Reflections from the Dean: Reaching the end of the beginning

News & Events

Affiliation aggreement signing

 Leaders from Renown Health, the Nevada System of Higher Education (NSHE) Board of Regents, University of Nevada, Reno and UNR Med converged for an affiliation agreement certificate signing on June 28, 2021. From left to right, Thomas L. Schwenk, M.D., dean, UNR Med; Laura Perkins, regent, Nevada System of Higher Education; Cathy McAdoo, chair-elect, Nevada System of Higher Education; Melody Rose, Ph.D., chancellor, Nevada System of Higher Education; Anthony D. Slonim, M.D., DrPH, FACHE, president and chief executive officer, Renown Health; Brian Sandoval, J.D., president, University of Nevada, Reno; Jim DeVolld, chair, Renown Health Board of Directors; and Joe Arrascada, regent, Nevada System of Higher Education. Photo by Brin Reynolds/UNR Med.

On Friday, June 11, the Board of Regents of the Nevada System of Higher Education gave near-unanimous approval for the University of Nevada, Reno School of Medicine to enter into a transformational affiliation with Renown Health. That agreement has now been signed by institutional leaders and is official and effective June 11, 2021.

It would be easy — and inaccurate — to declare this historic event of Regental approval as the end of this long and intense process. As Winston Churchill was quoted to say after a major victory in WWII, "Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning." However hard and demanding the process has been to this point — and it has indeed been hard and demanding — the real work begins now.

Over the coming years, this affiliation will create an integrated health center that will benefit the community and the state through the synergism of new and expanded programs in student teaching, residency and fellowship training, primary care and specialty clinical programs, and clinical research.

This affiliation opens up enormous opportunities for UNR Med to become an entirely new and different medical school. We have a long and impressive tradition of community engagement, community physician teaching and basic science research. That tradition will now be complemented by clinical and academic programs that are based in a large and thriving health system with an outstanding reputation. These are not either/or organizational structures. We can have the best of both with strong community engagement and teaching at the same time we are part of a large and thriving health system.

I was recently asked what worries me the most about this affiliation. What is the greatest threat to its success? It's clear that the success of this integration will depend almost entirely on our willingness and ability to meld two very distinct, and very different, cultures with the goal of serving the community. I think the greatest threat is to be unwilling or unable to ask the difficult questions about the partnership's implementation.

There will be dozens, perhaps hundreds, of difficult issues that will arise over time. Some have arisen already. I am very aware that some faculty and staff members have concerns about the partnership — perhaps more than concerns, perhaps resistance and deep reservation.

All I can ask is that everyone be willing to fully engage in the process of discussion, negotiation, compromise and problem-solving. It is critical that we focus on our fundamental missions, our core values and our community service at this transformational moment. This is not about us, not about how we used to do things, not about our history, and not about our traditions, however honored.

This agreement is not about our past — it is all about our future. It is a test of our ability to identify our deep commitments to our learners, to our patients, to science, to our community, and to be willing to explore new ways to meet those commitments.

So many UNR Med and Renown leaders and faculty and staff members have devoted thousands of person-hours to get us to this point. At some point, I will acknowledge more personally the work of several leaders whose expertise and dedication have meant so much to me personally and, more importantly, to the sophisticated affiliation agreement that has now been signed. Their work has created a document of enormous possibility and promise. It is now up to everyone to work toward realizing that promise.

I opened with a quotation from Churchill and will close with one from Shakespeare, which was shared with me by Dr. Mark Riddle, associate dean for clinical research:

There is a tide in the affairs of men, which taken at the flood, leads on to fortune.
Omitted, all the voyage of their life is bound in shallows and in miseries.
On such a full sea are we now afloat.
And we must take the current when it serves, or lose our ventures.

We are one of the last medical schools to create this type of health system integration. While I recognize the uncertainty many members of UNR Med may hold about the significant changes embodied in this affiliation, I want all of us to also recognize the tremendous anxiety we should all feel about not changing, about not taking advantage of the opportunities offered in this affiliation, about not taking the opportunity to create the next era of success at UNR Med.

We have succeeded admirably for 52 years with a community-based model that has served us well. We now have the opportunity to take this tide of affairs at full flood, taking the current when it serves to achieve our missions with even greater success.

Media Contact


The University of Nevada, Reno School of Medicine, Nevada's first public medical school, is a community-based, research-intensive medical school with a statewide vision for a healthy Nevada. Established in 1969, UNR Med is improving the health and well-being of all Nevadans and their communities through excellence in student education, postgraduate training and clinical care, research with local, national and global impact and a culture of diversity and inclusion.

Released: Monday July 12, 2021 @ 4:00 PM