Rao Yi: How did my alma mater go from a mediocre medical school to a top global one?

Mondo Education Updated on 2024-02-22

To prevent getting lost, the elevator goes directly to the safety islandNewspaper man Liu YaEast A

Intellectuals

Author:Rao Yi

Source: University of California, San Francisco official website.

Editor's note.

There is no such thing as a free lunch, and academic institutions need to be reformed if they want to progress. The reform of higher education institutions and scientific research institutions is not a mass movement, but a prescient person with foresight, breaking through the conventions and leading everyone forward, even if not everyone understands it at the same time. If a university or a research institute only maintains the status quo, and the rest of the world maintains the status quo, it can not be reformed. If there is a need for relative progress, from mediocrity to excellence, from excellence to leadership, reform is necessary. If other units are reformed, then they must be reformed, even if they remain in their original position. This simple truth is true everywhere. The author's alma mater, the University of California, San Francisco, went from a prosaic local medical school to one of the top medical schools in the world, and its reforms, including the overthrow of presidents who represented 90 percent mediocre teachers, began to rise dramatically, and in the first decade there were three jobs equal to or more than the Nobel Prize, and by the way, the president of the American Academy of Sciences, the president of the National Institutes of Health, the chair of the department who went to Harvard Medical School to create a new discipline, and students from all over the world. ●

Over the past 40 years, China has carried out many reforms, and many people have struggled for them, which has brought about China's progress; In the past ten years, the country has further deepened reforms, hoping that more people will work hard to move towards the forefront of the world. However, there are still many customs that do not reform and counter-reform that hinder the development of our country. In the field of higher education and scientific research, how many units and how many people dare to take on real reforms? How many units and how many people dare not take responsibility and do nothing? How many units and how many people not only do not carry out reforms, but also act in the name of reform and suppress reforms? Specifically, a pre-employment system that has accumulated successful experience in Peking University and Tsinghua University, why are many units in the country out of tune? Why are there still universities and research institutes that, in the name of such a system, inbreed in large numbers and do not reform or counter-reform in different aspects? Sometimes, it is not only necessary to learn about the reform of our country, but also to learn about the process of scientific and university reform in foreign countries. The most meaningful alma mater for my own upbringing is the University of California, San Francisco (UCSF). From 1985 to 1991, when I was a student, it was a world leader in biomedical sciences and a world leader in graduate education. Those of us who have benefited a lot do not understand the difficulties of the development of our alma mater, and some of us sit back and enjoy the success. This is partly because we are students who do not understand, and partly because of the habit of American universities and scientific research institutions: not to talk about contradictions, at least not for many years. Therefore, many details, even key points, are not only unknown to students, but also to teachers. Few people know that from a prosaic local medical school in the 1960s to one of the world's top medical schools in the 1980s, the reform required the best scientists to overthrow the president, who represented 90 percent mediocre teachers, so that future teachers and students could sit back and enjoy it. In 2011, Henry Bourne, a renowned cell biologist and former head of the Department of Pharmacology at UCSF, published a book that restores some of the people and events during the critical period of UCSF reform through interviews and research. University & CityThe University of California has several branch campuses. The main campus is located in UC Berkeley, and UCSF itself originated as its medical department and later as its medical school. It was not until 1958 that the name of the basic department was changed from the University of California School of Medicine to the University of California, which became an independent campus of the University of California. Berkeley had already made a name for itself in science, with six Nobel laureates in physics and eight Nobel laureates in chemistry by 1970. UCSF's sub-principals and their leadership teams, as well as the majority (more than 90% of Bourne's estimates) teachers, are content with the status quo and do not want to make progress. At that time, San Francisco was no longer the gold rush of the 1840s, but an international metropolis with a high level of economic and cultural development. The world-famous universities Berkeley and Stanford are on its outskirts. Silicon Valley has grown up in its backyard. ReformersThe reform of the UCSF was initiated by several professors and department heads and research institutes: Izzy SEdelman (1920-2004), Richard JH**el (Haver, 1925-2016), Julius HComroe (1911-1984), Lloyd HSmith (Smith, 1924-2018). Among them, Edelman was the first to work at UCSF, and the oldest was Conroe. It was Edelman who started the uprising, and it was Conroe who led the revolution. All four reformers complained about the eastern part of the United States and moved to San Francisco, where they went from the peak of the academic world full of academic leaders to a new place with more room for development. Edelman was a Jew in New York, but in the 1920s and 1950s, he was discriminated against Jews by white Americans, and only one medical school in an agricultural state (Indiana) admitted him to a medical school, internships, hospitals, etc., and the Atomic Energy Commission actually considered him a safety hazard and refused to let him go to a famous laboratory in Berkeley, where isotopes were used, to do postdoctoral research. Harvard has to go so far as not to pass the "security" requirement. Edelman's research was doing well, but finding a job in 1952 did not go well. As a white man, Boon believed that anti-Semitism was a factor, Edelman himself thought it was not. Just as many Chinese do not know and are unwilling to admit to being discriminated against, many white people obviously know that Chinese people are discriminated against, and the Chinese themselves do not admit it. In the end, he only had a job at UCSF, and the budget and laboratory were poor (no lab benches, no running water, no basements with light switches). He did well at UCSF, and in 1978 he went to Columbia University School of Medicine in New York to chair the Department of Biochemistry and Biophysics, where he promoted and supported young scientists such as Richard Axel, then 32 (Nobel laureate in 2004), and established the department as the pinnacle of molecular biology. Haver's postdoc at the NIH, where he improved quantitative ultracentrifugation, was important for the study of lipoproteins, and his 1955** was cited more than 10,000 times. In 1956, he said goodbye to the NIH and joined UCSF with the mindset of going to the West Coast Innovation Corner. Conroe's father and brother were both physicians who graduated from the prestigious University of Pennsylvania and its prestigious medical school. His elder brother was a well-known rheumatologist who had written classic textbooks (the English "rheumatist" was created by his brother). Conroe graduated first in both undergraduate and medical school. Because one eye was infected during surgery, he had to give up surgery and do research instead, and began to do research at the age of 25, and published more than 200 articles in his lifetime**. Between 1936 and 1938, his research identified the chemoreceptors of the carotid body and aortic sinus, clarifying some of the controversies surrounding the original discoverer, Corneille Heymans of Belgium. But after a decade as an assistant professor without promotion, Conroe was unhappy and joined the newly formed University of Pennsylvania Medical Graduate School as chair of its Department of Physiology and Pharmacology, when he was 35 years old. In 1955, he edited a book called "Lung", which focused on the physiology and function of the lungs. The book has been translated into many languages. My father, who did research as a respiratory doctor, had an English version. Conroe also pushed for new ways to teach basic medicine to medical students. The head of the Department of Physiology of the School of Medicine died in 1950, but many people objected to Conroe, who was very qualified to be the head of the Department of Medicine at this time. And it doesn't seem like Penn is ready to support its graduate medical school. In 1956, at the age of 45, Conroe was dissatisfied with Penn State and sought other possibilities. UCSF asked him to become chair of the Department of Pharmacology, and on the way to the San Francisco airport, he was accompanied by a member of the Pharmacology Recruiting Committee, who is also a member of the Faculty of Cardiovascular Research (CVRI) Presidential Recruitment Committee, and asked him to recommend a candidate for the director. Conroe replied, "I". Although he studies the lungs, not cardiovascular, he says blood flows throughout the body. Conroe continued his research at UCSF. For example, the role of nitric oxide (NO) was discovered in 1958, which was a prelude to the discovery of vascular endothelial cell-derived factors by Robert Furchgott in 1978. In 1986, it was determined that it was a gas molecule, and in 1998, it was the Nobel Prize. When Conroe took office, he asked the institute and the department to report directly to the dean of the medical school, rather than to several department heads. He is determined to make CVRI the best cardiovascular institute in the world. When my father went to UCSF in 1983, he joined a laboratory at CVRI, and although his supervisor was also a professor in the Department of Physiology, his main relationship was at CVRI, and all kinds of correspondence and procedures were handled by CVRI. Conroe's leadership role soon went beyond the scope of CVRI. He helped UCSF recruit other department chairs, demanding autonomy and strong support for high-level people. He also helps recruit high-level professors. He was a direct critic of the UCSF's weak administrative and administrative efficiency at the time. For example, finding that it was slow to submit research grant applications, he counted data from several schools and used comparisons to convince the president of the University of California that he needed to criticize UCSF. The Principal has repeatedly crossed the line of Principal to support CVRI. In the respiratory field and in the medical community in the United States, Conroe has played an important role. From 1963 to 1969, he published a series of articles in the New England Journal of Medicine, "Physiology for Physicians." He promoted U.S. support for basic medical research and the involvement of U.S. physicians in scientific research. Smith graduated from Harvard Medical School and has excellent research training and experience. He remained in the Department of Internal Medicine at the affiliated Massachusetts General Hospital (MGH) and presided over the Department of Endocrinology. At the age of 38, the director of the Department of Internal Medicine died and did not let him **, he was unhappy and sought other opportunities. Both Edelman and Conroe were involved in the UCSF recruitment process. He felt William O., dean of the School of Medicine, who took office in 1963Reinhardt had the guts to agree to join UCSF's Department of Internal Medicine on the way to the airport. He accepted whatever the dean gave, and did not mention any conditions, because he expected that the medical school would definitely need him to succeed as the biggest department, so he would naturally provide conditions in the future. His self-confidence in himself and his predictions for the school's development are accurate. He is aware of San Francisco's weaknesses and confident in its prospects. Elegance is an obstacle to reform

Medical schools in San Francisco in the 1950s clearly lagged far behind the city's development needs. In the 1950s and 1960s, UCSF's branch president was a professor of anatomy with a passion for the history of medicine. Like most of the school leaders and most of the staff, students, and staff at the time, he didn't realize that UCSF was lagging behind San Francisco's development, and he didn't understand the urgency of catching up. John BDe Saunders (1903-1991) was born in South Africa, received his medical degree from the University of Edinburgh, England, joined the Department of Anatomy at the University of California School of Medicine at the age of 28 (1931), became head of the Department of History of Medicine at the age of 34, head of the Department of Anatomy at the age of 35, librarian at the age of 40, dean of the School of Medicine in 1958, and became the first independent branch president in 1964. Sanders loves history and has published on the history of science. He loved books as much as his life, and took advantage of his convenience as a librarian to bring the school's rare and rare books back to his home, and returned them to the school after his death. Sanders' speech is suave and full of art and beauty with historical depth. However, he was slow to do things, hesitant to make decisions, indifferent to research, and did not have good ideas and methods for the progress of the school. Sanders is also conservative about the general trend of increasing research and research funding in American medical schools, worrying that too much research funding will affect teaching and medical care. In fact, not only is medical research funding in the United States skyrocketing, but UCSF research funding is also increasing rapidly. An elegant scholar can be the president of the maintenance society, provided that there is no need for substantial changes in the school, and anyone can be a monk who strikes the bell. When reform is the trend of the times, elegance is synonymous with slowness, which is an obstacle to the reform process. VictimsIn addition to San Francisco's history, the president of the University of California was also a pioneer of reform. Clark Kerr (1911-2003) served as Berkeley's branch president and then took over as president of the University of California in 1958. The industrial economist has been resolute in his reforms, establishing a number of new branch campuses and delegating power to give them a great deal of autonomy. During his tenure as Berkeley's president, Cole required every department to be in the top six in the nation. Cole made UCSF a branch and separated from Berkeley, moving all of his departments to San Francisco and building a new building for it. These buildings were completed in 1966 and became the main sites for world-famous research. He advocated for UCSF to improve the quality of research, not only by training students and allowing doctors to practice medicine in school buildings. Once he realized that UCSF's research was only about 20 in the U.S., a considerable distance from the top six he asked Berkeley, he was not satisfied. He was involved in key decisions about the future of the UCSF, although Kerr was removed from the position of president in 1967 due to the resurgence of the American right, represented by California Governor Reagan. In 1987, Reagan's press spokesman admitted that Reagan did not know what was going on with Cole and Berkeley at the time, but that the right-wing crowd was agitated and used to use each other, and Reagan used the slogan "Clean up Berkeley" to win right-wing votes, and became a victim of right-wing populism to the University of California's highly decorated President Cole. The war between reformists and conservativesLess than a month after Smith took up the Department of Internal Medicine, Conroe visited. He's single-handed: Sanders needs to be replaced. Smith was shocked. He had spoken to Sanders not long ago, and Sanders gave Smith a big talk about "human ecology," though Smith didn't get it. Before Conroe arrived at UCSF, there were professors who were dissatisfied with Sanders. But when Conroe arrived, he asked Harver and Edelman to be the deputy directors of CVRI. Hiring outstanding scientists will greatly improve the application and acquisition of NIH funding. In the process of applying for funds, when encountering various problems such as delays in the branch school, Conroe repeatedly bypassed the branch school leaders to ask the president for support. When encountering some unreasonable old rules and regulations, he also asked the principal to help solve them. In 1962, Conroe reported to the president: If Sanders is not removed from the dean of the medical school, several of our professors will resign. In 1963, the dean of the Faculty of Medicine was succeeded by Reinhardt. In 1964, Sanders became the branch principal. Sanders disagrees with Conroe and some professors and department chairs who want to improve UCSF's research capacity on the use of funds, the allocation of space, and the appointment and promotion of professors. Among them was Gil Goldman, chair of the Department of Surgery. Sanders sent a message to Goldman's family** that his daughter received, but would not convey Sanders' message that her father was asking for his resignation. Sanders could only speak to Goldman personally, but was persuaded by an enraged Goldman not to ask for his resignation. (Goldman's daughter married Diane Feinstein, a former mayor of San Francisco and a U.S. senator for decades.) Paang finds the cardboard box left behind by Conroe, labeled "Saunders". Conroe had been writing to the Principal since 1961, so much so that he lamented that I don't know who would write so many letters to the Principal. The document left behind lists the complaints against Sanders and how to resolve them, including who to replace. By 1963, there were 13 grievances against Sanders, four pages full of typed paper, including incompetence, non-delegation of authority, lack of visibility from professors, unreasonable delays, failure to admit errors in facts, judgments, and policies, failure to listen to advice, and being surrounded by yes men who were not as knowledgeable as professors, future development plans, promotions, budgets, poor recruitment of department heads, and collecting materials against their professors (dossier). Such a sub-principal is a huge waste of the professor's time (long and monotonous, avoiding big things). The headmaster was initially concerned about whether Conroe was going too far, but later decided that he was indeed capable and talented. On November 20, 1964, Conroe initiated a joint letter to the Rector, signed by ten people, including the Dean of the School of Medicine, the Dean of the Departments of Surgery and Internal Medicine, the Chairmen of the Departments of Anesthesia, Pharmacology, and Psychiatry, Edelman, and Cardiovascular Specialists. On the 27th, the Rector-General sent a representative to speak with 12 UCSF representatives. The latter suggested that UCSF is now a local institution and needs to be upgraded. But if they don't change their principals, they're all going to leave UCSF. Cole spent months learning about the UCSF, including reports from the Association of American Medical Colleges, experts outside of the University of California, other UCSF professors who had nothing to do with initiating reform, his own doctors, and more. In January 1965, a group of San Francisco physicians launched a pro-Sanders campaign against his removal on the grounds that Sanders had established a good collaboration between the medical school and San Francisco physicians. These doctors instigated ** to report. Sanders believes that the people who want to remove him are for "reputation, power, budget." Opponents of him believe that it is to solve the contradiction between "mediocrity and excellence" in academic medicine. Cole felt that the professors who supported Sanders' removal were excellent professors, but most professors did not support Sanders' dismissal. In fact, most of the doctors who support Sanders will be influenced by history. In 1965, Medicare, the first medical insurance for the elderly, and Mediticaid for the poor, began. These insurances support the medical care of the elderly and the poor, and such policies have brought great changes to the affiliated hospitals of the medical school, and some patients who could not afford to pay for medical care have become the main charges of the hospitals**. It turned out that clinicians, who had a great influence on medical school, relied on fees from wealthy patients. After the change, hospital fees, medical school economics will be much less dependent on these doctors. But when Cole considered it, it hadn't been a factor. Cole waited until the moon to make up his mind to pursue excellence for UCSF. The wind is surgingAfter the change of principal, the school's goal was clearly to strive for excellence. The policy is to support academically outstanding professors, attract outstanding research talents from all over the country, and vigorously apply for national research funding. The recruitment of several major department chairs emphasizes academics, the basic department strengthens the department, and the clinical department emphasizes research. After several years of recruitment efforts, and finally Smith's efforts, William Rutter finally agreed, and in 1969 he took up the position of chair of the Department of Biochemistry and Biophysics, bringing UCSF to the forefront of the world in molecular biology. He first recruited Gordon Tomkins, a researcher at the NIH, who was excellent in research, did not like administration but was happy to exchange academics with other professors, and had a good academic upbringing for young people, so that young people were as immersed in academics as he was. Over the course of three years, they recruited Howard Goodman, an expert in DNA chemistry, James Spudich, a biobiologist, John A Watson, a biochemist, and Christine Guthrie, a molecular biologist. Tomkins had a great impact on young people, but unfortunately died of a brain tumor in 1975. Julius Krevans (1924-2015), Dean of the Faculty of Medicine, who took over in 1971 (and later continued to serve as Branch Rector), led the UCSF for 22 years. He puts more emphasis on research. The Department of Basic Medical Sciences not only conducts research, but also receives funding from the Department of Clinical Medicine. The Department of Clinical Medicine not only provides funding to support basic research, but also conducts high-quality research itself. The Department of Basic Sciences also supports the School of Medicine's funding of space facilities needed for clinical research. The Department of Biochemistry continues to lead the way. Not only does it develop, but it helps other departments to develop. Herbert Boyer, who was not valued by the Department of Microbiology, had a good interaction with the Department of Biochemistry, and Rutter hired Boyer to the Department of Biochemistry. In 1973, together with Stanley Cohen, a microbiologist at Stanford University, Boyer continued to advance his humble research, inventing recombinant DNA technology based on Boyer's tool enzyme (the so-called "genetic engineering" was born). This invention is the most important biological technological invention of the twentieth century, perhaps the most important biological technological invention of all time. Mike Bishop and Harold Varmus of the Department of Microbiology studied the pathogenesis of cancer and proved in 1977 that the genes that cause cancer in viruses have corresponding endogenous genes in animals. This discovery was awarded the Nobel Prize in 1989. It reveals the essence of cancer pathogenesis: genetic mutations. There are some genes that have mutations that lead to increased function that promote cancer, and these are oncogenes. Later, other scientists discovered that some genes usually inhibit cancer (tumor suppressor genes), but mutations lack the suppressor function and cause cancer. Stanley Prusiner, who joined the Department of Neurology in 1972, ambitiously researched rare infectious diseases in sheep, and in 1982, despite all difficulties and opposition, proposed the concept of prions: as long as the protein does not contain nucleic acids, it can also cause infectious diseases. Since then, it has continued to be opposed from many quarters, but it has gradually been recognized as meaningful to humans, similar to a class of human infectious diseases (such as mad cow disease), and its pathogenesis may not really use nucleic acids. He was awarded the Nobel Prize in 1997. In other words, less than a decade after the reform of the UCSF, there are three Nobel Prize-level jobs, among which the recombinant DNA technology that did not win the Nobel Prize is an epoch-making invention that affects all mankind. In 1976, Boyer partnered with investors to launch Genentech, the world's first modern biotechnology company. The company is the first company in the world to produce insulin using recombinant DNA technology for original research and invention. Four years after its founding, on October 14, 1980, it was listed on Wall Street and IPO, setting a world record for the highest value added in one day until then. A group of professors, postdoctoral fellows, and graduate students at UCSF founded or joined the emerging biotechnology companies with their own skills and expertise, leading the world's industry and economic development. The roots are deep and leafyAfter the rapid development in the early days, if you only pursue brilliance, there will be problems later, and even there will be no successors. The UCSF tree has deep roots because new and talented scientists are constantly joining. It is necessary to persist in reform, popularize reform, promote the reform of one department after another, and finally improve the research and teaching of each department through breakthroughs in all areas, so that high-quality scientific work can continue to emerge. In 1976, the Department of Biochemistry recruited several people from Princeton University, led by biochemist Bruce Alberts, including molecular biologist Keith Yamamoto and cell biologist Marc Kirschner. Later, there were geneticist Ira Herkowitz, cell biologist Peter Walter and several structural biologists from other universities. Alberts is not only an authority on the study of the mechanism of DNA replication, but also attaches great importance to education. On the one hand, he helped with local secondary education, and on the other hand, he edited "The Molecular Biology of Cells". After its first edition in 1983, it sold well all over the world and became the premier textbook of biology. Not only does it educate the world, but it also becomes part of UCSF itself. Kirschner, whose cell cycle research is close to the Nobel Prize, seems to be drowsy every time he gives an academic report, and the last question he asks is admirable. Herskowitz, Yamamoto, Guthrie etc gave very good lectures. Herskowitz is the best teacher I've ever had, his lectures are thought-provoking and his questions are interesting. His research in the molecular genetics of bacteria and yeast is important. The Department of Biochemistry not only develops itself, but also helps other departments to develop. During his time at Krevans, he used to require other basic departments to recruit professors to have a professor from the Department of Biochemistry on their recruitment committee to ensure quality. UCSF's basic departments such as neurobiology, cell biology, pharmacology, immunology, physiology, and anatomy have made rapid progress after the reform. Peter Walter from the Department of Biochemistry and Ron Vale and D**id Julius from the Department of Pharmacology have all done Nobel Prize-level work. Julius has already won the 2021 Nobel Prize for his discovery of the function of a class of ion channels, and Valle and Walter have both won many other awards and are widely considered likely to win the Nobel Prize. Since leaving UCSF, Alberts has served as President of the National Academy of Sciences and Editor-in-Chief of Science Magazine. Since leaving UCSF, Varmus has led several biomedical institutions, including the world's largest NIH president, and led the doubling of NIH funding. Kirschner went on to Harvard Medical School, where he led a group of students to create the world's first systems biology department. With excellent research and serious education, UCSF produces students from major biomedical research institutions around the world.

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