Update from the Dean - Fall/Winter 2011

Dear UCSF School of Pharmacy Family and Friends:

As you know, the UCSF School of Pharmacy thrives on progress, and since I sent you news about the School last October our faculty members and students have continued to race forward at an amazing pace. In fact, as I put this Update together, I was stunned by the number and level of their accomplishments over the past 6 months. But before I share successes, I address the budget.

Budget

The state budget continues “top of mind” for all Californians. This fiscal year, the UC system faces a $1 billion budget gap. This includes $500 million in unfunded mandates for contributions to pension and health expenses, plus $500 million in cuts in state general funds. The latter amounts to a 16% state general fund reduction and comes on the heels of several years of rescissions.

If California Governor Jerry Brown’s ballot measure to extend tax increases that were passed under former Governor Arnold Schwarzenegger does not succeed, we must brace ourselves for deeper cuts next fiscal year. Student fee increases are likely to continue their upward march by 3% to 7% depending on the outcome of the ballot measure.

While we await news of the final state budget reduction number, we continue on course—saving money and improving the efficiency with which we administer the campus. We are fiercely committed to excellence as a public university, and we in the School remain determined to continue to better people’s lives through new therapies and improved pharmaceutical care.

Out in front

The School’s resolve to speak up and out remains strong. Here are but 3 examples of Department of Clinical Pharmacy faculty members whose voices are being heard.

  • During her keynote address to the California Pharmacists Association (CPhA) in February 2011, health policy expert Helene Levens Lipton, PhD, advocated for the pharmacist as a key player in successful health care reform. The title of her speech says it all: If You’re Not at the Table, You’re on the Menu. To lead by example, Helene called on CPhA’s legislative body, the House of Delegates, to officially proclaim its support for inclusion of compensated medication therapy management services, provided by pharmacists, in the mandated health benefit package offered under the California Health Benefit Exchange. The motion won overwhelming support from the House of Delegates. The Health Benefit Exchange will provide health insurance coverage for the uninsured and under-insured within the Affordable Care Act. California was the first state in the nation to pass legislation to create this insurance program under the health reform law.
  • Since I last wrote, Nancy Nkansah, PharmD, has frequently shared her therapeutics expertise with the vast viewing audience of the Dr. Oz television show. This show carries strong, well-researched health segments, and Dr. Oz clearly recognizes the role of the pharmacist in patient care. What a joy it is to see on national television a poised, articulate clinical pharmacist—in collaboration with a physician—advising on the best use of medicines. To view Nancy in action:

  • On the international front, Lisa Bero, PhD, led a move to include The Cochrane Collaboration on the World Health Assembly of the World Health Organization (WHO). The Collaboration was awarded an Assembly seat on January 23, 2011, and Lisa was named as the Collaboration’s representative. The Cochrane Collaboration is an international organization that promotes high-quality research and evidenced-based decisions about health care, so we anticipate that this move will significantly influence WHO’s use of research evidence in its policy decisions. Lisa is a long-time Collaboration member and director of the San Francisco branch of the U.S.Cochrane Center. She spent part of last year on sabbatical at the WHO in Geneva, Switzerland.

From the Department of Bioengineering and Therapeutic Sciences, Shuvo Roy, PhD, has been busy speaking to the print and broadcast media after unveiling a model of a surgically implantable bioartificial kidney he is developing as the lead investigator with colleagues across the United States. The bioartificial kidney promises to improve the health and lives of patients with end stage renal disease (ESRD) and to save health care dollars, including an annual savings to Medicare of $15 billion. The challenge we face now is finding the funding needed to get the device to clinical trials. Undaunted, Shuvo continues to speak boldly about this need and the importance of the project to 500,000 patients here in the U.S. suffering from ESRD. For more information: UCSF Unveils Model of Artificial Kidney.

Faculty awards

The newest members of our faculty are all stars—many gathering honors and awards from day one. Here is just a sample of their amazing accomplishments. I am so, so proud of them!

  • Bo Huang, PhD, Department of Pharmaceutical Chemistry, received one of 17 prestigious 2010 Packard Fellowships in Science and Engineering that support “unusually creative professors” early in their careers. Bo builds new technologies that allow scientists to see structures inside cells as well as cellular processes in action at the molecular level.
  • Danica Galonić Fujimori, PhD, who holds a joint appointment in the Department of Pharmaceutical Chemistry and the Department of Cellular and Molecular Pharmacology, has recently been given 3 awards. For her success as a teacher and a scholar, Danica received a National Science Foundation Faculty Early Career Development Program Award. In support of young, promising scientists just embarking on their independent research careers, and in support of March of Dimes Foundation goals, Danica became a 2011 Basil O’Connor Starter Research Scholar. She has also recently received a V Foundation Scholar Award, which funds the nation’s brightest physicians and scientists as they pioneer techniques leading to breakthroughs in cancer research.
  • Zev Gartner, PhD, Department of Pharmaceutical Chemistry, is leading a $3.2 million grant to study the interaction of different types of cells in breast cancer at its earliest stages. Research results might ultimately identify new classes of targets for anticancer drugs. The project is funded by the U.S. Department of Defense.
  • Michael Fischbach, PhD, Department of Bioengineering and Therapeutic Sciences, received 3 high-profile awards. From the Global Probiotics Council came a 2010 Young Investigator Grant for Probiotics Research to develop a new way of discovering new antibiotics from probiotic bacteria. Probiotics are live microorganisms that can benefit the health of their host. He received a 2010 National Institutes of Health Director’s New Innovator Award to identify and characterize small molecules from the human microbiome—the entire community of microorganisms that live in and on us. These molecules should help us better understand the connection between the human microbiome and human disease, and help lay the groundwork for engineering new probiotic bacterial strains—such as the bacteria found in yogurt—to promote human health and help fight diseases. Michael will use his 3rd recent award—a W.M. Keck Foundation grant—to identify antibiotics produced by gut bacteria and determine how these antibiotics affect the composition of the entire gut bacterial community. Research results could help reveal the causes of—and new treatments for—Crohn’s disease, obesity, diabetes, and colorectal cancer.

Meanwhile, our more senior faculty members continue to be recognized worldwide as forces in science, education, and health care. Briefly listed here are but a few of the awards they have received recently or will soon receive:
  • Charles S. Craik, PhD, Department of Pharmaceutical Chemistry, was elected a Fellow of the American Association for the Advancement of Science.
  • Brian Shoichet, PhD, Department of Pharmaceutical Chemistry, received the 2011 Biomolecular Sciences Section Accomplishment Award from the Society for Laboratory Automation and Screening.
  • James Wells, PhD, Department of Pharmaceutical Chemistry, was honored by The Division of Medicinal Chemistry of the American Chemical Society with the 2011 Bristol-Meyer Squibb Smissman Award.
  • Kathy Giacomini, PhD, and Deanna Kroetz, PhD, Department of Bioengineering and Therapeutic Sciences, received from the National Institutes of Health, $11.9 million for research into the genetics behind membrane transporters.
  • Kathy Giacomini, PhD, Department of Bioengineering and Therapeutic Sciences, also received a $3.2 million grant to continue and expand a Global Alliance for Pharmacogenomics. She was honored with the 2010 Therapeutic Frontiers Lecture Award from the American College of Clinical Pharmacy, and this November she will receive the 2011 Scheele Award from the Swedish Academy of Pharmaceutical Sciences.
  • Steven Kayser, PharmD, and Donald Kishi, PharmD, Department of Clinical Pharmacy, received honorary doctorates from Tokyo University of Pharmacy and Life Science (TUPLS). In its 130-year history, these are the first such awards given. The honorary doctorates recognize Steve’s and Don’s contributions to the educational training program between TUPLS and the UCSF School of Pharmacy that was established in 1994 and continues today.

Special recognition goes to Paul Lofholm, PharmD, who is a volunteer member of our Department of Clinical Pharmacy faculty and president of Ross Valley Pharmacy in Larkspur, California. Paul will receive the 2011 Remington Honor Medal from the American Pharmacists Association at its March 2011 annual meeting. Paul’s lifetime commitment to the innovative practice of pharmacy in the community is a model for us all.

PharmD Students

Not to be outdone by their teachers, our student pharmacists continue to bring in honor after honor.

Murphy and Bermingham
Lagniappe Studio
4th-year student pharmacists Jennifer Murphy and Rachelle Bermingham are the national winners of the 2010 American Society of Health-System Pharmacists Clinical Skills Competition during which they presented both written and oral evaluations of a patient with drug-induced Stevens-Johnson syndrome progressing to toxic epidermal necrolysis. These are both life-threatening conditions affecting the vitality of skin cells. I encourage you to watch their impressive, highly professional presentation on our website: Jennifer Murphy and Rachelle Bermingham win ASHP Clinical Skills Competition.

4th-year student pharmacist Melissa Kusaka is a 2010 recipient of the California Society of Health-System Pharmacists (CSHP) Student Leadership Award for professional involvement. Melissa has been active in everything from the Science Squad, which teaches science to elementary school children in San Francisco, to the UCSF student chapter of CSHP, for which she served as president.

Roth, Campbell, Wong
Congratulations to 4th-year student pharmacist Hilary Campbell, who was named the California Pharmacists Association (CPhA) Student Pharmacist of the Year. Hilary has been actively involved in the American Pharmacists Association-Academy of Student Pharmacists (APhA-ASP) and CPhA since her arrival on campus, and she brings her energy and enthusiasm for the profession to many student leadership roles. Hilary is interested in health policy and legislation, hopes to earn a law degree after pharmacy school, and shall ultimately pursue a career in governmental / legislative relations. Late-breaking news: Hilary has been accepted to the Duke University School of Law!

3rd-year student pharmacist Caroline Lindsay and Department of Clinical Pharmacy faculty member Lisa Kroon, PharmD, received a CPhA Best Practice Award for the Interprofessional Standardized Patient Exercise, which was developed in 2009 by faculty members and students from all 4 UCSF health professional schools. This award is significant, not just because it recognizes Caroline and Lisa, but because it demonstrates the power of interprofessional teamwork learned early. In the exercise, students from our pharmacy, medical, nursing, and dental schools form an interprofessional team. Each student on each team interviews a patient (an actor) who has multiple chronic conditions. Then, each team develops a care plan for the patient. In 2009-2010, more than 100 students participated in the pilot, including 24 3rd-year student pharmacists; this year, we have 200 students—50 from each school. The goal is to include this valuable exercise in the schools’ curricula.

PharmD education

This past fall we welcomed to the PharmD program an amazing group of 123 1st-year student pharmacists from more than 1,600 applicants. Here is the impressive class profile:

  • 67% female
  • 16% from groups historically underrepresented in pharmacy, up from 14% last year
  • 100% have a bachelor’s degree; 14 students have a master’s degree and 2 hold a PhD degree
  • 90% of the class is from California: 68% from the University of California and 13% from the California State University system.

The student pharmacists of the Class of 2014 have hit the ground running and are already serving the community and leading the way professionally.

A call for summer internship positions

The market for student pharmacist internships remains extremely tight as more pharmacy schools compete for placement, and some schools pay for internship experiences. Once again, I ask for help from those of you who are our pharmacy school alumni and our pharmacist friends. Please consider one of our students as a summer intern in your operation. I am confident that you will be as impressed as I am with the intelligence, energy, and passion our students bring to their work. To learn how you can participate, contact Cynthia B. Watchmaker, MEd, MBA, our associate dean of student and curricular affairs: [email protected] or 415/476-8025.

Graduate programs

In the last Update I announced the new 1-year Masters in Translational Medicine (MTM) degree program co-sponsored by UCSF and the University of California, Berkeley. We are halfway through the inaugural year of the MTM program, and according to Tejal Desai, PhD, program director, Department of Bioengineering and Therapeutic Sciences, we have already doubled the number of applications to the program—from 83 this year to 182 next year.

The graduate program in Biological and Medical Informatics (BMI), directed by Thomas Ferrin, PhD, Department of Pharmaceutical Chemistry, recently received the results of its external academic program review. The program has 2 tracks: (1) Computational Biology and Bioinformatics (Bioinformatics) and (2) a recently revived Clinical and Translational Informatics (CTI) track. The review committee noted insufficient support for the CTI track and recommended its discontinuation and separation from BMI.

The Bioinformatics track, whose associate director is Patricia Babbitt, PhD, Department of Bioengineering and Therapeutic Sciences, was praised as highly innovative with strong faculty engagement, and for a curriculum that is both innovative and socially supportive of its students. For example, 1st-year students go through a boot camp run by senior students. The camp is intended to build community, show students how they can succeed, and identify specific subject areas each student needs to address. Long-term funding in the face of rising costs for graduate education within the UC system was raised as an area of concern, but overall, the reviewers deemed the program excellent. My thanks go to Tom and Patsy for their spectacular leadership.

New teaching facility

Desmond-Hellmann cuts a red ribbon with giant scissors while others watch
Susan Merrell
team members perform a simulation around an artificial patient lying on a bed
Christian Burke

In mid-January 2011, Chancellor Susan Desmond-Hellmann, MD, MPH, opened our new Teaching and Learning Center (TLC). It is a high-tech facility that will incorporate telehealth and sophisticated simulations into the curricula of all 4 professional schools, while nurturing interprofessional education. The 22,000-square-foot center, which is in the Kalmanowitz Library on the Parnassus campus, includes 12 high-tech classrooms and clinical exam rooms, 10 full-body patient mannequin simulators, and telemedicine facilities. It will serve more than 2,500 students annually. We have the commitment, and now an amazing physical space on campus, to develop and evaluate bold, new ways of teaching and learning. Please visit this center on the 2nd floor of the library if you are on the Parnassus campus. More details: Teaching and Learning Center.

New associate dean of research

Following 2 spectacular deans—Tack Kuntz, PhD, and Ken Dill, PhD—Paul Ortiz de Montellano, PhD, Department of Pharmaceutical Chemistry, is our new associate dean of research. Paul advises me and my leadership group on how we can best position our science for success, and he represents our research agenda to the campus and beyond. Paul has a record of international accomplishment, an ability to explain science clearly and passionately, and a capacity to see the big picture—all criteria for the job. Many of you know Paul for his research on cytochrome P450, and his book Cytochrome P450: Structure, Mechanism, and Biochemistry, which is the seminal text in this field. I welcome Paul as a wise counselor.

Research

Our research continues to thrive—due to not only our expertise but also our collaborative spirit. That spirit is nowhere more prominent than in the work of the California Institute for Quantitative Biosciences (QB3), a partnership among the UC campuses at San Francisco, Santa Cruz, and Berkeley that was formed 10 years ago by then-Governor Gray Davis. The idea was to use research generated on the UC campuses to drive innovation and economic vitality in California. QB3’s success was celebrated in a 10th anniversary symposium held on February 23, 2011 on the Mission Bay campus and attended by Davis and former San Francisco Mayor (now Lieutenant Governor) Gavin Newsom. A great scientist, visionary leader, and friend of the School, Regis Kelly, PhD, directs the 3-campus institute.

To date, 37 companies have been nurtured in QB3 incubators, and QB3 finds and provides seed funding from venture capitalists. I am a champion. Our own Andrej Sali, PhD, Department of Bioengineering and Therapeutic Sciences, leads the UCSF arm of QB3. The institute drives partnerships and gives our discoveries the support they need to transition from our laboratories to the practical good of the public we serve.

An excellent example comes from the laboratory of Tejal Desai, PhD, Department of Bioengineering and Therapeutic Sciences. Tejal has developed micro drug delivery packets. When the packets are put into a capsule and swallowed, the capsule breaks apart, freeing the packets. The packets then stick to the lining of the intestine, where they release their precise medication payloads directly into the intestinal lining and then into the bloodstream. This technique is designed to reduce the amount of medication required in each dose while increasing the amount of medication that reaches the bloodstream. With the support of QB3, UCSF has completed a sponsored research agreement with Zcube s.r.l., the research corporate venture arm of Italian pharmaceutical leader Zambon Co., S.p.A. Zcube will license UCSF-developed microtechnology and support early research to deliver oral medications directly to a targeted site in the body.

This year marks our 31st consecutive year of top research funding from the National Institutes of Health, compared to pharmacy schools across the United States. In December 2010 we presented a 30-year retrospective of this accomplishment on our website, which I hope you will take the time to review: Reflection: 30 years of top NIH funding.

Suffice it to say that our faculty members continue to discover and improve the lives of people everywhere. Here are but a few of their recent publication topics:

  • Evaluation of different ways to assess the safe use of medications in medical centers
  • Pediatric HIV treatment costs over time
  • The application of the essential medicines concept to United States preferred drug lists
  • Inactivation of the tuberculosis bacterium by blocking an enzyme involved in cholesterol use, which the bacterium requires to survive
  • Programmed cell death by executioner enzymes called caspases.

Sakowski
Julie Sakowski, PhD, joins the School as assistant adjunct professor in the Department of Clinical Pharmacy and as executive director of the department’s Center for Translational and Policy Research on Personalized Medicine (TRANSPERS). Julie is a health economist who has more than 15 years of experience studying and evaluating emerging health care technologies, health services, and health care financing. She earned her PhD in economics from the University of Houston and completed postdoctoral studies in health services research/health policy studies at UCSF.

California Poison Control System

On February 9, 2011, Republican leadership in the U.S. House of Representatives made a surprise announcement of a long list of cuts to federally funded programs that the House intended to make in the current Continuing Resolution (CR) for this Federal Fiscal Year (FFY) ending 9/30/2011. The CR is in place because none of the budget bills have been passed by Congress, even though we are well into FFY 2011. Among the many cuts proposed is a $27 million cut in federal funding, through the Health Resources and Services Administration (HRSA), to the nation’s poison centers. There is a nationwide effort among all poison centers and their supporters to avoid these cuts. I was pleased to see the March 3, 2011 opinion piece in The New York Times that warned about the budget impact if poison control centers did not exist. As of March 4, 2011 Senate Democrats moved to include poison control centers in their version of the budget. The situation changes daily.

For the California Poison Control System, which we administer, this would mean a cut of more than $3 million, effective September 1, 2011. This amount is just under one-fourth of the System’s $11.3 million budget. The impact of a cut of this magnitude would be devastating and possibly fatal. Again, I will have more news in my next Update.

robotic pharmacy

I am very pleased to share the news that we have automated how we dispense medications to patients in our hospitals. We have incorporated 3 high-tech robots into the dispensing process, and the whole process is amazing. The robots are in a new pharmacy facility near our Mission Bay campus. Here is how it works:

  • The computers at the new facility electronically receive medication orders from our hospitals on Parnassus and at Mount Zion.
  • The robots in the facility pick, package, and dispense individual doses of pills for individual patients.
  • Machines assemble doses onto a ring that contains all the bar-coded medications for a patient for a 12-hour period.
  • The medications are transported to the hospitals.

Of course, pharmacists continue to review and verify the orders before they can be processed by the robots, and they are behind the scenes making certain that these technologies interface smoothly with others and enhance the workflow of all healthcare providers. The facility also has machines that automatically compound sterile preparations of chemotherapy and non-chemotherapy doses and fill IV syringes or bags with the medications. Many other features, including inventory control and tracking, increase our workflow efficiency.

This move aims to improve patient safety. There have been no medication errors in the 350,000 doses of medication prepared during the robotic pharmacy’s phase-in, which began in October 2010. It also frees the pharmacist to focus on the patient rather than the mechanics of dispensing the product. Moreover, it gives us a tremendous opportunity to train our student pharmacists in new systems supporting patient care.

Congratulations to Lynn Paulsen, PharmD, for this tremendous accomplishment. Lynn is director of pharmaceutical services for the Medical Center and, here in the School, is our associate dean of pharmaceutical services. Lynn works closely with Joseph Guglielmo, PharmD, chair of our Department of Clinical Pharmacy, who is also the Medical Center’s associate director of pharmaceutical services. Together, Lynn and Joe ensure that the pharmacy enterprise of the Medical Center and the pharmacy research, patient care, and education aims of the School support one another and ultimately benefit patients. More details: Robotic pharmacy aims to free the pharmacist, improve patient safety.

Campus

I wrote in my last Update that the Osher Center for Integrative Medicine building and the building that serves as the campus headquarters for the Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research were well under construction. They now are open—the former on the Mount Zion campus and the latter on the Parnassus campus.

aerial view of the Dolby building curving behind the Health Sciences buildings
© Bruce Damonte
The stem cell program structure has been named the Ray and Dagmar Dolby Regeneration Medicine Building in honor of the Dolbys’ successive $20 million and $16 million gifts to the $123.3 million construction project. This 1,270-ton structure is a series of 4 split-level floors with terraced grass roofs on a narrow slope, rising 90 feet above the ground. I have watched this incredible building rise against the hill. It is an engineering feat to be sure, so I encourage you to take a virtual tour: Video depicts UCSF Stem Cell science building: A monument to California.

As UCSF’s first vice chancellor of diversity and outreach, our colleague, J. Renee Navarro, PharmD, MD, will work with us to create and maintain a diverse UCSF environment. In 2007, Renee led a campus drive to increase the diversity of our faculty, students, and trainees. She has served as acting chief of anesthesia for San Francisco General Hospital and Medical Center, as chief of the medical staff, and as medical director of the hospital’s perioperative services. She earned a medical degree from UCSF and a pharmacy degree from the University of the Pacific in Stockton, California. We look forward to working with Renee on this important campus priority.

We have 2 senior-level promotions. Joseph Castro, PhD, vice provost for Student Academic Affairs, has been promoted to UCSF’s vice chancellor for student academic affairs. And Angela Hawkins, MBA, has been promoted to associate vice chancellor for campus life, facilities, and administrative services. Many of you remember Angela as our associate dean of finance and administration, who then moved up to serve as assistant vice chancellor for budget and resource management. I congratulate both for these well-deserved appointments.

Each time as I sit down to write this letter, I wonder if I will have much to report. But once again I find my pages overflowing with news. I have no doubt that our spring and summer months will be as busy and productive as ever.

With warm regards until I write again,

signature

Mary Anne Koda-Kimble, PharmD
Professor and Dean
Thomas J. Long Chair in Community Pharmacy Practice

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School of Pharmacy, Department of Pharmaceutical Chemistry, Department of Bioengineering and Therapeutic Sciences, Department of Clinical Pharmacy, PharmD Degree Program, BMI, CCB, PSPG, Bioinformatics, Biophysics

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.