Not Just Checking a Box

How UC San Diego Health Sciences is working to enhance faculty diversity for the betterment of science, education and patient care

When she was first transitioning from postdoctoral trainee to assistant professor in the UC San Diego School of Medicine, María Marquine, originally from Uruguay, found the many types of faculty—tenure-track, adjunct, in-residence, clinical and so on—confusing. So too were the “rules” for promotion from one level to the next within each series.

“For most young scientists, joining the faculty at a university medical school is daunting—you’ve been trained your whole adult life to be a scientist or treat patients and suddenly you’re faced with a whole set of new questions like: How do I set up a lab? Get grants? Stick to a budget? Hire and manage people?” said Dr. Vivian Reznik, professor in the Department of Pediatrics and Department of Family Medicine and Public Health, and faculty director of the Office of Health Sciences Faculty Affairs.

“And those challenges can be especially difficult if you don’t come in with the background, experiences, network, role models and mentors to set you up for success—as is the case for many junior faculty from communities that are underrepresented in the biomedical workforce.”

In addition to her own role as a physician-scientist and educator, Reznik leads a number of programs through the Office of Health Sciences Faculty Affairs, part of the office of the Vice Chancellor of Health Sciences, aimed at leveling the playing field for underrepresented minorities like Marquine, as they join the faculty ranks and begin to navigate the UC San Diego system.

For example, Reznik and colleague JoAnn Trejo, professor in the Department of Pharmacology and assistant vice chancellor of the Office of Health Sciences Faculty Affairs, lead the Hispanic Center of Excellence (HCOE) Faculty Development Program to enhance the academic skills and success of underrepresented faculty. The program also provides funding for HCOE Faculty Scholars to attend local and national professional development activities.

The HCOE program builds on UC San Diego’s long-running National Center of Leadership in Academic Medicine (NCLAM), one of four in the nation designated by the U.S. Department of Health and Human Services. Through NCLAM, Reznik and Trejo offer 16 workshops over six months. In each workshop, senior faculty and staff cover a range of topics, from UC San Diego’s expectations for academic promotion, to skill development in teaching and research, professional development and leadership training. During the second half of the program, junior faculty participants choose a professional development project and are matched with a senior faculty mentor who helps facilitate their progress.

In the HCOE program, Faculty Scholars like Marquine also participate in the Health Sciences Faculty Mentor Training Program to enhance their skills as both mentors and mentees. They use these skills to work with a senior faculty mentor and mentees of their own, including underrepresented minority students, fellows, residents and postdoctoral trainees.

In addition, Marquine said funding provided by the HCOE program was instrumental in helping her maintain a full-time position as an assistant professor in the Department of Psychiatry—it filled a salary gap as she moved from a career development award to her first independent investigator grant from the National Institutes of Health.

Originally from Colombia, Dr. Paula Aristizabal, assistant professor in the Department of Pediatrics at UC San Diego School of Medicine and hematologist-oncologist at Rady Children's Hospital-San Diego, went through the NCLAM program in 2017 and was among the first cohort to participate in HCOE in 2018.

“Besides helping me to navigate the UC San Diego system, the HCOE program gave me a support network and sense of community,” she said. “A network like this is so important for helping to lift underrepresented minorities. Most of us didn’t know each other before, and now we have a venue for discussion.”

Aristizabal credits this network with providing her with the support she needed to apply for and receive her own grant funding from the National Cancer Institute. She and others have now started a HCOE group at Rady Children’s Hospital to continue sharing their challenges and building one another up.

Quantified success

Reznik and Trejo often hear similar positive feedback on NCLAM and HCOE, but are these interventions really moving the needle when it comes to diversity among Health Sciences faculty?

To find out, they compared the makeup of UC San Diego Health Sciences faculty between 2005 and 2015. They found that in that time, underrepresented minority facultyhad increased from less than 1 percent to7 percent oftenure/tenure-track faculty and from 5 to 8 percent of all faculty—double the national average for research institution faculty. The proportion of women increased from 16 to 23 percent of tenure/tenure-track faculty and 31 to 40 percent of all faculty.

Meanwhile, reports of inappropriate behavior by faculty decreased significantly, while satisfaction and knowledge about available mentoring and resources improved.

The team published these findings February 2019 in the Journal of the National Medical Association.

While it’s difficult to attribute the improvement in faculty diversity to any one particular intervention, Reznik and Trejo credited a multifaceted approach that included faculty development opportunities such as NCLAM and HCOE; improvements in family-friendly policies; periodic climate, behavior and salary equity surveys; and better dissemination of information.

Passion project

Reznik and Trejo have full-time research and teaching jobs in their own departments. But they feel it’s their duty to carve out extra time to enhance diversity, equity and inclusion in Health Sciences.

“I believe that part of my role as a faculty member is to try to make the institution better,” Trejo said. “I want to do more than just bring in grant money. So, for us, this isn’t a job; it’s a passion.”

Both Trejo and Reznik believe that a diverse faculty makes for a better working and learning environment— one that is more congenial and more inclusive.

“And from a business standpoint, plenty of studies have shown that people with diverse backgrounds and life experiences bring incredible value to discussions, provide new insights and feed innovation and excellence,” Trejo said. “Diversity is an asset we must embrace in order to improve science, health care, education and economics.”

HCOE program graduates Marquine and Aristizabal have seen first-hand the value their backgrounds and culture bring to their work.

Marquine is trying to unravel the biological, environmental and societal factors that might lead to increased risk of neurocognitive problems among older Latinos with and without HIV. Aristizabal is interested in learning why Hispanic children have worse cancer outcomes and lower survival rates than Caucasian children. She is working with parents of Hispanic children to reduce their barriers to quality health care, by assessing their health literacy, access to clinical trials and communications with health care providers.

“Being Hispanic helps me see how and why other Hispanics are struggling to navigate the U.S. health system,” Aristizabal said. “I can also communicate directly with many of my families in their native language, and I can be more aware of their cultures and how it might play a role in their health care.”

Sustaining progress

Reznik and Trejo are proud that the number of underrepresented minority faculty in Health Sciences has nearly doubled, thanks to increased recruitment and retention. And once on the faculty, they find, a high percentage stay at UC San Diego and in academic medicine.

“But that’s still only 8 percent,” Trejo said. “Truly changing the culture and climate of academic medicine will of course require more — more focused attention and measurement over time.”

Reznik and Trejo are already looking ahead to their newest program, the UC San Diego Future Faculty of Cardiovascular Sciences (FOCUS) Summer Institute, part of a consortium of nine other such institutes sponsored by the National Heart, Lung, and Blood Institute. This all-expenses-paid, two-week program will focus on mentorship, grant-writing and research development to improve the long-term success of early career, underrepresented minority faculty.

Marquine would like to see increased focus on funding and retention of underrepresented minority faculty, students and trainees. “Community is an invaluable resource,” she said. “But funding is crucial. For many underrepresented minorities, it’s not an option to go even a short time without a salary. We don’t always have a cushion to fall back on like others might.”

Aristizabal hopes more underrepresented minority students will get the opportunity to be mentored by minority faculty members. “When I meet with underrepresented minority medical students, I often hear them say they feel discouraged not to have role models who look like them,” she said. “I know from personal experience that role models who share your background help you know that it is possible to succeed.”

Commitment to diversity isn’t limited to Health Sciences — it’s a campus-wide priority under the leadership of Becky Petitt, vice chancellor for Equity, Diversity, and Inclusion at UC San Diego.

“A true hallmark of sustainable campus transformation is when everyone acknowledges that they have a role to play in achieving inclusive excellence,” she said. “Our colleagues in Health Sciences have had a longstanding commitment to developing new strategies to improve our culture and accountability systems in pursuit of our shared diversity goals. I am grateful for their leadership. We value and celebrate UC San Diego’s cultural diversity because it enriches our lives and the university as a whole.”

Not Just Checking a Box