By Alec Rosenberg
Growing up in Sacramento, Renee Navarro never saw a black physician and medical role models were scarce. When she became the first doctor in her family, she didn't know what path to follow until a mentor suggested academia.
"He was very supportive," said Navarro, who studied pharmacy at the University of the Pacific and medicine at UC San Francisco. "I had never even thought of it."
Today, Navarro is a role model, the only African-American professor in UCSF's anesthesia department. She sees hopeful signs around her that times are changing — UCSF has women in key leadership positions, from the chancellor to three of its five deans. And as director of UCSF's academic diversity program, she works to nurture and enhance diversity among faculty, students, residents and postdoctoral scholars.
One key way to nurture diversity, Navarro said, is the UC Diversity Pipeline Initiative, where UC reaches out to some of its brightest female students to encourage them to pursue careers as faculty in the health sciences. The systemwide initiative, which had its fourth annual conference in April for 63 postgraduate students, highlights UC's efforts to increase diversity in the health professions.
"I'm so supportive of this conference because many of the participants, while they are in professional schools, have never really thought about the possibility of becoming faculty members," Navarro said. "Many of the women of color can't see the pathway."
At UC health professional schools, just 24 percent of faculty are women while only 5 percent of faculty are underrepresented minorities. The picture is similar nationwide and has changed little in two decades. But the population of UC medical school students is becoming increasingly diverse with gains in underrepresented minorities. Those gains are in part due to UC's PRIME program aimed at training students to care for underserved communities. Increasing faculty diversity, a priority for UC leadership, is viewed as a way to attract students, advance research in areas such as health disparities and improve access to care among medically underserved populations.
|UC Diversity Pipeline Initiative program committee members (from left): Maureen Conway, Mijiza Sanchez, Dena Bullard, Amy Levine and Linda Kane.
Video courtesy of UCSF Center for Gender Equity
Experts say it takes multifaceted efforts and strong leadership to boost diversity. The pipeline initiative is an effective step, according to conference evaluations. Before the conference, 20 percent of participants said they were very interested in academic careers; afterward, that share grew to 46 percent. In survey responses and follow-up comments, students called the conference inspiring.
"The conference exposed me to the importance of mentorship, strength in diversity and the basic tenets of the academic environment," wrote UCLA nursing school student Benissa Salem. "One day, my goal is to be able to mentor students, provide learning opportunities and help them to reach their goals."
"I have a new-found confidence, a new awareness of the many opportunities that lie ahead of me," wrote UC Berkeley optometry student Georgina Blanc. "I know that I can do research and see patients and have a family ... I want to help make an impact on the next generation of students so that perhaps, someday, the little utopia I experienced at the conference could become an everyday reality."
The deans of UC's health professional schools at Berkeley, Davis, Irvine, Los Angeles, San Diego and San Francisco each selected up to five participants for the three-day conference, which covered mentoring, negotiating, networking, communicating, balancing career-life issues and pathways to academia. In his remarks at the opening dinner, UC President Mark Yudof encouraged students to pursue faculty careers and fielded questions at the conference, whose sponsors included the UCSF Center for Gender Equity, Student Activity Center and UC Office of the President.
"By staying to help train the next generation of underrepresented women, you can have an enormous impact, not only on their lives, but also on the communities that they serve," Yudof said. "The fact is, the University of California needs you. We need you as trailblazers."
The UCSF Center for Gender Equity organizes a biennial UC women's leadership symposium for staff. Center director Amy Levine came up with the idea for the pipeline conference as a similar form of professional development for students.
"Women of color students don't see a lot of role models in academia," Levine said. "The message we're promoting through this initiative is that UC wants them, and we're trying to put mechanisms in place to accommodate them."
One mechanism is mentoring: Conference participants receive mentoring for a year.
"There are internal and external barriers to women's advancement," Levine said. "We can address internal barriers through professional development and workshops on negotiating, communicating and networking, but to address the external barriers, it really helps to have a mentor guide you through the political process."
UC Davis professor and Women's Cardiovascular Medicine Program director Amparo Villablanca, who spoke on the conference's career-life balance panel, told students it's important to have mentors, collaborators and personal and professional development. "You can't do it alone," she said.
The balancing act
Villablanca praised UC Davis' family-friendly policies such as parental leave, stopping the tenure clock and part-time appointments. But there needs to be an increase in their awareness and use, she said. In September, she and colleagues Lydia Howell and Laurel Beckett received a $1.3 million National Institutes of Health grant to study family-friendly policies and career flexibility options for women with careers in biomedical sciences. They will compare how awareness and use of the policies affect career satisfaction and advancement among faculty in the schools of medicine and veterinary medicine and the College of Biological Sciences at UC Davis. From those results they will determine effective models and seek to apply the solutions to other institutions.
"One key issue is, can I be a successful academic and still be a wife and mother?" said pipeline conference speaker Rosina Becerra, UCLA vice provost for faculty diversity and development. "The answer is certainly yes."
Becerra, who is also a professor of social welfare and Chicana/o studies, has worked 35 years at UCLA. She chaired the 2006 UC systemwide task force on faculty diversity and participated in a follow-up review of health sciences faculty diversity. "The issues are almost more dramatic in health sciences, particularly in medical schools," she said.
Female health sciences faculty tend to be more concentrated as lower-paying adjunct or clinical professors. While women account for 93 percent of tenure-track nursing faculty, they are only 20 percent of tenure-track medical school faculty. "We certainly need to do a lot better," Becerra said.
In July, UCLA's medical school established an Office of Diversity Affairs with Lynn Gordon as associate dean. Other UC medical schools have similar positions.
Gordon is focused on recruiting and retaining a diverse faculty. She has targeted eight areas for retention: starting a junior faculty lecture series, launching a website, supporting/recognizing faculty, networking, mentoring, giving mid-career advising, doing exit interviews and partnering with the community. For recruiting, she is working with department chairs to ensure they have diverse applicant pools.
Gordon can relate. She took time off to have children, then returned to do research and become a clinical professor of ophthalmology. "There were challenges," she said. "Academia is a tough road for anyone. If you have extra hurdles, it makes it more challenging. This job allows me to tear down some hurdles I had or others had."
Faculty diversity has been "the most intractable and longstanding problem at medical schools," said Patricia Franks, senior research associate with UCSF's Philip R. Lee Institute for Health Policy Studies.
Franks co-authored "Diversity in U.S. Medical Schools: Revitalizing Efforts to Increase Diversity in a Changing Context, 1960s-2000s." The report identified elements critical to increasing diversity in medical schools and highlighted efforts by UCSF and Stanford University to attract and maintain diverse student bodies. "It comes down to leadership, accountability and resources," Franks said.
Benefits of mentoring
Mentoring works, said Franks, who joined UCSF in 1976, the same year Gene Washington graduated from UCSF's medical school. Washington, who is African American, became UCLA's medical school dean in February after serving as UCSF's provost. "Here was a guy who wasn't clear about what path to take and found his way," Franks said. She also noted how UC Irvine Chancellor Michael Drake, another UCSF medical school graduate, received mentoring, too.
"I do think growing your own is a good way to do it," said Franks, praising the pipeline conference. "I've seen leaders who have been grown like Gene and like Michael."
It's important for students to know that resources are available to support them, said Linda Kane, a pipeline conference program committee member and executive assistant in UC Health Sciences and Services. "We need them to seriously consider going into academic careers, so students in the future don't have to fight these battles," Kane said.
Navarro tells students it's a marathon, not a sprint. "I'm very optimistic," said Navarro, who spoke at the first three pipeline conferences but missed the last one to be with her three teenage daughters. "Increasingly, people realize the benefits of having diverse health professionals."
Earlier this year, Navarro attended a meeting where she ran into a Johns Hopkins University resident who is a former UCSF student and pipeline conference alumna. "She said this conference sparked her interest (to become a faculty member)," Navarro said. "I was so excited. I told Amy, ‘We've got one.' We'll try to bring her back and make sure this place is welcoming to her."