Dean's Rounds, Issue #5
Dear VP&S Community,
Writing this Dean’s Rounds is bittersweet. It is my last one, and I have been sitting with that for a few days—all the things I will miss about this role, and all the people I am grateful to have worked alongside. At the same time, I am excited about what comes next with the Vagelos Institute, and I cannot think of a better way to use this final message than on a topic that has been at the center of my own scientific life for 30 years: the use of genetics and genomics to change the way we understand, prevent, and treat disease.
What is happening right now at Columbia in precision medicine is extraordinary. The Columbia Precision Medicine Initiative (CPMI), which is supported by Roy and Diana Vagelos, is building something that we all dreamed of when I first started in this field: a coherent, institution-wide system that connects genomic testing in the clinic to large-scale research infrastructure and back again to patient care.
Under the leadership of Jennifer Posey, CUIMC’s inaugural chief genomics officer, we have been working to transition genomic medicine from a specialty service to a natural part of patient care by expanding access, standardizing how we implement and interpret testing, and strengthening the link between what we discover in the lab and what we do at the bedside. A search is underway in the Department of Pathology and Cell Biology for a new vice chair of genomic pathology who will work closely with Dr. Posey to ensure that clinical infrastructure keeps pace with the science. The VP&S Genetic Counseling graduate program is central to this future, training the professionals who help patients and families understand genomic risk, make informed decisions, and navigate the increasingly complex role of genetics in prevention, diagnosis, and treatment.
On the research side, the Columbia University Biobank anchors an integrated genomic data ecosystem that allows data from consenting patients to be shared and studied across the institution. The Genomic & Bioinformatics Analysis Resource (GenBAR) has processed nearly 10,000 whole-genome samples, with exome processing ongoing. Not long ago, sequencing a single human genome was a years-long, multi-institution project. Now we are doing it at scale, with the bioinformatic infrastructure to learn from it. Columbia’s partnership with the New York Genome Center, led by Bing Ren, also provides access to sequencing capacity and collaborative research to amplify our internal efforts.
This system-wide approach is complemented by an extraordinary depth and breadth of precision medicine programs across our clinical departments. In the Department of Medicine, Ali Gharavi has established the Nephrology Division as a world leader in the genetics of kidney disease and is now expanding the implementation of genomic medicine in other areas, including the creation of a pilot program for rare disease programs. In psychiatry, the newly established SNF Center for Precision Psychiatry and Mental Health, supported by a $75 million gift from the Stavros Niarchos Foundation, is building large datasets of genomic sequences and longitudinal medical records to understand the causes of severe psychiatric disease and develop more targeted treatments. In ophthalmology, our physicians are using genome and exome sequencing in patients with inherited retinal diseases, and researchers like Stephen Tsang, professor of ophthalmology, and pathology and cell biology, are using CRISPR-based approaches that could one day halt retinal degeneration. In obstetrics and gynecology, the Women’s Genetics Center is moving whole genome sequencing into prenatal care. And across neurology, precision approaches to diseases like ALS are helping patients access experimental therapies informed by their specific genetic profiles. Faculty from all these departments and beyond are active contributors to CPMI's advisory structure and clinical working groups—guided by Jennifer Posey and Christine Garcia, chief of the division of pulmonary, allergy, and critical medicine—reflecting a community that genuinely embraces the idea that genomic medicine is not a subspecialty, but a way of practicing.
Nearly 30 years ago, I received a K award from the National Cancer Institute to study the role of genetic testing in reducing breast cancer mortality. It is incredible to see the scientific, technological, and clinical progress that has been made in genomic medicine since then. At the same time, one of that grant’s major findings remains largely unsolved: access to these advances is unequally and inequitably distributed.
Roy Vagelos’s belief in the power of biomedical discovery to drive better health for everyone is fundamental to the precision medicine initiative and forms the foundation of the Vagelos Institute’s mission moving forward. I have no doubt that we can be both scientifically bold and deeply equitable; protect curiosity-driven science that enables transformation change while ensuring that change reaches all of those in need; and follow in the footsteps of Dr. Vagelos in the school that bears his name.
Serving as dean of VP&S has been one of the great privileges of my career. Besides making this former Bostonian a Knicks fan, this community—the amazing people who make this place what it is—has shaped how I think about medicine, science, and what it means to lead. I am grateful for every bit of it.
With appreciation for all that you do,
Katrina Armstrong, MD
Dean of the Faculties of Health Sciences and the Vagelos College of Physicians and Surgeons
Executive Vice President for Health and Biomedical Sciences, Columbia University