|“I want Columbia to be recognized as the very best institution for learning and discovery in medicine and as a mecca for students, scholars, staff, and patients from this country and abroad.”
That is what I said in early 2001, when I arrived at Columbia, and that is what I believe today. “Medicine” is used here in the broadest sense to imply the understanding, diagnosis, treatment, and prevention of human disorders, a definition that embraces the schools of medicine, nursing, public health, and dental medicine, and the graduate school. I have emerged from my tenure as Dean of the Faculty of Medicine and EVP for Health and Biomedical Sciences more convinced than ever that there is “grandeur in this view of life” at Columbia but with a deeper appreciation of the diversity of interests, the complexities of the problems, and the challenges posed by even the most obvious, seemingly simple, solutions.
A Strategic Plan
In 2001, the medical center boasted several islands of excellence, but there was little attempt at coordinated planning among departments or across schools. I initiated a strategic planning process soon after I arrived that involved more than 200 faculty and staff from all four schools and the graduate programs. Recommendations that resulted from this effort provided a strong foundation for the future of this medical center.
Beyond specific recommendations, the planning process itself led to a culture of unprecedented participation, transparency, and shared responsibility. This new attitude is evident in current approaches to recruitment, space planning, finances, and departmental reviews. I am proud to have played a part in this evolution and I am convinced that it will serve us well as we face new pressures from within and outside the medical center. Progress has been made on many of the key recommendations. Here is a brief description of some of the accomplishments
Several advances have been made in genomic sciences. We are poised to move to the forefront of this field with
What Others Say
Timothy A. Pedley, chairman, Department of Neurology:
I believe that Gerry Fischbach has left a legacy that will be of increasing significance with the passage of time. He made a major contribution to Columbia’s stem cell initiative, especially in relation to neural stem cells, by helping identify key early recruits and raising the necessary private funds to support the first years of the program. And he has spoken out repeatedly to counter the misinformation and misguided political policies that are costing the United States dearly in terms of its previously unchallenged front rank position in biomedical science. He also is a wonderful person, simply one of the finest and most decent people I have ever worked with.
David Hirsh, executive vice president for research, Columbia University:
Gerry Fischbach instilled a sense of the values of high quality intellectual scholarship as the fundamental underpinning for all of health sciences. He brought to us the highest standards of fairness, kindness, and decency in our interactions and communications. Columbia’s values and achievements for decades to come will be the direct beneficiaries of this legacy.
David Brenner, chairman, Department of Medicine:
Gerry Fischbach was the main reason that I came to Columbia and it was an honor to work with him for the past three years. He is truly a gentleman and a scholar. Although I, of course, am biased, I also think he is a great judge of science and leadership and an outstanding recruiter. I look forward to working with him for many years.
Richard U. Levine, president and CEO, Columbia Faculty Practice Organization:
Gerry Fischbach took over as dean of our medical school at a time when the practice of medicine was undergoing radical and rapid change. He appointed the first dean for clinical affairs and recognized that we needed a Faculty Practice Organization more responsive to the clinical faculty. The needed reorganization of our FPO came about because of his mandate.
Shearwood J. McClelland’74, president, P&S Alumni Association, 2002-2004:
During his five-year tenure at the helm of P&S, Dean Fischbach was able to recruit, from both within and outside of P&S, superbly talented men and women to fill critical deanship and department chair positions. Moreover, he spearheaded and presided over visionary academic, research, diversity, and fund-raising initiatives that will continue to enhance the mission and reputation of P&S for many years to come. And there is no better evidence of his ongoing personal commitment to P&S than his decision, as dean emeritus, to remain actively engaged in neuroscience research as a member of our academic family.
Bob Kelly, senior vice president and COO, New York-Presbyterian Hospital:
Many leaders are ineffective because they are unwilling to display any sign of vulnerability; Gerry has shown us that people will respond to someone who can display humanity. There is no question that he has made the medical center a kinder and gentler place and that this behavior will last long after he has stepped down.
Martha Welch’71, president, P&S Alumni Association, 2001-2002:
As president of the P&S Alumni Association in 2001, I had the great pleasure of welcoming Gerry as our new dean when he and Ruth trekked all the way to Maine for a regional alumni meeting. This demonstration of commitment to the alumni has been amply demonstrated throughout his five-year tenure as dean. At his last and warmly received address to the Alumni Council in January, Gerry presented the inspiring vision for P&S that he has fostered. His belief that any group’s well-being depends on the well-being of all engendered a sense of community that will stand the new dean in good stead.
Herbert Pardes, CEO, New York-Presbyterian Hospital:
Gerry brought an informed and passionate intensity to strengthen the highest quality of science at Columbia University Medical Center. He has worked with Lee Bollinger to generate momentum for an exciting development at Manhattanville to house some of the university’s strongest scholarly areas. He has brought a taste for quality in science which reinforces the strong and pervasive commitment of the medical center always to seek excellence. He will be remembered for his particular emphasis on brain science, for his commitment to stem cell research, and for advocacy to change the restrictive policies that inhibit our ability to fully use the stem cell opportunity in a constructive way.
Roy Vagelos’54, chairman, CUMC Board of Visitors:
Gerry Fischbach is a warm and wonderful person whose expertise and accomplishments in neuroscience defined his career before assuming the leadership of CUMC. While he brought many endowed professorships and built many programs at the medical center during his tenure as EVP/Dean, his legacy will certainly be the planning and setting in motion several new programs in studies of the nervous system and especially the mind, brain, and behavior program that will be built as the initial science building in Manhattanville, the exciting new campus of Columbia University.
David Kahn, vice chair, Executive Committee, Columbia Faculty Practice Organization:
Gerry Fischbach’s crucial legacy to clinical practice at Columbia will be our evolution from an association of departments and central services that operate as isolated silos into an integrated, physician-led multispecialty program. He set this in motion by empowering the Faculty Practice Organization to manage the clinical practice as a coordinated enterprise, with a guiding philosophy that in an academic medical center the success of any one group is enhanced by the success of us all. As a result, it will be easier for patients to find high quality care, especially for complex illnesses, and doctors will have a more satisfying environment in which to practice and teach.
Robert S. Kass, chairman, Department of Pharmacology:
Gerry Fischbach facilitated many major changes that will have lasting impact on the medical center. One example: an office of postdoctoral affairs was established to meet the needs of a critically important, but long ignored, group both at the medical center and at the Morningside campus. Through his leadership, the chairs of both the basic science and clinical departments have become much more invested with information and decision-making that impacts not only individual departments but governance of the medical center as a whole.
Eric Kandel, University Professor and Nobel Laureate:
When the history of this period of P&S is written, we will look back on Gerry Fischbach’s remarkable contributions, while dean, as having changed the intellectual landscape of the medical school. Gerry has brought a fresh vision of academic excellence to bear upon the uptown campus and carried this vision forward in a series of outstanding appointments six new department chairs and nine new directors of institutes and centers. The intellectual plateau we now hold could not have been achieved without Gerald Fischbach. In addition to his remarkable scientific vision, Gerry brought to bear on all the activities of the medical center his deep sense of integrity, compassion, and insight a set of values that we all have learned to cherish in him.
Eric Rose, chairman, Department of Surgery:
Gerry Fischbach’s tenure generated a renewal of academic values, a master plan for the medical center campus that serves as a benchmark for the coming decades, and a series of spectacular recruitments. The vision he has developed for the institution requires little modification and aggressive implementation effort.
Monjri Shah, 2005 P&S graduate:
From the beginning, Dr. Fischbach was a champion for change. He encouraged students to come up with creative solutions to the problems they saw at P&S and, with Kevin Kirby’s assistance, brought those solutions to fruition. From a yearbook to an international travel scholarship, Dr. Fischbach’s legacy will endure at P&S.
Herman “Denny” Farrell, New York State Assemblyman, 71st District:
It has been a pleasure getting to know and work with Dean Fischbach. We all know he is a great scientist and teacher, but he also understands the importance of being involved in public policy and engaging the surrounding community. During his tenure, relations between CUMC and the surrounding areas have been very good and I am grateful for all the wonderful things the medical center does for the people of Northern Manhattan. I wish him all the best.
Mary D’Alton, chair, Department of Obstetrics and Gynecology: I’ve felt honored to be among Gerry Fischbach’s appointments here. His goals for our medical center have been only the highest, and he has tried to effect them with humanism and decency. As a chair, I have particularly valued his trust and support of significant decisions affecting the evolution of the department’s academic growth. His impetus to strengthen our faculty practice will be felt for years to come.
Steven Shea, vice dean:
Gerry’s contributions go way beyond all of the tangible accomplishments. He set a standard for scientific excellence, personal integrity, and commitment to the institution.
Len Tow, donor to P&S:
During his tenure as dean, Gerry successfully worked to reshape and refocus P&S into a cutting edge, 21st century institution positioned to capitalize on its strengths and its relationship to Columbia University.
An important step in that direction was the University’s adoption of Gerry’s plan to create the Columbia University Mind, Brain, and Behavior Initiative that combines P&S world-class strengths in neurological sciences with Columbia’s outstanding biological sciences.
major recruits and new programs. The Sulzberger Genome Center was reorganized with Jim Rothman as the new director, and it has been recognized by the NIH as a Center of Excellence in Genomic Science. Jim will use novel, cell-based assays and chemical libraries to identify new therapeutic targets and to analyze gene networks. Advances also have been made in the area of proteomics. The New York Consortium on Membrane Protein Structure, led by Wayne Hendrickson, is part of the NIH’s Protein Structure Initiative. Columbia researchers are participating in three of the 10 new centers established through the PSI.
Mathematics will play a key role in analyzing gene expression, protein structure, and other complex systems. Columbia’s great strength in this area was brought together in a new Center for Computational Biology and Bioinformatics (C2B2), directed by Andrea Califano and Barry Honig. C2B2 hosts MAGNet, one of the NIH’s National Centers for Multi-Scale Analysis of Genetic and Cellular Networks.
This new emphasis on chemical genomics, proteomics, and computational biology together with a new Center for Human Genetics (Angela Christiano, director), a new Human Genetics Resources Core (Richard Mayeux, director), and the appointment of a new chair of the Department of Genetics and Development (Gerard Karsenty) have placed us in the forefront of genome science and genetic medicine.
Advances have been made in
. Richard Vallee brought a strong program in molecular motors to the Department of Pathology. A Stem Cell Consortium has been formed that now numbers more than 30 labs studying adult and embryonic stem cells from nearly all organ systems. The Berrie Cellular Therapy Program, established with a $12 million gift from the Berrie Foundation, is directed toward replacement of pancreatic beta cells and a better understanding of type I diabetes. Other gifts totaling about $10 million have stimulated neural and cardiac stem cell research. Immunobiology in general and autoimmunity in particular was strengthened with the recruitment of Betty Diamond in the Departments of Medicine and Microbiology.
Cancer cell biology was enhanced with the appointment of Riccardo Dalla-Favera as director of the Herbert Irving Comprehensive Cancer Center. His leadership in cancer cell and molecular biology is recognized throughout the country. The new Irving Cancer Research Center building will bring together cancer researchers from different departments and allow recruitment of new investigators in several areas of cancer biology that will have a great impact on preclinical and clinical departments. Riccardo’s vision extends beyond basic research. His aim is to emphasize all components of our comprehensive center by strengthening medical oncology, public health, clinical trials, and cancer education as well as fundamental cancer biology.
, one of Columbia’s greatest strengths, was enhanced with new appointments in developmental neuroscience (physiology, pathology, and neurology), in neuro-oncology (neurology), and in schizophrenia research (psychiatry). Columbia’s Center for Neuroscience Initiatives (CNI) was created to coordinate efforts of the several existing neuroscience centers and programs and to emphasize links among fundamental science, translational research, and the delivery of patient care. The Center for Motor Neuron Biology and Disease is the first example of such a cross-cutting theme. Chris Henderson was recruited to direct the MNC along with Darryl DeVivo and Serge Przedborski. The MNC is responding to challenge grants of up to $30 million in the areas of ALS and SMA.
The CNI played an important role in the evolution of the Mind, Brain, and Behavior (MBB) Initiative. This exciting concept was a key component of the vision that led to the Dawn Greene gift of more than $200 million for the Greene Science Center in Manhattanville. Indeed, the Greene gift and the MBB Initiative will play a significant role in advancing the entire Manhattanville agenda.
The Gatsby Initiative in Brain Circuitry was founded with a grant of $5 million. We also established the Center for Theoretical Neuroscience, led by Larry Abbott and Ken Miller, outstanding theorists The Kavli Institute for the study of neural circuits was established through a pledge of $7.5 million with Eric Kandel as the founding director. An Integrated Imaging Center that includes fMRI, PET, and light microscopic facilities was established with an $11 million grant from the New York State Office of Science, Technology and Academic Research (NYSTAR). The initial NYSTAR grant has been more than doubled with support from industry, NIH grants, and private donations.
A new Department of Neurobiology and Behavior is in the works. The new department will give greater visibility and coherence to the neuroscience community and it will give this group a more direct voice in the management of the affairs of the medical center. The new department will provide a home for many of the new recruits interested in neural circuits and behavior.
was enhanced with the recruitment of Jeff Moses and Marty Leon and their team of interventional cardiologists. Thomas Pickering was recruited to create a new focus in hypertension. A group headed by Andy Marks and Allan Tall is now planning a Cardiovascular Research Institute that will capitalize on our great strength in molecular cardiology.
Several department chairs
appointed over the past five years, all of whom have extraordinary science credentials and clear views of academic medicine: David Brenner (medicine), Mary D’Alton (ob/gyn), Andy Marks (physiology), Jeff Lieberman (psychiatry and director of the New York State Psychiatric Institute), Gerard Karsenty (genetics and development), and Mitch Benson (urology). Each of the chairs has made several important new appointments. Searches are under way for chairs for biochemistry, microbiology, and radiation oncology.
A Task Force on Research Infrastructure
led to urgently needed reforms. The number of IRBs at CUMC expanded from one to four, as regulations tightened and the volume of applications increased. George Gasparis, recruited from the federal Department of Health and Human Services, has improved the administration of the IRB. He also has provided a valuable education program for faculty, students, and staff that has helped us conduct human subject research with the highest ethical standards and at a high level of efficiency. Jane Tsambis has brought great experience and expertise to Grants and Contracts, and Eileen Leech has expanded our efforts in the Clinical Trials Office. Thomas Martin was recruited to lead our Institute of Comparative Medicine and he has enhanced our already high standards of animal care across the entire university.
A new Center for Bioethics
, under the direction of Ruth Fischbach, has provided invaluable service to members of the university and hospital communities regarding the ethical conduct of research, including complex issues related to conflict of interest, human subjects research, reproductive ethics (including stem cell biology), privacy, and issues at the end of life. The center has organized a number of new courses for medical students, graduate students, undergraduates, and postgraduates.
The Education Strategic Planning Committee was charged with examining issues that affect all schools and the 3,300 students at CUMC. They recommended better recognition of superb teachers, removing barriers to collaboration across schools, and providing support for teaching and teaching assessment. The Glenda Garvey
|The photos, dated from 2001 to 2006, depict Gerald Fischbach in activities that marked his tenure as EVP and dean.
was established with the goals of recognizing and promoting scholarship in education. Harvard and UCSF have similar academies, but Columbia is the first to bring together educators in medicine, public health, nursing, dental medicine, and graduate programs. Tom Garrett was appointed the first director and the first 12 members were named last year. Compensation for teaching, promotion based on teaching excellence, and appropriate titles for educators are all under discussion.
Based on the recommendations of a follow-up Task Force on Education Infrastructure
classroom computer facilities were upgraded, and elegant study and relaxation spaces were built in the P&S building, the library, and Bard Hall totaling about 8,000 square feet.
Lisa Mellman was selected to succeed Linda Lewis as Dean for Student Affairs at P&S, and Hilda Hutcherson was appointed as the first Dean for Diversity and Minority Affairs. Both have had an enormous impact on student life. Dr. Hutcherson, through a strenuous outreach program, helped increase the number of underrepresented minorities in the P&S class to a high of 23 percent in 2004. A group of five student advisory deans at P&S has started to communicate in more detail and on a more personal level with students in all four years. An Education Council
(Sarah Cook, chair) with members from each school is implementing a “one stop shopping” approach for logistical support, assessment, and introduction of new technologies.
Each school initiated a thorough review of its curriculum
. Most importantly, areas of interaction among the schools will be examined. At P&S, the Curriculum Evaluation Committee, under the direction of Ron Drusin, is examining the possibility of creating “tracks” within the four-year curriculum.
The School of Nursing, under the leadership of Dean Mary Mundinger, conceived, planned, and introduced a new degree, the Doctor of Nursing Practice
(DrNP). This degree, the first in the nation, will recognize the expanding role of advanced practice nurses and will help meet a growing need for primary care/family medicine practitioners. Risa Granick, recruited as director of the physical therapy program, implemented a new doctor of physical therapy degree that immediately increased enrollment.
Jeanine D’Armiento was appointed to a new position as dean for gender equity, reinforcing our commitment to excellence and diversity among our students and faculty.
The Clinical Affairs Planning group called for appointment of a Dean for Clinical Affairs. Joe Tenenbaum was the first incumbent followed by Steve Shea. Both physicians brought extraordinary skills and dedication to addressing issues related to the quality of patient care, the finances of faculty practice, clinical research, the clinical departments, and hospital affiliations.
I appointed a Faculty Practice Task Force nearly two years ago with the hope of strengthening the FPO and encouraging formation of a more integrated faculty practice plan. The goals are straightforward: to enhance the experience of patients at CUMC; to improve the quality of care; to facilitate the practice of medicine; to better support our academic missions; and to improve the financial and professional security of our talented physicians. The task force, chaired by David Brenner and Eric Rose, met throughout the year, made site visits to five peer institutions, and oversaw a detailed financial review of our faculty practice. By unanimous vote of the FPO governing board, task force members became the Executive Committee of the FPO with Richard Levine as chairman and David Kahn as vice chairman. At this time, the group is focused on information systems, consensus building, financial management, and governance. The need for an Ambulatory Care Center (ACC), recognized early in our campus planning effort, has been adopted as a major goal by the FPO as well as the clinical chairs.
Hospital affiliations were reviewed and strengthened. NYPH is our principal partner, and regular meetings provide a forum for discussion of areas of mutual concern such as information technology, clinical trials, quality of patient care, joint recruitments, house staff training, and our many financial transactions. The St. Luke’s-Roosevelt affiliation agreement was renegotiated for the first time in 29 years. Harlem Hospital, another long-standing affiliate of P&S, is an invaluable partner in our efforts at medical education. In my view, these affiliations should be strengthened and new ones that would enhance our education and research goals should be sought.
A Campus Plan
It was evident from the start that we needed space for research, space for education, and space for patient care. The academic planning effort was accompanied by a detailed Campus Planning and Development Study undertaken in collaboration with NYPH. This effort included an evaluation of existing buildings, potential building sites within the medical center campus, and potential acquisitions within a 20-block radius of the campus. The analysis showed that we have room to grow in Washington Heights, an extraordinary and encouraging conclusion at an urban medical center. Our NIH grant support has increased each year and we are among the national leaders in NIH dollars per square foot of research space. However, we have fallen behind some of our peers in total NIH support because we have not grown at the same rate. Without some relief, the lack of swing space will prevent us from capitalizing on new research opportunities and it will limit our recruitment. We must build a modern ambulatory care center. With unrelenting pressure to reduce the length of stay of hospital patients, ambulatory care has become the future of modern medicine and much of medical education. We also need a new building dedicated to education. Our students are among the finest in the land yet we lack modern facilities including increasingly important simulation technologies and computer-assisted learning paradigms.
A Capital Campaign
An enormous amount of money must be raised to realize even a fraction of our ambitious plans. As priorities were translated into a development plan, it became clear that they called for a campaign to raise $1 billion. About equal amounts are earmarked for research, education, and patient care. We are ahead of our seven-year plan with more than $550 million raised or pledged in less than three years. The gifts support 25 new endowed chairs throughout CUMC, including eight in preclinical departments. To my knowledge, this is the first campaign at the medical center that involves fund raising for goals that transcend one individual, one group, or one department. This certainly has enhanced our sense of common purpose.
The past five years have brought a deeper understanding of our vision for the medical center’s missions and challenges on the part of the Board of Trustees, particularly those who serve on the Health Sciences Committee. Presentations by the faculty and staff have made these meetings among the most memorable and productive of my time at Columbia.
A new Board of Visitors was created to provide advice and to aid in the Capital Campaign. Roy P. Vagelos’54 chairs the board and the capital campaign. Roy’s great expertise in academic research and in industry, coupled with his love of P&S, have been of enormous value. The board includes individuals from academia as well as distinguished members of the business community. Board members have provided valuable advice regarding each of our core missions and they have asked important questions about our growth in Washington Heights and our roles in Manhattanville. I expect that the size and the influence of this board will grow in the coming years.
Two factors led to the development of a new identity for the medical center. First, the proliferation of names and logos created a tower of Babel in which the unifying force of Columbia University was often obscured. Second, with the merger of New York Hospital and Presbyterian Hospital the name “Columbia-Presbyterian Medical Center” became obsolete. The strong concept of the Columbia University Medical Center emerged and this name has gained acceptance in a very short period of time.
None of our accomplishments would have happened without the strong leadership team that I have had the privilege to work with over the past five years. Ira Lamster, dean of the College of Dental Medicine, Allan Rosenfield, dean of the Mailman School of Public Health, and Mary Mundinger, dean of the School of Nursing, are strong leaders who helped forge a more interactive and, hence, stronger medical center. We are unique and fortunate in having all four schools on the same campus. As the practice of medicine and the breadth of medical science expand, the whole becomes far greater than the sum of its parts.
The innovations described above have occurred in a time of reduced income due to the leveling off of the NIH budget, expiration of key patents, and reductions in Medicare/managed care reimbursement. It is also a time of increased expenses associated with research and the practice of medicine. Moreover, the profound and enduring emotional impact of 9/11 cannot be overestimated. Throughout this period of time, we have continued to invest in excellent people and excellent programs. In the end it is the quality of our faculty, our students, and our staff that will allow us to overcome any and all temporary obstacles. It is what makes me optimistic about the near and long-term future.
In June Dr. Fischbach begins a sabbatical during which he will concentrate on his neuroscience research and writing. He will also serve as scientific director of the Simons Foundation Autism Project.