As we enter the holiday season, it is a good time to reflect on the accomplishments and challenges of the past twelve months as well as our plans for the new year. In 2016 we continued to fulfill our mission by providing superb medical education, making great discoveries in our labs and moving them to patients, and enhancing the health of the Cleveland community.
In the area of medical education we continue to be recognized as innovators. This year, having developed strong pre-clinical, inter-professional programs, we received generous funding from the Macy Foundation to tackle the challenge of inter-professional education in the clinical setting. This will include pilot training programs in collaborating FQHCs and Cleveland Clinic’s intensive care units, pediatric outpatient programs, and emergency room. Congratulations to the team that developed the proposal and which will carry out the project, led by Ellen Luebbers, MD.
We also established two new pathways, or areas of concentration, in the medical curriculum – Humanities in Medicine, led by Susan Stagno, MD, and Wellness and Prevention, led by Hope Barkoukis, PhD. As Hope was establishing the curriculum for this latter pathway, she discovered that there are no other evidence-based wellness curriculums (encompassing nutrition, physical fitness, and stress management) in American medical schools. We are the first!
The drive to innovate in teaching anatomy continues. The first units of our new approach, a collaborative effort between Sue Wish-Baratz, PhD, Scott Simpson, PhD, and Mark Griswold, PhD, and his team of programmers, have been piloted in a class of 40 students. This curriculum won the 2016 Jackson Hole Prize for Science Media in the AR/VR category (above entries from Google and David Attenborough).
Finally, the elegant new Health Education Campus saw the topping off of the steel frame. This exciting new project represents the starting point for a new direction in health care education and training.
Our discovery engines continue to hum. Last year, total NIH funding throughout the school increased by about eight percent at a time when overall NIH funding remained static. Cancer discoveries were prominent at CWRU this year, including identifying gene mutations in colon cancers of African American patients different from those often seen in white patients (and which may be “druggable”). Sandy Markowitz, MD, Kishore Guda, PhD, and their group are pursuing these initial observations with great vigor.
Nicole Steinmetz, PhD’s, innovative immunotherapy has not only been successful against standardized melanomas in mice, it has also eliminated spontaneous melanomas in dogs (someone’s pets)! She will move on to humans once the appropriate studies for INDs are complete.
In other areas of note, Rafick Sékaly, PhD, and Jonathan Karn, PhD, continued their exciting work on strengthening the ability of patients to mount immune responses against HIV and eliminate HIV reservoirs, respectively. Perhaps the most immediately applicable discovery was the SPRINT trial led by Jackson Wright, MD, PhD, which found that tighter control of blood pressure, including in elderly patients, resulted in lower death rates and cardiovascular complications than the standard control. With over $230M in NIH funding, you can imagine that these discoveries only skim the surface of the deep pool of innovation in our labs.
Our investigators have been recognized at the national level – the Markowitz and Wright efforts as Top Ten Clinical Research Papers of the Year in the Clinical Research Forum; Karn by the Paradigm Builder Lectureship Award from the International Society for NeuroVirology; and Steinmetz by Ohio Cancer Research. Stan Hazen, MD, and Mukesh Jain, MD, were elected to the National Academy of Medicine and Mark Chance, PhD, was named a fellow of the AAAS. Space constraints prevent me from including other faculty members who received professional recognition, but I salute all of you for a job well done!
To say that our commitment to community-focused efforts stands good is an understatement. First, CWRU will be playing a key part in First Year Cleveland, the collaboration between the state, county, and city to reduce infant mortality. Michael Konstan, MD, is directing the school’s role as the fiscal agent for the program. In this capacity, over the next year we will be disbursing $2.9M from Ohio Medicaid in targeted zip codes to support group prenatal care, home visiting, and a fatherhood initiative.
Second, the Better Health Partnership (BHP), led by Randy Cebul, MD, reported improved processes and outcomes for type 2 diabetes (decreased HgBA1c by over one percentage point in 27,000 patients), hypertension, and heart failure as well as elimination of racial disparities in these areas seen at the beginning of the collaborative seven years ago. While continuing to work to improve the health of adults, the program will now tackle pediatric issues also.
Third, we are playing an active role in the Health Improvement Partnership – Cuyahoga County (HIP-C). The effort is co-led by Heidi Gullet, MD, who also heads one of the four concentrations, the relationship between public health and clinical care. Erika Trapl, PhD, leads another, access to healthy food and places to play and exercise. We have a strong presence in a number of other community programs as well, but again space limitations prevent including them here. But I want to thank all of our faculty members for the outstanding work you do to enhance health in our community.
This is not all . . . there are major activities clustered around our critical goals. We have had great success in bringing faculty together for improvements in medical education, not only within the medical school but also among the School of Medicine and the other health professional schools at CWRU. We have had great success in the research arena. Collaborations sparked by the Case Comprehensive Cancer Center, the Case Translational Science Collaborative, and the Center for AIDS Research have led the way in new discoveries and in bringing them to patients. In the community space, there is no progress without collaboration. BHP, HIP-C and now First Year Cleveland absolutely depend on it.
Collaboration, community, cures. The medical school has taken giant steps forward in the last year. However, we cannot spend long in self-congratulation. Centrifugal forces strain and pull away from the center to spin out separately. I believe that Cleveland can only be truly great – an A player – if we pull together – and remain together – in research and education and in the infrastructure required to support them. If we spin out separately, we will be at best an also-ran, a B player: good but not great. We need each other.
To us, much has been given in 2016. But to whom much is given, much is expected. Next year will test our resolve to sustain this year’s momentum and not waver in our progress toward our goals. I’m counting on each of you to play a major part as we work to do so. The future is indeed bright.