Identifying Positive and Negative Factors That Affect the Promotion of Clinical Faculty at the Wayne State University School of Medicine: Does Gender Matter?

INTRODUCTION: Despite well-documented gender disparity in academic medicine, there are many women who achieve success, including successful promotion to associate and full professor status. This study sought to determine whether there was a gender difference in the perception of positive and negative factors affecting the process of promotion to associate or full professor at the Wayne State University School of Medicine (WSUSOM). METHODS: All clinically active associate and full professors who achieved their most recent promotion at the WSUSOM were sent a link to a survey that obtained demographic information as well as the opinions of the respondents regarding what positive and negative factors impacted their most recent promotion. RESULTS: Of the 73 respondents (24%), 58 (19%) were included in our final analysis. Two obstacles ("Lack of interest and encouragement from institutional or departmental leaders" and "Lack of tangible commitment from institutional or departmental leadership [e.g., protected time]") were ranked in the top three ranks by a substantially greater percentage of females than males. Gender-specific networking was seen as significantly more valuable to female faculty members whereas having a stay-at-home partner was seen as significantly more valuable to male faculty members. CONCLUSION: At the WSUSOM, providing more gender-specific networking for women, increasing interest and encouragement from institutional and departmental leaders, and providing a tangible commitment to female faculty from these leaders may help more women to achieve promotion to associate or full professor.

RADx Tech Viability and Steering Panels: A Model for MedTech Translational Grant Review.

RADxSM Tech's mission is to rapidly accelerate deployment of SARS-CoV-2 tests and could not utilize typical grant application and review processes that can run 4 to 6 months. Instead, RADx Tech leveraged methodologies developed by CIMIT and utilized by POCTRN as described further in this special issue. RADx Tech uses a multi-stage review with two review panels, a Viability Panel and a Steering Panel, that are supported by subject matter experts and a Deep Dive team. Members of the panels have extensive commercialization and business experience in addition to scientific and technical knowledge. The Viability Panel is responsible for assessing whether the proposal is a good fit with the RADx Tech Program and whether it should be recommended to move into a Deep Dive. Less detailed information is requested in the application than a typical SBIR application since the application is refined and details added during the Deep Dive. The Steering Panel reviews the results from the Deep Dive and decides whether to recommend further funding. Everyone on the Viability Panel and Steering Panel reviews every application, thereby providing consistency and context for the reviewers. Utilization of an "assess, improve, and then select" process with review panels comprised of highly experienced review panel members has resulted in improved timing, efficiency, and effectiveness of reviews and has the potential to be extensible beyond RADx Tech.

The RADx Tech Deep Dive and Work Package 1 Process.

The RADxSM Tech program was a unique funding and support mechanism to accelerate the market introduction of diagnostic tests for SARS-CoV-2, the virus that causes COVID-19. In addition to providing funding, the RADx Tech program provided unprecedented levels of non- monetary support. Applications were evaluated using a deep dive process which involved a 1- to 2-week intensive collaboration between the applicant and a team of experts from RADx Tech. The result of this deep dive was a very comprehensive understanding of the potential and risks associated with the proposed work, which was far beyond what can typically be understood in a written grant application. This detail allowed the deep dive team to provide a better-informed recommendation on how to proceed. In some instances, the recommendation was made to not fund the project; in other cases, the recommendation was made to provide the applicant with more funding or support to help maximize their probability of success. After the deep dive, the project moved to a Work Package 1 (WP1) phase that focused on further de-risking. The same RADx Tech team that conducted the deep dive also worked with the applicant through the WP1 phase of the program. This allowed for joint responsibility of the work with the common goal of rapid, successful product introduction.

The Role of CoLab and GAITS in Enabling the RADx Tech Program.

The RADxSM Tech initiative required a massive mobilization of the biomedical community. It was chartered with the extremely ambitious goal of rapidly developing and deploying innovative tests to detect people infected with the SARS-CoV-2 virus. It needed to do so at a scale and with urgency to get the country back to daily activities such as school and work as soon as possible. It required forming and supporting a diversity of teams with members from around the country and beyond. These teams collaborated in complex workflows that needed to be carefully monitored and tracked. This paper describes the key elements of the secure, web-based infrastructure that was configured to enable the efficient and effective operation of RADx Tech's key processes and address its unique and urgent challenges. One such challenge was to manage the flow of applications through a multi-stage, interactive selection process (using the CoLab platform) and another was to support and facilitate the progress of projects selected for support and funding through an accelerated commercialization program (using the GAITS platform).

To Save the Country: A Lost Treatise on Martial Law, edited with an introduction by Will Smiley, and John Fabian Witt, New Haven and London: Yale University Press, 2019. Pp. 352. $55.00 hardcover (ISBN 9780300222548 )

With emergency measures in every state as a result of the COVID-19 outbreak, and with reports that the Trump White House had contemplated invoking the Insurrection Act, legal academics will be more interested than ever in contemplating emergency's past in order to understand its present. According to the editors, who found the treatise among G. Norman Lieber's papers in the National Archives, the father–son duo probably both contributed to it over the course of several decades. The publication of the manuscript comes at an inflection point in the way that jurists conceptualize emergency. Since the opening of the Second Iraq War, the American legal academy has largely begun this story with Carl Schmitt, the Nazi jurist on sovereignty and exception.

Harm reduction in the time of COVID-19: Case study of homelessness and drug use in Dublin, Ireland.

Dublin appears to have performed very well as compared to various scenarios for COVID-19 mortality amongst homeless and drug using populations. The experience, if borne out by further research, provides important lessons for policy discussions on the pandemic, as well as broader lessons about pragmatic responses to these key client groups irrespective of COVID-19. The overarching lesson seems that when government policy is well coordinated and underpinned by a science-driven and fundamentally pragmatic approach, morbidity and mortality can be reduced. Within this, the importance of strategic clarity and delivery, housing, lowered thresholds to methadone provision, Benzodiazepine (BZD) provision and Naloxone availability were key determinants of policy success. Further, this paper argues that the rapid collapse in policy barriers to these interventions that COVID-19 produced should be secured and protected while further research is conducted.

Virtual Surgery Oral Board Examinations in the Era of COVID-19 Pandemic. How I Do It!

INTRODUCTION: Traditional in-person Mock Oral Examinations (IP-MOEs) are utilized by surgery residency programs to prepare trainees for the American Board of Surgery Certifying Exam (ABS-CE). However, the COVID-19 Pandemic has led to a profound disruption of on-campus and in-person educational activities, with subsequent instantaneous revolutionization of educational systems all over the world, including a massive switch to virtual platforms. Many in-person didactics and examinations were canceled or rescheduled, including the ABS-CE. The study aims to evaluate Virtual MOEs' (V-MOEs) feasibility as a potential alternative to in-person MOEs in residency programs. METHODS: Twenty-five participants-16 general surgery residents (7 females, 9 males) and 9 faculty - in the inaugural Department of Surgery Virtual Mock Oral Examination completed an anonymous, voluntary online survey via Microsoft Forms. Faculty was given 24 questions, and residents 28, with 9 questions common between both residents and faculty. Participants were asked about the accessibility to virtual examination rooms, V-MOE effectiveness, resident's preparation for the exam, resident's stress, diversity, and number of clinical scenarios, and possible future implementation of, and barriers to, V-MOEs. RESULTS: All participants have participated in IP-MOEs in the past. All faculties were very satisfied or satisfied with IP-MOE, compared to 93.8% of residents. All participants were very satisfied or satisfied with the orientation and instructions before V-MOE. Only 66.6% of faculty, compared to all residents, was satisfied with time allocation for sessions. While 88.9% of faculty felt the V-MOE was less stressful on residents, only 68.8% of residents felt so. Additionally, 87.5% of residents said they prepared for the V-MOE similarly to the IP-MOE. As a future platform, only 22.2% of faculty compared to 43.8% of residents preferred V-MOE over the IP-MOE. Both faculty (88.9%), and residents (81.3%) preferred immediate feedback at the end of sessions. All faculty recommend collaboration with other programs to enhance the resident's preparation. Time constraints, lack of experience with the format, and availability were the top 3 barriers. CONCLUSION: V-MOE is feasible, accessible, and a potential alternative for IP-MOEs at a program level for ABS-CE preparation. Given the time constraints and costs associated with IP-MOEs, it is an opportunity to collaborate with other residency programs.