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 "Something there is that doesn’t love a wall,” Robert Frost wrote. Something there is, indeed, in medical science and health care, that doesn’t love walls—and isn’t well served by too many of them. For too long, artificial walls based on discipline, on division, on school, and on mission have separated fine scientific and medical minds at institutions like Columbia P&S. What we have achieved within these divisions is extraordinary, but what we might achieve in a more collaborative setting is truly inspiring. Collaboration is the course on which science is set and the direction in which medicine is moving. We are building a new paradigm of progress through partnerships. Old walls are becoming ever more porous. Molecular biology, for example, is no longer constrained within one department—anatomists and physiologists are using the same tools. Neurologists team up with cell biologists to trace the origins of Alzheimer’s disease and other neurodegenerative disorders. The development of genome science is inevitably linked to both biology and technology. Genome science will develop through the contributions of multiple disciplines and will likely draw upon talent from academia and industry. Throughout medicine, the very questions we ask are converging, defying the predefined barriers of the classic “academic medical center” discipline structure. Just as traditional disciplines are coming together in new collaborations, so too are the long-accepted “mission” silos of academic medicine moving beyond historic divisions. How do we separate teaching from research, or research from clinical care? Why, for example, should a clinical specialist in diabetes, doing translational research with patients in the clinic, be separated from a Ph.D. researcher in biochemistry working on diabetes-related research in animal models? Medical schools and teaching hospitals need not view or pursue these missions in isolation but as an integrated whole that pursues shared goals jointly. This is paramount if we are to succeed in our societal charge of easing the burden of human disease. The College of Physicians & Surgeons began moving in this direction several years ago. Our most significant courses for first- and second-year medical students are interdepartmental in nature. For example, rather than studying cell biology, biochemistry, histology, and physiology in separate chunks, students learn about these and other disciplines as an integrated whole in “Science Basic to the Practice of Medicine.” This groundbreaking approach to the foundations of medical education first envisioned 10 years ago is co-directed by a clinician and a basic scientist with participation by more than 60 faculty members from 19 basic science and clinical departments. But more must be done. Our new strategic plan identifies areas in which Columbia P&S can make this new vision of integration and collaboration a reality. Through interdisciplinary endeavors united under the auspices of new centers and institutes, as well as informal collaborations among divisions and departments, we will bring systems together to enable us to be more creative as scientists, clinicians, and educators. A 21st century space plan seeks to literally put these great minds closer together. Members of our new leadership team were hand picked for their unique capabilities to help us achieve this new, integrated approach. Dr. Harvey Colten, the new vice president for translational research, is charged with developing our research program into a seamless bench-to-bedside flow. Dr. Joanna Rubinstein, associate dean for institutional affairs, who joined us from Sweden’s renowned Karolinska Institute, will expand and enhance Columbia’s international reach with new global partnerships in research and patient care. Kevin Kirby, vice president for administration in the Health Sciences Division, directs a coordinated approach to the internal and external partnerships such as those in the growing Audubon Biomedical Science and Technology Park. At the heart of these evolutionary changes lies our mission. I refer not to the tripartite mission of teaching, research, and clinical care, but to the singular mission that informs every decision, every new building, every research grant, every curriculum enhancement: The ultimate mission of Columbia P&S, and of all academic medical centers, is to ease the burden of human disease. It is a privilege to be where we are, to pursue science and medicine in an atmosphere of vigorous intellectual inquiry. We have an obligation that goes with that privilege, to think always of translating our research and teaching so that health care is delivered in the most compassionate way possible.
Dr. Gerald Fischbach, executive vice president and dean, is a neuroscientist as well as an academic medicine administrator. He stands here in the hallway of Columbia’s NYSTAR Integrated Imaging Center, where radiologists, neurologists, neuroscientists, and bioengineers conduct high resolution imaging of functional neural circuits under normal and abnormal conditions, in both health and disease. The center, funded by the New York Science, Technology and Academic Research program, has state-of-the-art brain imaging services that will expand until the center is complete in 2004. This hallway joins two imaging centers, one for MRI, the other for functional MRI imaging. The center will combine neuroimaging technologies with Columbia’s strengths in basic and clinical neurosciences to create new ways to diagnose and treat major neurological and psychiatric diseases. | Top | |
