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    CFAS Rep Bulletin November 2020

    In this edition:

    Message from the Chair

    Dear Colleagues,

    With COVID-19 cases on the rise again, our first concern is for your well-being. I encourage you to take advantage of the resources published by the AAMC on its COVID-19 Resource Hub to stay safe, and to help others do the same during these perilous times. Also, please bookmark the page for the newly released AAMC Strategic Plan; it is a veritable roadmap and guide to engage all of us in CFAS, and more broadly in academic medicine, with building a healthier future. Thank you to all who contributed ideas, suggestion and comments. I'm excited to see it in print and to play a role in its implementation.

    The past month has been, again, packed with opportunities for all of us to engage with CFAS and the AAMC. It has been thrilling to see so many of you logging in to participate in our CFAS Connects session on October 29. Special thanks to Nicholas Delamere, PhD, representing in CFAS the Association of Chairs of Departments of Physiology, who moderated a Café Conversation on Teaching and Research during the COVID-19 Pandemic. You can find a recording of this and all other monthly CFAS Connects sessions on the CFAS Resources page.

    Many of you have also participated in online sessions of our open CFAS committees: the Communication Committee (November 4), the Resilience Committee and the Basic Science Committee (November 5), and the Mission Alignment Committee (November 11). The Diversity and Inclusion Committee is scheduled to convene virtually on November 20, the Advocacy is scheduled to meet on December 1, and the Communication Committee will convene on January 12 - know you are all welcome to participate. If any of you would like calendar appointments, please send an email to Eric Weissman (eweissman@aamc.org).

    Unlike these open committees (see list here), who welcome all CFAS reps, the Program Committee, the Nomination Committee, and the Administrative Board include only appointed members. These three groups have also held virtual sessions over recent weeks.

    Lastly, the CFAS New Representatives Orientation was held, also virtually, on November 12. It was a privilege for me to welcome during this session many new colleagues and to connect with seasoned reps. Special thanks to AAMC Chief of Staff Jennifer Schlener and Eric Weissman for providing a helpful overview of the AAMC and CFAS, and also to Laura Shaffer, PhD, representing the Association of Psychologists in Academic Health Centers, who shared some of the specific initiatives that have helped her to be such an effective CFAS rep.

    Finally, the first virtual Learn Serve Lead took place early this week. From my perspective, it was a resounding success. I was able to connect with many of you, learn a lot from national leaders, and raise my voice on the issues I'm passionate about. I hope you enjoyed it as much as I did, and I look forward to hearing about your experience with this event. It was especially thrilling for me to witness AAMC President and CEO David J. Skorton, MD, as he announced the renaming of the prominent Flexner Award. I was gratified that, as a member of the AAMC Board of Directors, I was able to cast one of the many votes that made this change happen.

    In closing, I wish you a safe and happy Thanksgiving holiday!

    As always, I look forward to hearing from you,

    Stay well,

    Gabriela K. Popescu
    CFAS Chair, 2019 - 2021
    popescu@buffalo.edu

    AAMC Releases Final Strategic Plan

    On October 27, the AAMC released its Strategic Plan and its vision for “a healthier future through learning, discovery, health care, and community collaborations.” The AAMC leadership team, board of directors, staff, and more than 1,500 members of the AAMC’s affinity groups (including CFAS representatives) participated in the strategic planning process.

    The Strategic Plan identifies 10 specific areas that will shape the work and focus of the AAMC and “guide medical schools and teaching hospitals in responding to the rapidly changing environments of medical education, health care, and biomedical research.” These 10 action plans that make up the overarching Strategic Plan are:

    1. Strengthen the Medical Education Continuum for Transformed Health Care and Learning Environments;
    2. Extend the AAMC’s Leadership Role in Helping Students Progress through Their Medical Professional Journey;
    3. Equip Medical Schools and Teaching Hospitals and Health Systems to Become More Inclusive, Equitable Organizations;
    4. Increase Significantly the Number of Diverse Medical School Applicants and Matriculants;
    5. Strengthen the Nation’s Commitment to Medical Research and the Research Community;
    6. Enhance the Skills and Capacity of People in Academic Medicine;
    7. Improve Access to Health Care for All;
    8. Advance Knowledge through the AAMC Research and Action Institute;
    9. Launch the AAMC as a National Leader in Health Equity and Health Justice; and,
    10. Adapt the AAMC to the Changing Needs of Academic Medicine.

    Action plan items 8 and 9 establish two new entities within the AAMC: The AAMC Research and Action Institute, which will conduct research and policy analysis on critical issues affecting academic medicine; and the AAMC Center for Health Justice, which will focus on initiatives related to population health, community health, and health equity to advance health justice.

    The strategic planning effort, launched in September 2019, was a multi-phase process. First, the association conducted an environmental scan to identify challenges and opportunities that would impact the AAMC and its constituents, patients, clinicians, health systems, associations, and society at large. The scan for the “Environment of Associations and Professional Organizations” included the following items:

    • Members are demanding that associations deliver increasing value.
    • Successful engagement extends beyond membership.
    • Online communities are driving engagement and transforming organizations.
    • Associations are providing lifelong learning that is relevant, timely, and cost-effective.
    • Demographic shifts are driving a need for new communication models.
    • Associations are facing critical challenges in managing, benefiting from, and securing data.

    Next, the AAMC sought input from members of the academic medicine community and asked for ideas about ways to address critical needs of learners, educators, researchers, and patients. Over 600 suggestions for specific action areas were submitted.

    Finally, the AAMC Board of Directors and Leadership Team used the insights collected during the earlier information gathering phases to develop the 10 focus areas highlighted in the released Strategic Plan.

    In terms of next steps, each of the 10 action plans have developed ideation teams dedicated to scoping a path forward and developing implementation plans to focus the AAMC’s work and efforts in these areas.

    CFAS has been interested in developing its own strategic plan and, now that the AAMC’s Strategic Plan has been released, opportunities exist for CFAS to move forward in identifying its areas of strategic alignment and impact. Additionally, CFAS may consider launching collaborations and developing programming to reflect the areas identified in the AAMC’s Strategic Plan.

    AAMC Issues Testing Standards for COVID-19

    In October, the AAMC released guidance on testing standards for Covid-19, detailing the issues that have hampered the nation’s testing efforts and kept the number of tests consistently below the number of daily tests required to effectively suppress the virus in tandem with other public health measures. The recommendations for getting the nation’s testing initiative back on track are centered around three components:

    • Developing and implementing a clear and transparent national testing strategy,
    • A coordinated focus on current testing targets to keep schools, businesses, and public gathering places open with confidence, and
    • A functional partnership between the federal government, state health authorities, academic institutions, and industry to fund and accelerate screening and surveillance testing.

    The guidance adds that up to 800,000 diagnostic tests are needed for every person who is symptomatic and close contacts of people who test positive. Additionally, there needs to be more than 8 million screening tests for:

    • Every person who enters a health care facility for an inpatient admission or outpatient surgery.
    • Routine testing of all health care providers in hospital settings.
    • Routine testing of first responders (law enforcement officers, paramedics, and EMTs).
    • Strategic sampling of residents in nursing homes and assisted living facilities.
    • Strategic sampling of incarcerated individuals.
    • Strategic sampling of residents and staff in homeless shelters.
    • Routine testing of every K-12 teacher.
    • Strategic sampling of K-12 students.
    • Strategic sampling of college and university students, faculty, and staff.

    The AAMC also issued a guide on the different types of Covid-19 tests. The testing recommendations and call to action issued by the AAMC Research and Action Institute were authored by Heather Pierce, JD, MPH, AAMC senior director for science policy and regulatory counsel, and Ross McKinney, Jr., MD, AAMC chief scientific officer.

    Learn Serve Lead: The 2020 Virtual Experience

    The AAMC’s signature annual meeting was held virtually this year due to the pandemic but was still widely considered a valuable and engaging experience even though the meeting’s usual hallmarks of interpersonal connection and robust networking weren’t possible this year. More than 4,000 registrants heard presentations from the following speakers:

    • Ibram X. Kendi, PhD, Bestselling Author, How to Be An Antiracist, Director, Center for Antiracist Research, Boston University
    • Nikole Hannah-Jones, Pulitzer Prize-winning investigative journalist, The New York Times; Creator, 1619 Project
    • Francis Collins, MD, PhD, Director, NIH
    • Anne Schuchat, MD, Principal Deputy Director, CDC
    • Anthony Fauci, MD, Director, NIAID
    • Vivek Murthy, MD, former Surgeon General of the United States

    In the coming days and weeks, we will post summary resources that you, as CFAS reps, can use to share features of the meetings with your school and society colleagues. Recordings of most sessions will also be available on the AAMC website. Registered attendees will also have access to a wider range of resources, including full recordings and slide sets. We will provide CFAS reps with the materials as they are available.  

    Interview with AAMC Chief Academic Officer John Prescott, MD

    After 12 years of service to the AAMC, Dr. Prescott will be retiring from his position as the AAMC’s Chief Academic Officer at the end of the year. Among his many roles at the AAMC, Dr. Prescott oversaw the Council of Deans, one of the three governance councils, which also includes CFAS and the Council of Teaching Hospitals and Health Systems. From the beginning, Dr. Prescott has been a strong advocate of CFAS and the voice of faculty. An Emergency Medicine specialist by training, Dr. Prescott was also dean at West Virginia University School of Medicine before he joined the AAMC.

    CFAS: Looking back on your time at the AAMC, how has the academic landscape changed and how has it stayed the same?

    Dr. Prescott: When I first started at the AAMC in 2008, there were 125 LCME-accredited medical schools in the United States. Now there are 155. This growth has changed the size and scope of academic medical centers, with significantly more people involved in the missions of patient care, research, education, and, more recently, community engagement. More servant leaders mean more students trained, more discoveries made, more patients treated, and more communities improved.

    This expansion is not without its challenges. Over the years, there has been an increasing administrative burden for everyone in the health care setting, especially faculty, who have had to adjust to implementation of the electronic health record, new requirements for research, and new frameworks for thinking about education that are learner- and competency-focused, among other changes. Being a faculty member is much more complex than it used to be, and there’s never enough time to adjust to new practices. It’s a challenge to learn and change when you’re already so busy, and faculty need to be given the time and tools to effectively adapt. Faculty development programs should take this into account.

    Luckily, these challenges will be met by a faculty workforce that is more capable because it is increasingly more diverse. We are seeing an increase in the number of women faculty (albeit a slow one), as well as a steady demand for representation of individuals from underrepresented backgrounds across leadership positions. Although there is a lot of progress to be made, the events of 2020 have made it clear that this is an expectation not just from within the ranks of academic medicine, but from the communities and society we serve, and I am heartened to observe the ways medical schools are moving from rhetoric to action around diversity, equity, and inclusion.

    CFAS: How has the role of faculty changed?

    Dr. Prescott: When I started at West Virginia University in 1990, you didn’t have to ask the question “Who are the faculty?” It was clear: they were hired by and worked at the medical school. As incredibly different models involving more community members have emerged over time, this has become one of the central questions to understanding the changing role of medical school faculty.

    The varied composition of medical school faculty has a profound impact on their role within academic medicine. Most faculty members’ salaries are now determined by the clinical care they provide. There can be a culture clash between faculty from education/research focused backgrounds and those who are primarily clinically focused. And this clash may feel more pronounced for academic faculty experiencing mergers, acquisitions, and partnerships within clinically focused systems. As medical school leaders confront the need to balance servant leadership with generating margins to support the academic missions, they end up having to determine philosophies around academics that guide decision-making. (How do you determine what constitutes research and teaching? How do compensation models, protected time, and productivity markers reflect these philosophies?)

    Changes in accreditation standards set forth by the LCME and the ACGME have also impacted the role of faculty within academic medicine. The expectations set for faculty now go beyond telling learners “watch me do things,” instead reflecting the knowledge, skills, and attitudes that learners must demonstrate to be successful in the clinical environment.

    CFAS: How has your work leading the Academic Affairs cluster impacted faculty?

    Dr. Prescott: The Academic Affairs cluster supports leadership at all levels of the academic medical center, including deans, department chairs, associate deans, interim leaders, and faculty and learners in a variety of ways. We provide and support role-, skill-, and career goal-specific leadership development programs to faculty at AAMC member institutions. We also provide medical school leaders with tools and resources to assess and improve faculty satisfaction, engagement, and the overall culture of the institution.

    Projects led by or produced in collaboration with Academic Affairs staff have resulted in key resources for medical schools as leaders work to achieve diverse, inclusive, and equitable environments for faculty, most notably the 2019 report Promising Practices for Understanding and Addressing Salary Equity at US Medical Schools and related resources on faculty salary equity. We work with colleagues across the AAMC on other issues that affect faculty, such as health equity, wellness, and transition to residency.

    CFAS: What are the biggest issues you believe faculty will have to address in the coming years?

    Dr. Prescott: The response to the pandemic, and whatever might follow the pandemic, will be the most pressing issue. A byproduct of the pandemic’s disruption is that the relationship between faculty and learners has been turned on its head, because there is less in-person interaction. New models of educating and evaluating our learners have emerged and will continue to develop.

    Faculty will continue to experience culture clash as academic systems integrate with other health systems that do not have the same missions. Faculty will also have to address issues of diversity, equity, and inclusion for the foreseeable future. We need to continue to do everything in our power to provide an equitable playing field for all faculty members, because this is an area of opportunity for academic medicine in the future.

    CFAS: What are some things faculty members can do to prepare themselves for leadership in their institutions?

    Dr. Prescott: My message to faculty members: Listen and look for opportunities and leverage points where you can have an impact or where you can provide unique talents or insights to others. Let your leaders know that you’re interested in new areas. When people see faculty step up, volunteer, and want to make a difference, they take notice.

    Faculty members should truly understand the promotion and tenure processes at their institutions. If you don’t understand the ins and outs of your school’s policies, you won’t advance as quickly as you could. So, become an expert in promotion and tenure at your institution.

    Another motto of mine is “learn your boss’s job and teach it to the person behind you.” When you do that, you prepare the whole organization. You also create opportunities for yourself to step into a role once someone moves on.

    CFAS Rep Profile: Maya Hammoud, MD, MBA, Professor of Obstetrics and Gynecology and Learning Health Sciences at the University of Michigan Medical School; CFAS Rep for the Association of Professors of Gynecology and Obstetrics

    CFAS: As the rep for the Association of Professors of Gynecology and Obstetrics (APGO), what are the important issues to professors of gynecology and obstetrics?

    Dr. Hammoud: APGO represents academic obstetrician-gynecologists in the United States and Canada and always strives to offer contemporary teaching tools and educational resources for its constituency with the ultimate goal of providing optimum health care to women. For example, APGO developed the medical student objectives which are used by most medical schools and updates them regularly based on research and scientific developments. Beyond teaching tools, APGO advocates for important educational issues which affect the education of medical students. For example, APGO published recommendations and issued a press release on obtaining proper consent for pelvic exams under anesthesia by students.

    Most recently, APGO has been very involved in the residency application process because we believe that we should make sure the right resident is at the right program and ready for day one of residency.  We also prioritize work on diversity and inclusion because this is how we ensure we are getting the best possible providers for women and all patients.

    CFAS: Tell us about your research in medical education, cultural competence, and women’s health.

    Dr. Hammoud: Medical education is the biggest part of my research portfolio. Early on it was focused on teaching tools, but now it’s focused on the transition from UME to GME. I’m also a consultant with the medical education group at the AMA, where I focus on health systems science and coaching.

    I’ve always had an interest in cultural competency, and I started the first clinic for Middle Eastern women at the University of Michigan in 2001. While the Middle Eastern population is not recognized as a minority group per the U.S. census, they still experience health disparities like other minority groups.  The principles of cultural competency we established in creating this clinic are now applied across the health system, so it’s not just confined to one clinic.

    CFAS: Tell us about some of the curricular innovations you’ve introduced throughout your career.

    Dr. Hammoud: In the early 2000s, as clerkship director, I incorporated formal simulations into the obstetrics and gynecology clerkship. This made us one of the first medical schools in the country to establish simulation as a routine part of medical student education. In addition, I introduced continuity clinics for medical students in the clerkship which were successful and got introduced into other clerkships. My work at Michigan positioned me well to help introduce new educational innovations on a national level through APGO.  These include, among others, a clinical skills curriculum, educational videos for clinical and preclinical students that now have more than one million views, self-assessment tools for students, and prep for residency courses.

    My current focus is on the transition from UME to GME and I’m the principal investigator on a $1.75 million Reimagining Residency grant APGO received from the AMA titled “Transforming the UME to GME Transition: Right Resident, Right Program, Ready Day One.” The grant has two main goals: to improve the residency selection and the interview process, and to make sure residents are fully prepared for the first day of their residency.  

    After identifying several issues in the current framework of residency selection, including the dramatic increase of number of applications and the effects of the application process on the fourth year of medical school, we proposed a novel approach to solve the problem that includes an Early Result Acceptance Program (like Early Decision for College) where students apply to a limited number of programs earlier than the regular Match. If they are not successful, they go into the regular Match. This proposal would hopefully decrease the number of total applications, decrease cost and anxiety, and help students focus on residency preparation while ensuring more applicants match to their top choices. We are currently in the planning stages of this 5-year project.

    CFAS: What are some recent accomplishments or initiatives at the University of Michigan Medical School that would be interesting for other CFAS reps to know about?

    Dr. Hammoud: The University of Michigan Medical School is one of the leading institutions working on the transition from UME to GME and we have become a national leader in that space. We have led in residency preparation courses and educational handover where program directors receive an educational handover letter describing the student’s strengths and weaknesses so they can better help them as residents. Currently, the medical school is expanding its coaching program to include special coaching during the transition from UME to GME.

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

    I like to travel and spend time with my husband and three daughters. My favorite place to go is Hawaii, specifically Maui. Currently, I am focused on my oldest, who is applying to residency this cycle, which is interesting given my work.

    CFAS Connects Summary Materials on CFAS Resources Webpage

    The CFAS Connects webinar series has successfully connected CFAS reps to an array of critical topics affecting faculty, with many CFAS reps expressing their appreciation to see so many of their colleagues and friends in lieu of regular in-person meetings. The CFAS Connects sessions have also been acknowledged in the larger AAMC as an effective model for virtual networking.

    The conversations during these webinars have been lively and have offered CFAS reps with valuable insights, information, anecdotes, and encouragement from fellow faculty members who are also navigating the difficulties and disorientation of the pandemic. The first two CFAS Connects sessions have featured discussions of racial injustice, diversity, equity, and inclusion; and the pandemic’s impact on clinical workload, daily working life and personal life, and teaching and research. Summary materials, including links to the recorded webinars and meeting notes, are available on the CFAS Resources webpage.

    The next CFAS Connects session will be held December 17. The topic is being finalized shortly and all CFAS reps will receive a calendar appointment with login details and a session description in the coming days.

    CFAS Committee Updates

    CFAS committees have continued to be active during the closing months of 2020, with the Mission Alignment and Impact of Faculty Educators Committee, the Basic Science Committee, the Communication Committee, and the Faculty Resilience Committee all having met in the past two months to offer their members support and guidance and to iron out next steps and future projects.

    To join a CFAS committee, visit the CFAS website and email one of the chairs, whose email addresses are linked in their names.

    The CFAS Communication Committee is open and its next meeting will take place on Jan. 12 at 8pm EST. If you are interested in participating in this meeting, please email CFAS Communications Specialist Alex Bolt or CFAS Communication Committee Chair Alan Dow, MD.

    Tell Us How You’re Doing in Response to the Pandemic

    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 eweissman@aamc.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.

    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.

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