UCSF at the Turn of the Year 2006

Dear Colleagues:

It is time once again to take stock. Here is my ninth annual survey of the past year at UCSF. It has been a year of great achievement and persisting problems. I have tried to give a representative sample of both.

Stature

UCSF continues to be recognized as one of the premier life sciences institutions in the world, holding its own even in rankings against general universities, which have larger and more academically diverse faculties, deeper pockets, and - in some instances - successful football teams.

• • Newsweek International ranked UCSF ninth among all the research universities of the world for its scholarly excellence and global impact. No other life sciences institution made the top 100.
• • UCSF ranked fourth in the nation in receipt of research support from the National Institutes of Health (NIH). The Schools of Dentistry, Nursing, and Pharmacy all ranked first among their peer institutions, the School of Medicine ranked third.
• • U.S. News and World Report ranked the UCSF School of Medicine fourth in the nation for research, the School's highest finish in the history of this ranking. The School was only one of three to be ranked in the top ten for both fundamental research and training in primary care, a testimony to the School's breadth of excellence.
• • The San Francisco Veterans Administration Medical Center (VAMC) continues to receive the most research funding of all VAMCs in the nation, reflecting the outstanding performance of the UCSF faculty who staff the San Francisco VAMC.

Faculty Laurels UCSF is proud of its distinguished faculty, whose achievements regularly earn international recognition. Here is an arbitrary sampling from the past year, designed to illustrate the many ways in which our faculty excel.

• • Elizabeth Blackburn: the Wiley Prize in Biomedical Science, the Peter Gruber Prize in Genetics, and the Albert Lasker Award in Basic Biomedical Research - the last of these is generally regarded as the premier U.S. award for fundamental medical research. Professor Blackburn was lauded for both her path-breaking research on the molecular machinery that preserves the integrity of our genomes and her political courage in defending the integrity of science.
• • Roger Nicoll: the Peter Gruber Prize in Neuroscience, for advancing our fundamental understanding of learning and memory.
• • Shaun Coughlin: the Stanley Korsmeyer Award of the American Society for Clinical Research, in recognition of his research on blood clotting.
• • Y. W. Kan: the Lifetime Achievement Award from the Society of Chinese Bioscientists in the United States, for his pioneering work on the genetics of human disease.
• • Richard Coughlin: the Humanitarian Award from the American Academy of Orthopaedic Surgery, for his volunteer work on medical education and patient care in developing nations.
• • Paul Ortiz de Montellano: the Volwiler Research Achievement Award from the American Association of Colleges of Pharmacy, for sustained excellence in research on drug metabolism.
• • Christopher Voigt: named a 2006 Young Innovator by Technology Review.
• • Kathleen Puntillo: the 2006 Society of Critical Care Medicine's Grenvik Family Award for Ethics.
• • Ruth Malone: honored by the American Legacy Foundation for her work in educating underserved populations about the hazards of tobacco.
• • John Featherstone: the Scientific Research Award from the World Congress of Minimally Invasive Dentistry for his research on the assessment and management of dental caries.
• • Genna Dowling and Janice Humphreys: named Fellows of the American Academy of Nursing, among the most distinguished recognitions in the nursing profession.
• • Kathleen Giacomini, James Marks, Arnold Milstein and John Rubenstein: elected to the Institute of Medicine.
  

New Leadership The Campus and its Schools were enriched during the past year by a bumper crop of new leadership. Renewal of this sort contributes greatly to the maintenance of our vigor and excellence. I congratulate all of the following individuals and thank them for taking on their new challenges.

• • Joseph I. Castro has joined the Campus from UC Santa Barbara as Associate Vice Chancellor for Student Academic Affairs.
• • New chairs were appointed to the Departments of Clinical Pharmacy (B. Joseph Guglielmo, Jr.), Epidemiology (Robert Hiatt and Neil Risch as co-chairs), Laboratory Medicine (Clifford Lowell), Ophthalmology (Stephen McLeod), Orthopaedics (Thomas Vail), Physiology (David Julius), and Social and Behavioral Sciences (Howard Pinderhughes).
• • Kevin Shannon is the new Director of the Medical Scientist Training Program, which oversees students studying for both the M.D. and Ph.D.
• • Joseph "Mike" McCune will lead the newly established Clinical and Translational Science Institute (see below).
• • Jonathan Showstack was appointed as Co-Chief Information Officer for Academic and Administrative Information Systems, a responsibility that he shares with Associate Vice Chancellor Randy Lopez.
  

Special Initiatives Innovation and new departures are a way of life at UCSF. Here are examples from the past year.

• • UCSF was one of seven U.S. universities to receive an award of over $100 million from the NIH to establish a Clinical and Translational Science Institute (CTSI). The Institute represents an unprecedented collaboration among our four Schools and the Graduate Division, designed to advance the application of fundamental research to the conquest of human disease. I commend the Deans and their faculties for this landmark undertaking.
• • The Program for Global Health Sciences has developed a research partnership with the Muhimbili University College of Health Sciences of the University of Dar-es-Salaam, Tanzania, and an alliance with Kenya for the training of Kenyan Ph.D. students in UCSF laboratories. The Director of Global Health Sciences, Haile Debas, is chairing a UC committee to explore the possibility of creating a system-wide program in global health, and has been asked to oversee the planning of a new "African Institute of Science" in Tanzania that will focus on interdisciplinary education in biomedicine, agriculture, water sciences, and veterinarian medicine.
• • Our School of Nursing has mounted an initiative to address a national shortage in nursing faculty, and is collaborating with the UCSF Schools of Pharmacy and Medicine, and the Medical Center in programs to improve patient safety. Both efforts have generous support from the Gordon and Betty Moore Foundation. The Robert Wood Johnson Foundation is also supporting a separate study on the role of nurses in patient safety.
• • The Campus has created separate administrative units for the Graduate Division and Student Academic Affairs. Joseph Castro has just arrived to lead the latter (see above), and a national search is underway for a Dean of the Graduate Division.
• • Last year, UCSF launched a new initiative on diversity, acknowledging that the Campus has fallen short of its aspirations to become a truly representative community. The initiative continues, under the leadership of Executive Vice Chancellor and Provost Gene Washington. Meanwhile, there are signs of progress and earnest effort. For example, 42% of tenured faculty at UCSF and 40% of full professors are now women - the highest such percentages among major research universities in the U.S.; and 28% of the students in the School of Medicine's incoming Class of 2010 are from groups presently underrepresented in medicine, compared to 19% in the Class of 2009. The School has a year-long Post Baccalaureate Program that helps underrepresented students prepare for application to Medical School. Now in its eighth year, the program has seen 91% of its 89 participants apply to medical school and be accepted.
• • The movement of faculty to our Mission Bay campus created the opportunity to recruit new talent to the research community at Parnassus Heights. In the basic sciences alone, at least 25 new faculty have been appointed to positions at Parnassus Heights since the opening of UCSF Mission Bay.
• • The School of Pharmacy and the Institute for Quantitative Biomedical Research (QB3) have jointly created a partnership in Systems Biology with Peking University, designed to train Chinese students in this rapidly emerging new discipline. The Institute has also entered into an agreement to train Malaysian students and senior scientists, with an emphasis on neglected and emerging diseases. Costs will be covered by the Malaysian government.
• • QB3 has created a small facility in Byers Hall at Mission Bay that is available for rental by start-up companies in biotechnology. Known informally as "The Garage" (inspired by the origins of the Hewlett-Packard company, and with a size suiting the name), the unit represents one of the devices by which QB3 is attempting to enliven the local and state economy, and to facilitate "bench to bedside" transfer of new knowledge - both core missions of QB3.
• • Planning has begun for construction of new patient-care facilities for the San Francisco General Hospital (SFGH) on the current Potrero site, under the auspices of the City and County. Construction of the facilities will depend upon funding by a bond issue, presently slated for the ballot some time in 2008. The admirable work being done at the SFGH, the extraordinary commitment of the staff, nurses, and UCSF faculty who work there, and the challenging circumstances under which they work were all captured movingly by a recent series of front-page articles in the San Francisco Chronicle, December 10-13, 2006. If you have not read those articles, I recommend that you do so.
• • UCSF has been inclined to let its record speak for itself - perhaps too much so: no full page ads in the New York Times, no radio "spots" during talk shows. In a symbolic departure from this time-honored practice, and after lengthy consultation with friends in the community, the Campus has adopted a motto that captures our ambition and achievement: "Advancing Health Worldwide." It would be difficult to improve on that as a succinct reminder to ourselves and to the public of who we are and what we do. Use it with pride!

Celebrations No year at UCSF is without celebrations of achievement, small and large. Four are especially deserving of note this year.

• • The School of Nursing is in the midst of a year-long program that celebrates the one-hundredth anniversary of its founding.
  (visit here for details)
• • The School of Dentistry is celebrating its 125th anniversary.
• • Forty years ago, a collaboration between the School of Pharmacy and the Medical Center made the clinical pharmacist for the first time a part of the team caring for hospitalized patients. It was a landmark innovation. Now, few major hospitals are without clinical pharmacy services, and clinical pharmacy is a standard part of the curricula at U.S. schools of pharmacy.
• • At a festive Founders Day Banquet at the Ritz Carlton Hotel, the UCSF medal was presented to Jane Brody, health columnist at the New York Times; Andy Grove, co-founder of INTEL, patient advocate, and National Chair of the Campaign for UCSF (1998-2005); Rudi Schmid, Dean Emeritus of the UCSF School of Medicine; and Maxine Singer, President Emerita of the Carnegie Institution and renowned advocate for women in science.

Campus Life Surveys of our staff and faculty inevitably report satisfaction with their work and responsibilities, but dissatisfaction with their work environment, with complaints ranging from poor infrastructure to inadequate mentoring. The Campus is attempting to deal with a multiplicity of shortcomings of this sort, within the limits of its resources. Here are a few of the positive steps from the past year.

• • Professor Mitchell Feldman assumed the position of Director of Faculty Mentoring, the first time that UCSF has had an officer who attends to faculty mentoring across the entire Campus.
• • We opened new housing facilities at both Mission Bay (750 beds) and Parnassus Heights (43 beds), augmenting our inventory of below-market housing by almost three-fold. Tenants at the Mission Bay housing presently include students, postdoctoral fellows, Medical Center residents, faculty and staff. The new Parnassus Heights facility includes units for students and faculty.
• • A new facility for child care was opened at Mission Bay, and one is under construction at Parnassus Heights. The result will be a tripling of our capacity.
• • The Campus has begun the roll-out of a new research administration system and joined in a UC-wide initiative for strategic sourcing that could save the Schools and Departments considerable sums.
• • New attention is being addressed to information technology, with the formation of the Office of Academic and Administrative Information Systems (OAAIS), directed by Randy Lopez and Jonathan Showstack.
• • Our free shuttle service has been substantially expanded and redesigned to meet new and shifting needs. The service now carries in excess of 2 million passengers every year.
• • The grand plaza at the Third Street entrance to UCSF Mission Bay was completed, along with "Ballast," a towering sculpture by Richard Serra. San Francisco Magazine commented that the sculpture "promises to be an international attraction [that] stands out not only for its scale, but also for its quality: such achievement is rare in public art."
• • Muni Light Rail service to Mission Bay is scheduled to begin after the turn of the year: weekends-only service in January (free!), full service in April (not free!). The service will be accessible at any Muni station between Castro and the Embarcadero.

Planning for the Future Our current exercise in strategic planning has proceeded rapidly, with a flurry of consultations through surveys, Town Hall meetings, interviews, and focus groups. (Details are online)

• • Professor Elizabeth Blackburn and Executive Vice Chancellor and Provost Eugene Washington co-chair a Strategic Planning Board that is overseeing the effort.
• • The exercise has reached the stage of the "nitty gritty," in the hands of six Strategy Design Teams, addressing: Recruitment and Retention, Research Directions, Education and Training, Clinical Care, Infrastructure and Resources, and Leadership and Governance. All told, the teams involve more than 150 participants, including representatives from every segment of the Campus community.
• • The final report is expected in the spring of 2007.
• • Having now worked with UCSF for more than a year, the planning consultants remarked recently that they had never encountered a more self-critical institution. That characteristic is one of the secrets of our success, and we would do well to sustain it.

Bricks and Mortar Construction of new facilities continues to be high on the UCSF agenda. It began at Mission Bay, but is of necessity spreading to other sites.

• • Construction of The Helen Diller Family Cancer Research Building is well under way at Mission Bay, just north of the new housing complex, whose residents have been graciously enduring the racket of pile driving and other unpleasantries of nearby construction.
• • The UC Regents recently approved the planning for six new buildings: at Mission Bay, buildings for cardiovascular research, and hospitals for children, mothers and cancer patients (see below); at Parnassus Heights, a building for the Institute for Regeneration Medicine; and at Mount Zion, a building to house both the Osher Center for Integrative Medicine and units of the Medical Center. The Regents also approved planning to retrofit portions of Mount Zion Hospital into compliance with seismic statutes.

Private Support The UCSF Development Office entered its second year under the able leadership of Associate Vice Chancellor James Asp. Private support from foundations, corporations and individuals presently represents 21% of Campus revenues, and grows ever-more important to UCSF, as support from the state budget and the NIH fails to keep pace with needs.

• • FY 2005/06 marked the seventh consecutive year in which UCSF received in excess of $200 million of private support.
• • The number of individual gifts exceeded 32,000, among the highest in our history.
• • A gift of $16 million from Ray and Dagmar Dolby will jump-start planning and construction of the Institute for Regeneration Medicine at Parnassus Heights.
• • The Sandler Family Supporting Foundation continued its remarkable and long-standing support of UCSF, with $10 million in gifts for research in the basic sciences, parasitic diseases, asthma, and the Osher Center for Integrative Medicine.
• • A $6.2 million bequest from the McEvoy family will help complete construction of The Helen Diller Family Cancer Research Building at Mission Bay.
• • The School of Nursing received the largest outright gift in its history, to establish the Lillian and Dudley Aldous Endowed Chair in Nursing.
• • More than 20% of our alumni provide gifts to UCSF each year, the highest fraction at any campus within the UC system, and among the better numbers in all of higher education. I salute the loyalty and generosity of our alumni, and encourage them to do even better in the coming year.

Campus Finances The State of California provides only 8% of the operating budget for UCSF and its Medical Center, but these funds are vital, because they include the core of our payroll for staff and faculty. So we enter each new budget year with anxious anticipation of how the University will fare in Sacramento.

• • The Regents have yet to approve a budget proposal to the State, and it would be premature to comment on what the UC budget might look like come May. The first hope is that Governor Schwarzenegger will continue the "compact" to assure the UC of a steady, albeit modest increase in funds annually, allowing for staff and faculty raises.
• • UCSF continues to spread its capital investments across the entire institution. Here are the numbers between 1997 and 2005: Mission Bay, $801 million; Parnassus Heights, $604 million; Mount Zion, $66 million; and other sites, $86 million.
• • The passage of Proposition 1D (the "Education Bond Issue") in the recent election was welcome news for the UC. But it will bring only limited benefit to UCSF, mainly for deferred maintenance and renewal of infrastructure. We remain a "tub on its own bottom" for major construction costs.
• • UCSF remains financially sound. But our discretionary funds have been severely challenged by punishing escalations in the costs of utilities, and the operation and maintenance of facilities. In the current fiscal year alone, UCSF will have to cover nearly $19 million of such costs that will not be reimbursed by the State. This circumstance constrains the ability of the Campus to support new initiatives and respond to unanticipated calls on its funds.

The Medical Center The UCSF Medical Center continued its strong performance, and was once again ranked among the top ten in the nation. But success remained a double-edged sword, generating healthy finances on the one hand, but overtaxed facilities and personnel on the other.

• • The Medical Center completed FY 2005/06 with an income of $95 million and reserves of $150 million. But the appetite for capital investment has been voracious and will only rise as the Medical Center moves ahead with plans to build new facilities at Mission Bay.
• • In September, the UC Regents approved planning for new hospitals for children, mothers and cancer patients, and ambulatory care facilities at Mission Bay. The cost of this project is currently estimated to be $1.0-1.3 billion.
• • The Campus completed acquisition of 14.5 acres immediately south of 16th Street and Genentech Hall, as a site for the new clinical facilities.

UCSF as an Economic Generator Universities regularly point to their beneficial impact on the local and national economies. UCSF is no exception, and we make such claims on sound grounds. Here are some examples.

• • In a recent study from the Milken Institute, UCSF ranked second among all universities in the number of U.S. biotech patents, fourth in the number of biotech research papers and citations, nineteenth in an overall assessment of innovation and technology transfer. UCSF is presently responsible for 31% of all patent income to the UC, and has spawned more than 60 biotech companies, including two pioneers, Genentech and Chiron.
• • The anticipated impact of our new campus at Mission Bay is becoming apparent. More than 1000 new residential units have been constructed in the neighborhood (including the Mission Creek Senior Community - 140 units for low-income senior citizens). The first new branch of the San Francisco Public Library in over forty years opened at Mission Bay this past July. The Gladstone Research Institute is thriving in its new quarters immediately across Owens Street from Genentech Hall and the Community Center. At least three biotechnology firms have set up shop in the neighborhood. One commercial life sciences laboratory building is nearing completion at the corner of Owens and 16th Streets, and another is slated for a site on Illinois Street, southeast of the UCSF campus. Contrary to popular perception, UCSF was not responsible for the seemingly premature (and much lamented) demise of the Mission Bay Golf Center at the northwest corner of our property: the facility fell prey to the installation of infrastructure for a private development in the vicinity.

UCSF in the Community UCSF is deeply imbedded in both local and global communities. We take particular pride in the public service that our employees render of their own volition, going far beyond our core missions or their official duties. The variety and volume of UCSF's outreach is not easily captured in a few sentences. But here are some representative examples from the past year.

• • Our University-Community Partnership Program, announced last year, is now in full swing, led by Director Elba Sanchez, and with a governing Council, co-chaired by Kevin Grumbach and Gwen Henry. The Program will maintain a data base of our myriad activities in the community, coordinate these activities to achieve greater effect and efficiency, cultivate credit for our faculty and staff who dedicate themselves to public service, and symbolize the idealism that is central to our institutional missions.
• • With support from the Robert Wood Johnson Foundation, the School of Dentistry has provided community externships for its students. Over the past four years, the students have seen more than 44,000 patients, the equivalent of more than $4 million of dental care.
• • UCSF is justly renowned for its pioneering program to assist the teaching of science in the public schools of San Francisco, embodied by our Science and Health Education Partnership (SEP) with the schools. But SEP has other dimensions. This year, for example, the program received a grant of $2.1 million from the Howard Hughes Medical Institute to fund an initiative for improving the teaching of science to undergraduate students.
• • Since the mid-1980s, our Graduate Division has conducted a summer program that provides undergraduate students with research experience. This program has just been enhanced by a grant of $1 million over four years from the Amgen Foundation, to provide 25 undergraduate students each year with a fully funded opportunity for research in the biological, biomedical, or behavioral sciences.
• • The School of Pharmacy has received a grant of $3.7 million from the Amgen Foundation for a program to assist elderly Californians in utilizing the Medicare prescription drug plan (by all accounts, no mean undertaking). Our School will collaborate with six other schools of pharmacy in California to implement the program.
• • The UCSF Program at Fresno is a major and very welcome presence in the community. Among its special activities are a six-month program that immerses UCSF medical students in either urban or rural settings that provide medical care to the underserved; and the Doctors Academy, a collaboration with the Fresno School District and the Fresno County Office of Education that encourages disadvantaged students to pursue careers in health and medicine. The program graduated its first students this past year. All 32 graduates are pursuing higher education, 14 at UC campuses, and 5 with UCSF Merit Scholar Awards that provide consideration for early admission to the UCSF School of Medicine. I have visited this program in the past and admire what it is doing.

Worries No institution with the size and complexity of UCSF is without its worries. Here are a few that presently give special cause for concern.

• • The recent increases in student fees, which may be repeated once again this coming year, have not been matched by adequate funds for student aid.
• • The funding of the NIH by Congress has flattened over the past several years, whereas the number of grant requests has doubled. The predictable outcome is that the procurement of research grants has become far more competitive than in the recent past. Highly accomplished biomedical scientists suddenly face the possibility of attenuation or even discontinuation of their long-standing support from NIH. These circumstances could have a particularly adverse impact at UCSF, where an exceptional fraction of research support comes from NIH.
• • Our need for capital funds beyond those already in hand is huge: combining the needs of the Campus and the Medical Center, current estimates for the next ten years approach $3 billion, merely for projects already in view. This need can be satisfied only by a substantial increase in private gifts and augmented debt. This may be the largest challenge that UCSF faces over the next decade.
• • The large and unfunded increases in costs for utilities, and for the operation and maintenance of facilities, have greatly taxed the discretionary funds of the Campus. There is no obvious remedy, other than an increase in state funding for these prosaic, yet vital functions.
• • The Regents remain committed to reinstatement of individual and institutional contributions to the UC Retirement Plan, but the details have not been resolved. Although prudent according to financial analysts, this action has unwelcome implications for the institution and all of its employees.

Conclusion Having read this far, you cannot help but have noticed that many of our unmet challenges are rooted in money. This is hardly surprising. The UC's share of State general funds has declined by more than two-fold since the early 1970s; the UC as a whole and UCSF in particular are increasingly "tubs on their own bottoms." Our continuing success is a great tribute to the energy, creativity, and commitment of the UCSF community. As part of that success, we are serving a distinctive public good: educating the coming generation of health care providers and medical scientists in a setting where they can be inspired by outstanding scholars, experience the excitement of discovery, come to understand the origins and limitations of what we know and use, and develop critical habits of mind. All the while, we continue our path-breaking research and the delivery of world-class health care. We are indeed "Advancing Health Worldwide." I wish you all a pleasant holiday season and a gratifying New Year. Sincerely, J. Michael Bishop, M.D.
Chancellor
Arthur and Toni Rembe Rock Distinguished Professor