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Where More Can Be Done to Promote Diverse Leadership in Neurology

ARTICLE IN BRIEF

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Gender, Age, Ethnicity, and Race

Members of the second annual AAN Diversity Leadership Program discuss the challenges and opportunities of assuming leadership roles as minorities in neurology.

Na Tosha N. Gatson, MD, PhD, just completed her neuro-oncology fellowship at the University of Texas MD Anderson Cancer Center, but she's already making a name for herself in the AAN. At this year's AAN Annual Meeting in Vancouver, Dr. Gatson chaired a topic workgroup on movement disorders designed for non-experts in the field to fulfill her commitment as a member of the AAN Conference Subcommittee. She also hosted a platform discussion for junior faculty, fellows, and residents on making the transition from trainee to faculty, as part of the newly offered “Navigating Your Career” education sessions.

The opportunity to take on these visible leadership positions at the conference so early in her career, Dr. Gatson said, has a lot to do with her experiences as part of the AAN's new Diversity Leadership Program (DLP).

The DLP was developed at the request of then-outgoing AAN President Timothy Pedley, MD, FAAN, who observed that the AAN had done relatively well in promoting gender diversity among its leadership, but was still lagging behind in ethnic diversity.

Dr. Gatson, who recently accepted a dual clinical and academic/research position with Geisinger Health System in Danville, PA, as an associate neuro-oncologist, was one of just 10 in the DLP's inaugural class. The group first met at the 2015 AAN meeting, where they had one-on-one mentoring with Academy leaders, meetings with organizational staff, leadership training, and networking opportunities. The goal: leadership in the AAN — and throughout neurology — that more fully represents the diversity of the populations neurologists serve.

A PAUCITY OF REPRESENTATION

It's a challenge: only 2.2 percent of practicing neurologists identified as black or African-American in 2013, according to the Association of American Medical Colleges, with 4.1 percent identifying as Hispanic or Latino, and 0.2 percent as American Indian or Alaska Native. Data from the AAN membership profile, as of 2015, does not tell a much different story: 4 percent of the membership identified as Hispanic or Latino, 2.4 percent as black or African-American, and 0.5 percent as American Indian or Alaska native.

In academic medicine, the percentage of minority faculty members has increased somewhat between 2000 and 2010 — from 6.8 percent to 8 percent—and the percentage of newly promoted minority faculty members increased from 6.3 percent to 7.9 percent, according to a 2013 study in the Journal of the American Medical Association, which did not break its findings down by specialty or department. But at the same time, the percentage of minorities in the general population increased to more than 30 percent.

“In most neurology residency programs, minorities are heavily underrepresented,” said Ayaz Khawaja, MD, a fourth-year neurology resident at the University of Alabama-Birmingham and chair-elect of the Consortium of Neurology Residents and Fellows. “In Alabama, for example, African-Americans make up about 25 percent of the state's population, but they are much less than 10 percent of our hospital's physicians and residents, and a vanishingly small percentage of the neurology faculty and residents.”

Previous studies have found that underrepresented faculty are less likely to be promoted or on tenure tracks than same-age majority peers, even when controlling for factors such as degrees, type of medical school, and receipt of NIH awards.

“In my early career, I definitely perceived a lack of role models available from a similar background as mine,” said Alberto Ramos, MD, co-director of the sleep medicine program at the University of Miami's Miller School of Medicine and another 2015 DLP participant. “I think the effect is that your potential network — the people you meet, who introduce you to others and sponsor you — is limited and not as robust as it might be. That may discourage some people from actively participating in the AAN. By actively engaging and making the AAN's leadership diverse, some of these barriers may cease.”

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DR. ALBERTO RAMOS: “In my early career, I definitely perceived a lack of role models available from a similar background as mine. I think the effect is that your potential network — the people you meet, who introduce you to others and sponsor you — is limited and not as robust as it might be. That may discourage some people from actively participating in the AAN. By actively engaging and making the AANs leadership diverse, some of these barriers may cease.”

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DR. JOSE MERINO: “Hopefully this will snowball into something much bigger than the ten people who participate every year. The key goal is to promote the growth of a very diverse group of neurological leaders who can really serve patients and also the profession itself.”

THE TRAINING PROGRAM

Dr. Gatson believes that what she has learned through the DLP, and the subsequent connections she's made, will help her overcome those odds. “Although I had some prior leadership experiences, the program was really transformative. It helped me understand the key differences between managers and leaders,” she said.

“The leader is the one responsible for galvanizing the team, while the manager is tasked to put the pieces into motion to achieve the desired outcome. The DLP really helped me to develop approaches to improve my leadership in my current position, and further helped position me so that the leaders within the AAN know who I am and what I am passionate about,” she said, citing access to guidance from prominent neurologists like AAN President Terrence Cascino, MD, FAAN; AAN President-Elect Ralph Sacco, MD, FAAN; and her DLP appointed “champion,” former AAN President Robert “Berch” Griggs, MD, as invaluable.

The DLP isn't just for newly minted junior faculty like Dr. Gatson, explained AAN Deputy Executive Director Christine Phelps, who spearheaded the program's development. “We had participants from their 30s to their 50s last year. We want to get more people of color involved in the AAN at early, mid, or even late career stages. The DLP's goal is to fast-track them into leadership by immersing them into the inner workings of the organization, giving them connections within the Academy, and providing them with leadership training and media training.”

The DLP also focuses on developing leadership skills that participants can take back to their own communities, in order to both advance their own careers and the careers of other underrepresented minorities in neurology. “They can serve as mentors or role models for even greater diversity within neurology,” said Jose Merino, MD, MPhil, a vascular neurologist at Johns Hopkins who chairs the DLP Work Group. “Hopefully this will snowball into something much bigger than the ten people who participate every year. The key goal is to promote the growth of a very diverse group of neurological leaders who can really serve patients and also the profession itself.”

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DR. NA TOSHA N. GATSON: “The DLP really helped me to develop approaches to improve my leadership in my current position, and further helped position me so that the leaders within the AAN know who I am and what I am passionate about.”

The program has evolved since its debut at the 2015 Annual Meeting, Dr. Merino said: “The participants wanted more formal leadership training during the meeting itself. We also reorganized it so that there will be more direct mentoring. We've been very careful in choosing the mentors, who are leaders at different levels of the Academy, and they have had their own training in effective mentoring.”

DLP participants will also work together throughout the coming year on a project that they identify, to help the Academy identify additional specific initiatives to promote diversity within the neurology workforce.

“To understand the human capital that is involved — the great people who make the Academy successful — and to see how they excel in what they do was really rewarding for me,” said Dr. Ramos.

“I now see myself getting more involved in larger roles within my institution, not only in leadership for myself but also in supporting others to become leaders. I'd also like to connect with local students and try to engage them from a very young age in the sciences, and hopefully in neurology, to keep up the pipeline of future minority neurologists.”

LINK UP FOR MORE INFORMATION:

•. The AAN Leadership Diversity Program: http://bit.ly/AAN-DLP
    •. Guevara JP, Adanga E, Avakame E, Carthon MB. Minority faculty development programs and underrepresented minority faculty representation at US medical schools http://www.ncbi.nlm.nih.gov/pubmed/24302093. JAMA 2013;310(21):2297–2304.
      •. Fang D, Moy E, Colburn L, Hurley J. Racial and ethnic disparities in faculty promotion in academic medicine http://www.ncbi.nlm.nih.gov/pubmed/10974686. JAMA 2000; 284(9):1085–1092.