Microbiology: Combo Vector Delivers Blow Against Melanoma Immunology: Shadow Proteins in the Thymus Give Clues to Autoimmunity OB/GYN: Genetic Sonograms May Reduce Need for Amniocentesis Medical Ethics: Panel Probes Cap on Resident Work Hours Letter to the Editor   Repeat-encoding Gene May Drive Brain Size Combing the Genome for Natural Selection Bystander Cells in Animal Model Affected by Radiation   HMS Faculty Council New Appointments to Full Professorships Dana-Farber/Harvard Cancer Center Awarded Third SPORE Grant IOM Recommends Better Protection for Research Subjects Family Van Back in Service New Peabody Associate Masters Named In Memoriam: Catherine Binderup Ronald Malt Honors and Advances News Briefs   Making Cultural Competency a Part of Medical Training   New Division Director Melds Learning, Service Front Page

BULLETIN HMS Faculty Council At the Sept. 25 Faculty Council meeting, Joseph Martin, dean of the Faculty of Medicine, welcomed members to the first meeting of the academic year. Mortimer Litt, associate dean in the Office for Faculty Affairs, distributed ballots for election of the new vice chair/chair of the docket committee. Accreditation Project Martin; Raphael Dolin, dean for clinical programs; and Lorraine Caristo, director of administration, presented a status report on the accreditation project, which will culminate in a site visit by the national Liaison Committee on Medical Education (LCME) from April 6 to 10, 2003. LCME certifies that medical school education programs meet prescribed standards. As a critical part of this process, medical schools undergo a period of institutional self-study. In the initial stages, a database is generated to gather information on a range of issues including governance and administration, medical education, research, and basic and clinical departments. Nine internal institutional self-study committees have been formed to analyze this data, identify institutional strengths and weaknesses, and define strategies to improve and strengthen the programs, all of which will be highlighted in a summary report. Many advances have been made in the years since the last accreditation, including better communication with an improved electronic mail system, institution of the annual department heads retreat, creation of satellite offices at the teaching hospitals, start of the dean's one-on-one meetings with hospital presidents, presentation of the State of the School address at the Medical School as well as at the major HMS teaching hospitals, establishment of the Council of Academic Deans, and the clinical departmental review program. New collaborations include the Harvard Center for Neurodegeneration and Repair, the Harvard Clinical Research Institute, the Dana-Farber/Harvard Cancer Center, the Juvenile Diabetes Research Foundation Center for Islet Transplantation, the Harvard Institute of Proteomics, and the Division of AIDS. A range of other initiatives are under way, such as construction of the new research building, new dean appointments in research (Ed Harlow) and diversity (Joan Reede), the IT initiative that includes MyCourses, the Virtual Patient, the Digital Library, the Countway renovation, the Academy at HMS, the national Centers of Excellence in women's health and minority health, the Resident as Teacher program, the mentoring award programs, and efforts at faculty development. The self-study has also revealed areas of ongoing need. These include the disparity between student and faculty diversity, the inability of the clinical faculty to devote adequate time to teaching given the ever increasing pressures to direct their time to clinical care activities, the need to extend the "special endowment distribution" for an additional five years to support teaching by the clinical departments, the need to ensure affordable and back-up child care, the need for affordable housing, more HMS-sponsored shuttle transportation, parking, and improved food service facilities. The committee also recommended a formal process for mentoring and career counseling and the requirement that every faculty member have an annual review with his or her chairman or other designated senior faculty member. With respect to educational issues, concerns include the need to assure comparable clerkship and residency experiences across all sites, to recognize the role of the resident as teacher, and to address the impact of changes in resident work hours. The Medical School also needs to continue to plan for the future of research computing, to implement the proposal designed by the Countway Library to integrate knowledge management into the curriculum, and to support the library and the program in medical education in working together to identify and fund appropriate supplemental electronic resources to support the students and teaching faculty. Clinical Department Reviews Dolin told the council that since the start of the clinical department review program approximately one year ago, 11 of the 55 clinical departments have been reviewed. Each department is scheduled for review every five years. The reviews, which examine aspects of clinical, research, and teaching activities, highlight areas of strength as well as those areas in need of improvement. The review team, comprising three external reviewers, spends two days interviewing faculty, hospital leadership, trainees, and students. Interviews take place at both the Medical School and the hospitals. At the end of the visit, the reviewers prepare a detailed report that is presented to Martin and the head of the institution whose department is under review. Then Martin and the CEO meet with the department chair to give an oral debriefing. Search for Medical Education Dean Robert Mayer, HMS professor of medicine and chair of the search committee to select a new dean for medical education, reported that the committee had received résumés from more than 40 candidates. To date, 11 have been invited for the first round of interviews. The search committee, which was selected by Martin, is made up of members who represent a cross-section of the Harvard medical community. The committee aims to make recommendations to the dean by the end of the calendar year.   New Appointments to Full Professorships These faculty members were appointed to a full professorship in September. Sanjiv Chopra Professor of Medicine Beth Israel Deaconess Medical Center Chopra is faculty dean for continuing education at HMS. He also serves as director of clinical hepatology at Beth Israel Deaconess Medical Center. His research and clinical interests have centered on chronic hepatitis C virus infection, non-alcoholic steatohepatitis, and idiopathic genetic hemochromatosis. He is currently working with the faculty to develop innovative initiatives in teaching and learning in postgraduate courses and in offering CME courses online. Joan Miller Professor of Ophthalmology Massachusetts Eye and Ear Infirmary Miller is a vitreoretinal surgeon with a special interest in age-related macular degeneration. Her research interests are focused on ocular neovascularization, particularly as it relates to macular degeneration and diabetic retinopathy, including the role of growth factors, the development of anti-angiogenic therapy, and photodynamic therapy. Miller pioneered the development of photodynamic therapy using verteporfin for neovascular macular degeneration, from experimental studies through multicenter clinical trials leading to approval by the FDA and other health authorities as the first pharmacologic therapy for macular degeneration. In addition, Miller and her group were among the first to demonstrate the relevance of vascular endothelial growth factor (VEGF) in the development of ocular neovascularization and the potential use of drug therapies targeting VEGF. R. Clay Reid Professor of Neurobiology Harvard Medical School Reid studies how the brain processes visual information. As signals are transmitted along the pathway from the retina through the thalamus and on to the cerebral cortex, there is a profound transformation of how visual information is encoded. Reid's laboratory has examined the connections between neurons in this pathway and how these connections underlie the sensory transformations performed by the brain. His work has contributed to the understanding of multiple aspects of this pathway, including the processing of motion, orientation, and color. Jeremy Wolfe Professor of Ophthalmology Brigham and Women's Hospital Wolfe directs the Visual Attention Laboratory at Brigham and Women's Hospital. Within the broad areas of visual attention and visual perception, his lab has been most concerned with the problem of visual search--finding what we are looking for in a visual world filled with distractions. Wolfe and colleagues seek to answer questions such as What are the specific features of the visual input that guide attention to possible target items? and How does attention to an object change the perception of that object?   Dana-Farber/Harvard Center Awarded Third SPORE Grant The Dana-Farber/Harvard Cancer Center has received a $15 million, five-year grant for prostate cancer research from the National Cancer Institute to create its third SPORE (Specialized Program of Research Excellence). The initiative aims to speed into clinical practice novel ideas that have the potential to reduce cancer incidence and mortality and to improve survival and quality of life. The DF/HCC already has been awarded SPOREs for breast and skin cancers. The principal investigator for the new prostate cancer SPORE is Philip Kantoff, HMS associate professor of medicine and director of Dana- Farber's Lank Center for Genitourinary Oncology and chief of the Division of Solid Tumor Oncology. "This is a real boost to our program and should accelerate the rate of progress in bringing clinically meaningful benefit to patients," said Kantoff. The SPORE grant bolsters an already strong program that is interhospital and interdisciplinary and features bench-to-bedside research. The five projects of the new prostate cancer SPORE will attempt to link the genetics of a key signaling pathway, the PI3-kinase signaling pathway, to dietary and serological risk factors such as caloric intake and IGF-1 levels; study whether PPAR-gamma is a possible therapeutic target in prostate cancer; use SNP chip technology to analyze gene activity in cancer cells and investigate whether a pattern of activity can predict resistance to radiation therapy; use gene expression profiling to determine which patients who have had their prostate removed might experience a recurrence of cancer; and investigate the possibility that the androgen receptor on cancer cells plays a role in tumor growth even among prostate cancer cells that are androgen-independent.   IOM Recommends Better Protection for Research Subjects Earlier this month, an Institute of Medicine committee released a report that recommended increasing protections for human research subjects, including requiring all organizations, whether publicly or privately funded, to participate in a research participant protection program that would be subject to federal oversight. Ultimate responsibility for ensuring that protections are in place and followed would be with each organization's leadership. The committee also said that institutional review boards must have adequate time to review the ethical issues of proposed protocols, the original role they were intended to serve. "It is striking that neither the number of persons suffering serious harm or death each year, nor the number of participants in clinical research, is known. In the absence of good data on the current risks, our committee felt it best to urge a high level of protection while establishing a comprehensive database," said Daniel Federman, who chaired the committee and is HMS senior dean for alumni relations and clinical teaching. "If experience confirms, as many feel, that less stringent precautions would be adequate, that would be great and guidelines could be relaxed. As a committee we were eager to avoid unnecessary additions and the risk of discouraging both patients and doctors from participating in clinical research. For now, the Hippocratic 'do no harm' seems a good guide." For a copy of the full report, visit the IOM's website (www.iom.edu) and click on recent reports.   Family Van Back in Service For the past year, the Family Van, which provided free health and social services to some of Boston's most vulnerable communities since 1992, has been in storage due to a lack of funds. Now with the help of funding from a variety of foundations and corporations, it will be back in Boston neighborhoods providing curbside assistance, including confidential medical screenings, health education, and referrals to appropriate health, city, and community services. Major gifts from the Putnam Investments Senior Executives Foundation, the Paul and Phyllis Fireman Foundation, the Robert Wood Johnson Foundation, the Blue Cross and Blue Shield Foundation, and the Sarita Kennedy East Foundation have enabled the van to return to service. The Medical School provides for staff parking and other support.   New Peabody Associate Masters Named The Peabody Society executive council has announced that Susan Pauker and Stephen Blacklow have been appointed associate masters of the Francis Weld Peabody Society. Pauker is an HMS associate clinical professor of pediatrics and chief of the Genetics Department at Harvard Vanguard Medical Associates as well as a pediatrician at Massachusetts General Hospital. Blacklow is an HMS associate professor of pathology and associate pathologist at Brigham and Women's Hospital. They join society master Ronald Arky and associate master Beverly Woo.   In Memoriam Catherine Binderup, retired assistant librarian for reference services at Countway Library, died on Sept. 9 at the age of 91. Binderup was an alumna of the University of Nebraska, Radcliffe College, and Simmons College. She worked as the head nurse of the psychiatric ward in the Bulfinch Building at Massachusetts General Hospital prior to serving as a lieutenant with the U.S. Naval Reserve Nurse Corps in 1946. She began working at the Boston Medical Library in 1948, and after many years there moved to the Harvard Medical Library, settling finally at Countway when the two libraries merged. She retired in 1979, but remained involved in activities held at Countway. She leaves two cousins, George Lnenicka of Atlanta and Roberta Masser of Billings, Mont. (Photo courtesy of Radcliffe Institute for Advanced Study, Harvard University) Ronald Malt, HMS professor emeritus of surgery at Massachusetts General Hospital, died Oct. 5. He was 70. Malt graduated with honors from HMS in 1955, then did his surgical training at Massachusetts General Hospital, where he was chosen as chief resident from 1961 to 1962. In 1962, an MGH surgical team led by Malt performed the first successful replantation of a completely severed human limb. After his residency he spent two years doing research at MIT before returning as a full-time faculty member in surgery at MGH and HMS in 1964. During the last 38 years, Malt had an outstanding and productive career. He was nationally and internationally recognized for his contributions to general and gastrointestinal surgery as well as to clinical teaching. He was chief of the GI Surgical Unit at MGH for more than 20 years. Malt authored or coauthored more than 500 publications, including a number of textbooks, most notably the first edition of The Oxford Textbook of Surgery, coedited by Peter Morris and published in 1994. He is survived by his mother, Ruth; his wife, Geraldine; his children Bradford, Barbara, and Margaret; and two grandsons, Alexander and Bradford. In lieu of flowers, donations may be made to the Ronald A. Malt Surgical Residents Fund at Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114.   Honors and Advances The Foundation for the History of Women in Medicine has named Carola Eisenberg, HMS lecturer on social medicine, as the recipient of the 2002 Alma Dea Morani, M.D. Renaissance Woman Award. The foundation cited her work as dean of student affairs at MIT and HMS and her role as a founding member and VP of Physicians for Human Rights.   News Briefs The Scholars in Clinical Science Program is accepting applications for its postgraduate training program at HMS designed for individuals interested in pursuing careers in patient-oriented research. Graduates of the two-year program receive a master of medical sciences degree from HMS. The deadline for applications for the 2003-2004 academic year is Jan. 15, 2003. Candidates must have an MD or DMD degree and have completed their clinical training by the time the program begins in July. Individuals with a PhD in a clinical discipline may also be eligible. For more information and an application, visit www.hms.harvard.edu/gradprograms/scsp or contact Sophia Reaud at 617-432-1386. The Kresge Center Proteomics Facility at HSPH recently purchased a mass spectrometer with a National Science Foundation grant. The machine is an LCQ Deca XP. The facility already offers 2D gel electrophoresis. For more information on the facility, visit www.hsph.harvard.edu/proteomics.