Challenges in Managing a Medical School.

We recently had the honor and enormous challenge of taking over as co-directors of the School of Medicine of the University of São Paulo (FMUSP). FMUSP has been nationally and internationally recognized for its pioneering spirit and excellence, both in terms of teaching and research and university extension. It has been training professionals for 110 years in the fields of medicine, physiotherapy, speech therapy, and occupational therapy, and the most recent Medical Physics Program establishes a partnership between the School of Medicine and the Physics Institute of the University of São Paulo. Our numbers speak for themselves: we have approximately 1,400 undergraduate students; more than 1,000 employees, including 368 professors; 2,000 graduate students; and 1,600 residents. We publish more than 2,500 scientific articles annually. Our Clinical Hospital (CH) is the largest hospital in Latin America, a state institution linked to the Secretary of Health of the State of São Paulo for administrative coordination purposes and associated with FMUSP for teaching, research, health initiatives, and community services. The CH comprises eight institutes (Central Institute, Psychiatry Institute, Heart Institute, Radiology Institute, Cancer Institute, Institute for Children and Adolescents, Orthopedics and Traumatology Institute, and Physical Medicine and Rehabilitation Institute) and two auxiliary hospitals (Suzano Auxiliary Hospital and Cotoxó Hospital Complex). Annually, we provide more than one million outpatient appointments, 180,000 urgent and emergency care appointments, and approximately 50,000 surgeries. We are one of the largest medical-scientific research centers in Brazil, with 66 medical investigation laboratories, 230 research groups, and extensive intellectual output. Our faculty and healthcare professionals represent a huge competitive advantage for obtaining resources in the areas of clinical research, innovation, education, and assistance. Many of our professors are among the most influential researchers in the world, according to an assessment by the British consultancy Clarivate Analytics.1 In the search for community-based planning that reflects the best strategies to meet the institution’s needs and define its future directions, the FMUSP 2030 strategic plan was prepared in December 2021 to outline new goals, processes, and guidelines for the new cycle that has just begun. Several CH leaders and representatives from the Zerbini Foundation (ZF) and the School of Medicine Foundation (SMF) participated in it. Planning is integrated between the FMUSP and the CH, with a focus on care, technical, and administrative teaching processes, research and innovation actions, and human resources. The actions are developed according to strategic axes, which deal with current themes of high social relevance, such as Excellence in Teaching, Culture, and Extension; Excellence in Care; Integration; Humanization-Participatory Management; Internationalization; Sustainability; and Research, Innovation, and Entrepreneurship. Faced with this challenge, we chose “talent retention” as our management motto. This motto represents our institution’s conviction that guaranteeing the future of our school as a place of transformation and excellence depends on our greatest immaterial wealth: the employees working at the FMUSP complex. However, “talent retention” requires economic sustainability; thus, we need to improve our capacity to retain qualified human resources, which involves competitive compensation and greater investments in infrastructure, innovation, and internationalization. IMD, PhD. Vice Director, Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, BR; Full Professor, Department of Cardiopulmonology, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, BR. Director, Scientific Department, Associação Paulista de Medicina (APM), São Paulo, SP, BR. https://orcid.org/0000-0001-7243-5343