Yale Psychiatry Grand Rounds: September 22, 2023

September 22, 2023

Information

"Ensuring That Historically Excluded Researchers Thrive in Academic Medicine: The UCSF ARCHES Program"

Christina Mangurian, MD, Professor of Psychiatry, University of California, San Francisco Weill Institute for Neurosciences

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00:00For this,
00:03for the kind introduction,
00:05it's a real honor to be here and
00:07to get to talk to all of you.
00:09I'm sorry I can't be there in person,
00:12but I'm delighted to see it.
00:13So many of your faces here on the screen
00:16as well as in that room over there also.
00:20So I'm going to share my
00:22screen now and bear with me.
00:24OK, so folks can see that.
00:28Yes, Okay. All right, excellent.
00:31So I'm going to get started.
00:32So as Doctor Diaz told you all,
00:35I'm going to be talking about
00:37the UCSF Arches program,
00:39which is advancing the research careers
00:40of historically excluded scholars.
00:42This is actually a program across
00:44all of the University of California,
00:45San Francisco,
00:46which is a Health Sciences university.
00:48But to set the stage,
00:50I'm going to be giving you some
00:52background about other work that I've
00:54done in addition to the Arches program.
00:58So I want to make it very clear
01:00that the work that I'm going to be
01:02discussing today is not just mine,
01:04It's the work of many, many others.
01:06It's possible through strong collaborations
01:08and partnerships with dedicated faculty,
01:11trainees,
01:11and staff inside of UCSF and outside UCSF.
01:15I've been mentored and mentored others
01:18and have received a lot of sponsorship
01:21and tried to sponsor others as well.
01:23This over here is kind of shows
01:25you a little bit about how I see
01:28some of the research that I do.
01:29So one of my mentors and somebody
01:31who I really admire a lot is
01:34Kirsten Bibbins Domingo.
01:35She was on faculty here at UCSF and
01:37is now the editor in chief at JAMA.
01:39And she taught me that,
01:41you know,
01:42scientists create the stones
01:44for policymakers to throw.
01:47And so I like shining spotlights on
01:49areas of growth within academic medicine.
01:52I create a stone and then I
01:54hope to create some ripples in
01:56the system to promote equity.
01:57I'm hoping today I give you all
02:01some ideas and some pearls to make
02:04changes in the university and and
02:06you're setting or nationally that you
02:08think are necessary to make it a more
02:11equitable climate for all of us so
02:13we can do the best work that we can.
02:15Some disclosures.
02:16So here are my financial disclosures
02:18and some of the people that I admire.
02:21I'd be remiss during Hispanic
02:23Heritage Month not to disclose
02:25some part of my identity.
02:27So from my last name,
02:28many of you probably think I'm
02:30Armenian and I am 1/4 Armenian.
02:33I'm also 1/4 daughter of
02:35the American Revolution.
02:36But the biggest part of me or the
02:39part that I identify the most
02:41with is related to my mother.
02:43My mother's from Ecuador.
02:44She's an immigrant from Ecuador.
02:45My father was a my grandfather
02:48was a physician there.
02:49And I love these two.
02:51I'm an only child and my parents
02:55and my other now family,
02:57my husband and child children
03:00mean the world to me.
03:01So.
03:01But this is part,
03:02a big part of my identity.
03:05All right, So today, today,
03:07we're going to be just,
03:08I'm going to be describing some of
03:10the problem related to diversity and
03:13research faculty and academic medicine
03:14to get us all on the same page.
03:17Some of you know a lot about
03:18this information, some know less.
03:20I'm going to be going through
03:23some of this relatively quickly,
03:25but I'm providing you with some QR codes
03:28so if you're interested in some of it,
03:31you can take pictures and afterwards I'm
03:33happy to make these slides available to you.
03:37I'm also going to including
03:39these national reports.
03:40Then I'm going to go over the arches
03:42program itself as well as some
03:44work that I did when I was in the
03:46Department of Psychiatry as the Vice
03:47Chair for Diversity and HealthEquity.
03:49And then I want to leave with each
03:53of you having a future direction
03:56that you could take or action item
03:58that you can take in your space.
04:00So that's that's really the wish that I have.
04:02I hope that some of you listen to
04:05what I'm saying and think, oh,
04:07I could do that part of it or that
04:09part really resonates with me.
04:11Now,
04:11something that's been hard for all
04:13of us in academic medicine has been
04:15the recent recent Supreme Court
04:17decision about affirmative action.
04:19And these are some statements that
04:21we've had as part of the Arches program.
04:23And I'm sure Yale has similar
04:27statements that it's made about
04:29the dedication to diversity,
04:30equity and inclusion.
04:31I will highlight this article
04:33that a colleague of mine scholar,
04:36a legal scholar at UC Law San Francisco,
04:40Joan Williams, wrote.
04:41And it has some information,
04:44really important information,
04:46about how it doesn't make our work illegal.
04:49Especially out here in California
04:51where we've been dealing with
04:53Proposition 209 prohibiting affirmative
04:54action for many years.
04:56And it's really continue doing what
04:59we're doing to make our climate
05:01more diverse so that we do the
05:04best science we can possibly do,
05:06deliver the best education,
05:08deliver the best clinical care
05:10and make our communities healthy.
05:14So here's where I'm going to frame some
05:16of the problem and tell you some of
05:18the work that I and others have done.
05:20This first slide should be a
05:22little bit of a tongue in cheek
05:24now this was in the
05:27BMGA Christmas issue.
05:28Can I see a raise of hands for folks
05:31who know the Christmas issue A/B, MJ?
05:34It's kind of a funny issue.
05:36And so a colleague of mine, Eleni Linos,
05:40who's at Stanford did this where
05:43she she looked at a cross-sectional
05:46study of School of Medicine chairs
05:48at the top 50 NIH funded institution.
05:51And she found that there were more
05:55mustaches than there were women
05:58at the institution is chairs.
06:01So it's tongue in cheek.
06:02But it told, you know, and it says, you know,
06:04maybe women should consider having mustaches.
06:07You know, maybe that will increase
06:08their likelihood of becoming chairs.
06:09It's tongue in cheek.
06:10But what it did was kind of highlight we
06:13got a problem, you know, what can we do?
06:15What can we do about this?
06:17And then you look at Deans.
06:19Now this is from the AM C you'll see
06:22the data here. This is by gender.
06:25These are the men.
06:27This is by URIM versus non URIM status.
06:31This is non URIM.
06:33As you can see there's not equity
06:36in terms of by gender yet and the
06:40portion that are URIM is low.
06:43Now a colleague of of mine and
06:46I wrote about this and we did a
06:49very simple graph showing, OK,
06:52well we're we're making some inroads.
06:55You know what would happen if we project out.
06:58So this is years in the X axis
07:00and this is the percent women,
07:03this is 1966, this is 2070.
07:06If we continue,
07:07these are the orange or the
07:10Deans and the blue is the chairs.
07:13If we keep doing what we're doing,
07:14this is great, right?
07:16We're going up. This is awesome.
07:18It's not going to achieve equity until 2070.
07:23That's not in my my career lifespan.
07:27It might not be till the end
07:29of my daughter's lifespan,
07:30You know, her career lifespan.
07:33This isn't good enough.
07:34I think we can all agree.
07:36Now with Hispanic Heritage Month,
07:39You know,
07:40I'm going to talk about what
07:42about Latinx faculty.
07:43There's actually not data available about
07:45this issue right now at the Dean's level.
07:48I think many of you know that despite
07:50the fact that the Hispanic population
07:52in the United States is growing,
07:5418% of the population,
07:56less than 7% are active physicians.
07:59And when you drill down and look at
08:02physicians like me or Esperanza,
08:04we're part of the coveted 2%,
08:07right, only 2% of the US physician
08:11population or Latina women.
08:13I'll get back into this in a few.
08:16Now I'm going to get into some
08:19of the reports.
08:21OK, This is again just level setting.
08:23So the National Academies of Science,
08:25Engineering and Medicine have produced
08:27multiple reports and I'll notice the time.
08:31So back in 2011 they started and
08:33there's been reports every year.
08:35So you know,
08:36almost every year since 2020
08:38I'll get into each of these,
08:40but there's excellent work about
08:43expanding underrepresented minority
08:45participation is for women the
08:48impact of COVID anti racism.
08:50A AM C has similar reports.
08:54If you can see here,
08:55what they've been really focused on
08:58recently is really on salary equity
09:01and based on gender as well as race
09:06ethnicity and looking at salary equity
09:09among medical student leadership.
09:11I'll say that at UCSF and I'm
09:13sure at Yale has a similar thing.
09:14We conduct A faculty salary
09:17equity review every year.
09:19My office is now responsible for a part,
09:22for a large part,
09:24of that review in the School of Medicine
09:26and we're adding in an evaluation of
09:29URM women into our evaluation to see
09:31whether there's disparities in that.
09:34And so really the devil's in the
09:36details here and it's it's challenging,
09:38but it's important for all of us
09:41to achieve equity in compensation.
09:45So again,
09:46this is the part where I said
09:47I was going to show you a lot
09:49of these reports with QR codes.
09:51You can take some pictures of this.
09:52I'll send this to you.
09:54This is mostly to say that this
09:56problem has been going on for a while.
09:59The National Academies of Sciences
10:01has been thinking about this
10:03of the under representation of
10:05historically excluded faculty in STEM.
10:09There are.
10:10They kind of describe promising
10:13practices for women in medicine
10:17and sciences and engineering,
10:19and actually they kind of show
10:22these sad photographs or graphs.
10:25Here is looking at Biological Sciences,
10:29physical sciences, computer science,
10:32engineering, math and chemistry.
10:34And this is the representation
10:36of women compared to men.
10:38And the, you know,
10:40you just look at this goes down as
10:43people advance in their careers.
10:45I'm sure the data is similar at Yale.
10:48It's at UCSF, it's it's everywhere.
10:53They have several recommendations
10:55to deal with this.
10:57A lot of this are for those
11:00implementation scientists out there.
11:02I'm an implementation scientist.
11:04It requires top leadership support.
11:06These are these are kind of key factors
11:08to implement programs and have and happen.
11:11Top leadership support dedicated financial
11:13and human resources to this issue.
11:16Often equity and diversity are
11:20underfunded or are issues that
11:23people expect are going to get done,
11:24just as the kindness of people's
11:28hearts are and that it needs money.
11:31You need to really have a deep
11:34understanding of the context of
11:35the university and then data
11:37collection and really adopting an
11:39intersectional approach is important.
11:41And so this was back in 2020.
11:42This was part of NASA.
11:45NASIM also has put out several
11:49reports about COVID-19,
11:50the impact on the careers and women
11:53and their academic productivity,
11:56work, life balance,
11:58mental health and wellbeing.
12:00I was part of the UCSF effort to
12:04promote wellbeing of our people
12:08that you see us have during COVID-19
12:10and I know that this hadn't a
12:13real impact on everybody.
12:14I'm sure everybody here
12:16knows and felt that as well.
12:18And the challenges with the pandemic
12:21that continue to this day because
12:23we're not over with with it quite yet,
12:26The effects of COVID on on
12:28effectiveness of women,
12:30they have these different graphs.
12:32These are just showing the same things
12:34that negative impacts that it's had on women,
12:39the challenges related to child care at home.
12:43There's been a lot of data on the
12:45amount of work that women do both
12:48office housework and more work doing
12:51domestic activities still to this day.
12:54And this includes, you know, women,
12:57faculty, trainees, and staff.
13:02And then Nassim also created
13:04a really important report as
13:06well on advancing anti racism,
13:09diversity, equity and inclusion.
13:12Again, they talk about, you know,
13:15how racism impedes careers and come up
13:18with important guidelines for doing this.
13:21So I urge you all to look into some
13:23of these if you haven't already.
13:25I imagine many of your leaders have already
13:27looked at these really important pieces.
13:32These are the ones that are from
13:34the AM C Again, as I mentioned,
13:36a lot of these are on salary equity,
13:39so here's some of the QR codes.
13:41Here again, same story over and over again.
13:46Women are earning less than
13:49men and room for improvement.
13:51This is talking about how you really
13:54need salary equity to attract and retain
13:57faculty and how how important that is.
14:02And then this actually was
14:04looking even among leadership.
14:06And I I did a publication on
14:09this with Michael Mensa looking
14:11at public medical school chairs.
14:15And even among public medical school chairs,
14:18there were gender disparities in
14:21compensation between men and women.
14:26I'm really proud of the work that's done
14:28by the AM CG Women's Steering Committee.
14:30This is a group on women in
14:32medicine and sciences.
14:33I actually have the honor of being on that
14:36steering committee as of late last year.
14:39This is led by Amy Gottlieb who
14:42is a scholar in compensation and
14:45academic medicine is now taking the
14:49role in faculty affairs at USC.
14:52They have developed a lot of really
14:55important toolkits through the
14:57AM C and issues related to women
14:59that you could should check out.
15:01I think something that I touched on
15:04very briefly was intersectionality
15:06and they actually,
15:07the AM C has a women of faculty of
15:10color toolkits that are I think,
15:13interesting for folks to look at that
15:15again have strategies for what you can do.
15:19I wrote a piece with some of my colleagues
15:22and many of you may know Carolyn Rodriguez.
15:25She's actually one of my best friends.
15:28We went to Columbia together
15:30and she's now at Stanford.
15:31She's an associate Dean for faculty
15:34and academic affairs in Stanford.
15:36And we wrote a commentary to that
15:38piece that I was talking about before
15:40by Doctor Ayana about the fact that
15:43only 2.4% of US physicians are Latina.
15:47Again said the same thing that I've
15:48been repeating over and over again
15:50about the bias of discrimination.
15:52You know that there are
15:54structural barriers in place,
15:55but what are our recommendations?
15:57Our recommendations are really increasing
15:59leadership opportunities for women of color.
16:02I think institutions to start thinking about
16:05centering their efforts on women of color,
16:07meaning looking at all their policies
16:10and procedures through that lens about
16:13how that might impact those people,
16:15those individuals.
16:15And if you do that,
16:17it actually lifts everybody.
16:20I think there's importance
16:21to reducing isolation,
16:22building community and of course
16:25data-driven accountability.
16:28Another portion of in our part of
16:31intersectionality that we don't
16:33talk about a lot is caregiving.
16:36Now, I think we talked about caregiving
16:39in terms of women having babies,
16:42right.
16:42And UCSF,
16:43and I'll give some data
16:45about what I've done here.
16:46UCSF has made great strides and increasing
16:49the amount of paid family leave for anybody,
16:52regardless of gender to 12 weeks paid leave.
16:55And so we think a lot about how
16:57are we going to support people,
16:59you know, people having children.
17:00But we don't talk a lot about is that
17:03a lot of people are also taking care
17:06of ill family members and many of your
17:09faculty as they advanced in their careers,
17:12especially the women faculty are
17:15taking care of elderly parents.
17:17This is coming up more and more.
17:20And so I was very,
17:21very pleased that NASIM has started
17:24a a work group on supporting family
17:27caregivers working in science,
17:28engineering and medicine.
17:29And I was very,
17:30very honored to be the inaugural speaker,
17:33talking about my experiences not only
17:35with my father, who now has Alzheimer's.
17:37I showed you his picture earlier.
17:39I'm an only child.
17:41This does fall on me.
17:43But also when even before that,
17:45my, my youngest son,
17:46who's now very healthy,
17:48had a very serious medical condition,
17:51required a bone marrow transplant
17:53when he was a baby.
17:54That was part of my that was
17:56something that happened in my life.
17:58Women that are in our,
18:00that are in our society tend to provide
18:03more of these kinds of caregiving needs,
18:05not only at the workplace where you're
18:07caring for our patients and maybe even
18:10the other people within the institution,
18:12but you're also at home caring for the
18:14family, including when they're sick.
18:17So I've given you a lot of kind
18:20of depressing information, right?
18:21Like, Oh my gosh, you know,
18:24here there's so much,
18:25so many problems.
18:26Sometimes it can feel hard to
18:29figure out what can I do,
18:32especially what can I do as an individual.
18:33This is too overwhelming, right?
18:36So I'm going to give you some stories.
18:37I'm going to show you some
18:39things that I've done and again,
18:41some things that you can hopefully pick up
18:44and take with you to try to do as you move,
18:47you know, in your institution or your
18:48little sphere of influence, right.
18:51So I'm showing part of a talk that I gave
18:54where I become the inaugural Vicechair
18:57for diversity and HealthEquity in the
18:59Department of Psychiatry from 2015 to 2022.
19:02So I'm going to tell you about some
19:04of the things that I did in that role.
19:07So and I'm looking at John.
19:09John, you may recognize this
19:10guy up here on the left.
19:11This is Andy Crystal,
19:13his brother who is the vice
19:15chair for research here who
19:16is an active partner with me.
19:18So something that I did was I focused
19:22on women faculty and increasing
19:25and advancing women faculty.
19:27So I was very much,
19:29because I'm a scientist, focus on the data.
19:32So I targeted our advancement strategy.
19:36I looked at our how we go about
19:38in our search committees,
19:40what we do in an appointment and advancement,
19:45how we're moving people forward.
19:47I actually would write the
19:49division chiefs to say hey so and
19:51so's an associate professor.
19:53Have you thought about them going up
19:55for full professor what are you doing?
19:57And I have some pretty impressive outcomes.
20:01We went up for an increase in our
20:04full professors from 30 to 50%.
20:05We increased our overall women faculty
20:08in the department up to close to 58%,
20:11which is higher than the AM CI can
20:14talk about specific strategies
20:15that we did to do this.
20:16I created Mom Pods during the
20:19pandemic to help some people who
20:22felt isolated be together.
20:23I'd actually created groups of
20:27women earlier in my career when
20:29I was an assistant professor.
20:30I'd gone to the AM C Early Career
20:33Workshop for women and I noticed
20:35that I learned a lot from my peers.
20:37And so I just created a women's
20:39group and it's going on to this day,
20:41and they have all sorts of different events.
20:44It was called warm hearts and this was
20:46I I think these peer groups are very
20:49important to reduce isolation and also
20:52can be really advocates for change.
20:55And so I encourage you all to
20:58think about community building.
21:00I had some listening tours.
21:01I developed reports, I focused on research.
21:06So I was fortunate with Christine
21:09Yaffe to get one of the Doris Duke
21:11funds to retain clinical scientists.
21:13This was funds to actually give small
21:16grants to informal caregivers like I
21:20mentioned to fact to research faculty
21:22who were caring for ill loved ones.
21:24I believe GAIL has one of these doors
21:27to FRCS grants, grant mechanisms.
21:30I created a URM Research Mentorship Award.
21:34We created a gender equity work in progress.
21:38We were looking at the data in
21:40our department.
21:41We created several high impact papers
21:45and I also created a mid career
21:48program across the university.
21:50This is Kirsten, this is me.
21:51These are our three first fellows.
21:53And so I felt like there was
21:55a gap in providing mentorship
21:57and support for our mentors.
21:59So created this program for extraordinary
22:02mentors at UCSF and they actually
22:05get some funding and a sponsorship
22:08and mentorship from us through this.
22:11I mentioned the family leave.
22:13I'm really proud of this work that I did.
22:16And you see my chair here,
22:17Matt, Matt Gold, Matt State,
22:20as well as Brian and his who's who's
22:22from Yale, as many of you know,
22:24a friend of many and Brian Aldridge.
22:27And I remember Matt saying to me, hey,
22:29let let's, let's let's do this together.
22:31We should, we should increase our paid leave.
22:33And then I spoke to Brian Aldridge and he
22:35said, you know what would really help me?
22:37Brian Aldridge is our vice Provost.
22:39He said, you know,
22:40if you collected data on all on some of
22:43our peer institutions and their family leave.
22:46So I collected this data and
22:48then I published on this data.
22:51So this is something that I suggest to
22:53those of you who are doing diversity work.
22:56Make sure you're publishing some
22:58of your work so that the work gets
23:02gets out to others to try to use,
23:05but also advances your career.
23:07So I certainly suggest publishing the work.
23:09So I published the work kind of
23:11against shining the spotlight.
23:13There's a gap in our paid lead
23:15policies at the leading institutions.
23:17I looked at that UCSF expanded
23:19to after after that piece,
23:21along with decades of work by others.
23:24This is kind of the last straw on it
23:26And because of really strong leaders,
23:28we were able to get 12 weeks of
23:31paid leave from a CGME and A/B Ms.
23:33thanks to Kirsten here,
23:35we were able to actually increase based
23:37on some of our data looking at residents
23:40increase resident paid leave to six weeks,
23:42now I wanted 12.
23:43You can look at some of the pieces,
23:45a piece that we have in the New
23:47England Journal where there's talk of
23:4812 because I really want 12 weeks,
23:50but that's it's incremental steps
23:53are important and then there's been
23:56some really important policies that
23:58have been made on dependent care.
24:02I had a big focus on sponsorship.
24:04Now this is actually the wrong word,
24:06is the word we use in medicine is
24:09sponsorship and the business in business
24:12they use access to opportunities.
24:14I'm using sponsorship because more of,
24:15you know what sponsorship is.
24:17It's different from mentorship.
24:19It's when somebody's talking about you
24:22in high settings and also in a position
24:24of power to actually be able to give you
24:27resources or give you access to people.
24:29And so I focused a lot on sponsorship
24:32and in getting people into the
24:34right rooms and getting them awards
24:37to increase their visibility and
24:39increase their access to funds.
24:41And so I I definitely put up many
24:44individuals for Chancellor awards.
24:46Watson Fellows,
24:46which is at UCSF,
24:48gives $75,000 a year to this prestigious
24:50program and sponsor people for the
24:55SMMA. At the same time,
24:56I had been asked to be the chair of
24:59the Council of Minority Mental Health
25:01and Health Disparities in the APAI
25:04did some things I I brought people
25:06together on the two sides of the house.
25:08So I don't know how many
25:09of you know about the APA,
25:11but the APA has caucuses and
25:13then they have these councils.
25:15It's almost like the House of
25:17Representatives in the Senate.
25:19And they're not really supposed
25:20to always get together.
25:21And in this case,
25:23I was bringing folks together to
25:25formally so that we could attend to our
25:28shared goals to diversify our profession.
25:32I also created many APA position position
25:36statements and then had created this
25:39what's called Fierce sister could
25:42and this is a group of diversity
25:45leaders across psychiatry nationally.
25:48You'll recognize many of them
25:49including Ayanna Jordan who was
25:51there at Yale for many years and
25:53this group still meets to this day.
25:55We provide support to one another
25:58and the work that we do and and have
26:02written about our work including
26:04diversity leader guidelines in academic
26:07medicine that was published in a JP.
26:10Now for the main thing that I was the billing
26:14here was about the UCSF Arches program.
26:17So what is the Arches program?
26:21Okay the Arches is a career
26:24development program designed for the
26:26historically excluded research faculty.
26:29Recognizing the diversity is
26:31critical to institutional success
26:33and scientific progress.
26:35Now,
26:36historically excluded individuals are
26:38individuals who have historically
26:40faced discrimination,
26:42prejudice and systemic barriers that
26:44prevented them from achieving equal
26:46opportunities and access to resources.
26:48That's the definition that we used.
26:50Now this was stimulated by the 1st grant.
26:53Can I see a show of hands?
26:54How many people know what the first grant is?
26:58OKI see one of couple in the audience there.
27:00I don't see any in the OKA few in this.
27:03OK, great.
27:04OK, so a couple,
27:05but not many of you know about it.
27:07Oops, it took me forward. OK.
27:10So the first grant is an NIA.
27:13It was basically Hannah Valentine's baby.
27:15Hannah Valentine was the Chief
27:18diversity officer and NIH.
27:20And she created this award,
27:21which was a $20 million award to
27:24institutions to recruit faculty,
27:26diverse faculty to their institution.
27:28So every institution under the sun
27:30was applying for this because this
27:32was dollars to bring people in.
27:34UCSF applied as well.
27:36Now, UCSF history,
27:38we were applying with Dan Lowenstein,
27:40who was our Executive Vice
27:41Chancellor and Provost at the time,
27:43and Kirsten Bibbins Domingo,
27:44who was, as I mentioned before,
27:46she was the one of the vice teams for
27:49HealthEquity at UC or the inaugural
27:51vice team for HealthEquity at UCSF.
27:53So they were both the MPI's on the grants or,
27:58you know,
27:58work and work at UCSF that many
28:00of you may or may not know is,
28:02you know, we've had really impressive
28:04DEI efforts over the years.
28:05Yeah,
28:06Our climate survey still identifies gaps,
28:09making people feel like they belong.
28:11It's not Nirvana.
28:12There's lots and lots of opportunities still.
28:15We've written this grant intending to
28:19create institutional transformation and we
28:22did not receive the grant despite trying.
28:24But then we just were like we're
28:26just going to do this anyway.
28:27So we initially called it the first light
28:30program and it was built just you know
28:32about a year and a half ago in March,
28:34the end of March of 2022.
28:36So what have we done?
28:38So because and the reason why I was
28:39chosen in is I was the head of the
28:42faculty development core for the program.
28:43So I had built this the the grant,
28:47the, the section of the grant.
28:49And so I was going to be
28:52launching this program component.
28:55Now the team was very important to me that
29:00we had diversity in terms of not just gender,
29:04race, ethnicity, types of science,
29:07types of school,
29:08that we had the right people here.
29:11People often think of it as,
29:13you know, where their MD's and
29:15PHD's who who is at the table,
29:16do we have diversity and representation.
29:19We also had to have people who are able
29:21to be in the administrative assistants,
29:22the program manager.
29:23To help us run this,
29:25I created a group of advisors.
29:28So this is what I call
29:30the changemaker circle.
29:31So these are top senior leaders at the
29:35university who are also women of color.
29:37So wanted to have this group of leaders
29:41who could advise us as we move forward.
29:44I had continued to have advisors
29:47where we had an Advisory Board.
29:49So I put together the folks who are in,
29:52you know, this is the Vice Executive,
29:54Vice Chancellor and Provost.
29:56This is our Dean.
29:57This is the Vice Chancellor
29:58for diversity and outreach.
30:00This is the Associate Vice Chancellor
30:02for research in diversity.
30:04I was bringing together all the top
30:07leaders and had the sponsors and actually
30:09had other ad hoc advisors to guide the work.
30:12And many of you will recognize Kamara Jones,
30:14who's obviously an incredible
30:17scholar in this space.
30:20I also wanted to develop
30:22the target population.
30:24So you might not have heard it,
30:26but with the first grant,
30:27what they were focused on
30:29was bringing in individuals.
30:31So they wanted to bring in like
30:3312 people and dump all the
30:35resources into these 12 people.
30:38And that's important.
30:39I think it's important to bring
30:41people in like this and and various
30:44places including Sinai and Yu
30:46others have developed these cohorts,
30:48right that they bring in cohort
30:50models are incredible bringing in
30:52cohorts be together form a group.
30:54However,
30:54it leaves out the masses who
30:57are already there, right?
30:59And there's a lot more people
31:01who are already here.
31:03So rather than selecting a few faculty,
31:06recruits 12 we you know we have 3500 faculty,
31:09let's look at all UCSF historically excluded
31:13research faculty across all schools.
31:15That's our target.
31:17And So what our goal was,
31:19was to build activities in response
31:21to what our people
31:22said. They needed specific skills,
31:24sponsorship and community,
31:26and we would know we'd succeeded.
31:28I remember asking Kirsten and Dan about this.
31:30We know. So you succeeded.
31:32If people knew about the program,
31:34and I'll just tell you as a teaser,
31:36they definitely know about the program now.
31:39And now our next goal for this year is
31:41that people feel part of the program,
31:44feel like they're part of the program,
31:45not just and they trust the arches program.
31:48So here I'm going to tell you about
31:50building the different program components.
31:53As usual we've we've done a
31:55listening tour and talked to folks.
31:57We all also had our own experience
32:00as historically excluded faculty,
32:02but it came in in areas that were
32:05predictable, right We when people
32:07wanted community and mentorship,
32:10they wanted, you know,
32:11working to support, you know,
32:13needed advocacy from us and working
32:15to train all people regardless of
32:18where you were early to mid and senior
32:21folks and building infrastructure,
32:24they also wanted skills, right?
32:26So we wanted we developed an
32:28early career development program,
32:30program seminar series.
32:31So this we've had several of these,
32:34these are quarterly,
32:36we had a mentoring panel discussion,
32:39we had a discussion focused on your
32:42advancement and optimizing your CV
32:45because this is focused on research
32:48faculty and we define research
32:50broadly as any kind of scholarship.
32:52We talked about building your research team.
32:55And then the one that's been really
32:58concerning and important I think
33:00is how little a lot of the faculty
33:03knew about their finances and making
33:05sure that the that they understood
33:08the research support they should
33:10be getting from the institution
33:12and get some kind of finance 101.
33:14So that they really start looking
33:16at their budget status reports,
33:18understand those status reports,
33:19understand the projections so that
33:21they can manage their resources well.
33:23We also created online resources.
33:27I mentioned that I created this program.
33:30I brought this program into arches.
33:33This was our next group of faculty
33:35that we were able to recruit.
33:37Thanks to the Chan Zuckerberg Bio Hub,
33:41I was able to expand our group to four.
33:44We also have some funding from Genentech
33:47to get this work off the ground.
33:49And this is just a quote from one of
33:52the people who took the program and
33:54just how much it meant to them and
33:57how career changing it was for them.
34:01We, I said this before,
34:03but we provided flexible funds,
34:06$75,000 a year to each of them.
34:08And the impact is there's been over $10
34:11million in new funds and we've been,
34:14as I said, we've been able to
34:16leverage efforts across the campus.
34:18Here's another quote.
34:19My mentees and I've been impacted in more
34:22ways than count than I can describe or count.
34:24My confidence has great has improved greatly,
34:27making me a better leader,
34:28mentor and sponsor.
34:29I'm able to ask for what I need and advocate
34:32on my on behalf of my mentees in new ways,
34:35and it was amazing what
34:36they did for their people.
34:37So it had not only an impact on them,
34:40but because they were selected for
34:42how extraordinary mentors they were,
34:43it trickled down and really had
34:45an impact on their trainees.
34:47We will have more data on the impact
34:49of this and comparing to those who
34:51are not able to enter the program.
34:53I'll get into that a little bit later.
34:57We also have done a lot of
34:58community building.
34:59This is led by Ryan and Steve,
35:02Ryan Hernandez and Steve Mack.
35:04We have a we had a little social.
35:06This is some part of the
35:08people at the social.
35:09We created a listserv so arches,
35:11faculty receive information from us.
35:15We have an online landscape
35:17of community affinity groups,
35:19so people can find different groups
35:21that they might want to join.
35:23And we have developed peer mentorship groups.
35:26These are not funded,
35:27meaning people don't receive
35:29funds to go to this,
35:30but they just receive some
35:32of the administrative support
35:33to put the groups together.
35:35And we also built what's called arches,
35:37coins.
35:38And So what this is,
35:39is actually money for people
35:42to go out together.
35:44And so all all you have to do is
35:46just organize a community activity,
35:49going out to dinner and then take
35:51a picture of yourself and then
35:53send it to us And you, you know,
35:55you you get the funds for for for doing that.
35:58And so mostly it's just to build community.
36:00It's just to build community.
36:02So this has been launched very
36:04effectively in the Department of Medicine.
36:06So we borrowed it for arches.
36:08Here's some of our products.
36:09This is our, this is our website.
36:12You can look that up.
36:13Here is a picture of that website and
36:16here's a picture of our newsletter,
36:19what it looks like. This was the first one.
36:21And what we do within the newsletter is
36:24very intentionally spotlight individuals
36:26and we track who are we spotlighting,
36:29who are we sponsoring.
36:30So that we make sure that we have
36:34representation again across schools,
36:36across divisions,
36:37across types of science.
36:39That we're not just doing basic sciences,
36:41just doing physician scientists that
36:43we're really paying attention to making
36:46sure everybody feels included and seen.
36:49Now we also had as part of my grant,
36:52I had a change maker portion of
36:54the grant now that was much bigger
36:57within the grant and I have,
36:59I've still got this in my back pocket.
37:01I'm doing little elements of this and maybe
37:03in the Q&amp;A we can talk more about this.
37:05But what I what I feel happens and
37:09many of you who maybe are in this
37:12diversity space or are historically
37:14excluded identifies historically
37:15excluded yourself often you know you're
37:18doing your research and you're doing
37:21some of this work at the same time.
37:23And So what I really wanted to do
37:26with changemakers was give people
37:28the resources they needed to do that
37:31extra work given funding and or people
37:34support and or access to sponsors.
37:37So what I did is I partnered with our
37:40institutional resource allocation program
37:42which gives these anti racism awards.
37:45So these are different scientists who
37:47won these awards and I met with them and
37:50connected them with different sponsors
37:52at the institution to amplify their work
37:54and make their work have even a higher reach.
37:58So not just giving the money
38:00went out to them,
38:01but then connect with them,
38:03get them connected to high level
38:05individuals and also sponsor them by
38:07showing their work in our newsletter.
38:09I've also been developing key
38:11partnerships with other folks across
38:13the university and exploring giving
38:17consultation to other investigators
38:20throughout the university who are
38:23doing NIH funded DEI focused awards.
38:26Finally, I also have been working,
38:28I mentioned Joan Williams before
38:31I recently received,
38:33you see an NSF Advanced Partnership Grant.
38:36This is a grant focused on
38:38interrupting bias in medicine.
38:40And so I've been working closely with
38:42Joan and what we're trying to do is
38:45increase access to opportunities for all
38:48faculty across the School of Medicine,
38:51focusing in on the research faculty
38:53and by doing this really delving into
38:56where bias occurs in the workplace.
39:01And then these are two women,
39:04Claire Brenda's is a Latina.
39:06You can't tell by her name either.
39:09So I'll I'll sponsor her
39:10and let you know about her.
39:11She is an incredible woman in the net.
39:14She was the director of the
39:15Institute for Health Policy Studies,
39:16nationally recognized for her work
39:19and family planning and is a member of
39:23the National Academies of Medicine.
39:24And this is Elizabeth Ozer,
39:26who's currently one of the
39:27Associate vice Provost for faculty.
39:29And they are leading the engagement,
39:33the evaluation portion of Arches.
39:37And they actually have new hot
39:39off the press late yesterday.
39:41So I didn't include this in here
39:44survey of our people and just how
39:47much the faculty really feel like
39:49they really like the arches program
39:52we had submitted as a survey.
39:54And they even if they're not
39:58attending the program,
39:59even having the newsletter
40:00components of the program,
40:02even having the newsletter was something
40:04that was very meaningful for for them,
40:06which was very surprising for us.
40:07So here's this.
40:08You know very high click rates
40:10and open rates.
40:11They did this survey and many
40:13of them felt like the work was
40:16there's wonderful qualitative
40:17and quantitative work that I'll
40:19be able to share more later when
40:21I when I have it all condensed.
40:23But but it's people are engaging.
40:25I told you some of the outcomes
40:27from the mid career program.
40:30I didn't mention that I have a had
40:33a sponsorship component to it and I
40:35had kind of targeted their division
40:37chiefs and all of the scholarships
40:40were nominated that scholars that
40:41were nominated for awards received
40:43awards and half of them were invited
40:46to speak grand at grand rounds.
40:48And there were other opportunities
40:50as well here,
40:52let's see there's all all people
40:55are attending these seminars and
40:57there's a high degree unsatisfaction
40:59from attending the seminars and
41:02the people want them.
41:03We kind of afterwards write up
41:05the pearls from the seminar and
41:07post those on our website.
41:09And so actually folks at Yale
41:10can go look at our Arches website
41:12if you want to and see some of
41:15the information that we post.
41:16So then this is the last part,
41:18is just some pearls to take home.
41:21So my recommendations for you
41:24all and what you can do.
41:26So my thought a lot of institutions
41:32are focusing on recruitment now.
41:36Recruitment is important.
41:37I'm not saying a recruitment isn't important,
41:40but it really needs to go
41:42hand in hand with retention.
41:45I think there needs to be increased
41:48efforts focused on retaining the
41:51outstanding historically excluded
41:53faculty and trainees that enter
41:55and then faculty that we have,
41:58so keeping people here.
41:59So some of the ways that I think
42:03that you can do this are focused
42:06on improving the mentorship and
42:09sponsorship at your institution.
42:11So as I mentioned before,
42:13consider centering efforts around
42:15the idea of women of color.
42:19So for example,
42:19a lot of things that people are
42:21wondering about today is return to work.
42:22How many people are going to get
42:24come to work Now it looks in there,
42:25there's a big group of people together.
42:27But I know what UCSF sometimes there's
42:29big groups of people together and
42:30sometimes some buildings are empty,
42:32like a lot of people aren't
42:34in some of the buildings.
42:35And so when you're thinking about what is
42:38our return to work policy going to be,
42:40think about it and think about, well,
42:42how might this impact a woman of color?
42:44How might this impact her ability to
42:46get the kid into her kids into school?
42:49How might it impact her experiences
42:51of discrimination at work?
42:53What are we going to do to make sure
42:55that some of the policies that we put in
42:56place don't have these adverse effects?
42:58So it's not saying we're going to make
43:00something special for women of color.
43:01It's that we're thinking about that
43:04population when we're developing
43:06policies and procedures.
43:07I'm obviously biased to offer research
43:10support for family caregivers.
43:11I think especially in medicine we
43:14can learn a lot from people who are
43:17caregivers themselves lot about
43:19how we can improve our system.
43:22I think you should increase peer
43:25mentoring starting groups if
43:26you don't already have them,
43:28of identity groups or community affinity
43:31groups in the department and facilitate
43:35sponsorship for Latin eggs and or women.
43:38And think about specifically like looking
43:40at the population and saying oh are we
43:43are we distributing opportunities equally?
43:44How can we do this in a way
43:47that really lifts everybody?
43:49I don't know like couple more slides,
43:53use data to shine the spotlight
43:56on these issues.
43:58So sometimes what will happen
44:00is you'll look at like, no,
44:02we've got equal representation
44:04of women and men.
44:05There's no problem here.
44:07But I would separate out the
44:10data into what series are these.
44:13Let's say if I'm using faculty,
44:15what series are they in?
44:16Are they in clinical series?
44:17Are they in research series?
44:20What series are they in?
44:21What rank are they in?
44:25Are they in the,
44:26are they in leadership roles?
44:28And what you'll find,
44:29which is what we find everywhere,
44:31is that there are gaps and
44:33opportunities and that can target our,
44:35you know,
44:35that can help us to figure out
44:37where our efforts should be.
44:39I do think it's important to gather
44:42data on salaries and endowed
44:44chairs and to look at these things
44:47and be transparent about this.
44:49Where UCSF had been doing,
44:51I I published many pieces on
44:54endowed professorships and the
44:56differences in distribution of these.
44:58I'm particularly interested now in
45:00the size and finding out the size of
45:03these endowed professorships and I'm
45:05looking at our data internally at UCSF,
45:07those those with more Gray hairs like mine,
45:10which you can't see mine,
45:11but that's because of their dyed,
45:13you know,
45:14know that there's a difference
45:15between the baby endowed chairs
45:18and a distinguished professorship.
45:20So who has what are there differences?
45:24Can should they be like that?
45:27How are we distributing these these these
45:30are major resources that have impacts.
45:33And then focus on his
45:36policies and procedures.
45:37You know, these are accountability
45:39metrics with leadership reviews,
45:41salary transparency, paid family leave.
45:44I have a paper that's coming
45:46out around lactation policies.
45:48I think those are something else that is
45:50important for us to be thinking about,
45:52to encourage people who've had
45:54their children to be continuing to
45:57encourage and and allow there to be
45:59policies and procedures to allow them
46:00to continue to nurse their children.
46:03Given the strong evidence for health
46:05of of the baby and the mother.
46:07I also think around elder care,
46:11perhaps Yale is different,
46:12but most institutions do not
46:14have a specific elder care paid
46:16leave policy and this is going
46:18to increasingly become a problem.
46:20And then I think targeting recruitment
46:22for leadership roles and really thinking
46:23about making sure we have as diverse
46:28candidates as possible and that we have
46:30checks and balance for when you are
46:33selecting people so that our biases don't
46:36take over and select the majority group.
46:41I want to thank all of these people.
46:43These are mentors and sponsors that I've
46:46had over the years inside UCSF and outside
46:51of UCSFI did not get here on my own.
46:56These are people who have lifted me
46:58my career, served as role models,
47:00giving me sage advice and putting
47:03me in the room where it happens so
47:05I can make an impact. And I'm just
47:08extremely grateful to all of them.
47:10And there's actually many,
47:11many more peers and mentees that aren't
47:14even on this slide who've impacted
47:17my career and made it fulfilling.
47:19I'll leave you with this last slide.
47:22I I really like this quote.
47:24I changed it a little bit.
47:25It's from RFK, Bobby Kennedy.
47:29Each time a person stands up for an ideal,
47:34or acts to improve the lot of others,
47:37or strikes out against injustice,
47:39they send forth a tiny ripple of hope.
47:43And those ripples can be a current
47:47that can sweep down the mightiest
47:49walls of oppression.
47:50And
47:53I really believe that.
47:54So I really believe that
47:56little things that you do,
47:57it doesn't need to be big,
48:00can make a huge difference and
48:03help make our our home better.
48:07So that's it. Thank you so much.