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RESPONSE & FINAL REPORT OF JOHN A. BURNS SCHOOL OF MEDICINE


Presented to the Mānoa Faculty Senate on February 16, 2005


To: UH-Manoa Faculty Senate Executive Committee
Manoa Faculty Senate Office
Bachman Annex 9A

From: UH-Manoa Faculty Senate Committee on Academic Policy and Planning
Manoa Faculty Senate Office
Bachman Annex 9A

Re: Report of MFS CAPP on Regents Task Force Report on the Biomedical Complex.

Date: February 10, 2005

The Manoa Faculty Senate Committee on Academic Programs and Policy (CAPP) has been asked by the Senate's Executive Committee to comment on the Regents Task Force Report of October 2004 on the UH Biomedical Complex. This report is based on our reading of that report, of the reply from JABSOM, on discussions within CAPP, and on meetings with Prof. Steve Ward from JABSOM and with the UH interim Vice President for Research Jim Gaines.

Much of the dialogue about the future of JABSOM has revolved around cost issues, and current and future research plans. CAPP notes that in addition to research, JABSOM participates as well in many academic programs at all levels. In particular, JABSOM faculty currently teach courses to a substantial number of general science undergraduates at UHM, they offer their own specialized undergraduate degrees, and they offer nonprofessional graduate degrees through the Ph.D.

There are important concerns relating to these academic programs that we believe any plan involving a change in the status of JABSOM should address at the outset, and not leave as an afterthought to be worked out after a change of address and/or governance structure.

The JABSOM Senate has expressed a commitment to these programs, courses, and students. We believe that this commitment is sincere. However, we believe that the disposition of these programs concerns all Manoa faculty, not just those at JABSOM.

The first set of concerns relate to the impending move to Kakaako, and apply whether or not JABSOM is spun off from Manoa.

  1. Issue: The consulting report suggests that Manoa's general science students be required to commute by bus back and forth between Manoa and Kakaako to take their classes. We believe that this would be unreasonably disruptive to the schedules of these students, and think this is not an appropriate solution. JABSOM proposes instead to keep the classes, and the faculty who teach these classes, in Manoa.

    Questions: What assurance do we have that this solution will remain practical in the future? To what extent do es it depend on decisions such as JABSOM retaining the current Biomedical building after the move to Kakaako?

  2. Issue: Much of the undergraduate teaching done by JABSOM is done by faculty who are nearing retirement age. JABSOM has indicated an intention to hire replacements when the time comes who will fill the same teaching role.

    Questions: Is this consistent with JABSOM's pro jected hiring plan? If future hiring at JABSOM is scaled back, what is the assurance that the teaching effort will not suffer disproportionately? If these faculty are replaced with primarily research faculty, will student access to their time outside of class be guaranteed?

  3. Issue: The proposal suggests a geographical disconnect between the undergraduate teaching and the research effort. Such a two-tier system of instructors and researchers is not consistent with the philosophy of education in a "Research-Extensive" university.

    Question: What efforts will be made to prevent such a disconnect, and to assure undergraduate access to active research faculty?

    Our remaining concerns arise under the assumption that JABSOM becomes an independent unit in the System.

  4. Issue: There is no precedent for the education of Manoa undergraduates at Manoa being largely under the administrative control of another campus. In the event that JABSOM is separated from Manoa but retains this teaching, the Manoa Chancellor will be required to transmit concerns about programs and policy for our own undergraduate curriculum through an indirect route, presumably the System.

    Questions: What control will Manoa have over the integrity of its own programs in this situation? Will Manoa have a say in the selection and retention decisions for the faculty who teach Manoa courses? Will the new indirect governance relationship entail increased direct System control over Manoa programs? What (if any) will be the ramifications with respect to Manoa's accreditation? Would it be more sensible to return the responsibility and resources for these courses to Manoa, and have the individual JABSOM faculty members teach these courses under Manoa's supervision?

  5. Issue: JABSOM currently offers baccalaureate degrees in Medical Technology and in Speech Pathology (and if all recommendations of the task force report are followed they will also offer degrees in Dental Hygiene and Nursing). Presumably JABSOM do es not intend to recruit and admit undergraduates, or offer a complete selection of diversification courses, so these degrees would remain housed at Manoa.

    Questions: How would the administration of these degrees be managed? Will the ma jors be housed in Manoa departments, or in an administrative entity such as Interdisciplinary Studies? Which campus will have authority over factors like ma jor requirements? Will these ma jors be sub ject to Manoa program review? Will courses offered within these departments for ma jor and graduation requirements need to be articulated to Manoa as do those from the Community Colleges?

  6. Issue: JABSOM currently offers graduate degrees other than the MD, notably the MS and Ph.D. The UHMFS has already clearly articulated the view that such degrees should remain under Manoa's control.

    Questions: Will the degrees officially be housed in Manoa or at JABSOM? Assuming the former, in which Manoa departments will the degrees be housed? How will requirements such as residency be determined? Will graduate students still be required to operate within Manoa's regulations, for example regulations concerning proprietary research? Will graduate faculty status be determined by Manoa or by JABSOM?

  7. Issue: JABSOM expects to retain their Manoa building in addition to the new facilities in Kakaako. This would reduce by one the number of buildings available to Manoa for classro om and office use, without reducing the demand for the space.

    Questions: Will Manoa retain any control over the scheduling of classes in this building, or the assignment of offices to new hires? Will the responsibility and cost for daily maintenance and utility service of this building remain with Manoa? Will Manoa have any say over the types of research that continue to be carried out in this building, in particular research on hazardous agents (such as anthrax or emergent diseases), and if so who will be in charge of safety proto cols and management in case of emergency? Will the activities in the building be sub ject to Manoa policies, for example any future policies on classified and proprietary research?

cc: James Gaines, Interim Vice President for Research, University of Hawaii, Bachman 201


Response of the Manoa Faculty Senate Executive Committee to the Report of the Regents' Task Force on the John A. Burns School of Medicine

February 7, 2005

The Executive Committee of the Manoa Faculty Senate has considered the recommendations of Regents' Task Force on the John A. Burns School of Medicine (JABSOM). In responding to this report, we cannot speak with authority on behalf of the Senate, which has not yet adopted a formal resolution on the matter. However, we understand that the matter is of some urgency, and so we wish to let you know our views now. We are convinced that the position we express here is widely shared among the Manoa faculty.

We see two main intersecting issues: one relating to the internal constituency of a "health sciences unit"; the other relating to the location relevant units--within Manoa, or at the System level.

The Task Force recommended that the JABSOM, the Cancer Research Center of Hawaii (CRCH), the Pacific Bioscience Research Center (PBRC), and possibly the School of Nursing (which might be made a unit of JABSOM), be removed from Manoa and joined in a single unit at the System level--effectively forming a separate UH campus. This is the first and central recommendation of the Task Force, and it provides the context for all the other recommendations.

Let us dissect this recommendation. First, moving CRCH and PBRC outside of Manoa would be a serious error in our view. These units are an integral part of the research and instructional environment of UHM. Every one of our colleagues in these units, without exception, is opposed to being removed from Manoa. They feel that such a move would have a serious negative impact on their effectiveness. And, their removal would weaken the rest of Manoa. These faculty have created very successful entrepreneurial research units in the University, and we take their views very seriously. We will not reiterate their reasons, which have been presented fully in their own written statements and in meetings with senior System administrators. We have heard no persuasive argument in favor of the proposal to remove CRCH and PBRC from Manoa.

Second, we strongly oppose having the School of Nursing report to JABSOM. In this we concur both with the Nursing itself and with JABSOM's own administration, which is also on record as opposing this move.

The third question involves the position of JABSOM itself. This matter is more complex. JABSOM has embarked on an ambitious plan to expand and to re-create the School as a leader in peer-reviewed science and as an "engine [...] for the biosciences industry in the State." (Report, p. 6) Many at Manoa and throughout the University are sympathetic to this vision. JABSOM has argued that the effort will require the School to act more like an entrepreneurial business, able to respond agilely to opportunities, unfettered by bureaucratic controls, and able to accept substantial risks and uncertainties in order to achieve a larger long-term goal. The Report suggests that JABSOM needs a "different, more independent governance structure,." It is suggested that moving outside Manoa, to the System, will foster the requisite "culture of entrepreneurship," as Dean Cadman puts it in his response to the Task Force Report.

We fully understand that JABSOM will be taking large risks. Under very optimistic assumptions, JABSOM may operate at a deficit of many millions of dollars each year for some time into the future. Under different assumptions, these shortfalls may be several times as much. It is possible that governmental agencies, private enterprise, and individuals in Hawaii will consider the long-term benefit to be worth the risk. Nevertheless, we are adamant that the current core instructional and research activities of the University must not bear the brunt of this risk.

JABSOM must be able to act autonomously in an aggressive entrepreneurial fashion; at the same time, the rest of the University must be protected from potential damage from an extremely risky endeavour. The University must create an environment in which these two concerns can be balanced. JABSOM should be permitted to succeed or fail on its own--neither hampered by nor subsidized by the rest of the University. It is unclear to us whether this can be done; and, if it can be done, whether it will be easier to create this environment within Manoa or at the System level. Manoa itself has recently launched an initiative to explore the concepts of responsibility-center management at the College level. Conceivably, these principles might be applied to creating a suitable entrepreneurial environment for JABSOM.

We have no definite recommendations to make on the matter of the location of JABSOM, but we do feel that the concept of "culture of entrepreneurship," needs substantial elaboration before a decision can be made on the administrative location of JABSOM. Under the circumstances, the burden of proof must be on those that propose removing JABSOM from it current location.

The Task Force also recommended the creation of a Vice Presidential office for Health Sciences, at the System level. We see no need for such a position at this time.

Recommendations 2 and 3 of the Task Force deal with the responsibilities of the Vice President, essentially pointing out the need to coordinate health sciences initiatives. Coordination is desirable, though a Vice President is not necessary for this.

Recommendation 4 suggests an "entrepreneur in residence." We concur with the Dean of JABSOM that this is not necessary. It is premature to propose particular offices.

Recommendation 5 proposes a designated University Hospital. We see no persuasive argument for this, and the Dean of JABSOM has argued convincingly against it.

Recommendation 6 suggests a concentration on certain designated fields of excellence. Certainly, this makes sense, especially in the context of limited resources and the consequent need for focus.

Recommendation 7 proposes that an independent financial study be conducted of JABSOM's projected costs and revenues. We agree with this recommendation: it is a most urgent matter. Until there is a realistic assessment of the financial situation, many of matters involving risk-assumption and entrepreneurship cannot be adequately addressed.