Member Profile: University of Texas Health Science Center at San Antonio School of Medicine

Background

The opening of The University of Texas Medical School in 1968 and the creation of The University of Texas Health Science Center at San Antonio (UTHSCSA) in 1972 have proven to be momentous events in San Antonio's history. Today, the Health Science Center extends to South Texas cities through a variety of educational and clinical programs, and has a presence at the Texas Research Park set amid the prickly pear and stony soil of Texas' Hill Country.

From the early days when great pride was taken in the completion of a single building housing the Medical School, to the creation of the Texas Research Park with its Institute of Biotechnology and other components in the 1990s, the Health Science Center has been on a steady pathway of growth.

In hindsight, it seems odd that San Antonio did not open a medical school until the 1960s. After all, the city had been inhabited since 1718, when the Spanish founded it as the San Antonio de Bexar Presidio. Fully 120 years before Galveston was founded, a colony of 200 Canary Island families had made San Antonio their home. By the time of the American Revolution, San Antonio was a bustling settlement of 2,060 people and was the capital of Spanish Texas.

Yet, 170 years later, in the 1880s, it was Galveston, not San Antonio or Houston, that was selected as the location for Texas' first state-run medical school. By that time, San Antonio was an important city in Texas with a population of more than 20,000. Galveston could have argued that its historical ties to Texas medicine began when Spanish explorer Alvar Nunez Cabeza de Vaca, shipwrecked on Galveston Island in 1528, attended to the few Karankawa Indians who did not succumb to diseases brought by de Vaca's entourage.

Spanish priests in the San Antonio missions used herbal remedies and prayer for the infectious disease outbreaks that occurred with frequency in the 1700s. As immigrants from Europe began to pour into Texas in the early 1800s, more scientific, but still-crude, medical solutions were offered. The Republic of Texas was founded, in part, by the courage and foresight of physicians. Seven of the fifty-nine signers of the Texas Declaration of Independence at Washington-on-the-Brazos were physicians.

Great progress would be made in the physical and organizational development of the medical school, its teaching hospital and other affiliated and non-affiliated hospitals within the South Texas Medical Center. New schools would be launched, paving the way for the creation of a Health Science Center.

For Dean Pannill and others who were the pioneers in launching the medical school, however, it would be a period marked by tremendous optimism, overwhelming disappointments and a whirlwind of activity aimed at creating a top-notch school. In September 1968, nearly 90 years after San Antonio's first attempt to gain a medical school, The University of Texas Medical School at San Antonio opened. It was an achievement that had taken cooperation, determination, and the support of some of the city's and the nation's most respected leaders.

By the mid-1990s, the Health Science Center had reached maturity as an institution. The many achievements by its schools were reported in the national press with regularity.

With a total enrollment approaching 2,700 students, the university had become a respected center of learning. Its many scientific endeavors and innovative patient care procedures literally made headlines the world over. By the end of the decade, more than 600 students annually were receiving graduate and baccalaureate degrees, as well as certificates, from UTHSCSA.

Mission

The mission of the University of Texas Health Science Center at San Antonio is to serve the needs of the citizens of Texas, the nation, and the world through programs committed to excellence and designed to:

• Educate health professionals for San Antonio and the entire South Texas Community and for the State of Texas to provide the best possible health care, to apply state-of-the-art treatment modalities, and to continue to seek information fundamental to the prevention, diagnosis, and treatment of disease.
• Play a major regional, national and international role as a leading biomedical education and research institution in the discovery of new knowledge and the search for answers to society's health care needs.
• Be an integral part of the health care delivery system of San Antonio and the entire South Texas community, as well as an important component of the health care delivery system of The State of Texas and the nation.
• Serve as a catalyst for stimulating the life science industry in South Texas, culminating in services and technology transfer that benefit local and state economies.
• Offer continuing education programs and expertise for professional and lay communities.

Teamwork

San Antonio Life Sciences Institute (SALSI)
In October of 2003 this new innovative funding opportunity was created by Presidents Cigarroa and Romo of UTHSCSA and UTSA, to increase both the UTHSCSA's and UTSA's research-funding base with cross campus collaborative programs. SALSI will encourage interaction between investigators in support of the acquisition of established extramural, peer-reviewed research funding—a combination of institutional and state funds over a two year period—and will involve supporting development of programmatic/thematic/translational group research efforts between the two campuses. Targeted areas include, but are not exclusive to: bioengineering, bioterrorism, health disparities, and neuroscience, areas described in the NIH Roadmap to the Future.

Innovation

The Health Science Center continues to be the primary catalyst for San Antonio's biomedical industry. As the only Tier One research university in South Texas, the Health Science Center is ranked in the top 10 percent of all research universities nationwide

Inventions stemming from the Health Science Center include:

• The Palmaz Stent - One of the top 10 patents that changed the world; used to treat more than two million coronary patients a year.
• EZ-10 - A lifesaving method for critically ill patients who might die waiting for a traditional IV lines.
• The Titanium Rib - An FDA-approved treatment that saves hundreds of children across the country.

Demographics

San Antonio is home to the largest military health care and biomedical research operations in the United States, providing unique collaborative opportunities not available elsewhere.

San Antonio is the home to one of the world's largest primate research colonies, the Southwest National Primate Research Center housed at the Southwest Foundation for Biomedical Research (SFBR) and featuring long-standing collaborations among many partners and representing an outstanding resource for T1 research activities.

UTHSCSA is comprised of six campuses, three in San Antonio and three in South Texas. In particular between 10-15% of each School of Medicine Class spends their 3rd and 4th years in Harlingen completing their clinical studies at the Valley Baptist Hospital and other clinical facilities throughout the Valley. This program has been on-going for six years and is intended to increase the number of physicians who will practice in this terribly underserved area. The students have responded favorably to the opportunity because the Health Science Center serves a 46,000 square mile area including the Lower Rio Grande Valley populated by predominantly Hispanic residents comprising some of the poorest people plagued by the highest rate of health disparities in the U.S., providing an opportunity, challenge and obligation for them to make a significant impact on human health.

UTHSCSA has invested substantially in research resources and infrastructure to support programs in the Lower Rio Grande Valley, including a 47,000 sq ft translational research facility with the only BSL3 lab in the region and a state-of-the-art clinical research center.

Discovery

CTSA
In November 2005, the UTHSCSA established the Institute for Integration of Medicine and Science (IIMS), the home for our Clinical and Translational Science Award (CTSA) Program. The mission of the IIMS is to achieve optimal integration of clinical and translational research, education, training, and career development across all UTHSCSA schools and programs and among our diverse public and private partner organizations in the South Texas region. The IIMS will focus existing and newly developing resources and intellectual capital on advancing the discipline of clinical and translational research, including both type 1 (T1) translation (basic to clinical) and type 2 (T2) translation (clinical to best practices) for the improvement of human health. (approximately 35M).

Aging
The Barshop Institute is dedicated to enhancing the quality of gerontological research and clinical application, with the ultimate goal of providing humankind with longer lives, free of debilitating disease. The Barshop Institute is bringing together the world's leading scientists in aging research and equipping them with the latest technologies and research methods to understand, treat, and cure aging-related diseases such as cancer, diabetes, heart disease, and Alzheimer's and Parkinson's diseases. In its quest to eradicate the ravages of age-related disease, the Barshop Institute has become the premier center for aging research, world-wide.

Neuroscience/PTSD
A $33 million research program—the largest ever undertaken to help armed forces personnel cope with combat-related traumatic stress—will likely ensure better detection, prevention, and treatment of traumatic stress' often-devastating effects and improve countless lives. The research program is supported by a grant from the U.S. Department of Defense (DoD) as part of $450 million the U.S. Congress allocated in 2007 to address the issue of post-traumatic stress disorder (PTSD). The DoD Peer-Review Medical Research Program awarded the grant.

Metabolic Biology
Type 2 diabetes mellitus affects approximately 6% of the U.S. population or around 18 million individuals. Each year approximately 800,000 Americans develop type 2 diabetes. The cost to treat diabetes and its associated complications exceeds 140 billion dollars per year. Most disturbing, the prevalence of type 2 diabetes mellitus is increasing at an alarming rate, having risen by 33% over the last decade. The incidence of type 2 diabetes mellitus is especially high in certain ethnic groups and, in Mexican Americans over the age of 45 years, approximately one out of four individuals has type 2 diabetes mellitus. Thus, of the 18 million type 2 diabetics in the U.S., the state of Texas has a disproportionate share, and this is attributed in large part of its ethnic mix. The goals of the Center for Metabolic and Molecular Diabetes Research goal are to:

1. assemble a group of basic and clinical investigators who work collaboratively to define the cellular/molecular/genetic mechanisms responsible for insulin resistance, diabetes mellitus, accelerated atherosclerosis, and associated metabolic disorders;
2. establish an integrated program that translates discoveries about basic disease mechanisms into human studies designed to ameliorate/prevent these common metabolic-cardiovascular disorders;
3. develop a training program for young M.D./Ph.D. investigators who demonstrate interest and excellence in both basic and clinical investigation (approximately $13M).

Current Projects

Completion of the Medical Arts and Research Center (MARC) which will be the 280,000 sq. ft. home of our Faculty Practice. Not only is a new building being completed but the Faculty Practice recently completed the implementation of the EPIC Practice Management System and is currently installing EPIC's EMR System. While clinical revenues underwrite approximately 26% of the HSC's operating budget, we are optimistic that these investments will result in a substantial increase of clinical revenues.

Merger of the Cancer Therapy and Research Center with the Health Science Center. The HSC partnered with this standalone NCI designated Cancer Center for years and in December 2007, the CTRC became a Center within the HSC. Integrating these two disparate institutions has been a challenge but will no doubt strengthen our ability to both service patients suffering from cancer while strengthening our ability to improve our research in an effort to help find the cures for this dreaded disease.

Building the South Texas Research Facility. We are close to accumulating the necessary funding to break ground for this dramatic new facility which will house collaborative and inter-disciplinary research. The facility will not only help accelerate our rate of discoveries through a state of the art research facility but it will also serve as the gateway to our North Campus in San Antonio.