Report from Annual Meeting: Association of American Medical Colleges Council of Faculty and Academic Societies

The Association of American Medical Colleges Council of Faculty and Academic Societies (AAMC-CFAS) held its annual meeting in Salt Lake City, Utah, on April 11-13, 2023. ASPET is a AAMC-CFAS member society. Joe Blumer (Medical University of South Carolina) as senior faculty society member represented ASPET at the meeting. CFAS provides a platform for faculty at academic medical centers to identify critical issues facing medical school faculty and academic societies and provide a voice for faculty in the creation and implementation of AAMC programs. This was the first in-person CFAS meeting since 2019.

Major topics discussed included mission alignment within academic medical centers; leveraging wellbeing to support researchers, educators and clinicians; unintended bias; faculty salary equity; and sustaining faculty for success as medical educators.

A new CFAS committee, Faculty as Medical Educators, was recently established and held its inaugural meeting during the 2023 CFAS spring meeting. Action items for the committee included: sharing best practices regarding how faculty are recognized and compensated for teaching; tension between preclerkship medical educators and increasing student disengagement; the impact of reducing numbers of basic science departments and a concomitant increase in departments of medical education on promotion and tenure policies of educators; and the development of an educator portfolio. In a separate but related plenary entitled “Mission Accepted: Sustaining Faculty for Success as Medical Educators,” the attendees discussed the perspectives of educators, department chairs and deans on medical education.

Three troubling trends were identified regarding sustaining the success of faculty as medical educators: 1) the devolving relationship between students and faculty, 2) student preference for communicating with administrators rather than teaching faculty, and 3) how medical educators are valued. Chairs of basic science departments often feel powerless to make changes in medical education because they have largely been taken out of the planning decisions. From the dean’s perspective, there must be institutional transparency in how departments and individuals get funded for teaching.

The newly renamed Biomedical Research and Training committee held a session entitled, “’I Couldn’t Sleep at All Last Night’: Challenges to Biomedical Researchers and Educators” moderated by Neil Osheroff, PhD (Vanderbilt University) with Martha AlexanderMiller, PhD (Wake Forest) and ASPET member Kelly Quesnelle, PhD (USC School of Medicine-Greenville) as speakers. The committee called for increase advocacy to promote the value of research at academic medical centers (AMCs) in a way that would be most persuasive to AMC leadership, particularly those involved in financial decisions who point out that “research costs the medical school money.” Many basic scientists have reported feeling undervalued even though most medical schools are recognized by their research. Committee members also called for action regarding the evolving role of basic scientists in graduate student education, including the structure of graduate education and updating a framework for the relationship between faculty and their students. The AAMC is developoing a framework for aligning the graduate student mentor-mentee relationship, which was last updated in 2016 (https://www.aamc.org/whatwe-do/mission-areas/medical-research/grad-compact).

Mission alignment among the pillars of academic medicine – education, research and patient care – was a consistent theme among many of the plenaries and sessions during the meeting. The opening plenary, “Faculty Thriving in Academic Medicine: From Mission Impossible to Mission Accomplished” pointed out that the strength of AMCs is having faculty participate in a mix of all three of these missions; however, it can often seem like the missions are in conflict from an individual standpoint. An oft-used phrase during the meeting was, “No mission, no margin; no margin, no mission.” Workforce shortages across the clinical enterprise combined with continued financial fallout from the

COVID-19 pandemic and adjustments to the Medicare fee schedule has stretched the patient care mission near its limit. One of the recommendations to address the patient care pillar was for AMCs to better realign for translational science and encourage clinicians to partner with data and quality scientists to get better patient care.

Medical educators face one of the biggest challenges for the education mission, including the lack of a sense of community and a perceived lack of value placed on educators. Institutions should ensure promotion tracks reflect the educational activities faculty do, including mentoring and coaching. AMCs should provide for robust faculty development for teaching and education research, support teaching academies, peer coaching, and educational consults, as well as recognition of exceptional educators with teaching awards.

ASPET member and invited speaker Dr. Kent Vrana (Pennsylvania State University College of Medicine) identified numerous challenges regarding the research mission and called for a re-valuing of research in the tripartite mission. Some of the challenges to research include the widespread recognition that research is expensive, greater emphasis on clinical revenue generation over research and discovery, competition for institutional resources, creation of medical schools with minimized research emphases, and recruitment of non-educator basic scientists. Dr. Vrana pointed out that research crosses all three missions of AMCs and that faculty should find ways to bind these missions together through research.

Some of the potential solutions included establishing and nurturing clinical and translational science institutes (CTSAs), using team science to support clinician involvement in research (beyond simply being a source of samples), engagement of research scientists in education and development of centers for medical education research.

AAMC Chief Scientific Officer, Ross McKinney, provided an update on research funding. Dr. McKinney pointed out that with the power and control of AMCs shifting away from deans to CEOs of health systems and an increasing focus on margins, academic medicine must keep the focus on our missions of research, education, and patient care. There is the possibility of a 25% cut to the NIH budget, and it may not have a permanent director for another two years due to the current political climate. The funding rate for NIH is still ~30%, but a challenge is that NIH funding is set as criteria for promotion. Inflation is eroding the value of NIH grants (current NIH funding is almost at 2003 levels in inflation-adjusted dollars); if the average grant size increases, then fewer grants will be funded if the NIH budget remains flat. Faculty engaged in these policy conversations will help ensure sufficient appropriations to the NIH budget.

ASPET representatives will continue to engage with CFAS to ensure AMC and the general public hears the voices and concerns of pharmacologists voices, including at CFAS meetings.

Do you have issues you would like raised at the next CFAS meeting? Email your comments to ASPET representatives. Visit the CFAS website for more information and resources: https://www.aamc.org/members/cfas/.

Joe Blumer, PhD

Department of Cell and Molecular Pharmacology and Experimental Therapeutics

Medical University of South Carolina

Charleston, SC blumerjb@musc.edu

Marieke Kruidering-Hall, PhD

Department of Cellular and Molecular Pharmacology

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A growing ASPET means greater recognition for the field of pharmacology, more resources and support for our members, and a louder voice with policy makers.

Some benefits include:

A growing ASPET means greater recognition for the field of pharmacology, more resources and support for our members, and a louder voice