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    CFAS Rep Bulletin January 2024

    In this edition:

    • Message from the Chair
    • Registration Opens for 2024 Joint CFAS – GRA – ORR Spring Meeting
    • Accessing AAMC Faculty Salary Data
    • CFAS Connects: Leveraging AAMC Data to Advance Faculty Interest
    • New Leadership for the CFAS Advocacy Committee
    • CFAS Rep Profile: Evadne “Evie” Marcolini, MD

    Message from the Chair

    Dear CFAS Colleagues,

    In the years I’ve been involved with CFAS, I have become accustomed to the rhythm of the annual cycle of our meetings, where we traditionally do the bulk of our CFAS work. Through the summer and early fall, we are anticipating Learn Serve Lead, the AAMC’s Annual Meeting, where there’s an array of programming opportunities for all faculty, followed by a brief respite (which inevitably gets consumed by the holidays), and then all of a sudden, we are blocking time for our next in-person event, the CFAS Spring Meeting. Don’t rest, because before you know it, we’ll be talking about LSL again!

    You already should have received an email invitation encouraging you to register for the 2024 joint meeting between CFAS, the AAMC’s Group on Resident Affairs, and the Organization of Resident Representatives April 2-4 in Arlington, VA, just across the Potomac from Washington, DC. There’s a prolonged early bird registration period lasting through most of February, so I very much encourage you to reserve your spot as soon as you can.

    What’s always gratifying about these meetings is how the topical content of the program opens up real dialogue and conversation with colleagues from around the country, enriching the overall experience and making me feel more connected to my community and better equipped to understand the changes we are seeing all around us. This year’s meeting is at once unusual and potentially familiar to CFAS reps who have been engaged with the AAMC for many years.

    On one hand, we will be meeting with the Group on Resident Affairs (GRA), a first for us. This AAMC affinity group is focused on an array of issues related to residency training, from the transition medical students make to the training phase of their careers – and the work that goes into making them prepared for that monumental leap – and also the experience residents have as they move from the application and selection stage to the beginning of their independent practice.

    On the other hand, CFAS will be rejoining the Organization of Resident Representatives (ORR) which, in the past, regularly met alongside CFAS and its predecessor, the Council of Academic Societies. I have put a lot of thought into the dynamic in the move from junior faculty to senior faculty – but this opportunity also has us considering the role and experience of future faculty as part of our conversation. As a clinical department chair, there are few people I like interacting with more than residents. I find it refreshing and assuring to interact with the skilled young professionals who will keep the legacy of more senior faculty moving forward to new heights.

    Topics at the upcoming spring meeting include the impact of AI on medical education and academic medicine at large; the experience of URM women in academic medicine; the contrasts in how different generations of learners process information; what the leadership of the AAMC is actively doing to ensure a brighter future for medical schools, teaching hospitals, and health systems; and an exploration of misinformation in science with none other than Holden Thorpe, PhD, the editor-in-chief of Science. On top of that, CFAS will have its committee meetings, a business meeting, and opportunities for you to connect with peers through social interactions.

    So, as you plan your trip this spring, I recommend you get to the DC area the night before the start so you can jump into CFAS committee work the morning of April 2. I will be there along with my colleagues Dr. Art Derse, CFAS Chair-elect, and Dr. Adi Haramati, CFAS Immediate-past chair, and the rest of the CFAS Administrative Board, ready to hear from you and learn from you in the best tradition of CFAS: working collectively to advance our cause as faculty and as change agents in academic medicine.

    Looking forward to the journey,

    Nita Ahuja, MD
    CFAS Chair
    Yale School of Medicine

    Registration Opens for 2024 Joint CFAS – GRA – ORR Spring Meeting

    Registration has opened for the 2024 Joint Council of Faculty and Academic Societies (CFAS) – Group on Resident Affairs (GRA) – Organization for Resident Representatives (ORR) Spring Meeting in Arlington, Virginia, from April 2 – 4. The meeting will feature plenary sessions ranging from an examination of AI’s impact on medical education, to the residency application environment, to measures being taken to increase safety in medical schools and teaching hospitals, to the challenges faced by women of color in academic medicine. The meeting will also feature a full array of wide-reaching concurrent breakouts, poster presentations, Ignite-style sessions, town hall conversations with AAMC leaders, legislative updates, and networking opportunities from beginning to end. Concluding the meeting will be a conversation with Holden Thorpe, PhD, editor-in-chief of the journal Science.

    The meeting will be held at the Renaissance Arlington Capital View Hotel and early bird registration lasts through most of February. Don’t miss this rare opportunity to have a joint meeting with these two other important AAMC groups – a first with GRA and a reunion with ORR!

    Accessing AAMC Faculty Salary Data

    One of the most important resources the AAMC disseminates for faculty members is its yearly Faculty Salary Report, and the 2023 edition is available for purchase online at a steep discount for CFAS representatives and members for a yearlong subscription to the data. The Faculty Salary Report displays total compensation of full-time medical school faculty broken out by rank, degree, department/specialty, medical school type, region, gender, and race/ethnicity. This publication is designed for academic medicine professionals intending to negotiate compensation or use medical school faculty compensation information for benchmarking, strategic planning, or staff hiring and retention. The report also enables medical community leadership to make internal wage decisions, identify compensation trends, and develop strategic plans and budgets.

    As a reminder, CFAS reps get a discounted price for this resource at $60 instead of the regular price of $1,500. Be sure to click on the correct purchase option from the AAMC’s online store. An AAMC member login, which you can request online if you don’t already have one, is required to access the discounted price.

    CFAS Connects: Leveraging AAMC Data to Advance Faculty Interest

    CFAS Connects returned on December 21 for presentations from Valerie Dandar, MA, director of medical school operations research at the AAMC, and Stefanie Wisniewski, MPH, MSW, director of data operations and services at the AAMC. The conversation centered around how AAMC data can be useful to faculty, either through fueling research for publications, finding benchmarking data for institutions, or bringing back valuable tools and insights to their institutions or societies.

    CFAS Mission Alignment Committee Chair Stewart Babbott, MD, and CFAS Mission Alignment Committee member Adam Franks, MD, both of whom serve on the CFAS Administrative Board, discussed various projects that they have undertaken, including the development of scholarly publications on gender parity and underrepresented faculty members, that have been generated thanks to AAMC data sources such as the Faculty Roster. A recording and summary notes of the presentation portion of the session are available on the CFAS Resources webpage.

    CFAS Connects will return for a discussion on AAMC advocacy efforts and the work of the CFAS Advocacy Committee on the 24th of January. A full summary and recordings of that session will be available online soon after.

    New Leadership for the CFAS Advocacy Committee

    With the appointment of CFAS Administrative Board member Arthur Derse, MD, JD, to the position of CFAS Chair-elect, another CFAS Ad Board member will be stepping in to serve as the new chair of the CFAS Advocacy Committee. Deanna Sasaki-Adams, MD, CFAS rep from University of Arkansas for Medical Sciences, will bring new energy, thoughts, and direction to the committee, while also continuing ongoing projects. Joining her in a vice-chair role is CFAS Rep Laura Shaffer, PhD, of the University of Virginia School of Medicine.

    The CFAS Advocacy Committee’s objectives are as follows:

    1. Educate faculty about AAMC efforts in advocating for academic medicine.
    2. Share priority advocacy issues affecting academic societies and faculty.
    3. Communicate with the AAMC to align, when appropriate, with academic societies on advocacy issues.
    4. Incorporate regular opportunities for bi-directional communication between AAMC government affairs staff and committee members from representative societies and schools about policy issues, through scheduled conference calls.
    5. Propose advocacy presentations/ panels for future AAMC LSL & CFAS Spring meetings.

    Dr. Derse has led the CFAS Advocacy Committee as its chair for more than four years. Under his leadership, the committee has become more active, establishing a regular meeting schedule and creating educational sessions for faculty members, such as CFAS Connects presentations and regular Washington legislative and policy updates from AAMC Senior Director of Government Relations Tannaz Rasouli. These meetings also allowed society reps to bring issues specific to their societies to the attention of the AAMC. Finally, the Advocacy Committee has presented several advocacy-focused sessions at CFAS spring meetings and Learn Serve Lead: The AAMC Annual Meeting.

    “The CFAS Advocacy Committee is a place where faculty members can get connected with a community that helps them advocate for the needs of their institutions and societies, but the advocacy agenda is set by the AAMC itself and the committee doesn’t engage in advocacy by itself, but functions more as a conduit for information from the AAMC’s advocacy team to faculty members while also providing a space where AAMC government relations can be informed on the issues facing schools and societies,” said Dr. Derse.

    The committee is currently developing a resource that will help faculty members become advocates and explores the various routes that are available to them for engaging in advocacy. A summary of the February CFAS Connects session with the Advocacy Committee and AAMC Government Relations leaders will appear in next month’s CFAS Rep Bulletin.

    CFAS Rep Profile: Evadne "Evie" Marcolini, MD

    Evadne “Evie” Marcolini, MD, Associate Professor in the Department of Emergency Medicine and the Division of Neurocritical Care in the Department of Neurology at the Geisel School of Medicine at Dartmouth; CFAS School Rep.

    Dr. Marcolini was a speaker in a concurrent session on increasing violence in health care settings at Learn Serve Lead 2023: The AAMC Annual Meeting. She will also speak on the topic during a plenary session at the upcoming CFAS-GRA-ORR Joint Spring Meeting in Arlington, VA, April 2-4.

    CFAS: Please tell us about your work in preventing violence in health care settings.

    Dr. Marcolini: I was a board member for the American Foundation for Firearm Injury Reduction in Medicine (AFFIRM). We assembled in Chicago to bring together multiple specialties including social work, surgery, and emergency medicine to move the needle on reducing firearm injury. This organization has since become a part of the Aspen Foundation and they continue to do great work.

    More recently, I’m serving as an adviser for a Geisel medical student who is doing work in firearm injury reduction as part of a Swigart Ethics Fellowship. His perspective is that an effective approach to firearm safety can be to make firearm ownership safer, and that doing so requires both those who own guns, and those who do not, to come together. This is along the lines of what we do in emergency medicine when we offer resources such as lock boxes for guns. Currently, we are working on a survey study of physicians to gauge knowledge and opinions surrounding firearms and harm reduction resources, as well as outlook regarding firearm owners.

    CFAS: From a faculty member’s perspective, what are some of the important recent trends in emergency medicine?

    Dr. Marcolini: Overcrowding, or boarding, in emergency departments is at historical records across the country and is now a public health crisis. The causes for this are multifactorial. In some areas, this is due to rural and underserved area hospitals closing or losing resources that can’t be sustained or are being centralized. In other areas, it is due to the lack of long-term care beds in a community, causing hospitals to carry high levels of non-acute patients, which further blocks those beds from being utilized by patients coming from the emergency department in need of acute care. In some instances, staffing challenges caused by burnout or lack of appropriate staff members to care for acutely ill patients are impacting the ability to keep beds open. Mental health resources are severely lacking which also leads to patients needing acute mental health stabilization to spend inordinate amounts of time in an ED awaiting bed placement. We know that poor patient outcomes occur secondary to overcrowding. This issue is a priority for our specialty. EDs are the safety net for all hospital systems and communities – we cannot turn any patient away and divert them to alternate resources, even if those resources are deemed more appropriate. When societal support systems fail, the ED becomes the back-up solution.

    Patients who have to wait for long periods of time in a chaotic, overwhelming environment while simply trying to access care for their acute medical needs understandably become frustrated and upset. We are all subjected to more verbally and physically violent encounters targeted at the ED staff on a daily basis.

    Another big issue occurring within emergency medicine, but now also affecting dermatology, anesthesiology, radiology and others, is the corporatization of medicine. As part of this push from corporate groups backed by private equity, physicians are being replaced by non-physician practitioners for financial reasons, despite evidence that this is bad for patient care. Corporate groups are establishing emergency medicine residencies in large numbers and there is controversy over whether these are being maintained with the same high-quality standards that have been present over the last fifty years within our specialty.

    One of the offshoots of this is that emergency medicine used to be one of the most competitive specialties. Now students are worried about their ability to work as an emergency physician after residency and the training they will get during residency. There is competition that exists within some programs for procedures between residency trainees and non-physician practitioners. Last year, there were more than 500 open spots coming out of the initial Match within emergency medicine, and even after the Scramble, not all positions filled.

    Those who have stayed in emergency medicine, despite all of the recent challenges, are some of the most dedicated educators and physicians you will ever meet, and many are being called to action within advocacy work to fix these issues.

    CFAS: Please tell us about your work and interests in neurocritical care, ethics, and wilderness medicine.

    Dr. Marcolini: I completed my Emergency Medicine Residency and pursued a Surgical Critical Care Fellowship at the R. Adams Cowley Shock Trauma Center in Baltimore. After fellowship, I stayed on as faculty, where I worked clinically in Emergency Medicine and Critical Care. I subsequently moved to Connecticut and served as a faculty member at Yale-New Haven Hospital, where I was invited to help start a dedicated Neurosciences ICU. After eight wonderful years at Yale, I moved to Dartmouth-Hitchcock Medical Center to help develop a Neurosciences ICU, where we are going strong and building an important resource for patients with neurologic illness in a very rural area. It’s a great opportunity to work in a tertiary care medical center out in the middle of the woods of New England, and I’m fortunate to still be able to do clinical work in both Emergency Medicine and Neurocritical Care.

    Ethics is also a very important part of my academic work. Through membership on the Ethics Committee and consult team at Yale-New Haven Health, I learned from some very masterful ethicists. I continued this work when I came to Dartmouth-Hitchcock and am now the Subcommittee Chair of the Clinical Ethics Consultant team. This spring I’ll be finishing my Master of Bioethics at Harvard, which I was only able to do because a virtual program that was put together during the pandemic – a silver lining for sure. I’ve been a member of ethics committees for the American College of Emergency Physicians, the Society for Critical Care Medicine (SCCM), and a recipient of the Grenvik Family Award in Ethics from SCCM in 2017.

    In Critical Care and Emergency Medicine, there is an ethics question around every corner, and we keep the humanity in medicine through focusing on and developing ethics in a world that presents many ethical challenges. I also teach ethics at Geisel School of Medicine, and at the Sherwin B. Nuland Summer Institute in Bioethics at Yale.

    My interest in wilderness medicine started when I was a ski patroller – before I even got into medicine. I worked with Outward Bound, became a paramedic, and with that experience I started teaching wilderness medicine through Wilderness Medicine Associates International. I now teach wilderness advanced life support courses, which is wilderness medicine for physicians, nurses, nurse practitioners, physician assistants, and paramedics. Our courses bring the science of medicine to the wilderness environment. We teach how to approach medical or trauma problems when you and your expedition are greater than two hours from definitive care.

    CFAS: Is there anything happening at the Geisel School of Medicine that would be of interest to other faculty members?

    Dr. Marcolini: Geisel has been making great strides in the effort to balance the rising cost of medical education with the multitude of new information that medical students need to embrace. They are also working toward softening the typical transition from UME to GME, challenging the model of factual learning in medical school, versus the opportunity to become a lifelong learner.

    This month has been banner for Geisel, especially in the area of diversity. They have been putting on multiple programs and celebrating those in our community for their dedication to implementation of diversity into their programs and the community. Visiting speakers have included Dr. Barbara Ross-Lee, DO, the first African American woman to serve as dean of a medical school and Melvin Rogers, a professor of political science at Brown University and author of The Darkened Light of Faith: Race, Democracy, and Freedom in African American Political Thought during the monthlong celebration of the life of Rev. Martin Luther King, Jr.

    CFAS: What do you like to do in your free time?

    Dr. Marcolini: I love to skijor with my two Siberian huskies. I also like to cook, read, ski, and climb.

    Tell Us How You’re Doing

    Please 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 at eweissman@aamc.org, or call 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.

    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.