The University of Maryland School of Medicine announced a sweeping initiative Friday that aims to change the culture in the institution, which took a public bruising recently from allegations that officials there failed to create an equitable environment for women.
The school is promoting several women to executive leadership positions, creating a committee to make more recommendations and assess progress, and launching an email box for anyone to raise concerns or ask questions under the initiative called “Program in Cultural Transformation.”
“Addressing these issues starts with assembling a diverse leadership team which can help guide us through this process of making real substantive cultural changes,” said Dr. E. Albert Reece, dean of the medical school and executive vice president for medical affairs at the University of Maryland, Baltimore, in a statement ahead of an announcement to faculty, students and staff.
The initiative drew a mixed reaction from advocates and women, who outlined complaints against the school in articles in the The Baltimore Sun earlier this month.
An anonymous group of women that included faculty and medical residents said they had warned top university officials in January that prominent surgeons had inappropriate sexual relationships with subordinates and created a “hostile work environment” in the medical school and its affiliated hospital, the University of Maryland Medical Center.
There was a culture, the women wrote in a letter to Reece and University of Maryland, Baltimore President Jay A. Perman, where it appeared women could get ahead if they slept with certain surgeons. They signed it #TimesUp, #MeToo, reflecting a national movement to empower women to speak up about sexual harassment and other treatment.
“We don't understand why you continue to promote men who abuse their power, fuel a culture of inequality, and further extend a work environment of hostility,” said the letter, obtained by The Sun.
The letter came eight months before Carly Goldstein, a 31-year-old former research coordinator, filed suit against the university alleging she was sexually harassed by a vascular surgeon and professor, Dr. Robert Crawford. The suit claims university officials ignored her pleas for help stopping the harassment she says went on from 2014 to 2017.
The Sun found that at least three other women had complained about the doctor’s behavior. They said inappropriate comments were accepted as part of the male-dominated vascular surgery department.
Goldstein said her first reaction to the transformation plan was that the initiatives were good and putting women in positions of power was important.
But she wonders what ultimately will change since the same people remain in positions of power. Those in charge already had dismissed complaints from women. Also, she said no men who were accused of harassment or who tolerated the culture appear to have been punished.
“It’s hard to be hopeful after what I went through,” she said. “My personal experience taught me one thing and that is: Nothing can substitute for accountability. Just fire one of these guys and that will send the message.”
Another woman who witnessed others being sexually harassed, Dr. Alexis Smith, agreed that not much will change if no one suffers consequences. Smith was a surgical resident at Maryland and is now a pediatric surgeon at an Atlanta hospital.
She said promoting women, who should have been promoted based on merit, and promising to address the problem in the future isn’t enough. Even firing one person wouldn’t be enough.
“Their actions say this is an institution that protects the people who protect sexual predators,” Smith said. “This is disappointing to see. They trained me to be a surgeon and it’s a phenomenal place to train, but I can’t see how many women would want to go work there.”
Others said the problem is larger than Maryland. Dr. Alison J. Whelan, chief medical education officer at the Association of American Medical Colleges, said officials there might be setting an example about combating sexual harassment and misconduct. She called Maryland’s plan “a positive step” that could encourage action among other academic medicine leaders.
“The AAMC encourages all of our member medical schools and teaching hospitals to evaluate their own institutions as they work to promote a culture of inclusiveness and respect,” she said.
Toni Van Pelt, president of the National Organization for Women, a supporter of the #MeToo movement, also called Maryland’s efforts “commendable and necessary to support survivors at a local level.” But she also said such measures only work if violators are held accountable and often women don’t even complain.
She cited data from the National Sexual Violence Resource Center that found 63 percent of all sexual assaults are not reported to the police and more than 90 percent of campus sexual assaults are not reported.
“With more survivors coming forward in the #MeToo era, these conversations are making a difference,” she said. “But in order to have lasting change at all levels there needs to be a greater push overall to end the culture of protecting those in power.”
University officials said they have taken allegations of misconduct seriously and have taken steps to address the broader culture issue through sexual harassment prevention training, for example. They haven’t said if anyone has suffered specific consequences for their behavior.
Officials recognize they must do more, said Dr. Nancy Lowitt, who will head Maryland’s new Program in Cultural Transformation as associate dean for faculty affairs and cultural transformation. She said the latest efforts are a direct result of both rumblings officials had begun hearing about and the specific allegations.
Lowitt, who had been the school’s associate dean for faculty affairs and chief conflict of interest officer, already had been working on initiatives aimed at helping develop women as leaders through workshops and an informal working group to discuss mentoring and work-life balance.
A challenge in dealing with unprofessional behavior has been the lack of a clear and consistent policy, she said. And she acknowledged allowing harassment or bullying with impunity “cultivates a toxic work culture.”
The priority now will be creating such a policy that applies across the medical campus on the West Side of downtown. Doctors at the University of Maryland Medical Center typically also hold titles in the medical school, where the initiative is being rolled out, and the new standards will apply to everyone no matter where a complaint is made. There will be consequences when violations are found.
Lowitt said the policy should be ready in January. And though she understands if some women may remain wary of reporting unprofessional behavior, she wants to send a message.
“We know that women and men have felt harassed and bullied and disrespected in our workplace culture,” she said. “Our leadership understands the depth and pain of this more clearly now than ever before. The experiences that our students and faculty have shared are profoundly disappointing, and also profoundly motivating.”
University officials said some of the problems stem from a lack of diversity among leadership. Women generally have been under-represented at Maryland, and in the top ranks of medicine across the country. Roughly four out of five surgeons are male, and on the academic side, women constitute 26 percent of assistant professors of surgery, 13 percent of associate professors and 8 percent of professors, according to the Association of Women Surgeons.
Before the initiative was announced at Maryland, there was just one woman among the 25 department chairs in the medical school and women represented only 19 percent of its medical school leadership, including chairs, directors and deans. This is despite growing numbers of women entering and working in medicine. About 40 percent of full-time faculty and 60 percent of medical students in the medical school are women.
The new leadership appointments will change the numbers, including in the top tiers. Women have been named to positions of chief operating officer for the school of medicine, senior associate dean for medical student education and associate dean for medical student admissions.
In total, the changes will mean women make up 43 percent of the dean’s executive cabinet and 23 percent of the school’s senior leadership, including department chairs, the executive cabinet and directors of programs, centers and institutes.
“They will also provide strong academic and scientific leadership of the various programs and academic units within the” school of medicine, Reese said.
Reece said the goal is a respectful, inclusive and professional work environment. Another is to be a model for academic medicine, which the university says has been identified in a recent national Academies of Science, Engineering and Medicine report as having a high risk for discrimination, inequity and harassment.
Lowitt said these changes will be important to the university’s future.
“We know that our ability to provide high quality patient care, ensure patient safety, develop new devices and therapies, test new ideas, and teach our students and colleagues, depends on an environment and a culture defined by professionalism, respect and collaboration,” she said, “and where all have the opportunity to contribute and to succeed.”