UC Irvine's Med School Chief Leaving

Times Staff Writer

UC Irvine's medical school dean announced Thursday that he was stepping down eight months ahead of schedule, ending 12 years marked by record growth and high-profile problems.

Thomas Cesario is the second top official in UCI's health sciences programs to leave his position after The Times reported that 32 patients on the liver transplant waiting list died while UCI Medical Center rejected scores of viable organs. Ralph Cygan, chief executive of the medical center, resigned in January.

"The fact that Tom has decided to step down in the midst of all this controversy doesn't surprise anyone," said William Parker, a former vice chancellor for research, who praised Cesario as a "man of great integrity and honesty."

In an e-mail to UCI's health sciences staff Thursday morning, Cesario said he would remain dean until Nov. 1, when a newly hired vice chancellor for health affairs would also assume his duties as medical school dean. Cesario had said he would work on international health issues at UCI until his retirement in July 2007.

Chancellor Michael V. Drake created the vice chancellor position in January to provide senior-level management of the medical school and Orange hospital. When he announced the new position, he did not say the job would absorb the medical school dean position. A spokesman on Thursday said he could not explain how that change came about.

Cesario said the structure was the same as that at other medical schools and that he was announcing his plans now so the job description could be announced and the search to fill the position could begin.

Cesario and Cygan were criticized in a February report by a UCI-assembled panel for insufficient leadership and failure to address serious shortcomings in the university's medical programs. A separate University of California inquiry in February found that Cesario was present at a Chicago meeting in which UCI officials misled regulators about the transplant program in an attempt to keep them from shutting it down. The report said the dean did not understand "the significance" of communications with the regulators.

At the time Cygan resigned, Drake said more personnel changes were possible. Cesario's resignation had been rumored for months, although he denied it. In a February interview, he said he had "no plans to immediately resign. There's been no discussion of a transition."

Thursday, however, Cesario, who will turn 66 next month, said he was retiring early out of concern for his health. He underwent surgery for prostate cancer and had a triple-bypass last year. He said he was not pressured to resign and that the recent controversies, though "a stress," played no role in his decision.

"This decision was really based primarily on my health and would have happened, I think, no matter what," he said. "With cancer and major heart problems, I realized I was vulnerable. I had to begin thinking about what my plans were."

An infectious-disease specialist, Cesario joined the UCI faculty in 1972. He was named acting dean of the medical school in 1994 and permanently appointed to the position the following year.

In a separate e-mail to staff, Drake praised Cesario's service, noting that his tenure was the longest of any medical school dean in UCI's history. He said research funding had more than tripled under Cesario's leadership, to more than $236 million in 2004, and he recruited 70 faculty members for teaching and research programs.

"His generous contributions of time and talent, as well as his tireless commitment to patient care, have created a firm foundation for our efforts to take the UCI health sciences to the next level," Drake said. A UCI spokesman said Drake was not available for an interview.

Despite the achievements, UCI's medical programs during Cesario's tenure became synonymous with scandal. Besides the problems in the liver transplant program, UCI has gone through controversies over the loss of cadavers and illegal sale of body parts from the Willed Body Program and the improper billing of cancer patients for experimental research drugs.

Cesario began his tenure as dean just as UCI acknowledged that doctors in its fertility clinic had stolen eggs and embryos from patients and implanted them in other women.

Subsequent newspaper reports found that UCI suffered shortcomings in its kidney and bone marrow transplant programs similar to those in the liver program, and that the school misused a state medical board exemption to hire cardiology department chiefs who lack basic credentials, such as California medical licenses or U.S. board certification.

Cesario and other top medical officials also had several relatives on UCI's payroll; an internal investigation found that they had not violated policy.

Parker, now a physics professor, said Cesario had earned the trust and respect of his colleagues. "He has deserved all of the rest and relaxation he will now have in retirement," he said.

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