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John Harvard's Journal

Dr. Dean

September-October 2007

Jeffrey S. Flier, M.D., becomes dean of Harvard Medical School (HMS) on September 1; President Drew Faust announced his appointment on July 11. Flier, the Reisman professor of medicine, is an expert on the molecular mechanisms involved in the production and use of insulin (fundamental to understanding diabetes) and on obesity. He succeeds neuroscientist Joseph B. Martin, who stepped down at the end of the academic year, on June 30, after a decade of service (see “Medicine Man,” January-February, page 64). In the interval, Barbara J. McNeil, M.D. ’66, Ph.D. ’72, Watts professor of health care policy and professor of radiology, served as acting dean at Faust’s request; a faculty member since 1983, McNeil founded and chairs the department of health care policy.

Photograph by Jon Chase / Harvard News Office

Jeffrey S. Flier

Faust called Flier, who joined the Harvard Medical community in 1978 (after earning his M.D. from Mount Sinai School of Medicine in New York City in 1972, training in internal medicine at Mount Sinai, and serving as a clinical associate at the National Institutes of Health for four years), “an outstanding academic leader, scientist, and medical educator.” She underscored the intersection of his “collaborative instincts” and his combination of “exceptional intelligence with an admirable ability to bring people together around issues of academic and institutional importance.” And Faust also cited Flier’s atempts to “strengthen cooperative efforts within the broader Harvard medical community [and] to pursue important new opportunities for fruitful connections with other parts of the University.”

Even more than the leaders of other Harvard schools, the HMS dean requires that blend of experience and attributes. The school educates future physicians and biomedical researchers; its faculty members do science of fundamental importance; and in pursuit of those missions, it is tightly interwoven with the affiliated hospitals, which of course face not only the financial challenges common throughout the healthcare system, but also the costs to academic medical centers of managing both clinical training and large applied research enterprises. Contemporary research raises the stakes still further, as HMS and hospital-based faculty members apply new tools—genomics, advanced imaging technologies, systems biology (the costs of which exceed what any individual laboratory can support)—and as multiple disciplines are brought to bear, for example, on the range of cancers. The multiyear leveling-off of the budget of the National Institutes of Health (the principal source of research funds) exacerbates competition for support just as the costs of biomedical science have risen significantly.

Flier has exposure to all these challenges. He has run a large research operation (in remarks to the HMS community on July 16, he cited the past and current 100-plus associates in his laboratory). He has been based at Beth Israel Deaconess Medical Center, which ranks in the top tier of affiliated hospitals in providing clinical education for HMS M.D. candidates, and during the past five years he has served as both chief academic officer and Harvard faculty dean for academic programs there. One of his early priorities will be to continue implementing HMS’s new course of study, which aims to improve medical education by having students stay with patients for an extended period, and by immersing them more deeply in modern, complex hospitals and other healthcare settings, rather than rotating them from place to place too rapidly (see “The Pulse of a New Medical Curriculum,” September-October 2006, page 64).

Beth Israel was hardest hit among the University’s principal affiliates when academic medical centers nationwide had financial problems (or in its case, crises) earlier in the decade; Paul F. Levy, then HMS executive dean for administration, moved over to the hospital as president and chief executive officer in January 2002 to perform a radical financial restructuring that by all accounts saved the institution—so Flier has some immediate sense of the affiliates’ problems and needs. Levy appointed Flier as chief academic officer during a time when the hospital’s teaching mission was severely tested.

Finally, Flier was also a member of the University Planning Committee for Science and Engineering, in which Provost Steven E. Hyman brought together Harvard schools and affiliated hospitals to investigate how to organize and fund interdisciplinary research and teaching. He then became a founding member of the implementing body for those recommendations, the Harvard University Science and Engineering Committee. That work helped acquaint Flier and other scientific leaders from across the University and beyond with each other and with the most exciting opportunities for collaborative research (see “For Science and Engineering, New Life,” March-April, page 65). The committee’s initial concrete fruits are the first multischool academic department (of developmental and regenerative biology, a formal home for research, faculty appointments, and teaching in stem-cell science and related fields), a $50-million commitment from the Corporation for start-up support, and a very large scientific research facility now in advanced stages of planning as the first new building to be constructed as part of the Allston campus.

Nor are such issues all external to HMS, at the boundaries among schools and hospitals. As President Derek Bok pointed out in his report to the community published in June (see “Managing Harvard: A New Deal?,” July-August 2007, page 62), there are significant differences of opinion within HMS about how best to conduct biomedical research and teaching in the future. Bok described how the school “has built a series of highly distinguished departments of preclinical science of which the University can be justly proud,” but added that “few of the preclinical scientists teach medical students and…many of them do research that is more closely related to the work of scientists in Cambridge than it is to medicine or human health. Only recently, after the number of preclinical faculty had grown to more than 100 scientists, did the question of their relationship to the rest of the Medical School become clearly visible when all of the preclinical chairs announced a desire to move en masse to Allston.” No such massive relocation of staff from HMS and the Faculty of Arts and Sciences appears in the offing, but the faculty debate suggests just how significantly biomedical research may change.

In sizing up the dean’s responsibilities and strengths at the July 16 HMS reception, Faust, an historian, recalled President Charles William Eliot’s centennial remarks to the school in 1883. She quoted him as saying that the school had “no thought of resting contented with its present condition,” and that medicine itself was a “fresh and boundless field of unimaginable fertility.” Accordingly, Eliot noted, “a medical school must always be expecting new wonders.”

She also cited another speaker that day, Oliver Wendell Holmes, who said of an eminent HMS professor that he was “a man who forgot himself in his care for others and his love for his profession”—a description she said suited Flier perfectly.