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Nina F. Schor, MD, Phd, FAAN, Deputy Director of the NINDS: On Harassment, Equity, Disparity and Inclusion, and Gender Barriers

Article In Brief

NINDS Deputy Director Dr. Nina F. Schor spoke to Neurology Today about how the NIH and NINDS are addressing disparities in funding for female researchers and implementing initiatives to improve the work culture.

On June 12, Francis S. Collins, MD, PhD, director of the National Institutes of Health (NIH), announced that he wanted to send a clear message of concern that it is time to end the tradition in science of all-male speaking panels, sometimes referred to as “manels.” He added that if attention to inclusiveness is not evident in the agenda, he would decline to take part. Eight days later, Walter J. Koroshetz, MD, FAAN, director of the National Institute of Neurological Disorders and Stroke (NINDS), made a similar proclamation. Word of these announcements spread virally on social media where women and members of other groups long underrepresented in science applauded the show of support.

Neurology Today spoke to Nina F. Schor, MD, PhD, FAAN, who was named deputy director of the NINDS in January of 2018, to ask whether this news signaled real culture change at the NIH.

We caught up with Dr. Schor just as she was leaving for Chile on her first vacation in four years—perhaps not surprisingly for a science scholar—to witness the total solar eclipse from the best vantage point.

Prior to being named deputy director of the NINDS, you had extensive basic research and clinical background as well as leadership experience. How did this prepare you for your current role?

When I first accepted the position at NINDS, many people both at the University of Rochester and at the NIH told me I was in for culture shock. Fortunately for me, they were wrong! I think people on each side of the equation think the other side operates under more inexplicable rules and restrictions. The fact is that both academia and government have many rules borne of cultural, historical, and political precedents; the contexts are forgotten but the rules persist.

The University of Pittsburgh, where I worked for 20 years, was as different from the University of Rochester as the University of Rochester, where I worked for over 11 years, was from the NIH. Having made a career move before and having always held jobs that required me to roll with unanticipated punches and equip and empower others to work through them, too, prepared me for change and adaptation.

Being chair of a large department of pediatrics and pediatrician-in-chief at Golisano Children's Hospital prepared me for leadership of a diverse group and enabled me to discern relatively quickly what was missing from the leadership portfolio at NINDS that perhaps I could provide. My basic research background and clinical work gave me credibility with the diverse group I help lead and experience talking with elected government officials, advocacy groups, and the general public about difficult health and science issues.

Can you describe your research background?

If you wake me up in the middle of the night, I will still say I am a medical biochemist. I was extremely fortunate to have done protein chemistry research with Julian Sturtevant, PhD, at Yale University; to have gotten my PhD doing medical biochemistry, which enabled drug design in the lab of Anthony Cerami, PhD, MD (hon), at Rockefeller University; and to have used my residency elective time to begin working in the lab of Manfred Karnovsky, PhD, at Harvard on leveraging the “neural” characteristics of neuroblastoma cells to develop targeted therapies for this disease. Although the project was not something on which Dr. Karnovsky's lab was working, his lab had all of the technical expertise and equipment I would need, and my initial approach involved toxic dopamine analogues that generated reactive oxygen species in situ. The reactive oxygen species made Dr. Karnovsky, a wonderfully generous and gracious soul, agree to doing this project in his lab and I was off and running. I have spent the rest of my scientific career defining the biochemical, cellular, and molecular characteristics of neuroblastoma cells and trying to target them with pharmacologic agents that would be both safe and effective for this disease.

As a clinician-scientist, did you encounter any gender barriers in your career?

I once read a quote (I do not recall from whom) that went something like, “In order to get half as far, a woman has to be twice as smart as a man. Fortunately, this is not difficult.” I sometimes humor myself by saying this is why I do not recall much in the way of gender-related obstacles being thrown in my path.

I have always been very goal-directed and have instinctively blamed my own shortcomings for the impediments I have faced and used humor to make it easier to get to the end of the day. I doubt there is a professional woman in any field who hasn't met with off-handed, ill-advised comments or jokes. But I never faced true gender-related barriers until I felt ready to take on something bigger and broader than my roles as department chair and pediatrician-in-chief.

My interest in building bridges—between the academic sector interdisciplinary programs; the undergraduate and professional campuses; the departments of any one campus with each other; and the university, corporate and government sectors around it—was met repeatedly by many institutional leaders with the suggestion that I become the “department chair and pediatrician-in-chief for life”. It seemed, quite disappointingly to me, that the top of my head had finally hit the underside of the glass ceiling.

Coming to the NINDS was the opportunity for which I was looking to implement what I had learned in child neurology and pediatrics leadership across a broader platform, working in government and serving as a liaison to the academic and public sectors.

The interim results of the NIH Workplace Climate and Harassment Survey were released on June 13, 2019 and showed that 21.6 percent of respondents experienced some type of harassment in the past 12 months. What will the NINDS do to address these findings?

We recently completed this survey at NIH and have begun what is planned to be a broad and deep analysis of its results. Already, we have identified troubling aspects of our workplace climate. Dr. Collins has charged a committee of his Advisory Council with recommending enforceable, durable solutions to these issues, the outcomes (positive and negative) of which will be monitored, and the negative aspects of which will be remedied.

I honestly don't think there are too many who were surprised by the results or who think the NIH is uniquely or even disproportionately affected by such egregious behavior. I think the thing that worried and upset me the most was the fact that our trainees, individuals who are the most vulnerable and often the most doubting of themselves, are affected the most. To me the most urgent agenda, both for them and for the survival of the scientific enterprise into the future, must be to protect and empower these young people vis-à-vis assaults to their person, their dignity, and their career choice and advancement.

Over the past few years there has been a focus on diversity at the NIH and special attention given to gender issues. Can you describe the new initiatives?

In the intramural space, NIH has launched and implemented initiatives to address such issues as salary and promotion equity, not only for women and in relation to gender identity, but across all aspects of recruiting and welcoming a diverse workforce.

In the extramural space, the NIH has launched and will continue to launch grant mechanisms and supplemental opportunities aimed at leveling the playing field in research. These allow individuals from underrepresented minority groups, individuals with disabilities, and women to obtain the kind of training and mentoring that might not have been as readily available to them as to their majority counterparts. They facilitate recruitment by academic institutions of a cohort, rather than a lone representative of individuals from these populations, so that they mentor and support one another and so that they do not become “singled out” in the academic milieu.

There are new initiatives aimed at sustaining the research careers of women during their child-bearing years and of anyone during times when they are caring for an ill family member. Finally, we are working with academic institutions and professional organizations to define our respective roles in ensuring and designing and instituting measures that ensure that laboratories and scientific meetings, particularly for trainees and junior colleagues, are always safe and welcoming places for everyone.

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“What has changed at NIH at this early point is not yet the culture, but the concerted, visible, and accessible effort to identify the issues loudly and clearly and to begin the processes of healing, remedying, and, ultimately, preventing them in a durable way.”—DR. NINA F. SCHOR

A recent JAMA study found sex differences in the size of NIH funds awarded to comparable first-time female and male principal investigators; women at the Big Ten universities received an average grant amount of $66,365, compared with $148,076 for men, for example. Is the NIH addressing this disparity?

NIH is both calling public attention to the importance and value of women scientists and their scientific approaches and viewpoints, and creating mechanisms it hopes will encourage women to apply for and persist in NIH-funded career opportunities. The initiatives I mentioned above, and particularly that men in NIH leadership now insist on women colleagues sharing the scientific stage with them, will serve to alert scientific and public audiences to the issue at hand. In addition, NINDS has launched a new e-column (https://schorline.ninds.nih.gov) aimed primarily at the general public. My hope is that it serves, in part, to encourage young women to pursue careers in science and to advocate for themselves.

It is interesting that, while women are highly likely to apply for and receive K-award funding, there is a wide gap between men and women in submitting applications for R-award funding subsequent to the K-award. Those women who do apply for R-award funding are slightly more likely to get it than men, but you have to apply in order to get an NIH grant! I have not looked directly at this, but it would not surprise me if women who apply for R-award funding ask, on average, for fewer dollars per grant year, as women do not tend to negotiate for resources or salary when they apply for jobs.

There have been allegations that the NINDS/NIH is a difficult place for women to work, and one in which dissension, criticism, or reporting of harassment is met with retaliation. Is this accurate or has there been a real culture change?

One thing that is true in every environment, because it is a function of the human condition, is that culture cannot and does not change overnight. There is far too much important and complex work to do to accomplish it all in an instant. The leadership of the NIH knows this and has accordingly taken an approach that takes this into account.

First, we cannot wait for “culture change”—a slow and necessarily pervasive process—to occur for sexual harassment and reprisal for its reporting to vanish from our midst. We have created several reporting options for victims of sexual harassment; educated everyone on the NIH campus as to their availability, authority, and level of confidentiality; educated senior members of every institute, center, office, and unit within NIH as to what can and cannot remain confidential and how and when to convey this to a reporting victim; and ensured that everyone knows to whom to bring what kind of reports with what level of urgency. Our Workplace Climate and Harassment Survey indicated that we have, in the judgement of those who work at NIH, done an outstanding job of making everyone aware of and comfortable with the many ways in which such intolerable behavior can be reported and stopped.

In contrast, true culture change—the kind in which everyone values everyone else's contribution and is sensitive to everyone else's needs, vulnerabilities, and “offensiveness buttons”—will not come easily or quickly. But we have begun to put in place many mechanisms through which we hope to effect it. For example, NIH has made mandatory participation in training on unconscious bias. The American Association for the Advancement of Science Policy Fellow, Elizabeth (Liza) Litvina, and I carried out intramural focus groups at NINDS with the help of a seasoned facilitator. In partial response to what we learned, NINDS is instituting professional coaching training for its senior and mid-level leadership and has made this available to individuals from other institutes.

In August, we will begin a new “Career Conversations” course at NINDS, that includes sessions on combining family and career, dealing with and avoiding committing “microaggressions,” and on negotiating for the perfect job at each stage of your personal life. I have authored and already distributed on our Intranet a companion “text” for this course.

Our director, Dr. Koroshetz, has charged the leaders of our intramural and extramural components with initiating an annual NINDS-wide retreat, this year focused on workplace climate and harassment at NINDS.

I think the best move towards changing culture is opening the dialogue in a way that gives everyone comfortable options for participating in it, teaching leaders to model optimal behavior, and having those crucial feedback conversations in the moment when an infraction occurs. What has changed at NIH at this early point is not yet the culture, but the concerted, visible, and accessible effort to identify the issues loudly and clearly and to begin the processes of healing, remedying, and, ultimately, preventing them in a durable way.

Link Up for More Information

• Interim Executive Report on the NIH Workplace Climate and Harassment Survey: http://bit.ly/NT-NIHSurvey. Accessed July 7, 2019.
    • NIH funding mechanisms: http://bit.ly/NT-NIHfunding. Accessed July 7, 2019.
      • Oliveira DFM, Ma Y, Woodruff TK, Uzzi B. Comparison of National Institutes of Health grant amounts to first-time male and female principal investigators https://jamanetwork.com/journals/jama/article-abstract/2726973. JAMA 2019;321(9):898–900.