This Just In...
Stay up-to-date on the latest news and information from AADPRT.
August 16, 2021
By Mike Travis, MD
This morning, August 6th, I heard the StoryCorps excerpt on NPR. It was about Dr. Charles R. Drew, a graduate of McGill University who became a surgeon and was African-American. He was responsible, during World War II, for creating blood banks and preserved blood products that saved countless thousands of lives. Initially Black soldiers were unable to give blood and then when they were, their blood products could not enter the supply chain and had to be stored separately. Blood segregation. He took a stand on this and resigned his position as Director of the first American Red Cross Blood Bank. He was honored for his work with the Spingarn Medal by the NAACP and with honorary doctor of science degrees, by Virginia State College and by Amherst. He is further honored by the Charles R Drew University of Medicine and Science in Los Angeles. Sadly, this pioneer and polymath, (see his Wikipedia entry) died as a result of a car accident at the age of 45.
When I heard this StoryCorps article, I was struck by just how much of a difference Dr. Drew made in a relatively short life and how much he could have gone on to achieve had he lived. What Dr. Drew overcame to get into medical school, his accomplishments there and in the profession are singular, as is his legacy. Yet, despite his brilliance and awards, living in the District of Columbia, his local chapter of the American Medical Association would not let him join because they only allowed white doctors.
I would like to think that we have come a long way since then and I suppose by some metrics we have. Recent events, though, in politics and protecting the right to vote, in health inequalities laid bare by the covid-19 pandemic, and in the social injustice and hardship that we see day in and day out in our clinical work, make me think we have not come such a long way after all. I am sorry, as a Doctor of 30 years, to have been a part of making so little change. We still have a lot of work to do.
I want to repeat my gratitude to those AADPRT members who stepped up to be part of our recent focus groups for the AADPRT Racial Equity Organizational Assessment. In the report from Dr. Hardy, the anonymized comments from members of the groups echoed what I wrote above, there is a lot of work to do.
I wanted to write about the process of what we are intending so that you can, if you so wish, put time aside to read and respond to the report and the draft Strategic Plan. You will see this in the bullet points, but in the spirit of transparency the full report from Dr. Hardy will be released to all AADPRT members. I have detailed our plan for doing this as follows.
· Dr. Hardy’s report and recommendations were released to the AADPRT Steering committee on August 5th.
· The SC will meet for a retreat on Saturday September 11th to discuss the findings and recommendations of the report and will meet with Dr. Hardy as part of the retreat to discuss further with him and brain-storm an initial action plan.
· The SC will draft a summary of the brainstorming session and action plan that will then be shared with members of the Executive Committee (EC) along with Dr. Hardy’s report.
· The SC and EC will meet on September 25th to further refine the draft action plan and brainstorm further on actions that may need to be taken by each committee and caucus
· The SC and EC will work on the initial action plan, and from it, create a draft Strategic Plan addressing each of the areas highlighted in the report.
· This draft Strategic Plan will include changes to the Nominating Committee process as this is one of the areas highlighted in the report as requiring reform. The initial changes to this process need to be enacted well in advance of the Annual Meeting to allow a new committee to be formed and for the initial new process of the committee to be decided. This could be changed based on members’ subsequent feedback.
· We are aiming to have the completed draft Strategic Plan ready for dissemination after the steering Committee meeting on December 9th 2021, though we may have it ready earlier. The draft Strategic Plan will be disseminated to all AADPRT Members along with the full report from the Dr. Hardy’s AADPRT Racial Equity Organizational Assessment.
· The current plan is for an online form to be made available as well as a message board for AADPRT members to comment on both the report and the draft Strategic Plan. We want to use these methods to garner feedback and not the listserve. The online form will allow people to comment anonymously and without sharing their feedback with the membership as a whole. The message board allows for discussion of the report and Strategic Plan in a non-anonymized way that can be shared with all AADPRT members in real time. The message board rather than the listserve also avoids email clutter and keeps the discussion in a single place for easy reading and summation.
· Before the 2022 Annual Meeting, likely end January 2022, there will be time set aside for a Town Hall meeting chaired by the President and President-Elect. At this Town Hall, a summary of the comments and feedback will be shared along with the revisions made to the Strategic Plan as a result of the members input. There will be Q&A as part of this Town Hall.
· The final Strategic Plan will be ratified by the SC and EC at the Annual Meeting and subsequently implemented.
I hope that this will be a significant step forward for us as an organization and I thank you in advance for your thoughts and comments as we try to be as equitable and inclusive as we can.
July 12, 2021
By Mike Travis, MD
Welcome to the start of the new academic year! I have been reflecting on this as our second start to an academic year during COVID-19 and how this might be affecting the various member groups of our community differently.
For those of us that have been PDs or APDs for a few years, the continued disruption is wearing, but bearable as we have a clear idea of what “normal” used to be and what the “new normal” might look like. For those who started during the pandemic, the way forward may be less clear and I expect to see increasing threads on the listserve about new practices and revamped resources as we continue to help and support each other. The IT committee is very aware of the limitations of the listserve and is developing and sharing ideas about how we might handle and distribute information differently in the future and make it easier to navigate all the treasure house of information and experience that is represented in the thousands of emails to which we have all contributed.
In addition to our newly minted PD and APD colleagues who need and deserve our help and support, we also all have two classes of residents who have had most of their residency training post-COVID. I am sure I am not alone in struggling to understand properly the longer-term effects of the pandemic restrictions on their experience and training and how these might translate into the kind of physicians and psychiatrists they will be in the future. Trying to anticipate these potential effects and developing adaptations and potential interventions are going to be a key part of this next year. I look forward to reading and hearing about your suggestions and innovations.
Consensus Statement from AADPRT and ADMSEP on 2021-2022 Residency and Fellowship Application Cycle
In response to the ongoing COVID-19 pandemic, the leadership of AADPRT and ADMSEP have reviewed the concerns of key stakeholders and compiled the following recommendations for our trainees, faculty advisors involved in Undergraduate Medical Education, and psychiatry residency program and fellowship directors overseeing Graduate Medical Education. We have reviewed and appreciate the recommendations from the Coalition for Physician Accountability, which may also release additional guidance. Our support for the following recommendations is intended to prioritize the safety of our trainees and communities and to support a fair and equitable process for all.
Psychiatry-specific recommended standards as of June 11, 2021
Interviews for psychiatric residencies and fellowships for the 2021-2022 recruitment cycle will be virtual. We expect all programs to comply with this recommendation and we will re-evaluate for future cycles. This includes local applicants as well. Many other disciplines such as Pediatrics and Obstetrics and Gynecology have released statements on their plans to only utilize virtual methods.
- We expect that all residency and fellowship training directors will follow the recommendations set by the AAMC and the Coalition for Physician Accountability to provide away rotations preferentially to those individuals who do not have access to clinical experiences in a psychiatry residency program in their home institution. Students are not expected to do away rotations and if they choose to do so, a maximum of one away rotation should be secured.
- We recommend that faculty advisors work closely with students and encourage them to use the “Apply Smart” data and reference A Roadmap to Psychiatric Residency (updated version to be released summer 2021) when considering the number of residency programs trainees should apply to.
- We support the holistic review of applications and recognize students may have experienced non-traditional rotations during the pandemic. We recommend programs require only one psychiatry-specific letter among the letters of recommendation submitted. We recommend that programs do not require Step 2 results to be completed at the time of the initial application review.
- We recommend that programs are as transparent as possible in the interview process. For instance, program website and social media would list dates of application deadline, release dates of interview offers, and specific interview days. The anticipated structure of the interview day (e.g. number of interviews and length) can be outlined and posted publicly.
- We recommend that programs not offer more interviews than interview spots. Release of interview offers should be done as late in the day to minimize disruptions to clinical learning and allow applicants 72 hours to respond before releasing the interview offer.
- Post-interview communication should be avoided, except for the provision of significant updates (e.g., an additional publication since interviewing), asking/responding to specific necessary questions, or basic thank you notes. We will continue to follow the NRMP Match Communication Code of Conduct despite the virtual platform.
- The Interview day itself should all take place on one day, not spread across multiple days (exception would be if technology fails and rescheduling is truly needed), and no applicant interaction should be recorded.
- It is reasonable to offer optional and nonbinding “open houses” prior to the interview season process. Programs should not take attendance and ensure applicants know that these are not mandatory. All true open houses and multiprogram residency fairs should conclude by September 29, 2021. We recognize that some programs may choose to have only a few larger evening virtual gatherings instead of the classic dinner before or on the interview day. Should a program choose to do this given the reduced student exposure that may have occurred with the pandemic, attendance should not be taken, and an absence should not be considered by programs when ranking candidates. We recognize that with this deviation there may be scheduling conflicts and tension, and urge programs to keep all events applicants are expected to attend as part of the formal interview process on one day for each applicant.
- We are still exploring if in-person “second looks” will be permitted this season, pending additional information from the scientific community and balancing this with maintaining the most equitable option.
- We strongly recommend no “swag.” If programs plan to mail hard copies of materials it should not include anything of value, which includes gift cards for food.
- Data from NRMP reflect the probability of matching plateaus at >95% after 14 ranked programs for allopathic applicants. Applicants should discuss their individual circumstances with their psychiatry advisors prior to submitting applications and during the interview season.
- While we recognize that individuals may have unique circumstances, we generally recommend that applicants interview at 15 or less programs. Interview offers above this number should be declined by student, so other applicants have opportunities to interview. Similarly, this will prevent programs from unnecessarily re-reviewing applications of those who do not plan to interview.
- If cancellations are necessary, applicants should notify the program as soon as possible and at least 5 business days in advance.
- As stated above, students should only participate in one away rotation, if at all as this is not a necessary component of applying to psychiatric residency.
The above recommended standards are put forth to provide the best interview season possible and ensure a fair and equitable process.
June 11, 2021
By Mike Travis, MD
Firstly, I want to thank the Diversity and Inclusion Committee and especially Raziya Wang, Adrienne Adams and Consuelo Cagande for writing the moving and also wonderfully pragmatic letter that served as the President’s update last month. This served both to remember George Floyd and to provide practical advice about the next steps we all need to take to incorporate ally and anti-racism practices within our own programs and institutions.
As the saying has it, “everything starts from home”. As such, I am very grateful to everyone who took time out of their busy schedules in May to be part of one of the focus groups for the Racial Equity Organizational Assessment, each led by Kenneth Hardy of the Eikenberg Institute for Relationships. In the end, thanks to your commitment, we were able to convene seven groups in total; two drawn from the Diversity and Inclusion Committee, two randomly chosen from self-identified members of AADPRT, one each from the Regional Representative group and the Program Administrator group, and then a group comprising the current members of the AADPRT Steering Committee. These meetings concluded the Friday before last and we expect a report from Kenneth Hardy by the early part of July. This report will be published on the AADPRT website along with an organizational development plan which will be formed over the coming months.
It is too early to say what the focus groups have highlighted as areas upon which we, as an organization, need to work to enhance our diversity, increase equity and ensure inclusivity. The Steering Committee will meet in early September to discuss the report and then later in September we will convene the Executive Committee to develop our responses to the report and the EC and SC will subsequently lay out our proposed changes and our organizational development plan before we all gather in Minneapolis. At our Annual Meeting we will be able to reflect on, and amend, this plan together, hopefully with input from all of our members. We want this process, in itself, to be as transparent and inclusive as possible.
This time of the year is filled with milestones, though not only the ACGME kind! As we say goodbye to our graduating residents and fellows, we recognize that they have each become a part of our lives, for better or for ill, and we will be welcoming those who stay as departmental colleagues and those that leave as part of our ever-expanding specialty. We also mark the beginning of a new class; people we have come to know virtually during the recruitment season and then in-person, as they visit our cities and programs, many for the first time this year. Their arrival always fills me anew with hope and excitement for the year ahead and one of those hopes is that you feel the same.
Remembering George Floyd: Antiracism Strategies for Psychiatry GME
May 17, 2021
By Raziya S. Wang, MD | Adrienne L. Adams, MD | Consuelo Cagande, MD
Members of AADPRT's Diversity and Inclusion Committee
George Floyd grew up in Houston, Texas, in the Third Ward, a historic Black neighborhood. He played football and basketball at Jack Yates High School, where he helped lead his football team to the state championship game in 1992. He then continued sports at South Florida State College before transferring to Texas A&M University - Kingsville. His college basketball coach started him as a power forward and he later remembered Mr. Floyd's athleticism and how he consistently contributed 12 to 14 points and 7 to 8 rebounds in a game (Fernandez and Burch). Returning home without a degree, Mr. Floyd began a hip-hop career as Big Floyd in the mid-1990s with two groups...
April 9, 2021
By Mike Travis, MD
Since writing last month I have been reflecting on allyship and its importance as we move forward.
I am convinced that defining what allyship means, and its different levels (from awareness, through action, to integration), seems to have led to a stronger sense of purpose in everyone and a collectiveness that is, or at least appears to be, less forced.
So much of allyship is about education; coming together and sharing ideas, reframing those that are wrong, and reinforcing those ideas that aid understanding and promote diversity, equity, and inclusion.
I am pleased to write that the Steering Committee has agreed to expand the focus groups for our Racial Equity Organizational Assessment within AADPRT beyond the original two groups, (Steering Committee and Diversity and Inclusion Committee) proposed by our consultant.
For the first of these additional groups, those of you who are regional representatives will be asked to select one of the representatives from each region for the “Regional Focus Group”. The Regional Representatives will also be asked to select a second person from within their caucus to also be a part of the focus group. This choice should be made with a special emphasis on selecting people who represent the diversity of AADPRT but have not yet taken on a formal leadership role within the organization.
On the recommendation of the Diversity and Inclusion Committee during our meeting last month, we will be forming two more focus groups drawn randomly from a stratified list of volunteers. Soon all members will receive a very brief, totally optional survey asking for name, age, position, gender, ethnicity/race, and asking you if you would be willing to serve on one of the focus groups. There will be a fuller explanation of what this would entail on the survey. We will stratify those interested persons in this self-identified group into different subgroups based on survey responses. We will then randomly select focus group participants from across the diverse segments of our membership.
In addition, we will be using a similar methodology with the Program Administrator Caucus to select 10 of their members to form the sixth focus group. This will help to ensure representatives from all parts of AADPRT are included.
We hope that you will consider putting your name forward for one of the groups!
To mark the anniversary of George Floyd’s death on May 25th , we have asked Adrienne Adams (chair) and the Diversity and Inclusion Committee to write a column in this space for next month.
I know that none of us is immune to the uncertainty we all have to bear at this time. My hope, though, is that justice will prevail, be seen to prevail, and will be accepted by all.
March 15, 2021
By Mike Travis, MD
I have been reflecting on what a great meeting we just had and how it shows that as a community we remain strong because we remain connected. On Saturday afternoon, I felt the same sense of loss at the end of the meeting that I normally have while waiting for my flight home, and this was the only time that has happened to me when attending a virtual meeting. In fact in some ways, I felt it even more so. We had all been talking and sharing, praising and cajoling, teasing and joking so much, through the chat functions, during the workshops and plenaries, that the meeting felt even more intimate. I want to reiterate my thanks to Sara and Doug, to Randy, to Melissa and to all of you for making the whole so memorable and so much greater than the sum of the parts.
As we contemplate the year ahead and the “new normal,” it is clear that we have all had experiences that have changed the way we will see the future. One of the biggest impacts is having to change the way we deal with each other. This is embodied in the ground swell towards actively and intentionally addressing issues of diversity, equity and inclusion and combating structural racism and intolerance.
These will be major components of the year ahead, both in terms of planning our 50th in-person annual meeting in Minneapolis in 2022 and in terms of the work we need to do as an organization and as individuals between now and then. As an organization, we will be engaging with an external consultant “to ascertain how AADPRT’s vision of effectively addressing issues of racial sensitivity, equity, and inclusion are being implemented throughout all facets of the Association’s structure.” To accomplish this, we will convene focus groups with participants drawn from across our membership.
These themes will be a large part of the annual meetings going forward just as they were a significant theme at this year’s Spring Conference because of your submissions and your participation.
As much as we will be reflecting on the history of the first 50 years of AADPRT over the coming year, I would also like us all to be thinking about the next 50 years of AADPRT and the changes we will need to incorporate to make us as relevant in 2070 as we are in 2021.
AADPRT Endorses Biden Anti-racism Statement
In previous statements we have clearly laid out AADPRT’s position as an organization committed to diversity, equity and inclusion. Part of this commitment is to deplore violence towards others based on race or culture. To see and hear about additional violence visited upon Asian-Americans and Pacific Islanders is deplorable. We are pleased to support President Biden’s statement on January 26th 2021 “Condemning and Combating Racism, Xenophobia, and Intolerance Against Asian Americans and Pacific Islanders in the United States”. We recognize the contribution made to our society at large, and our GME community in particular, by our Asian American and Pacific Islander colleagues, residents and co-workers and stand in solidarity with them against racism and violence.
President Mike Travis, MD and AADPRT Steering Committee
February 15, 2021
By Melissa Arbuckle, MD
I’m looking forward to our 2021 Spring Conference, scheduled for March 1-6! I can’t believe that almost a year has passed since we met in Dallas for our last Annual Meeting. I was just recently reviewing some of my email exchanges with colleagues last March when everything was moving to online “as a precaution.” At the time, I couldn’t imagine all that would unfold this past year. It has been a tough year to say the least. However, I’m incredibly proud with what we have accomplished as a community. Our theme for this year’s conference (Innovation, Collaboration, and Inclusion!) highlights our resiliency and our commitment to our mission: to promote excellence in the education and training of future psychiatrists, and to best prepare them to meet challenges by fostering a transformative environment that embraces diversity, inclusion, equity and justice.
As a community, we have come together to share resources for teaching online, implementing telepsychiatry, addressing systemic racism, and supporting wellness and mental health among our trainees, our colleagues, and ourselves. We have come together to work on becoming better allies, and to re-imagine recruitment as we pivoted to a virtual world.
While our new zoom reality has created a lot of challenges, it has also expanded opportunities for innovation, collaboration, and inclusion. I don’t think our community has ever been stronger or more important. I have been so grateful for the support of this community over the past year and am excited to see you soon.
January 25, 2021
By Melissa Arbuckle, MD
Over this past tumultuous year, I’ve been thinking about the many things I have taken for granted -- everyday actions and events that you can’t recognize the value of until they are gone. I have found myself especially missing those small conversations that happen when you’re standing next to someone waiting for the elevator, or while you wait in line to order lunch at the café at work. I never really thought about how important those moments were. While I’m thankful for the ability to work remotely, it’s clear that those brief interactions are an important interstitial glue that keeps a community together.
Perhaps more than anything, I have come to realize the true value of honest leadership, the value of data and science-informed decisions, and the value of civility. It’s not that I didn’t value those things before. It’s just that I really couldn’t imagine what the world could be like without them.
And last week, as I watched the insurrection attempt at the U.S. Capitol, I was reminded just how precious our democracy is. I’m grateful in that case that we do not have to learn what life might be like without it.
Watching the peaceful transition of power in our country as President Biden and Vice President Harris took office this week has given me reason for hope.
As you may recall, last fall we joined the AAMC in calling out President Trump’s executive order barring any organization receiving federal funds from participating in diversity and inclusion training that highlighted institutional racism in the United States. I was excited to learn that one of the executive orders signed by President Biden on his first day in office reverses this ban and calls for an “equity agenda” to tackle systemic racism.
The next few months are not going to be easy as we continue to face the ongoing surge in COVID-19 cases. Systemic racism is another ongoing challenge, one that will require a long-term commitment to diversity, equity, and inclusion. However, I have even greater appreciation for the value of our community and our ability to adapt and evolve in the face of such challenges and to advocate for social justice together.
I’m looking forward to connecting with all of you in the near future and wishing you all the best as we wait for spring!
AADPRT Responds to Common and Specialty Specific Program Requirements
The ACGME has appointed a Task Force to review its Common and Specialty Specific Program Requirements relating to duties, functions, dedicated time, and full-time equivalent (FTE) support for program directors, assistant/associate program directors, program coordinators, and core faculty members. As part of this effort, the Task Force asked us (along with other organizations) to submit a formal position statement in September.
In crafting a response, our ACGME Liaison Committee (including Melissa Arbuckle, Adam Brenner, Jessica Kovach, Alan Koike, and Chris Snowdy) reviewed the current ACGME requirements across specialties and subspecialties and conducted a survey of psychiatry program directors. Additional input was solicited at our Executive Council meeting held on 8/21/20 and our Steering Committee meeting on 9/10/20.
A final statement was compiled by the AADPRT ACGME Liaison Committee and recommended significantly increasing protected time for program leadership and administration. A full copy of the statement can be found here. We are grateful to the ACGME for taking on this issue and for the feedback provided by AADPRT members on this critical topic. As a follow up, AADPRT will present an additional testimony on this topic at the ACGME Congress on November 2nd.
October 12, 2020
By Melissa Arbuckle, MD
In June, AADPRT joined with the AAMC in calling out police brutality and racism in America. In supporting their call to action, we endorsed speaking out against all forms of racism, discrimination, and bias, and taking a lead in educating ourselves and others to address these issues head-on. We committed to employing anti-racist and unconscious bias training and to move from rhetoric to action to eliminate inequities in clinical care, research, and education.
As part of this effort, we hosted two relevant workshops in July. Sarah Mohiuddin, Michael Jibson, and Adrienne Adams presented a workshop on supporting trainees who experience patient aggression and discrimination-based aggression/harassment. A week later, Corey Williams, Jessica Isom, Matthew Goldenberg, and Robert Rohrbaugh presented their workshop on race and racism in clinical documentation. Both workshops are available on the AADPRT website.
Under the leadership of Adrienne Adams, our Diversity and Inclusion Committee reviewed our mission statement and recommended changes (which have since been approved) to underscore our commitment to “diversity, inclusion, equity and justice.”
We are not done. In recognition that real change takes time, we are committed to making this a long-standing priority in our work. As part of our pledge to educate ourselves, we plan to hire an outside consultant to help us do an in-depth review of our own organization and provide recommendations for next steps. We hope that through this process we will have an opportunity to address the role systemic racism may have in our own organization and to strengthen our commitment to diversity and inclusion.
At the same time, we are thankful for our members committed to allyship and our Committee on Diversity and Inclusion for lending their time, effort, and expertise to educating our community and supporting this work. We are excited about our upcoming spring conference and anticipate that these critical issues will be a major focus of the meeting. We are hopeful that these combined efforts will provide us all with a roadmap for how we might take on anti-racism within our home institutions and training programs.
I have never been more grateful for this community and am looking forward to seeing what we will accomplish together.
AADPRT Supports AAMC Statement in Response to Executive Order
September 28, 2020
2021 AADPRT Awards and the time of Covid-19
By Mike Travis, MD
President-elect and Awards Committee Chair
September 14, 2020
The AADPRT awards system opened on August 6th and closes on October 1st 2020.
In this time of social distancing, face covering, hand washing and anxiety heightening it can easily seem that awards are secondary to the daily facts of life. Yet, in the adversity we have faced over the last few months there have also been many opportunities for innovation, moments to show fortitude and circumstances that have called for superb acts of kindness and impactful feats of leadership. These are exactly the things that should be noted and lauded publicly. I therefore urge you to reflect on the many outstanding achievements of your colleagues, faculty or residents and consider submitting a nomination for one of the following AADPRT Awards.
The Annual Lifetime Service Award, which acknowledges a psychiatrist AADPRT member who has provided significant service to AADPRT, had an impact on psychiatric residency education nationally, demonstrated excellence in psychiatric residency education, provided generativity and mentoring in residency, or some combination of these. The George Ginsberg Fellowship Awards which acknowledges the excellence and accomplishments of outstanding residents interested in education and teaching who are pursuing careers as Clinician-Educators and/or Academic Administrators. The Nyapati Rao and Francis Lu International Medical Graduate (IMG) Fellowship, designed to promote the professional growth of exceptional IMG residents and fellows and facilitate their successful development as leaders in American psychiatry. The Lucille Fusaro Meinsler Program Administrator Award recognizing the outstanding skills that psychiatry residency Program Administrators possess and utilize in the day-to-day management of a residency program. Peter Henderson MD Memorial Award given for the best published or unpublished work in the area of child and adolescent psychiatry. And the Victor J. Teichner Award (deadline December 15) developed to promote and improve the teaching of psychodynamic principles to trainees in Psychiatry.
The time of Covid-19 is a time to seize on the chance of recognizing those who have continuously excelled and have really come to the fore since our last Annual Meeting. It is also a grand moment to single out those who have responded to the crisis by really stepping up their game and making a profound difference to the lives of those around them and the patients for whom they care.
Additional Joint AADPRT/ADMSEP Statement on Guidelines for Virtual Recruitment
September 14, 2020
50th Annual Meeting Moved to 2022, Replaced with Spring Conference
August 22, 2020
Read Member Letter
Department of Homeland Security Letter to AADPRT RE: IMGs
International Medical Graduates: Going extinct or rising like a phoenix?
By Vishal Madaan, MD, Chair, IMG Caucus
July 14, 2020
With the pandemic impact intensifying with increased morbidity and mortality, the need for physicians has never been felt more in the US. More recently, a Presidential proclamation was released on June 24th thereby suspending new applications for a number of foreign worker visas until the end of 2020. We asked Dr. Vishal Madaan, Chair of the IMG Caucus, to comment on these recent events and the potential impact on IMGs more broadly:
As the United States grapples with a grueling pandemic running concurrently with a soul-searching debate on racism, several International Medical Graduates (IMGs) have found themselves suffering collateral damage. IMGs constitute about 30% of the psychiatric workforce and 33% of our trainees. While continuing to heroically serve on the clinical frontlines during this unprecedented pandemic, they have been facing numerous unique challenges related to COVID and immigration. Slower visa processing times and lack of premium processing for 3 months have resulted in a lot of anguish. The financial downfall in many hospitals and medical institutions has resulted in several physicians being furloughed or laid off. Laid off trainees and physicians may only have 30-60 days to secure another position, which obviously entails undergoing interviews, negotiating contracts, and then going through the credentialing process; otherwise, they can’t maintain legal status. Similarly, salary cuts run the risk of requiring another formal department of labor approval, thereby, delaying the whole process. Furthermore, international travel restrictions can easily create an inability to take care of a sick family member back in their home country. For several others, administrative decisions are making it temporarily impossible for physicians to return back to the US from there countries of origin, even when they may have their homes and children here.
In addition, there are several upcoming challenges ahead. The number of IMG residency applications has steadily decreased over the past 5 years, which will have downstream effects on fellowship recruitment as well. It is unclear how the change in USMLE step 1 score reporting to pass/fail will affect IMG residency applicants---one of the concerns being that with this change, IMG applicants may lose another way to showcase their application. USMLE Step 2 CS has been postponed, and alternative pathways for IMGs are being explored since IMGs will not be eligible for residency without ECFMG certification. As virtual interviews become the norm this year, issues related to time zone differences, access to stable internet bandwidth and a secure location, and video-based interview etiquette, could become stand out issues for IMGs unlike prior years. Overt and covert pressures and implicit biases to not hire IMGs given some of the aforementioned issues will likely become more evident. And yet, IMGs, in general, are a resilient group and prior generations have faced mighty challenges in the past. Probably the most provocative question to ask ourselves as program directors is whether we can challenge ourselves and continue to recruit IMGs based solely on merit? Let us hope and strive to continue to do that!
AADPRT Endorses AAMC Statement on Police Brutality and Racism in America; We Must Take a Stand
Jun 03, 2020
It is hard to fathom where our country is today. For far too long, communities of color have endured unimaginable atrocities. The brutal murders of George Floyd, Ahmaud Arbery, and Breonna Taylor, all carried out with apparent immunity, provide a painful reminder of the limited value our society continues to place on Black lives. The stories have become all too familiar. They shed light on the world of racism and danger communities of color face every day.
As a community, we stand together with the Association of American Medical Colleges and support their call for action. As they outline in their statement released yesterday:
- We must acknowledge and speak out against all forms of racism, discrimination, and bias in our environments in our institutions, communities, and society.
- We must stand in solidarity with the Black community and speak out against unjust and inhumane incidents of violence.
- We must demonstrate empathy and compassion and acknowledge the pain and grief that the families and the communities of these victims are experiencing.
- We must take the lead in educating ourselves and others to address these issues head-on.
- We must be deliberate and partner with local communities, public health agencies, and municipal governments to dismantle structural racism and end police brutality.
- We must employ anti-racist and unconscious bias training and engage in interracial dialogues that will dispel the misrepresentations that dehumanize our Black community members and other marginalized groups.
- We must move from rhetoric to action to eliminate the inequities in our care, research, and education of tomorrow’s doctors.
In the year ahead, we are looking forward to identifying opportunities to translate these guiding principles into specific actions. As an organization, AADPRT has made significant progress. At the same time there is a lot of work to do. Addressing racism demands that we call out violence and condemn police brutality. It will also require examining the cultural drivers that reinforce racism and white privilege in our own communities. As educators overseeing the training of future psychiatrists, it is critical that we identify concrete ways to combat health disparities and provide culturally appropriate mental health care to all communities. As academic leaders in positions of influence, we have an obligation to raise awareness about systemic racism. We cannot stay silent.
Melissa Arbuckle, MD, PhD
IMG Caucus letters to congress supporting the Healthcare Workforce Resilience Act
On behalf of AADPRT, the International Medical Graduates (IMG) Caucus advocated via letter for the Healthcare Workforce Resilience Act (S3599/HR2678). Click below to read the letters.
Letter to House Representatives
Letter to Senators
AADPRT/ADMSEP Special Statement on 2020 Recruitment
May 18, 2020
The COVID-19 pandemic has caused unprecedented disruptions to medical education. In addition to postponed medical student clerkships, lost opportunities for away rotations and sub-internship experiences, and delayed USMLE assessments, our trainees and programs will face substantial new challenges over the 2020-21 residency and fellowship application season. Recent recommendations released by the Association of American Medical Colleges (AAMC) and the Coalition for Physician Accountability, in addition to shifts in the ERAS 2021 residency timeline and the NRMP match schedule, make it more important than ever for us to come together as a community to address the challenges ahead. Continue reading...
COVID-19 Message from President-elect Melissa Arbuckle
Mar 16, 2020
Dear Friends and Colleagues,
I hope that you are all doing well. I can't believe that we were in Dallas just a week ago -- I already miss "bumping elbows" with you! This past week in New York City has been a blur. There is no doubt now that we are facing a global emergency with COVID-19.
Christina Girgis's post on Thursday seeking guidance for how to best navigate the challenges ahead really resonated with me. Many people may be turning to you for recommendations and you may feel unsure yourself. However, you are likely in the best position to lead your team (and dare I say, own your awesome)! The larger system is unable to make decisions quickly or at the granular level you might need given the implications and numerous unpredictable downstream consequences they're considering.
While there is no clear roadmap for how to navigate the challenges we're facing, you are part of a community that's here to help you. AADPRT and the steering committee are monitoring the situation and have reached out to several committees to help collate and disseminate information to help you manage this unprecedented crisis. Based on the number of COVID-19 cases around the country, some of us may be 1-2 weeks ahead of you. I'm hopeful that sharing our own personal experiences may help some of you better prepare for what's to come.
My program has decided to host class, process group, and group meetings over Zoom (teleconferencing software, zoom.us). We have also rearranged resident rotation schedules and increased our capacity for telepsychiatry so as many residents (and staff) as possible can be working remotely from home. Our goal is to not only minimize exposure for everyone, but to create a back-up team that can provide essential clinical services should we experience extreme staffing shortages. We have also looked at breaking up our night float schedule and encouraged residents to trade call shifts in order to limit the emotional toll for those on the front lines.
I recognize that all of this may seem like overkill, and it may not be necessary right now depending on what is happening in your own community. You should follow the recommendations coming from your own institutions. However, if you aren't doing so already, I strongly recommend that you prepare for this level of change now. The situation is rapidly evolving and is likely to escalate faster than you think. Since programs are likely to be impacted differently across the country, we are looking at tapping into our regional caucuses to help coordinate a more local response and to help you share strategies that will be most relevant in addressing your most immediate needs.
Amidst the logistical planning, know that a listening ear may still be the best thing you have to offer to your residents, colleagues, and staff. Uncertainty is anxiety provoking for all of us. Disruption is not just about work, it's about our personal lives and our families. Constant communication with words of encouragement and support is critical right now. I really appreciated Ed Kantor's posting on the listserv about the importance of staying socially connected, noting that the CDC recommendations are really about "physical" distancing.
Most of all, take time for yourself. We are all in this together. Find time to take a break from the news and your email and social media. Do those things that keep you grounded. We are going to have to adjust to a new normal, which may be here for a significant time. While there will be ongoing acute emergencies to address as training directors, this is likely to be a prolonged challenge. Now is the perfect time to join the AADPRT mentorship program-either as a mentor or a mentee! We're here to support you.
Melissa Arbuckle, MD, PhD