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In Reply to Rodríguez and Campbell

Pololi, Linda MBBS

doi: 10.1097/01.ACM.0000437283.53633.f9
Letters to the Editor

Senior scientist, Brandeis University, and director, C - Change: National Initiative on Gender, Culture and Leadership in Medicine, Waltham, Massachusetts;

Drs. Rodríguez and Campbell should be applauded for their application of scholarship from organizational development to the disadvantages experienced by underrepresented in medicine minority (URMM) faculty in academic medicine. In addition to examining why URMM faculty might leave academic medicine—and to achieve the goal of increasing URMM faculty—I believe we should focus on creating inclusive environments that support the humanity and vitality of all faculty.

Examining faculty attrition is important; in recent C - Change ( National Faculty Survey studies, over 40% of a nationally representative sample of medical school faculty (including 512 URMM faculty) seriously considered leaving their institutions in the prior year due to dissatisfaction, and over a quarter had seriously considered leaving academic medicine entirely. Data showed no difference between URMM and non-URMM faculty. Certain dimensions of the culture were associated with these disturbing findings.1 First, lack of relationships, a low sense of belonging and trust, and non-alignment of personal and institutional values predicted leaving one’s institution. Additionally, higher levels of ethical moral distress and a sense of being adversely changed by working in medical schools was linked to abandoning academic medicine entirely.1 Second, when compared with their non-minority counterparts, URMM faculty reported higher leadership aspirations, but lower relational connection and trust, and lower alignment between personal and institutional values.2

These trends need to be addressed, but instead of focusing on quitting, let’s concentrate on creating environments that empower all faculty to contribute to their fullest ability. The following constructive suggestions3 can help us move beyond knowing why people leave to make sure that they stay:

  1. Facilitate and support relationship formation among faculty, administrators, and learners.
  2. Develop opportunities for explicit conversations about personal values to amplify the meaning faculty find in the practice of medicine and in their careers.
  3. Encourage positive curiosity when encountering “otherness” and recognize differences in faculty as benefitting our institutions.

Such practices, embraced and encouraged by leaders, faculty, and trainees, could help create a culture in academic medicine that would be more inclusive, relational, and collaborative; enhance faculty engagement and productivity regardless of race, ethnicity, or gender; and secure the relational trust of URMM faculty. Thus, we might achieve the goal of a more diverse and values-based leadership of academic medicine.

Linda Pololi, MBBS

Senior scientist, Brandeis University, and director, C - Change: National Initiative on Gender, Culture and Leadership in Medicine, Waltham, Massachusetts;

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1. Pololi LH, Krupat E, Civian JT, Ash AS, Brennan RT. Why are a quarter of faculty considering leaving academic medicine? A study of their perceptions of institutional culture and intention to leave in 26 representative medical schools. Academic Medicine. 2012;87:859–869
2. Pololi LH, Evans AT, Gibbs BK, Krupat E, Brennan RT, Civian JT. The experience of minority faculty who are underrepresented in medicine, at 26 representative U.S. medical schools. Academic Medicine. 2013;88:1308–1314
3. Pololi LH Changing the Culture of Academic Medicine. 2010 Lebanon, NH Dartmouth College Press
© 2013 by the Association of American Medical Colleges