Dean's dedication, vision transform medical school

The Baltimore Sun

CLARIFICATION

An article in Saturday's editions about the retirement of Dr. Donald E. Wilson as dean of the University of Maryland School of Medicine quoted Dr. Morton I. Rapoport, who was chief executive officer of the University of Maryland Medical System in 1991 when Wilson was hired. Dr. Rapoport was succeeded in that post in 2003 by Edmond F. Notebaert. Eighty-hour workweeks, plus the wear and tear of academic politics, egos and turf battles are enough to push U.S. medical school deans from office after an average of just 4 1/2 years.

But after a decade and a half on the job, it was Dr. Donald E. Wilson's kidneys that persuaded him to retire as dean of the University of Maryland School of Medicine in Baltimore. Kidney failure and a transplant in December 2004 left him short of energy.

"It became clear to me that I couldn't put in the kind of workday I'd been used to," Wilson said. "I didn't feel comfortable doing less than I thought I should be doing."

And so, the second-longest-serving medical school dean in the country officially relinquished his office yesterday at the age of 70, after a tenure that has transformed the institution.

Wilson is succeeded by Dr. E. Albert Reece, who was dean of the College of Medicine at the University of Arkansas for Medical Sciences, at Little Rock.

"When he came, the University of Maryland [medical school] was not regarded generally as one of the real research powerhouses in the country," said Dr. Jordan J. Cohen, president emeritus of the Association of American Medical Colleges. But Wilson's stewardship "has increased the research prominence and success of the school dramatically."

As a research institution, Maryland's medical school has long existed in the shadow of crosstown colossus Johns Hopkins University. But Hopkins' President, Dr. William R. Brody, said that UM has become "a real power ... a dynamic and vital organization at a time when medical schools around the country are struggling."

Maryland is now "highly competitive for some of the very best students," as well as for top faculty members. And that's a good thing, Brody said. Competition "makes us more responsive to the marketplace."

Under Wilson's leadership, the medical school built two bio-medical research buildings and is angling for a third. He also established the Center for Health Disparities, a new National Institutes of Health organization to study ethnic, racial and geographic differences in the diagnosis and treatment of disease.

Full-time staffing, student enrollments, clinical revenues, private gifts, endowed chairs and professorships have all grown enormously. So have research grants to the school's faculty - from $77.5 million when he took over in 1991, to $349.5 million last year.

Wilson's journey to UM was an unusual one. He was born in Worcester, Mass., where his father, Rivers Wilson, settled after leaving the South. The elder Wilson bought a truck, launched a trash-collecting business and invested his profits in real estate.

At 5, Donald decided he wanted to be a doctor. His parents ultimately rejected a school principal's advice that they send him to trade school, and he went to a college prep school instead - one of just three black students in a class of 300.

Described by classmates as humble, jocular, outspoken and popular, he fit in easily and excelled. He told a Sun reporter in 2000 that race was never an issue in his high school.

"Although I was quite aware that I was different, I didn't grow up feeling that I was burdened," he said. "Given my education and my background, no matter what color I was, you would expect me to succeed."

His approach to the subtle but inevitable bias he's encountered since then has been to "prove everybody wrong and do well."

Wilson graduated from Harvard University and the Tufts University School of Medicine. He was the youngest full professor ever at the University of Illinois medical school, and when Maryland came calling in 1991, he was physician-in-chief at the University Hospital and Kings County Hospital Center in Brooklyn, N.Y.

At Maryland he became the first African-American dean of a predominantly white U.S. medical school. When he arrived, the state-funded medical school was still adjusting to its partnership with its affiliated, but recently privatized hospital - the University of Maryland Medical Center.

Dr. Morton Rapoport, chief executive officer of the parent UM Medical System, was working to get the hospital's financial house in order. That created tensions and turf battles in many camps, including the medical school, where the priorities had always been research and education, not hospital management and budgets.

"What makes strong academic medical centers is aligning those priorities," Rapoport said. "He [Wilson] was a great partner ... We didn't always agree, but we found ways to compromise and found ways to achieve our common objectives."

Wilson quickly launched his own agenda. He was determined to change the culture of the medical school, "from folks who were satisfied with being OK, to folks who decided they wanted to be the very best in the country."

"You talk about your vision; you talk about your ideals, what you expect people to accomplish," he said, explaining his strategy. "You try to motivate people who may not want to change their approach, and if they don't change their approach, then you replace them with people who do have a vision that's similar to yours."

Some didn't care for Wilson's style. "I know there are people who say he is arrogant," said Nelson Sabatini, a close friend of Wilson's who served under two governors as Maryland's secretary of health, and as a corporate vice president at the UM Medical System.

"I've always felt that when you're as good as he is, it's not being arrogant. You're just reflecting reality," he said. Like boxing great Muhammad Ali, Sabatini said, "He really was the greatest."

Wilson pushed his department chairs to overhaul the curriculum. They reduced the long hours of lectures and augmented textbooks with exposure to clinical practitioners. Students learned in smaller groups - and they were all required to have a laptop computer, a rarity at the time.

"The reality is, half of what you teach is going to be irrelevant" in short order, Wilson said. "We try to teach the students how to learn, how to access the databases, how to evaluate the literature and how to use the technology in order to keep them up to date."

Wilson's greatest challenge was to recruit top-flight educators and researchers to a Baltimore medical school that was not Hopkins.

"He recognized quality, and he strived to achieve quality among the people we recruited," Rapoport recalled. "He was incredibly honest. He cared, and he had a high standard of integrity. You want to be around people you respect, and people respected Don Wilson."

Dr. Frank M. Calia was preparing to leave the school when Wilson persuaded him to stay and made him chairman of the Department of Medicine. "He's a very charismatic guy," Calia said. "He recruited [department] chairs very well, and they in turn recruited scientists. He also knew his way around the National Institutes of Health and was very wise in getting all kinds of different support from the NIH."

The faculty now includes top scientists and clinicians in radiology, organ transplants, cardiac surgery, infectious diseases and genomics. And as more leading lights join the faculty and publish in the top medical journals, other institutions across the country take notice.

The net result: "Faith in the leader, in the dean, just gets stronger," said David J. Ramsay, president of the University of Maryland, Baltimore. "On the whole, they believe he's moving the institution in the right direction."

In 2003-2004 the school ranked fifth among all public and private medical schools in the value of research grants per clinical faculty member - actually ahead of Johns Hopkins (which still receives far more total dollars).

For his part, Wilson said he knew he couldn't recruit top researchers without state-of-the-art equipment and lab space. He oversaw the completion - primarily with state funding - of two research towers in 1995 and 2003. Now that they're full, he says a third is critical.

"That's the major problem we have in holding on to our outstanding faculty and recruiting faculty to come here - our lack of research space," he declared.

Although the School of Medicine is still widely perceived as a public institution, less than 5 percent of its annual operating budget comes from state appropriations. And even that amount has declined during Wilson's tenure - from $32 million in 1991, to $25 million this year. In constant dollars, that's a 44 percent decrease in buying power.

Wilson said Maryland ranks "dead last" in state funding among the nine public medical schools he regards as its peers. "It's public in name only," he said. "There's never been that much of a commitment to higher education in the state of Maryland."

More state support, he argued, could help reduce rising tuition, which discourages minorities and others from applying. "If we end up having a cadre of physicians who come only from those families who can afford to pay $120,000 to $150,000 to go to medical school, then I think our country is going to be poorly served," he said.

Under Wilson, the school's diversity has slowly increased. More than half of incoming medical freshmen last year were women, and 16 percent were underrepresented minorities.

Minority faculty nearly tripled during his tenure, from 31 to 88 - from 3.7 to 7.4 percent. African-Americans lead the departments of radiation oncology, family medicine, reproductive sciences and, until recently, ophthalmology.

He insists he never specifically ordered increases in minority enrollment or faculty. But he understands why that happened. "I came here and leveled the playing field," he said. "Most people want to please the boss."

The school has more minority students "because they feel more comfortable here than they did 15 years ago," he added.

Wilson said he has asked to be left alone for 90 days after his official retirement. But he plans to work on "finishing up" some pet projects, including the new Center for Health Disparities.

Even so, he seems determined to slow down and enjoy time with his wife, Patricia, their four children and two grandchildren, splitting time between homes in Owings Mills and Bradenton, Fla.

After his transplant, he said, "I decided that ... whatever days or years I had left I was going to spend a little more time dealing with me and my family rather than dealing with the institution."

And, he said, "I'd like to do a little bit of fishing."

frank.roylance@baltsun.com

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