University Times

Pitt’s medical school is bracing for a difficult year in the face of declining government and philanthropic funding, said Arthur S. Levine, senior vice chancellor for the Health Sciences and dean of Pitt’s School of Medicine.

In his 2012 State of the Medical School address, delivered May 16 in Scaife Hall, Levine commended the medical school’s collaborative spirit, adding, “One way that I think that we can keep going is to really leverage each others’ strengths.”

While Pitt ranked fifth among recipients of National Institutes of Health total research awards, based on averages from fiscal years 2007 through 2011, “There is plenty to worry about for the future,” he warned, citing declining NIH grant success rates overall.

Although the rate at which proposals have been funded historically has hovered around 32-35 percent, the rate has fallen to 17 percent and is expected to drop further in the coming year.

“The best we can hope for is the Obama budget for fiscal ’13, which is flatlined over fiscal ’12, but it’s based largely on raising taxes. So we’re in the midst of divisive election-year politics; I don’t think any of us knows how that’s going to end,” he said.

Levine predicted success rates next year at best would be around 13-14 percent. “At that point it’s almost impossible, I believe, for a study section to make an informed judgment as to what grants to fund. Essentially it becomes a crapshoot at 13 percent,” he said. “It’s going to be difficult.”

Levine said, “We will do everything possible using the money we have to try to keep good labs operating. I don’t want to close a good lab, because it’s probable that that lab will never open again and the people that work there will see their careers disappear. So we’ll do all that we can to try to maintain these labs. But I do anticipate that next year is going to be a very, very difficult year for us.”

Academic support

Levine said the medical school’s current budget is $1.87 billion, up from $1.8 billion last year.

About $150 million of the budget comes from UPMC and the University of Pittsburgh Physicians (UPP), Levine said. “It is more money than any medical school in the country receives from its associated hospital system. I think we need to look upon this as generous and an amount for which we should be appreciative. This is true academic support.”

The med school, by the numbers

Levine said the 2011-12 medical class comprises:

• 604 MD students: 273 women (45 percent) and 331 men (55 percent).

• 163 (27 percent) Pennsylvania residents.

• 441 (73 percent) out-of-state students.

• 87 (14 percent) under-represented minority students.

• 293 PhD program students.

• 86 medical scientist training program students.

Full-time faculty number 2,202, he said. “Of that number, probably half are doing something facultative in addition to seeing patients — teaching, participating in clinical trial leadership and so forth,” Levine said. “The other half are essentially funded full-time or close to full-time researchers.”

Levine said the medical school distributes about $18.5 million in Educational Credit Unit (ECU) compensation — faculty teaching compensation — approximately the same amount collected from medical students’ tuition.

Curriculum

“I think that our curriculum tends to be one of the more innovative ones nationally. It’s not fossilized,” he said noting many faculty members contribute to its design and evolution.

He called attention to two new short courses: one designed to bring graduating medical students up to speed on how the basic science of medicine has evolved during their time in medical school, and another to help them understand health care reform.

Levine called on faculty to support the school’s teaching efforts in spite of increased pressure to see more patients and write more grant submissions. “I do understand that this is a very difficult time,” he said, adding, “I want you all to remember that this is a medical school. By definition our first priority ought to be to educate our medical students.”

Citing the more than 30 mini-electives for first- and second-year students, he said, “To support a curriculum that is innovative and robust depends hugely on faculty recruitment, especially for small groups and for clinical skills instruction.”

Student research requirements

Levine noted that the current graduating class is the fourth class with a scholarly research project requirement. The research requirement is attracting students who want that experience — a reversal of the reaction when the requirement was first announced, said Levine, noting that some students at the time threatened to withdraw over the change.

Pitt has included the requirement in the curriculum in part “because there continues to be a dramatic decline in the number of physicians who embark upon academic careers, something the country certainly needs,” Levine said.

He said Yale, Stanford and Duke are among the handful of other medical schools in the United States that have such a requirement, adding that the curriculum at these schools takes five years while Pitt’s takes only four.

Columbia and Harvard have announced they too will add a scholarly project requirement, he noted.

“By research, I really mean learning how to practice the scientific method independently and with the full reach of a student’s imaginative and intellectual potential,” Levine said, telling faculty, “This is what’s important to me and what ought to be important to you. This goes beyond simply memorizing books and lecture notes and taking tests.

“Even if the preponderance of our students do not become physician-scientists, they will become better physicians because they’ll have learned to think independently, creatively, analytically — the kind of physician that you and I, I think, would most like to attend to our health.”

Niche graduate programs

Levine called attention to the school’s niche programs for graduate students: neuroscience, biomedical informatics, computational biology, molecular physics and structural biology, and integrated molecular biology.

“I think these programs are attracting very well differentiated students for obvious reasons,” Levine said, adding that these students tend to move more quickly than others through their graduate studies. “So my own view is that we should place emphasis on these specialty graduate programs and perhaps expand them,” he said.

Personalized medicine institute planned

A search is underway to find the first director of a planned institute for personalized medicine that will be housed in the former Ford Motor Co. building next to Hillman Cancer Center.

Levine said the building is being renovated and expanded to create 330,000 square feet of new research space. “All that I want to say about it at the moment is that we think it will be ready in about two-and-a-half years and at that point we will be well on the way to starting a major new effort.”

He said some lab space in Oakland will be freed up in conjunction with the new institute, noting that some departments, “dermatology and immunology in particular, will move to the new building because we think they have good connections with personalized medicine.”

Italian biomedical center funded

Levine said an Italian government-sponsored biomedical research and biotechnology center that will be managed by the School of Medicine and UPMC in the Sicilian town of Carini is nearing construction.

The center is a project of Fondazione Ri.MED, a partnership established in 2006 by the School of Medicine, UPMC, the Italian government, the Presidency of the Region of Sicily and the Italian National Research Council to promote biotech and biomedical research and translational medicine.

“It’ll be our job to manage this research institution which will be very much like BST 3 — a lot of basic science, with its derivative drug discovery, vaccine development, some tissue engineering,” Levine said. In addition to labs, it is hoped funding will be sufficient to build a small research hospital as well, he said.

“The government has been sufficiently pleased with UPMC’s hospital management in Sicily that they now want us to start the nation’s biotech industry in the south of Italy and that’s what this building is about.”

UPMC has operated a transplant center in Palermo, the Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione, or ISMETT, since 1999.

Tsinghua University partnership begins

Pitt’s medical school is partnering with Tsinghua University, which Levine said is considered the best science and engineering institution in China.

Tsinghua has a new medical school that will educate a class of 45 students. “The idea is for them to spend two years of the eight-year curriculum doing research with us here and having a little clinical exposure as well,” Levine said, noting the first group will arrive in Pittsburgh in August.

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Video of Levine’s entire State of the Medical School address is posted at http://mediasite.cidde.pitt.edu/mediasite/Viewer/?peid=5eb70c237bf04e0ead71666eddb456e8.

—Kimberly K. Barlow