Leadership in Education and Research
“We must continue to ensure that our trainees, as well as our physicians in practice, never lose sight of providing the human touch to medicine. We must continue to stress communication skills and the importance of spending time with patients and their families to make sure they understand their disease and the reasons behind various tests and treatments that are prescribed.”
A Message from Gerald S. Levey,M.D.
Vice Chancellor, UCLA Medical Sciences
Dean, David Geffen School of Medicine at UCLA
There is an excellent article in this issue of UCLA Medicine that offers insight into the current environment for training residents. Every generation has its challenges, and our present one is no exception with regard to residency training. The 80-hour workweek, increased emphasis on the ambulatory-care experience, rapid turnover of patients in the hospital and the limited time that modern trainees spend in the hospital pursuing diagnostic evaluations because of pre-admission workups require us to develop new models for residency training.
Facing these challenges is a positive thing, forcing us to think about how we teach, why we teach and what we teach. In addition to the points made in the article (“Making Better Doctors,” Page 8), I will add some other challenges we face.
First, there is an increasing need to train physician scientists. We are blessed at UCLA to have the Specialty Training and Advanced Research (STAR) program, which offers the opportunity to combine clinical fellowship training with advanced research training to complete a Ph.D. or a Master of Science degree, depending on the pathway chosen.
Second, we must find ways to train our house officers in the broad area of therapeutics. The Institute of Medicine report on medical errors and side effects of medications, and the frightful price that is paid in terms of our patients’ health and well being, makes it clear that we must do a better job in this area. Knowledge about the systems for drug metabolism, including genetic perturbations to the cytochrome p450 system, will have enormous ramifications for physicians and patient treatment by, ultimately, enabling us to predict how individuals may metabolize certain drugs, the implications for potential side-effects of drugs and their efficacy.
Finally, we must continue to ensure that our trainees, as well as our physicians in practice, never lose sight of providing the human touch to medicine. We must continue to stress communication skills and the importance of spending time with patients and their families to make sure they understand their disease and the reasons behind various tests and treatments that are prescribed. The power of modern medicine can be frightening to anyone with a serious illness.
Our challenge is to incorporate meaningful interactions with patients and their families regardless of the pressures and time constraints of today’s stressful medical environment. Despite all the changes and all the challenges, our curriculum must ensure that our students and residents leave UCLA with outstanding skills in history-taking and physical diagnosis, and with the skills, knowledge and abilities to practice not only the science but also the art of medicine.
Congratulations to the world-class Jules Stein Eye Institute, which has celebrated its 40th anniversary (“VisionQuest,” Page 24). In many ways Jules Stein’s track record of excellence and success parallels that of the David Geffen School of Medicine at UCLA. Both have enjoyed steady leadership, a focused emphasis on science and medical practice, generous philanthropy, and, of course, exceptional faculty and staff.
In the School of Medicine’s 55-year history, there have been only four deans—Drs. Stafford Warren, Sherman Mellinkoff, Kenneth Shine and myself. Given that the average time on the job for a dean in this country is four years, this is an extraordinary record of stability. This stability has enabled the school to develop and follow an institutional vision. In its 40 years, Jules Stein has had two outstanding leaders.
Dr. Bradley Straatsma, the founding director, guided the Institute’s development and set it on a trajectory of excellence by recruiting the finest faculty and developing superb clinical, research and training programs. Dr. Bartly Mondino, who succeeded Dr. Straatsma in 1994, has elevated the Institute to its next level of excellence.
Both the School of Medicine and the Jules Stein Eye Institute have dedicated themselves to the principle that the best clinical care derives from cutting-edge science. The faculty of both institutions recognizes the importance of basic research and its translation to patient care. It is this concept that has catapulted the School of Medicine and Jules Stein into the top ranks of healthcare centers worldwide.
Philanthropy, too, has played a major role in the success of both the School of Medicine and Jules Stein. This success has stemmed largely from the generosity of the entertainment industry. Jules Stein, the founder of theMusic Corporation of America (MCA), and LouWasserman, the chair ofMCA and Universal Studios, were the industry legends responsible for the extraordinary endowment base of the Jules Stein Eye Institute.
I learned a great deal from observing this success, and when it came time to attract someone to name and endow the School of Medicine, the Jules Stein experience profoundly influenced my negotiations. When I met with David Geffen, the cofounder of DreamWorks SKG, to discuss the naming, I asked that the funds be unrestricted in their use and that his gift be a quasi-endowment, and he readily agreed. These special people have secured our respective financial futures for generations to come.
Finally, the faculty and staff of both the school and the Institute are exemplary. The UCLA medical sciences are successful because we have the best faculty, who are dedicated, talented and committed to serve science and our patients, and the best staff, who are dedicated to supporting that work. We are grateful for our challenges and for our milestones because they give us the opportunity to reflect on our past, enhance our present and anticipate the brightness of our future.