Johns Hopkins University: Advancing Knowledge in the 21st Century, Study notes of Medicine

Download Johns Hopkins University: Advancing Knowledge in the 21st Century and more Study notes Medicine in PDF only on Docsity! 1 A Vision for Johns Hopkins University Through the Year 2020 10 2020 x 2 We are Johns Hopkins Johns Hopkins is an extraordinary institution. We are a university of firsts. We were America’s first research university, a model emulated throughout the United States, and, more recently, around the world. Ours is the university that gave birth to modern medical education, with its synthesis of research, education and patient care. We founded the first research-based school of public health. We were a pioneer in the serious investigation of the humanities and social sciences, from the conception of the first modern classics department to Arthur Lovejoy’s founding of the history of ideas to our elite writing seminars, among the first such programs in the country. We are home to the oldest music conservatory in the United States. We forged groundbreaking interdisciplinary programs in areas such as biomedical engineering, the brain sciences, cell engineering and bioethics. We have been at the fore in bringing a systems perspective to grand challenges in areas such as health care, infrastructure, energy and the cosmos. 5 We need to build on our exceptional foundation to preserve and strengthen our great enterprise . . . for our students, for our faculty and staff, and for those we serve around the world. Our Challenges A number of serious challenges approach higher education in the coming years. None is unique to Johns Hopkins, but each could carry profound consequences for the future of our institution. • The imperative of collaboration. We no longer, if we ever did, live in a world where solutions to our most compelling challenges can be achieved entirely within one academic discipline, or even one division. Great universities will never lose the discipline of the disciplines. And yet the urgent questions of the day – healthcare delivery, global climate change, the future of our urban centers and economic destabilization, to name only a few – are not confined to intellectual silos, and neither will be the solutions we devise. What is more, the search for knowledge will often require a commitment of expertise and resources so great that a collaboration that spans institu- tions may be the only option. These trends only will be reinforced by the growing insistence on interdisciplinary cooperation expressed by external funders. • The transformative capacity of technology. Over six million college students in the United States now take at least one class online each semester, and the rate of growth for online education far exceeds that for more traditional higher education courses. Technology provides universities an unparalleled opportunity to spread knowledge and ideas to students and populations around the world. At the same time, new technologies offer the capability to enrich the traditional residential experience, reimagine pedagogy, expand research collaborations, drive institutional sustainability and forge ever stronger connections between alumni and the university. In these ways and more, technology holds the potential to transform radically the educational experience and recast the reach and mission of the modern university. • Preserving access to a college education. Our nation is facing declines in household wealth and widening disparities in income while the cost of a university education only continues to rise. College tuition and fees have risen more than 400 percent over the last three decades, and student loan debt across the country recently exceeded $1 trillion. The median list price to attend a single year of a four year private university is now roughly the same as the amount of income that a median household in the United States earns in a single year. Our university has made inroads in recent years in reducing the average net cost of attendance for Home- wood undergraduate students on financial aid, but the surging cost of higher education raises important questions about how universities will continue to provide access to the best and brightest students irrespective of their family’s financial state. 6 • Meeting student expectations in an ever-changing world. Students are arriving at universities with heightened expectations for their educational experience. Coming of age at a time when a keystroke can instantly connect them to the world, our students are demanding a university education that extends well beyond the campus walls, one that offers a greater understanding of the communities of which they are part and that marries a rigorous academic experience with rich opportunities for learning through real world application. And in an era defined by the creation and sharing of information in a knowledge-based society, our students more than ever recognize the need for building and honing their capacity for integrative thinking and creativity, for critical judgment and reasoning skills, and for effective, persuasive communication. • The globalization of higher education. Unprecedented economic expansion in the developing world is fueling a global market for higher education. This trend is a double-edged sword. There has been massive growth in the demand for tertiary education, with the percentage of students in higher education more than doubling in India and tripling in China in the last decade alone. Increasingly, these students are committed to securing an education of the highest international quality, opening the door for U.S. universities to become truly global universities, beacons of knowledge to the world. At the same time, countries such as China, Singapore and Saudi Arabia recognize the foundational importance of the research university in realizing a host of developmental goals, and are investing heavily in national universities of their own that are aimed at challenging America’s dominance in higher education. • A decline in government investment in research and clinical funding. Despite the many compelling reasons for public support for the research enterprise, fiscal pressures are jeopardizing these investments. In the last decade, the purchasing power of National Institutes of Health grant funding has declined roughly 20 percent. The federal budget sequestration and related fiscal pressures threaten billions of dollars in federal research funding. And over 40 states have cut their support on a per student basis for public research universities over the past decade, many by 30 percent or more. This retrenchment is occurring at a moment when academic medical centers can expect to see reductions in reimbursements for patient care from federal, state and private payers. The potential consequences of these trends for the academic mission are grave: declines in research, delays in career development, a decrease in students and re- search faculty, and ultimately, fewer discoveries to advance knowledge and heal the world. • Wrenching needs at home and abroad. Universities cannot be islands of privilege in a sea of pressing needs. Many American cities are working to emerge from post-industrial decline – none more so than Baltimore. The nation seeks to recover from the worst economic downturn since the Great Depression. The world faces heart-rending disparities in health, education, civil and political liberties. Colleges and universities hold the capacity to contribute so much for the betterment of the communities of which they are a part. There is a dawning recogni- tion that our institutions of higher education must harness their collective intellectual and moral strengths to heed this call as never before. 7 The Path Forward Few of the enumerated challenges are entirely new to Johns Hopkins. Indeed, several have received close and searching inspection in reports and analyses developed over the years by university task forces, symposia, trustee reports, and external reviews of schools and divisions. Through these reports – most recently, the Report of the Committee for the 21st Century (1994), the Report of the Commission on Undergraduate Education (2003) and the Framework for the Future (2009) – our community has grappled with issues ranging from the challenges of interdisciplinary research and education in a highly decentralized environment, to the rejuvenation of undergraduate education, to the effort to expand access for students through a need-blind admis- sions process. In considering our response to the many challenges ahead, we are fortunate to be able to draw on a rich and thoughtful set of insights that have been developed through collegial debate and reflection. Based on these reports and many conversations over the years with the university community, I have prepared these ten priorities for the university through the remainder of the decade. The goals seek to chart a course for the university that meets the looming challenges and captures the boundless opportunities ahead, while building on our strengths and honoring our history and traditions. Then professor and director of radiology and eventual Hopkins president Bill Brody put it well in the Report of the Committee for the 21st Century: “The vision that we have for Johns Hopkins University in the 21st century is thus not so much that of a university whose mission has changed as it is that of a university whose traditional mission is realized in new ways.” The ten goals are not watertight compartments, but are overlapping and complementary, interwoven threads that will help to shape the direction and the identity of our university, into the future. The priorities are arrayed under the three over-arching themes articulated in my inaugural address: One University, Individual Excellence, and Commitment to Our Communities. In addition, there is now a fourth thematic heading: Institution Building. The inclusion of this theme reflects the importance of marshaling the required resources, policies and institutional arrangements to support the realization of our academic mission. One such undertaking that will sit at the heart of our institution building in the coming years, and serve the priorities in the Ten by Twenty, is the $4.5 billion Rising to the Challenge campaign launched in May of this year, the largest fund- raising effort in our history. 10 1. Selectively invest in those programs and activities that will advance significantly our core academic mission. We are one of the leading research and educational institutions in the world, with elite programs in medicine and music, nursing and international affairs, biomedical engineering and public health, writing seminars and bioethics, and astrophysics and cosmology, to name a few. Our tra- dition of excellence can be traced to the founding of the university, when luminaries such as Basil Gildersleeve in classics, James Sylvester in mathematics, Ira Remsen in chemistry, Henry Rowland in physics and Henry Newell Martin in physiology taught the first generation of Johns Hopkins students, and surgeon William Halsted, pathologist William Henry Welch, internist William Osler and gynecologist Howard Atwood Kelly helped to found a world-class medical school and hospital. These scholars laid the groundwork for the manifold strengths of the university we know today. Our schools, divisions and programs are now the envy of the world. Our areas of distinction were built on a concept of “selective excellence,” an approach that connotes purposefulness, choice and discipline. We will need to remain true to these principles as our schools and divisions set our academic priorities in the coming years. To support the highest degree of rigor in our pursuit of these ideals, our decisions must be informed in the first instance by objective data and sound analysis. Over the last several years, we have taken several steps towards this goal. We have strengthened the quality of academic decision-making by developing systems to track the composition of our faculty, the profile and performance of our doctoral students and trends in our funded research. Our schools are now subject to external review, as is each of our school’s departments on a periodic basis. The information we obtain from these analyses should then inform our academic priority setting within departments and schools. And the priorities that emerge from this process should determine budgetary and organizational decisions, not the reverse. Of course, by definition, a commitment to selective excellence means that certain academic priorities will be advanced while others will be de-emphasized or not pursued at all. Predictably, there will be tension between protecting excellence in our existing programs and investing in the innovative programs of tomorrow. We will need to remain true to principles of purposefulness, choice and discipline as our schools and divisions set our academic priorities in the coming years. 11 These decisions are never easy, nor are they self-evident. Even so, we can draw guidance from certain core principles. Our lodestar at all times should be the values that rest at the heart of our enterprise: excellence, integrity, intellectual rigor, freedom of inquiry. Our mission must allow space for the many facets of the quest for knowledge, with fundamental research occurring alongside applied science, the search for meaning married to the search for solutions. And finally, we will ensure that our investments are aligned with our core academic mission if, in the best traditions of the academy, they emerge from discussions that are premised on transparent, participatory processes that allow for informed and respectful debate and deliberation. In so doing, we will honor our tradition of selective excellence and our remarkable multiplicity of strengths, while building an even stronger university that meets the challenges of the future. 12 2. Strengthen our capacity for faculty-led interdisciplinary collaboration and launch a set of innovative cross-cutting initiatives that will contribute substantially to the world of ideas and action. Johns Hopkins has long been home to profound acts of collaboration. We have championed the role of interdisciplinary cooperation as a means of solving the world’s most complex problems and fundamental questions. From Gordon “Reds” Wolman’s creation of the pioneering Department of Geography and Environmental Engineering, to contemporary initiatives such as our Berman Institute of Bioethics, the Institute for Cell Engineering and the Brain Science Institute, we have, time and again, achieved distinction through interdisciplinary collaboration. Many of our highly regarded graduate programs draw students and faculty from more than one school or depart- ment, while undergraduate interdisciplinary majors such as international studies, public health, biomedical engineering and neuroscience consistently stand among the most popular choices for our students. However, it is also true that our organizational and budgetary arrangements can impair faculty and student success in mounting interdisciplinary ventures. Our structures too often inadvertently impede the enterprising impulses of our faculty, staff and students to connect. The report of the Framework for the Future underscored this point, observing that “different sources of support, attendant responsibilities and policies have created logistical barriers to collaboration” across the university. These hurdles are only compounded by the geographic dispersion of our university across multiple campuses. To be sure, robust collaboration must be built on strong and vibrant disciplines, which are marked by shared norms and methodologies and fuel rigorous inquiry. We will never lose the “discipline of the disciplines”. And yet, if we are to honor our tradition of en- trepreneurship, we need to ensure that those disciplines can be easily permeated, that it is as easy to work across the disciplines as it is within them. Accordingly, we will systematically identify and redress the barriers that stand in the way of academic collaboration. The responsibility for creating such an institutional environment rests with the collective academic leadership of the schools and divisions. There is ample precedent for how to make collaboration work across Johns Hopkins, and our School of Education and Carey Business School will provide the capabilities and the platforms for a more diverse array of possible connec- tions across the university than ever before. The university’s relatively thin annual operating sur- plus places a premium on careful cash management to protect our liquidity and weather sudden downturns in funding. The task will be to imprint our record of collaboration in every corner of our policies and practices, from faculty appointments to tenure and promotions processes, from joint degrees to doctoral education, from research costs to teaching and laboratory spaces, from schedules and the academic calendar to the harnessing of technology to bridge our campuses and create connections among scholars that might otherwise never have formed. 15 Through the remainder of the decade, we will continue to place a premium on collaborative discovery, in areas such as genomics, pathobiology, clinical research methods, patient safety, patient self-man- agement of chronic illness, individualized health and ethics. We will forge even deeper ties among the three schools in research support, facility development, inter-professional education, innovative clini- cal program delivery, and faculty recruitment to advance the mission of an integrated academic health center. Finally, we will continue to explore partnerships with other entities across the nation and the world when doing so would advance our core academic, research and clinical priorities. 16 Build Johns Hopkins’ undergraduate experience so it stands among the top ten in the nation. Build on our legacy as America’s first research university by ensuring that at least two-thirds of our Ph.D. programs stand among the top twenty in their fields. Attract the very best faculty and staff in the world through a welcoming and inclusive environment that values performance and celebrates professional achievement. Individual Excellence 4. 5. 6. 17 4. Build Johns Hopkins’ undergraduate experience so it stands among the top ten in the nation. From our university’s founding, President Daniel Coit Gilman regarded undergraduate education as crucial to Johns Hopkins. He declared, “A university cannot thrive unless it is based upon a good collegiate system,” and he built an undergraduate program to reflect that belief. Today, it is hard to imagine a great university without a strong undergraduate program. Known for their independent spirit and enterprising intellect, our students use their time at Johns Hopkins not only to learn but to challenge, to experiment, and to push past boundaries in a range of fields and endeavors. They renew the traditions of the university and carry the ideas of the university into the world. A strong undergraduate program casts a broad halo over our entire university. Over the last decade, the university made great strides in strengthening the undergraduate experience. Our students have benefited from investments in undergraduate research and strengthened student services and support, the rising quality and diversity of our undergraduate classes, the creation of new undergraduate majors and expanded opportunities for local and international internships, and the increased availability of financial aid (including the bold and innovative Baltimore Scholars Program). These enhancements have been accompanied by transformational investments in the campus environment, student spaces (Charles Commons, Brody Learning Com- mons, the Undergraduate Teaching Labs), and academic buildings (Gilman, Hodson, Hacker- man, and Malone Halls). And yet, we can do far more to cultivate and support our next generation of scholars. Our students’ independence is a virtue to be nurtured, and we must continue to enrich and expand student opportunities for entrepreneurial exploration. At the same time, we must help to create bridges for our students beyond their own ideas, so they have a chance to be full participants in a thriving intellectual community, one that will foster connections among thes roving independent minds. We will start by drawing to our university the most talented and original students from a diversity of backgrounds, who will bring different perspectives and experiences inside and outside the classroom. At the core of this aspiration must be continued strengthening of our finan- cial aid program, so that our university’s undergraduate admissions will be made on a need-blind basis. Over the last three years, and fueled by the endorsement of the university’s trustees, we have taken important steps towards realization of this goal: Our net cost of attendance for Homewood undergraduate students who have received financial aid has decreased by 12 percent. However, there is still a marked gap in financial aid between Johns Hopkins and our peer institutions that we must redress. Our students use their time at Johns Hopkins not only to learn but to challenge, to experiment, to push past boundaries in a range of fields and endeavors. 20 6. Attract the very best faculty and staff in the world through a welcoming and inclusive environment that values performance and celebrates professional achievement. The university’s faculty and staff are the bedrock of our institution. They ground our research, teaching and service, and our tradition of excellence would not be possible without them. We must ensure that through our practices, programs and ethos we are able to recruit faculty and staff who honor the standards of our best. And we must ensure that once here, they are able to flourish: that we give them the support and opportunities for advancement such that they do not merely want to start their careers at Hopkins, but finish them here. More than any other factor, our ability to attract, invest in, and retain our faculty and staff will determine the future of the university for decades to come. Over the next ten years, retirements and philanthropy will allow us to recruit a generation of new faculty who will define our university for decades to come. Through the Rising to the Challenge campaign, we will undertake an unprecedented mission to invest in these men and women: Our goal is to nearly double the number of endowed chairs at the university over the course of the campaign. Once here, we must continue to take steps to support our faculty throughout their time at Johns Hopkins, early in their careers through mentorship and transparency of process, and later through recognition of their accomplishments. While we often ask a great deal of our faculty, they thrive and excel in an intellectual environment that is without peer, a place suffused with bold innovation and a warm generous and collegial spirit that we must nurture and protect in order to continue to attract the best and brightest minds to our community. We must also be deliberate in our efforts to attract, develop, and retain a talented and diverse workforce of engaged employees. Our objective is to cultivate a working environment with a culture of intellectual curiosity, innovation and teamwork, a place where everyone can develop professionally and make a difference. To achieve those ends, we will provide our employees those services and support necessary to ensure that a Hopkins position is conducive in every respect to growth and performance at the highest levels. As one example, we will continue to offer a struc- tured professional development process where employees can receive constructive feedback, are recognized for their contributions, and are coached in areas of concern. This development process will be complemented with rigorous training programs that help our employees develop the skills they need to respond to feedback they receive and advance their careers. 21 Finally, we affirm our uncompromising commitment to the values of diversity, respect and work-life balance, each of which is indispensable to the achievement of excellence on the part of our faculty and staff. Johns Hopkins is dedicated to guaranteeing equal opportunity for every person in our community, and the recruitment and retention of women and underrepresented minorities, including into positions of leadership. Our ongoing work in this area includes the Mosaic Initiative, our economic inclusion initiative, and our diversity innovation grants. We will create a welcome, inclusive, respectful environment that inspires our faculty and staff to achieve their personal best. And, we will continue to provide a range of programs and services that reflect the importance of achieving a healthy mix between work, personal and academic pursuits, including steps to increase the availability of high quality child care options. Each of these values is a pillar of a successful university, making it possible for all of us to perform and contribute at the level of excellence that is the hallmark of Johns Hopkins. 22 Enhance and enrich our ties to Baltimore, the nation and the world, so that Johns Hopkins becomes the exemplar of a globally engaged, urban university. Commitment To Our Communities 7. 25 Strengthen the institutional, budgetary, technological and policy frameworks necessary to set priorities, allocate resources, and realize the highest standards of academic excellence. Reinforce our position as the leading university recipient of competitively funded federal research support, while increasing the amount of annual research investment from other sources with appropriate cost recovery. Develop the resource base necessary to support investments in key academic priorities. Institution Building 8. 9. 10. 26 8. Strengthen the institutional, budgetary, technological and policy frameworks necessary to set priorities, allocate resources, and realize the highest standards of academic excellence. As an elite research university, we are pioneers in rigorous, empirically-based analysis. We must be prepared to turn that same searching eye on ourselves. As stewards of the university’s resources, we must ensure that we have the structures and processes in place to make considered decisions about its future, informed by healthy expectations, strategic planning, rigorous data and expert analysis. To meet the challenges before us and strengthen our position as one of the world’s pre- mier academic institutions, we must adhere to best practices, prioritize self-evaluation and informed decision-making, and constantly safeguard our commitments to innovation and excellence. The university has taken a number of steps toward this goal in recent years. For instance, we have begun external reviews of our schools and programs and launched a program of external departmental reviews. And following a period of comprehensive study, the Board of Trustees also recently adopted several far-reaching and bold changes in its structure and governance in order to enhance accountability, improve its performance, and better position itself to respond to the evolving challenges facing the university. One of the reforms reduced the maximum size of the Board of Trustees from 65 to 35 members; another instituted term limits for the Board members. A priority for the university and its schools and divisions in the coming years will be to create and enhance processes and mechanisms that will allow us to make informed and considered judgments about our future in uncertain times. This means, first and foremost, putting into place the capacity for data generation, aggregation and analysis that will allow us to understand our strengths and limitations and make sound strategic decisions about the future. This capacity will need to include the development of internal measures and evidence-based assessments of our education, research and service activities. In light of looming funding pressures and restraints on capital, the university is also developing an integrated decision-making process for how best to deploy its scarce capital resources across divisions in support of its core academic mission. Next, we will place a premium on open and participatory frameworks for decision-making, looking to draw broadly where possible on the perspectives and expertise of the university community. Finally, we will make certain that our decision-making and allocation of resouces is aligned with the values and commitments at the heart of our university. For instance, we will continue to make the investments needed to ensure that the digital delivery of educational content is a core competency of the university that will advance our academic mission. As another example, we will ensure that we are acting as responsible stewards of our natural resources, and incorporate principles of sustainability in planning and programs across the university in areas such as energy, building design, food choice and resource conservation. 27 9. Reinforce our position as the leading university recipient of competitively funded federal research support, while increasing the amount of annual research investment from other sources with appropriate cost recovery. Federal funding fuels our institution. It drives our research enterprise, is a magnet for graduate and post-doctoral students, supports investments in scientific infrastructure, and spurs extraordinary discovery in areas as far-ranging as the origin and fundamental laws of the universe, the workings of the brain, the design of stealth aircraft, how genes fail in cancer, and how vaccines control infection outbreaks. Johns Hopkins has ranked first in the nation in the merit-driven competition for federal research dollars for 31 years. In fiscal year 2012, we earned $2.6 billion in research and contracts funded primarily by the National Institutes of Health, the Department of Defense, the National Aeronautics and Space Administration, and the National Science Foundation. All said, more than half of our total revenue is derived from federal research funding sources. However, we are operating in a time of considerable uncertainty. Over the past decade, there has been a steady decrease in federal investment in research as measured in real dollars. Our reliance on federal funding leaves us highly vulnerable to likely further reductions in federal support for research and development. Accordingly, we will need to develop forward looking strategies that will preserve and enhance our competitiveness for federal funding streams. The Best Environment for Research and Scholarship project is an integrated cross-university initiative that seeks to lessen the administra- tive burden on researchers, make it easier for Johns Hopkins faculty to carry out research activities, and generate more support for this important work. We will also create innovate cross-disciplinary initiatives to compete more successfully for these scarce research dollars. One example is the Military and Veterans Health Institute, a cross-university initiative to integrate science, engineering and clin- ical care to improve health and wellness for our military service members, veterans and their families in partnership with the Department of Defense and the Department of Veterans Affairs. Even so, we cannot stop there. In the coming years, we will need to pursue all potential funding opportunities for our research, and strengthen our voice in conveying to funders the academic world’s critical contributions to solving the world’s most pressing problems. This will includes integrated efforts across the university to attract non-federal resources for research support, including through innovative research-based collaborations with foundations, corporations, technology accel- erators and venture funds. Our network of alumni will provide an indispensable reservoir of wisdom and guidance as we seek to forge these new partnerships and relationships. We will continue to strengthen the capacity of the university to harness the potential of our intellectual property, in- cluding through licensing, commercialization and technology development. These initiatives are vital to the mission of the university: They will bring the benefits of our discoveries to the world, while allowing us to re-invest the resulting resources into core academic priorities and the groundbreaking research of tomorrow.