Report from the AAMC's Leadership Forum
The 2018 AAMC Leadership Forum was held June 11-12 at the AAMC's Washington, D.C. headquarters and drew 84 of academic medicine’s top leaders to a spirited, two-day discussion of the opportunities and challenges institutions face in fully engaging with their surrounding communities. The core message of the forum was, in order to reduce health disparities, medical schools and teaching hospitals must build trust, develop meaningful relationships, and appreciate the historical perspectives of their community members, especially those perspectives that view the medical establishment with skepticism due to past incidents of misconduct and discrimination.
The forum offered examples of how institutions such as Rush University Medical Center, Michigan State University's College of Human Medicine, and the University of Texas Rio Grande Valley are making progress toward greater community engagement by financially investing in their communities, sharing power, and acknowledging a shared, and sometimes painful, history.
A number of CFAS Administrative Board members and representatives attended the event, which featured presentations by Consuelo H. Wilkins, MD, MSCI, executive director of the Meharry-Vanderbilt Alliance at Vanderbilt University Medical Center and Meharry Medical College, and Camara P. Jones, MD, MPH, PhD, senior fellow at the Satcher Health Leadership Institute and Cardiovascular Research Institute at Morehouse School of Medicine, among many others.
“Community engagement is not the new word for outreach,” said Dr. Wilkins, who was a keynote speaker. “Outreach is unidirectional. It means you’re offering them your vast knowledge and resources and they should be grateful. Engagement is bidirectional. It requires you to build relationships and trust. You cannot change health outcomes if people don’t trust you.”
Faculty Members Invited to Join AAMC Action
As part of the AAMC’s ongoing effort to expand its digital grassroots advocacy community, AAMC Action, the association recently has encouraged faculty and others in the academic medicine community to become involved in the effort. AAMC Action is an important part of our advocacy and education activities around issues such as research funding, ensuring patient access to care, addressing the doctor shortage, and more. Please let your colleagues know about this effort by directing them to www.aamcaction.org, where you too can sign onto the initiative to make a significant difference on Capitol Hill on issues important to medical schools and teaching hospitals.
CFAS Rep Profiles: Lumy Sawaki-Adams, MD, PhD, and Steven Feldon, MD, MBA
Lumy Sawaki-Adams, MD, PhD, Junior Medical School Rep; Associate Professor, Physical Medicine and Rehabilitation, University of Kentucky College of Medicine
CFAS: Tell us about your research.
Dr. Sawaki-Adams: I’m a clinician scientist and have been working to further recovery in neurological patients for more than two decades. I work with noninvasive neuromodulation to promote functional recovery. I stimulate the brain or peripheral nerves with noninvasive techniques in order to boost neuroplastic changes, which is the capacity for the central nervous system to rewire. I’m particularly passionate about helping people with severe impairments, for example people who don’t have movement of the arm after a stroke, or people who are wheelchair users after spinal cord injuries. Severely impaired patients often aren’t functional or independent, but they can live for a long time, so we’re trying to find out how to provide them with long-term care.
CFAS: What are some important issues to women faculty members that CFAS could address?
Dr. Sawaki-Adams: Among the many issues, perhaps the most important is the issue of equity. There is a paucity of women leaders in the C-suite. There are a lot of women associate and assistant deans but not many deans. We also need more representation at the chair level.
Another extremely important issue is that we are not doing enough to protect our students, trainees, and young faculty from sexual harassment. We act like ignoring the issue will make it go away. Academic medicine has not yet caught on to the #MeToo movement, and it’s imperative that we don’t miss out on it. I was subjected to sexual harassment early in my career. Future generations of female physicians need to feel respected and valued for their competency, not their appearance.
A separate issue that impacts young faculty is childcare. One program that is doing good work to help with childcare is “WeWork.” You have to buy a membership but they have shared office space where you can use a computer. It feels like you are in an office, but your children are being taken care of in the same building. There is a need for a program like this in academic medicine.
CFAS: What are the important issues today in physical medicine and rehabilitation?
Dr. Sawaki-Adams: Because of the aging population, we have a lot of people coming into rehabilitation. It’s a complex patient population with many comorbidities. We are trying to evaluate how we can care for these patients particularly in light of changes in reimbursement systems, especially with performance-based payment models. So there is a need for continued recovery outside the inpatient rehabilitation setting. We are trying our best to adapt to these changes and to make the rehabilitation system more efficient to better serve our patients.
Another issue that is very challenging is the opioid crisis, which is a huge problem in my state, Kentucky. Physical medicine and rehabilitation is affected by opioid addiction just like any other specialty, if not more so. Knowing how to safely and effectively handle chronic pain is a huge issue for us.
Another issue in physical medicine and rehabilitation is that there is still a lot of stigma about disabilities. We need to advocate to increase funds and opportunities for people with disabilities and to also increase hospital accessibility. Political challenges make this work harder to find funding for certain services for people with disabilities. And since we don’t focus enough on prevention in our country, there is more hospitalization.
CFAS: What are some recent accomplishments at the University of Kentucky College of Medicine that would be interesting to CFAS reps?
Dr. Sawaki-Adams: We have a fairly new dean, Robert DiPaola, MD, who has been very supportive of the entire academic mission, including diversity, which is so needed in our state. He has been a great advocate of the Women in Medicine and Science group in the College of Medicine. He knows well that creating opportunity for women goes beyond just creating a position, it requires continual care and nurturing, so he has implemented several initiatives to optimize transdisciplinary collaborations.
Another exciting change is the creation of the position of associate dean of faculty affairs. One role of this person will be to help support the institution’s work on well-being and resilience and make sure we’re proactive about preventing burnout.
Also, we have a large portion of the surrounding population that doesn’t have convenient access to health care. In order to address this, as well as to deal with the physician shortage in Kentucky, the University of Kentucky College of Medicine is opening three new satellite medical schools across the state.
CFAS: What do you like to do in your free time?
Dr. Sawaki-Adams: I’m a news junkie. I like to stay on top of what’s going on in the world. I also like rescuing animals, and I love spending time with my two dogs and two cats, who are all rescues. Spending time with my husband is also very important to me. Additionally, I’ve been influenced by many of the talks I’ve heard at AAMC and CFAS meetings and am trying to make time for myself. I recently went to a two-day silent retreat. As hard as it was, in the end it was very rewarding and allowed me to decompress.
Steven Feldon, MD, MBA, Society Rep, Association of University Professors of Ophthalmology; Professor and Chair, Department of Ophthalmology, University of Rochester Medical Center
CFAS: How can CFAS provide value to ophthalmologists?
Dr. Feldon: Our society consists of chairs, program directors, medical student educators, and administrators in every academic ophthalmology department in the U.S. and Canada. Our goal is to enhance the mission of academic ophthalmology. In most medical centers, we’re not part of the required undergraduate medical curriculum and, being completely outpatient in our care, we don’t occupy beds in the hospitals. But since hospitals are the dominant source of revenue for academic medical systems, that presents financial challenges for us. But we excel in areas like population health and outpatient surgeries.
For example, we are starting to consider whether cataract surgeries can be safely performed in the doctor’s office rather than in an operating room once ultra-miniaturization proceeds to the next level. We hope that CFAS will help us communicate the importance of having ophthalmology education as a critical part of the medical school curriculum. We would also like to work with other academic sub-specialty societies within CFAS to develop common goals for advancing the role of sub-specialties in academic medical centers.
CFAS: What are the trends in ophthalmology?
Dr. Feldon: One trend involves the changes in treatment for glaucoma through the use of miniaturized implantable devices, called MIGS, which look like tiny stents. They allow fluid to escape the eye through a more natural channel than traditional drainage surgeries. Two more rising trends are the interest in utilizing telemedicine as a primary health tool for preventing diabetic retinopathy.
CFAS: Tell us about your research.
Dr. Feldon: My basic research interest is in thyroid eye disease. My team is looking for the underlying mechanisms for scarring in the eye and orbit. Once the immunologic mechanisms are known, identifying potential drugs that might be effective becomes possible. I also run a national photographic reading center to assist any clinical trials that need photographic documentation of eye disease. Currently, we are involved in a randomized multicenter trial for the study of idiopathic intracranial hypertension, a brain disease that causes optic nerve swelling. I’ve also been involved in the leadership of major multi-site NIH sponsored clinical trials.
CFAS: What are some recent accomplishments from your institution that would be of interest to other CFAS reps?
Dr. Feldon: My department is known for adaptive optics imaging. We have the ability to look at single rods and cones of the retina and we can use this imaging technology to advance science by imaging the structure of the retina and its function. This ability also allows us to see which cells are functioning properly. In my department, 30-40% of research involves adaptive optics imaging.
The rest of my department’s research involves animal models and in vitro models of eye disease. My department is able to develop potential eye drugs very quickly because we replicate a lot of clinical eye diseases in a petri dish. Some members of my department are doing research in population health and, since up to 90% of the known causes of irreversible blindness are preventable, they are trying to focus on identifying patients at risk for eye disease. This strategy optimizes chances for prevention, early detection, and early treatment of eye disease.
CFAS: What do you like to do in your free time?
Dr. Feldon: I like snow skiing and I’ve been a wine collector for decades. I primarily collect California and French wines, both cabernets and pinot noirs.
CFAS Society Profile: The Association for Surgical Education (ASE)
The Association for Surgical Education (ASE) focuses on surgical education and scholarships by recognizing excellence and innovation in surgical education. “ASE is tasked with taking surgical education forward into the future and we have a very diverse group of people positioned to help guide us,” said Amalia Cochran, MD, FACS, FCCM, the president of ASE. For the last 6-7 years, ASE has served as an incubator for multi-institutional research, trying to build alliances and provide support for people to do education research across institutions and programs. For example, ASE has started awarding a grant for multi-institutional education research. Keith Lillemoe, MD, the chief of surgery in the Department of Surgery at Massachusetts General Hospital, has helped support this grant, which is a joint project between ASE and Mass Gen.
“Another area we’re doing a lot of work in is global surgery. Our Global Surgery Task Force does a lot of work with sustainability and developing and disseminating best practices for global surgical clinical experiences for trainees,” Dr. Cochran noted.
ASE began through informal meetings of surgery clerkship directors who saw the need to develop and share best practices. The group evolved with the emergence of a population of PhD-level educators who expanded the organizational mission to also focus on research in surgical education. Now ASE is creating a community that embraces both applied and discovery aspects of surgical education.
ASE’s constituency is broad and includes anyone involved in surgical education. The largest membership group is the surgeons who have educational leadership roles and another fairly large group is both surgeons and PhD level scientists who are involved in educational scholarship. Two smaller constituencies are nurse educators and program coordinators who are involved with surgical education.
ASE partners with the American College of Surgeons and the Association of Program Directors of Surgery to host Surgical Education Week, which serves as the association’s national meeting. Surgical Education Week provides practical support for surgical education and also offers more specialized knowledge. In the most recent Surgical Education Week, ASE addressed entrustment and operationalizing the AAMC’s EPAs in surgical education.
The societies involved in hosting Surgical Education Week each contribute different components of the programming, which makes the programming very robust and tailored to a diverse range of professionals in surgical education. “We offer everything from informal ‘thinking outside the box’ sessions to formal podium presentations on very refined surgical techniques. ASE is distinct among other surgical societies because we’re so inclusive. And everyone is a full member regardless of their professional identify and no one is regarded as an affiliate or adjunct member,” said David Rogers, MD, MHPE, the senior society rep for ASE; senior associate dean of faculty and professional development; and professor of surgery, medical education, and pediatrics at the UAB School of Medicine. Dr. Rogers also said that putting all members on the same level in terms of membership status has helped foster a vibrant and collaborative culture at ASE.
Membership in CFAS is important to ASE because of the natural synergy between the two groups stemming from the various education issues addressed in CFAS meetings and initiatives. It’s also beneficial for ASE reps to network with CFAS reps from organizations with different emphases on education. “Because CFAS is part of the AAMC and the AAMC’s reach into the education space is deep and broad, there are great opportunities for synergy around how we train students and residents. We have the responsibility to train the surgeons of the future, so staying engaged with the AAMC through CFAS is important to us,” added Dr. Cochran
Funding for residency training and medical research are also specific areas of mutual concern between CFAS and ASE in regard to the national policy landscape. But perhaps the biggest issue for ASE is the widespread consolidation in health care. Because education typically receives less resources than other missions, the challenge for those in education is doing more with less and less, said Dr. Rogers. “There’s a lot of uncertainty, change, and burnout because of that. We have appreciate the proactive stance that CFAS has taken in addressing these faculty distress and burnout as we need tools to help our members maintain their resilience in these challenging times.
Ad Hoc Surgical Subspecialist Meetings
At the most recent CFAS meeting in Chicago, an ad hoc group of surgical subspecialist reps and those involved in surgical education convened to discuss issues of particular importance to them. The effort originated with Steven Feldon, MD, MBA, profiled in this edition, who is interested in leveraging CFAS to explore critical issues around education and training issues related to surgical subspecialties and to improve knowledge sharing between CFAS-member societies.
The group found that although it has narrow constituencies, there are similar challenges, including the need for more attention from deans and adopting a more expanded focus on subspecialties in medical education in part through improving representation in the medical school curricula. Findings from the meeting in Chicago will serve as the basis for future conversation among group members prior to the Learn Serve Lead meeting in Austin this November. If you are interested in participating in this work in the future, please send an email to Eric Weissman, who will add your name to the distribution list.
LSL Awards Dinner Open to CFAS Reps
As in past years, CFAS reps are invited to attend the awards dinner at the upcoming Learn Serve Lead 2018: The AAMC Annual Meeting in Austin, Texas. The dinner is a black tie event that provides unique networking opportunities and celebrates the accomplishments and commitment of leaders in academic medicine. CFAS reps are always encouraged to attend these dinners. Be sure to select the option to attend the dinner when you register for LSL. The cost will zero out of your registration fee when you complete the registration process.
Rally for Medical Research Capitol Hill Day
The 6th annual Rally for Medical Research Hill Day will take place on Thursday, September 13, 2018 with the Rally for Medical Research Hill Day reception taking place the evening before on Wednesday, September 12, 2018. The rally provides researchers an opportunity to meet with Congressional representatives to advocate for federal support of biomedical research. The AAMC is a supporter of the event and we encourage CFAS reps to participate, if time allows.
AAMC Advocacy Sign-on Letters to CFAS Societies
Through CFAS, the AAMC has engaged academic societies in advocacy initiatives pertinent to academic medicine through the distribution of sign-on letters. When societies add their names to these letters, it gives them a collective voice on an important issue to academic medicine. These letters represent real opportunities to keep policymakers informed on the important issues to societies and academic medicine as a whole. In the past year we have asked societies to sign onto the following letters:
- VA Research Recommendation (4/2018) – 15 societies signed.
- NIH Funding Letter (3/2018) – 25 societies signed.
- Amicus brief; Supreme Court (3/2018) – 34 societies signed DACA Letter (9/2017) – 15 societies signed amicus brief.
- NIH F&A Letter (9/2017) – 23 societies signed.
- Fetal Tissue Letter (8/2017) – 3 societies signed.
- NSF Funding Letter (4/2017) – 29 societies signed.
2018 CFAS Spring Meeting Materials Available - Reminder
The 2018 CFAS Spring Meeting was held in Chicago from April 19-21. Detailed summary materials from the meeting are available on the CFAS Resources webpage. You are free to adapt these materials as needed.
Have you had a recent professional accomplishment? Let us know, and we’ll feature it in the next edition of the CFAS Rep Update!
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