Dean Edward Abraham Brings Sweeping Vision to the Miller School of Medicine

As the next step in a spectacular career dedicated to advancing research, medical education and clinical care, Dean Edward Abraham describes the University of Miami Miller School of Medicine as an unmatched opportunity, with “great leadership, great colleagues, an exciting environment built on shared values, innovation and making a difference.”

“That’s really what led me to Miami,” said Dean Abraham, who became chief academic officer of the Miller School of Medicine and physician executive of the University of Miami Medical Group this week. “We have this tremendous potential to be a transformative institution in defining the future of medicine.”

The reasons for that potential include “wonderful faculty” who are outstanding clinicians and educators, as well as researchers making groundbreaking discoveries. As the one major research-intensive academic institution in a big urban area, the University of Miami can capitalize on geography to continue building its international reputation and its impact, Abraham said, attracting growing numbers of patients and the best students.

“Research has to be part of our DNA,” said Abraham, who was Dean of the Wake Forest School of Medicine. “We have to be able to have clinical programs that use novel therapies that non-academic medical centers aren’t providing, so we really advance the care of the patients, families and populations we serve. It’s part of our commitment to be able to say to them, here are our special programs, unique therapies, unique approaches to disease and the prevention of disease that you just can’t find in a non-academic medical center.”

That’s critical for medical students, too. “They need to see not only the best of today’s medicine but what’s coming down the pike so that they’re not only great physicians when they leave, but also prepared to be great providers in five years, 10 years, 20 years, all through their career.”

The Importance of Mentorship
Mentorship of those students and junior faculty is a huge priority for Abraham, and influenced his path immeasurably. As an undergraduate at Stanford, he wandered into the Department of Biochemistry “looking around for people to do research with – I guess I was sort of fearless.”

Dr. Ron Davis, who is now director of the Stanford Genome Technology Center, welcomed Abraham to his lab. “I had lots of his time and he was very enthusiastic, a wonderful mentor,” Abraham said. “That kind of excitement about discovery really got me hooked.”

After medical school at Stanford, Abraham did a residency in internal medicine at UCLA, followed by a fellowship at Harbor-UCLA, where he found other inspiring mentors. Dr. William Shoemaker, one of the founders of critical care medicine and the first editor of the journal Critical Care Medicine, encouraged Abraham to pursue discovery. “This enthusiasm for asking and answering questions just continued for me” as he became one of the first critical care physicians at UCLA, and led him to a Fulbright fellowship at the Pasteur Institute in France, working on basic immunologic mechanisms leading to lung injury and that were involved in defending the lung against infection.

Several years later, Abraham returned to UCLA and then moved to the University of Colorado, where he became chief of the pulmonary and critical care division and vice chair of the Department of Medicine. “I was able to move from the laboratory and start doing patient-based studies, which was tremendously exciting since we were able to see if the cellular pathways and mechanisms that we were exploring in the laboratory actually were important in patients who had overwhelming infections, sepsis, or acute lung injury.”

Research Linked to Clinical Care
As chair of medicine at the University of Alabama Birmingham, Abraham continued his work in “a very research-intensive department.”

That research links to clinical care in the personalized medicine model that is changing the environment of health care delivery. The growing emphasis on value, on prevention of illness rather than just treating disease, inspires important questions, Abraham says. How do we best manage diabetes, hypertension, or other illness so that a patient doesn’t have to come to the emergency room? How do we modify risk for a patient whose genetic background might predict Alzheimer’s disease or other problems?

Lifelong Learning
The fact that we have new therapies, new ways to diagnose risk, new approaches to preventing illness means our approach to education cannot be static, Abraham said. “We have to give our students tools for lifelong learning and train them how to deal with uncertainty and multiple sources of information,” he said.

“Students also have to know about health care economics, population health, and how to function in multidisciplinary teams.”

These skill sets weren’t included in the classical medical curriculum, and passive learning in lectures is being transformed into much more active, individualized, problem-based learning. Students must demonstrate competencies in several areas, and the new spaces and other features of the Miller School of Medicine Center for Medical Education will significantly enrich their experience.

Abraham has an idea of the possibilities because he recently designed a new medical education building at Wake Forest, with open, flexible spaces. “It’s one of the newest medical education buildings in the world,” he said, “and now I get to do it again, which is fabulous.”

The Future of Medicine
The Dean is also excited about the growth of outpatient activity, particularly at The Lennar Foundation Medical Center on the Coral Gables campus, which he calls “absolutely gorgeous.”

“That’s the future of medicine,” he said. “More and more complex procedures are done on an outpatient basis rather than inpatient. It allows us to take the University of Miami Health System experience into multiple other locations. It doesn’t require patients to come downtown when what they need – and what they need can be very complex – can be done closer to where they live.”

This rapidly changing health care environment also presents many challenges. Changes in the nature of reimbursement for patient care, and potential reductions in NIH funding and other government-supported research activities will have a major impact on all medical centers.

A Shared Vision
“We can’t do everything – no one can do everything,” Abraham said. “We have to think about where are we going to invest, where are there opportunities for us to have programs that are truly unique and truly nation-leading, and put our investments there.

“We need to come together – the faculty, the administration, the staff – and develop a shared vision of how we can achieve real pre-eminence, and how we can best support our multiple activities in clinical care, education and research, so that we can really be a very special, nationally and internationally renowned institution. Again, it comes back to the transformational role.”

Abraham sees these conversations as critically important to defining the strategic path for our research, education and clinical innovation, and making sure we follow it. “What I and our leadership team need to do is to try to remove as many bumps from the road as possible, and to facilitate our wonderful faculty in terms of reaching our shared goals,” he said.

Making a Difference
Making a difference in the community is a major goal for Abraham and his wife, Norma-May Isakow, who has been involved in community engagement programs with the provost at Wake Forest, and before that was director of service learning at UAB. They have two daughters, one a pediatric resident at Columbia, and the other doing email marketing in Boston.

“I’m also a very avid runner, so you may well see me in that alternate role,” Abraham said. “There were a lot of sightings in Winston-Salem, as well as in Denver and Birmingham.”

Running or walking, Abraham is committed to meeting people where they work, “to remove as many barriers as possible so that faculty and staff and students feel that their voices are heard.”

“This is really a wonderful institution,” the Dean said. “With our terrific faculty and community, commitment to the school and medical center, and shared vision for innovation, we can really accomplish remarkable things.

“I’m very excited about being here.”

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