Medical School Deans Research Articles

Medical School Dean as a Turnaround Agent

Taking on the role as a new medical school Dean in a new city after Hurricane Katrina posed many challenges. To facilitate turnaround, 3 principles were applied: hit the ground running, promote community involvement, and gain a common vision for the future. This article describes Tulane University's process for implementing change and expands on its vision for the future.

Recommendations from the Society for Academic Emergency Medicine (SAEM) Taskforce on Women in Academic Emergency Medicine

The Society for Academic Emergency Medicine (SAEM) convened a taskforce to study issues pertaining to women in academic emergency medicine (EM). The charge to the Taskforce was to "Create a document for the SAEM Board of Directors that defines and describes the unique recruitment, retention, and advancement needs for women in academic emergency medicine." To this end, the Taskforce and authors reviewed the literature to highlight key data points in understanding this issue and made recommendations for individuals at four levels of leadership and accountability: leadership of national EM organizations, medical school deans, department chairs, and individual women faculty members. The broad range of individuals targeted for recommendations reflects the interdependent and shared responsibility required to address changes in the culture of academic EM. The following method was used to determine the recommendations: 1) Taskforce members discussed career barriers and potential solutions that could improve the recruitment, retention, and advancement of women in academic EM; 2) the authors reviewed recommendations in the literature by national consensus groups and experts in the field to validate the recommendations of Taskforce members and the authors; and 3) final recommendations were sent to all Taskforce members to obtain and incorporate additional comments and ensure a consensus. This article contains those recommendations and cites the relevant literature addressing this topic.

Qualities of the Medical School Dean: Insights From the Literature

To review the literature and resources for professional development of medical school executives in order to identify the characteristics proposed as relevant to medical school deanship. In 2006, the authors conducted a PubMed search using the key words leadership, dean, medical school, and academic medical center to identify relevant publications since 1995. Articles were excluded that that did not address the roles and responsibilities of the North American medical school dean. Articles gleaned through review of materials from relevant executive development programs and interviews with leaders involved in these programs were added. Both management skills (e.g., institutional assessment, strategic planning, financial stewardship, recruitment and retention of talent) and leadership skills (e.g., visioning, maximizing values, building constituency) are commonly cited as important deans of contemporary medical schools. Key content knowledge (e.g., academic medical center governance, expectations of clinicians and scientists, process of medical education) and certain attitudes (e.g., commitment to the success of others, appreciation of institutional culture) are also noted to be valuable qualities for medical school deans. The literature review identifies a number of areas of knowledge and skill consistently affirmed by scholars as important to success for medical school deans. These characteristics can provide a basic foundation for needs assessment and professional development activities of academic medical executives preparing for and entering medical school deanships, and they can also provide insight to those charged with selecting their next dean.

Burnout in Medical School Deans: An Uncommon Problem

To assess the burnout level among U.S. and Canadian medical school deans and to study how burnout relates to certain characteristics including hours worked, effectiveness, and support from family and colleagues. Questionnaires were sent in September 2006 to 100 deans who had served at least one year. The questionnaire included 13 questions from the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), which measures three subcomponents of burnout: emotional exhaustion, depersonalization, and personal accomplishment. The response rate was 90%. The median age of participants was 60; the median length of service at the current institution was four years; the median number of hours worked per week was 70.0. Deans most frequently identified school budget deficits, loss of funding, and departure of key faculty as stressors. Whereas only 11% reported being dissatisfied with their positions, 33% reported it was likely they would step down within the next two years. The predominant pattern of MBI-HSS subscale scores in participating deans was moderate emotional exhaustion, moderate depersonalization, and high personal accomplishment. Only 2% of respondents satisfied all three subscale scores for high burnout. Emotional exhaustion was significantly directly associated with work week length and number of weekend days worked and was inversely associated with spousal support, length of service, and age. Despite having an "extreme" job, only 2% of deans exhibited high levels of burnout. A high sense of control and self-efficacy, a supportive family, increasing length of service, and increasing age may be factors which reduce burnout in deans.

Medical Schools Grapple With Drug-Industry Influence

Surveys on the relationships between medical academia and the pharmaceutical industry have raised concerns over potential conflicts of interest. To address the issues, more medical schools are establishing policies and taking steps to limit the pharmaceutical industry's presence and influence on campus, though with different approaches. Email this article to a Colleague Similar articles in this journal Alert me to new issues of the journal Download to citation manager

The great opportunity: Evolutionary applications to medicine and public health.

Evolutionary biology is an essential basic science for medicine, but few doctors and medical researchers are familiar with its most relevant principles. Most medical schools have geneticists who understand evolution, but few have even one evolutionary biologist to suggest other possible applications. The canyon between evolutionary biology and medicine is wide. The question is whether they offer each other enough to make bridge building worthwhile. What benefits could be expected if evolution were brought fully to bear on the problems of medicine? How would studying medical problems advance evolutionary research? Do doctors need to learn evolution, or is it valuable mainly for researchers? What practical steps will promote the application of evolutionary biology in the areas of medicine where it offers the most? To address these questions, we review current and potential applications of evolutionary biology to medicine and public health. Some evolutionary technologies, such as population genetics, serial transfer production of live vaccines, and phylogenetic analysis, have been widely applied. Other areas, such as infectious disease and aging research, illustrate the dramatic recent progress made possible by evolutionary insights. In still other areas, such as epidemiology, psychiatry, and understanding the regulation of bodily defenses, applying evolutionary principles remains an open opportunity. In addition to the utility of specific applications, an evolutionary perspective fundamentally challenges the prevalent but fundamentally incorrect metaphor of the body as a machine designed by an engineer. Bodies are vulnerable to disease – and remarkably resilient – precisely because they are not machines built from a plan. They are, instead, bundles of compromises shaped by natural selection in small increments to maximize reproduction, not health. Understanding the body as a product of natural selection, not design, offers new research questions and a framework for making medical education more coherent. We conclude with recommendations for actions that would better connect evolutionary biology and medicine in ways that will benefit public health. It is our hope that faculty and students will send this article to their undergraduate and medical school Deans, and that this will initiate discussions about the gap, the great opportunity, and action plans to bring the full power of evolutionary biology to bear on human health problems.

Yes Sir, no Sir, not much difference Sir

To assess whether making the sender's knighthood explicit in a series of letters would have any detectable effect on the response.A random sequence was generated by flipping a coin to determine whether a letter would have 'Sir Iain Chalmers' or 'Iain Chalmers' typed under the signature. This sequence was prepared independently of the preparation of an alphabetic list of the intended recipients and was then used to determine which letter would be sent. The allocation could not be influenced by prior knowledge of the recipient. Two batches of letters were sent.Medical royal colleges and associated faculties, and postgraduate medical and dental schools in the UK.Presidents and deans of medical royal colleges and deans of postgraduate medical and dental schools in the UK.Rates of response and the mean number of days between the posting of the original letter and the date on the response.No differences between the groups were detected in the response rates: 91% and 90% for 'Sir Iain Chalmers' and 'Iain Chalmers' (relative rate for response of 1.01, 95%CI 0.83-1.23, P = 0.92), or in the mean number of days to response ('Sir': 32 days; 'no Sir': 33 days).This finding is consistent with a systematic review of responses to postal surveys, in which the effect of the status of the signatory was investigated. Combining our result with the two trials that are most comparable to our study, in which letters from professors were compared with letters from students, gives a relative response rate of 1.00 (95% CI 0.91-1.10, P = 0.99). There is, therefore, no evidence from the existing randomized experiments that the status of the signatory has any impact on the likelihood or promptness of response-even if the status was conferred by the British monarch.

Yes Sir, no Sir, not much difference Sir

To assess whether making the sender's knighthood explicit in a series of letters would have any detectable effect on the response. A random sequence was generated by flipping a coin to determine whether a letter would have 'Sir Iain Chalmers' or 'Iain Chalmers' typed under the signature. This sequence was prepared independently of the preparation of an alphabetic list of the intended recipients and was then used to determine which letter would be sent. The allocation could not be influenced by prior knowledge of the recipient. Two batches of letters were sent. Medical royal colleges and associated faculties, and postgraduate medical and dental schools in the UK. Presidents and deans of medical royal colleges and deans of postgraduate medical and dental schools in the UK. Rates of response and the mean number of days between the posting of the original letter and the date on the response. No differences between the groups were detected in the response rates: 91% and 90% for 'Sir Iain Chalmers' and 'Iain Chalmers' (relative rate for response of 1.01, 95%CI 0.83-1.23, P = 0.92), or in the mean number of days to response ('Sir': 32 days; 'no Sir': 33 days). This finding is consistent with a systematic review of responses to postal surveys, in which the effect of the status of the signatory was investigated. Combining our result with the two trials that are most comparable to our study, in which letters from professors were compared with letters from students, gives a relative response rate of 1.00 (95% CI 0.91-1.10, P = 0.99). There is, therefore, no evidence from the existing randomized experiments that the status of the signatory has any impact on the likelihood or promptness of response-even if the status was conferred by the British monarch.

Climbing through Medicine's Glass Ceiling

Only 14 of 124 U.S. medical school deans are women. Dr. Nancy Andrews writes that if institutions are to accelerate the emergence of more female deans, they will need to consider women who have not stepped on every rung of the traditional academic career ladder.

Sports dermatology “illustrated”: why I do it, how I do it, and what about you?

Whether I'm talking to the medical school dean, to prospective residents, or to friends at a dinner party, I hear the same question all the time: “Wow, sports dermatology. I've never heard of that. What is it?” I almost universally begin by noting the genesis of my academic pursuits. As a toddler, the importance of erudite dedication clearly pervaded my daily activities while I “coexperienced” my mother obtaining her master's degree in education. In somewhat stark contrast, I vividly recall my father's diatribes on the importance of athletics. An outstanding and natural athlete by any measure, my father understood the strength of sports. A competitive baseball player who fell short of professional aspirations, in part related to leg velocity, my father encouraged my running long before my fourth birthday. I distinctly recall a regional newspaper's article whose title askedwhat mademe run before I had even entered kindergarten. Sports and academics filled my grammar school, high school, and collegiate days. But at the same time that I ran for years on varsity track and crosscountry and played on select baseball summer teams, I studied hard and garnered the valedictorian spot in my 1600-student high school. I have always struggled to locate the balance between these seemingly mutually exclusive endeavors. It was not until 1991, when I traveled 2 blocks down from my undergraduate collegiate house to my New

Advancing educators and education by defining the components and evidence associated with educational scholarship

This study aimed to establish documentation standards for medical education activities, beyond educational research, for academic promotion consistent with principles of excellence and scholarship. In 2006 a Consensus Conference on Educational Scholarship was convened by the Association of American Medical Colleges (AAMC) Group on Education Affairs (GEA) to outline a set of documentation standards for use by educators and academic promotion committees. Conference participants' work was informed by more than 15 years of literature on scholarship, educator portfolios and academic promotion standards. The 110 conference participants, including medical school deans, academic promotion committee members, department chairs, faculty and AAMC leaders, re-affirmed the 5 education activity categories (teaching, curriculum, advising and/or mentoring, education leadership and/or administration, and learner assessment), the contents of each category, and cross-category documentation standards. Educational excellence requires documentation of the quantity and quality of education activities. Documenting a scholarly approach requires demonstrating evidence of drawing from and building on the work of others, and documenting scholarship requires contributing work through public display, peer review and dissemination; both involve engagement with the community of educators. Implementation of these standards - quantity, quality and engagement with the education community - should occur in parallel with the development of an infrastructure to support educators, including sustained faculty development for educators, access to educational resources and journals, peer review mechanisms and consultation and support specific to each activity category. Educators' contributions to their institutions must be visible to be valued. The establishment of documentation standards for education activities provides the foundation for academic recognition of educators.

Solutions and Strategies from Medical and Nursing School Leadership for the Challenges Facing the Clinical Research Enterprise

For decades, the U.S. clinical research enterprise and its workforce have faced diminishing numbers and significant challenges. This study, conducted by the Institute of Medicine's Clinical Research Roundtable (CRR), sought to learn about the perceptions by medical and nursing school deans of these challenges or the efforts and strategies needed to address them. The authors mailed structured questionnaires about clinical research and workforce issues to medical and nursing school deans in the continental United States in the fall of 2003, and on October 16 and 17, 2003, the CRR held a two-day workshop with deans and their representatives to discuss the survey findings and to propose solutions. Survey participation was 55 (45%) for medical school deans and 37 (46%) for nursing school deans. Various efforts exist at individual schools for recruitment, training, and retention of clinical researchers. Most of the responding medical (53; 96.7%) and nursing (28; 75.4%) school deans reported that demand for clinical researchers exceeded or sharply exceeded supply, and about half of these institutions had a formal mentor program for their students. The percentage of graduates with methodological training in clinical research varied widely, with a mode of 10% and 100% for medical and nursing schools, respectively. Most medical school deans (47; 85.5%) rated their basic research enterprises good to excellent, whereas only a third (19; 34.6%) rated their clinical research programs similarly. Likewise, nursing school deans rated their basic research programs more favorably (23; 62.2%) than they rated their clinical research enterprises (17; 46.0%). However, prioritization of changes needed to address the challenges facing clinical research and its workforce were similar for medical and nursing school deans. Clinical research is underdeveloped and underrepresented within the clinical research enterprise. There is a need to develop and execute uniform strategies to grow and expand the clinical research workforce. Workshop participants, including 14 deans or their representatives as panelists and CRR members, proposed solutions and strategies.

A Measure of Gold

Since its founding in 1954, the Society of Anaesthetists of Hong Kong has set fundamental aims to assure professionalism of the specialty, uphold the honor and status of anesthetists, provide appropriate anesthetic training, establish close liaison with professional partners worldwide and educate the lay public about anesthesia.

An Aboriginal and Torres Strait Islander oral health curriculum framework: development experiences in Western Australia

Indigenous oral health is widely acknowledged as paralleling the significant issues faced in general health. It is recognized that as part of the process of addressing these issues, practitioners need to be aware of the complex nature of working in an Indigenous social and cultural context, including issues beyond direct health care services. It is against this backdrop that collaborators from The University of Western Australia's (UWA) Centre for Rural and Remote Oral Health (CRROH) and Centre for Aboriginal Medical and Dental Health (CAMDH) developed a comprehensive, integrated Indigenous Oral Health Curriculum Framework for the Bachelor of Dental Science (BDSc) course. This development was based on the existing framework developed by the Committee of Deans of Australian Medical Schools (CDAMS) for medical education but was tailored to the specific issues and needs of oral health. Additional consultation with the Oral Health Centre of Western Australia (OHCWA), the School of Indigenous Studies (SIS) as well as Indigenous Australian groups occurred to ensure the development process was inclusive. The inclusion of an Indigenous Oral Health Curriculum Framework in the BDSc will enable UWA dental graduates to practise dentistry in a culturally appropriate manner. The framework provides the structure for students to develop and demonstrate an understanding of Indigenous histories, cultures and social experiences and how these impact on Indigenous peoples' health. It is anticipated that this will foster more positive and culturally secure patient-practitioner interactions between UWA dental graduates and Indigenous Australians, thereby making it more likely for Indigenous Australians to present for treatment. The increased awareness of Indigenous oral health issues will hopefully encourage more graduates to become involved in the treatment of Indigenous peoples. The combination of these factors could lead to an improvement in oral health outcomes for Australia's Indigenous peoples and a concomitant positive impact on the general health of Indigenous Australians.

Streamlining Administration at the University of Minnesota Medical School

The authors describe the events and restructuring efforts of the 1990s that led the University of Minnesota Medical School leadership to advocate a new administrative model for its clinical departments. This new streamlined model established six administrative centers, each serving a cluster of two to four clinical departments. Each administrative center was charged with managing functions of finance, human resources, information technology, clinical service unit operations, research support, and education support for its departments. These centers, first proposed in 1993 when an outside firm analyzed the medical school's administration, were initially seen by most medical school department heads as too radical. Yet, after a campaign of one-on-one persuasion by medical school dean's office leadership, combined with a successful example of clustering that occurred spontaneously among three medical school departments, the administrative centers were launched in late 1998 to serve clustered clinical departments. The administrative centers were intended to improve departmental responsiveness to the dean of the medical school; improve internal medical school controls; improve on administrative services traditionally provided by outside units, such as grants management and information systems; and reduce administrative costs. Since their establishment, these administrative centers have evolved into a flexible, efficient system of administration. In a 2005 evaluation, ECG Management Consultants found the administrative center model appropriate and effective in managing the school's clinical departments. In addition, the consultants estimated that if the medical school still had stand-alone departmental administrative units, annual administrative costs would be $3 million higher.

Does Agreement on Institutional Values and Leadership Issues Between Deans and Surgery Chairs Predict Their Institutions??? Performance?

To gain a better understanding of the values that medical school deans and surgery chairs consider most essential for effective leadership, to assess their perceptions of the values and leadership climate in their institutions, and to test the premise that agreement on leadership values and climate predict greater organizational effectiveness and performance. From June 2005 through March 2006, questionnaires designed to assess leadership core values and organizational leadership climate were mailed to medical school deans and surgery chairs of the 125 U.S. academic health centers. Institutional performance measures used were the National Institutes of Health (NIH) standing and U.S. News and World Report ranking of each institution. Sixty-eight surgery chairs (54%) and 60 deans (48%) returned surveys. Q-sort results on 38 positive leadership values indicated that integrity, trust, and vision were considered the most important core values for effective leadership by both chairs and deans. Both groups ranked business acumen, authority, and institutional reputation as least important. Deans consistently ranked the leadership climate as being healthier (more positive) than did their surgery chairs on multiple scale items: leadership is widely shared (P = .005), information is widely shared (P = .002), missions are aligned (P = .003), open communication is the norm (P = .009), good performance is rewarded (P = .01), teamwork is widely practiced (P = .01), and leaders are held accountable (P = 002). Tighter alignment between chairs and deans on core values and on the leadership climate scale correlated with higher school and department NIH standing and higher U.S. News and World Report medical school and hospital ranking (P < .05). Although surgery chairs and deans espouse similar core leadership values, deans believe that a healthier leadership climate exists in their institutions than their surgery chairs do. The study findings suggest that tighter leadership alignment between deans and surgery chairs may predict a higher level of institutional performance in the clinical and academic arenas.

Leadership Strategies of Medical School Deans to Promote Quality and Safety

In April 2003, an informal collaborative of medical schools was convened by the Institute for Healthcare Improvement to achieve learning objectives for medical students for the improvement of care. The deans of the 10 founding schools were interviewed in 2004 regarding their strategies to achieve this goal. The deans felt that their work in recruiting leaders in the field of quality, developing organizational structures to facilitate quality initiatives, empowering faculty, and promoting educational reforms were essential elements for achieving learning objectives. PROGRESS IN MEETING THE COLLABORATIVE'S GOALS: The collaborative's work is organized around themes considered essential to the goals of the collaborative such as interprofessional learning, exemplary clinical settings, student-initiated learning, and evaluation. The collaborative has grown from 10 medical schools to 48 health professions schools in three years. Pilot exemplary clinical settings for education and patient care at seven sites, along with strategies to ensure interprofessional learning at 16 of the 20 sites, represent important intermediate outcomes of the deans' initial leadership initiatives and the collaborative's faculty vision. Of the 10 founding schools, 7 continue to serve as role models for newer members. The approaches suggest building blocks for achieving goals for improving care in academic institutions and may help other health professions schools and the clinical settings where learning takes place.

At Age 80, Geriatrics Pioneer Continues Advocacy Efforts

At Age 80, Geriatrics Pioneer Continues Advocacy Efforts

Women in Radiation Oncology: Time to Break Through the Glass Ceiling

The participation of women in medicine has increased dramatically in the past several decades. Whereas women constituted only 10% of the US medical student body and only 8% of practicing physicians in 1970, these figures had reached 37% and 17% by 1990. Today, 49% of medical students are female [ 1 American Association of Medical Colleges. Women in U.S. academic medicine statistics and medical school benchmarking 2004-2005. Available at: http://www.aamc.org/members/wim/statistics/stats05/start.htm. Accessed May 1, 2006. Google Scholar ], and 26% of practicing physicians are women [ 2 American Medical Association. Table 1—physicians by gender (excludes students). Available at: http://www.ama-assn.org/ama/pub/category/12912.html. Accessed February 20, 2006. Google Scholar ]. However, concerns have been raised about the low proportion of women in visible, senior positions of leadership in the medical profession. Indeed, only 15% of full professors, 10% of medical school deans, and 11% of department chairs are women [ 1 American Association of Medical Colleges. Women in U.S. academic medicine statistics and medical school benchmarking 2004-2005. Available at: http://www.aamc.org/members/wim/statistics/stats05/start.htm. Accessed May 1, 2006. Google Scholar ], and studies have suggested that women are not advancing at expected rates [ 3 Nonnemaker L. Women physicians in academic medicine: new insights from cohort studies. N Engl J Med. 2000; 342: 399-405 Crossref PubMed Scopus (381) Google Scholar ].

The Yapunyah project: Embedding Aboriginal and Torres Strait Islander perspectives in the nursing curriculum

The Yapunyah Project is an initiative of the Faculty of Health at Queensland University of Technology. It was instigated to further improve the development of cultural competence in health graduates with respect to Aboriginal and Torres Strait Islander perspectives. The project was informed by the cultural competence in healthcare delivery models of Campinha-Bacote (1998a) and Cross, Bazron, Dennis and Isaacs (1989) and by the cultural safety reforms to nursing curricula in New Zealand. The Yapunyah Project involved extensive consultation and collaboration with Indigenous staff and health experts in the local Aboriginal and Torres Strait Islander community. A core curriculum, and associated graduate transcultural competencies, were informed by these discussions and earlier reforms in health curricula by the Committee of Deans of Australian Medical Schools and the Royal Australian College of General Practitioners. Although the overall project involved four separate schools within the faculty, this paper details the experience of embedding Indigenous perspectives within the undergraduate nursing curriculum. The experience has been a challenging and positive one, and the reforms have been supported by a sustainable framework. This paper outlines how one university faculty is endeavouring to prepare nursing students educationally to practice with evidence-based transcultural nursing knowledge based on culture care values, beliefs, and traditional lifeways of Indigenous people of Australia. As such, the project aims to contribute to the improvement and promotion of the health and well-being of Indigenous Australians in culturally and ethnohistorically meaningful ways.