Written by Stephen R. Smith, MD, MPH, Professor Emeritus of Family Medicine, Warren Alpert Medical School of Brown University, and founding member of the National Physicians Alliance.
How can you be an effective change agent at your medical school?
First of all, don’t underestimate yourself. Students have a tremendous potential to bring about change in a medical school, but often don’t realize it. Whenever a delegation of medical students asked to meet with the dean at Brown, I immediately got a summons from the dean to tell him what was going on. Deans meet with faculty day in and day out and it never fazes them. But when a group of students meet with the dean, it sends the dean’s office into a tizzy.
I used the words delegation of students. It’s much better to go in with one or two other medical students. Alone, you’re “a” student. When it’s two or three of you, suddenly you become “the” students. Here are some strategies to bring about the change you want to see at your medical school:
Don’t underestimate how much power and influence medical students can have, individually and collectively through the American Medical Student Association (AMSA)
Effective ways to approach your dean:
- Send email briefly laying out reasons for wanting a meeting
- Go as a “delegation” of 2–3 students
- Honor the culture of the med school, then explain why change is needed
- Focus on professionalism
- Use real examples of problem areas with conflict of interest (COI)
- Point out how other peer med schools have stronger policies
- Be familiar with the process used to develop and approve policies
- Ask the dean to refer these issues to the appropriate policy-making group
- Ask the dean to invite your delegation to that group to present and discuss
- Follow-up with a thank-you email to the dean, publicize the meeting outcome
Tactics at the policy-setting committee level:
- Reiterate the arguments presented to the dean
- Bring copies of policies at peer institutions
- Get a subcommittee formed with student representation to further delve into the issues, draft new policies, and make recommendations to the full committee
- Create a grid showing model policies and comparing your school’s policies to them and present this at the subcommittee meeting
- Bring authoritative materials (e.g., AAMC Task Force Report, Pew Expert Panel recommendations to the subcommittee)
- Distribute the toolkit from Community Catalyst relating to the policy area under consideration to the subcommittee members
- Be present when the subcommittee makes its report to the full committee, thank the subcommittee for striving to safeguard integrity and promote professionalism and how proud you are to be a part of that process
The most difficult and most important part of the process is taking the first step. That’s what leadership is all about. That’s why you’re reading this today. You are the leaders. You can do it. I’m sure.
This piece was presented during the NPA’s March 2014 National Grand Rounds, “Agents of Change: Empowering Students to be Leaders in Conflict of Interest Policy Reform,” at the AMSA Convention in New Orleans. The webcast recording is available here along with full National Grand Rounds Series Archive. These events are offered as part of the Partnership to Advance Conflict-free Medical Education (PACME). This partnership and related materials were made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program which is funded by the multi-state settlement of consumer fraud claims regarding the marketing of the prescription drug Neurontin.