5 Questions for Columbia’s First Associate Dean for Medical School Professionalism

This fall, Jean-Marie Alves-Bradford, MD, associate professor of psychiatry, began a new role as inaugural associate dean for medical school professionalism in the learning environment. In this role she will spearhead efforts to design and implement training programs for departments, clerkships, and courses related to student mistreatment issues. As part of the role she will serve as an additional point of contact for students in the Vagelos College of Physicians and Surgeons who wish to discuss issues in the learning environment.

We spoke with Alves-Bradford about the unique stresses of medical school and how new efforts will help students adapt and succeed.

What is professionalism and why was this new role created?

Professionalism is a shared set of values, principles, and behaviors that exemplify a physician.

In reaction to the changing landscape of our world and health care system, we need roles like mine to have an effect on our systems, so we can be more inclusive and respectful.

Similar roles already exist on our campus: CUIMC has an Office of Professionalism for faculty and NYP has an Office of Professionalism for their staff as well as the Office of Professionalism in the Learning Environment for residents. I am excited to join the larger team.

What about this role appeals to you?

I’m excited to implement change in our systems. Medicine is hard. You don’t know how you will react to it until you’re in it. We all go to doctors when we’re young, and we imagine what it's like to be one, but not even volunteering can prepare you for the experience of medical school and being a physician. I’m excited to help students navigate learning environments and work with other health care team members: faculty and staff.  

I look forward to learning from other people and I encourage anyone to reach out and talk to me about professionalism-related needs.

You were hired in part to help resolve mistreatment and issues in the learning environment that affect academic life. What are examples of these issues?

Because of competing demands of health care workers, worsening stress, and burnout since the COVID-19 pandemic, mistreatment issues like demeaning or ignoring students in the learning environment can occur. Not including students in the efforts to solve problems as much as possible in educational endeavors; not considering the best way to work with them.

In medical school you learn a lot about yourself. Sometimes you need help to adjust to the volume of work, the unpredictable hours, the new information, the intensity of evaluation, the frequent schedule changes year to year, rotation to rotation. There are lots of changes over the four-year period.

And most people are not used to this level of evaluation. You're constantly being evaluated on knowledge and performance. That's unsettling. You may need help to find the best coping skills, to learn ways to maintain your own wellness. Staff and faculty may need help navigating the changing landscape of health care.

Are these issues increasing for medical students?

Today at lunch a student said to me, “I don't know what I expected but it wasn't this. This is a lot.”

COVID enhanced the challenges. Demand for help addressing issues like stress and burnout is increasing.

What’s an immediate thing students can do to avoid negative impacts on their health?

Interact with your colleagues and with faculty and staff. Seek help. Increase the range of people who are supportive and can be supportive to you. The more people you have available to you, the more helpful it is getting through stressful situations.

Many people in medical school are good at doing things on their own. But medicine is a team sport. Think about the teamwork and team support aspect.