March 27, 2019
Hello,
I spent this past weekend at the spring meeting of the AAMC Council of Deans. Last Friday, I thought I had too much going on and wished I didn’t have to go to the meeting. But, I had registered and attending this meeting, especially interacting with colleagues, is a valuable part of being a dean. Moreover, all AAMC meetings are quite expensive — and I’m frugal with UTHealth funds, so I knew I needed to attend.
I’m glad I did. The meeting was excellent and well worth attending. A few highlights:
The event kicked off Friday afternoon with a panel discussion on leveraging academic health centers and community partnerships to address health inequities. The discussion was led by a team from the New Orleans-based group, “Propeller,” an incubator for social innovation. The discussion that ensued focused on institutional racism and closing the gap. The conversation was uncomfortable but important.
Saturday started with a keynote talk by Dr. Anthony Chang, who spoke on “The Power of Artificial Intelligence to Transform Medicine.” Dr. Chang is a pediatric cardiologist and chief intelligence and innovation officer at LA Children’s Hospital. I had met Dr. Chang at a meeting several years ago, have followed his career from afar, and remembered him as a visionary leader. As a mid-career clinician (with an MBA and MPH), he went back to school to complete a MS in data science specialization, with a focus on artificial intelligence. His talk was the clearest review of AI in medicine I’ve ever heard. I spoke with Dr. Chang after his talk and invited him to come to UTHealth — in part to help us work more effectively with our colleagues at the School of Biomedical Informatics and to enhance medical student teaching. Our students are growing up in a world where AI will be increasingly important and ever present — in decision support, patient monitoring, medical imaging, diagnostics, precision medicine, drug discovery, wearable technologies, virtual assistants, etc.
The rest of the morning was dedicated to short presentations by several medical school deans on “Sleeper Innovations and Audacious Ideas.” Dr. Jay Hess from Indiana University discussed the strategic advantages of an in-house executive search firm geared to senior faculty recruits. They’ve documented larger applicant pools, reduced time to fill positions, more diverse faculty hires, and substantial cost savings vs. using commercial search firms.
Dr. Pam Davis, dean at Case Western, discussed the school’s Pathways in Medicine Program— similar to our Scholarly Concentrations. The program starts in the pre-clinical years and runs throughout medical school. I was particularly interested in two pathways — “Urban Health” designed to address social determinants of health and “bridges out of poverty,” closely linked to community partners; and “Wellness and Prevention,” which received an innovation award from the Alliance for a Healthier Generation.
Dr. Jerry Youkey, founding dean at the University of Southern Carolina at Greenville, discussed a comprehensive training program in Substance Use Disorder — that started as a lunch and learn event introducing students to recovering addicts and expanded to become part of the core curriculum.
Dr. Toni Ganzel, dean of the University of Louisville School of Medicine, discussed a city-wide program called “Surgery on Sunday,” which is designed to expand access to screening colonoscopy. The impetus for the program was the public health importance of screening in a state with high rates of colon cancer. The program has brought together four competing health systems and over 600 volunteers. Dr. Ganzel underscored the importance of linking a compelling cause with an engaged academic and community partnership.
Dr. David Wilkes, dean at University of Virginia (Charlottesville), discussed the development of a mandatory training program at UVA to address and respond to incidents of disrespectful or discriminatory behavior, using a syllabus and situational videos. https://aamc.elevate.commpartners.com
Dr. Craig Kent, dean at Ohio State, talked about changing the culture at his school—surveying faculty, hosting workshops, and identifying and addressing issues. A new “Faculty Experience Group” made up of eight mid-career emerging leaders, rather than established leaders, has the mandate to help address problems and move the needle. Initiatives include implicit bias training for 200 leaders, expanded parental leave benefits, and recognition of accomplishments. Dr. Kent talked about focusing on “small wins” that make a difference, such as giving RVU credit for lactating women.
Dr. Fred Meyer, dean at Mayo Medical School, talked about Mayo’s program to develop leaders — giving faculty the tools needed for effective leadership and focusing on leadership capabilities, including inspiring values, engaging colleagues, bold thinking, and driving results. The school has fixed terms for leaders, increasing the importance of preparing leaders before they are named to leadership roles and early in their tenure — and the urgency of getting things accomplished quickly.
Dr. Lloyd Minor, dean at Stanford, talked about Stanford Medicine’s Electronic Health Record National Symposium, which is designed to promote innovation in the EHR. He recommended a recent Fortune Magazine article, “Death by a Thousand Clicks, Where Electronic Health Records Went Wrong.”
Finally, Dr. Larry Jameson, dean at U Penn, talked about empowering the clinician innovator. He focused on a project to tackle burnout by returning 90 minutes to the clinician each day. The aim was to deconstruct and then reconstruct the clinician’s work day with increased efficiencies, enhanced documentation, better use of the EHR, and other efforts to help the physician work at the top of his/her abilities.
The last session of the day was a panel discussion, led by AAMC outgoing President Darrell Kirch on “Supporting the missions of academic medicine.” Speakers represented the AAHC, NBME, ACGME, and the Josiah Macy Foundation. The day ended with a festive tribute to Darrell Kirch. Christle Nwora, a third-year student at McGovern, serves as board chair of the Organization of Student Representatives (OSR), the student branch of the AAMC. I was delighted to meet her at the dinner (photo below) and proud to see one of our students leading this national forum.
Sunday was another busy day — starting with a very important session on “Effective Approaches to Student Assessment for the UME-GME Transition.” The session focused on the recent AAMC Invitational Conference on USMLE Scoring (InCUS). The conference was a response to strong concerns voiced by students, deans, and others on the stress of the residency application process, with increased competition for positions, increased numbers of applicants to each program, increased use of pass/fail rather than grading at schools, and heavy reliance on USMLE scores as part of the residency admission process. The session reviewed the pros and cons of USMLE numeric scores, with a number of scoring options considered, including change to pass/fail, change to broad categories, reporting the score for Step 2 CS but not Step 1, and no change to the current numeric score. A conclusion of the InCUS meeting was the complexity of the problem and the lack of a clear single voice. A very lively conversation ensued with agreement that as a profession we need to address these issues in a timely but thoughtful manner — our students and our profession deserve no less. A summary of the InCUS meeting (which Christle Nwora attended as an OSR representative) is being put together and will be available on the AAMC website.
The afternoon had several concurrent breakout sessions: Managing Faculty Conflict of Interest; Supporting Medical Student Mental Health and Well-Being; Supporting the Academic Mission; and Improving Approaches to Recruiting and Retaining African-American Men in Medicine.
The afternoon plenary was a very thoughtful presentation by Dr. Reshma Jagsi, director of the Bioethics and Social Sciences in Medicine at the University of Michigan. Her talk, “Ensuring Safe and Equitable Environments in Academic Medicine,” focused on gender imbalance in leadership of academic medicine/gender equity and eliminating sexual harassment in the workplace. Regarding sexual harassment as well as uncivil disrespectful behavior, she emphasized the importance of gathering data, facilitating reporting, and demonstrating a commitment to change by developing and disseminating clear policies. Regarding enhancing gender equity, she encouraged promotion of evidence-based implicit bias training, and transparent and consistent criterion-based evaluation and promotion processes. She ended her talk by discussing specific mentoring and sponsorship programs for women. Her talk was followed by a reception for women deans — a small group given that only 16 percent of deans are women.
The day ended with a talk by Dr. David Asch, professor and executive director of the Penn Medicine Center for Healthcare Innovation. He presented a number of creative approaches to improving patient care through health behavior change and improved patient outcomes.
A very busy but thoughtful and worthwhile weekend. Much to think about and much to do.
Warm regards,
Barbara
![Dean Stoll and student](https://med.uth.edu/wp-content/uploads/2019/03/medical-student-1.jpg)
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