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Spotlight: Minority Faculty Initiatives at Washington, D.C. National Medical Center
by Valarie Clark, M.P.A.
Spotlight on a successful leader of an institutional transition in academic medicine: Strategies for institutions and faculty facing transitions.
Standing in front of a conference room of a small group of minority faculty from Children’s National Medical Center (CNMC) in Washington, DC, Dr. Denice Cora-Bramble, skillfully moves through the agenda of the Minority Faculty Affinity Group meeting she initiated over a year ago. Dr. Cora-Bramble is ideally suited to lead this professional development initiative, which began in 2003 when CNMC’s pediatric residency program merged with Howard University Hospital (HUH). She is bilingual, of Latino and African-American heritage, received formal training in mediation and conflict management and above all is committed to increasing access to culturally competent health care for underserved populations.
Making an Opportunity out of the Challenge of a Merger of Residency Programs and Cultures
The merger of the pediatrics residency programs for Howard and CNMC was the culmination of several collaborative initiatives to include an NIH-funded Pediatric Clinical Research Scholars Program and a Disparity of Care Research Grant between the two institutions and Johns Hopkins University. Already having an established relationship, it would seem the merger would be seamless. "Not so," says Dr. Cora-Bramble, Executive Director of the Primary Care Center of Excellence, the Diana L. and Stephen A. Goldberg Center for Community Pediatric Health at CNMC.
In 2002, Dr. Cora-Bramble was tapped early on by Dr. Mark Batshaw, CNMC’s Chief Academic Officer and Chair of the Department of Pediatrics at George Washington University (GWU), to lead the organizational change associated with the merger and to facilitate team building among the residents. Having trained at Howard and being the first minority to lead one of the six Centers of Excellence at CNMC, Dr. Cora-Bramble served as the metaphoric bridge between both institutions and viewed the merger much like a corporate one with differences on various levels. Dr. Cora-Bramble reported, "The merger presents significant opportunities and challenges within the context of organizational change, inter-institutional collaboration and cross-cultural communication." CNMC is a top ranked tertiary care hospital and HUH is a hospital affiliated with Howard University, a premier and culturally rich, historically black college. While CNMC residents and faculty are predominately white, HUH residents are overwhelmingly African-American or international. According to Dr. Cora-Bramble, the merger was an unexpected opportunity to enhance the collaboration between HUH and CNMC, to diversify the pool of residents, and to recruit and retain minority fellows and faculty. How do you begin to craft an initiative that addresses minority faculty concerns?
Commitment, Teamwork, and Leadership
The leaders of both institutions recognized the importance of their involvement in the success of the merged programs. Drs. Renee Jenkins and Bernhard L. Wiedermann, HUH’s Pediatrics Department Chair and GWU’s Vice Chair for Education/CNMC’s Pediatrics Residency Program Director, respectively, worked tirelessly to ensure its success. Although Howard has collaborated with CNMC on other research endeavors and programs, the training program merger was much more entwined and had a deeper commitment. Dr. Batshaw notes the importance of having an individual as a member of the leadership hierarchy in the program as a key element of building trust and encouraging open communication. “The success of the merged program is a reflection of the competence and commitment of a team of leaders from both institutions. The delicate and important task of leading and managing the institutional change at CNMC was placed on Dr. Cora-Bramble’s shoulders and she excelled in this role. Additionally, the respect and trust she has earned at both institutions enabled her to address difficult inter-institutional issues with relative ease. In our case, three elements were essential: commitment from the top, teamwork, and skillful leaders.”
The connections of leadership and modeling for residents have been valuable. By bringing residents together with minority faculty, both gain insights on generational differences and residents learn to navigate the system. Equally important, it allows residents to be exposed to scarce minority faculty role models who are pursuing academic careers.
Professional Development for Minority Faculty
Dr. Cora-Bramble enlisted the existing CNMC minority faculty to assist in guiding the merger, in tackling difficult issues and in mentoring the Howard University residents. Under her shared leadership with Dr. Joseph Wright, CNMC’s Minority Faculty Affinity Group (MFAG) provided a culturally responsive forum to discuss merger issues and to recruit mentors for the residents. The Minority Faculty Affinity Group is thriving. At first, the quarterly meetings were largely social in nature and provided the forum to conduct the first survey, which focused on minority faculty members’ perception of the institutional support, adequacy of mentorship, clarity of the advancement, promotion and tenure processes, and perception of salary equity. The survey data served as a springboard for discussion at the MFAG meetings and as a data source for CNMC leadership. It was the first snapshot of the needs and perceptions of minority faculty.
More recently, the established MFAG served as a natural venue to implement a minority faculty development workshop series, which focuses on academic advancement and productivity (see their agendas below). Moreover, mentor relationships are developing among MFAG members and special invited guests, minority fellows and residents. Unexpected networking opportunities emerged by broadening the scope of the group to include minority faculty from Howard University Hospital.
Most importantly, the MFAG has been able to engage in difficult yet candid discussions regarding minority faculty recruitment efforts and retention challenges. The group now finds itself serving as a critically important venue for networking, mentorship and academic career advancement, and as a tool to improve minority faculty satisfaction.
What Wisdom Can We Gather from the Children's-Howard Experience?
Drs. Cora-Bramble and Batshaw offer the following transition tips for institutional change:
1. See challenges as opportunities. Begin to look for potential opportunities when a significant change or transition occurs. Identify where there could be intersection with other faculty or groups.
2. Develop clear plans. If starting a new initiative, be sure you have a clear mission, vision, and purpose. Query the minority faculty for their insights. Invite all faculty to participate. The initiative should be transparent. All faculty should gain from the new initiative.
3. Understand how long start-up takes. It takes time for people to understand new ideas. And even more time to form and strengthen relationships. The process is often slow. Consistent, frequent communication is key to keeping the initiatives in front of leadership.
4. Teamwork is essential. Invite an interdisciplinary and engaged group to the table. Do not underestimate the value of trust and personal relationships in accomplishing a common goal.
The Children's National Medical Center Minority Affinity Group Workshops
A year-long effort focused on academic excellence and career advancement.
Tina Cheng, M.D., M.P.H.
Chief of General Pediatrics and Adolescent Medicine
Johns Hopkins University
Danielle Laraque, M.D.
Chief of the Division of General Pediatrics
Mount Sinai School of Medicine
Renee Jenkins, M.D.
Chair of the Department of Pediatrics
Howard University Hospital
A year-long dialogue on minority recruitment and retention - salary equity issues.
A year-long focus on minority faculty networking/understanding the perception of institutional support for academic promotions
Denice Cora-Bramble, M.D., M.B.A.
Diana L. and Stephen A. Goldberg Center for Community Pediatric Health
Associate Professor of Pediatrics
Children's National Medical Center
Joseph Wright, M.D., M.P.H.
Medical Director, Advocacy and Community Affairs
Children's National Medical Center
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