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The Department of Medicine

The Department of Medicine. Welcome to the Department July 8, 2011 Donald W. Landry, MD, PhD Samuel Bard Professor of Medicine Chair, Department of Medicine Physician-in-Chief, NYP/Columbia. The Department of Medicine. Samuel Bard

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The Department of Medicine

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  1. The Department of Medicine Welcome to the Department July 8, 2011 Donald W. Landry, MD, PhD Samuel Bard Professor of Medicine Chair, Department of Medicine Physician-in-Chief, NYP/Columbia

  2. The Department of Medicine Samuel Bard Founder and Chair, King’s College Medical Faculty, 1767-1784 President of the College of Physicians & Surgeons, 1811-1821 Theodore Janeway 1909-1914 Walter Palmer 1921-1947 Robert Loeb 1947-1959 André Cournand Dickinson Richards

  3. Department Statistics Faculty: 1,542 Full time: 641 Part time: 901 Staff: 752 Fellows: 154 (14 training programs) Clinical 101 Research 53 Residents: 150

  4. Clinical Medicine Outpatient Services: 104,911 visits 60,770 procedures AIM Clinic: 74,308 visits Admissions to the Medical Service: 26,100 (~50% of all admissions) 19,500 Milstein 6,500 Allen MICU: 1,405* (*2010 calendar year) CCU: 1,388* (*2010 calendar year)

  5. Education Medical Student Teaching 175 faculty 35% of all teaching; ~ 40% of in first 1.5 years Preclinical course directors; 4/9 major courses Leadership and effort will increase with the New Curriculum Residency and Fellowship Training Residents: 150 Fellows: 154 > 300 months of ward/ICU attending (25 person-years/yr)

  6. The Department of Medicine New NIH/Internal Funding - 2010* NIH/External Awards 17 R01's awards (new/competing renewal) 8 individual K awards CUMC/CU Internal Awards 6 CTSA/CTO Pilot Awards 3 Gerstner Awards 1 Irving Scholar 1 Paul Marks Award * calendar year

  7. Department of Medicine Research Expenditures

  8. Finance $292,000,000 aggregate FY 12 budget (from $227M, 2008) ActualActual Actual Estimate 2008 200920102011 Faculty Practice/Patient Care $78M $81M $82M $87M NYPH $53M $56M $64M $66M MSA $ 6M $ 8M $ 8M $ 8M Government grants $46M $48M $50M $55M Private grants $ 7M $ 9M $11M $11M Gifts & Endowments $11M $12M $16M $14M Indirect cost recoveries (AIM HI) *N/A $17M $19M $21M Education & Tenure Support (AIM HI) *N/A $ 4M $ 4M $ 4M Endowment principal $100M $114M$113M $118M *AIM HI effective 2009

  9. Columbia Funds Flow

  10. National Rankings #4 in Kidney Disease #6 in Infectious Diseases #6 in Heart & Heart Surgery #7 in Endocrinology #9 in Gastrointestinal & Digestive Disorders #12 in Pulmonary & Critical Care #18 in Rheumatology #24 in Oncology U.S. News & World Report 2010

  11. Faculty Development Annual Reviews Committees on Retention & Recruitment Young Faculty Mentoring Program Basic & Translational Program Clinical & Epidemiological Program Review progress and criteria for Promotion

  12. Diversity Female to Male Ratio across Rank and Track

  13. Research Objectives of the DOM Translational Immunology Human Genetics - Basic Science Hughes Investigator/Immunologist Outcomes and Populations based research Trans-Divisional, Collaborative Cardiovascular - CVRI

  14. Translational Immunology: Recruitment of Dr. Megan SykesDirector, Center for Translational ImmunologyDirector of Research, Transplantation Initiative, Director of Research for BMT Unit • Multi-disciplinary Collaborative Creative Recruitment • Medicine • Cardiology, Pulmonary, Nephrology, Hepatology • Surgery • Pediatrics • Pathology • Microbiology and Immunology • Berrie Diabetes Center • Herbert Irving CCC/Division of Oncology • NewYork Presbyterian Hospital

  15. Translational Immunology Program • People • Transplant Immunologist • Cellular immunologists • Translational scientist in Autoimmunity/Type 1 Diabetes • Translational scientist in Rheumatology • Translational scientist in hematopoietic cell tx • Transplant surgeons for large animal studies • Space • Initially 12,000 square feet • Animal research facilities • Large animal OR • BMT Unit (NYPH ~$10M) • GMP cell facility (NYPH) • Technology • Small animal in vivo imaging • Flow cytometry • Cell & body fluid bank • Microscopy – confocal, LCM, laser dissection • DNA & peptide synthesis

  16. Department of Medicine Center for Human Genetics . Strategic partnership with University of Glasgow: Wellcome Trust Functional Genomics Consortium Joint recruitment Funding through the Medical Research Council (the UK equivalent of the NIH) The national health care system EMR identification of patients for genetic studies Centralized medical records, blood tests, and imaging studies for individuals enrolled in a genetic studies Generation Scotland underway to recruit a family based cohort of 50,000 individuals for genetic studies of complex traits, such as cardiovascular disease, osteoporosis, mental health, metabolic disorders and mental health Biobank will store, DNA, serum and urine. To date, 10,000 individuals recruited Genotyping/sequencing, genotyping service (Illumina and Affymtrix) through the cardiovascular unit. “Next- gen” sequencing is available (Solexa) Opportunities for Columbia: insider access to well phenotyped cohort for primary discovery of phenotypes

  17. Outcomes and Population-based Research Initiative Leverage the experience of Steve Shea, Karina Davidson, and the Division of General Medicine and the Center for Behavioral Cardiology New Outcomes and Population-based Research Center on PH9c/9w 12,000 sq. ft., $4.5M renovation – will be complete in September 2011

  18. Research Initiatives • CVRI • Director: Alan Tall – Gregg Stone • Henry Ginsberg • Ira Goldberg • Martin Leon • Donna Mancini • Andrew Marks • Steven Marx • Allan Schwartz • Ira Tabas • Summer 2011 beginning 8,000 sq. ft., $5M

  19. Population-based Research Unit Harkness Pavilion 11 NYPH space, currently used as on call rooms 12 rooms, solarium, 4,000 sq.ft. 2011 renovation for $250K

  20. Clinical Assets 5 Primary Care startup packages $1.5M 20 Subspecialist startup packages $7M

  21. Clinical Practice Primary Care Initiative CUMC Division of General Medicine Initiative: TBA CUMC Lodge Practice: Kara Nugent Hudson Heart Cardiology Consultants of Westchester Scarsdale Medical Group

  22. Clinical Space 600 Madison Avenue Westside General Medicine NYPH Heart Hospital Bone Marrow Transplant Unit

  23. Clinical Medicine and NYP LOS Reduction/Readmit reduction Problem: 24,000 Excess days Integrated Medical & Nursing through Clinical Care Coordinators Integrated ED and MICU MICU and non-med ICU via an “ICU without borders” strategy Hospitalist strategy for medicine teams Extension of integration strategy to CHF Critical pathway Integrate with NP’s running the CP pathway New CHF team Post discharge resources

  24. Education: P&S P&S Curriculum Reform 1st Year Basic Science Jonathan Barasch, MD 1st-2nd Year Clinical Science Tom Garrett, MD 2nd Year Physical Diagnosis Deepu Gowda, MD 3rd Year Clerkship Director Katherine Nickerson, MD 4th Year Advanced Pathophysiology Donald W. Landry, MD, PhD

  25. Education:House Staff Training Program House staff Career Guidance Morning Report: In-take Rounds (Division Chiefs) iPads (Pete Stetson MD, George Hripcsak MD, Chair, Biomed Informatics) International Elective (Scott Hammer, MD) Research Track (Jonathan Barasch, MD)

  26. Glenda Garvey Medical Society • All current Columbia Presbyterian House Officers and Fellows • All past Columbia Presbyterian House Officers and Fellows • All Columbia Department of Medicine Faculty • Associate Status: All P&S medical students eligible • Former Chief residents as the Board • Society of Master Clinicians • Pod casts of Morning Report and Grand Rounds • Networking for current House Officers and Fellows • Philanthropy

  27. The Department of Medicine Excellence Clinical Innovation Integrity Devotion

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