State of the School Art Kellermann, MD, MPH F Edward Hebert School of Medicine January 22, 2014 1 Unclassified.

State of the School

Art Kellermann, MD, MPHF Edward Hebert School of Medicine

January 22, 2014

1Unclassified

Summary

• The Hebert School of Medicine is faced with significant challenges and organizational threats

• These challenges are more than offset by numerous opportunities to make critical contributions to health professions education, research and performance improvement in the MHS

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Summary

• The underlying premise for the Hebert School of Medicine is as sound today as when the school was founded more than 40 years ago

• If we stay true to our mission, and pursue our goals with discipline, vision and purpose, we’ll make lasting contributions to the health of our nation and the world

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Acknowledgements

• The observations discussed in this address are derived from wide-ranging discussions with HSM faculty members and students, as well as senior university leaders, regents, deans, chairs, center directors, members of the Faculty Senate, committees, alumni, public officials and private citizens

• In other words, YOU

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“America’s Medical School”

USU’s SOM and GSN each have over 25 clinical teaching sites across the US

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Our Medical Students

36%

32%

30%

2%

Distribution by UniformArmy Navy Air Force PHS

Class of 2015

All in a uniformed service

~170 students per class:• 680 total

Avg. age: 24.4 years

Female: 35%

Prior military service: ~32%

Minorities: ~20-23%

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Our Graduate Students

20%

10%

7%

2%

60%

Distribution by Service

Army Navy Air Force PHS Civilian

~ 175 civilian & uniformed students

Masters and doctorate programs

A limited number of International students

Unique emphasis on military-relevant topics and programs

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We are Part of a Larger Whole

• Inouye School of Nursing• ~170 military students & several federal govt civilians

in the DNP & PhD programs

• Armed Forces Radiobiology Research Institute• Radiobiology research in five major thrust areas

• Postgraduate Dental College • 3 programs; administered from USU’s campus in San

Antonio

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F. Edward Hebert School of Medicine

One of 141 LCME-accredited medical schools*

9* Source: http://www.lcme.org/directory.htm

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F. Edward Hebert School of Medicine

One of 141 LCME-accredited medical schools*

10* Source: http://www.lcme.org/directory.htm

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USU’s “Supplemental” Curriculum

• Preventive and Occupational Medicine

• Combat Casualty Care: • Environmental Medicine and

extreme environments• Global infectious diseases• Disaster & humanitarian

assistance • Combat Stress and other

psychiatric issues• Communications • Cultural Competency

• Leadership and Officership • Teamwork• The Military Healthcare

System • The Operational Environment

• Austere, resource constrained, and often dangerous environments

• Learn/train in a joint environment

• Ethical Decision Making in Operational Environments

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USU’s “Supplemental” Curriculum

• Preventive and Occupational Medicine

• Combat Casualty Care: • Environmental Medicine and

extreme environments• Global infectious diseases• Disaster & humanitarian

assistance • Combat Stress and other

psychiatric issues• Communications • Cultural Competency

• Leadership and Officership • Teamwork• The Military Healthcare

System • The Operational Environment

• Austere, resource constrained, and often dangerous environments

• Learn/train in a joint environment

• Ethical Decision Making in Operational Environments

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We are the leadership academy of the MHS

USU Doctors in the MHS

~10% of physician accessions ~25% of the total medical officer force~33% of the MHS’ top clinicians & MD leaders

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0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 290%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

FQ HPSP USUHS

Commisioned Years of Service (CYOS)

Cum

ulati

ve C

ontin

uatio

n Ra

te (C

CR)

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Our Research is Relevant to the DoD

• Combat casualty care

• TBI & regenerative medicine

• Psychological health

• Rehabilitation sciences

• Emerging infectious diseases

• Performance optimization

• Prev. Med & Public Health

• Disaster Medicine & humanitarian assistance

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Where Do We Go From Here?

)

Opinions are those of the presenter and do not represent positions of USUHS or the Department of Defense

Unclassified

External Challenges

• Furloughs and fiscal uncertainty• Salary and hiring freezes• Travel restriction• NIH funding cuts • Little national visibility• Poor brand recognition• Our MTFs under pressure• The MHS is challenged as never before

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Internal Challenges

• Our faculty is small relative to the size of its mission, and demographically imbalanced

• Curriculum reform has increased teaching workloads w/o a matching increase in resources; concerns expressed about equity of effort

• ↓ research funding + ↑ teaching = ↑↑ stress• In challenging times, bureaucratic hassles &

obstacles are even harder to take

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However, USU Also Has Formidable Strengths…

• We are nationally unique. We have a vital mission, excellent facilities & equipment, outstanding students, a talented faculty, no debt and a funding base that’s stronger than most

• Our work is well aligned to our sponsors’ priorities and needs

• We have loyal alumni & many friends in the MHS, the PHS, and other federal agencies

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We Also Have a Top-Tier Board

• Ronald Blanck, DO (Chair)

Chairman and Partner, Martin, Blanck, and Associates

• Otis Brawley, MDChief Medical Officer, American

Cancer Society

• Sheila BurkeSenior Public Policy Advisor at Baker

Donelson, former COS to Bob Dole

• Haile Debas, MDExecutive Director of Global Health

Sciences at UCSF

• Ronald Griffith, GEN (Ret)

Serves on Board of Visitors at the Virginia Military Institute

• Michael M E Johns, MD

Past Chancellor Emory University and Dean at Johns Hopkins

• Kenneth Moritsugu, MD

Former Dep. SG, Vice President Global Strategic Affairs of Life Sciences, Inc.

• Gail Wilensky, PhDEconomist and Senior Fellow at

Project HOPE, former HCFA Administrator

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We Also Have a Top-Tier Board

• Ronald Blanck, DO (Chair)

Chairman and Partner, Martin, Blanck, and Associates

• Otis Brawley, MDChief Medical Officer, American

Cancer Society

• Sheila BurkeSenior Public Policy Advisor at Baker

Donelson, former COS to Bob Dole

• Haile Debas, MDExecutive Director of Global Health

Sciences at UCSF

• Ronald Griffith, GEN (Ret)

Serves on Board of Visitors at the Virginia Military Institute

• Michael M E Johns, MD

Past Chancellor Emory University and Dean at Johns Hopkins

• Kenneth Moritsugu, MD

Former Dep. SG, Vice President Global Strategic Affairs of Life Sciences, Inc.

• Gail Wilensky, PhDEconomist and Senior Fellow at

Project HOPE, former HCFA Administrator

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Plus the ASD(HA) & the 4 Surgeons General

Opportunities• We have access to mechanisms and

sources of funding that are largely out of reach of other medical schools

• We offer a great deal to students• We have a compelling mission, and equally

compelling stories• The MHS needs what we produce –

outstanding graduates, discoveries, capabilities & ideas

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Threats

• A bad report from the LCME• Our MTFs lose too many patients• Congress eliminates the CDMRP• The MHS is sharply downsized• We’re targeted by a future BRAC• The DoD severely cuts our budget, or

decides that we are irrelevant to its mission

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Priorities

• People• Programs• Purpose

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People • Curriculum reform• Sustainability, coordination & resources

• The LCME• Time to prepare!

• Diversity• We can and will do better

• Respect• We need to take a hard look at ourselves & each

other

• Leadership• Our job is to train the future leaders of the MHS

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People• Overcome constraints• People, resources & programs

• Promote excellence• Engagement & impact

• Encourage collaboration • Between investigators, departments and

institutions

• Enhance diversity• It will make us stronger and better

• Build for a brighter future• We’re in this for the long haul

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Programs• The DoD is our #1 client (11/53/290) • Ask not what WRB can do for you; ask

what you can do for WRB • Our off-campus faculty and MTFs matter;

we are America’s medical school• Global health is a national security issue.

Are we ready to play an important role?• The MHS needs high value discoveries &

innovation. We can provide them

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Programs• The Line is our #1 priority• We need to build our brand w/ key groups

and individuals• We must strengthen our ties w/ current

funders, cultivate new ones and devise new mechanisms of support

• We have opportunities to forge strategic alliances inside and outside the MHS

• We will tackle problems that matter

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Purpose Our business is saving:

1. Lives - Through our teaching, practice & high-impact research

2. Function – Through HPO, expert medical and surgical care, neurological & behavioral science & expert rehabilitation

3. Dollars – In addition to becoming better stewards of our own resources, we can help the MHS become more efficient and effective

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2014 MHS Pillars

1. Modernize infrastructure – governance, technology, innovation, PCMHs

2. Medical capabilities – training, career development

3. Rebalance force structure – human capital

4. Develop strategic partnerships – w/ agencies and academic institutions

5. Benefit reform – tied to benefit commission

6. Global health engagement – Whole of gvt29

From “Good” to “Great”

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1. Level 5 Leadership

2. First Who…Then What

3. Confront the Brutal Facts (Yet Never Lose Faith)

4. The “Hedgehog Concept”

5. A Culture of Discipline

6. Technology Accelerators

The “Hedgehog Concept”

“The Fox knows many things, but the hedgehog knows one big thing”

• Foxes pursue many ends at the same time and see the world in its complexity. They are “scattered or diffused, moving on many levels”

• Hedgehogs embrace a basic principle or concept that unifies and guides everything

- Jim Collins, Good to Great, Harper Collins, 2001

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Collins’ “Three Circles”

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Our Mission

“[USU serves] the uniformed services and the Nation as an outstanding academic health sciences center with a worldwide perspective for education, research, service and consultation; we are unique in relating these activities to military medicine, disaster medicine, and military medical readiness.”

- Source: USUHS Mission Statement

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Our Mission

“[USU serves] the uniformed services and the Nation as an outstanding academic health sciences center with a worldwide perspective for education, research, service and consultation; we are unique in relating these activities to military medicine, disaster medicine, and military medical readiness.”

- Source: USUHS Mission Statement

The Bottom Line

To ensure a bright future, we must:• Support the Line, and the MHS• Set & enforce high standards for

ourselves and our trainees • Boost our visibility & reputation• Cultivate new sources of support• Wisely manage our resources• Tackle high-impact issues & ideas

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“[USU] is the nation's federal health sciences university…committed to excellence in military medicine and public health during peace and war.”

“America’s Medical School”

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“We are the nation's federal health sciences university…committed to excellence in military medicine and public health during peace and war.”

“America’s Medical School”

Last Decade’s Challenge

J Trauma Vo.l 25 no. 2 August Supplement 2013

This Decade’s Challenge

Questions?

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