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Update from the Dean - Fall/Winter 2009
By Mary Anne Koda-Kimble / Mon Mar 2, 2009
Dear UCSF School of Pharmacy Family and Friends:
The economic and political changes that have occurred in all of our lives since I last wrote to you are astounding. There is no need to recount here what we are all experiencing in our homes and workplaces. As dean of this School, I am intensely optimistic, yet realistic, as I draft this letter. With bold action, I am confident that the School can make it through these dire financial times and take advantage of a new national stance on the importance of science, health care for all, and accessible education. This is why I begin by summarizing our budget situation so that I can move on to ever-growing good news about the School, its people, and its programs.
It will come as no surprise to you that the School is being squeezed by today's powerful economic vise. The state's $15 billion budget deficit translates into a $48 million University of California (UC) cut in state funds, which could increase to $115 million by fiscal year end. UC must add to these cuts additional expenses for health care, retirement, and infrastructure, which are mandated across all fund sources, but unfunded.
UC President Mark Yudof, LLB, has advised the 10 UC campuses to prepare for a 10% cut in state funds for the next 3 years. Here at UCSF we already have absorbed a 4% cut in state funds and will absorb another 3% cut before the fiscal year ends on June 30.
In response, UCSF Chancellor J. Michael Bishop, MD, has convened an executive budget committee, which is charged with developing a comprehensive, 3-year action plan that will enable the campus to respond effectively to the financial crisis across all units and sources of funds. I am a member of this committee.
What does this mean for the School of Pharmacy? Only 15% of our $68 million School budget comes from state of California general funds. Yet, most of this money is earmarked for salaries of just some of our core faculty and staff members who support the foundations of our teaching and research. These state funds are an essential part of our budget, but they do not begin to meet the minimum expenses we incur daily to deliver our PharmD and PhD programs. Other fund sources include student fees, donations, grants, and contracts for services.
When we look at our projections over the next 4 years, 75% of the School's "cuts" will take the form of unfunded additional expenses for health care, retirement, and infrastructure. All of this translates into an additional $820,000 we must cover this year, and more than $2.5 million we must cover in each of the next 3 fiscal years.
As daunting as these numbers are, I am confident that the School is well positioned to address this budget situation. We have been necessarily frugal and efficient for decades, and we have planned well. Having been through budget crises before, I have set out several goals and principles to which we will adhere during the next 3 years. We will:
- minimize the impact of the cuts on our core education, research, and service missions
- advance our strategic plan
- improve service with the same number or fewer people
- sustain faculty and staff morale.
Already, faculty and staff members are making tough decisions and taking actions across the landscape of our School in response to our financial challenges. As examples, we are:
- judiciously responding to the findings of last year's PharmD program accreditation report, which directed us to meet expanded national curriculum requirements for introductory pharmacy practice experiences (estimated new costs would be $500,000 annually)
- deferring hires for several open faculty positions
- using any additional income from PharmD student fees to backfill state general fund reductions
- attending to the care of our volunteer faculty members who play such a critical role in our success
- halting plans to increase the size of our PharmD class to meet a severe pharmacist shortage in California
- pursuing our multi-year plan for professional degree fee increases to reach parity with UC schools of medicine.
We are becoming more efficient in how we operate by, for example:
- serving as a campus test site to streamline the administration of our grants
- standardizing our financial reports across the entire School and making them viewable in real time to administrators and faculty members
- eliminating the development and production of all but essential printed materials
- reviewing all of the ways we use and secure supplies and services
- leaving vacant many open administrative staff and management positions and reassigning responsibilities.
And, we are increasing our visibility and enhancing our ability to develop collaborations and attract resources to support our work. For example, we are:
- strengthening our web presence
- redoubling our efforts to attract private support
- offering revenue-generating courses to business and industry
- actively seeking research partnerships with industry through the work of a newly appointed associate dean for external scientific affairs
- expanding our contract work into new areas.
Budget constraints, along with other concerns, have also affected our PharmD satellite program in San Diego. I share the disappointing news that we have been advised to discontinue the School's program at the University of California, San Diego (UCSD) beginning with the 2011 UCSF graduating class. Our student pharmacists who are scheduled to begin their rotations in San Diego this March will be accommodated. As enrollment and the need for practice sites at the UCSD Skaggs School of Pharmacy and Pharmaceutical Sciences have grown, the presence of UCSF students strains UCSD faculty resources and precious introductory and advanced pharmacy practice sites. In this time of economic crisis, these concerns are certainly understandable. Over the next few years, we look forward to finding new ways to work collegially and collaboratively with our sister school at UCSD.
We are extremely grateful to all of the paid and volunteer faculty members who have made the UCSF satellite program in San Diego and the UCSD pharmacy school so strong—especially David Adler, PharmD, Tony Manoguerra, PharmD, and Bob Weibert, PharmD, who developed and implemented this program. The faculty's dedication to teaching and patient care inspires us and lives on through the many students they have touched. Our satellite clerkship program at UCSD was the first satellite program we established more than 30 years ago. It served as a model as we added programs throughout California and was a model for other schools as they began similar programs. Faculty members who have been teaching our students in San Diego will forever remain a part of the UCSF family.
This, then, is the big financial picture. Although it is not bright, the work of our faculty, staff, and students will continue to shine and improve health through exceptional science and clinical care. Now, I share the good news that supports my optimism.
Faculty Honors and Awards
Leslie Benet, PhD, department of biopharmaceutical sciences, received the prestigious 2008 Paul Ehrlich Magic Bullet Lifetime Achievement Award at the 2nd World Conference on Magic Bullets sponsored by the International Society of Anti-Infective Pharmacology and the German Pharmaceutical Society. The award calls attention to Les' pioneering work in pharmacokinetics and pharmacodynamics. Early approaches to drug dosing and pharmacokinetic modeling emphasized enzyme metabolism but did not adequately consider the movement of drugs and metabolites into and out of cells through molecular gatekeepers called transporters. The Magic Bullet Award recognizes Les' work in revising models to take transporters into account.
Kathy Giacomini, PhD, biopharmaceutical sciences department chair, will soon be the first woman to receive the 2009 Rawls-Palmer Progress in Medicine Award from the American Society for Clinical Pharmacology and Therapeutics. The award recognizes scientists who help bridge the gap between research results and their application to patient care. As many of you know, Kathy is a leader in the study of pharmacogenomics, specifically the pharmacogenomics of membrane transporters.
Another member of the department of biopharmaceutical sciences, Deanna Kroetz, PhD, was recognized as a Fellow of the American Association of Pharmaceutical Scientists for her outstanding research and contributions to the association. Deanna is leading a whole genome analysis of predictors of doxorubicin-induced neutropenia in women with breast cancer. The information Deanna gathers will be used to study how genes might play a role in this dose-limiting adverse event. She is also looking at how genes might affect differences in response to antiretroviral therapy in Uganda and San Francisco.
Department of Clinical Pharmacy Professor Emeritus Michael Winter, PharmD, was just named Distinguished Alumnus of the Year for 2009 by the UCSF Pharmacy Alumni Association. Mike was one of the first pharmacists to practice clinical pharmacokinetics. He believed strongly that the incorporation of pharmacokinetics into pharmacy practice should extend beyond specialists to every pharmacist. Mike, a gifted teacher, is the author and publisher of Basic Clinical Pharmacokinetics (now in its 5th edition), which presents the complex concepts of clinical pharmacokinetics in a manner accessible and practical to students and practicing pharmacists alike. Through translations of his texts and courses taught around the world, Mike has made a lasting impact on pharmacy practice and patient care.
Associate Dean Robert Day, PharmD, is a 2009 recipient of the California Pharmacy Hall of Fame Award, which is given by the California Pharmacists Association (CPhA).
Glenn Yokoyama, PharmD, Bob's colleague in the department of clinical pharmacy, received the award in 2008. The award recognizes those who inspire the practice of pharmacy in California. Over the course of many decades, Bob has remained unerringly responsive to the needs of student pharmacists and has assiduously promoted the advancement of students within the profession. He was the second full-time practitioner to be appointed to a faculty position in a U.S. school of pharmacy. He created the nation's first course on over-the-counter medications and recruited the nation's first volunteer pharmacist faculty members to teach it.
Glenn's tireless dedication to pharmacy is reflected in his service to state and national associations. He served as president of CPhA and the California Society of Health System Pharmacists and as a member of the California State Board of Pharmacy. In this latter role, he advocated for mandatory patient counseling and other responsibilities for pharmacists that would advance the profession.
William Soller, PhD, and Eleanor Vogt, RPh, PhD, department of clinical pharmacy, will be honored this winter with the 2009 Jane Boggess Advancement of Pharmacy Practice Award given by the Pharmacy Foundation of California. The award recognizes their work in establishing the Northern California Pharmacist Care Collaborative, which aims to improve health outcomes and reduce health care costs. Through our Center for Consumer Self Care, the collaborative is providing field management, program assessment, and/or pharmacist care for chronic disease management to patients in Raley's pharmacies and, via telepharmacy, to Union Local 447 members in Sacramento and underserved patients at St. Anthony's Free Medical Clinic in San Francisco.
A research paper, which is shedding new light on gene regulation in the parasitic protozoan Giardia lamblia, was one of the "must read" articles on the website for Faculty of 1000 Biology this winter. Congratulations to authors CC Wang, PhD, department of pharmaceutical chemistry, and postdoctoral scholar Ashesh A. Saraiya, PhD. Their paper appeared in the November 8, 2008 issue of PLoS Pathology. Faculty of 1000 Biology is an online research service that reviews the most interesting papers published in the biological sciences, based on the recommendations of a faculty of more than 2,300 selected leading researchers.
Student Honors and Awards
Congratulations to two of our student pharmacists, Lindsey Elmore and Evan Clemens, for winning the national 2008 American Society of Health-System Pharmacists Clinical Skills Competition. The competition, which involves both a written and oral evaluation of a specific patient case, is designed to encourage future health systems pharmacists to work as teams, to analyze the medication needs and care of patients, and to ultimately help patients make the best use of their medications.
One of our PhD biophysics students, Gabriel Rocklin, and colleague Jacob Heller, a Stanford University law student, were 1st-place winners of the Science, Technology and Engineering Policy (STEP) White Paper Competition 2008 sponsored by the STEP Policy Group at the University of California, Berkeley (UCB). The contest is designed to explore the interplay between technology and pressing policy needs. Their paper, Promoting Pharmaceutical Research Under National Health Care Reform, proposes the establishment of a new federal fund to support the development of pharmaceutical products based upon what Gabriel and Jacob define as the true measure of a product's value—its contribution to the quality and length of human life.
New Associate Deans
I have created 2 new part-time associate dean positions. As we implement our current strategic plan, we are expanding our partnerships with industry and extending our work globally. These actions now will be coordinated by Daniel Santi, MD, PhD, associate dean for external scientific affairs, and Steven Kayser, PharmD, associate dean for global affairs.
Dan is charged with developing new research partnerships, primarily with the pharmaceutical and biotechnology industries. As we state in our strategic plan, "we believe that the wellsprings for advances in drug discovery and development are to be found in the deepest reaches of academia." Dan will help us bring our academic science to the attention of industry. He knows industry well. As an entrepreneur, Dan founded or co-founded 4 biotechnology companies. He has published more than 300 scientific papers and is co-inventor on more than 30 issued U.S. patents. In 1996, he co-founded Kosan Biosciences where he served as chief executive officer and chairman until 2006. He was a member of our faculty from 1974 until 2000 and is now with us again, as a faculty member in the department of pharmaceutical chemistry and as associate dean.
Steve is charged with overseeing relationships with the international community and with people and programs at UCSF involved in international work. I rely on him to evaluate the many requests we receive for potential international partnerships on my behalf and to advise the School on opportunities that will extend our work globally. Steve will help make sure that our work is coordinated within the School and with campus programs. I am especially sensitive to ensuring that our international work is supported appropriately by external fund sources. Steve specializes in anticoagulation and cardiology. He teaches our PharmD students and cares for patients on the UCSF Medical Center's cardiology service and in its intensive cardiac care unit. He is the long-time director of our academic clinical pharmacy program with Tokyo University of Pharmacy and Life Sciences. And, he is currently working with pharmacy colleagues in Vietnam to develop academic collaborations based on a partnership agreement with all Vietnamese pharmacy schools.
New Faculty Members
Two exciting new faculty members have joined us since I wrote to you last. Zev Gartner, PhD, department of pharmaceutical chemistry, moved across the San Francisco Bay to UCSF from the University of California, Berkeley (UCB) where he was conducting postdoctoral research in Carolyn Bertozzi's laboratory. Before his work at UCB came an extended trip around the world, consulting work for a Cambridge, Massachusetts, start-up company and, in 2004, a PhD degree in chemistry and chemical biology from Harvard University. Using chemistry and engineering, Zev is researching how to design cellular networks in order to learn more about how cells communicate in real tissues. He received a Sandler Opportunity Award, which supports potentially high-impact projects that are substantially more creative or risky than projects supported by traditional funding mechanisms. Zev is applying the award toward the development of new strategies for making living tissues from individual cells. Completion of the project will advance regenerative medicine and cancer research by providing precisely assembled multicellular structures constructed from any cell type. Zev is also an award-winning surfer.
Shuvo Roy, PhD, department of biopharmaceutical sciences, joined us from the Cleveland Clinic, where he co-directed the BioMEMS Laboratory. He is a builder of things small and an expert in microelectromechanical systems (MEMS)—the microelectronics, microfabrication, and micromachining technologies that, in Shuvo's case, are being used to create medical devices. Shuvo has made high-performance ultrasonic transducers, which are small enough to fit within a catheter, to obtain high-resolution coronary images; wireless implantable sensors, without batteries or wire connections, to monitor the pressure between spinal discs; catheters mounted with micro-needles to deliver drugs locally; micro-/nano-structured scaffolds to help engineer cells and organs for replacement. He is now working on an implantable artificial kidney that will not only filter blood but also perform other functions of the natural kidney. Shuvo was a triple undergraduate major in physics, mathematics, and computer science at Mount Union College. He earned an MS in electrical engineering and applied physics in 1995 and a PhD in electrical engineering and computer science in 2001 from Case Western Reserve University. With these accomplishments to his credit, it is clear why Shuvo now holds the Harry Wm. and Diana V. Hind Distinguished Professorship in Pharmaceutical Sciences II. This endowment was established by a generous gift from Harry and Diana Hind. An alumnus of our School, Harry is the inventor of both the wetting solution that helped bring contact lenses into widespread use, and the Lidoderm patch, which is prescribed to treat nerve-injury pain from shingles.
The wider world use of medical tests and treatments based on individual genetic differences is the focus of a new $5 million research program funded by the National Cancer Institute (NCI) and led by health economist Kathryn Phillips, PhD, department of clinical pharmacy. This is the first major NCI grant focused on health policy issues related to personalized medicine and pharmacogenomics. Grant participants include scientists at leading U.S. and international universities, and experts from the health insurance industry and government regulatory agencies. The NCI grant and foundation grants form the nexus of the newly established Center for Translational and Policy Research on Personalized Medicine, which is based in the clinical pharmacy department and led by Kathryn.
Kathryn's faculty colleagues in clinical pharmacy are investigating—with colleagues in the UCSF School of Medicine's departments of medicine and laboratory medicine and division of medical genetics—the practical application of pharmacogenetics in the real world setting. Initiatives include treatment of cancer and anticoagulation. In the former, Ogechi Ikediobi, PharmD, PhD, is evaluating the use of pharmacogenomics to reduce chemotherapy-associated toxicity. In the latter, Jaekyu Shin, PharmD, and Steven Kayser, PharmD, are assessing the impact of genomics to improve the dosing of warfarin.
UCSF Medical Center Collaborations
We continue our close professional relationship with the UCSF Medical Center and, in particular, with the medical center's department of pharmaceutical services, which is headed by Lynn Paulsen, PharmD. The department of pharmaceutical services provides long-standing, outstanding preceptorship for our San Francisco-based student pharmacists in their advanced pharmacy practice experiences. The School's Department of Clinical Pharmacy Medication Outcomes Center oversees evidence-based medication therapy reviews in the medical center, evaluates the safety of medication use, and directs pharmacoepidemiological investigations. Recent examples of these efforts include the creation of a novel database for all U.S. Food and Drug Administration black box warnings and medication use evaluations of the medical center's high-risk medications.
In the News
Two of our faculty members, James Wells, PhD, chair, department of pharmaceutical chemistry, and Lisa Bero, PhD, department of clinical pharmacy, were highly cited recently in the lay and scientific media.
Research by Lisa and UCSF colleagues Kristen Rising, MD, and Peter Bacchetti, PhD, found that the information readily available to health professionals in the scientific literature on clinical drug trials is incomplete and potentially biased. Their study, which appeared in the online open access journal, PLoS Medicine, November 24, 2008, attracted international media attention.
Jim, with Mary Woolley, PhD, president and chief executive officer of Research!America, call for an (Al) Gore-like populist movement for global health. They urged scientists to speak out now—as individuals and through advocacy groups—to educate the public about the importance of basic science research and to rally support for more funding. Read their editorial in the October 3, 2008 issue of Science.
As a campus we are doing very well, despite the serious budget crisis. Our doctor of pharmacy program was again ranked 1st by U.S. News and World Report. Our nursing program was ranked 2nd, and our medical program was ranked 5th. Rankings did not include dental schools. In terms of NIH research support, our School, along with the dental and nursing schools, led the nation among peers. Our medical center is ranked as one of the top 10 in the nation and the best in the Bay Area. It has set new patient census records and is currently in a strong financial position. However, UCSF Medical Center Chief Executive Officer Mark Laret explains that since the medical center is at operating capacity, it is "no longer possible simply to add more beds in order to increase revenue. That fact, combined with significant new expenses…means it will be difficult to achieve our financial goals in the coming years." That being said, and with bond financing and an intensive campaign for private support under way, plans are on course for the construction of new medical center facilities at our Mission Bay campus. We are proceeding as well with construction of a cardiovascular research building at Mission Bay and a stem cell research building on Parnassus Heights, both of which have received significant private support for construction.
In terms of campus leadership, there has been a lot of turnover, especially as a generation of senior leaders reaches retirement age. Interim School of Dentistry Dean John Featherstone, MSc, PhD, was offered the deanship after a national search. He accepted, and we are fortunate, indeed. Sam Hawgood, MB, BS, remains interim dean of the medical school. A national search for the position has been completed, but the appointment will remain pending until a new UCSF chancellor is named and can participate in the final appointment decision. Sam is an exceptional colleague whose selfless leadership and thoughtful attention to the School of Medicine and its partnerships with the School of Pharmacy have been gifts to us all.
For those who might not yet know, our chancellor of 10 years, J. Michael Bishop, MD, will step down on June 30, 2009. Mike has positioned our campus to excel during his tenure. We now have a strategic plan, a thriving Mission Bay campus, plans to reinvigorate our Mount Zion and Parnassus sites, and a culture in which respectful and ethical behavior are openly discussed and valued. He passes on to a new generation of administrators and faculty members an institution that has been transformed beyond our imaginations. Mike appointed me as dean, and I credit him with providing vital support to the School at key moments, which has allowed us to thrive. His collegiality and friendship are beyond measure. I know you will join me, as June 30 approaches, in thanking both Mike and his wife Kathryn for the decade they have so generously given to us.
With warm regards until I write again,
Mary Anne Koda-Kimble, PharmD
Professor and Dean
Thomas J. Long Chair in Community Pharmacy Practice
About the School: The UCSF School of Pharmacy aims to solve the most pressing health care problems and strives to ensure that each patient receives the safest, most effective treatments. Our discoveries seed the development of novel therapies, and our researchers consistently lead the nation in NIH funding. The School’s doctor of pharmacy (PharmD) degree program, with its unique emphasis on scientific thinking, prepares students to be critical thinkers and leaders in their field.