoverers in Engineering and Science (INCLUDE)

DIVERSITY, EQUITY, AND INCLUSION

Latinx Center of Excellence (LCOE) The UCSF Latinx Center of Excellence (LCOE) has wrapped up its first year of programs. Funded by HRSA and UCSF, and housed within the UCSF SOM, with close affiliation with the Center for Vulnerable Populations CVP) at Zuckerberg San Francisco General Hospital and Trauma Center (ZSFG), the UCSF LCOE is primarily focused on UIM career development at multiple places along the journey to academic medicine. It also has an ambitious goal: to contribute to the health of California via strategic partnerships and initiatives.

Shaping Academic Leaders United in Diversity (SALUD) faculty Drs. Sarah Schaeffer and Michelle Guy join residents for a GME Welcome Event in August 2019. SALUD is a Latinx Center of Excellence (LCOE) initiative that is aimed at increasing the individual and group mentorship available to Latinx/URM residents in all departments across UCSF. Photo courtesy Latinx Center of Excellence.

LCOE programs are collaborations with undergraduates at California State University, Fresno (Fresno State) and San Francisco State University (SFSU); medical students and residents at UCSF; faculty members early in their careers at UCSF; and a community clinic.

In addition to the LCOE’s programmatic efforts, the LCOE has been working on partnership development at the local, regional, and state levels, including sister LCOE’s at Stanford and UC Berkeley and well-established community-based organizations such as Institute Familiar the la Raza. The goal with this work is to advance workforce diversification, support for DACA and immigrant students, and promote health equity for Latinx populations in California.

Learn more about the LCOE’s Key Initiatives.

Childbearing/Childrearing Leave Task Force “Latinos are California’s largest ethnic group at nearly 40% of the population, so California’s health is increasingly tied to the health of the state’s Latino population. This center will build on UCSF’s existing underrepresented minority programs by significantly enhancing its academic infrastructure to train Latino physicians and physicianscientists.”

Effective July 1, 2019, paid childrearing leave was increased from four weeks to 12 weeks – childbearing and childrearing paid leave are now each 12 weeks. Faculty are also eligible for full-time or part-time parental leave without pay for up to 12 months following the birth, adoption or placement of a child.

UCSF also established a systematic funding mechanism for childbearing and childrearing leave. The faculty leave assessment will be charged as a benefits expense, similar to vacation time. All HSCP faculty funding sources will be charged at the current estimate of 1.25% of HSCP faculty actual salary (X’+Y).

The UCSF SOM is committed to being supportive of faculty work life balance, and this revised childbearing and childrearing leave was a step in this direction. The SOM developed resources for departmental leaders to answer any

Alicia Fernández, MD; Director, UCSF LCOE

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questions about the policy changes and help steward positive culture change, including: • FAQs • Guidelines and a Statement of Principles • A department policy template • An overview presentation for faculty • A who to call for what one-page reference guide • A department checklist and conversation guide to aide in a series of conversations with faculty to plan leave • A childcare resource snapshot

DEAN’S PRIORITIES

Staff Engagement Gallup Staff Engagement Survey Gallup defines engaged employees as those who are involved in, enthusiastic about, and committed to their work. These individuals are more likely to contribute to their organization in a positive manner. As our institution grows and becomes more complex, we must ensure that our staff, faculty, and learners feel connected and committed to our shared purpose of advancing health worldwide.

At the UCSF SOM, we believe engagement is something we all own and impact. Following the 2018 survey, units and teams in the School of Medicine worked hard to develop and implement action plans focused on the most important issues in their areas. Some highlights include: • Revamping our management training programs and increasing opportunities for staff advancement, including relaunching our Leadership Development Program,

• Creating opportunities for cross-team and cross-departmental inclusion and collaboration, and • Sharpening our focus on timely and transparent communication. This includes increasing the frequency of Dean’s Forums and holding them at all sites, providing staff with opportunities to hear from School of Medicine leadership about our organization, through the lens of each of our missions.

In FY19, our Staff Engagement GrandMean (across all 12 questions) held steady at 4.04. Our percentage of “actively engaged” employees (50%) is 16% higher than the US working population average (34%). We were pleased that employees continued to report a strong connection to the School of Medicine’s mission and purpose, and highlighted a strong focus on employee development, learning, and growth.

However, amongst aspects related to belonging, “sense of direction” scores were the lowest, driven by employees’ lack of clear individual career and developmental direction. Finally, our Accountability Index has declined by 0.07 to 3.55, from 3.62 in FY18, suggesting that more effort needs to be put into survey feedback, action planning, and real progress on survey action items.

We have dedicated School of Medicine faculty and staff working on these issues and collaborating across the campus with the Learning & Organization Development and Human Resources teams to develop and disseminate professional and leadership development resources and programming, establish taskforces to identify and address systemic issues, and create engagement and belonging community forums, with the goal of promoting a culture of inclusion, dialogue, and teamwork that will empower everyone to succeed at the UCSF SOM.

Administration & Infrastructure Leadership Appointments Since his appointment in 2015, Dean King has welcomed three new Vice Deans, six new Associate Deans and an Executive Vice Dean.

In addition, we have recruited 15 new Chairs and Directors of our 42 clinical and basic science departments, interdisciplinary research centers and organized research units.

Jayanta Debnath, MD Chair, Department of Pathology Appointed July 1, 2018

Bruce Ovbiagele, MD, MSc, MAS, MBA Associate Dean, San Francisco VA Healthcare System Appointed August 9, 2018

Brian Dolan, PhD Chair, Department of Anthropology, History and Social Medicine Appointed July 1, 2018

Brian L. Black, PhD Director, Cardiovascular Research Institute Appointed March 1, 2019

Amber Fitzsimmons, PT, MS, DPTSc Chair, Department of Physical Therapy and Rehabilitation Science Appointed July 1, 2018

Raphael Hirsch, MD Chair, Department of Pediatrics and Physician-in-Chief, Benioff Children’s Hospitals Appointed July 15, 2019

Kelley Meade, MD Associate Dean, Clinical and Academic Affairs at UCSF Benioff Children’s Hospital Oakland Appointed July 1, 2018

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DEAN’S PRIORITIES

On Progress, Plans, and Space Management Space is one of our most important resources and the UCSF School of Medicine relies upon departments to make appropriate and effective space management decisions. Without space, we cannot launch a new program, recruit a new faculty member, or expand to meet increased research/clinical needs.

occupancy data and partnering with us to make effective space management a shared priority.

The School of Medicine currently occupies over two million assignable square feet of space and in partnership with campus leadership is planning significant additions and renovations in the next few years. Accountable and responsible management of this space is a considerable task and a strategic priority for the School.

Bruce Wintroub, MD

Best,

Professor and Chair, Department of Dermatology Vice Dean for Space Strategy, UCSF School of Medicine

Our goal is to provide the right amount of space to support employee needs. To match needs to solutions, rigorous and up-to-date space and occupancy data is essential. We hope that you will support our efforts to improve space management by maintaining rigorous space and

Space Highlights Despite exceptionally high construction costs and an ultra-competitive market for construction and trade professionals, the 2018-2019 academic year was marked by several milestones in space development: 1. To support continued growth in our education and research missions, we continued construction of almost 300,000 ASF of education, research, administration, and patient care space at the Child, Teen and Family Center and Department of Psychiatry Building at 2130 3rd Street, the Joan and Sanford I. Weill Neurosciences Building at Block 23a, and the Wayne and Gladys Valley Center for Vision at Block 33.

2. To help our people weather an intense real estate market and to allow UCSF to make best and highest use of its space resources, we added offices while reconfiguring Mission Hall and built a new student housing complex at 590 & 600 Minnesota Street, adding much needed capacity for 708 students and trainees.

3. To ensure the Parnassus campus retains its vital role as a critical hub of learning, discovery and patient care, the School of Medicine led the conceptualization and early planning for revitalization of the Parnassus campus. Our advocacy and

planning efforts continue to provide critical support for all campus revitalization projects, including: a. Development of the Parnassus 20-year master plan b. Development of Co-Labs at Parnassus c. Planning for a new research and academic building at Parnassus d. Planning for the new adult medical/ surgical hospital at Parnassus In addition, the School of Medicine: 1. Continued to foster a shared understanding of appropriate space use and management techniques through increased outreach, publications, and tool development.

2. Continued to advocate for improvements to the campus space management system of record (Archibus), developing enhancements with campus partners to facilitate active space management.

3. Continued to partner with campus and department leaders to ensure the spaces we are each assigned are used intensively, safely, and for the best and highest use.

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4. Continued to enforce existing School of Medicine space policies, work with its departments to develop their own space policies, and work closely with campus space leadership to refine campus space governance and policies.

5. Ensured that Ophthalmology and Proctor’s Parnassus release space will go to the best and highest use.

6. Developed a pathway to consolidate Ophthalmology, OB/GYN, and Pediatrics to Mission Bay. 7. Continued to support planning efforts for a new research and academic building at ZSFG.

DEAN’S PRIORITIES

Philanthropy Endowed Professorships Holding an endowed position is considered a great honor in the academic world. It makes a statement about the individual’s work and publicly recognizes their accomplishments and the promise of their ideas.

When donors create an endowed professorship, they forge an enduring relationship with UCSF’s faculty members and the School of Medicine as a whole. Through this partnership, our university is empowered to recruit and retain leaders who advance research, teaching, and clinical care.

In 2019, ten new endowed chairs and five new distinguished professorships were established.

Giving to School of Medicine (FY19) Gifts and Pledges by Type & Purpose

Giving to the School of Medicine in Fiscal Year 2019

Current Use - Dept Support Rest

$165,502,745

Current Use - Dept Support Unrest

$13,466,046

Current Use - Faculty, Staff & Instruct

$2,485,819

Current Use - Fellowships

$10,663,880

Current Use - Lectureship

$70,068

Current Use - Other Restricted

19,322 Total Donors

Current Use - Patient Care

$721,644

Current Use - Professorships/Chairs

$53,135

Current Use - Public Service

$30,569

Current Use - Research Current Use - Scholarships Current Use - Student Award

6,992 New Donors

12,330 Renewing Donors

17,837

Total Gifts and Pledges

$20,037,247

$151,892,574 $1,320,950 $20,380

Endowment - Dept Support Rest

$1,511,260

Endowment - Dept Support Unrest

$75,935,964

Endowment - Faculty, Staff & Instr.

$2,194,612

Endowment - Fellowships

$3,184,413

Endowment - Lectureship

$408,918

Endowment - Patient Care

$67,255

Endowment - Professorships/Chairs

$25,775,107

Endowment - Research

$8,854,037

Endowment - Scholarships

$2,819,051

Plant - Equipment

$147,059

Capital (Construction)

$41,100

Total PEOPLE, PURPOSE, PRIDE

487,203,832 27

A Look

Ahead

T Summer fog intermittently covers the Parnassus campus and Mt. Sutro, shot from California Street, San Francisco. Photo by Susan Merrell.

he 2018-2019 academic year saw tremendous growth at UCSF – from numbers of patients served and employees recruited, to types of research being conducted, philanthropy garnered, and the physical footprint of our campuses.

Next year, my team will continue our focus on creating the most equitable and inclusive learning and training environment for everyone in the School of Medicine. This includes convening leadership meetings on how to strengthen our residency and fellowship program while addressing significant concerns about work hours and burnout.

Despite the rapid rate at which our academic health system has and continues to grow, I am proud of our ability to productively manage that change with an ever-present focus on delivering high-quality patient care, pursuing cutting-edge innovation, and supporting a culture of equity and inclusion for all faculty, staff, learners, and patients.

We are also committed to improving staff and faculty engagement, and will support and expand leadership development opportunities for both faculty and staff.

UCSF is as strong as ever and the clinical and academic excellence of our organization is a source a pride. As one of the country’s leading academic health systems, UCSF has made a commitment to Advancing Health Worldwide. Fulfilling this commitment requires that we tackle and solve today’s most challenging problems in biomedical science and healthcare.

Our academic health system is successful because we are able to recruit the best and brightest faculty, staff, and learners from around the world, who • set standards for and provide the highest quality patient care, • train the next generation of healthcare professionals, • conduct cutting edge biomedical research, and • guide health policy throughout the nation and the world.

Every aspect of academic medical centers is undergoing transformation: how care is delivered, how learners are educated and integrated into clinical care, how the research enterprise is organized and funded, and how the missions come together in new and meaningful ways. The UCSF SOM is, in many ways, a pioneer in this operational and cultural shift.

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Finally, we must work together to create a welcoming and adaptable environment that can nimbly implement new technologies as they arise, so we can accelerate innovation and improve the experience of the people who work, learn and receive care at UCSF. I will continue in the tradition of supporting our exemplary people above all else – learning from our past successes and challenges to support the inclusive and transparent decision-making, strategic planning, and operational excellence that makes the UCSF SOM a great place to work, teach, learn, and discover.

Regards,

Talmadge E. King, Jr., MD Dean, UCSF School of Medicine

Students gather in front of San Francisco City Hall after the 2019 White Coat Ceremony. Photo by Elisabeth Fall.

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