The development of a diversity, equity, and inclusion committee in a neurology department and residency program.

BACKGROUND: Diversity, Equity, and Inclusion (DEI) initiatives have been described in different academic and graduate medical education settings, but not specifically in neurology. OBJECTIVE: To describe the development of a DEI committee within a neurology department and training program. METHODS: The need to prioritize DEI as a critical focus within our neurology department led to the appointment of an initial task force who identified strategic priorities and stakeholders to establish a committee. DEI committee members included faculty, trainees, and staff, and this phase of the initiative took place from May 2019 through January 2021. RESULTS: The DEI committee was established and has met monthly for over one year. Initial meetings formulated goals of the initiative. Specific objectives were developed in the domains of recruitment, education, engagement, training, conflict resolution, and recognition. Early outcomes included augmented resident recruitment efforts of UiM students, curriculum changes including frequent representation of DEI topics in Grand Rounds, and measures to reduce unconscious bias. CONCLUSIONS: The creation of a DEI Committee within a specialty department such as neurology is feasible and can result in immediate and long-term actions related to recruitment and education in particular. Our blueprint that heavily involves graduate medical education stakeholders may be generalizable to other specialty departments in academic medicine.

Current state of educational compensation in academic neurology: Results of a US national survey.

In the current medical climate, medical education is at risk of being de-emphasized, leading to less financial support and compensation for faculty. A rise in compensation plans that reward clinical or research productivity fails to incentivize and threatens to erode the educational missions of our academic institutions. Aligning compensation with the all-encompassing mission of academic centers can lead to increased faculty well-being, clinical productivity, and scholarship. An anonymous survey developed by members of the A.B. Baker Section on Neurologic Education was sent to the 133 chairs of neurology to assess the type of compensation faculty receive for teaching efforts. Seventy responses were received, with 59 being from chairs. Key results include the following: 36% of departments offered direct compensation; 36% did not; residency program directors received the most salary support at 36.5% full-time equivalent; and administrative roles had greatest weight in determining academic compensation. We believe a more effective, transparent system of recording and rewarding faculty for their educational efforts would encourage faculty to teach, streamline promotions for clinical educators, and strengthen undergraduate and graduate education in neurology.

Status of neurology medical school education: results of 2005 and 2012 clerkship director survey.

OBJECTIVE: To survey all US medical school clerkship directors (CDs) in neurology and to compare results from a similar survey in 2005. METHODS: A survey was developed by a work group of the American Academy of Neurology Undergraduate Education Subcommittee, and sent to all neurology CDs listed in the American Academy of Neurology database. Comparisons were made to a similar 2005 survey. RESULTS: Survey response rate was 73%. Neurology was required in 93% of responding schools. Duration of clerkships was 4 weeks in 74% and 3 weeks in 11%. Clerkships were taken in the third year in 56%, third or fourth year in 19%, and fourth year in 12%. Clerkship duration in 2012 was slightly shorter than in 2005 (fewer clerkships of ≥4 weeks, p = 0.125), but more clerkships have moved into the third year (fewer neurology clerkships during the fourth year, p = 0.051). Simulation training in lumbar punctures was available at 44% of schools, but only 2% of students attempted lumbar punctures on patients. CDs averaged 20% protected time, but reported that they needed at least 32%. Secretarial full-time equivalent was 0.50 or less in 71% of clerkships. Eighty-five percent of CDs were "very satisfied" or "somewhat satisfied," but more than half experienced "burnout" and 35% had considered relinquishing their role. CONCLUSION: Trends in neurology undergraduate education since 2005 include shorter clerkships, migration into the third year, and increasing use of technology. CDs are generally satisfied, but report stressors, including inadequate protected time and departmental support.