You may notice in both the video and the transcript that certain names are redacted. We want to assure you that S.L.A.M values transparency above all else. The redactions were a demand from our administration to which we acquiesced.
Transcript of Video
DEAN HAMM MEETING TRANSCRIPT
0:00 – SLAM introductory statement
Anagha N: Great. Yeah. I do think there will be a few people that trickle in. This is a really diverse meeting of people. I’m really happy to see you all. Before we start, I’m just going to offer some brief thoughts. So thank you all for coming.
Before we start, or before we get too deep into what is sure to be a complex discussion, we just want to clarify S.L.A.M’s purpose in being here. We are here out of a genuine love and empathy for the Tulane community. We are here to hear perspective and to deepen our common understanding of what’s happening.
We are a small group of students from underrepresented backgrounds, but we represent an extremely diverse body of 300-plus students, and even more residents and faculty beyond that. So, in our commitment to the transparency that we want to model for the future of Tulane, we do have to tell you that many of the people that we represent are calling for accountability from the leaders in this room. We represent that position just as we represent a suite of other positions.
We are committed to hearing and publishing perspectives. We’ve heard from Dr. Dennar, we’ve heard from the residents at Tulane, and we’ve heard from our own student body. And we believe them. We believe their experiences and their stories. But we are here to listen now to your experiences, and we have no presupposition of what your truth is.
What we do hope to gain is just an account that fully answers our questions, and one that is honest. We’ve now heard several sets of stories from faculty and residents, and any account that simply and categorically denies all of those experiences, I’m sure we can all understand and agree, simply cannot be the whole truth, just as we acknowledge that their experiences can’t encompass faculty and admin perspective. Beyond this, we hope that admin can offer us a measure of accountability.
We have to imagine that all the stories that have come out over the past few days speak to a certain culture at Tulane that has allowed for these things to happen and to go unreported. So, in fact, there are people who wanted to be here today, who have wanted to write to you, who have just wanted better from this institution have not been able to speak up. They fear their careers being robbed from them, they fear a culture of retaliation, they fear punishment for speaking up about harm that was done to them. Culture at an institution as old as this one is top-down, and leadership has to take some accountability for that. We look forward to hearing how you plan to address the hierarchical and patriarchal nature of Tulane that creates this fear.
But with all of this being said, we really do want to hear what you have to say and would really love to hear your perspective. Thank you for taking the time to hear us out at the start of this meeting.
3:15 – Dean Hamm Introductions
Dean Hamm: Well, let me first start out by thanking you for giving us an opportunity to meet. It’s very important for us and we appreciate it. We do take your concerns extremely seriously, and we want to fully understand them, or as best we can, so we can move forward together as a community. Let me be certain that – I suspect that most people know most of the people are sort of from the University side. Let me just make certain that everybody knows that each of the ones that I asked to join me on the call.
First, Ms. Bennetta Horne, I can’t imagine anyone doesn’t know Ms. Horne. Maybe you can wave? This is the director of the Office of Multicultural Affairs.
The second one I think all of the students know is Dr. Elma LeDoux, the associate Dean for Student Affairs and Admission.
Dr. Paul Gladden, who has a whole variety of roles, but has two important ones relevant for today. First, he is the Program Director for the orthopedic residency program. Second, he is the assistant Dean for Graduate Medical Education. He has served, for the Med-Peds program, as the DIO (Designated Institutional Official) which is an office from the ACGME (the Accreditation Council for Graduate Medical Education). The official overseeing that is called a DIO. For the Med-Peds program, Dr. Gladden has served in that role for about two and a half years.
And then, Dr. Anneliese Singh, who is the Chief Diversity Officer for Tulane University.
Thank you to all of us for being here.
With that, I think you had posed questions. I don’t know what format you wanted to use, but that’s sort of what we came for. To address questions.
AN: Yeah, so we sent you a list of questions. We were hoping first and foremost that you could address the questions that we offered up in our original email.
6:36 – question one
DH: Okay. Let me pull those out. So, I’ve got “What were the details of the warning status applied to the Med-Peds program by the ACGME? Was any part of the warning status applied due to the ACGME’s inability to rule out racial discrimination in the program?”
So, let me take a few minutes with that. Let me first describe the Med-Peds program. For those of you that don’t know. And also the warning status and what led to that.
So, the med-peds program is a residency that sits between two departments. Most residency programs, like orthopedics, there’s a department and a residency program. This one sits between two departments, internal medicine and pediatrics. So it is a bit more complicated in some ways than most. The warning status that came in, I think, November of 2018 was based on two findings.
First, there was some concern about work hours and whether there was proper monitoring and some excesses of that. And the second was, due to the complexity of the program, some concern about the relationship between the program director of internal medicine, the DIO – who at the time of the initial site visit was Dr. Jeff Wiese, who was also serving as the internal medicine program director.
Site visitors had come in during June of 2018 in response to claims that there were both gender and racial issues, prompting problems. So there were three external, professional, peer site visitors that came in and did a thorough examination that found, basically, nothing. There quote was “there was nothing to substantiate those claims.” They did issue two citations that I mentioned about duty hours and complexity. Nothing about their findings and warning status related to racial discrimination. Do you want me to just go on to the next question?
10:18 – first follow-up question to Q1
AN: No, I was actually going to follow up, if that was okay?
AN: Was any part of the warning status applied because Dr. Dennar was unable to state in good confidence [sic] that she had full authority over issues in her program?
DH: There were, in some of her statements – she has said that she did not have full authority. Let me state that, in response to the citations and recognizing some of the issues that were identified, there were three things done. Let me state also that she does and did have full authority for her program.
There were three things that were done. First, Dr. Bhatnagar became the internal medicine Program Director. Second, beginning in the latter part of 2018. Or I guess, it was earlier than that. Fall of 2018. Dr. Gladden became the DIO for the program, supervising the program, so that if there were perceived conflicts with Dr. Wiese they were no longer relevant. And then the third thing that began was that a monthly or, in an actual fact there were more meetings, to collaboratively and constructively guide and help the program. Those meetings were with both Dr. Gladden and with the chairs of the two departments and with the other two program directors, Dr. Bhatnagar and Dr. Carlson.
12:45 – second follow-up question (Q1)
AN: Also, I would like to follow up briefly. The quotation we have is that “it was noted that the medicine-pediatrics residency program has more individuals of color than the IM program, and an association could not be excluded” – an association to race and gender-based discrimination. Is your account that that is untrue?
DH: [Pause] I’m not quite sure where the statement you just said…I know that the letter that came from them states that they did not find any evidence to substantiate that claim.
AN: That quote is initially from the body of the lawsuit filed by Dr. Dennar, as quoted from the report that she received. I can look up further – it seems that it came from the MPPDA, or the Medicine-Pediatrics Program Directors Association statement as well.
13:58 – third follow-up question (Q1)
I’d also like to ask you briefly if you clarify which program the work hour violations were initially reported in. Medicine? Pediatrics Or the Med-Peds program as a whole?
DH: The – and here I may not know completely – some work hour violations – and I may have Dr. Gladden speak to that in just a minute – but, an occasional work hour violation may happen in any program. Unless it’s a pattern, it may not be a. It may be happenstance of a particularly severe circumstance. I think that at the time there were work hour concerns in both Medicine and Medicine-Pediatrics.
Maybe Dr. Gladden may have more comments on that?
Dr. Paul Gladden: Sure I’d be happy to add some comments on that. You are correct, the concerns were mainly with Medicine and Medicine-Pediatrics. And when we started our meetings, and initially it was Dr. Dennar, Dr. Bhatnagar and myself. We immediately dove into that.
Believe me, it was a world wind [sic] of understanding systole and gemini and things I still don’t fully understand that are probably second nature to you guys. But we worked very hard to figure out where there could be potential problems. And it seems that the Medicine department really worked to improve upon those. I can’t thank Dr. Bhatnagar enough. It was not something I would have been able to figure out. It was a lot of good work to correct even the perception that there might be a problem. I think Dr. Dennar was very pleased about how we jumped in on that and fixed that.
15:59 – third follow-up question (Q1)
AN: So, just to clarify, when the complaints were originally made about the work hour violations, it was Dr. Wiese in charge of IM and as DIO, but when it was time for those complaints to be addressed it was Dr. Bhatnagar, you – Dr. Gladden, and Dr. Dennar who were responsible for instituting those corrections?
PG: I really, in all honesty, can’t speak to whether Dr. Wiese had done any of the corrections before. I can only speak to when I got involved. I don’t want to not give him any credit for not trying to fix that. I know we regularly talk about Med Hub and all those sorts of hours.
I can just tell you that the three of us – Dr. Dennar and myself and Dr. Bhatnagar sat at the UMC lounge, and sat in some Tulane areas, all around campuses to try and get those things resolved. From there, we made a good amount of progress. But I wouldn’t want to discredit what was done before I got involved. I’m sure there was some work done already.
16:54 – fourth follow-up question (Q1)
AN: And just to ask once again for this to be clarified. The quotation we have states that racial and gender discrimination could not be ruled out in the med-peds program because of the higher number of people of color and women in that program. We just want to clarify, 100%, is the position of administration that that is not true?
DH: I will state that is not true. Let me say that quoting from the case is something that I’m going to have difficulty doing, because of the restriction on commenting on pending cases. Which is a major comment on all of this.
17:47 – question 2
AN: This sort of discussion leads up into our next question. Which, we would like to know, what evidence the school of medicine has that Dr. Dennar and the residents of med-peds were given ample support to strengthen their program prior to her suspension.
So we are pretty clear on the fact that there was a warning status, that it was issued because of the work-hour violations. There seems to be now some discrepancy whether or not some part of the warning status was applied due to racial discrepancy because the accounts differ. We can’t – we at this stage are unable to say. But we would like to know after the warning status was placed, what resources were given to the program that strengthened its ability to control work hour violations and the other things that brought this situation to light.
DH: There are many things that can address work-hour issues. Whole complexity of things. Because I’m not on the inpatient schedule, presently, I’d be too far out on a limb to speculate on all the things. And to the extent that there are in any residency program, multiple issues that come up, the major thing that was done was to give this forum so that Dr. Dennar had ample opportunity to work with everyone that had a stake in this collaboratively and constructively. If resources were needed – if that was the issue – this was the forum to do it in. If adjustments, rather than resources, which often is the case – then that can be done. That was usually the case.
20:03 – first follow-up (Q2)
Jonathan A: So can you say, then, Dean Hamm that the previous protocols that were used to monitor programs under warning status were used in Dr. Dennar’s case. If yes, can you give us a recent example?
DH: This warning status precipitating a special review is a process that is relatively new. It was began in April of 2020. It is a new process that the GMEC instituted in response to the ACGME doing an institutional review. Both individual residency programs and the institution have reviews.
And one of the things done in response to the institution being reviewed was to standardize that aspect of things. So that if a program goes on a warning status, there’s an automatic special review of a certain format – again – to keep it standardized. That seemed to be the prudent and rational thing to do to standardize it. There are two other programs, I think it is, three other programs that have recently undergone. Two, because of warning status. One because of another circumstance. [These programs] have undergone special review that are in process.
It’s similar to the process that’s been used for some time to address programs that have had issues. Since 2016, there were, I think it’s three other programs that have had issues resulting in program director changes.
22:44 – second follow-up question (Q2)
JA: Okay, thank you. We do have from the letter that we’ve received that during the time when Dr. Wiese was PD, that his program was also put on warning status. Was that program at that time also put on special review?
DH: By the time that the special review that the institution had instituted that, that program had come off of warning status. But two other programs were on warning status.
23:27 – third follow-up question (Q2)
AN: So just to clarify, Dean Hamm, the position is that IM and Med Peds were both put on warning status in 2018. That IM alone was removed from warning status, and that that’s why in 2020 only Med-Peds was put on a special review process?
DH: It didn’t undergo this automatic review because it was not on warning status. It went back on warning status. There was an initial warning status in November of 2018. Then there was a second warning status in May of 2020.
24:01 – fourth follow-up question (Q2)
AN: Can you speak as to what that second warning status was?
DH: That second warning status had some concern about those initial two, and added a number of other citations.
24:46 – fifth follow-up question (Q2)
AN: We’ve been told in our conversations that the APDs for Medicine were approved in September of 2020 in response to the warning status issues that had been circulating since 2018. Can you speak to the truth of that? And also, can you speak to why when Dr. Dennar was temporarily suspended / dismissed, however you want to put it in this current time frame. Why, when her two immediate APDs were women of color, the institution chose Dr. Debord – who, I personally love and respect – but I’m just curious to hear.
DH: Well one of the associate program directors, with a point to FTE, hasn’t been out of residency long enough, I think Dr. Mai is the name, to qualify as program director. I think she’s only been out of residency – I don’t know if it’s 1 year or 1.5 years. The other program director has substantial enough duties that it was not thought that this was possible.
26:15 – sixth follow-up question (Q2)
AN: And, I’m so sorry for the follow-ups. Can you clarify – were they involved in a conversation about promotion to a full Program Directorship? Or to be an interim Program Director? At least the one who was too busy?
26:35 – seventh follow-up question (Q2)
AN: One last clarification on this point. Would you be willing to further expand on why it was that in April of 2020, the special review process was revamped from what it was since 2016?
DH: This is because the institutional oversight of the ACGME – thinking that aspect of the ACGME policies and procedures needed tightening and strengthening. So that was put in place to make it more standardized.
27:23 – eighth follow-up question to Q2
AN: Sorry – so the ACGME is the review board that puts programs on and off of warning status – or can Tulane take a program off of warning status on its own?
AN: Tulane cannot remove a program from warning status of its own volition.
DH: That’s right.
AN: And the May 2020 warning status was only for Med-Peds not for Medicine?
DH: Right. Right.
AN: Okay. Thank you.
27:52 – question three
JA: Okay. Let’s move on here. Could you provide evidence, Dean Hamm, that Dr. Dennar’s complaints of discriminatory treatment over the past 18 months, prior to her removal or suspension, were met with support and collaboration rather than threats or dismissal?
You have exclaimed that when a review board came to look at it, that they couldn’t declare that racism or discrimination was present. We do, respectfully, know that a lot of the systems in place are unable to detect that. That’s why we have asked for people of color to be put in places of power so they can come up with a better apparatus to measure those kinds of things.
Putting the review board aside, can you please comment on the kind of support, or lack thereof, that Dr. Dennar was given when she or her team of residents brought up complaints of discrimination or harassment?
DH: Let me say that the principal way of providing support and knowing what support was needed was through these collaborative meetings, monthly. So that was where she would have the opportunity to address any issues that arose, whether they were new issues or old issues.
And that was the principal mechanism of identifying and addressing issues. We were fortunate in the fact that Dr. Gladden was in this position. He was in this position before issues with Med-Peds began. But it was additionally reassuring that Dr. Gladden was in that position. I guess I’d love for him to comment further.
PG: Sure. A little more background on me, perhaps, might help. I was involved with the GME before I was asked to help out with the Med-Peds program. I’m also the orthopedic Program Director, which I’ve been – going on a decade now. And to comment on that, a couple years ago I thought about moving to some other things and Program Directors in general need to always consider that. So as I was looking forward to 10 years, I asked my APD about it. And initially he was very supportive, and then he decided not to do it. And that’s one of the reasons I’m still the orthopedic Program Director, because I want the job done well and I have nothing but love for all my residents.
As far as the GME, I was initially the hospital consultant from the outside for UMC. Subsequently I got more and more involved, as you guys know now. Interesting fact about my particular residency is that aside from just loving the guys – and by guys I mean guys and gals, I hope that doesn’t come across wrong, no offense there – we are pretty diverse ourselves.
We have now 4 Black males and 4 women. Couldn’t be prouder of all of them. And we’re only 15 residents. We try hard to basically be like our city, and to be what our University is trying to be. One Black male that I “lost”, I lost to an outstanding fellowship in Colorado. And I’m actively recruiting him back to be faculty.
We have a couple Hispanic males on our faculty. We have 1 woman. We lost a woman who retired. So, we’re pretty proactive on trying to emulate what our city, and more so, what our med school looks like. My big challenge is women. As many women are in medicine, orthopedics is one of the worst in obtaining women. So every year I rank women to match and every year they break my heart. But we’re gonna keep doing it. Because we think it’s that important.
I don’t know if I answered your question there, I just gave you a little background about myself in case you were wondering how I was involved.
32:30 – first follow-up to Q3
JA: I think – I don’t want to quote Dean Hamm and be mistaken – but I think he was passing the microphone to you to make comments about the complaints of discrimination and harassment that Dr. Dennar and her residents mentioned. I think he wanted you to perhaps comment since at the time you were in a form of leadership. Our question is what was done when those complaints were raised?
PG: Sure. Well, some of the obvious changes were me getting more involved. The complaints being raised were prior to my being involved. However, we obviously take all of that very seriously. So, one of the things we did was remove the interaction that may be seen as contentious. And then there were the meetings. And the meetings were extensive. Myself and Dr. Dennar, so there were actually three minorities trying to fix program problems. Race did not really come up in our meetings. And then we added in our chairs, Dr. El-Dahr for pediatrics and Dr. Bateman, who I know, there’s a new chair now, but Dr. Bateman was also instrumental, and Dr. Carlson, who’s the pediatric PD. We had some very productive meetings along with representation from the dean’s office for both information as well as for resource support. We were able to make quite a bit of progress. I have a hard time speaking to what happened before I truly got involved, but it was all very positive once we did get going. Maybe I’m not fully getting the question, but I also may not be able to answer it. I can only tell you from me onward.
34:08 – second follow-up (Q3)
AN: I would just like to clarify a point. It seems that one of the issues raised in the ACGME report was the conflict of interest held by Dr. Jeff Wiese as both DIO and IM program director. Can you explain your role as both program director and DIO at the same time, Dr. Gladden. Was that not also a conflict of interest?
PG: So program director for orthopedics and DIO? Was that the question?
AN: Yes, exactly.
PG: So, that’s one of the reasons that Jeff, Dr. Wiese, still looks over the orthopedics program. So there’s not that conflict. That’s one of the reasons I stepped in and Dr. Bhatnagar stepped in as PD. The difficulty of the situation is that you want people involved who know something about medicine. It would be really easy to choose someone who has no background in anything, but then that really doesn’t help our situation, so, I think I bring around a good bit of knowledge for a program director, but not necessarily on the med-peds side. So, that’s why it kind of went the way it went. Jeff is still involved with orthopedics, but not at all with med-peds, and I think that works. And i think our processes there work. Like I said, I don’t think anyone wants a complete stranger running any of this thing. It’s best that we have people who at least, we know, and can come talk to if we need to.
35:29 – third follow-up (Q3)
AN: Can someone please clarify all of the current positions that Dr. Wiese holds in our institution?
DH: I think he only holds one position that has sort of, two titles. One is the associate dean for graduate medical education and with that is the DIO. You know, those are the two title type things. He is also an associate professor of medicine. You know, as sort of the academic title. I think those are the only..
36:15 – fourth follow-up (Q3)
AN: in his role as DIO, which he has retained, how does he oversee complaints?
PG: I could maybe help with that a little bit. So, it’s not just him. And I think that’s very important. It is a committee. He may get the complaint, because a lot of times. The ACGME may contact him or myself first. But, it is not just him as the decider or the judicator, that’s why we have our GME committee to go through it. It’s 15 people. I wouldn’t want to give you names, but I can give you makeup, if that is of interest to anybody. But, it is a very diverse committee, that you know, tries to make good decisions.
36:57 – fifth follow-up (Q3)
JA: Can you please say a little more about the diversity. What does that mean, sir?
PG: Sure. So, it’s 15 people. I [unclear] smart enough to have printed out one of our emails or something, but I’ll do it kind of off the top of my head if I can here. So you know about the internal medicine PD, that’s [redacted]. You know about the pediatric PD, that’s [redacted, but was previously implicated in the Tulane PGY3 letter]. You may have come across the anesthesia representative, who is one of the hospital people, that’s [redacted]. [redacted], from radiology. A doctor from our surgical side, there’s two people, [redacted] from the ENT side. We recently took away [redacted]. He has a lot going on. We added a gentleman that I have not had the chance to meet, but he is a black gentleman who will be taking over for the nephrology side. For the hospital association side,[redacted] is from the VA, [redacted] who is also from the VA. [redacted], she’s from UMC. I know I’m missing people, but in my opinion…
DH: I think there’s some program administrators.
PG: Absolutely. I’m missing [unclear] [redacted]. I’m missing all of those. I apologize. They would be upset if they knew I had forgotten about them. They are invaluable. They are some of our program coordinators and I’m blocking on their names. Two women from that group. Some of our administrative assistant type people.[redacted], [unclear]. The guys are pretty much outnumbered in this particular situation and we are pretty pleased that we have that many women involved as well as some representation, i think, of substance, from minorities and recently grown. I think we are heading in the right direction on that committee.
38:59 – fourth question
JA: Just a follow up then, with respect to the reporting process, is, then, how are these issues raised by leaders who are concerned at Tulane? Though what channel were specifically Dr. Dennar’s reports processed? At what point, could she perhaps make a complaint about someone, and that person would be in the process of reviewing her complaint? Because one of the things we are mindful of through this thing, it seems like there is a linear channel through which you make reports and then you appear before a body, but we want to know the process clearly, so how does someone move from point A with their complaints and then relay their concerns? How does it get to that body? And at what point could it be potentially intercepted by an administrator who does not want it to be processed further?
DH: Let me take that complex question and make it a little bit generic.
Not just this one, but ordinarily, a program director, if they had a problem, there would be several ways that they could address it. They could address it in a linear way by going to their department chair. They could address it to the DIO, in this case, Dr. Gladden. They could go straight to somebody around that. If it was one based on gender, ethnicity and a number of other categories, they could report it to OIE. They could report it to ACGME, you know, that’s externally. There is also, going back, it began in about, I think it didn’t get instituted until about 2018. There is the professionalism portal, that any level of people can report to, from students to staff to faculty. One can report any number of things, and that goes to a trio of individuals to sort out how it is handled. If it is one related to Title IX or any related issues then it would go straight from that to OIE. And there may be another office involved that Annelise can talk about in just a minute, but let me talk more about the trio. There are other issues that the trio involves. The trio is three people. I don’t know how many of you could listen to the medical grand rounds last Wednesday. The trio is Diane Blake in Biochemistry, Dr. Keith Ferdinand in Cardiology and Dr. David Doukas in Family Medicine who is also the Ethics chair. Those three determine where it may get routed next depending on the level and importance of things. Annelise, do you want to comment on how complaints can be handled?
AS: Sure, Lee, if you’re talking about the Office of Institutional Equity, those are just the bias incidents, reported directly to our Office of Institutional Equity. That becomes a formal investigation. There are investigators assigned. That generally is a pretty legal process that begins at that point. Is that what you wanted me to explain, Lee?
DH: Yes, yes.
AS: Okay, great.
43:52 – first follow-up (Q4)
AN: Dr. Singh, would you mind, following up a little bit with us on how those investigators are selected?
AS: As you may all know I’m in my seventh month as Chief Diversity Office at Tulane, and so I don’t know if I may have all of the questions, all the answers there. But, I can tell you that once it comes in, their office has several staff and they will route it depending on the type case, sexual harassment, racil discrimination, but other things may play into that as well. There is a central recording line in the Office of Institutional Equity, and then they divy up the cases themselves. That is not a process that I am even involved in or anyone else, and then they would contact appropriate people – first is the person who filed the complaint and then there is an investigation that proceeds.
44:49 – second follow-up (Q4)
AN: I think there is some concern over how the selection process is handled, how the investigative body is held accountable, and I think Jonathan spoke beautifully about this earlier, how a lot of times, racism is entirely missed in these kinds of investigations, so are the people assigned to look into these kinds of things, well versed and apt in looking for them. How do we truly ensure neutrality if we don’t have transparency?
AS: Yeah, it makes sense why you would all have that question. Even for me, on the outside, you know, it does start a process, really, it’s those legal definitions of racism, sexism, like bias based on gender, bias based on age, those categories that Dean Hamm was talking about. So, I have full trust in that group, I will say. Again, I’ve only been here seven months, but they are some of my go-to people. I refer people to them all the time. I do think one thing that can be frustrating to our community is, for instance, If I submit a complaint, Anagha is not going to know about it. There’s a lot of really important privacy that goes into that process. I think it can be frustrating when we know that things are going on campus and does it meet a legal definition of racism? Well, that’s kind of a high bar in the United States of America. Then there’s climate, culture and all of that stuff. So, Anagha, I understand that there can be distrust there, but I think in general, bias incident reporting is something that we are looking at at Tulane, looking to strengthen, but I do have full confidence in our investigators, I will say that.
46:41 – third follow-up (Q4)
AN: I would just like to say, that I think we all agree that as a community we are looking to clear the low bar of legality and attain the highest possible ethical standard, and for that, complete and total transparency into how our current process are handled, so that we can understand whether or not there are things in that that need to be changed.
AS: You’re exactly right. Sorry to interrupt Anagha. You’re exactly right. That’s one of the reasons my office was created, and I think Benneta’s office was created. But, you know, we can’t rely on only a legal definition of these things to improve our culture and our climate. That will never happen. And, so, that’s why there’s so many other efforts with equity, diversity, inclusion, and anti racism on campus. We’re just building on that work generationally right now, but you’re exactly right that to get to culture and climate, we need to do a lot more.
47:36 – fourth follow-up (Q4)
AN: Can you speak to how some of those initiatives are being created, under whose input and how they will be moved to the medical school?
AS: Sure, happy to help, and I’ll properly defer to Ms. Horne for part of this. At the university level, what we have been preparing for is an EDI inventory. EDI stands for equity, diversity and inclusion. And that inventory, that happens in March, we’ve been building towards it, it helps us figure out where the gaps are on campus. You can tell that this isn’t about the law, but about what climate and culture we’re building and then our strategic planning process starts in march as well, and i think that you already know that there was a climate survey planned but that was also announced earlier in response to some of these concerns. But those pieces of collecting data are really important to see what’s happening and where it’s happening, and those processes include everyone on campus. Those are things that I’ve been working on for the last six months. Of course there are other professional development pieces that are really important; we have to have a foundation of EDI and anti racism at Tulane, and i will say that over the last six months my work with Ms. Horne has been some of the strongest on campus, y’all aren’t surprised. The school of medicine is one of the few schools that has a designated office. We’ve got the school of law, and we’ve added a new person to the school of architecture, which is really just a baby school, but the school of med has staffing. Can I pitch it over to Ms. Horne?
BH: Sure, Annelise. Hi guys. Just to follow up on what Annelise has said, in terms of the Office of Multicultural Affairs and the initiatives and programming, some of you may be aware, many of you may not be aware, the resources, the focus and attention have been going to expanding the office, literally as we speak in terms of personnel and physical space expansion of the office. We are looking towards creative safe spaces, enhancing our programming, being able to do more, in conjunction with and under the direction of the Chief Diversity Officer so that we can expand what we do, and that is in terms of programming, personnel and space, so lots of things ongoing there.
50:21 – question five
AN: I think something that keeps coming up is just this idea that all of our current reporting systems or systems for change, the things that we ask to modify the culture at Tulane, so that it can be more equitable and diverse, they all end up on the desks of the deans or people at the highest level of decision making and many times the people we want to hold accountable are those same people. How do we trust in a process where, you know, those that we ask for change are also responsible for delegating the change that comes back down to us?
AS: is that question for me or Dean Hamm, or both?
AN: I would love to hear everyone from the administration’s perspective on this. This is a growing conversation to build trust in our community.
PG: One thing I should have mentioned, and I don’t know how I could have forgotten them, because you guys are why we are here. Two people on the GME Committee are residents, both minorities, one woman and one male, and I know that while working with leadership since the time i’ve been here, there has been more and a growing push, for lack of a better way to put it, for the stakeholders, I mean we are all here at a university because we all believe in education, and you guys are why we have a job, and you guys are why we do education. Of course we like taking care of our patients, but you can go do that in a private realm, so we want to get it right for you guys. I think part of what I’ve been seeing, and I know Bennetta would agree, is that you guys are more and more involved in big time decisions and big time time committees, and I think that’s favorable. I think there is still some more work to be done. If you look at my own group, there are residents of course involved in our PEC, and you guys all know what that is, it used to be called the REC, now it’s the Program Evaluation Committee. One resident from each class and among that group are 2 minorities, a woman and 2 white males, and that group drives our department. You know, I know what they need to be a good orthopedist, but I don’t know what they need necessarily to have a good department. I don’t know how to say it other than to say, they are the end user. They are the ones to know whether it’s working. So, we definitely include residents in all of our decision making, and I think that’s actually something that’s growing here and they’re doing a real good job of including people who matter so that they get to both know what is going. We don’t say hey this is the part of the meeting where you have to step out. You’re in the committee, you’re there and you hear everything and you react to everything. So I’m glad they’re there because sometimes I’m getting to be old. We can lose sight of what younger people with bright minds both need and offer so that’s one of the things the university is doing pretty well and continuing to grow in, and that is having residents, and I know you guys are all leaders such as yourselves, involved in these decisions. That’s just one take. I’m ashamed that I didn’t mention our two resident representatives on the GME because I can picture both their faces. I talk to them regularly. They’re just great people.
53:43 – question six
AN: Something that has come up, and I can speak to this a little, is that even with residents and students like us on these committees, the way our systems are structured still leaves the power very much in the hands of administration, of attendings, and of those higher institutional bodies. And there is very little in the way of protection of our careers and our livelihoods from a sense of retaliation which is why there are many more people who wish they could’ve been here today who have elected not to be, and I would love to hear what your thoughts are on that culture.
AS: I can lean in here and it looks like Dean Hamm wanted to share something. I mean one of the things that was done prior to my arrival is that we looked at our bias incident reporting and had a consultant come in. It seems like that person came in pre-Covid and so some of the, and again this is the very you know you report it, there’s an investigation, that’s not fun to go through that process right? But when the consultants were looking at that, there were some recommendations on looking at things like restorative justice, and I don’t know about you but I haven’t seen a lot of that in schools of meds and mostly happens in K-12. You may notice in both the video and the transcript that certain names are redacted. We want to assure you that S.L.A.M values transparency above all else. The redactions were a demand from our administration to which we acquiesced. And I know I spoke with you and Ally just about how be student activists make sure their efforts last, and I think we have some important conversations to have about student leadership and addressing issues that you all brought up earlier about fear of reprisal not just for students but also faculty and staff. Dean Hamm, did you want to jump in there?
LH: I wanted to mention that in medical education whether at student level or at the resident level, one of the things that has appropriately, one of those never things that should occur is retaliation or fear of retaliation. So if Dr. Gladden told a resident, one of his residents, that unless you take extra call I’m just not going to recommend you for that fellowship after your residency. Now, you have to have such things validated but that’s sort of, that is so whatever that it’s standard in the medical education operations- at the student level, at the resident level; it’s also true at the faculty level in terms of you know based on your opinions, based on your reporting. (Pause) So, that’s one thing I wanted to make. I also wanted to comment on this about trust. Bennetta and I have talked a lot about trust recently, and I think you build trust by having more conversations. And you have them in both good times and bad times, and I talked to one of the psychiatry colleagues last night, and you know, we somehow and I know we’re a long ways from it, but we have to develop, redevelop more trust. So it is extremely important. The other thing though that I want to comment on is process, and Dr. Gladden spoke to it. And these processes like the special review process and having the GMEC thoroughly evaluate something and then vote on it. When 15 people unanimously vote on a thorough recommendation, the 15 people include a lot of diversity, it includes residents, people from other institutions not just from Tulane. That process, you know, is something that I would hope would give some element of to say ‘huh’ you know maybe the process is based on something. So, anyways those were comments based on the things that you said.
AN: I would love to follow up on that. Yes, Ms. Horne Sorry.
BH: Just wanted to add something to the conversation. There are processes and things in place to also help deal with and or combat things you said about how sometimes it’s hard when the persons that you want to bring attention to are in charge of the process for making decisions. And I know something that happened with my office is that we have an internal advisory committee that meets to, used to be monthly, used to be every other month, and had gotten to be every month, to advise my office in terms of issues like that; and something else that we’re instituting is and external advisory committee so that items and things such as this can be brought to a, I can’t think of the word, a-non biased group of people who are not as immersed in the day to day who can make recommendations. So processes like that. And on those advisory committees there are representatives at all levels. So just wanted to add that in. Didn’t mean to interrupt you.
1:01:21 – first follow-up (Q6)
AN: No, thank you for that. I would like to address Dean Hamm, the point that you made. We would like to follow up on this. We’d like to know how you define diversity when you state that the 15 people in that group are diverse—what that looks like, were there any of Dr. Dennar’s peers, black women on the committee? Can you speak to the fact that even if that specific process of review was legitimate, it doesn’t address the years of reporting concerns both from Dr. Dennar and her residents that were prior to that. We’re a little concerned that we’re focusing a lot on the specific details of this case, and we as a committee are more interested in the overarching culture that allowed it to get to this point.
LH: I think one, let me say I don’t pick the GMEC, and I would not have gotten as far as Dr. Gladden did in naming the people on it. I think there was one black woman on it. Let me hasten to add that I also have a good deal of, many of our colleagues, I hope, develop trust not just based on how they identify but also other things. The people on this call that I work pretty closely with, Dr. LeDoux, Ms. Horne, and I’ve worked closely now with Dr. Gladden for months. I trust them with any decision. It doesn’t need to be a decision aligned with their various identities. I trust their maturity and their perspective. Now everyone brings perspectives and that’s one of the things, I must admit, this conversation is being very helpful to me. It is actually going to take me awhile to process it even more. Anyways, I don’t even know what to say. I’m almost to the point of not being able to say. Let me hasten to add, and I’ll be fine to schedule more time but in 7 minutes, I’m supposed to be on another zoom with a prominent alumnus of color to give me advice. So I’m hoping to make that call. I don’t know the others, from the administration, which is a word I hate but anyways (laughs), what their time frame is but unless we can’t somehow can’t talk again, which I’m glad to schedule another one, but anyways. I’m learning a lot and obviously have a lot to learn.
PG: Dean Hamm, if I can add a little more about the GME. I know now we’re perhaps a little time constrained. The GME is made up of the core specialties, and as arrogant as orthopedics is, we’re not a core speciality. The core specialties are internal medicine, pediatrics, surgery, OBGYN. And there’s another person I forgot, Chi Dola, if you remember the New Orleans Doctors Magazine, she was the cover. They never go to me (laughs). As an Asian woman, and she’s also phenomenal. So I think our diversity is pretty strong on that committee because you go to the main, take medicine. You go to the main group and then you have to find someone within that group and if you look at that, those people are often women and a good amount of times, minorities. And I think that group is fairly diverse if you really take a close look at it.
EL: I’d also, I know that time is short but I’d just like to thank you all for being willing to have a dialogue with us. I did want to mention one thing that Annelise brought up about restorative justice. The professionalism reporting that has been put in place, I have to say just from my position as Student Affairs Dean, has made some restorative justice for some students in the 3rd year, and I obviously can’t go into details but there are some patterns of behavior in some attendings that have been identified and they’ve been held accountable for them. So that’s important, identifying those people who haven’t learned how to act professionally or act compassionately. But beyond that I think it’s important that once those who are identified, we have to be in a position, we have to continue to have dialogues that will change hearts and minds of those people so that they won’t just hide their behaviors in some other way but truly have a change of heart about how they interact with others that don’t look like them. And I’d love to have another meeting with you.
AS: And Dr. LeDoux, thank you for that. I’d go even further, that word ethics, professionalism, there are certain basic competencies that we need to see people demonstrating. We just know that we have a leaky, bumpy pipeline into any university in terms of solid foundation of EDI and anti-racism. I don’t know how much y’all were asked about that coming on board as students (laughs). And so we just have to, that is our next step in building that for all faculties, staff, and students. I mean it is the only way we can, we can have excellence in our community. So I would just go even further in supporting what you’re saying Dr. LeDoux.
1:09:06 – final comments
AN: In respect for the time of everyone who took the time out of their day to come be here with us, I think I’d like to call the meeting at that stage. I will say I don’t think that everything we came here to have answered has been answered. And I’m sure that you all agree and feel the same way. Thus far, the institutional response has simply been to deny that racism has been present or to reaffirm that Dr. Dennar’s termination was a justifiable one, and we would like to expand the conversation beyond that and to continue to grow our perspective to look at how institutional culture needs to change. And we’re looking forward to seeing the ways we can do that. So thank you all so much for your time.
PG: Thank you guys for putting this together.
LH: Thank you very much for having this meeting today.
BH: Thank you.
AS: Thank you very much.