Diversity in our ranks

Over the past week and for the next couple weeks, we will be introducing you to the faculty who have joined us in 2020. Some of these new members just joined us at the turn of the new academic year, others have been with us a little longer. Some are returning to academic medicine; others have joined us from other institutions. And still others, my favorite, were successfully recruited to stay with us after finishing their residency or a subspecialty fellowship. I can think of few greater endorsements for what we can offer than a physician who trains here and then stays here. No matter what road led you here, welcome to you all.

In looking over these names and faces, reading about the various corners of the world from which they have come to Iowa, it is worth reflecting on what we are building in this department and with whom. As part of our ongoing focus and strategizing about how Internal Medicine should respond to systemic racism, and in order to support a diverse and inclusive community focused on the success of each of our members, we have been examining our recruitment processes and ensuring that mentorship begins on a new faculty member’s first day. Moreover, when this year began, we affirmed our commitment to diversity within medical education. But it is important now for us to examine ourselves and understand the scope of the challenge that lies ahead to ensure our faculty ranks reflect the diversity of our nation. Below are six charts that provide a snapshot of our department’s demographic breakdown by race/ethnicity and by gender across academic rank and senior leadership roles, as of June 30. There are signs of promise, but also signs of where we need to focus our efforts.

1-Gender Diversity by Rank2-Gender Diversity by Rank-Clinical Track3-Gender Diversity by Rank-Tenure Track4-Racial Ethnic Diversity by Rank-All Faculty-Clinical Track5-Racial Ethnic Diversity by Rank-All Faculty-Tenure Track

These data, based upon self-reporting, speak for themselves, but I would like to bring your attention to definitions used to parse the data graphically represented. We first defined “minority” as “non-white” and “gender” along a male-female binary, though we recognize that both of those divisions are reductive and do not necessarily accurately reflect the broader spectrum that may exist here. These broad strokes allowed us to identify more quickly, however, where our challenges lie. We next overlaid data on the federally defined “under-represented minority” (URM), which is more narrowly limited to Black, Pacific Islander, Native American, and individuals of Hispanic origins. Although there are striking disparities at first glance, I believe there are also green shoots of promise that we must nurture. For example, although the graph on racial/ethnic diversity by rank in our clinical track does reveal only 3 percent of our professors as minority and UR, there are a number of interpretations of these data. One could use these results to conclude that barriers exist for advancing minority faculty. Alternatively, given the long runway from initial faculty appointment to full professor, these data could reflect the recruitment practices from a decade or more ago. If we focus on the pipeline it is clear that there is now significant opportunity when we look at diversity in the instructor rank (66%) and Assistant Professor (53%) groups. If we are pro-active in ensuring that our colleagues at the early stage of their careers are mentored, supported, and retained, then the hope and expectation would be that the next decade will realize greater diversity in the Associate Professor and Professor ranks. Over the next ten years, with our eyes fixed firmly on this goal, we will strive to increase the diversity in the ranks and celebrate a faculty that more closely reflects the demographics of our students, trainees, and importantly our community.

One other aspect that bears mention is gender diversity among our Division Directors. A recent pre-pandemic group photo posted on Twitter received appropriately critical feedback earlier this year for its lack of a single woman among our ranks. We are and have been aware that, despite our racial and ethnic diversity, we have faced challenges in successfully hiring and promoting women into these roles. This is not an excuse, and as this department’s chair, I take responsibility and pledge to continue to work to correct this as opportunities arise to replenish our ranks. I would however like to note that when we expand the definition of our department leadership to include our Vice and Associate Chairs, our fellowship Program Directors, and our residency Educational Leadership team, the view does improve somewhat. This can be seen in the clinical track graph for gender diversity by rank. Regardless of the conclusions we draw from these graphs, please remember that our doors remain wide open to discuss your concerns, to answer your questions, and to collaborate on solutions both in the short- and long-term. Now that we have a diagnosis, a treatment plan should now be devised and implemented.

WeStandForSafetyFinally, I would just like to echo the message sent out earlier this week by Carver College of Medicine Dean Brooks Jackson and Suresh Gunasekaran, CEO of UI Hospitals & Clinics. The current outbreak of COVID-19 in Johnson County is cause for concern and close monitoring. I continue to be grateful to our UI Health Care leadership, our epidemiologists, and our providers on the front lines in outpatient clinics and in our ICUs. Each of you continues to showcase the very best of what we do here, and I have no doubt we will weather the rough waves ahead, just as we have throughout this pandemic. Please be careful in the community and, if you have not done so already, commit to protecting our neighbors, even when we are not in the hospital, by signing the Pledge for Safety.

About E. Dale Abel, MD, PhD

E. Dale Abel, MD PhD Francois M. Abboud Chair in Internal Medicine John B. Stokes III Chair in Diabetes Research Chair, Department of Internal Medicine Director, Fraternal Order of Eagles Diabetes Research Center Director, Division of Endocrinology and Metabolism Professor of Medicine, Biochemistry and Biomedical Engineering

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