2016-2017 Harvard Medical School Dean's Report

coda I

Dean’s Report 2016–2017 harvard medical school

4 10 18 1 Message from the Dean 4 Education 10 World Outreach 12 Opus: Achievements 14 Leadership and Service 16 Affiliates 18 Discovery 22 Honors and Awards 23 HMS Leadership 24 Facts and Figures 25 Financial Report

Jeffrey S. Flier, HMS Dean, 2007–2016

On the cover: A Longwood Symphony Orchestra cellist bows his strings during a performance.

LSO musicians are primarily health care professionals, many of them doctors, medical students and scientists from HMS and its affiliated hospitals.

Inside cover: During the 2016 Introduction to Patient Clinics, firstyear students hear that they will “learn how to learn medicine at HMS,” because new discoveries will change the field many times during the course of their careers.

One of the first skills medical students practice is how to listen well. Listening is essential for conducting successful patient interviews and taking histories. It is one of the criteria used to evaluate students on national medical board exams.

Some medical educators have experimented with the use of music as a teaching tool to develop listening skills—a metaphor for verbal communication in medicine. At one school, intricate classical music pieces were deconstructed to help students sharpen concentration and become more engaged listeners. An effective doctor must be able to “hear” a patient’s unspoken cues, such as variations in pitch, rhythm and repetition.

Since 1782, Harvard Medical School physicians and scientists have been deciphering and creating what is needed in the present as well as discerning what might be necessary in the future. Remarkable medical advances have been achieved by innovators attuned to the importance of high-quality patient care and skilled at working in harmony for the betterment of human health.

As any conductor can attest, superior listening skills and a dedication to collaboration are required for an orchestra to create complex, beautiful music. This is not unlike the teamwork required of the more than 11,000 HMS faculty on the Quad and at our 15 affiliated teaching hospitals and research institutions. Every year these researchers and clinicians train thousands of students, postdocs and residents, all working in concert to advance discovery, develop therapies and deliver exceptional health care to thousands of patients here and around the world.

»

2 Dean’s Report 2016–2017

HMS excels in educating leaders in medicine and biomedical research, in advancing basic and translational discovery, and in promoting the delivery of exemplary health care. It accomplishes this through its far-reaching education and discovery enterprises and its many training and research partnerships.

When I first became dean, a comprehensive strategic planning process produced a vision for a vital, more cohesive academic community that was well-positioned to advance scholarship and service to human health into the next century.

We wanted to create medical, graduate science and continuing medical education programs that were increasingly collaborative and to ensure that Quad and affiliate research efforts were more closely linked to education.

The priorities we identified included revitalizing our commitment to the HMS educational mission, expanding opportunities in biomedical research, creating a more inclusive community, and furthering strategic investments in tools and technology.

EDUCATIONAL ACHIEVEMENT

In education, we embarked on a sweeping reform of the preclerkship MD curriculum.

Hundreds of faculty forged a new pedagogical structure that more effectively fuses basic science with clinical training. The Pathways curriculum moves students into clinics earlier in their training, and evolving teaching models are being supported by advanced

technology and tools that have been integrated into reimagined classrooms.

Our Scholars in Medicine requirement engages MD students with faculty through mentored scholarly projects that help students hone sophisticated discovery and critical thinking skills.

Our top-ranked program in graduate science education has expanded to serve master’s and doctoral students whose leadingedge research takes place at the intersection of life science, medicine, global health and health policy.

We established a new academic Department of Biomedical Informatics to train future scientists in the acquisition and interpretation of big data and to develop more powerful tools for data capture and analysis.

We transformed the Division of Medical Ethics into the Center for Bioethics and created a new Master of Bioethics program.

Two new hospital-based academic departments in Emergency Medicine and Neurosurgery were created, recognizing each as a distinct specialty within the HMS academic system. Part of the Center for Primary Care, the Academic Innovations Collaborative was launched five years ago with a major philanthropic gift and is spurring new models of education and care delivery at affiliated primary care teaching practices.

The consolidation of the School’s global, executive, online, consumer and continuing medical education programs within the new Office for External Education has allowed HMS to provide advanced learning oppor-

Jeffrey S. Flier, dean of HMS from 2007–2016, leads a round of applause for graduates in front of Gordon Hall on Class Day 2016.

tunities to new cohorts of learners around the world by implementing exciting new residential, online and blended initiatives.

RESEARCH AND DISCOVERY

Within the HMS biomedical research enterprise, remarkable discoveries occur nearly every day. Our scientists’ work is yielding insights into the mechanics of the DNA damage response and has allowed us to glean a better understanding of neurologic disorders such as autism, ALS and Alzheimer’s. New findings have given us clues to the causes of schizophrenia and helped us develop a better understanding of the origins of human beings.

As of this year, 151 current faculty are elected members of the National Academy of Medicine, 69 belong to the National Academy of Sciences and 34 are Howard Hughes Medical Institute investigators.

Over the past nine years, HMS has recruited 40 new faculty to the Quad’s basic and social science departments and named five outstanding new Quad chairs.

The Department of Global Health and Social Medicine was renamed to reflect expanded areas of focus and an exciting new vision. The Department of Health Care Policy advanced its work through the recruitment of new faculty and the development of new programs, while the Department of Microbiology and Immunobiology emerged from the union of Pathology with Microbiology and Molecular Genetics.

Dean’s Report 2015–2016 3

A new Laboratory of Systems Pharmacology has become the cornerstone of the Harvard Program in Therapeutic Science, which brings bioscientists, software engineers and physicians together to advance the science of drug discovery.

Harvard Catalyst | The Harvard Clinical and Translational Science Center was created and awarded two successive five-year federal grants. It continues to convene, connect and catalyze investigators throughout Harvard and across the U.S. with the resources, tools and training needed to conduct clinical and translational research.

The Ludwig Center at Harvard, which conducts cancer research, was re-envisioned, and HMS was chosen to be the coordinating center for the nation’s Undiagnosed Diseases Network. HMS also initiated several transinstitutional collaborations with the Broad Institute of Harvard and MIT; Harvard Department of Stem Cell and Regenerative Biology; the Ragon Institute of MGH, MIT and Harvard; and the Wyss Institute for Biologically Inspired Engineering.

SERVICE

Because disease knows no borders, HMS has continued its decades-long effort to help protect and advance human health at home and abroad, whether by training physicians in Africa or in the Emirate of Dubai. We have also instructed research clinicians in Portugal and taught medical students in Thailand.

We are working to prevent and treat AIDS, tuberculosis, cholera and malaria in countries such as Haiti and Peru, and we have searched for antifungal agents in Brazil.

When the Ebola epidemic erupted in West Africa, HMS faculty evaluated and planned responses. The School also has taken a leadership role in a global surgery initiative.

HMS health care policy experts continue to evaluate the effectiveness and efficiency of health care systems, with their findings informing our national debate. This year, the U.S. Surgeon General looked to HMS to promote physician awareness and training related to the nation’s opioid epidemic.

HMS students and faculty deliver medical care through initiatives such as the Crimson Care Collaborative. The School also provides education and research opportunities to students underrepresented in medicine through a wide range of educational outreach programs, fellowships, research opportunities and symposia.

LEADERSHIP

The outstanding achievements of HMS faculty stem directly from their commitment to the School’s mission. Easing the path to recognition of their scholarship and contributions, the School has streamlined the promotions process and clarified criteria on advancement, eligibility rules and appointment titles.

HMS has also made significant strides in recruitment and retention by creating best practices for identifying exceptional ju-

nior and senior faculty, particularly women and other groups traditionally underrepresented in medicine, and by strengthening mentoring requirements for junior faculty.

There have been financial challenges and difficult choices during the past two decades, but astute financial sustainability efforts have resulted in reduced costs, better resource management, adjusted financial models, recalibrated hospital financial contributions and new revenue streams.

The grassroots Community Values Initiative is preserving a vision of citizenship in the HMS community, while the generosity of philanthropists and partners has resulted in The World Is Waiting: The Campaign for Harvard Medicine raising more than $584 million, 78 percent of its $750 million goal, as of June 30, 2016.

CONCLUSION

In any symphony, each movement comes to a close at a point designated musically with a coda. HMS has reached another historical coda as it transitions to new leadership. It has been my greatest honor to serve this superb institution and all the individuals who drive its extraordinary record of achievement. I am proud to share here some of the highlights of their work and to express my sincere appreciation for the exceptional dedication that continues to fulfill the noble mission of this School. n

HMS Students

education

“Watching my brother­, who was born with osteogenesis imperfecta, interact with the health care system was among the reasons I developed an interest in medicine.”

Omar Bayomy MD 2017 CANNON SOCIETY

“Medicine allows “There are few me to unite a things more love of science important than and critical think- making a direct ing with an over- and tangible whelming desire difference in the to dedicate my life of another career to serving human being.” others.”

Aakash Shah Jessica Ruiz MD 2018 LONDON SOCIETY

MD 2016 PEABODY SOCIETY

“Neuroscience research allows me to explore fascinating questions about the human brain while using my creativity to help others.”

Krissy Lyon PHD 2019

“By fostering a “I want to work as “Seeing my strong conneca surgeon in post- dad—a veterition to the huconflict settings narian for large manities, medical where I can apply animals—invesprofessionals are my policy studies tigate disease well-positioned while playing a pathologies to make imporsignificant role opened my tant contributions saving lives.” eyes to being a to broader, ever different sort of Samia Osman more complex detective.”

MD 2017/MPP 2017 bioethical issues.” CASTLE SOCIETY Benyam Kinde Diana Alame MBE 2017

MD 2018/PHD 2016 HOLMES SOCIETY

MORE ABOUT THESE STUDENTS hms.harvard.edu/hms-students

Dean’s Report 2016–2017 5

Within a budding entrepreneurial community at HMS, Holmes Society students Marissa Lynn and Matt Alkaitis work with a 3-D printer in the student-run Makerspace Prototyping Lab. In the background, Peabody Society student Kira Seiger and Castle Society student Steven Dalvin use design-modeling software to develop ideas for new medical technologies.

6 Dean’s Report 2016–2017

Katie Yates, Class of 2019, performs a physical exam on patient Larry Yensen at the Cambridge Health Alliance Windsor Street Health Center.

Opposite page: Richard Schwartzstein, the Ellen and Melvin Gordon Professor of Medical Education and director of The Academy at HMS, talks with students during the Homeostasis 1 course while Peabody Society student Leangelo Hall discusses Starling forces with classmates.

I EDUCATION

I

EDUCATION Dean’s Report 2016–2017 7

PROGRAM IN MEDICAL EDUCATION

New Curriculum Underway The School’s innovative Pathways curriculum, launched in 2015 and guided by Dean for Medical Education Edward Hundert, the Daniel D. Federman, M.D. Professor in Residence of Global Health and Social Medicine and Medical Education, has fundamentally restructured the four years of study at HMS. Using a flipped-classroom model of learning, students take basic, social and population science courses built on case-based, collaborative learning. Under the leadership of the newly appointed Dean for Students Fidencio Saldaña, assistant professor of medicine at Brigham and Women’s Hospital, students gain patientcare experience during the first year of the MD program. Applying skills taught in the new Practice of Medicine course, first-year students are assigned to primary care practices. To help them become more reflective practitioners, they hone interviewing and communications techniques and gain experience performing physical exams and making diagnoses. In the second year, these foundational experiences are connected to the site of their clerkship assignments. Third- and fourth-year work focuses on advanced science courses, clinical electives and mentored scholarly research projects that align more closely with career paths. In Fall 2016, entering students began version 2.0 of Pathways.

STUDENT AFFAIRS

Shaping Opportunities To help shape the Pathways curriculum, representatives from four HMS student academic societies meet weekly with faculty to offer real-time feedback on the new course of study. These curriculum consultants sign up through The Academy at HMS, a faculty group supporting innovation in pedagogy and curriculum development. Under the guidance of former Dean for Students Nancy Oriol, faculty associate dean for community engagement in medical education, new opportunities are being created for students and faculty to work together in local communities and gain experience with the social determinants of health. The students are also reshaping their extracurricular activities by adding programs such

as a social medicine journal reading club and participating in groups involved in social dentistry, refugee work, racial justice, treatment of sexual assault injuries and health care for the homeless.

HMS FACILITIES IMPROVEMENTS

Future Planning A formalized 10-year campus master plan has identified and made recommendations for campus-wide improvements that are designed to enhance and facilitate educational, research and administrative programs. Several major projects have been completed, including renovations to the Tosteson Medical Education Center.

The new Clinical Skills Center houses 18 exam rooms with cameras that allow teachers to monitor student competencies.

Flexible classroom learning spaces can accommodate small- and medium-sized groups. New learning suites are supported by advanced-technology teaching systems. High-capacity broadband installed throughout the campus is helping support the flipped-classroom pedagogy, which requires students to view short online concept videos before attending classes. Ongoing facilities improvement is overseen by a capital management committee composed of administrators and faculty who review space utilization plans, address facilities requests and set construction priorities.

8 Dean’s Report 2016–2017

I EDUCATION

GRADUATE EDUCATION

Developing Alliances and Creating Cohesion As a blueprint for the future, the HMS strategic plan prescribed the formation of the Program in Graduate Education. It is now an active program guided by David Golan, the HMS George R. Minot Professor of Medicine at Brigham and Women’s Hospital, professor of biological chemistry and molecular pharmacology at HMS, and dean for basic science and graduate education. The program has led to greater cohesion between PhD programs and between graduate education and the Program in Medical Education, spurring innovative alliances and sparking new areas of study.

Max Mertens is pursuing a PhD in virology. A student in the David Knipe Lab, Mertens studies a cell’s antiviral response to infection by the herpes simplex virus. Pictured behind Mertens, green shows a protein responsible for detecting viral infection and red shows the skeleton of the cell.

DOCTORAL STUDIES

HMS doctoral programs are designed to launch superbly trained scientists into a wide range of careers, from biomedical research, academia and industry to positions in government service, patent law and science communications. In 2016, 841 PhD students were enrolled in nine disciplines. The HMS Division of Medical Sciences is made up of six programs, including bioinformatics and integrative genomics, biological and biomedical sciences, immunology, neuroscience, speech and hearing bioscience and technology, and virology.

Three programs—biophysics, chemical biology and systems biology—are collaborations between HMS and Harvard’s Faculty of Arts and Sciences.

MASTER’S PROGRAMS

In recent years, HMS has launched six new master’s degree programs. The following concentrations, comprising one-year and two-year programs, are designed for biomedical professionals wishing to further their career aspirations. Enrollment in 2016 totaled 142.

MMSc in Clinical Investigation provides training in methods of clinical investigation for

future leaders in patientoriented research.

MMSc in Medical Education prepares professionals to lead in medical education and develop new courses and curricula.

MMSc in Immunology provides a research-based foundation in basic, translational and clinical immunology.

MMSc in Global Health Delivery focuses on improving health services in resource-constrained settings.

Master of Bioethics covers bioethical questions that arise in clinical and research settings.

Master of Biomedical Informatics immerses physicians and scientists in data science methods.

INTERDISCIPLINARY PROGRAMS

Among its many successful enrichment programs, HMS and its partners are focusing on multidisciplinary areas of medicine: The Bertarelli Program in Translational Neuroscience and Neuroengineering, a partnership with École Polytechnique Fédérale de Lausanne in Switzerland, advances faculty and student

exchange programs that are aimed at moving basic research in neuroscience and engineering toward clinical applications.

The Leder Human Biology and Translational Medicine Program has attracted 150 doctoral students since its inception.

It focuses on translating basic science discoveries into new ways to diagnose and treat disease.

The Osher Center for Integrative Medicine at HMS and Brigham and Women’s Hospital, which was created in 2010, connects HMS researchers, educators, clinicians and graduate students who are fostering a new model of wellness and healing by integrating therapies such as nutritional supplementation, chiropractic, meditation, acupuncture, tai chi, yoga and movement therapy into treatment plans and lifestyle approaches.

The Therapeutics Graduate Program, which develops interconnected themes that lead to new drug discoveries, enrolled nine PhD students in 2016, for a total of 37 students from seven of the Harvard Integrated Life Sciences programs. n

FOR MORE ON EDUCATION hms.harvard.edu/education

world outreach GLOBAL HEALTH AND SOCIAL MEDICINE

Providing Innovative Solutions Researchers and clinicians in the HMS Department of Global Health and Social Medicine, led by Paul Farmer, the Kolokotrones University Professor of Global Health and Social Medicine and co-founder of Partners In Health, continue to advance worldwide health research by studying some of the globe’s leading infectious killers, such as AIDS, tuberculosis and malaria. Programmatic initiatives designed to train the next generation of global health leaders involve the entire HMS community—mentored medical students, teaching hospitals, residents, graduate students and fellows—and produce a vibrant research corps that supports faculty and the School’s humanitarian effort.

Infectious diseases HMS faculty and researchers have assisted world communities in combating Ebola (Liberia and Sierra Leone), tuberculosis (Peru), cholera (Haiti) and HIV/AIDS (Haiti, Lesotho, Malawi, Peru, Rwanda and Uganda), which put millions of children and adults at risk.

Rwanda HMS is entering the fifth year of the Rwanda Human Resources for Health program, which is designed to help build the education infrastructure and workforce necessary to create a highquality, sustainable health care system that addresses the country’s most challenging health care obstacles, including a limited number of skilled workers, substandard facilities and equipment, and inadequate facilities management.

Middle East A partnership between HMS and Dubai authorities resulted in the HMS Center for Global Health Delivery–Dubai, which offers new ways to address the most pressing health care delivery challenges in Dubai and the region. The center’s main areas of focus are surgical care, mental health, infectious diseases, obesity and diabetes.

Surgery access In response to the HMS-authored recommendations of The Lancet Commission on Global Surgery to improve access to safe, timely and affordable surgery for 5 billion people worldwide, representatives from 17 countries met in Dubai in 2016 for implementation discussions guided by HMS faculty.

Master of Medical Sciences in Global Health Delivery The most recent group of 12 health professionals entering the two-year MMSc program included 10 international students, many of whom were from resource-poor settings, including two physicians supported by the Liberian government. In addition to completing HMS coursework, the students are developing models designed to create better health care systems in their home countries. In the past five years, 36 students have enrolled in the program.

HMS, together with Partners In Health and Brigham and Women’s Hospital, is part of a multiorganizational effort working to improve treatment strategies for multidrugresistant tuberculosis in Peru. Assistant Professor of Medicine Michael L. Rich and Kwonjune Seung, HMS instructor in medicine, are part of the endTB project.

Pictured, right: Field technician Yecela Rodríguez works with Francisco, a patient.

Opposite page: Thailand’s Kohn Kaen University has renewed and expanded its participation in HMX Fundamentals, an online curriculum for prehealth career students, created by the HMS Office for External Education.

Dean’s Report 2016–2017 11

EXTERNAL EDUCATION

Medical Knowledge Goes Global Innovative teaching strategies are emerging from the HMS Office for External Education, led by David Roberts, dean for external education, extending the reach of HMS medical expertise to an ever-expanding group of new learners around the globe.

Executive Education This year, the first HMS Executive Education program provided weeklong sessions to 40 Google executives who work in areas such as search, clinical genomics and informatics. Their experiences at HMS gave them an inside look at issues that arise at the intersection of technology, medicine and health care.

Additional intensive, customized programs for local, national and international companies are scheduled for the coming year.

HMX Fundamentals HMS is reaching even greater numbers of students globally through this online learning platform. In one instance, medical and prehealth career students at Khon Kaen University in Thailand are learning fundamental concepts in health sciences through the use of narrated videos, interactive modules and state-of-the-art biomedical visualization.

Lessons are reinforced in forums with faculty moderators leading discussions and advanced students facilitating topics. University grants are supporting research into how to expand this innovative pedagogical approach to develop future programs.

Global reach Through a combination of online and in-person workshops and seminars, HMS has, to date, offered blended-earning opportunities to more than 1,500 physicians, scientists and health care professionals around the world, focusing on clinical research, leadership, and cancer biology and therapeutics. Other courses cover quality, safety and informatics training. An expansion of the School’s blended-learning

programs is underway in China through workshops at the Harvard Center Shanghai.

Continuing Medical Education In addition to more than 200 programs and courses on a vast array of clinical topics, HMS is creating an online platform to deliver recorded content to physicians worldwide via webcasting and other digital techniques.

Consumer education The consumerfacing Harvard Health Publications is continuing to develop new multimedia health-related content that features HMS world-class faculty and promotes wellness concepts for both individuals and companies.

Many new types of educational programs are planned, including an open online course via HarvardX on the opioid crisis.

CENTER FOR PRIMARY CARE

A Leading Voice in Primary Care The HMS Center for Primary Care, launched in 2009 under the leadership of Russell Phillips, the HMS William Applebaum Professor of Medicine at Beth Israel Deaconess Medical Center, has become a national leader in promoting innovations in primary care. Among the Center’s achievements: • Introduction of the Physician as Leader course • Development of a blueprint for primary care education that is being used to guide curricular change at HMS, which was published in Academic Medicine • Development of a learning collaborative consisting of 28 academic primary care practices where 300,000 patients are served by primary care staff and 500 resident trainees, with new team-based approaches that are expanding into behavioral health • Establishment of the InciteHealth program, which granted fellowships to 20 emerging physician-entrepreneurs • Creation of the Abundance Agents of Change Challenge Grant program, which helps HMS students develop innovations in health care delivery in partnership with community health centers •F ormation of new curricula built on original case studies of high-performing organizations for leaders of health systems • Development of a microsimulation model for assessing the financial impact of team-based care and new payment models on primary care practices n

Achievements

opus Achievements at Harvard Medical School, 2007–2016 I Jeffrey S. Flier, Dean EDUCATION

RESEARCH

• Pathways curriculum • Program in Graduate Education • Scholars in Medicine • Six master’s degree programs • PhD program cohesion • Therapeutics in Life Science Research Program • Department of Global Health and Social Medicine • Department of Biomedical Informatics • Office for Academic and Clinical Affairs • Office for External Education • Center for Bioethics • Five Quad chairs appointed: Biological Chemistry and Molecular Pharmacology, Biomedical Informatics, Cell Biology, Global Health and Social Medicine, and Neurobiology • Two new clinical departments: Emergency Medicine, Neurosurgery • Special advisor on entrepreneurship appointed

• Harvard Catalyst | The Harvard Clinical and Translational Science Center •H arvard Institute of Therapeutic Science and Laboratory of Systems Pharmacology • Transinstitutional initiatives: Bertarelli Program in Translational Neuroscience and Neuroengineering; Eli and Edythe L. Broad Institute of Harvard and MIT; Harvard Ludwig Center; Harvard Stem Cell Institute; HMS–Portugal Program in Translational Research and Information; Leder Human Biology and Translational Medicine Program; Osher Center for Integrative Medicine at HMS and Brigham and Women’s Hospital; Ragon Institute of MGH, MIT and Harvard; and Wyss Institute for Biologically Inspired Engineering • Harvard Office of Technology Development initiatives: entrepreneurship and industry partnerships • New Conflicts of Interest and Commitment policies • Evergrande Center for Immunologic Diseases at Brigham and Women’s • Harvard Cancer Collaborative • HMS Center for Glycoscience

COMMUNITY

• Diversity inclusion programs • Dean’s Postdoctoral Fellowship • Faculty promotions process streamlined • New faculty and staff recognition awards • Community Values Initiative • Facilities renovations: 10-year master plan, Clinical Skills Center, learning suites • IT enhancements: data capacity, storage and movement HEALTH CARE

• Center for Primary Care • HMS Center for Global Health Delivery–Dubai • National leadership in health care policy • Worldwide research and training programs in infectious diseases, surgery, mental health, obesity and diabetes • Global Clinical Scholars Research Training Program • Continuing Medical Education online course expansion

FINANCE

• Student financial aid increased • Middle-income initiative launched • Work-stream management and procurement efficiencies enacted • Increase in affiliates’ annual HMS operations contributions, beginning at $12 million per year, rising to $30 million per year •T he World Is Waiting: The Campaign for Harvard Medicine saw $584 million raised, 78 percent of goal as of June 30, 2016

Dean’s Report 2016–2017 13

The Longwood Symphony Orchestra, performing at New England Conservatory’s Jordan Hall.

The LSO presents public concerts each year that raise funds for nonprofit organizations aiding medically underserved communities.

leadership and service 14 Dean’s Report 2014 I 2015

ACADEMIC AND CLINICAL AFFAIRS

Centralizing Professional Development The Office for Academic and Clinical Affairs, headed by Dean for Academic and Clinical Affairs Nancy Tarbell, the C.C. Wang Professor of Radiation Oncology, oversees the School’s clinical and faculty affairs, diversity inclusion initiatives and research integrity programs. This centralized office fosters cohesiveness and collaboration among all of these key branches of administration.

The core Academic and Clinical Affairs Office performs clinical departmental reviews and provides oversight of HMS centers, faculty development and diversity initiative awards, Foundation Funds and hospital affiliation agreements.

Among achievements in 2016 were the creation of new policies for faculty recruitment and search practices, including a training program to minimize unconscious bias and the establishment of both the HMS Initiative in RNA Medicine and the HMS Center for Glycoscience. Each will foster collaborative research and education within these emerging scientific fields.

Dean’s Report 2016–2017 15

FACULTY AFFAIRS

Kathryn Hall, instructor in medicine in the Division of Preventive Medicine at Brigham and Women’s Hospital, is a fellow in the Harvard Catalyst Program for Faculty Development and Diversity Inclusion, which supports exceptional clinical and translational researchers. She has made pioneering discoveries in the study of how genes influence the placebo response.

The Office for Faculty Affairs, led by Dean for Faculty Affairs Maureen Connelly, is committed to streamlining and strengthening the processes for faculty advancement and recognition. Achievements include: Restructured promotions process In 2016, 60 faculty were promoted to professor, 151 to associate professor and 390 to assistant professor, with all candidates assessed for excellence in teaching, investigation, clinical expertise and innovation.

Increased gender diversity among senior faculty In 2016, three women from populations underrepresented in medicine (URiM) were promoted to professor. A total of eight women of URiM backgrounds have achieved this rank since 2007. Overall, the total number of women professors has risen to 18 percent of the senior faculty; 8 percent of promotions to professor this academic year went to URiM faculty.

Enhanced career support for junior faculty Criteria were created that outline requirements for attaining instructor status, including an expectation that candidates will have an identifiable mentor and will attend an annual career conference.

Seventy comprehensive presentations regarding career advancement were offered to basic and social science departments as well as to the School’s clinical affiliates.

A record 76 faculty members enrolled in a three-day course designed to promote leadership in academic medicine.

DIVERSITY INCLUSION AND COMMUNITY PARTNERSHIP

Promoting excellence through the pursuit of diversity has been a priority at HMS for 25 years. Led by Dean for Diversity and Community Partnership Joan Reede, significant achievements include the following:

Above: Joan Reede, dean for diversity and community partnership, was named a full HMS professor of medicine in July 2016. Reede has created dozens of programs that support and promote the recruitment, retention and advancement of individuals from groups underrepresented in medicine.

Opposite page: Nawal Nour, HMS associate professor of obstetrics, gynecology and reproductive biology at Brigham and Women’s Hospital, visits with Layla Guled.

Nour is an alumna of the Commonwealth Fund Mongan Fellowship in Minority Health Policy and the founding director of the African Women’s Health Center.

In June 2016, HMS celebrated the 20th anniversary of the Commonwealth Fund Mongan Fellowship in Minority Health Policy, a one-year fellowship offering intensive study to physicians committed to transforming health care delivery systems for vulnerable populations.

HMS welcomed two additional scientists from groups underrepresented in medicine to the Dean’s Postdoctoral Fellowship program, for a total of seven.

The annual Faculty Fellowship Programs now support a total of four junior faculty drawn from the ranks of minority faculty at HMS hospital affiliates.

Outreach to promising candidates from groups underrepresented in medicine resulted in more than 400 college, medical and graduate students and fellows attending the School’s 2016 New England Science Symposium, where they presented research and engaged in career development activities.

Nearly 300 middle-school students from Boston and Cambridge public schools participated in a one-day Explorations program where they attended presentations on educational options and were hosted by Harvard faculty and research associates in laboratory and clinical settings.

HMS celebrates a culture that honors outstanding service through the Daniel D. Federman Staff Award for Exceptional Service to HMS/HSDM and the Barbara J. McNeil Faculty Award for Exceptional Service to HMS/ HSDM. The Dean’s Community Service Award recognizes exceptional service contributions by members of the HMS community.

FACULTY AND RESEARCH INTEGRITY

Under Dean for Faculty and Research Integrity Gretchen Brodnicki, this year HMS revised its policy concerning faculty relationships with industry by instituting a small but significant change to the School’s conflicts of interest policy. With approval of the HMS Standing Committee on Conflicts of Interest, the revised policy states that investigators who develop a technology at HMS that is subsequently licensed to industry may petition to continue to be involved in that research at HMS. It was determined that this change will benefit both academia and industry, furthering the research and development successes of both. n

affiliates

Dean’s Report 2016–2017 17

HMS affiliates are Center indicates that more effective known for their treatments may be possible using PACESETTERS IN DISCOVERY AND CARE world-class clinical For more than 200 years, HMS affiliates Judge Baker connective-tissue Children’s Center cells is working derived from a care and groundhave been key Lorem partners ipsumindolor the School’s sit ametieduconsedbreaking dson multiple initiatives patient’swith ownthe skin.

Commonwealth research. cation, research dindfs elit and sedpatient o eijsijdn caretoendeavors. orpr infciniePictured: usdt ofEther MassachusettsThe and Quality others toCare improve Initiative mental at Judge the Dome in thehealth surgical Today, 15slavoer hospital fwodoswefkemfsd affiliates and research kmangow lufdnd care forBaker children.

Children’s Massachusetts Center Eye helps and children institutions sIn addition house more to the than more 11,000 thanHMS 151 facultyamphitheater Earat| Schepensand Eyefamilies ResearchbyInstitute translating researchevidenceMassachusetts faculty whose based on research the HMS ranges campus, from basic there are nearly ers computationally based strategies reconstructed intothe sustainable ances- practice General Hospital, research12,000 into how faculty cellsatwork the School’s to clinical15 affiliated hostral state of a viral changes capsid in that real-world is highly settings. effectiveResearchwhere the first public surgery using studies pitals designed andtoresearch transform institutions medical care who provide as a synthetic ers vector from to deliver Massachusetts gene therapies Eye and Ear were was worldwide. patient care and clinical training while anesthetic mento the liver, muscles amongand leaders the retina. of an international effort performed in 1846.

TRANSFORMING MEDICAL CARE

Thistoring year, in aspiring the global physicians effort toand combat scientists in the Zikaresearch virus, a programs research team that transform led by medical.

Beth IsraelThis Deaconess year alone, Medical researchers Centerathas HMS affilidemonstrated ates attained that two a remarkable candidate range vaccines of achieveprovidement. complete In cancer protection research, from investigators the viat Beth rus in animal Israel Deaconess models, which Medical suggests Centerthat discovered a vaccine that fora humans pseudogene, mayan beRNA feasible. subclass By that has studying lost thethe genetic ability mutations to produce that proteins, causehas a role in deafness, causing scientists cancer. at Boston On the bioengineering Children’s front, Hospitalinvestigators have taken at key Boston steps Children’s toward de-Hospital velopingdeveloped gene therapies a protein-based to restorescaffolding hearing. that can Investigators help the anterior from Brigham cruciate and ligament (ACL) repair Women’s ipsum Hospital lore ehave pl;uribus. found that people with multiple In neurologic sclerosis have studies, different researchers pat- at terns ofBrigham gut microorganisms and Women’sfrom Hospital theirdiscovered healthy acounterparts, gene variant that a finding may help that patients may with lead to new multiple therapies sclerosis for better this disease. respond to a certain Psychologists medication. at Cambridge As a result Health of its Alliefforts to imance have prove shaped health a community care systems,safety Cambridge net Health that identifies Allianceand ranked helpsamong at-riskthe youth, top performers an in initiative a national that theypilot say has program reduced aimed juveat reducing nile arrests hospital in Cambridge readmission by rates. more than 50 percent over Early eight results years. of a clinical immunotherapy Investigators trial at Dana-Farber at Dana-Farber Cancer Cancer Institute revealed Institutethat have a cancer shownvaccine that a simple combined blood with an test cananti-angiogenic accurately detect drug keyimproved genetic mutasurvival in tions incertain non-small patients cell lung with cancer, relapsedavoidglioblastoma ing the tumors. challenges Harvard of traditional Pilgriminvasive Health Care Institute biopsies. has Harvard been chosen Pilgrim byHealth the U.S. Care Food and Drug InstituteAdministration researchers have to lead shown thethat Sentinel pa- System, a tients who program experience that uses a nonfatal health overdose care data to monitor of opioids theoften safetycontinue of FDA-regulated to receivedrugs opioidand other prescriptions—a medical products. situation that potentially could be avoided Investigators by making in the providers Institute for Aging more aware Research of prior at Hebrew overdose SeniorLife events. found that A study imperceptible of healthy vibrations elders ledapplied by to the soles of Hebrewfeet SeniorLife improved Institute balancefor andAging gait in elderly study Research participants. has shownAtthat Joslin theDiabetes ability toCenter, studies dual-task, focusing such asonwalking bacteriawhile in the performdigestive system’s ing a separate microbiome cognitive showed task,that wasthe im-host’s genes proved interact in elderswith by stimulating microbial genes the to boost insulin prefrontal resistance cortex ofand theother brainmetabolic with a disorders. painless transcranial electrical current. In a novel approach to aid wound healing in diabetes, research at Joslin Diabetes

A team at to Massachusetts identify threeGeneral geneticHospital associations that created a bioartificial influence replacement susceptibility forelimb to primary opensuitable for transplantation angle glaucoma, in the humans. most common form McLean Hospital of adult-onset investigators glaucoma. uncovered a potential treatment Massachusetts for Parkinson’s General disease Hospital investhat involves existing tigators found antimalarial that amyloid-beta drugs. protein, Mount Auburn whichHospital is deposited opened in the a mulform of plaques tidisciplinary in program the brains to track of Alzheimer’s patients with patients, is lung nodules,aaiming normaltopart identify of theand innate treatimmune syscancerous lesions tem, earlier. suggesting Researchers limitations at to therapies Spaulding Rehabilitation designed to eliminate Hospital found amyloid that plaques a medicine tofrom treat patients’ attentionbrains. deficitIn hypera first-of-its-kind activity disorder study, may findings also help by patients McLean with Hospital repost-traumatic searchers stress disorder. have linked Studies abnormalities at the in cirVA Boston Healthcare cadian rhythms Systemtoshowed specificsigns neurochemical of acceleratedchanges aging ininthe thebrains brainsofofU.S. people with bipoveterans injured lar disorder by bombthat blasts. coincide with increased The scopeseverity and breadth of symptoms of the impressive in the morning. accomplishments With thatthe HMS Zika partners virus spreading have realized in theworldwide, past year are physicians truly extraordiat Mount Auburn nary. n Hospital provided guidelines on how to diagnose Zika infection, including blood tests to differentiate it from other possible diseases or co-infections, such as dengue and chikungunya. Spaulding Rehabilitation Network researchers are conducting studies that will more accurately determine when concussion symptoms resolve and when athletes may FORsafely MORE ON AFFILIATES return to sports. The VA Boston hms.harvard.edu/hms-affiliates-research Healthcare System has implemented the Precision Oncology Program, a clinical care program with a research component intended to bring precision medicine and cutting-edge cancer diagnostics and treatment to veterans. n

FOR MORE ON AFFILIATES hms.harvard.edu/hms-affiliates-research

discovery Teaching and Learning

HARVARD PROGRAM IN THERAPEUTIC SCIENCE

New Science for Better Medicines The Harvard Program in Therapeutic Science (HiTS) and its flagship Laboratory of Systems Pharmacology (LSP) use laboratory-based experiments, computer science and molecular medicine to advance drug discovery and precision medicine. HiTS trains pre- and postdoctoral students to be leaders in drug discovery and builds partnerships with hospitals to test new theories. Directed by Peter Sorger, the Otto Krayer Professor of Systems Pharmacology, the LSP is focusing on the beneficial and adverse effects of cancer drugs and on new ways to developing therapies for complex and incurable diseases such as Alzheimer’s disease. In 2016, HiTS launched its Program in Regulatory Science and established the Henri and Belinda Termeer Early Career Investigator Fellowship jointly with Massachusetts General Hospital. Funded by a $5 million gift from the Termeers, this program supports a home in the LSP for a clinician-scientist and accelerates the application of systems pharmacology concepts to clinical trials and patient care.

Dean’s Report 2016–2017 19

RESEARCH HIGHLIGHTS

Strength of Purpose HMS has a unique ability to convene multiple research communities around innovative discovery strategies, creating the potential to relieve human suffering in powerful new ways. Within Harvard, for example, a partnership with the Department of Stem Cell and Regenerative Biology, which exists within the University’s Faculty of Arts and Sciences, was established in 2007, making it one of the first cross-departmental collaborations in the University’s history.

Selected HMS achievements in 2016 Sponsored research The combined research efforts of HMS and the Harvard School of Dental Medicine resulted in $238,463,884 in new awards for sponsored research programs at HMS and HSDM, which included $186,713,836 in federal grants. Of those grants, $171,846,734 was awarded by the National Institutes of Health.

Research administration HMS completed the consolidation of research operations within one centralized office, resulting in School-wide efficiencies. The Research Administration and Operations office now oversees the Harvard Center for Comparative Medicine, which manages animal facilities; the Office of the Institutional Animal Care and Use Committee; the Committee on Microbiological Safety; and the Sponsored Programs Administration, previously under the Office of Finance, which provides pre- and post-award support for sponsored projects. The Harvard T.H. Chan School of Public Health provides administrative oversight and support for the Institutional Review Board for HMS, HSDM and the Harvard Chan School.

IT infrastructure Biomedical science is data-driven and requires customized software, multiple storage platforms and accelerated capacity for processing vast amounts of data, particularly in fields such as bioinformatics and genetics. The Office of Information Technology implemented new data management solutions and broadened IT highways on the Quad by upgrading the HMS network and increasing wireless capacity, benefiting both the research and educational communities.

Technology development Harvard’s Office of Technology Development (OTD) continues to engage and support HMS faculty in advancing research toward the clinic through productive industry collaborations and gap funding from the Blavatnik Biomedical Accelerator. OTD has promoted entrepreneurship and innovation at HMS through networking events such as the Guppy Tank, Pathways to Entrepreneurship and the Biomedical Informatics Entrepreneurs Salon. It also has established a new entrepreneur-in-residence program in the Department of Biomedical Informatics. In 2016, OTD launched 13 new startup companies and granted 52 new licenses to develop and commercialize Harvard technologies.

HARVARD CATALYST

Catalyzing Locally, Sharing Nationally Founded in 2008 with the largest NIH Clinical and Translational Science Award (CTSA) granted, and funded again in 2013, Harvard Catalyst | The Harvard Clinical and Translational Science Center connects, convenes and catalyzes Harvard faculty and trainees, accelerating research while training the next generation of clinical and translational investigators. Directed by Lee Nadler, the Virginia and D.K. Ludwig Professor of Medicine and dean for clinical and translational research, Harvard Catalyst, among its many achievements, has awarded more than $14 million in pilot awards to new teams of investigators; educated more than 4,000 junior faculty on the foundations of clinical and translational research, as well as on advanced topics such as medical device development, network medicine and biomarker development; and provided study design assistance, project management and regulatory guidance on more than 1,500 clinical protocols.

As a facilitator of Harvard multi-investigator research, Harvard Catalyst leads the Football Players Health Study at Harvard University and has enabled the creation of the Scalable Collaborative Infrastructure for a Learning Health System network, which is funded by the Patient-Centered Outcomes Research Institute, and the BostonBiomedical Innovation Center, which is funded by the National Heart, Lung and Blood Institute. In 2015, Harvard Catalyst was awarded a Massachusetts Department

Opposite page: Rachel Warden, lab automation specialist, operates the Epson 6-axis robot arm paired with the Cartesian (linear) robot. Custom designed and built at the ICCB-Longwood Screening Facility, these robots are used

by HMS investigators to perform highthroughput screens of chemical libraries.

of Public Health contract to evaluate the Commonwealth’s $60 million Prevention Wellness Trust Fund.

As one of the 64 members of the CTSA Consortium, Harvard Catalyst leads several national initiatives to accelerate clinical research, including SMART IRB, a platform to implement the new NIH Single IRB policy for multisite studies. SMART IRB evolved largely from the Harvard Master Reciprocal Common IRB Reliance Agreement, which was developed to accelerate IRB approval of studies conducted at more than one Harvard site. The Shared Health Research Information Network (SHRINE) connects clinical data warehouses at dozens of CTSA sites to access research information about millions of patients. Profiles, a web tool that provides real-time information about faculty and trainees and enables collaboration, has been adopted by more than 30 institutions globally. Eagle-i, a biomedical search engine, helps researchers locate any of 101,000 resources at Harvard and 42 other participating institutions.

BIOLOGICAL CHEMISTRY AND MOLECULAR PHARMACOLOGY

Revealing the Structure of an Elusive Receptor The human sigma-1 receptor is an enigmatic cellular protein implicated in diseases ranging from cancer to amyotrophic lateral sclerosis (ALS). Despite more than 40 years of research, the molecular details of the sigma-1 receptor and its activity have remained elusive. Work in the lab of Andrew Kruse, assistant professor of biological chemistry and molecular pharmacology, has revealed the molecular structure of the sigma-1 receptor for the first time, showing the architecture of this unusual protein. As reported in Nature, the molecular structure is composed of three receptor molecules in a triangular arrangement, each bound to a drug-like inhibitor.

These findings open the door to further exploration of the molecular basis for sigma-1 function and its potential as a therapeutic target for ALS and other diseases.

BIOMEDICAL INFORMATICS

A Natural History of Neurons Inherited mutations have been implicated in brain diseases and disorders, but the role of noninherited mutations has been murkier.

20 Dean’s Report 2016–2017

I DISCOVERY

A discovery made by pairing single-cell genome sequencing with rigorous data analysis lays the foundation for investigations into whether noninherited mutations contribute to neurodevelopmental and neurodegenerative diseases. The study, published in Science

by Peter Park, associate professor of biomedical informatics, and Christopher A. Walsh, the HMS Bullard Professor of Pediatrics and Neurology at Boston Children’s Hospital, demonstrated for the first time that a large number of somatic (noninherited) mutations are present in the brain cells of healthy people. The researchers showed that somatic mutations occur more often in the genes that neurons use most. They also demonstrated that it is possible to trace cell lineages based on mutation patterns, which may lead to decoding the brain’s pattern of development.

CELL BIOLOGY

Facebook for the Proteome The mapping of the 20,000 genes in the human genome was completed in 2003, but until recently, only a small fraction of proteins produced by these genes were known. Now a proteomics method developed by Wade Harper, the Bert and Natalie Vallee Professor of Molecular Pathology and chair of cell biology, and Steven Gygi, professor of cell biology and director of the Thermo Fisher Center for Multiplexed Proteomics at HMS, has streamlined the mapping of all protein complexes in the human proteome. As published in Cell, the researchers combined high-throughput affinity purification with mass spectrometry to create a publicly available resource called the BioPlex network, which identifies nearly 24,000 interactions among more than 7,600 proteins—86 percent previously unknown.

As scientists add to this web-based network, which predicts where proteins are located within cells, they hope that protein interactions and influences on health and disease will be revealed.

GENETICS

Biological Origin of Schizophrenia Based on genetic analyses of nearly 65,000 people, molecular analyses of brain tissue from 500 people, and new genetic methods developed by an HMS graduate student, HMS researchers discovered that the risk of schizophrenia increases if a person inherits

overactive variants in a gene that stimulates synaptic pruning, the process whereby connections between neurons are eliminated.

The study, published in Nature, was led by Steven McCarroll, associate professor of genetics and director of genetics for the Stanley Center at the Broad Institute of Harvard and MIT. It is the first time schizophrenia’s origin has been linked conclusively to specific gene variants and a biological process. It also helps explain two decades-old observations: that synaptic pruning is particularly active during adolescence, when symptoms of schizophrenia typically develop, and that the brains of individuals affected with schizophrenia tend to show fewer connections between neurons. These findings may lead to future therapies directed at the disorder’s roots, rather than just its symptoms.

GLOBAL HEALTH AND SOCIAL MEDICINE

Charting a Course to Zero TB Deaths Tuberculosis has been curable and preventable since the 1950s, but more than 1.5 million people each year still die from this airborne disease. In a series published in The Lancet, Salmaan Keshavjee, associate professor of global health and social medicine, and colleagues in GHSM detailed scientific and therapeutic policies to rapidly stop TB deaths and change the epidemic’s course one community at a time—an effort called the Zero TB Cities Initiative. Rather than follow current practices that often target only the sickest patients and provide incomplete therapies, the TB elimination plan deploys methods such as targeting hot spots of transmission, identifying infected individuals before they can transmit disease to others, treating those infected with TB before they develop active disease, and delivering prompt and proper treatment for all forms of tuberculosis.

HEALTH CARE POLICY

A high-throughput liquid handler transfers reagents to 384 experimental wells simultaneously.

More than 500,000 small molecules and several RNAi libraries are available for screening at ICCBLongwood, and the screening collections are continuously growing.

Payment Reform Achieves Early Gains Accountable care organizations (ACOs), groups of health care providers who provide care to a population of patients under a global budget tied to performance benchmarks, are achieving early success. ACOs that joined the Medicare Shared Savings Program (MSSP) when it launched in 2012 achieved modest savings while maintaining or improving performance on measures of quality of patient care in 2013, the program’s first full year.

These findings, published in the New England Journal of Medicine, emerged from a study led by J. Michael McWilliams, the Warren Alpert Foundation Associate Professor of Health Care Policy. Compared with non-ACO providers in the same areas, ACOs that were early adopters of MSSP lowered spending by 1.4 percent in 2013, a $238 million reduction.

MICROBIOLOGY AND IMMUNOBIOLOGY

Microbial Symbiosis Constrains Intestinal Inflammation Immune system cells, called T regulatory cells, that express the transcription factor Foxp3, are known to promote tissue homeostasis, or equilibrium, in several settings. As reported in Science, HMS researchers found a broad but specific array of individual bacterial species in the human gut that work together in the mouse colon to constrain immuno-inflammatory responses by symbiotically giving rise to a distinct population of T regulatory cells. The induction of these T cells in the colon requires the transcription factor Rory, which is a paradox because in other tissues Rory antagonizes Foxp3.

The investigative team, led by Christophe Benoist and Diane Mathis, both the Morton Grove-Rasmussen Professors of Immunohematology, and Dennis Kasper, the

I

EDUCATION Dean’s Report 2016–2017 21

HMS William Ellery Channing Professor of Medicine at Brigham and Women’s Hospital, showed that Rory acts differently in the colon, demonstrating how the activity of microbes can influence different characteristics of immune cells.

NEUROBIOLOGY

Odor Alternative HMS researchers have discovered a new mechanism for how the nose detects smells.

For more than 25 years, research has shown that smells are detected via pathways triggered by seven-transmembrane G-protein coupled receptors (GPCRs). Only one type of GPCR is expressed per sensory neuron in the nose, which enables the brain to distinguish different smells. But a team led

by Sandeep Datta, assistant professor of neurobiology, has uncovered an alternative method by which some odors are sensed.

Findings published in Cell reveal that a system known as the “olfactory necklace” does not use GPCRs but instead uses a new family of proteins that act as smell detectors.

Rather than discriminating between odors, these necklace receptors may instead detect a variety of odors that trigger innate behaviors, perhaps working as a mammalian alert system.

STEM CELL AND REGENERATIVE BIOLOGY

Making Bone Marrow Transplants Safer HMS scientists have taken the first steps toward making bone-marrow transplantation safer and more widely available for millions of people with AIDS and blood disorders such as sickle cell anemia and thalassemia. Transplantation currently is the only curative therapy, but for the new transplanted stem cells to do their work, the faulty stem cells must be killed first by using damaging chemotherapy or radiation. As reported in Nature Biotechnology, a team led by David Scadden, professor of stem cell and regenerative biology and chair of the department, and co-director of the Harvard Stem Cell Institute, developed a procedure using specific antibodies that successfully removes more than 98 percent of blood stem cells in lab animals, making it as effective as chemotherapy and radiation but without collateral damage. The scientists are now working to identify antibodies effective in humans.

FOR MORE ON DISCOVERY hms.harvard.edu/research

Cymbals allow composers to add color and emphasis to musical scores.

They often provide a resounding closing note. Here, a Longwood Symphony Orchestra percussionist prepares for a key moment in a performance.

SYSTEMS BIOLOGY

HARVARD SCHOOL OF DENTAL MEDICINE

Hidden in the Code

Redefining Renal Phosphate Handling

Knowing the three-dimensional structures of proteins, RNA molecules and other building blocks of the body provides a key to understanding how these molecules work, what goes wrong in disease, and how abnormalities might be fixed. But methods such as X-ray crystallography or nuclear magnetic resonance can take time and money, and for RNA, it’s not even clear which molecules have 3-D shapes or definable functions. Adapting a tool previously developed to predict portions of protein structures using only their amino acid sequences, researchers led by Debora Marks, assistant professor of systems biology, did the same for RNA molecules.

Published in Cell, these findings promise to help researchers determine which of the hundreds of thousands of as-yet unstudied RNAs serve useful functions in the body.

The body must maintain normal phosphate levels or serious health consequences can arise, especially among patients with chronic kidney disease. To maintain normal levels of phosphate in the body, bones produce fibroblast growth factor 23 (FGF23), which signals the kidneys to excrete phosphate.

FGF23 acts only in the presence of Klotho, a protein primarily expressed in the kidneys’ distal tubules where it regulates calcium.

Klotho also is present in low levels in renal proximal tubules, but its role there has been unclear. As reported in Kidney International, a study led by Beate Lanske, professor of oral medicine, infection and immunity at HSDM, described for the first time that Klotho expression in the proximal tubules of transgenic mice has a limited but definite role in regulating phosphate. This work opens new pathways for exploring the interplay between distal and proximal tubules in controlling mineral homeostasis. n

22 Dean’s Report 2016–2017

I HONORS AND AWARDS

Honors and Awards National Medal of Science Rakesh Jain, the A. Werk Cook Professor of Radiation Oncology (Tumor Biology) at Massachusetts General Hospital Albert Lasker Basic Medical Research Award William Kaelin Jr., professor of medicine at Dana-Farber Cancer Institute and senior physician at Brigham and Women’s Hospital, shared the award with Peter Radcliffe, University of Oxford/Francis Crick Institute, and Gregg Semenza, Johns Hopkins University School of Medicine Wolf Prize in Medicine C. Ronald Kahn, the Mary K. Iacocca Professor of Medicine and chief academic officer and senior investigator at Joslin Diabetes Center, was a co-recipient with Lewis Cantley of Weill Cornell Medical College National Academy of Sciences Two faculty members were elected: Myles Brown, professor of medicine and co-director of the Center for Functional Cancer Epigenetics at Dana-Farber Robert Kingston, professor of genetics and chief of the Department of Molecular Biology at Mass General National Academy of Inventors Two faculty members were elected: Donald Ingber, the Judah Folkman Professor of Vascular Biology in the Department of Surgery at Boston Children’s Hospital and founding director of the Wyss Institute for Biologically Inspired Engineering Guillermo Tearney, professor of pathology, a Mike and Sue Hazard Family MGH Research Scholar and a faculty member of the Wellman Center for Photomedicine at Mass General 2016 March of Dimes and Richard B. Johnston Jr., MD Prize in Developmental Biology Gary Ruvkun, professor of genetics, was a corecipient with Victor Ambros of the University of Massachusetts Medical School American Academy of Arts and Sciences Four faculty members were elected: Donald Ingber, the Judah Folkman Professor of Vascular Biology in the Department of Surgery at Boston Children’s and founding director of the Wyss

Bruce Rosen, the Laurence Lamson Robbins Professor of Radiology at Mass General and professor of health sciences and technology in the Harvard-MIT HST program Yang Shi, professor of cell biology and professor of pediatrics at Boston Children’s Ralph Weissleder, the Thrall Family Professor of Radiology at Mass General and professor of systems biology 2015 Philip Hauge Abelson Prize, American Association for the Advancement of Science Eric Lander, professor of systems biology and president and founding director of the Broad Institute of Harvard and MIT American Association for the Advancement of Science One faculty member was elected: Wenyi Wei, associate professor of pathology at Beth Israel Deaconess Medical Center EMBO (European Molecular Biology Organization) Two scientists were elected: Marc Kirschner, the John Franklin Enders University Professor of Systems Biology and chair of the Department of Systems Biology Timothy Mitchison, the Hasib Sabbagh Professor of Systems Biology and deputy chair of the Department of Systems Biology International Electrotechnical Commission 1906 award John Hedley-Whyte, the David S. Sheridan Professor of Anaesthesia and Respiratory Therapy at VA Boston Healthcare System 2016 Young Investigator Award, Bert L and N Kuggie Vallee Foundation Andrew Kruse, assistant professor of biological chemistry and molecular pharmacology Vilcek Prize for Creative Promise in Biomedical Science Fernando Camargo, associate professor of stem cell and regenerative biology NIH Director’s Pioneer Award Hao Wu, the Asa and Patricia Springer Professor of Structural Biology and professor of biological chemistry and molecular pharmacology

National Cancer Institute Outstanding Investigator Award Peter Howley, the Shattuck Professor of Pathological Anatomy Endowed Professorships The following newly established HMS professorships were celebrated in fiscal year 2016, recognizing the generosity of their respective benefactors and the accomplishments of their inaugural incumbents: Nathanael S. Gray, the Nancy Lurie Marks Professor of Biological Chemistry and Molecular Pharmacology in the Field of Medical Oncology Paula A. Johnson, the Grayce A. Young Family Professor of Medicine in the Field of Women’s Health Gregory W. Randolph, the Claire and John Bertucci Associate Professor of Otolaryngology in the Field of Thyroid Surgical Oncology Howard J. Shaffer, the Morris E. Chafetz Associate Professor of Psychiatry in the Field of Behavioral Sciences Alfred G. Knudsen Award in Cancer Genetics, National Cancer Institute Leonard Zon, the Grousbeck Professor of Pediatrics and director of the Stem Cell Program at Boston Children’s Science of Oncology Award and Lecture, American Society of Clinical Oncology William Kaelin Jr., professor of medicine at Dana-Farber and senior physician at Brigham and Women’s Scientific Innovations Award, Brain Research Foundation Jeffrey Macklis, the Max and Anne Wien Professor of Stem Cell and Regenerative Biology and professor of surgery and professor of neurology at Mass General 2016 E. Donnall Thomas Lecture and Prize, American Society of Hematology David Scadden, professor of stem cell and regenerative biology, chair of the Department of Stem Cell and Regenerative Biology and co-director of the Harvard Stem Cell Institute

Harold Hamm International Prize for Biomedical Research in Diabetes C. Ronald Kahn, the Mary K. Iacocca Professor of Medicine and chief academic officer and senior investigator at Joslin 2016 Banting Medal for Scientific Achievement, American Diabetes Association Barbara Kahn, the George Richards Minot Professor of Medicine at Beth Israel Deaconess William Rippe Award for Distinguished Research in Lung Cancer, Lung Cancer Research Foundation Carla Kim, associate professor of genetics and associate professor of pediatrics and principal investigator at Boston Children’s American Association of Cancer Research Academy One faculty member was elected: Eric Lander, professor of systems biology and president and founding director of the Broad Thomas B. Clarkson Outstanding Clinical and Basic Science Research Award, North American Menopause Society JoAnn Manson, the Michael and Lee Bell Professor of Women’s Health at Brigham and Women’s Stein Innovation Award, Research to Prevent Blindness Anders Näär, professor of cell biology and assistant cell biologist in the Center for Cancer Research at Mass General 2015 John Blair Barnwell Award, VA Clinical Science Research and Development Terence Keane, lecturer on psychiatry and director of the Behavioral Science Division of the National Center for PTSD at VA Boston 2016 Grant V. Rodkey, MD Award for Outstanding Contributions to Medical Education, Massachusetts Medical Society Katharyn Meredith Atkins, assistant professor of obstetrics, gynecology and reproductive biology at Beth Israel Deaconess

FOR MORE ON HMS AWARDS hms.harvard.edu/awards

I

HMS LEADERSHIP Dean’s Report 2016–2017 23

HMS Leadership António Champalimaud Vision Award John Flanagan, professor of cell biology, was named a recipient with three awardees from other institutions

Jeffrey S. Flier, MD Dean of the Faculty of Medicine (Sept. 2007 – July 2016)

Paul Dudley White Award, American Heart Association Elliott Antman, professor of medicine at Brigham and Women’s and associate dean for clinical and translational research

Barbara J. McNeil, MD, PhD Acting Dean of the Faculty of Medicine (Aug. 2016 – Dec. 2016)

Clinical Scientist Development Award, Doris Duke Charitable Foundation Lynn Matthews, assistant professor of medicine at Mass General Elaine Yu, assistant professor of medicine at Mass General

ACADEMIC DEANS

Gold Medal, American Society for Radiation Oncology Anthony Zietman, the Jenot W. and William U. Shipley Professor of Radiation Oncology at Mass General

Gretchen Brodnicki, JD Dean for Faculty and Research Integrity Maureen Connelly, MD, MPH Dean for Faculty Affairs David Golan, MD, PhD Dean for Basic Science and Graduate Education

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

ADMINISTRATIVE DEANS John Czajkowski Executive Dean for Administration Lisa Boudreau Interim Dean for Resource Development Pamela Caudill Chief of Research and Administrative Operations Susan Dale Chief of Staff Rainer Fuchs Chief Information Officer

2017 Excellence in Science Award, Federation of American Societies for Experimental Biology Diane Mathis, the Morton Grove-Rasmussen Professor of Immunohematology

Edward Hundert, MD Dean for Medical Education

2016 JDRF Mary Tyler Moore and S. Robert Levine Excellence in Clinical Research Award George King, professor of medicine and chief scientific officer at Joslin

Nancy Oriol, MD Dean for Students (Oct. 2004 – June 2016)

Richard Shea Associate Dean for Campus Planning and Facilities (May 2008 – July 2016)

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

Julie Stanley Chief Human Resources Officer

2016 Laufman-Greatbatch Award, Association for the Advancement of Medical Instrumentation Ary Goldberger, professor of medicine at Beth Israel Deaconess Roger Mark, assistant professor of medicine at Beth Israel Deaconess 2016 Signature Award, American Medical Informatics Association Isaac Kohane, chair of the Department of Biomedical Informatics and the Marion V. Nelson Professor of Biomedical Informatics Career Awards for Medical Scientists, Burroughs Wellcome Fund Jonathan Abraham, instructor in biological chemistry and molecular pharmacology Mariella Gruber Filbin, clinical fellow in pediatrics at Boston Children’s

Lee Nadler, MD Dean for Clinical and Translational Research

David Roberts, MD Dean for External Education Fidencio Saldaña, MD Dean for Students (July 2016 – ) Nancy Tarbell, MD Dean for Academic and Clinical Affairs

Lisa Muto Associate Dean for ​Institutional Planning and Policy

Gina Vild Associate Dean for Communications and External Relations and Chief Communications Officer Michael White Chief Financial Officer

PRECLINICAL DEPARTMENT CHAIRS Stephen Blacklow, MD, PhD Gustavus Adolphus Pfeiffer Professor of Biological Chemistry and Molecular Pharmacology Chair, Biological Chemistry and Molecular Pharmacology Paul Farmer, MD, PhD Kolokotrones University Professor of Global Health and Social Medicine Chair, Global Health and Social Medicine Michael Greenberg, PhD Nathan Marsh Pusey Professor of Neurobiology Chair, Neurobiology Wade Harper, PhD Bert and Natalie Vallee Professor of Molecular Pathology Chair, Cell Biology Marc Kirschner, PhD John Franklin Enders University Professor of Systems Biology Chair, Systems Biology Isaac Kohane, MD, PhD Marion V. Nelson Professor of Biomedical Informatics Chair, Biomedical Informatics Barbara J. McNeil, MD, PhD Ridley Watts Professor of Health Care Policy Chair, Health Care Policy John Mekalanos, PhD, MSc Adele Lehman Professor of Microbiology and Molecular Genetics Chair, Microbiology and Immunobiology (July 2011 – June 2016) David Knipe, PhD Higgins Professor of Microbiology and Molecular Genetics Interim Co-Chair Microbiology and Immunobiology (June 2016 – ) Arlene Sharpe, MD, PhD George Fabyan Professor of Comparative Pathology Interim Co-Chair Microbiology and Immunobiology (June 2016 – ) David Scadden, MD Gerald and Darlene Jordan Professor of Medicine Chair, Stem Cell and Regenerative Biology Clifford Tabin, PhD George Jacob and Jacqueline Hazel Leder Professor of Genetics Chair, Genetics

24 Dean’s Report 2016–2017

I FACTS AND FIGURES

FUNDRAISING HIGHLIGHTS Harvard Medical School counts on a generous philanthropic community whose support helps people throughout the world live longer, healthier lives.

The School’s circle of supporters—made up of more than 3,800 alumni, board members, volunteers, faculty, staff, foundations, corporations and friends—gave more than $123 million in fiscal year 2016 to support the School’s four priorities: education, discovery, service and leadership. These generous gifts support The World Is Waiting: The Campaign for Harvard Medicine, a transformative $750 million fundraising initiative that has raised more than $584 million, representing 78 percent of our goal as of June 30, 2016.

In education, these gifts are making it possible for us to continue to attract and accept the best and brightest students, regardless of their ability to pay; to create modern, sophisticated spaces for teaching and learning; and to expand our postgraduate and external and global education programs. In the area of discovery, philanthropy propels the largest biomedical research engine in the world—from rethinking the basic and clinical science needed to discover, develop and deliver better drugs to advancing pathbreaking investigations in the areas of biochemistry, biomedical informatics, cell biology, genetics, immunology, molecular pharmacology, neurobiology, systems biology and therapeutic science.

HMS service initiatives are being amplified through gifts that are helping us strengthen and transform health systems in the U.S. and abroad, including revamping primary care practice and education, shaping policies, and addressing diseases and injuries for those living in extreme poverty. Finally, in the area of leadership, discretionary gifts provide the School with the ability to act swiftly on unanticipated opportunities and the flexibility to invest in the innovative ideas that have the greatest potential to improve human health.

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

As of September 2016 Total faculty 11,366 Tenured and tenure-track faculty on campus in 10 preclinical departments 176 Voting faculty on campus and at affiliates 5,813 Full-time faculty on campus and at affiliates 9,332

I

I

Nobel Prizes (cumulative) Physiology or Medicine, Peace: 9 prizes, 15 recipients | National Academy of Sciences members (current) 69 National Academy of Medicine members (current) 151 Howard Hughes Medical Institute investigators (current) 34

I

I

I

I

Total students: MD 723 PhD 848 (841 HMS, 7 HSDM) MD-PhD students 171: basic sciences 156, social sciences 15 (total included in MD and PhD counts) DMD 140 MMSc 147 (96 HMS, 51 HSDM) MBE 36 MBMI 10 DMSc 27 Trainees (residents and postdoctoral fellows) 8,861

$87,107,000

Medical school living alumni: 9,961 (MD and MMSc degrees)

$97,603,850

Additional joint degree programs: MD-MBA; MD-MPH; MD-MPP

$113,763,436

I

$ 94,685,992

I I I I MD applicants 7,069 I Admitted 235 (3.3%) I MD entering 2016 165 (includes 14 MD-PhD students) I Men 81 (49%) | Women 84 (51%) I Underrepresented in medicine (African-American, Hispanic, Mexican-American, Native American) 27 (16%) I Asian 59 (36%) Entering 2016: PhD 170 (167 HMS, 3 HSDM) I DMD 36 I MMSc 68 (50 HMS, 18 HSDM) I MBE 25 I MBMI 10 I DMSc 7 I

Fundraising progress to date:

Remainder to raise in FY17-18 $165M FY16 $123M FY12-15 $462M

COLLABORATIONS ACROSS HARVARD Broad Institute of Harvard and MIT Harvard Catalyst | The Harvard Clinical 4% 7% Science Center and Translational Harvard9% Stem Cell Institute Wyss Institute for Biologically Inspired 41% Engineering 12%

BY THE NUMBERS

I

THE WORLD IS WAITING: THE CAMPAIGN FOR HARVARD MEDICINE

FY

FY

FY

FY

11

10

09

08

AFFILIATED HMS HOSPITALS AND 27% RESEARCH INSTITUTIONS Beth Israel Deaconess Medical Center Boston Children’s Hospital Brigham and Women’s Hospital Cambridge Health Alliance Dana-Farber Cancer Institute Harvard Pilgrim Health Care Institute Hebrew SeniorLife7% Joslin Diabetes 12% Center Judge Baker Children’s Center 37% Massachusetts Eye and Ear | 14% Eye Research Institute Schepens Massachusetts General Hospital McLean Hospital 30% Mount Auburn Hospital Spaulding Rehabilitation Network VA Boston Healthcare System

FY17-18 $165M FY16 $123M FY16 $123M

FY12-15 $462M FY12-15 $462M

FY 2016 OPERATING REVENUE

4%

7%

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

Total

$271,496,784 $176,661,620 $76,889,670 $57,234,798 $49,692,942 $24,217,829 $656,193,643

41% 27% 12% 9% 7% 4%

4%

9% 7%

41%

9% 12% 12%

I

FINANCIAL REPORT Dean’s Report 2016–2017 25

41% 27% 27%

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

FY 2016 OPERATING EXPENSES

n Research subcontracts and affiliates n Plant operations and interest

FINANCIAL REPORT

$ 94,685,992 $ 94,685,992

Total

This past year, Harvard Medical School achieved remarkable progress in advancing its academic and scientific FY 11 mission while continuing the work of FY improving its financial situation. Promis11 ing new investments continued in FY16, including greater educational and research opportunities created through the Office for External Education and the launch of the Department of Biomedical Informatics. HMS continues to invest in recruiting the world’s most talented faculty—with new hires in biological chemistry and molecular pharmacology, biomedical informatics and neurobiology and several searches in progress.

Members of the inaugural class in the redesigned medical education curriculum, Pathways, completed their

$113,763,436 $113,763,436

n Depreciation

$257,052,862 $204,750,884 $97,559,528 $84,145,024 $48,727,887 $692,236,185

37% 30% 14% 12% 7%

7% 12%

7% 37%

12% 14%

37%

14%

$87,107,000 $87,107,000

n Supplies and other expenses

$97,603,850 $97,603,850

n Personnel costs

first year of coursework to prepare for clerkships in their second year. Also, the FY FY FY our hospital partners School leadership, 10 09 08 and the University Provost plan to coFY FY FY invest the creation 10 in 09 08 of a cryo-electron microscopy facility on the Quad in order to offer our faculty access to a worldclass imaging resource.

We continue to expand support for information technology through a bold, multiyear investment that will reshape the School’s IT foundation, streamline service and create a more sustainable IT environment to support our medical curriculum and biomedical research. Much of this continued investment is possible because of donors’ generous gifts and pledges that allow HMS to pursue its strategic priorities. These funds are

30% 30%

enabling us to educate future leaders, advance science for the benefit of all and maintain our reputation as the leading academic medical center in the world.

Keeping our strategic priorities in mind, HMS has a number of key initiatives underway to realize cost savings and increase School revenues. We are currently reviewing all administrative and academic units with a careful eye toward preserving all that makes HMS great.

We believe we can gain substantial efficiencies in many areas, from facilities management and planning to increasing revenue from new and exciting academic programs. We will continue on our strategic path toward financial health by making adjustments in these areas.

HMS is unwavering in the pursuit of its

academic and scientific mission and will continue to invest in areas that most benefit faculty and students.

In summary, HMS ended FY16 with a $36.0 million operating deficit, compared to $31.8 million in 2015. In FY16, operating revenues totaled $656 million, an increase of $40 million compared to the previous year. Revenue growth was led by robust research activity resulting in an increase in grants of 9 percent.

Total operating expenses in FY16 increased by $44 million, or 7 percent, to $692 million, mainly attributable to the growth in sponsored research activity. As we begin FY17, we are optimistic that the good work of the last several years will continue to improve the School’s financial outlook.

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

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

Mattia; photography direction by Jill Carrico and Bobbie Collins; copyediting by Bobbie Collins, Susan Karcz and Ann Marie Menting. Photography by Jill Carrico, Gretchen Ertl, Steve Lipofsky, Sam Ogden, Stu Rosner, John Soares and Steven Vote. Additional photos courtesy of William Castro Rodríguez / Partners In Health, iStock/artman09. Printed by Kirkwood Printing.

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

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