Dr. Venter Delivers UCSD 2015 School of Medicine Commencement

Full text for the address follows.

J. Craig Venter, PhD, UCSD , 2015 School of Medicine Commencement Address

Chancellor Khosla, Dean Brenner, Dean Savoia, UC Regent Charlene Zettel, UC Regent Sheldon Engelhorn, invited guests, families and graduates, thank you for inviting me to speak to you on your very special day, and Congratulations on making it to this momentous occasion!

It’s always an honor for me to give commencement speeches but it’s especially gratifying to come back on campus because this is also my alma mater.  40 years ago I finished my Ph.D which included the first two years of medical school in 1973 and 1974. UCSD gave me the best education, in an environment that was intellectually stimulating and nurturing. I truly credit my experience at UCSD to forming the scientist I became.  I made life-long friends here and continue to establish and strengthen scientific and medical collaborations that I believe are helping to change the face of healthcare today.

The good news is here you are within minutes of receiving your newly minted UCSD diplomas including Ph.Ds, MDs and Masters Degrees. This is probably the single most important day of your lives, so far, the culmination of all your years of hard work and dedication, and the sacrifices that you and your families made to get to this day. Congratulations to all of you for getting this far.

I would like to particularly acknowledge Jesse Dixon who is getting both his MD and Ph.D today. Jesse is the son of Jack and Claudia Dixon and 40 some odd years ago Jack and I worked here in the Basic Science Building in the late Nate Kaplan’s lab. Jack now Associate Vice Chancellor of Scientific Affairs at the medical school was a co-author with me on my first scientific publication in 1972.

The bad news is the next steps will for most be much harder as you actually begin your independent phase of your medical and scientific careers and leave the school environment. Real life is very different from medical and graduate school and the practice of medicine will undergo such a major transformation during your next 40 years that most of what you just learned will be viewed as naïve, over simplistic and just plain wrong (sorry David).

40 years from now your memories of the past 4-6 years will be vivid and hopefully the friendships that you established will still be strong but we are moving from our current ad hoc sick system to a much more proactive preventive medicine model together with a precision medicine approach. These changes will have enormous disruptive impact on all aspects of the medical industry - pharmaceutical companies, health and life insurance companies, and health care providers – and particularly you as physicians and scientists and medical practitioners.

I predict that within a decade all of you will find it hard to believe that you were practicing medicine without knowing the genome sequence of every patient.  Many of you weren’t even in high school when my company, Celera and the government funded program were racing to sequencing the first genome which I announced in 2000 with President Clinton at the White House. The first genome sequence cost my team $100 million and 9 months to complete and nearly $3 Billion for the government funded program. Today, we are close to $1,000 per genome and that cost will likely be down below $500 per genome within the decade. To put that number in context some individual gene tests such as the BRAC1 test currently cost several thousand dollars.

At my company, Human Longevity Inc. which is less than a mile from Thornton Hospital, we are building the world’s largest and most comprehensive database of whole genome, phenotype and clinical data.  We are developing and applying large scale computing and machine learning to make novel discoveries to revolutionize the practice of medicine. For example we are working to predict your face and voice from your genetic code.

Currently we are sequencing 3,000 genomes per month and are scaling up to 100,000 per year and on track to meet our goal of 1-2 million complete genomes in our databases by 2020.

This fall we will open the first of its kind genomic enhanced health center. This place, called the HLI Health Nucleus, will be the embodiment of our philosophies and ideas on how individuals can assess risk of disease and monitor wellness using complete biological measures including MRI imaging, full genome and microbiome sequencing, metabolome, etc. We will partner with physicians to enable patients to get the most complete picture of their health possible. We are working to ensure that this scenario becomes standard medical practice.  Technology and computers and machine learning will become a much more integral part of clinical decision making.

Specialist physicians are going to be challenged with much more definition and diversity among diseases as we reveal new molecular complexity and begin re-classifying diseases by sets of specific genomic and other molecular markers. This is already happening in cancer as we begin the transition from thinking of cancer as a phenomenon of a specific site or organ - like lung cancer - to non-small cell lung cancer with the ALK fusion gene which makes this individual a candidate for a specific new drug.

At HLI we are sequencing the whole genome of cancer patients and their tumors. Sequencing enables us to do many things including a comprehensive analysis of the B and T cell repertoire in the immune system. Through sequencing we find 20,000 to 100,000 mutations in different cancers. Tens to hundreds of those result in protein coding changes in the tumor. Sequencing the immune system shows us if the patient has mounted an immune response to their cancer proteins.

From here we can use this information to make therapeutic decisions and to develop novel therapeutics specifically individualized vaccines specific to an individual’s tumor. We are starting a clinical trials with Moores Cancer Center here at UCSD to test these personalized cancer vaccines.

For those who will become primary care physicians the changes genomics will bring are likely to even more profoundly change to your medical practice.  If we are working from a set of individualized genomic risks, the new demands on primary care physician to establish and manage individualized care plans focused on early detection and prevention will radically change medical practice patterns.

Care teams will become more multi-disciplinary, compute technology will be more ubiquitous, and data from wireless monitors and sensors relevant to individual health will be flowing 24/7/365. Data will be mined constantly to identify new actionable medical intelligence, and individuals and their physicians will be working together sort signal from noise. At the same time we get more technical physicians are going to have to get more personal and much more sophisticated in supporting people in taking ownership and control over their own health and behaviors.

Medical practice will become even more dependent on continual learning but with new medical insights being generated and applied in real time from computational based interactions at a pace that will likely make current medical practice look frustratingly static.

Will you be ready for this new world? Your UCSD Ph.D and/or Medical degree is a great first step but I urge you to pay intense attention to computational and genomic based medicine and to become the leaders of this new medical revolution or you can wait for your patients to drag you into the future.

Good luck and congratulations!