THE JIM INTERVIEW - SNYDERMAN,RALPH, MD

In response to changing market pressures, academic medical centers hav e adopted a variety of coping strategies. In 1989 Ralph Snyderman beca me chancellor for health affairs and dean of the Duke University Schoo l of Medicine. Snyderman came to Duke after two years in senior leader ship positions at Genentech Inc., and immediately utilized his strong understanding of the private sector to build several innovative progra ms at Duke. Under his aegis, Duke has worked to set up its own HMO, se rve as a major center for clinical trials, and pioneered at times tumu ltuous efforts to ''right-size'' its academic programs. Interviewed in his office on the plush grounds of Duke University. Snyderman discuss ed the future relationship of industry and academia, the economics of medical care reimbursement, and the implications of those changes on g raduate medical education.