State of the School Art Kellermann, MD, MPH F Edward Hebert School of Medicine January 22, Unclassified

Summary The Hebert School of Medicine is faced with significant challenges and organizational threats These challenges are more than offset by numerous opportunities to make critical contributions to health professions education, research and performance improvement in the MHS 2

Summary The underlying premise for the Hebert School of Medicine is as sound today as when the school was founded more than 40 years ago If we stay true to our mission, and pursue our goals with discipline, vision and purpose, we’ll make lasting contributions to the health of our nation and the world 3

Acknowledgements The observations discussed in this address are derived from wide-ranging discussions with HSM faculty members and students, as well as senior university leaders, regents, deans, chairs, center directors, members of the Faculty Senate, committees, alumni, public officials and private citizens In other words, YOU 4

5 “America’s Medical School” USU’s SOM and GSN each have over 25 clinical teaching sites across the US

6 Our Medical Students Class of 2015 All in a uniformed service ~170 students per class: 680 total Avg. age: 24.4 years Female: 35% Prior military service: ~32% Minorities: ~20-23%

7 Our Graduate Students ~ 175 civilian & uniformed students Masters and doctorate programs A limited number of International students Unique emphasis on military- relevant topics and programs

8 We are Part of a Larger Whole Inouye School of Nursing ~170 military students & several federal govt civilians in the DNP & PhD programs Armed Forces Radiobiology Research Institute Radiobiology research in five major thrust areas Postgraduate Dental College 3 programs; administered from USU’s campus in San Antonio

9 F. Edward Hebert School of Medicine 141 One of 141 LCME-accredited medical schools* 9 * Source:

10 F. Edward Hebert School of Medicine 141 One of 141 LCME-accredited medical schools* 10 * Source:

11 USU’s “Supplemental” Curriculum Preventive and Occupational Medicine Combat Casualty Care: Environmental Medicine and extreme environments Global infectious diseases Disaster & humanitarian assistance Combat Stress and other psychiatric issues Communications Cultural Competency Leadership and Officership Teamwork The Military Healthcare System The Operational Environment Austere, resource constrained, and often dangerous environments Learn/train in a joint environment Ethical Decision Making in Operational Environments 11

12 USU’s “Supplemental” Curriculum Preventive and Occupational Medicine Combat Casualty Care: Environmental Medicine and extreme environments Global infectious diseases Disaster & humanitarian assistance Combat Stress and other psychiatric issues Communications Cultural Competency Leadership and Officership Teamwork The Military Healthcare System The Operational Environment Austere, resource constrained, and often dangerous environments Learn/train in a joint environment Ethical Decision Making in Operational Environments 12 We are the leadership academy of the MHS

USU Doctors in the MHS ~10% of physician accessions ~25% of the total medical officer force ~33% of the MHS’ top clinicians & MD leaders 13

14 Our Research is Relevant to the DoD Combat casualty care TBI & regenerative medicine Psychological health Rehabilitation sciences Emerging infectious diseases Performance optimization Prev. Med & Public Health Disaster Medicine & humanitarian assistance

15 Where Do We Go From Here? ) Opinions are those of the presenter and do not represent positions of USUHS or the Department of Defense Unclassified

External Challenges Furloughs and fiscal uncertainty Salary and hiring freezes Travel restriction NIH funding cuts Little national visibility Poor brand recognition Our MTFs under pressure The MHS is challenged as never before 16

Internal Challenges Our faculty is small relative to the size of its mission, and demographically imbalanced Curriculum reform has increased teaching workloads w/o a matching increase in resources; concerns expressed about equity of effort ↓ research funding + ↑ teaching = ↑↑ stress In challenging times, bureaucratic hassles & obstacles are even harder to take 17

However, USU Also Has Formidable Strengths… We are nationally unique. We have a vital mission, excellent facilities & equipment, outstanding students, a talented faculty, no debt and a funding base that’s stronger than most Our work is well aligned to our sponsors’ priorities and needs We have loyal alumni & many friends in the MHS, the PHS, and other federal agencies 18

We Also Have a Top-Tier Board Ronald Blanck, DO (Chair) Chairman and Partner, Martin, Blanck, and Associates Otis Brawley, MD Chief Medical Officer, American Cancer Society Sheila Burke Senior Public Policy Advisor at Baker Donelson, former COS to Bob Dole Haile Debas, MD Executive Director of Global Health Sciences at UCSF Ronald Griffith, GEN (Ret) Serves on Board of Visitors at the Virginia Military Institute Michael M E Johns, MD Past Chancellor Emory University and Dean at Johns Hopkins Kenneth Moritsugu, MD Former Dep. SG, Vice President Global Strategic Affairs of Life Sciences, Inc. Gail Wilensky, PhD Economist and Senior Fellow at Project HOPE, former HCFA Administrator 19

We Also Have a Top-Tier Board Ronald Blanck, DO (Chair) Chairman and Partner, Martin, Blanck, and Associates Otis Brawley, MD Chief Medical Officer, American Cancer Society Sheila Burke Senior Public Policy Advisor at Baker Donelson, former COS to Bob Dole Haile Debas, MD Executive Director of Global Health Sciences at UCSF Ronald Griffith, GEN (Ret) Serves on Board of Visitors at the Virginia Military Institute Michael M E Johns, MD Past Chancellor Emory University and Dean at Johns Hopkins Kenneth Moritsugu, MD Former Dep. SG, Vice President Global Strategic Affairs of Life Sciences, Inc. Gail Wilensky, PhD Economist and Senior Fellow at Project HOPE, former HCFA Administrator 20 Plus the ASD(HA) & the 4 Surgeons General

Opportunities We have access to mechanisms and sources of funding that are largely out of reach of other medical schools We offer a great deal to students We have a compelling mission, and equally compelling stories The MHS needs what we produce – outstanding graduates, discoveries, capabilities & ideas 21

Threats A bad report from the LCME Our MTFs lose too many patients Congress eliminates the CDMRP The MHS is sharply downsized We’re targeted by a future BRAC The DoD severely cuts our budget, or decides that we are irrelevant to its mission 22

Priorities People Programs Purpose 23

People Curriculum reform Sustainability, coordination & resources The LCME Time to prepare! Diversity We can and will do better Respect We need to take a hard look at ourselves & each other Leadership Our job is to train the future leaders of the MHS 24

People Overcome constraints People, resources & programs Promote excellence Engagement & impact Encourage collaboration Between investigators, departments and institutions Enhance diversity It will make us stronger and better Build for a brighter future We’re in this for the long haul 25

Programs The DoD is our #1 client (11/53/290) Ask not what WRB can do for you; ask what you can do for WRB Our off-campus faculty and MTFs matter; we are America’s medical school Global health is a national security issue. Are we ready to play an important role? The MHS needs high value discoveries & innovation. We can provide them 26

Programs The Line is our #1 priority We need to build our brand w/ key groups and individuals We must strengthen our ties w/ current funders, cultivate new ones and devise new mechanisms of support We have opportunities to forge strategic alliances inside and outside the MHS We will tackle problems that matter 27

Purpose Our business is saving: 1.Lives - Through our teaching, practice & high-impact research 2.Function – Through HPO, expert medical and surgical care, neurological & behavioral science & expert rehabilitation 3.Dollars – In addition to becoming better stewards of our own resources, we can help the MHS become more efficient and effective 28

2014 MHS Pillars 1.Modernize infrastructure – governance, technology, innovation, PCMHs 2.Medical capabilities – training, career development 3.Rebalance force structure – human capital 4.Develop strategic partnerships – w/ agencies and academic institutions 5.Benefit reform – tied to benefit commission 6.Global health engagement – Whole of gvt 29

From “Good” to “Great” 30 1.Level 5 Leadership 2.First Who…Then What 3.Confront the Brutal Facts (Yet Never Lose Faith) 4.The “Hedgehog Concept” 5.A Culture of Discipline 6.Technology Accelerators

The “Hedgehog Concept” “The Fox knows many things, but the hedgehog knows one big thing” Foxes pursue many ends at the same time and see the world in its complexity. They are “scattered or diffused, moving on many levels” Hedgehogs embrace a basic principle or concept that unifies and guides everything - Jim Collins, Good to Great, Harper Collins, 2001

32 Collins’ “Three Circles”

33 Our Mission “[USU serves] the uniformed services and the Nation as an outstanding academic health sciences center with a worldwide perspective for education, research, service and consultation; we are unique in relating these activities to military medicine, disaster medicine, and military medical readiness.” - Source: USUHS Mission Statement

34 Our Mission “[USU serves] the uniformed services and the Nation as an outstanding academic health sciences center with a worldwide perspective for education, research, service and consultation; we are unique in relating these activities to military medicine, disaster medicine, and military medical readiness.” - Source: USUHS Mission Statement

The Bottom Line To ensure a bright future, we must: Support the Line, and the MHS Set & enforce high standards for ourselves and our trainees Boost our visibility & reputation Cultivate new sources of support Wisely manage our resources Tackle high-impact issues & ideas 35

36 “[USU] is the nation's federal health sciences university…committed to excellence in military medicine and public health during peace and war.” “America’s Medical School”

37 “We are the nation's federal health sciences university…committed to excellence in military medicine and public health during peace and war.” “America’s Medical School”

Last Decade’s Challenge J Trauma Vo.l 25 no. 2 August Supplement 2013

This Decade’s Challenge

Questions? 41