In this edition:
- Message from the Chair
- CFAS COVID-19 Disparities Tweet Chat
- CFAS Rep Profile: Nicholas Delamere, PhD
- Call for Nominations: Coalition for Physician Accountability UME-GME Transition Review Committee
- CFAS and AAMC Wellness Activities During the Pandemic
- AAMC Strategic Planning Update
Message from the Chair
I hope that you and your families are well. More than two months into the national pause enforced by the pandemic, I write to update you on the activities that the CFAS Administrative Board continues on your behalf.
As you were recently informed, the AAMC has decided to cancel all planned, in-person AAMC meetings through June 30, 2021. The CFAS Administrative Board appreciates the thought and deliberations that persuaded the AAMC leadership to make this courageous decision, and we also recognize that this decision will result in a substantial loss to our constituents in the face-to-face education and networking time that was so valuable for all of us.
Over the years, CFAS reps have been prominently engaged in both the Learn Serve Lead Annual Meeting and the annual CFAS Spring Meeting, as well as with many other AAMC-sponsored gatherings. Many of us place great value on the interactions and connections that such in-person meetings facilitate. For this reason, the CFAS Administrative Board has already committed to developing alternative means that will address your immediate needs for information and collaboration, while also protecting the health and safety of all potential participants.
A first decision was made to extend the terms of all current members of the Program Committee for another year. Next, the committee was charged with drafting proposals for new means of information exchange and collaboration, which maintain physical distance. Adi Haramati, PhD, the chair of the Program Committee, will convene the committee online and will report on their deliberations at the virtual June conference of the CFAS Administrative Board. The CFAS Administrative Board is also working with AAMC leadership to align our engagement strategies with a uniform policy that will meet our representatives’ needs for information and collaboration.
Several of our committees have been active in serving you during the past month. Mona Abaza, MD, chair of the CFAS Resilience Committee, is coordinating daily postings on the closed Facebook page COVID19Wellbeing. This page is open to all faculty in academic medicine to share support and resources on how we can best cope at this difficult time. VJ Periyakoil, MD, chair of the CFAS Diversity and Inclusion Committee, and Alan Dow, MD, chair of the CFAS Communication Committee, along with AAMC Senior Director of Health Equity Research and Policy Philip Alberti, PhD, hosted a successful tweet chat on Twitter (#COVID19Disparities) focusing on the subject of the health disparities highlighted by the pandemic.
Wishing you and your families a safe and productive month ahead, and please continue to send us your feedback and suggestions. We love to hear from you.
Gabriela K Popescu, PhD
CFAS Chair, 2019 - 2021
CFAS COVID-19 Disparities Tweet Chat
On May 6, CFAS hosted a tweet chat on Covid-19 health disparities, facilitating a thought-provoking conversation on how the health care system and individual health professionals can improve health equity during and after the pandemic. CFAS Diversity and Inclusion Committee Chair VJ Periyakoil, MD, led the tweet chat with CFAS Communications Committee Chair Alan Dow, MD, and AAMC Senior Director of Health Equity Research and Policy Philip Alberti, PhD, serving as co-hosts. Included in the 140 participants involved in the chat were many CFAS reps who contributed a range of insights and resources.
Also, AAMC President and CEO David J. Skorton, MD, participated in the chat and the conversation itself received widespread attention on Twitter, garnering more than one million impressions (the number of times a hashtag associated with the tweet showed up in peoples’ news feeds). A list of the resources shared during the chat can be found here.
CFAS Rep Profile: Nicholas Delamere, PhD
Nicholas Delamere, PhD, Department Head, Physiology, University of Arizona College of Medicine – Tucson; CFAS Rep for the Association of Chairs of Departments of Physiology
CFAS: How has the COVID-19 pandemic affected basic scientists?
Dr. Delamere: My lab is still doing essential work and fortunately we have been able to maintain our colonies of the genetically unique mice we use for our studies. We have approved wages for work to maintain those colonies and do other work on the lab to avoid catastrophic losses. But because of the partial closure of the lab, undergraduate students can no longer work inside because lab training requires two people to be in close proximity, which is impossible under these circumstances.
Right now, basic science departments are anxious because we are always trying to assess our value to the institution, more so than clinical departments, and its hard for us to assess our value to our institutions virtually when people are used to gauging each other’s body language and having regular in-person meetings. The political dynamics of our institutions are a bit mysterious to us right now during this time because we can’t take the temperature of our institutions and the role we play in them and that produces stress and anxiety for basic science departments. The pandemic and the move to virtual work is also forcing us to grapple with questions such as, what exactly is a basic science department and what is its role?
Early career scientists are the most vulnerable in this crisis because they have less credentials and are often juggling the demands of young children and spouses along with having to build their labs and reputations. It's so important for us to be conscious of this cohort and look after their needs, especially during this crisis, because they look to our institutions to help them start their careers and their mental health stress is really mounting during this time. Institutions need to be especially aware of whether their reopening plans are prioritizing the institution’s established, marquee labs or whether there is an even playing field for the early career scientists with small labs and the more senior scientists with bigger labs.
CFAS: Tell us about your research.
Dr. Delamere: I’ve spent most of my career doing vision research. For 30 years, I worked in clinical departments (ophthalmology) before moving to a basic science department (physiology) 15 years ago. Essentially, I study how ion transport mechanisms are controlled and what’s defective about their control in glaucoma and cataracts.
CFAS: Based on your experience, what advice do you have for PhDs leading departments at academic medical centers?
Dr. Delamere: Academic medical centers are an exciting mix of clinicians, basic scientists, educators, and researchers. Leaders learn quickly that each of the various stakeholders has their own unique viewpoint. The goal in any kind of decision-making process is to get buy-in from various groups led by people with differing agendas. PhD and MD faculty inhabit the same campus ecosystem but their needs and wants are very different. PhDs tend to be concentrated in basic science departments and, within those walls, research funding has long been the coin of the realm, not clinical earnings.
Obviously basic science departments have a critical teaching role too. In recent years, institutions have increasingly used faculty teaching metrics to guide allocation of institutional funds to departments. You could say my department helps earn its keep by generating tuition revenue for the university. We teach medical students, graduate students and undergraduates and we keep close tabs on how much we do and how we can improve.
When you look at career development for faculty in clinical departments vs basic science departments, there are subtle and not so subtle differences. Promotion and tenure matter to everyone, of course. A PhD’s research and teaching portfolio is likely to be different from that of a clinician colleague who has significant patient care responsibilities. Clinical and a basic science departments often have a different support structure for salaries. Clinician salaries tend to have a relatively small institutional component and significant clinical earnings-related component. PhDs in a basic science department like mine have more institutional salary support though a significant component of their salaries comes from research grants from the National Institutes of Health (NIH).
Unfortunately, NIH grant funding is being awarded at lower rates than in the past and this has contributed to negative pressure on PhD salaries. The doubling of NIH budget had a legacy effect that wasn’t sustained, so it actually backfired in the long term. These days, even the most diligent faculty member in a basic science department can’t expect an uninterrupted flow of grant money. Departments strain to support faculty though gaps in research funding. This makes it challenging for a basic science department chair to build and maintain a stable faculty team. It’s helpful to have a strong teaching program as another source of revenue.
CFAS: As the society rep for the Association of Chairs of Departments of Physiology, how can CFAS continue to provide value for its society members?
Dr. Delamere: CFAS provides a national forum that brings together disparate societies that would otherwise never interact. The Association of Chairs of Departments of Physiology meets for a retreat every year and we always take time to discuss and reflect on what’s going on at CFAS. By staying plugged into CFAS, we feel that we’re listening to the national conversation and that helps us reference the trends that are arising.
Physiologists think of themselves as part of an education pipeline that provides critically important instruction before, during and after medical school. We build a foundation of understanding and teach a way of thinking that we hope will last a lifetime. We give a lot of thought to whether the curriculum content and manner of delivery is properly aligned with the needs of today’s students. This is easier said than done because the landscape keeps changing. It helps to look beyond our discipline and see where physiology fits in the broad context of medical education. CFAS is the only forum that provides that opportunity. By participating in CFAS, we get connected to the bigger picture.
I think now that CFAS has found its feet, academic societies have come to understand that there’s value in the way things are currently set up. Having reps from institutions as well as societies puts more stakeholders in the room. CFAS meetings draw together people with a very diverse array of expertise and experience. That being said, CFAS can be a fairly steep learning curve for new reps who sometimes find it takes time to get a feel for what’s going on.
CFAS: Are there any recent accomplishments or initiatives at the University of Arizona College of Medicine that would be interesting to CFAS reps?
Dr. Delamere: We changed our preclinical curriculum not long ago from 2-years to 18-months. A number of institutions have undergone a similar overhaul. It was an interesting process to watch and I was partly involved in the decision-making. Each redrawing of a boundary line between topics in a medical school’s curriculum is vigorously contested and it was a significant challenge to downsize ours to such a degree. Sacrifices were required from everyone. We were able to complete the process without hurting relationships. Importantly, the exercise was an opportunity for thoughtfully rethinking how we teach as well as what we teach.
There were several good reasons to revamp our curriculum. One consideration was timing of the USMLE Step 1 exam and the significance of exam scores in applications for residency programs. We also had experienced a steady decline in students going to lectures and learning instead from podcasts. With students increasingly focused on getting a good Step 1 score, their pressure to learn for the test sometimes tangled with faculty’s pressure to learn for a lifetime. Step 1 drove much discussion. Now the exam has been changed to pass/fail we’re watching with bated breath to see how this plays out.
CFAS: What do you like to do in your free time?
Dr. Delamere: I think it’s terrifically important to build free time into your schedule. If you’re going to be in academic medicine for the long haul, you need to be as diligent about personal wellness as you are about work. You simply must set aside time to do things for yourself. Many people depend on you and it’s your responsibility to stay in good physical and mental shape. I do a yoga class most days. In winter, I ski whenever possible. I still enjoy running but lately seem to be spending more time cycling. My garage is getting overrun with bikes!
Call for Nominations: Coalition for Physician Accountability UME-GME Transition Review Committee
The Coalition for Physician Accountability, which brings together national organizations with oversight of the education and assessment of medical students and physicians, is seeking nominations of qualified individuals to participate in the UME-GME Transition Review Committee to review and make recommendations to improve the transition from undergraduate medical education (UME) to graduate medical education (GME), particularly around preparation and selection for residency and the application process.
Candidates for the Review Committee must have in-depth knowledge of undergraduate and graduate medical education, a sincere desire to solve a problem, a willingness to work collaboratively, a willingness to dedicate the time needed to contribute actively. Nomination materials are to be submitted no later than Monday, June 15, 2020.
The Coalition’s membership includes the AAMC, American Association of Colleges of Osteopathic Medicine (AACOM), American Board of Medical Specialties (ABMS), Accreditation Council for Continuing Medical Education (ACCME), Accreditation Council for Graduate Medical Education (ACGME), American Medical Association (AMA), American Osteopathic Association (AOA), Council of Medical Specialty Societies (CMSS), Educational Commission for Foreign Medical Graduates (ECFMG), Federation of State Medical Boards (FSMB), Liaison Committee on Medical Education (LCME), National Board of Medical Examiners (NBME), National Board of Osteopathic Medical Examiners (NBOME), and members of the public.
CFAS and AAMC Wellness Activity During Pandemic
CFAS continues to strategize on how to support faculty members in their well-being during this time and has launched several social media initiatives on that front, including tweets with the Twitter hashtag #COVID19Wellbeing and a closed Facebook page for academic medicine professionals administered by CFAS Faculty Resilience Committee Chair Mona Abaza, MD. The page is very active with new posts and content generated daily. To be added to the page, search “COVID19Wellbeing” in Facebook and request to join the group. Dr. Abaza will also host a soon-to-be-announced tweet chat on well-being for academic medicine professionals during the Covid-19 pandemic.
Also in May, the National Academy of Medicine’s Action Collaborative, in conjunction with the AAMC and the ACGME, offered a webinar, "Supporting Clinician Well-Being During COVID-19." Several CFAS reps and member societies have played a role in the advancement of this work and the related programming.
This most recent event featured presentations from Jonathan Ripp, MD, MPH, Chief Wellness Officer at the Icahn School of Medicine at Mount Sinai, and Joshua Morganstein, MD, assistant director of the Center for the Study of Traumatic Stress Uniformed Services University of the Health Sciences, among others. Slide presentations, background material, and other resources from the presentation are available.
And as always, CFAS and the AAMC maintains a collection of articles and resources related to well-being in academic medicine. If there are resources you would like to add to this page, please reach out to Alex Bolt at email@example.com.
AAMC Strategic Planning Update
Earlier this year, the AAMC completed a comprehensive scan of the environment as part of its strategic planning process, updated its mission and vision statements, and identified broad themes and goals. More than 1,500 members of AAMC’s affinity groups viewed the draft themes and goals and offered critical feedback and insight.
Then the strategic planning team formulated 10 plans for action to prepare for the immediate post-pandemic world and work toward improvements in educational, research, health care, and community collaboration systems to better prepare academic medicine and the nation for the future. Currently, the AAMC is working on implementation plans for each of the 10 action plans and will share the details of the strategic plan in September.
Tell Us How You’re Doing in Response to Coronavirus
During this unprecedented public health crisis, we ask you to keep the lines of communication open so we can provide you with the resources and information that would be most useful. It is helpful for the AAMC to understand in detail what is happening on the ground at the medical schools, teaching hospitals, and academic societies we serve. Please email Eric Weissman at firstname.lastname@example.org, or call Eric directly at 301-437-2572 with updates or feedback from your perspective. You can also reach out with questions or comments to CFAS Communications Specialist Alex Bolt.
We are especially interested in hearing what is happening on the academic society side. We invite all CFAS-member society executives to share your plans and strategic approaches for dealing with the coronavirus pandemic.
If you are looking for information about CFAS, find what you need on our website, from the names of CFAS leaders, to updates on committee and working group initiatives, to upcoming offerings and meetings, and finally, current and previous editions of CFAS News.
Do you have an article or study coming out? A new promotion or professional accomplishment? Let us know and we’ll feature it in an upcoming edition of the CFAS Rep Bulletin.