Leadership Development for Future Medical School Deans: Outcomes of the AAMC Council of Deans Fellowship Program.

PURPOSE: To determine the outcomes of the Association of American Medical Colleges (AAMC) Council of Deans (COD) Fellowship Program with respect to participants' achieving the goals of becoming a medical school dean and developing leadership skills, and to ascertain fellows' views about the program's value, beneficial aspects, and areas for improvement. METHOD: The 37 COD fellows from 2002 to 2016 were invited to participate in a 2017 survey addressing demographics, training, current leadership position, and value of the program. The survey also included 3 open-ended questions. A 2018 web-based search was conducted to determine fellows' senior leadership roles since their program participation. RESULTS: The survey response rate was 73% (27/37). The majority of respondents were male (82%, 22), aged 51-70 (89%, 25), and white (82%, 22). The top 5 medical specialties reported were internal medicine, pediatrics, anesthesiology, psychiatry, and surgery. Most respondents (63%, 17) reported having a graduate degree. All reported being in leadership positions in academia and/or health care. The web-based search found that 27% (10/37) of the fellows became medical school deans (average tenure 5.6 years); 2 fellows became deans of other types of schools. Overall, survey respondents perceived the program as valuable. Respondents identified shadowing a dean mentor, attending COD meetings, and attending the AAMC Executive Development Seminar for Deans as the most valuable program components. The majority (88%, 23/26) indicated their fellow experience persuaded them to pursue being a dean; 2 (8%) indicated it did not. Respondents identified 4 key opportunities for program improvement: more sponsorship by deans, development of a learning community, enhanced mentoring, and coaching. CONCLUSIONS: The COD Fellowship Program appears to be successful in preparing senior faculty to become deans and assume other senior leadership roles in academia and/or health care. Fellows' feedback will be used to inform future revisions to the program.

Developing a Culture of Mentorship to Strengthen Academic Medical Centers.

Mentorship is central to academic medicine and its missions, and it has long played a critical role in the training and career development of physicians and scientists. A growing body of literature has documented the positive impact of mentorship on various outcomes, including research productivity, academic promotion, faculty retention, and career satisfaction. These benefits span academic medical centers' missions and have the potential to enhance biomedical research, patient care, education, and faculty diversity and leadership.In this Invited Commentary, the authors argue that a dynamic culture of mentorship is essential to the success of academic medical centers and should be elevated to the level of a major strategic priority. This culture of mentorship would capitalize on an institution's intellectual resources and seek to develop leaders in biomedical discovery, patient care, and education. The bidirectional transmission of knowledge between mentors and mentees, through both formal programs and informal relationships, can foster the growth of faculty members needed to meet the complex challenges currently confronting medical schools and teaching hospitals.Developing a culture of mentorship requires a strong commitment by leaders at all levels to nurture the next generation of physicians and scientists as well as grassroots efforts by trainees and faculty to seek out and create mentorship opportunities. The authors conclude by outlining possible mechanisms and incentives for elevating mentorship to the level of a strategic priority to strengthen academic medical centers across their missions.

Progress for whose future? The impact of the Flexner Report on medical education for racial and ethnic minority physicians in the United States.

The publication of the Flexner Report in 1910 had an immediate and enduring impact on the training of African American physicians in the United States. The Flexner Report's thesis, "that the country needs fewer and better doctors," was intended to normalize medical education for the majority of physicians, but its implementation just 48 years after the Emancipation Proclamation obstructed opportunities for African Americans pursuing medical education and restricted the production of physicians capable of addressing the health needs of a nation that would grow increasingly diverse across the century.This article provides a working definition of structural racism within academic medicine, reviews the significant physician workforce diversity initiatives of the past four decades, and suggests the most successful of these possess strategies common to addressing structural racism (community empowerment, collaboration, clear and measurable goals, leadership, and durable resources). Stymied by popular ballot initiatives, relentless legal challenges, and dwindling funds, current and future efforts to increase diversity in medicine must maintain a focus on addressing the active remnants of structural racism while they build on the broad benefits of diversity in education and medicine. Despite creative and tireless efforts, no significant progress in expanding diversity within the U.S. physician workforce can be made absent a national effort to address this enduring barrier in the collective social, economic, and political institutions. The centennial of the Flexner Report is an opportunity for the academic medicine community to renew its commitment to dismantling the barriers to diversity and improving medical education for all future physicians.

Race-neutral admission approaches: Challenges and opportunities for medical schools.

In 2003, the U.S. Supreme Court's rulings in Grutter v. Bollinger and Gratz v. Bollinger affirmed the use of narrowly tailored, race-conscious admission programs by institutions of higher education that find that the benefits derived from diversity rise to a compelling interest. The rulings also required institutions that use race-conscious admission programs to explore whether the results of such programs could be met through race-neutral alternatives. In this article, the authors review relevant literature in the context of medical education and summarize the existing information about race-neutral alternatives and the challenges and opportunities in implementing them, with the goal of encouraging further research that will inform medical school admission policies. The authors argue that although undergraduate and graduate institutions across the nation are pursuing the goal of diversity within the guidelines set forth by the Court, there is too little known about how race-neutral alternatives to race-conscious admission policies can be effective in promoting diversity. They conclude that although certain approaches show promise, medical schools--as they continue to employ race-conscious admission policies to achieve the benefits of diversity--must take advantage of their compliance with the Court's decision to investigate whether race-neutral approaches can contribute to the diversity of medical school classes.

Effects of reviewers' gender on assessments of a gender-related standardized manuscript.

BACKGROUND: Several factors including reviewers' gender can influence the assessment of submitted manuscripts. PURPOSE: This study was designed to investigate the effects of reviewers' gender on the assessment of a gender-related study. METHOD: One hundred reviewers (50 women) were randomly selected from Academic Medicine's reviewer pool. Two versions of an empirical study of medical students in which women forecast a lower professional income than men were prepared, and each version was randomly assigned to 25 men and 25 women reviewers. The two versions were identical except for one sentence in the abstract and two sentences in the conclusion. Version 1 attributed the lower forecast income of women to intrinsic gender factors (e.g., lower financial incentives). Version 2 attributed the difference to extrinsic social learning factors (e.g., socialization bias). RESULTS: Results showed no significant gender difference in reviewers' evaluations of the two manuscript versions. CONCLUSION: Although no evidence of reviewers' gender bias was found in this study, alternative explanations of the findings suggest that further empirical research is needed.