Becoming our Best YSM

To the YSM Community:

Last week, Jewish members of our community marked Yom Kippur, the Day of Atonement. As someone who was raised in another faith and came to Judaism as an adult, I have often been struck by the power of the communal acknowledgement of shortcomings on Yom Kippur. Acknowledging one’s flaws together is intended to lead to a renewed commitment to repairing ourselves and our community. It is in this spirit that I share with you the results of a recent survey conducted at the medical school related to faculty, student, and staff engagement, inclusion, and belonging. The university will soon share the results of a university-wide faculty survey conducted in the fall of 2021.

The AAMC Diversity Engagement Survey was designed to measure and assess inclusion in academic medicine. YSM’s results were presented in comparison to data from 80,900 respondents from 50 other academic medical centers collected through October 2020. The survey questions addressed inclusion factors—common purpose, access to opportunity, equitable reward and recognition, cultural competence, trust, sense of belonging, appreciation of attributes, and respect; and engagement factors—appreciation, vision/purpose, and camaraderie.

Among 10,893 YSM students, faculty, and staff, 3,183 participated. The response rate was higher among staff (41%) than faculty (31%) and quite low among students (9%), clinical trainees (6%), and postdoctoral fellows (9%).

“Comparisons are odious,” and we note that YSM was benchmarked against peers who completed the survey largely before the pandemic. Nevertheless, it would be a mistake to ignore patterns. Due to limited space, I will highlight the three questions where we ranked lowest compared to our peers. For the “Factor: Appreciation of Individual Attributes,” 69.3% of YSM faculty or staff ranked this as favorable versus 75.4% among peers. For “Respect,” 74.3% answered in the positive versus 81.1% among our peers. For the “Factor: Trust – Confidence that the policies, practices, and procedures of the organization will allow the individual to bring their best and full self to work,” only 61.3% responded in the positive versus 72.7% among peer institutions.

Underrepresented minority (URM) faculty and staff scored lower in several areas than non-URM faculty and staff. For one group, this was relative to faculty and staff at peer institutions, while for another group, scores were comparable to those at peer institutions but lower than other groups within our school. The gap from benchmark was slightly greater for women than men in the appreciation cluster and vision/purpose cluster, as well as in the trust, cultural competence, and respect factors. Research rank faculty and social workers scored many areas lower than their colleagues. The survey revealed a few departments in which there are concerns about access to opportunity, equitable reward, recognition, and appreciation among staff.

How do we learn from this survey to make YSM all that we aspire to be? We have shared department or section–specific data with the chairs, who will review these data with department members so that together, you can reflect on the changes you would like to see within your departments. Department diversity vice chairs and champions are working together through the YSM Diversity Council to share best practices to inform departmental initiatives. For the rare department that consistently ranked lower in faculty or staff engagement, we have planned additional support to facilitate constructive change.

Deputy Dean Robert Rohrbaugh has been visiting with department faculty and staff to share the work of the Office of Academic and Professional Development (OAPD). OAPD has implemented a system for confidential reporting, a process for identifying patterns (at the individual or unit level), and an approach to addressing unprofessional, disruptive, or concerning behaviors. If you have not already done so, I encourage you to visit the OAPD professionalism concerns webpage.

To promote more effective mentoring within departments, we have developed the Faculty Development Annual Questionnaire (FDAQ)—a tool designed to provide faculty with opportunities to reflect on their career progression and to facilitate meaningful annual discussions with departmental leadership regarding their professional development goals. The FDAQ was piloted in 12 departments last spring and was formally adopted across the school in September.

Similarly, as I wrote about in a recent Beyond Sterling Hall, over the past year, a group of YSM faculty and leaders led by Deputy Dean Linda Bockenstedt has been considering the career development and trajectory of our faculty in the research ranks. The school is actively working to adopt the group’s recommendations to revise offer letters for faculty entering the research track to ensure a common understanding of expectations; to develop a dedicated research rank Faculty Development Annual Questionnaire; and to create resources that facilitate development along specific career trajectories and educational materials that enable candidates to compare the benefits of the research track versus professional staff positions.

In addition, the university kicked off the Emerge Program a year ago to develop a cohort of talented and diverse staff to serve as university leaders.

As a school we are committed to transparency. In the coming weeks, we will post the overall results of the survey online. Sharing our results will allow us to track progress over time as a community. We are also developing a repository that includes data presented each year at the State of the School, such as demographic data by faculty rank and professorships, as well as an annual summary of the number and types of behavioral concerns referred to the Office of Academic and Professional Development.

Lastly, although we learned a great deal from our participation in this survey, we recognize the need to reduce the burden of asking our community to complete multiple surveys. Survey fatigue is real. We ask faculty members to complete annual chair review surveys; the hospital asks clinical faculty to complete an annual wellness survey; and departments or others often send out targeted surveys. It is no wonder that our overall response rates hover around 30%. We need a bit of discipline to balance the imposition on our community with the value of the information gleaned. I have asked Deputy Deans Rohrbaugh and Latimore to review the schedule of surveys with the goal of decreasing their frequency and reducing the burden on our students, faculty, and staff. Going forward, we request anyone who would like to survey faculty and staff across the school to ask for clearance from Deputy Dean Rohrbaugh. We will be working closely with Yale New Haven Health to coordinate this effort as well.

We have taken an inventory of where we are as a community. We have paused for reflection. Now we must go forward and commit to becoming the community we would like to be.

Sincerely,

Nancy J. Brown, MD
Jean and David W. Wallace Dean of Medicine
C.N.H. Long Professor of Internal Medicine