Q&A with Dr. Howard Federoff

 

 

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Just over two years ago, Howard Federoff, MD, PhD, took the position of executive vice president for health sciences at Georgetown and executive dean of the School of Medicine. He recently spent some time with Georgetown Alumni Online to discuss his experience since coming to Georgetown, his vision of expanding a systems medicine approach at the Medical Center and more.

Has there been a signature achievement or accomplishment in the last two years that you point to as a sign of progress for Georgetown University Medical Center?

I think the strategic planning initiative we started about a year ago will wind up being our first significant milestone. I anticipate its recommendations will touch on the creation of a more efficient organization, the conduct of research, the education of students of all kinds and the Medical Center’s interface with our clinical partner, MedStar.

More modest but certainly not insignificant was the recruitment in 2007 of a top-flight director for the Lombardi Comprehensive Cancer Center, Dr. Louis Weiner. His arrival was absolutely critical for the Medical Center to position itself to be competitive for the reapplication of the National Cancer Institute comprehensive designation in May.

What was the biggest surprise you encountered upon arriving here?

Among those that were important and not fully anticipated is the realization of how lean this organization is. That makes it difficult for investigators to have the full support they need to secure extramural funding, which in turn has an impact on the reputation and quality of the institution.

I also didn’t fully appreciate the importance of relating what we’re doing at the Medical Center to the people on the main campus. I think that — in part due to financial losses that compelled the sale of the hospital in the ‘90s — some faculty and staff working on the main campus may believe that the Medical Center is still a drain on the university’s efforts to enhance its resources. But a great deal of the research that has led Georgetown to be designated a Carnegie Tier I research university, and the prestige and resources that accompany that designation, has come through the Medical Center.

What are some misconceptions about GUMC that you have seen?

I think there is a misconception among some that GUMC pursues research at the expense of education. When I look across this campus, though, I see a very substantial amount of effort on the educational side — from undergraduate and second-degree nursing programs to our programs in medicine and graduate programs in the biomedical sciences.

Also, I think people don’t realize that what we are doing scientifically — whether it is basic, translational or clinical research — is really top-flight. I’d like to see greater attribution for the quality of contributions across the Medical Center.

Finally, I get the sense that we haven’t embraced the Washington, D.C.-area clinical community, so in turn they’ve paid very little attention to us. We need to be a community contributor and to be valued as such, even though what we are able to contribute may be modest. We want to be able to demonstrate to private practice doctors that have no relationship with Georgetown that we understand they add value — as do we — and we want to find ways to work together.

On that same note, Georgetown is known for its work serving disadvantaged and underserved populations. How do you hope the Medical Center might contribute to that effort?

What we do well is discover and impart knowledge. Through our own doctors and more so through our MedStar partnership, we should be utilizing that knowledge to reduce health care disparities. The Capital Breast Care Center is one example of that, but we have to do more. There are many options to consider, from offering K-12 educational programming, to expanding our Mini-Medical school (a program that offers presentations on a variety of health-related topics to the public), to participating in community-sponsored lectures. We have an obligation to add as much as we can to the community we reside in.

You have instituted a focus for both the School of Medicine and the rest of the Medical Center on systems medicine, an approach that utilizes breakthroughs in genetics, biochemistry and other areas to focus on prediction, prevention and empowering the individual patient rather than reacting to the cause of a patient’s problem. What are some of the major steps that have been taken to facilitate this new focus on systems medicine?

First, we have a vast array of research projects under way that are generating a great deal of molecular information on the complex interactions among genetic, biochemical, physiological and environmental influences on the human body. This will lead to the development of an information technology infrastructure, a shared database that will have value for any kind of research. The Georgetown Database of Cancer (G-DOC) is one example of this.

The second piece is in education. Through the leadership of Robert Clarke [interim director of the Biomedical Graduate Research Organization and professor of oncology], we are in the final stages of designing what will be a Master of Science in systems medicine that we hope to offer to medical school students. We anticipate it being a five-year joint M.D./M.S. program where one year is spent in depth on systems medicine.

Third, we’ve asked Fr. Kevin FitzGerald, Ph.D., S.J., to organize an effort to look at various ethical considerations of systems medicine, which need to be constructed, framed and answered as we move this down the road. We feel it is important that these ethical considerations, such as patient privacy and genetic discrimination issues, are not an add-on, but rather central to this process.

Has the scope or focus of research shifted in your time here?

Not dramatically, though I sense there may be a shift. One of the things the strategic plan is heralding is the ability to do more inter- and multidisciplinary collaborative research. I think in the future that type of research can actually scale to the appropriate level required by the magnitude of the problems we confront as a nation. So I’m pleased to have recommended that we contemplate changing our organization to support that type of collaborative research.

If you could, share some short- and long-term objectives you have for GUMC.

In five years, we have to have an organization and financial model that produces limited but nonetheless sustainable growth in the Medical Center. It has weathered incredible adversity, and the fact that it has survived suggests we have very talented people here. But we have to look to the future, and that means recruiting young, talented, best-in-class faculty.

Beyond five years, I anticipate that we will need a new physical location. I don’t believe this medical center can legitimately be competitive within the region or nationally if we remain here on the Hilltop. Not because the Hilltop isn’t a great location, but our infrastructure here is tired, and it’s extraordinarily, some might say prohibitively, expensive to renovate for world-class research. Moreover, I believe strongly the entire Hilltop will be needed for the university’s main campus so, like the Law Center, we’ll have to pick ourselves up and move to another location.

Any other thoughts?

This is a university that has consistently impressed me as having some of the best ideas about how to do impactful work that changes societies — regionally, nationally and internationally. We are at an interesting crossroads in higher education. With the imposition of a new set of economic conditions, we’re going to emerge at a very different place than where we are now. What I would love to see is for Georgetown University, including its Medical Center, to have more opportunity to effect positive change than has ever been the case in the past, and I think the president is likely to get us there. In short, I think we’re in for an interesting ride.

By Lauren Wolkoff, excerpted from Georgetown Alumni Online