哈佛医学院本来就陷入了赤字。然后特朗普来了
【中美创新时报2025 年 4 月 24 日编译讯】（记者温友平编译）该国首屈一指的医学院多年来一直亏损，严重依赖研究经费，而这些经费现在正受到白宫的威胁。《波士顿环球报》记者迪蒂·科利对此作了下述详细报道。
哈佛医学院因其在抗击糖尿病和天花方面的突破、 11 项诺贝尔奖以及仅接受 3% 申请者的竞争性学术课程而闻名。
学校官员上周在一次教职工大会上表示，学校目前财务状况岌岌可危，因为学校准备进行裁员和大规模削减，并呼吁对运营方式进行“长期、可持续”的转变。
在特朗普政府对哈佛大学和其他大学施压的背景下，这些举措标志着美国顶尖医学院的彻底变革 。长期以来饱受财务亏损之苦的哈佛医学院尤其容易受到本月 22亿美元联邦资金冻结的影响，其中包括美国国立卫生研究院的部分拨款。根据自2008年以来的年度院长报告， 哈佛医学院在过去17年中12年处于亏损状态， 平均每年支出比收入高出1100万美元。
一位发言人表示，赤字源于 学校 运营 成本 与收入之间的差距不断扩大，预计随着 关税上调、通货膨胀以及联邦政府研究资助的预期削减和延迟，这一差距还将进一步扩大。为了打击哈佛大学未能保护犹太学生的指控，特朗普总统 还在考虑将捐赠税提高十倍，并取消其免税资格。
削减的具体范围 目前尚不清楚。哈佛大学周一起诉特朗普政府滥用职权，称其违反宪法。目前，该医学院的领导层仍在为如何精简 预算而苦苦挣扎，而削减幅度究竟有多大仍未可知。
迄今为止，资金冻结并未波及医学院的附属医院——包括布莱根妇女医院、麻省总医院和贝斯以色列医院——这些医院 为哈佛医学院学生提供教学，并授予约1万名医生大学教授头衔 。但医学院的教职员工表示，这些职位很少获得大学提供的薪酬。因此，任何裁员行动都可能影响到由哈佛医学院支付薪酬的岗位，包括博士后研究员、教职工以及在校工作的190多名教授。（据MassLive报道，独立于医学院的哈佛大学陈曾熙公共卫生学院也面临预算危机，已开始裁员并退出两份租赁协议。）
研究可编程疗法以治疗从癌症到普通感冒等各种疾病的博士后研究员亚当·西克拉 (Adam Sychla) 表示，医学院的学生和研究人员已经准备好用更少的资源做更多的事情，因为他们可能会失去美国国立卫生研究院 (NIH) 的资金来支付他们的薪水。
“削减开支会导致更少的教师教授更多课程，这种想法很正常。这可能会导致行政人员减少，而行政人员无法帮助学校处理许多必要的事务，”他说。“我每天回家都打算明天不工作。”
大部分担忧都源于研究经费。白宫对哈佛大学的处罚指令可能会让该医学院失去数百万美元的拨款。去年，该医学院超过三分之一的运营收入依赖于政府和私人机构的拨款和合同。自二战以来，该学院的研究人员凭借其卓越的 研究水平一直获得着稳定的政府支持。这笔资金使 实验室 能够购买设备、支付科学家的工资并支付维护费用——而且目前 没有其他替代方案。
哈佛大学长期以来的财务计划都期望每个学院都能保持偿付能力，但哈佛医学院却难以做到这一点，尽管其慈善事业规模庞大，拥有50亿美元的捐赠基金——这笔资金是从哈佛大学530亿美元的捐赠基金中分拆出来的。医学院最大的收入来源是来自外部研究经费，其次是出版物收入、版税收入、慈善捐赠、学费以及年度捐赠基金分配。捐赠基金也不能被随意用于支付成本，而是在很大程度上受到捐赠者限制，用于特定用途。
行政执行院长丽莎·穆托 (Lisa Muto)在市政厅表示，研究资金 的消失迫使人们讨论“我们如何才能缩小我们的企业规模”。
“我们重视哈佛医学院所做的一切，”穆托说，“但我们现在将进入一个无法做所有事情的时代。”
（ 《哈佛深红报》获得了这次会议的录音， 《波士顿环球报》也向出席会议的教授们证实了这些评论。）
外部专家表示，医学院一直处于亏损状态，部分原因是研究成本不断增长。医学期刊《美国医学会杂志》（JAMA）今年4月的一项研究显示，如今开展科学研究的成本比几十年前更高，而美国国立卫生研究院（ NIH）的资金拨款在2003年停滞不前，落后于通货膨胀率。
《JAMA》研究报告的作者、宾夕法尼亚大学麻醉学教授纳迪尔·叶海亚 (Nadir Yehya) 表示，现在生物医学研究的材料价格越来越高，研究人员的工资也在不断上涨，实验室必须承受这笔开支才能避免员工流失。
“其他行业随着时间的推移而提高的效率，并不会直接转化为研究成果，”叶海亚说。“我不能偷工减料，因为我必须确保我的动物得到合乎伦理的照顾。我需要确保我的做法安全合法，这些都是合理的约束。但这些都需要时间和人力，而这往往会转化为成本。”
哈佛大学教职员工向《波士顿环球报》透露，2024 年，美国国立卫生研究院对哈佛大学的资助将出现 11 年来首次全面减少，医学院领导在特朗普第二任期前指示教职员工寻求生物制药公司的进一步投资，以平衡预算。
自 2008 年以来，哈佛医学院的人员、物资、工厂运营和研究分包合同的年度成本增加了 3.62 亿美元。2019 年，该学院近十年来首次实现非限制性现金储备收支平衡，但其 2022 年较为乐观的财务表现随后 受到新冠疫情和通货膨胀持续影响的打击。
9月，院长乔治·戴利（George Daley） 在学校状况演讲中将最近的预算赤字 归咎于“一系列负面财务逆风” 。医学院财务办公室誓言将在6月前制定解决赤字的计划。然而，特朗普时代却出现了削减开支的现象。
2008 年全球金融危机迫使时任院长杰弗里·弗利尔 (Jeffrey Flier) 在不解雇教授的情况下削减成本，学院面临的一些挑战开始浮现。
他降低了实验室的垃圾清运率，限制了可自由支配的差旅，冻结了招聘，并取消了新的学术项目。弗利尔表示，稳定的研究经费流入有助于缓解损失，这“维持了许多教职员工的运营”，涵盖了部分工资和开支。但弗利尔当时实施的零散成本削减策略，他表示，不足以弥补研究经费的损失。
弗莱尔说，如果哈佛医学院的所有拨款都被削减，“预算对医学院的影响将比2008年高出10倍”。“如果发生这种情况，他们会怎么做？没人知道。这是一个未知领域。”
麻省总医院神经科学家、哈佛医学院教授布鲁斯·菲舍尔说，这迫使与医学院有关联的研究人员必须谨慎行事。
他的工资来自他本人和医院（而非大学）获得的拨款，但他已经开始削减神经影像实验室的成本，为即将到来的削减做准备。菲舍尔说，所有实验室都不允许购买电脑等大型设备。但真正的问题在于劳动力成本：他无法按计划聘请博士后研究员，只能将预算集中起来 支付几名实验室助理的工资。
相关：哈佛大学的外国资金备受关注。但这些资金从何而来？
“即使是短期规划都无法做到，也会造成损害，”菲舍尔说道。“正常情况下，我会雇佣更多人。也许明天我就不会有这种感觉了。但八个月或一年后，我不知道该如何量化其影响。”
《波士顿环球报》的克里斯·塞雷斯 (Chris Serres) 对本报告做出了贡献。
题图：哈佛医学院。Jonathan Wiggs/《波士顿环球报》员工
附原英文报道：
Harvard Medical School was already in the red. Then came Trump.
The country’s premier medical school has lost money for years and leans heavily on research dollars that are now under threat from the White House
By Diti Kohli Globe Staff,Updated April 24, 2025
Harvard Medical School.Jonathan Wiggs/Globe Staff
Harvard Medical School is known for its breakthroughs in combating diabetes and smallpox, 11 Nobel Prizes, and a competitive academic program that accepts only 3 percent of applicants.
Now its finances are in a precarious place as it prepares for impending layoffs, sweeping cuts, and calls for a “long-term, sustainable” shift in the way it operates, according to school officials at a faculty town hall last week.
The moves signal radical change at the country’s premier medical school amid the Trump administration’s pressure campaign against Harvard and other universities. Long pummeled by financial losses, Harvard Medical School finds itself particularly vulnerable to this month’s freeze of $2.2 billion in federal funds, which includes some grants from the National Institutes of Health. The school operated in the red for 12 of the last 17 years and on average spends $11 million more a year than it earns, according to annual dean’s reports since 2008.
The deficits stem from a widening gap between the school’s operating costs and what it earns in revenue, expected to worsen with increased tariffs, inflation, and anticipated cuts and delays in federal research support, a spokesperson said. To kneecap the university for allegedly failing to protect Jewish students, President Trump is also exploring a tenfold hike in endowment taxes and an end to Harvard’s tax-exempt status.
Where the cuts will land exactly is not yet clear. Harvard sued the Trump administration on Monday for an unconstitutional abuse of power, leaving leaders at the medical school tussling with how to streamline its budget with the breadth of rollbacks still in question.
The funding freeze so far spares the medical school’s affiliate hospitals — including Brigham and Women’s, Mass. General, and Beth Israel — which teach Harvard medical students and bestow university professorship titles on around 10,000 of their doctors. But medical school faculty said those positions rarely come with compensation from the university. That raises the possibility that any terminations would affect jobs that are paid by Harvard Medical School, including postdoctoral researchers, staff, and 190-some professors who work on the campus. (Facing a budget crisis of its own, the Harvard T.H. Chan School of Public Health, separate from the medical school, started terminating staff and withdrew from two lease agreements, MassLive reported.)
Within the medical school, students and researchers are already bracing to do more with less, as they may lose the NIH funding that powers their paychecks, said postdoctoral researcher Adam Sychla, who studies programmable therapeutics to treat everything from cancer to the common cold.
“It’s only normal to think the cuts would lead to less teachers teaching more courses. It could lead to less administrative staff to help run the many things that need to happen for the institution,” he said. “I go home every day and plan on not having a job tomorrow.”
Much of the worry comes down to research dollars. The White House directives to penalize Harvard could eliminate millions awarded to the medical school, which leaned on grants and contracts from the government and private organizations for more than a third of its operating revenue last year. Researchers at the school have received a steady flow of government backing since World War II because of the caliber of their studies. That pool of funds enables labs to buy equipment, pay scientists, and cover maintenance costs — and it has no immediate substitute.
The university’s longstanding financial plan expects each individual school to remain solvent, but Harvard Medical School has struggled to do so despite its vast philanthropic enterprise and $5 billion endowment — a carve-out of the university’s $53 billion endowment. Outside funding for research is how the medical school earns the largest share of its money, ahead of income from publications and royalties, philanthropic gifts, tuition, and its annual endowment distribution. The endowment, too, cannot be tapped indiscriminately to cover costs and instead is largely restricted for specific uses by its donors.
Related: Even to Harvard, the world’s richest university, $2.2 billion makes a big difference
The disappearance of research money forces conversations about “how can we shrink our enterprise,” Lisa Muto, executive dean for administration, said in the town hall.
“We value the whole breadth of what happens here at Harvard Medical School,” Muto said, “but we’re going to be in an era now in which we can’t do everything.”
(A recording of the meeting was obtained by The Harvard Crimson, and the Globe verified these comments with professors in attendance at the town hall.)
The medical school has been in the red partly because of the growing cost of research, outside experts said. Scientific studies are more expensive to run today compared to a few decades ago, while funding allocations from the NIH stagnated in 2003 and fell behind inflation, according to an April study in the medical journal JAMA.
Nadir Yehya, author of the JAMA study and a professor of anesthesiology at the University of Pennsylvania, said materials for biomedical research are pricier now, and wages for researchers are ever-rising, an expense labs must swallow to avoid losing staff.
“The efficiencies that you find in other industries that come with time do not directly translate to research,” Yehya said. “I can’t cut corners, because I have to make sure my animals are taken care of ethically. I need to make sure I am doing this safely and legally, and those are appropriate constraints. But they all take time and personnel, and that often translates to costs.”
NIH funding for Harvard across the board decreased for the first time in 11 years in 2024, and medical school leaders directed faculty before the second Trump term to explore further investments from biopharmaceutical companies to balance the budget, faculty members told the Globe.
Annual costs for personnel, supplies, plant operations, and subcontracts for research at Harvard Medical School have grown by $362 million since 2008. The school broke even on its unrestricted cash reserves for the first time in nearly a decade in 2019, but its rosier financial performance through 2022 was then battered by lingering effects of the COVID-19 pandemic and inflation.
In September, dean George Daley in his state of the school address blamed “a perfect storm of negative financial headwinds” for its most recent budget shortfall. The medical school’s office of finance vowed to produce a plan to resolve the deficit by June. Then came the Trump-era cuts.
Some of the school’s challenges surfaced after 2008, when the global financial crisis forced then-dean Jeffrey Flier to cut costs without terminating professors.
He reduced the rate of trash pickup in labs, limited discretionary travel, froze hiring, and canceled new academic initiatives. What helped buoy the losses was a predictable stream of incoming research grants, Flier said, which “kept many of the faculty going,” covering some salaries and expenses. But the piecemeal cost-cutting strategy Flier enacted then will not be enough, he said, to make up for lost research dollars.
“The effect of the budget on the medical school would be 10 times greater than what it was in 2008,” if all the grants to Harvard Medical School are slashed, Flier said. “What would they do if that happened? Nobody knows. It’s uncharted territory.”
It’s forcing researchers associated with the medical school in any way to move cautiously, said Bruce Fischl, a neuroscientist at Mass. General and professor at Harvard Medical School.
He is paid through grants awarded to him and the hospital, not the university, but has started slashing costs at his neuroimaging lab in preparation of cuts to come. Big purchases such as computers are a no-go for all labs, Fischl said. But the real squeeze is the cost of labor: He cannot hire a postdoctoral researcher as planned and is pooling the budget to pay several lab assistants.
Related: Foreign funding at Harvard is in the spotlight. But where does it come from?
“Not to be able to plan for even the short term is damaging,” Fischl said. “In the normal course of events, I would hire more people. Maybe I won’t feel that tomorrow. But in eight months or a year, I don’t know how to quantify the impact.”
Chris Serres of the Globe staff contributed to this report.
