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Calling all voices

Patrick Boyle , Staff Writer
May 7, 2020

New editor-in-chief of Academic Medicine seeks to broaden perspectives in the esteemed journal.

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Laura Roberts, MD, in her office
Laura Roberts, MD, editor-in-chief of Academic Medicine, relaxes in her office at the Stanford University School of Medicine, where she chairs the Department of Psychiatry and Behavioral Sciences.
Courtesy: Laura Roberts, MD

Since becoming editor-in-chief of Academic Medicine in January 2020, Laura Roberts, MD, has set out to broaden the scholarly journal’s reach and relevance. She assembled a broad and diverse editorial leadership team; published editorials on such topics as holistic admissions processes, motivations for academic writing, and belonging and diversity in the health professions; and drew more than 400 submissions from trainees with her call for letters about “first experiences in training.”

When the coronavirus pandemic hit, the journal pivoted to respond rapidly, assessing hundreds of submissions about COVID-19 from around the world through a rigorous and expedited review process.  

Roberts, who is also chairman of and professor in the Department of Psychiatry and Behavioral Sciences at the Stanford University School of Medicine, recently spoke with AAMCNews about her vision for the journal. The conversation has been condensed.

What are your priorities for the journal? What might change?

The journal represents many perspectives throughout academic medicine. The medical education community in particular is appreciative of the journal for advancing the most rigorous scholarship and the most thoughtful policy positions in the field. My whole career, I’ve focused on all of the missions of academic medicine: advancing science, educational excellence across disciplines, clinical innovation, community engagement, and leadership, all on a foundation of respectful inclusion, sustainability, and professionalism. The journal needs to reflect all of those components.

The real issue is, how do we continue to make the journal valuable to the field? I’m looking for ways to broaden our engagement across academic medicine, with attention to the rapidly evolving issues of our field and greater focus on underrepresented perspectives. I am giving special attention to early career authors and early career issues, for example, through social media communications, invitations and calls for submissions, and workshops to try to bring tentative young authors forward.  We want to make sure there’s greater representation of people and views. To have greater reach and relevance, we need to hear from our colleagues across the health professions, including throughout the developmental trajectory; listen to underrepresented voices and perspectives; and ensure that we elevate work from academic institutions widely.

You’ve emphasized reaching underrepresented populations, saying, “We want to give voice to underheard perspectives.” What are the underheard perspectives and how might you give them more voice through the journal?

Everything we do will reflect this fundamental commitment to respectful inclusion and multiplicity — a commitment to ensuring that we have not overlooked things, that we have not failed to take into consideration the viewpoints of others. I love to hear different ways of thinking and different perspectives, and I think we do better work when we bring different strengths together.

The combined effect of our missions in academic medicine is where we can make a greater difference. The potentiation that comes with multidisciplinary collaboration, the generation of novel ideas through engagement of people with wider experience and understanding — these types of things really matter. Certainly, I view inclusion as a social justice issue, but it’s really just wise. In the practice of medicine, for example, it’s just wise to have a more representative workforce. The evidence on respectful inclusion and diversity is clear: you pick up on, understand, and address health issues better; you do a better job taking care of your patients; and you do a better job collectively.

In terms of how to accomplish these ideals with the journal, we have lots of approaches. We developed a new assistant editor role for the journal. We performed a national search — the response was amazing — and we have now brought on board five new assistant editors from really different backgrounds, really different institutions, and different areas of expertise. They, along with members of the editorial board, will be ambassadors to engage new authors, engage new reviewers.

And I hope everyone on our team and across the field will educate me about what topics of concern are of greatest importance to the people we serve. We are inviting commentaries from different leaders, at all developmental levels and with different areas of expertise, and we are putting together collections of papers that are meant to touch on concerns of readers from different backgrounds. We also have a social media strategy for broader stakeholder engagement. We’re tweeting much more frequently (@AcadMedJournal); we’ve picked up activity through our blog, LinkedIn page, and podcasts; and we’re hosting more webinars.

What are some of the areas where readers might notice the impact of those changes?

The main scholarly articles and research reports will continue to be rigorously peer-reviewed and, we hope, will be impactful, influential, valuable work. My sense is that the topics we address will continue to expand to cover the full portfolio of importance and concerns of academic medicine. The first mission is to serve the field by advancing knowledge. A companion mission is making sure we stay attuned to — and valuable and present for — all the people of academic medicine.

Invited Commentaries, Perspectives, and Letters to the Editor are key features of the journal and are places where we can look to elevate new views, highlight experiences from underrepresented institutions, or bring greater attention to new segments of our field. We are undertaking an analysis of where our manuscripts come from, with the intention of stretching to make sure we have perspectives from people who aren’t from some of the institutions that we have typically published papers from. We also are looking for submissions from people from different positions and roles throughout the field. We’re looking at developing new features where our colleagues from different developmental stages in their careers can express their work.

I have always considered Academic Medicine to be “my” journal because I had some of my first work published in the journal and because it has always focused on topics that were key to my professional development and work — as a medical student or an academic leader and physician-scientist. I want this same experience for others. I want to be the journal that serves the young people of the field, to be their companion for the next 30, 40 years of their careers. I want our journal to be the spot where young people of the field get their first letter to the editor or first article published, where somebody was able to submit cover art or a personal narrative, where they performed their first peer-review — while still being the “home” to more senior people like me.

In short, I’d like to bring more people to our journal — and to keep them connected and to have them feel like our journal is their journal.

Are there topics you’d like to see writers address more often or in a different way than they’ve typically been addressed?

The issues of greatest impact aren’t necessarily the ones that are most written about: prevention, the public health apparatus, interprofessional collaboration, policy, leadership, innovation. These have not been the most cited topics in the literature.

But look at us today. What could be more important than the investigation by physician-scientists into a disease that has caused a true global pandemic? What could be more important than scientifically-informed public policy? Those have not been the most highly funded topics. What journals can do, and editors can do with the help of everybody, is try to rebalance it so that we can get some of these less well-recognized topics into review and critique. 

When David Sklar [your predecessor] asked you in a podcast what you lose sleep over, you said, “I lose sleep about us together, as all of academic medicine, not being able to address the hardest challenges that we’re facing.” What are those challenges?

Here we’re living them, through the coronavirus and COVID-19. How do the health professions work together to bring about an appropriate standard of care for all people? How do we reach the uninsured, the homeless, the special populations who don’t have strong advocacy or are — by virtue of circumstance or specific qualities — much more vulnerable to health risks? How do we properly balance the role of technology and late-stage disease intervention with primary prevention and public health initiatives that, until this moment, have been undervalued? How do we build a workforce that truly reflects the people we serve?

These are hard things. Academic medicine is in this incredible position to serve society right now because we’re the ones who can do great discovery science. We can do great implementation science and translational science. We’re the ones who can cultivate the next generation who can deal with worldwide problems. We can inspire and support medical students and graduate students to grapple with the hardest problems in human health. We can create new treatments and get them out into the world. We can focus on access to care, on workforce and well-being, and on resource issues in health systems.

What role does the journal play in helping the field address them?

Academic Medicine is publishing accepted manuscripts related to COVID-19 online after an accelerated review process. We have a new call for trainee-authored letters on “courage, connection, and COVID-19.” The flood of scholarship during this time reveals the generosity and mutualism of the academic medicine community.

Our world has been dealing with tremendous chronic health issues, traumatized and displaced persons, a suicide crisis, the opioid epidemic, and now the coronavirus pandemic. We have an aging and exhausted workforce, often carrying huge debt and feeling overwhelmingly challenged as they try to balance their roles, risks, and responsibilities. These issues are immense, and they will not subside. It is a time to lead, using all of the strengths of academic medicine to guide us.

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