UCSF mourns the death of epidemiology great Stephen Hulley, MD, MPH

Stephen Hulley, who has white hair and a mustache, smiles in front of a bookcaseWe are sad to announce that Stephen Hulley, MD, MPH, passed away on November 22 after a brief illness. Hulley was on the UCSF faculty for more than 30 years and served as Chair of the Department of Epidemiology and Biostatistics from 1994 to 2006. He made major contributions in the fields of epidemiology and clinical research.

Hulley’s research played a pivotal role in determining that systolic hypertension warrants treatment and that hormone replacement therapy for postmenopausal women does not reduce the risk of heart disease. Hulley also helped launch and steer the thirty-year CARDIA study on risk factors for heart disease that generated some 800 published papers.

Hulley was born to diplomat parents in Paris in January 1939. The family fled coming war with baby in tow. When his parents retired from the foreign service, they settled in Hyannis, Mass. Hulley went on to graduate from Amherst College, Harvard Medical School and UC Berkeley School of Public Health.

In 1976, Hulley joined UCSF as an adjunct assistant professor. Six years later, he established the clinical epidemiology program in what was then called the Department of Epidemiology and International Health with funding from the Mellon Foundation. At the time, there was little institutional support for epidemiology or clinical research training at UCSF. With an entrepreneurial spirit and an “If we build it, they will come” optimism, Hulley continuously found ways to increase opportunities for training in clinical research.

Hulley played a part in establishing the San Francisco Coordinating Center, a UCSF-affiliated non-profit research collaborative focused on multicenter clinical trials; the Prevention Sciences Division of the Department of Medicine; and the Center for AIDS Prevention Studies.

He is remembered by his colleagues as an optimistic and warm team-builder who recruited good people, supported them well and then let them lead.

“In the early 80s, he talked about assembling a ‘warm and sensitive cadre’ of coworkers, and we all laughed at the time,” recalled Dennis Black, PhD. “We thought it was so 60s. But, in fact, many long-term members of the cadre are still working together and are close friends.”

In 1994, Hulley was appointed chair of the department that by then was called the Department of Epidemiology and Biostatistics; he would hold the post for the next 12 years. In 2000, a K-30 NIH grant Hulley led supported a growing set of post-doctoral training activities in clinical research methods that were the focus for a certificate program and, eventually, the department’s first master’s degree.

Stephen Hulley, pictured on a boat in the Puget Sound, smiling while holding a crab trap

“The training program in clinical research has taught hundreds of trainees - from medical students to faculty - in rigorous ways to design clinical studies,” said longtime colleague Steven Cummings, MD, director of the San Francisco Coordinating Center. “Most of the successful careers in clinical research at UCSF can be traced back to Steve's mentorship.”

Hulley and Cummings co-wrote what would become the standard textbook for the field, Designing Clinical Research (1988), now in its fifth edition. Cummings saw Hulley’s “passion for getting details right” behind the tiny, red edits that came back on “every draft I sent.”

Thomas Newman, MD, MPH, a contributor to the book, said: “Steve had incredibly high standards about writing, insisting that every word and every sentence be just right and necessary, but he also had an infectious enthusiasm for getting things right, which he fostered in trainees.”

Hulley retired in 2010. Robert Hiatt, MD, who followed Hulley as chair (initially with Neil Risch, PhD) and the current interim chair, Mark Pletcher, MD, MPH, were both recruited by Hulley.  Pletcher and outgoing chair Kirsten Bibbins-Domingo, PhD, MD, MAS, were both Hulley’s mentees.

“I feel like I learned so much from him – to really value good writing; he was funny and humorous and so warm, I loved the way he ran meetings. I loved watching him bring people together and get things moving along,” Pletcher said.

In retirement, Hulley and his wife, Linn, settled the San Juan Islands in Puget Sound, where they spent time crabbing and sailing as Hulley had as a boy in coastal Massachusetts. Hulley, a beloved and inspired leader, led the local yacht club as its commodore.



Jeffrey Martin, MD, MPH, Chief of the Division of Clinical Epidemiology and Health Services Research: “The passing of a legend. He meant so much to so many.” 

Robert DuWors: “The work lesson he taught me was to create a work environment that people would want to be there, and that has really served me well all these years.”

Thomas Newman: “Back in 2001, in a letter I wrote for Steve’s Stewardship review as department chair, I wrote, ‘When I review protocols and proposals… I can often divide them into those written by people who have taken the “Hulley Course” and those written by people who need to take the “Hulley Course.” That is still true today.”

Mike Martin, MD: “His talents were the talents of an excellent leader. He was able to recognize great people and recruit them to work with him. He would mentor them and share the limelight with them – he wasn’t trying to get attention for himself – then he was able to turn things over to the people he had recruited and step back and let the flower he had planted blossom.”

Michael Nevitt, PhD: “Steve Hulley was a dedicated, visionary and wise steward of the organizations at UCSF in which he had a leadership role, and in some cases helped to create. I think Steve strove to create an environment where there was synergy between high-quality clinical research and rigorous training of the next generation of investigators in clinical research and epidemiological methods. Steve’s calm and supportive persona, combined with attention to detail and persistence in implementation, helped him and his colleagues succeed in implementing this vision. His kindness, humor, support, and compassion helped created a strong sense of community among staff, trainees, and faculty.”