Periodic External Evaluation Of Any Academic Institution Is Never A Bad Idea

Periodic External Evaluation Of Any Academic Institution Is Never A Bad Idea

By

Leonard Zwelling

https://www.nytimes.com/2026/04/21/opinion/yale-report-academia.html

Although the MD Anderson Cancer Center has been through a bunch of media promotions, tag line changes, and now a new logo, the underlying mission of the cancer center has remained the same—eradicate cancer.

It has utilized four guiding academic pursuits to attempt to do that—clinical care, research, education, and prevention. My question is, has anyone examined whether or not this endeavor is succeeding? And, what are the metrics of success? These academic pursuits cannot be measured only in dollars, square feet, or numbers of personnel. But easy metrics are hard to find.

In the attach editorial from The New York Times on April 22 by Bret Stephens, the recent report from a committee at Yale empaneled by Yale’s president Maurie McInnis determined that Yale had lost its way. It said that the purpose of the university is “to preserve, create, and share knowledge.” This is a much different mission than that of MD Anderson, but just as basic. Yale had lost its way in pursuit of DEI and wokeism among other distractions. Has MD Anderson lost its way? Has anyone looked?

The Yale president had determined that public trust in elite universities had vanished and that the universities needed to do something to gain it back. Two of the reasons for the lack of trust were listed as “bureaucratic bloat” and “an intellectual atmosphere of censoriousness and self-censorship.” These two apply at Yale and may apply at MD Anderson as well. Has Anderson grown too big? Has the huge growth in bureaucracy served the underlying mission of the cancer center? And what about the intellectual environment at Anderson? Are faculty and staff free to speak their minds or do they self-censor for fear of job loss?

Also noted in the Yale report is the difficulty of making change. “Part of the problem is that a university that spent decades turning itself into what it is now cannot easily turn itself into something else—not least because the self-governing (and often self-dealing) structures of academic life make it difficult to foster deep cultural changes that universities require.”

As this blog has reported many times, the inflection point downward in MD Anderson’s history was when its president, John Mendelsohn, got involved with two, major headline-grabbing business scandals, Enron and ImClone, and the UT Board of Regents left him in place for another nine years. Overnight, it seemed, Mendelsohn turned the reins of institutional governance over to the lawyers. All decisions were based on risk aversion, none on boldness in the pursuit of the conquest of cancer. “Research-driven patient care” gave way to lawyer-driven overregulation where money trumped discovery and policies overrode publications. What else can explain the plethora of on-line training aimed at blaming any wrongdoing by a faculty or staff member on that person by saying that the institution informed all personnel about every rule one could imagine? If someone broke one of the rules, it is no longer the institution’s fault. That may be avoiding risk through obfuscation, but that will not cure cancer and it sure takes everyone many hours to take the annual computer-based trainings like the EEE. These are faculty hours away from patient care and research and, thus, wasted just to avoid risk. Ask any patient at the other end of an IV line getting a phase 1 drug about risk.

I think the time is right for a thorough examination of the direction that MD Anderson has taken in the past 25 years, its successes and failures, and the plan on moving forward again in pursuit of the mission of eradicating cancer as opposed to increasing income, over hiring, and over paying institutional leaders.

Here are some questions for any committee tasked with this review. If such a committee is formed it should contain real experts in clinical cancer care, cancer research, graduate education, and cancer prevention. Its members must have no past or current affiliation with MD Anderson including people involved with pharmaceutical companies in contractual relations with the cancer center.

Here are some of my questions:

Is MD Anderson non-protocol clinical care objectively and measurably better than standard of care elsewhere? What are the critical metrics (e.g., alteration in the natural history of cancer)? For which cancers does MD Anderson truly alter the outcome and give patients a better chance at greater survival? For example, I am certain that care on the Adult Leukemia service is state-of-the art and that department has metrics of its success. I believe that MD Anderson surgeons, pathologists, radiologists, and radiotherapists are without equal. But does all that fire power lead to more cures and prolonged life spans?

In research, has any new drug emerged from research that began in an MD Anderson laboratory? Drug company trials with MD Anderson discoveries count if Anderson identified the drug. An example from the past of a treatment that saved lives is liposomal muramyl tripeptide invented by Dr. Fidler and clinically developed by Dr. Kleinerman for the treatment of osteosarcoma. In my time as a vice president, the Leukemia Department was a leader in accruing patients on Gleevec trials. I’ll bet there are many other examples of MD Anderson leadership in clinical research. What are they? Which department has been a leader in this? Which departments have been treading water and require new leadership?

In education, how many MD Anderson fellows have gone on to make significant contributions in academic medicine? Which PhDs and MD-PhDs have continued to make significant contributions after their training at Anderson? I know that several of the MD-PhD graduates of the UT Medical School-MD Anderson Cancer Track that I initiated back in 1989 and ran for ten years are now on the MD Anderson faculty. One is a department chair. Has that continued in this century?

Finally, in prevention, what discovery at MD Anderson has altered the way populations can be screened for cancer and what practices have MD Anderson faculty developed that alter cancer risk in any population?

I am sure you can think of many other questions that such a committee could examine to determine the quantifiable strengths of MD Anderson and the areas needing work and investment.

Finally, on the administrative side, I can readily point to the fact that under my vice presidency, there was a single door through which all paperwork supporting research would enter. Faculty did not have to search for the right person. That person was LZ. That was the purpose of my office—“service with a sense of urgency” was our mission statement. My guess is today there are many doors for research paperwork (clinical protocols, animal protocols, biosafety declarations, conflict of interest disclosures, grant applications, contracts, and submissions to the FDA) and few are under faculty control. They used to be. That they aren’t is too bad for the current faculty.

I have been made aware of tremendous runarounds perpetrated on wronged faculty who are bounced between the Compliance Office, HR, and departmental administration only to have their grievances ignored or overturned by the department chair or even the president. That’s not good administration at all.

I am going to argue that MD Anderson is no longer fulfilling its mission just as the president of Yale thought was the case at his institution. However, I could be wrong. It’s time to find out.

I wonder if President Pisters has the courage to look in the mirror, form the committee, and act on the results. It would be a far greater contribution by him than his quest for more buildings and might even justify the $4 million he is paid.