State of the School Address: 2017

Voice Over: We are the leaders. The visionaries. The doers. The hope givers.

The game changers. The world changers.

We are pioneers of a new era. Explorers of an ever evolving frontier.

Trailblazers of tomorrow. We are knowledge seekers, laboratory phenoms, classroom heroes.

With the support of our partners, we are the heart of a culture, the soul of a community,

and the embodiment of A Healthy Nevada.

We are the University of Nevada, Reno School of Medicine.

Our future is bright. Our future is alive. Our future is now.

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Thomas Schwenk: How can you watch this video and not feel proud of this great School of Medicine? This is an extraordinary event, extraordinary video. I love this video because it is all about you, and I am proud to be working with you at this great school of medicine.

This video is also about the future. Our future is bright. Our future is exciting. And our future is now.

The video, the redesigned fact sheet, the reel of department achievements that I hope you watched as you came in, our new venue, the score board, the banner; all details that have gone in to make this event so great are due to the great work of our Advancement and Engagement team, led by Julie Ardito. I would like Julie and the A+E team to stand so you can thank them for the great work they did here.

My thanks also to Nevada Wolf Pack Athletics for making this exceptional venue available. I think it's a stunning place to start this new phase of our medical school.

So, welcome to the School of Medicine's "State of the School Address." I'm thrilled and humbled to see how many of you have turned out for this event. To our faculty, our staff, our students, alumni, donors, campus colleagues, community partners, community faculty members, and community leaders-and to all of you who are watching online tonight and I know there are several-thank you for being with us here tonight.

We are also joined by some distinguished guests; I'd like to recognize them at this point:

• From the Nevada System of Higher Education Regent Dr. Mark Doubrava class of 1989.
• Regent Carol Del Carlo
• Regent Cathy McAdoo
• University of Nevada, Reno School of Medicine Alumni Association Vice President and Class of 1976, Dr. Joe Hollen
• Executive Director of the Washoe County Medical Society Mary Ann McCauley
• From Renown Health, CEO and President, Dr. Tony Slonim
• and right next to him, Executive Vice President and Chief Operating Officer, Sy Johnson

And I want to thank all of you who are here tonight. Each of you contributes in some way to the School's mission. And this the one chance I have every year to thank all of you for what you do.

So, thank you! Thank you for being here.

Tonight's event is different than those in the past, because we are different.

Over the course of the year, we hear about accomplishments; bits and pieces. A note in Nevada Medicine Weekly. A story in Synapse. But when you take the time to read these achievements all together, it's truly awe-inspiring. And that's what we are going to celebrate tonight.

Fans of "Ferris Buehler's Day Off" may remember the famous Matthew Broderick quote, "Life moves pretty fast. If you don't stop and look around once-in-a-while, you could miss it."

We're not taking off in a car. That's OK. Those of you that remember that scene. Our life at UNR Med moves pretty fast. Tonight is our opportunity to stop, look around, and make sure that we don't miss the phenomenal events and achievements that took place over the past year.

We have so much of which to be proud. We continue to be one of the most affordable medical schools in the nation-13th most affordable in a recent survey. We have expanded residency programs, created new clinical departments, recruited hundreds of new clinical community faculty members, welcomed several new outstanding biomedical scientists to the faculty, engaged with the community in so many areas of service, and transformed our clinical practices.

We've spent much of the past year holding important, strategic discussions about the direction of UNR Med. Those discussions start with you, and who you are and who we are.

So, who are we?

The elevator speech goes something like this.

We are the University of Nevada, Reno School of Medicine-a community-based (thank you)- a community-based medical school with a mission of excellence in education, research and service, committed to a culture of diversity and inclusion.

But can't other medical schools say essentially-if not exactly-the same thing?

We've asked ourselves that very question during our rigorous strategic planning process, to which we have received a wealth of data-driven answers. And you will hear a bit about that tonight.

But the bottom line is, we are special, we have special responsibilities, and the way we serve the state is special.

We boast nearly 50 years of tradition and history.

Yet we're an innovative, competitive, questioning academic institution.

We're small enough to search the UNR Med email directory by first name.

Yet we're growing, adding new faculty members, developing new leaders, and creating new partnerships and programs-from our Masters in Physician Assistant Studies program, to new Departments in Obstetrics Gynecology and Surgery.

We are not about staying small for the sake of staying small, or growing for the sake of growing. But we focus on excellence, we focus on quality, and we focus on the opportunities to become more complex and more diverse.

We're cohesive, and we leverage our resources for the best possible outcomes, especially now that we have an integrated northern Nevada campus. As an example, we brought communications, marketing, creative design and events under the umbrella of Advancement and Engagement to better connect with our internal community and external constituents. Alumni, donors, partners and patients all benefit from this integration. We think that this is a strategic improvement that may be unique in the country.

We are northern Nevada-based but statewide-focused. Our third and fourth year medical students have new and exciting opportunities in Reno for their clerkships and electives, but they still benefit from the tremendous legacy of teaching in Las Vegas.

We offer hands-on experience at the Student Outreach Clinic. Our first- and second-year students can now receive priceless mentoring as they work side-by-side with third-and fourth-year students now in Reno.

We boast a state-of-the-art anatomy laboratory, one of the best in the nation, and state-of-the art instructors to go with it. At the end of each school year, our first-year students plan a memorial for the donors and for their families-these donors are our students' first patients-to thank the families for the lessons learned that go far beyond anatomy. Lessons that can't be replaced by computer technology.

This school sits at a unique crossroads of community engagement and research excellence. We are perhaps the most research-intensive of the community-based schools, and the most community-based of the research-intensive schools.

One of the key issues that has come up repeatedly in these strategic planning discussions is money. Not surprising. Financial transparency is an issue. Fiscal responsibility is an issue. Long-term sustainability is an issue.

To ensure the future of our medical school, we must make sound and responsible financial decisions. The choices we make today have a direct impact on the choices we're able to make in the future-even decades from now. As the saying commonly goes, we can do anything we want, we just can't do everything we want.

Much effort has gone into reorganizing our administrative structure to integrate both academic and clinical missions. We are enhancing our infrastructure in Reno with new expert staff in finance, Human Resources, faculty compensation, facilities, research administration, information technology, and clinical operations, all under the lead of Jeremy Alltop, our new (assistant… sorry) Senior Associate Dean of Administration and Finance.

With input from many of you, guided by our strategic plan, and under Jeremy's leadership, we've undertaken a comprehensive financial analysis, led to closer alignment of types and sources of funding with expenses. The financial progress we have made in the past year has come with some level of sacrifice from each of you, and I understand that and appreciate your commitment to these changes. And challenges still remain. But the process has been invaluable in ensuring our financial health.

Many of you have asked about the debt from our statewide practice plan. We knew the debt would grow during the last fiscal year, but we ended up doing far better than expected. Rather than beginning our new era with what we projected to be a 13 million dollar or more debt, I reported to the Board of Regents last week our debt of slightly under 10 million. This is a huge accomplishment and cannot be overestimated in its importance. We can manage this debt to the University while continuing to invest in our future. And I want to make sure you hear that point clearly. We have the capacity to continue to invest and continue to grow. We will have a very detailed plan to present to the regents in December.

Thanks to support from new donors, expanded support from long-time donors, and a solid partnership with Development and Alumni Relations, we've expanded scholarships to cover over 40% of our students' tuition burden, up from 35% the prior year. This is a remarkable level of support that often goes unappreciated. It exceeds that of many, perhaps most, medical schools. It is part of the reason why USA Today ranked us as the 13th most affordable school in the country.

Our endowments, designated to support medical student scholarships and faculty teaching and research, are currently valued at nearly 43 million dollars. The investment income from this endowment is precious when it comes to recruiting and supporting best-in-class students and colleagues.

Space also plays a major role in recruitment. Through the support of the Nevada state legislature and private donors, we occupy teaching facilities, research labs and technological infrastructure valued at over 300 million dollars. Impressive, absolutely. Is it enough? No. We will work with University to develop plans for new research space and infrastructure, both clinical and biomedical, including the possibility of off-campus space and partnerships with Renown Health. I am particularly excited about having this problem… "problem"… of ensuring adequate space while we are growing. That is a good problem to have.

We continue to enjoy strong, in fact expanded, support from the Governor and legislature for our core academic programs. Last fiscal year, we expended over 37 million dollars in state funds to support teaching and research. Our total economic contribution was over 153 million, including employment of twelve hundred Nevadans. That is a 4 to 1 return on investment for the state, surely one of the best investments the state could make.

Our measure of our current success and future aspirations is continued accreditation. As Dr. Tim Baker has succinctly noted, as only Dr. Baker can, "Nothing is more important than accreditation."

We recently completed a mock site visit to prepare us for the official visit from the Liaison Committee on Medical Education, the LCME, in late October. In my opening remarks to the mock site visit team, I made the point that there could not have been a better time for this accreditation cycle. The self-study gave us a structured approach to describing our transformation, and answering the questions of who we are, where we are, and why we are.

It is a complex but exciting transformation to describe.

The LCME process has been intense to say the least, especially by those who have led it, and I'd like to recognize that leadership of Dr. Melissa Piasecki, the Executive Associate Dean; Dr. Krystle Oates, Accreditation Coordinator; and Dr. Amy Smith, Director of the Office of Continuous Institutional Assessment who I believe is watching at home online. Melissa and Krystle.

Our sustainability is not all about money. Our history of success predicts a future of success, rooted in our passion, our excellence and our commitment. This is why the state will continue to fund us; why we continue to recruit outstanding students, faculty and investigators; why our donors continue to support us; and why I am confident in our future.

But what does that success look like?

Or more accurately, who does that success look like?

Success is all about people. Our greatest asset is all of you-our clinical community faculty members, scientists, investigators, students, hospital partners, alumni, donors, faculty and staff, which is why the video is all about you.

When it comes to student success, for example, our clinical faculty members are critical. These generous individuals invite our learners into their practices. They don't do it for money or recognition (although they don't turn it down); they do it because someone did it for them. They share their expertise and experience, providing our medical students a realistic view of medical practice. They are paying it back as well as paying it forward. They were taught, and, in return, they teach.

The lofty goal in our strategic plan was to increase the number of these dedicated community faculty members from 630 to 775. We missed that by a little bit. We recruited a thousand clinical faculty members total who are committed to this institution and making a difference in the lives of our learners.

Our clinical community faculty members are a great example of the partnerships we've developed in northern Nevada. Our hospital partners are another. While medical school may begin in the classroom, it ends in the clinic and in the hospital.

It is thanks to our hospital partners that I can proudly talk about students completing all of their third-year clerkships in northern Nevada- Neurology, Internal Medicine, Family Medicine, Psychiatry, Pediatrics, and now Obstetrics and Gynecology and Surgery. The last two departments are closely linked with Renown Health, the Sierra Nevada VA Health Center, Carson Tahoe Hospital and other community health partners.

This is a good time for me to acknowledge and personally thank Dr. Tony Slonim, Dr. Doug Merrill and Mr. Sy Johnson for all they do from Renown Health to make our critical partnership so successful. Dr. Slonim and Mr. Johnson are here as you know; please thank them.

It takes committed leaders to get new clerkships up and running. I would like to highlight the contributions of one of those key players who is with us this evening, Dr. Jim Harris, who is the Surgery Clerkship Director.

Dr. Harris' contributions have brought the new, northern Nevada surgery clerkship into existence, but not just to exist-to thrive. His leadership in building this program is having a powerful, positive impact on our clerkship students. His hard work has set the stage for a new full Department of Surgery, in partnership with the VA, with new clinical and didactic teaching programs, suture and simulation labs, career advising and more.

Dr. Harris is with us tonight. Dr. Harris please stand so we can acknowledge and thank you.

We are well along in exploring roles that Dr. Harris and Dr. Lori Rawson, the Chief of Surgery at the VA, will take in leading this new department of surgery. So this is a good place for me to recognize the leadership of the VA, Lisa Howard who is the Executive Director of the VA, and Dr. Rawson herself, who could not be with us here tonight. It's important that you know how critical this partnership is, and how much this commitment has meant to me personally and to the school.

Equally exciting is the progress we are making with our Department of Obstetrics and Gynecology, thanks to funding from the State of Nevada, the leadership of Interim Chair and School of Medicine alumna, Dr. Neda Etezadi-Amoli, and, of course, our primary clinical partner, Renown Health.

The state's growth compels us to explore new ways to support that growth. Part of that support will come from keeping our medical students in state. Students who attend our medical school have a 40% likelihood of ending up here in practice. Students from out-of-state who come here for residency training have a 60% chance of staying. But if a student comes here, stays for medical school into residency training in Nevada, they have an 80% chance of staying after that. Of all the physicians practicing in northern Nevada, nearly a quarter are UNR Medical alumni. As we work with our hospital partners to increase residency opportunities, our goal is to increase the percentage of alumni who practice in northern Nevada.

This formula begins with recruiting the best and the brightest to come to UNR Med. One great example among the impressive Class of 2021 is Anita Savell.

When Anita graduated with her electrical engineering degree, she was awarded the Herz Gold Medal. The Herz Gold Medal is awarded to the University of Nevada, Reno undergraduate with the highest overall grade-point average.

So why did Anita decide to stay here for medical school? As an undergraduate, she was encouraged to take advantage of everything the University had to offer-opportunities to volunteer, to be mentored and to participate in research. Anita worked with School of Medicine investigators and researchers to write a successful grant application to the American Heart Association. Anita told us that, quote "seeing the medical school faculty and staff invest in students first hand-even an electrical engineering graduate-made me confident that UNR Med was a medical school where I could be both happy and successful." She received acceptances and scholarship offers from other medical schools. But our dedication and excellence and dedication to our students influenced her to enroll here.

Anita, please stand and be recognized.

Let's talk about Graduate Medical Education for a bit. Through our relationships with Renown Health and the VA, we have over 100 residents and fellows in our GME programs. They come to northern Nevada to train in family medicine, internal medicine, and psychiatry and behavioral sciences, and to pursue fellowship training in child and adolescent psychiatry, geriatric medicine, hospice and palliative care and primary care sports medicine.

Over a third of the UNR Med Class of 2017 chose to stay in Nevada to train. While we are proud of the students who have the opportunity to leave Reno for outstanding out-of-state residency training, we are absolutely thrilled when the right residency opportunity keeps a graduate in Nevada.

Joining a residency in northern Nevada turned out to be the right match for Sara Robertson.

After graduating from UNR Med in May, Dr. Robertson began her internal medicine residency training at Renown Health. In her words: "I always knew I wanted to practice as a physician in Reno, so it made the most sense to receive my medical education from the community in which I wanted to work. During my rotations as a medical student, I really enjoyed working with UNR Med faculty and residents, as well as our community's patients. My family and friends live in Reno, and it means a lot to me to stay here to practice and learn medicine."

Dr. Robertson is another example of recruiting the best and brightest. One way we continue to attract top students is through donor support. Dr. Robertson was a recipient of a Pennington Foundation Scholarship. Retaining promising young physicians to practice in the community is part of the Pennington Foundation's long-standing tradition for support of education and health care.

Dr. Robertson has joined us this evening, and I invite her to stand and be recognized by you as well.

A critical role and responsibility for UNR Med is to support our rural partners and campuses. We offer learners like Dr. Robertson a unique educational opportunity to learn from and contribute to our rural communities' healthcare needs. I've heard from many medical students and residents that our rural rotations had a direct impact on their choice to come here.

We are leading the expansion of rural physician and healthcare workforce development. In 2016, our Office of Statewide Initiatives, led by Dr. Evan Klass, assisted in the recruitment of 16 healthcare providers to the Nevada Health Centers, out of 24 total. Working with the Nevada Health Service Corps, we have recruited and placed 158 healthcare professionals throughout our rural communities since 1989.

One great example of how we are helping rural communities is in Elko, a medical service area of about 100,000.

Much of Elko's health care is provided by the Northeastern Nevada Regional Hospital and the Elko Clinic. UNR Med residents rotate at both the hospital and the clinic. They learn patient care in a rural setting with limited resources and specialist availability, leading to higher than usual levels of responsibility and independence.

But they learn from seasoned clinicians who enjoy the opportunity to mentor and to teach. I had the opportunity last week to actually meet and thank many of these clinical faculty members and they are extraordinary; their dedication is fabulous. Our residents explore the beautiful country around Elko and become a part of the community. A number of graduates over the years have enjoyed the experience so much that they are working in Elko on a permanent basis.

One such resident is Dr. Tanzeel Islam.

Dr. Islam had a number of rural training experiences in Pakistan. In Nevada, he immediately jumped on the opportunity to train in Elko. He enjoyed his experience so much that he decided to work full-time as a hospitalist in Elko and is about to become a permanent part of the medical community. There is no better example of the power of our training programs to serve the state.

Dr. Islam was unable to join us this evening. Should you see him, please thank him for his contributions to Elko's health care.

Anita, Dr. Robertson, Dr. Islam and all of our students, residents and fellows represent the future of UNR Med and the quality of health care in northern Nevada. They are our ambassadors and are the way much of the state knows the quality of the School of Medicine.

To continue to attract this caliber of learners requires exceptional education and world-class research.

Our biomedical scientists are some of the most heavily funded in the country. Our scientists have generated over 235 million dollars in research funding over the past decade, supporting research that is enhancing the quality of life both locally and globally, and fueling the economy.

This research has attracted private investment and generated two Reno-based startup companies. Our biomedical scientists are internationally recognized in the fields of infectious disease, reproductive endocrinology, muscular dystrophy, gastrointestinal disease, cardiac physiology, neurosciences, and much more.

We have been particularly successful this year in recruiting another outstanding group of early- and mid-career scientists who discovered the personal and professional satisfactions of living in Reno and working at the School of Medicine.

Among the new investigators in the Department of Pharmacology are Drs. Peter and Takako Jones, a husband and wife team who are international experts on facioscapulohumeral dystrophy-FSHD. Dr. Peter Jones has been appointed to the Mick Hitchcock, Ph.D. Endowed Chair in Medical Biochemistry, an extraordinary honor. Peter and Takako have joined forces with Dr. Dean Burkin and his team of muscular dystrophy experts to explore new treatments for various muscular dystrophy, some of which will come to clinical trials soon, and will be attractive to the pharmaceutical industry.

Three new faculty members in Microbiology and Immunology, Drs. Cyprian Rossetto, Paul Brett and Mary Burtnick, are bringing substantial grant funding to study viral and bacterial pathogenesis, develop new diagnostic tests and new approaches to vaccines, with the potential to save thousands of lives.

Other grants in Microbiology and Immunology are supporting research on the Zika virus, led by Dr. Verma, and the Ebola virus, led by Dr. AuCoin. Drs. Tom Kozel and Amanda Burnham-Marusich are developing a point-of-care test for whooping cough.

And then there's Physiology and Cell Biology, one of the top-ranked departments and scientific teams in the country.

Dr. Kent Sanders and his team have secured NIH funding that ranks them 4th, I repeat 4th, in the nation for NIH funding, a remarkable achievement ahead of schools like UCSF, Penn, Hopkins, Yale, and UCLA. Dr. Sanders himself is ranked 8th in the U.S. for research funding among academic investigators in physiology.

We are fortunate to boast a facilitative and collaborative research environment-an environment in which undergraduate, graduate and medical students and postdoctoral fellows thrive. One example of such a student is Anita Savell, whom you have already met. The postdoc fellow who assisted Anita with her successful grant application is Dr. Paulo Pires.

And here you see a picture of Dr. Pires hard at work in his lab.

Dr. Pires is an outstanding young investigator in Dr. Scott Early's lab. His ground-breaking research investigates the role of ion channels and cell-surface receptors in the regulation of cerebral blood flow and neurovascular coupling. These discoveries may one day lead to the development of new therapies to treat ischemic stroke and vascular cognitive impairment. Paulo has received numerous national and international awards for his research and has published several important papers in prominent journals including the Journal of Physiology.

Dr. Pires is with us this evening. Please congratulate him for his achievements.

Science is a team sport. Here's a question that the most productive and outstanding organizations ask: "If you had to solve a complex problem, and your life depended on finding a solution, would you want to be in a room with people exactly like you, or with people different than you?"

After decades of research, we've learned that groups with diversity of race, ethnicity, gender sexual orientation and are more innovative than homogeneous groups-better at solving complex, non-routine problems.

People with diverse backgrounds bring new information. Working with individuals from different backgrounds with different life experiences forces us to be better prepared, to be comfortable with alternate viewpoints, and to anticipate that reaching a decision may take more effort, but that the outcome will be worth it.

I've spoken tonight about education, research and service-each a component of our mission. The fourth component where I will end is a commitment to an institutional culture of diversity and inclusion.

In May, we named Dr. Nicole Jacobs to the new position of Associate Dean of Diversity and Inclusion. Dr. Jacobs and her team are creating initiatives, policies and programming to promote a more diverse and inclusive climate at UNR Med, a climate that will enhance the working environment for all.

Dr. Will Torres, Assistant Dean of Admissions, Outreach and Inclusion, is working with Dr. Cherie Singer and Student Affairs to increase the diversity of our medical students. Two-thirds of our incoming class this year speak two or more languages. One third are first generation students. And for the first time, in a long time possibly forever, women outnumber men in the entering class.

Working with the Office of Recruitment and the Office for Faculty Development, we've launched an important program of implicit bias training to facilitate the recruitment and retention of diverse faculty in our mission-based diversity groups: African-American, Latino, rural, women and first generation or educationally underserved students and faculty. This work is particularly exciting because much of it is being adopted by the wider University.

The Office of Diversity and Inclusion started Diversity Dialogues, a monthly discussion forum in which everyone at UNR Med can communicate, be heard, and engage with the complex landscape of diversity and inclusion. Diversity Dialogues are held over the lunch hour and are open to all faculty, staff, residents and students. In addition, there are opportunities for faculty and staff to get involved with our diversity-based student interest groups.

There are many ways to contribute to the culture and climate of UNR Med. I would encourage all of you to get involved in these opportunities.

You've heard just a handful of stories tonight, but there are so many of you doing so many extraordinary things-and making a difference-at the School of Medicine.

And that's why our future is now. Here. With all of you.

We're a complex, living organism made of faculty and staff members, students, community faculty members and leaders, hospital partners, alumni, and donors.

With each student we recruit, each class that graduates, each new community faculty member who joins us, and each new partnership negotiated. With each paper that's published, each grant that's funded, each new discovery made. With each patient who benefits from our care, each family who is supported and consoled. We're getting better all the time.

It can be easy for us to get distracted with metrics, graphs, and surveys, with spreadsheets and balance sheets-all of which are important but none of which tell a story. Working together, engaging with each other and meeting our mission and vision-that's what's important. That's where we find the stories that describe who we are-our successes, our achievements, our contributions.

Who we are is the cumulative impact of what all of you do every day.

During next year's State of the School, we will be a few months into our 50th Anniversary celebration. I look forward to commemorating 50 years of excellence, 50 years of success, and 50 years of tradition with you.

You are UNR Med. Together we make UNR Med the exceptional school that it is.

Thank you all for coming together tonight to celebrate our extraordinary year.