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Approved by the Mānoa Faculty Senate on April 17, 1996

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April 17, 1996

Whereas the program review of the John A. Burns School of Medicine did not follow the required procedures for faculty consultation and participation,

Be it resolved that all current activities and plans cease, that previously and currently-existing policies, practices, and programs within JABSOM be continued, and that the process of program review and reorganization begin again with proper involvement of faculty in the affected units, within JABSOM and without, and with appropriate participation by the Faculty Senate.

James Dator	E. Alison Kay	Kiyoshi Ikeda Secretary	Co-chair	Co-chair 

This resolution was made, seconded and passed unanimously at the Manoa Faculty Senate meeting on April 17, 1996.

University of Hawai'i at Manoa
Manoa Faculty Senate
1630 Bachman Place. BA 9-E Honolulu. Hawaii 96822
Telephone: (808) 956-7725 Facsimile: (808) 956-9813
April 26, 1996


TO: Kenneth P. Mortimer
President, University of Hawai'i and
Chancellor, University of Hawai'i at Manoa

FROM: E. Alison Kay Kiyoshi Ikeda, Co-Chairs Manoa Faculty Senate

SUBJECT: Prompt Attention to Faculty Senate Concerns the Reorganization of the John A. Burns School of Medicine

At the April 17 meeting of the Manoa Faculty Senate meeting, the Senate received a status report from the Committee on Academic Policy and Planning about the substance and process in the reorganization of the John A. Bums School of Medicine. A copy of the status report is attached. Based on the report received by the Senate as well as reports from faculty at JABSOM (reported in the minutes of the April 17 meeting of the Manoa Faculty Senate), the following resolution was adopted unanimously.

Whereas the program review of the John A. Burns School of Medicine did not follow the required procedures for faculty consultation and participation,

Be it resolved that all current activities and plans cease; that previously and currently existing policies, practices within JABSOM be continued; and the process of program review and reorganization begin again with the proper involvement of faculty in the affected units, within JABSOM and without; and with appropriate participation by the Faculty Senate.

Your prompt written response to this set of concerns is appreciated. Given strong interest by the Manoa Faculty Senate, please anticipate that your response will be placed on the Manoa Faculty Senate Homepage.

Status Report, 4/16/96

CAPP Subcommittee on JABSOM Reorganization

Reorganization of JABSOM

The current reorganization of JABSOM will no doubt be the subject of campus lore for years to come. The participants have expressed such divergent views of the same facts that the situation is akin to the proverbial 50 blind men describing an elephant. The CAPP subcommittee on the reorganization (a) reviewed all available documents concerning the reorganization, (b) requested information from all the basic science departments on their courses (frequency, numbers of students, who taught what, what other programs required the courses, etc.), and (c) interviewed Vice President Smith, Dean Gulbrandsen, Martin Raynor (proponent of reorganization who was involved in planning), Leslie Tam (Chair of Tropical Medicine and head of the Medical Education Committee), and chairs of several basic science departments.

The reorganization calls for closure of six basic science departments (Biochemistry and Biophysics, Anatomy and Reproductive Biology, Tropical Medicine and Medical Microbiology, Physiology, Pharmacology, and Genetics) . Faculty from these departments are to be given the following options: various forms of retirement, joining a newly formed interdisciplinary Biomedical Sciences Department, joining a clinical department (closely tied to education of M.D.s), or transferring out of JABSOM. The Biomedical Sciences Department is intended to be a research-oriented unit which will consolidate funded researchers from the Pacific Biomedical Research Center (PBRC) and the Cancer Research Center of Hawaii (CRCH), as well as from the basic science departments. The reorganization plan is a response to three major problems facing the school: (1) shrinking federal funding for biomedical research, (2) budget cuts at the university level, and (3) concerns raised during the last accreditation site visit (1995) by the Liaison Committee on Medical Education. The aim is to (1) unite active researchers in the new Biomedical Sciences Department which will offer one graduate degree, (2) relieve the heavy teaching loads of the clinical department faculty by transferring basic science faculty not involved in research to those departments, (3) enhance the basic science education of medical students by increasing the involvement of basic science faculty in teaching, and (4) reduce the budget of the school (presumably by encouraging the retirement option, although this is not specifically stated).

JABSOM is obviously at a critical stage. Proponents of the reorganization argue convincingly that major change is necessary to ensure survival. This subcommittee, however, has several criticisms of the plan and the process by which it is being implemented.


First of all is the lack of information. Beyond the general description of the reorganization given above, virtually no details are available. Thus, there are widely divergent and very vague perceptions of the proposed changes. Fears have been spawned by a lack of reliable information and a lack of consultation with the affected units. This situation can, at least in part, be attributed to the management style of Dean Gulbrandsen. As an example, the reorganization plan appeared in faculty mailboxes without prior consultation with the units most directly affected, and without indication of authorship. This kind of anonymous communication does not inspire trust. At a JABSOM faculty meeting called to discuss the plan, many questions were raised that could not be answered fully because details had not yet been thought out. To our knowledge, those details are still not available.

Our second general concern is with the process, or lack thereof, of planning and implementation. No mechanism has been developed by which the key players (Vice-Presidents Smith and Eastman, Dean Gulbrandsen, and faculty members representing all impacted units) can sit down together and address the issues raised by the problems facing JABSOM and by the proposed reorganization. This needs to be done now!

Beyond the problems of poor communication within the school and the lack of consultation and established process, we have three major, specific concerns with the reorganization plan: (1) the nebulous nature of the proposed new interdisciplinary department, and (2) the absence of a plan to cover the current undergraduate teaching obligations of the school, and (3) the vagueness of plans to enhance the basic science component of the medical curriculum.

The proposed Biomedical Science Department remains an undescribed bureaucratic shell -- no secretary, no staff, no chair, no charter, no desc of faculty duties or methods of faculty evaluation, and no plai for continuity of teaching currently done within the six basic science departments. Faculty from the basic science departments are currently in the process of choosing where to transfer their positions, or whether to retire. They are making these decisions based on very scant information about the nature of the new department. Even strong partisans of the reorganization are deeply troubled by the lack of substance. They see departments being torn down with nothing yet being built to replace them.

Graduate admissions to the basic science departments for Fall Semester 1996 were stopped out, with applications being redirected to the Biomedical Science Department. This department does not yet have an established faculty roster! Who sits on the admissions committee? The new department will offer a single PhD (in biomedical science) , but whether the various specialties now represented in the basic science departments will continue to be available remains to be seen. Rumors abound concerning deletion of all masters degree programs (with one exception), but nothing has


been made official to our knowledge. Currently enrolled PhD and MS candidates have been assured that they may continue pursuing their degrees, but with the complete reshuffling of faculty, and possible retirements and transfers out of the school, this may be difficult.

Our second major concern is the fate of undergraduate teaching in the school. The basic science departments teach over 1500 undergraduate students each year in courses required by a number of programs including nursing, dental hygiene, and public health. The faculty of the basic science departments have been criticized by some factions of the school for their involvement in undergraduate teaching. There is also a perceived lack of quality in some of this teaching, according to some sources. NevertheleSs, these undergraduate courses are essential to many UH programs. It is clearly the intention of Dean Gulbrandsen to get out of the job of undergraduate instruction, yet no plans have been made for the future of these courses. We understand that a committee was recently established to look into this problem, but no information is yet available. There is a very immediate need for a plan: who will teach these courses each semester, will there be TA's for laboratory classes, who will assign rooms and times, who will handle registration?

Our third concern involves the Problem Based Learning (PBL) curriculum. One goal of the reorganization is to improve the basic science education of medical students. The PBL curriculum established in the late 1980's is an inspired and visionary program, but one criticism has been the weakened basic science background of the students. Some students take commercial courses to cram for board examinations because they perceive their education to be deficient. Test scores indicate that their education is adequate, but scores have dropped from pre-PBL JABSOM standards. Efforts must be made to improve the basic science input to PEL, but how this is to be accomplished is unclear. Simply transferring faculty between departments within the school will not make a difference. The increased focus on research in the new Biomedical Sciences Department, and the possible retirements and transfers of some faculty out of the school, may actually detract from this goal.

Our subcommittee feels that the reorganization holds promise. There has been a major shift in federal funding of medical research in recent years. Billions of dollars are available for molecular level work in biology, most significantly in genetics with programs such as the human genome project. At the same time, there is much less money available for fields that flourished only 20 years ago. To sustain JABSOM as a significant center for biomedical research, a critical synergy of research talent must be created. By bringing funded researchers from the basic sciences, PBRC, and CRCH into one research unit, a critical mass may be achieved which could greatly enhance medical research and grantsxnanship in Hawaii both at UH and at. the research hospitals. Moreover, in the era of managed care, hospital-based research will be critical to sustaining the pool of


specialists in medicine now resident in Hawaii and to making medical care both better and more efficient. JABSOM may well be critical for sustaining quality medical care in Hawaii, but only if its research focus is strengthened. If this can be accomplished, it will be important for UH, the medical profession in Hawaii, and fcr the state as a whole. This promise is important enough to make medical research a central focus of JABSOM.

The reorganization plan focuses on improving medical research, but does not address well the education mission of the school. Our subcommittee feels the following issues require immediate attention:

  1. From the President and Vice Presidents on down, there needs to be attention to the process of reorganization and the management of details. Representatives of all impacted academic and administrative units must sit down together.
  2. The detailed char and composition of the new Biomedical Sciences Department must be worked out.
  3. The future of undergraduate course offerings in the school must be established and alternative homes for courses be determined.
  4. The PBL curriculum must be restructured to incorporate more basic science instruction. This does not require a complete overhaul, but changes will need to be made.
  5. The fate of faculty from basic science departments who devote a majority of their time to teaching rather than research, but whose interests may not coincide with one of the clinical departments, is unclear in the reorganization plan. Efforts should be made to accommodate these faculty, perhaps by transfer to another college.
  6. Finally, we find the July 1 deadline unrealistic for achieving such a major reorganization. Although budgetary constraints may be driving this schedule, a rush to action could cause real damage. Alternatives to the reorganization plan generated within the ranks are not being considered. Moreover, it is unfair to the faculty to be faced with career decisions based on such scanty information concerning their choices.

Note added 4/17/96: A document from JABSOM made available to us yesterday after completion of this status report provides additional information and addresses some, but not all, of the concerns expressed in this status report.