 It's a great pleasure to welcome you to this week's Disparity Seminar. It is, believe it or not, the 27th seminar in our year-long series, with two or three more to go as we end the year. Our speaker today is Dr. William McDade. Dr. Dade is an associate professor of anesthesia and critical care, and recently had been the associate dean for multicultural affairs at the medical school. But some of you know that Dr. McDade was recruited or asked by the university to move over from the medical school to the Central University, where he recently accepted a position as deputy provost for research and minority issues. Dr. McDade has always been committed to the support and recruitment of underrepresented minorities at Pritzker. He founded the Bowman Society, named after Jim Bowman, well-known famous professor emeritus of pathology and medicine, who was one of my teachers when I came to the medical school here in 1963. The Bowman Society is now in its sixth year, and the model that we used in putting together this year's set of seminars was pretty much the model that Bill and his colleagues had developed at Bowman, to bring in really wonderful speakers on a regular basis and let them speak to an interested audience. Bill's training included a medical degree from the University of Chicago Pritzker School of Medicine, his PhD is from the University of Chicago, and his residency training was at the Mass General. This is the topic that I have been waiting for all year, today's topic, because Bill is going to talk to us today about the changing face of medicine, diversity at the Pritzker School of Medicine. Bill, welcome. Well, thank you very much, Mark. It's a great pleasure to be here. I must say that I was very excited when Mark asked me to be part of the series, because it really means a chance for me to talk about some of the things that I've been doing here at the University of Chicago for many years. I think as a medical student, and there are a few medical students in the room, I first began involvement with trying to increase the diversity here, and it stems from something I'll show you on the very last slide of this talk. So I'll try to keep your anticipation for that one. Also it was very interesting, because I came to Pritzker in 1980, and in 1980 there was an interesting transition that was taking place, actually in our curriculum. Dr. Siegler first introduced his course in medical ethics to our class, and so we were very excited to be here and colleagues for so many years. Changing the face of medicine actually comes from, or the title at least, comes from a presentation that was featured in the University of Chicago Alumni, Biological Sciences Alumni Magazine, the Medicine on the Midway. And this is a picture of me standing in the BSLC, kind of contemplating the future. And it said, when Southside native William McDade arrived as a first year medical student, he wasn't surprised to learn he was the only African-American student in his class. It really wasn't an unusual thing at the time. And so that is what I'm going to show you today, how we've transitioned from those sorts of days until today, in which I think we do far better at enhancing the university. So, after seeing Professor Norton Gamble's presentation last week, I became very interested in the history of the University of Chicago. And since we're talking about changing the face of medicine in Chicago, it probably makes sense to think about what has happened before at the University of Chicago, so we can see what that changes. And so the first thing I like to talk about is the history of recognition, the potential of African-American scientists that's been invested in the University of Chicago Biological Sciences Division for many, many years. And you hear people talk about it, but you don't really understand the players involved. So for instance, Numa PG Adams graduated from what was then the Rush Medical School of the University of Chicago in 1924. He was the first African-American dean of Howard University. Many of you know that Howard University is a historically African-American institution of medicine, of other things as well. But it was actually led by white deans or Caucasian deans at its inception. And in fact, Numa Adams was the first African-American dean of Howard. And he's a graduate of the University of Chicago Medical School in 1924. Benjamin Anthony, also from Rush, was a specialist in radiology. And he was at Billings at one time, as a matter of fact, in 1924 as a clinical associate. And he headed the radiology department at Providence Hospital, which you will see as a great community partner then. And we hope with the Urban Health Initiative may continue into the future. Joseph Berry was a graduate of Rush in 1924. And he was actually the Surgeon-in-Chief at Daily Hospital of Chicago, one of the other historically black hospitals that was begun in Chicago out of an exigency of not being able to be accessed to hospitals if you were African-American in Chicago. Leonidas Berry was the inventor of a number of gastrointestinal endoscopy devices, many of which are actually on display in the Chicago area. He actually published a book that was called, I Won't Take Nothing for My Journey, which was actually very highly reviewed. And it describes his history and his family's history of being in Chicago and how medicine evolved in that context. And he's a graduate of the University of Chicago from 1929. Walter Booker was a physiologist and was chairman of the Pharmacology Department at Howard for many years, graduated from Chicago in 1943. Jim Bowman, who we've already talked about as the namesake of the Bowman Society, was the African-American professor, tenured African-American professor in 1962. He's now a professor emeritus, but when he was here, he was the blood-brank director at one time and directed the Comprehensive Sickle Center from the NIH. He was an expert, an international expert in sickle cell disease. Henry Callis of the Rush Medical School of the University of Chicago was founder of Alpha Phi Alpha, one of the historically black fraternities in America. And he was a cardiologist here. Nathaniel Callaway was an MD-PhD, and he was an instructor in pharmacology in the 1940s at the University of Chicago. And then George Cannon, also a graduate of 1934, was a radiologist and chairman of the Board of Trustees at Lincoln University. Donald Chatman is associate professor at the University of Chicago from 1969 to 1974 in an OB at Rush. And then we had our affiliation with Michael Rees Hospital. Kenneth Clark, who's a trustee of the University of Chicago, was a psychologist trained, as it turns out, and was very instrumental in Brown versus the Board of Education, that lawsuit. He and his wife, actually, are amazing psychologists. The Blackdoll-Whitedoll study that you may know about was the work of his wife, Margaret Collins, graduated from zoology and then headed Florida A&M University's biology department for many years. So it's quite a long legacy of individuals who were trained in the first part of the last century. Carol Cotton, a PhD in psychology from the University of Chicago, Spencer Dickinson, another graduate of the University of Chicago Medical School at Rush in 1901. And he was chairman of the Providence Department of Ophthalmology and a Brigadier General and the commander of the Black Regiment, the Illinois 8th, later known as the Illinois 370th, here in town. Margaret Collins was a graduate in 1950 as a zoologist and then went on later to go to Florida A&M as well. Claudius Fortney was an ear, nose, and throat surgeon directed the residency and fellowship program in ophthalmology at the University of Chicago in 1931. Roscoe Giles, studying in Vienna under the Rosenwald Fund from the University of Chicago, became the first Black surgeon to be certified by the American Board of Surgery. Also, he was one of the first four Black members elected to the American College of Surgeons. And with two other folks that we're going to talk about later on led the movement to remove the word COL after the name of African-American physicians in the American Medical Association Physician Registry. So these are amazing people here from the University of Chicago. James Hall was a physician allergist. And he also went to college at the University of Chicago, graduating in 23, graduating from Rush in 1925. He was director of the Medical Research Laboratory at the University of Chicago from 32 to 40. He's also at Providence Hospital on the staff there. And then he became the chairman of medicine at Howard University for a few years as well. Louis Hainsborough was an embryologist who received his master's degree from the University of Chicago in 1931, later went on to get his PhD at Harvard in 38 and became professor of zoology at Howard University and eventually assistant provost at UConn for 20 years. Harry Harris is a physician and neurologist. And he was a Rosenwald scholar of the University of Chicago. He was the first black appointed to be coroner of Cook County. And he held a faculty position at the University of Illinois for most of his life. James Henderson is a plant physiologist and then went on to chair the Division of Natural Science at Tuskegee University and received their imminent faculty award in 1965. And he is a person who worked as a research assistant at the University of Chicago in the early 1940s. Alfonzo Holliday was a physician and surgeon from Gary, Indiana originally, who went on to receive, it should be an MBA, an MBA and health administration from the University of Chicago and then later went on to become the director of the Medical Center of Gary and then the Lake County Jails there. Robert Jason, who passed in 84, received his MD at Howard, then came to Chicago for a PhD and received that in 1932. And he was the first black to earn a PhD in pathology in the country. Later, he served as the dean for Howard Medical School and was general education board fellow at the University of Chicago from 27 to 31, a full bright scholar and elected to the National Academy of Sciences, which is a huge achievement for an individual. You can see the relationship between the University of Chicago and Howard has been very strong, where we've provided a lot of the intellectual leadership that's gone on to lead one of the major institutions for African-American training in the country. Frank Johnson was a pathologist, received his MD training at Howard, was a research associate here from 1950 to 52, and then was also an AC fellow in the medical sciences at the University of Chicago from 48 to 50. Joseph Johnson was a physiologist and an MD PhD from the medicine and physiology PhD in the University of Chicago in 1931. And so for a long time, I labored under the thought that I was the first MD PhD that we had here. As a matter of fact, I was the first actually African-American accepted in the medical science training program, which is our formal MD PhD program that we have here. But in fact, I was bested by 50 years by Joseph Johnson. Now, I must tell you, between Joseph Johnson and me, I don't think there are any others. But the early movement in that direction was certainly something that the University of Chicago should be proud of. And he and Arnold Maloney were the second and third blacks in this country to earn MD PhDs. Ernest Everett Just, who many may know about because he has his own stamp now, got his own stamp in 1996, is also a product of the University of Chicago, graduating with his PhD in Zoology and Physiology in 1916. At the time, he was one of the few African-Americans who received the PhD from major university. His is a rather tragic story. If you ever get around to it, there's a Pulitzer nominated book called Black Apollo of Science, which describes his story. And unfortunately, after he graduated in 1916, he couldn't get a position at a major university anywhere in the country. And so he ended up going back to Howard University, where he headed the physiology department many years, but was very unhappy, spent a fair amount of time in Europe, was actually captured in World War II, as it turns out, and held in the prison camp for a while. He was then freed by the US government for a negotiation and was able to come back to this country. But he died soon after, probably because of a pneumonia he picked up while in the prison camp. He won the spring arm medal at a very early age, if you appreciate how early this is in 1915. And he was a journal editor for the journal Protoplasm, and did a lot of the early research on fertilization embryology and sea creatures, and actually went every summer to the Woods Hole Marine Biology Lab in order to do this work. John Wesley Lala was a radiologist, graduate of the University of Chicago Rush from 1932. The transition between the University of Chicago and Rush happened in the late 20s, early 30s. And there were still people who were in both groups and were affiliated with the University of Chicago. He was a medical director at Providence Hospital between 35 and 41. And then he went on also to become a dean at Howard University Medical School. Julian Lewis is a pathologist who received the master's from the University of Chicago in 1912, then his PhD in physiology in 1915. A year before, Ernest Just received his PhD here at the University of Chicago. He was a Guggenheim fellow in 26 and 27. And he was the first African-American to gain a PhD in physiology. He won the Benjamin Rush Medal in 1971. He was AOA, Sigma Chi, Phi Beta Kappa. And he was in the Chicago Institute of Medicine. Audrey Forbes Manley also spent time at the University of Chicago as a faculty member. And she was actually the first African-American woman on the faculty at the University of Chicago. She's a pediatrician and was here for about two years or so between 67 and 69. She later went on to be acting Surgeon General, then actually Surgeon General for a brief period of time. And then she went on to become president at Spellman College in 1997, where she is today. Frederick Mapp is a zoologist, earned his PhD in 1950, later went on to become professor in chair of biology at Morehouse College. Roscoe McKinney is an anatomist. He got his PhD in 1930 from the University of Chicago. And he was the first African-American to earn a PhD in anatomy. He then went on to become professor and head of the department at Howard University and actually was one of the great mentors for one of the great stars at Howard University later on, who became dean there as well. Spy, Beta Kappa, and Sigma Chi. Clarence Payne was a physician surgeon, graduated from the University of Chicago in 1920. He was leader of interns and residence program at Providence Hospital. He was actually Surgeon General of the VFW in Illinois. And he led a commission where he was appointed by President Roosevelt to lead to, that formed a commission to lead to, leading to the segregation, the destruction of segregation in the armed forces. And he was also one of the other two individuals who served along with Roscoe Giles, who we heard about before, and C.G. Roberts, who led to the removal of the color designation for physicians on the AMA list. Those of us who are old enough in this room may remember Dr. Steptoe, who passed in 1994. But he was a physician here on the faculty for many years in obstetrics. He actually did his PhD at the University of Chicago in 1948. He was chair of the OB-GYN department at Mount Sinai Hospital. He was a professor at Rush. He was chief of gynecology at the University of Chicago from 1979 to 1989. He was president of the Chicago Board of Health. And he was most known for this list of Chicago's health needs, and the needs assessment of the Chicago community that he did with Quentin Young back in 1983 when Harold Washington, for the late mayor of Chicago, took office. Charles Turner is a zoologist and entomologist, actually studied insects, where he actually looked at the behaviors of ants and spiders. He actually was the first person to identify the fact that roaches can hear and that they respond to pitch. And he ended up going to serve as a professor of Clark colleges as he was earning his PhD, but he then couldn't get a job in the same way that Ernest just suffered and ended up working as a high school biology teacher after having earned his PhD. Johnny Watts is a chemist and nutritionist, got her PhD at the University of Chicago and then went on to do research in amino acids, was named a special fellow in the late 1950s. Raymond Wilkins was a chemist. He was head of the Instrument Technology Lab at one time here, and he was also part of the Process Control Analysis Department, and more importantly, he helped develop the electron microscope. Leon Wilson is an obstetrician who was on the faculty at the University of Chicago as a fellow, also did research at Lyon Inn Hospital for about 50 years. And then there's my favorite early graduate of the University of Chicago, a gentleman named William Moses Jones. He graduated from what was then the University of Chicago Rush Medical School in 1932, and he died in 1988. He was an ophthalmologist. He was on the faculty of the University of Chicago Medical School for 23 years, where he was a clinical assistant professor. He directed the eye clinic at Billings Hospital where we are sitting right now, and he was consultant in charge of the Student Health Service for 19 years. He was also on the staff of the Woodlawn Hospital, Providence, and Jackson Park. And it's important because, as you recall, one of the early graduates from the University of Chicago was someone who went into ophthalmology, and later set the groundwork for a burgeoning group of ophthalmologists in Chicago, and William Moses Jones became one of those individuals. Chicago was the leading center for African-American trained ophthalmologists, and there were four board-certified African-American ophthalmologists on the staff at Providence Hospital in the early 30s and early 40s, late 30s, early 40s. And the other individuals were Claudius Fortney, William Moses Jones, James Richardson, and Roosevelt Brooks. And you can see what a rare sort of thing that is. If you look at all specialties, and this was documented in the Journal of the National Medical Association in the 1950s, if you look at all specialties, and the people who were board-certified in those areas in 1956, 51, 47, the number of people that existed, they were certified those years, Chicago was one of the top institutions in the country for having people who were board-certified on their staffs. You can see here a few of the others. These are the historically black colleges there. Going back to William Moses Jones, at the time this was written in 1956, there were only five board-certified African-American ophthalmologists in the country. And you can see that William Moses Jones, who graduated from Chicago in 32, is on the faculty in Chicago at that time and received his certification in 1939. So if you look at the list here, he was the fifth, fourth actually individual, no fifth individual to receive his board certification in ophthalmology in the country. More interestingly, he actually received the Alumni Association Public Service Award in 1979, which is the year before I met him, because in 1980, he was selected as my alumni association mentor. And this was a program the Alumni Association was beginning in order to pair graduates in the University of Chicago with incoming students so we could develop a relationship. And he turned out to be a splendid individual and we had many engaging conversations. Ironically, he didn't talk a lot about medical history at the time, but he actually told me many stories about his experiences at the University of Chicago and was very encouraging all throughout my career until he passed, which leads to the second part of the talk, which is the kind of historical context and the actual numbers of scholars we had within the Biological Sciences Division. So I told you the fact that we actually have a long history of African-Americans who contribute to the diversity of what we did when no one else in the country was doing it. And we were at the vanguard of bringing people in. But then there was a hiatus for many years and we'll look at those numbers right now. And in fact, the story is kind of a tale of three deans. There's Joseph Seidhammer, who came back for an alumni association event. We were able to take that picture. And he was dean of students from 1951 to 1988. And then Norma Wagner from 1989 to 2002 was the dean of students. And then the now dean for medical education, Holly Humphrey. And the approaches and challenges they faced in each of the different eras that in which they served in these capacities, I think is very illuminating to the problems that existed within the University of Chicago and some of the challenges that we face today. And so I quote George Bernard Shaw, who says, you see things and say why, but I dream things that never were and I say why not. And so that really kind of brings us to the point in which we consider the individual deans and their challenges and contributions. In the Seidhammer era from 1951 to 1988, there was a strong emphasis on excellence. We wanted to produce the best possible physicians we could here at the University of Chicago. Scholarship meant a lot. And we wanted to make sure that we brought in people who were gonna be very successful in our programs and our academics. When we started to think about diversity under the Seidhammer era, it really started with the importation, I guess, of African American immigrant students to come and train in the United States. And so if you look through the hallways of the old photographs, you'll see a fair number of West African names associated with the very early people who were able now to come to study at the University of Chicago. You could actually measure the level of excellence by the quality outcomes that you saw with respect to the students who were here. So things were numerically driven to a large extent. People who came in became very successful. They impacted a large group of people when they went back to train. And in fact, one of our Bowman lecturers was a graduate from 1962, Donald Hopkins. And Donald Hopkins led the drive to eradicate smallpox as it turns out for the World Health Organization and gave the delightful talk of the Bowman lecture series about his work and now elimination of river blindness in Africa, works with the Carter Foundation today. The work of Dr. Seidhammer was impacted by the affirmative action movements as well. It took place in the late 1960s, early 1970s. And you can see the transition and we're gonna see the numbers in a second from having very few African-Americans or Latinos in the medical school to a place in which we actually gathered a lot, as it turns out relatively, of diversity. It was also impacted by the early anti-affirmative action and Reaganomics. I remember when I was sitting in Regenstein Library on the B level and we got the news, actually it was the A level, and we got the news that Reagan had won the election and everyone thought that, oh no, what's going to happen now? And we soon found out. And he also, Seidhammer era was really substantiated by his, was codified by his substantial commitment to students, advocacy and fairness. I mean, above all, I think Joe Seidhammer was a fair individual and really wanted to do the best he could for the university and worked very hard. He had new students by name. He kept a book in which he had all this information about students. You walk in, he knew everything about you and he was a fantastic individual. So here are the numbers. If you go back to the year that Joe Seidhammer started as the Dean of Students here, you see the number of underrepresented minorities and underrepresented minorities are people we describe as African-American, Hispanic and Hispanic at that time or up until recently, actually, was considered as Mexican-American or mainland Puerto Rican and Native-American. So that's underrepresented minority. And so this data comes from using the P-chord graph photographs. So I'm gonna miss some people admittedly in this because I don't have the actual records from that time available to me. But if you look at 1951 all the way to 1964, that's when we got our first graduate of the University of Chicago who was African-American that year. And I misspoke because that was the, 1966 was Donald Hopkins year, 1962 wasn't. 66 is Donald Hopkins. This is an African immigrant. This is another African immigrant. That's Donald Hopkins. This is another African immigrant in 1968. And then we had the turmoil that took place in this country after the death of Martin Luther King and the development of civil rights activity in the area of education. And that preceded the Baki anti-affirmative movement. And so the numbers actually went up. 1970, there were two African-American students. 1972, two, 1973, three, 1974, four, including the first woman at the Pritzker School of Medicine, Irma Bland was that individual. 1975, eight, 76, six, 77, three, 78, one, 79, seven. And then 1980, there were two. And that's the year that I actually came to the Pritzker School of Medicine. So I think everybody else from 1980 onward, I can probably tell you by name who they are. But it continued on in the Sighamel era all the way through 1988. And you can see in this entire interval, even in the heyday of the civil rights era, there were only eight students, African-American students identifiable by the photographs in the class. That was the max, 779. What happened in 1978? Well, there was the Baki decision that came out that year. That's the first kind of legal anti-affirmative action program that took place. And it had a bit of a chilling effect. But people then said, well, let's rebound from that and see what we can do. But by the time we actually came to the 1980s, it had really taken hold. And so remember, these are graduation photographs we're looking at. So what I'm showing you is what actually happened four years before, approximately for most people. And so you see in 1984, there were zero. That was the year that I would have graduated had been just a straight MD student as opposed to the MD-PhD student. So I was the only African-American student in my class. If you look at the people who graduated the year before me and I see one of the graduates in the audience over here, Dorian Miller, she was one of four students. 1982, John Ellis was the graduate in that particular class. So the numbers actually were fairly low. And then Norma Wagner came in. And so she started in 1988. So 1992, pretty much in the early 50s or so, mid 50s, it was lower than it is today. It's about 104. And it's been that way since, I think, the late 50s onward until just recently, as it turns out, when went to 112 one year. And now the class size is 88. 112, 101, then down to 88. OK, so here we are looking at what's happened in the Norma Wagner era. And so we see that the numbers are substantially higher, at least on a more regular basis. 1991 is the only other year that we actually had no graduates. And that was the year that Eric Whitaker was the only student in his class. And Eric took time out to become president of AMSA and then to get an MPH degree at Harvard. And so that represents the zero that you see here. But we had a number of students under the Wagner tenure as well. And so what was Norma Wagner's time here at the University of Chicago like? Well, she put an emphasis on change and provisions for opportunities for all. Most importantly, it was the change in gender that took place in the time that Norma Wagner was here. And it's really come to fruition lately in the last, maybe, seven or eight years in which our medical class is, I think, for the first time about eight years ago, we actually had more women than men in a Pritzker class. But if you look at the photographs in the hallway for many of those years at Joe Seidhammer was here, there were barely 10 women, if that, in a class, usually less than that. Exactly. There was actually a lot of emphasis on quantity as opposed to quality. But we actually got people who were high quality as well despite that. And it makes you think about what we're really doing and looking at so many of the factors that factor into what we do. It was impacted by the AMC's movement for 3,000 by 2,000. And that's when something started in 1992 with the Association of American Colleges. And the idea was to try to make medical schools look more like the general population. So their thinking is, what medical schools should do is to provide outreach to communities, try to help to build the educational infrastructure and their environments to allow opportunities on their campuses for students to come and learn from the people who are here in the medical school of convincing them to go into medical careers. So at that time, when 3,000 by 2,000 was started, there were about 1,600 and 1,600 first year seats throughout the country. And the idea was they have 3,000 of them filled by underrepresented minorities. Those are African-Americans, Native Americans, mainland Puerto Ricans, or Mexican Americans as defined at that time. So it all started out great. And one of the programs that actually spearheaded this was something that was called the Minority Medical Education Program at that time. We'll talk about that in a second. There were a number of partnerships that took place between medical schools and high schools, medical schools, and colleges. And really, there was a great hope. And so 1996, the largest number of underrepresented minority students in the country were admitted up to that point and was 2026. And then three things happened. So the first was Proposition 209 in California, which restricted the use of race. It was led in terms of higher education admissions projects. It was spearheaded by a fellow you may know named Ward Connerly, who was still very active in doing the same thing most recently. He was active in Michigan. And so Michigan has now removed the ability to use race as a consideration in the admissions process. It was also active in some of the other areas out west. And this happened in Arizona. And I think it happened in Utah as well. There was a second thing. It was called Proposition 215, or Initiative 215. And this was in Washington state. And that was a similar sort of thing, where you can't now use race in consideration of hiring of individuals or of higher education decisions. And then finally, there was the Hopwood decision down the Fourth Circuit that affected Texas, Mississippi, and I believe Louisiana. There it is, that's the circuit. And so what happened to numbers of applicants who were from underrepresented minority groups after that particular, after those three events in that very short period of time? Well, it had a chilling effect. The number of people who applied to medical school who were underrepresented minority dropped significantly. And the number of people who were admitted reflected that. And also the fear that medical schools had that they might actually be the next lawsuit. And so medical school admissions kind of tightened up around that time, too. And to make a really long story short, we never got to 3,000. In fact, it's now 2010, and we still haven't gotten to 3,000. And now the number of first year medical seats is closer to 18,500 or so. As the WMC has asked medical schools to expand their class sizes, many of the people who've done this, many of the schools have done this, have done so with a focus toward eliminating racial and ethnic health disparities. The Key University of California system has a focus on both urban health, as well as health disparity elimination, as well as rural health. And they do this on individual campuses. And other medical schools aren't open entirely on the basis of trying to eliminate health disparities. And actually one of our speakers early in this series talked about their work in Florida in that regard. Under the normal Wagner, pipeline programs began in earnest at the University of Chicago. And so she got together with Dean Goldman over at Rush, and they wrote a proposal for the first pipeline program sponsored by the Association of American Medical Colleges, the Minority Medical Education Program. And we had one of the first chapters here on Pritzker campus. There were about 10 of them nationally. The Association of American Medical Colleges put money, or actually administered the money that was given to them by the Robert Wood Johnson Foundation, and the idea was to try to attract a national audience of college students who, if you impacted early enough in their college careers, might improve their performance on the medical college admissions test. That was MMEP's focus. It was helping students improve their performance in the medical college admissions test. Later on, it morphed into other things, and we'll talk about that in a second. There was less emphasis in the Wagner administration on cognitive aspects. And so we actually have had Pritzker students admitted to the University of Chicago. And you can hardly believe this with an MCAT score of 21. And you think to yourself, 21 in the MCAT, that's a really low score. But in fact, that individual went on to have a wonderful career here at the University of Chicago, graduated with honors as a matter of fact from the college, went on to become chief resident at the Brigham and Women's Hospital in the Harvard Medical System, and then did a fellowship later on, and has had an outstanding career. So it's just an isolated example of the fact that sometimes people with low scores actually are able to achieve quite high things. And Norma recognized this. She put emphasis more on humanism and leadership, and actually began the white coat ceremony here and the Gold Foundation. And I think those things really have to be taken to account in looking at the holistic view of people who apply to medical school. And there's greater emphasis in the American medical, in the Association of American Medical Colleges on looking at some of these humanistic characteristics of physicians and putting a little bit less emphasis on the cognitive things. And then there's a big community focus and admissions that start to evolve under Dr. Wagner, Dr. Wagner's administration as the dean for students. And we saw students become active when they got on campus to involve themselves in community activities, and it was a lot of fun. So those are the numbers under the Wagner administration. We've actually seen some of the work that she's done already on this slide, and I'll show you the next slide. So as not to confuse you, these are classes upon admissions. So now this is data that actually comes from records at Pritzker School of Medicine that we have access to. And we'll look at the individuals from 1990 who started. So those are people who graduated in approximately 1994. So it overlaps with the previous slide by a couple of years. And so the more diversity that you have on admissions committee, the more likely it is you're able to get people admitted to medical school. And I think it's because there's a humanizing effect that exists around a small table of individuals who make decisions. And so I think it's very important in any search process, in any admissions process, that we maintain diversity within the search process itself by having people of diverse backgrounds involved in that particular process. I think it also helps because individuals from diverse backgrounds can talk about experiences that individuals have had. And when you look at who's gonna really be successful in medical school, there's a certain amount of distance traveled that you'd like to see in people to really understand their humanism. That is if you come from disadvantaged backgrounds or situations of deprivation or discrimination and you've survived it this far, that's a resilience test to a large extent. And so what are we gonna do to you in medical school that will stop you from being successful after you've overcome extreme poverty or abject discrimination in one way or another? So I think that we've been very successful over the years and in many people. And while there have been a few students over the last couple of decades, and this is a couple of decades data that we're looking at, who haven't completed medical school, I'd say those are the exceptions as opposed to the rule. I think there are about five students in this period of time, maybe six, who didn't complete one starting. But you can see that compares to this large number of people here. So looking at the time that Norma Wagner was here from 88 to 2002 or so, it leads you to believe that we were actually making a difference. 16 in 1994, dropped down to nine the following year, up to 15, 18, 16, 13, 17, 18, actually this is a larger number here. So this is 28, 29, 30. So that's a larger number of people there than we're used to seeing. I should have totaled it there for you. But that represented a kind of an interesting transition as it turns out, because Norma Wagner then left the University of Chicago. And Larry Wood came in as the interim dean for medical education, the first dean for medical education, followed by Dean Humphrey. And you can see that the numbers have gotten even stronger in terms of the individuals there because of their commitments to diversity as well. And that brings us to the current era that we're in of Dean Humphrey. And there is an emphasis on excellence but willingness to support diversity. I.e., we weren't gonna look at students necessarily throughout the time that Dean Humphrey has been dean, who had these really impossibly low scores. I mean, because there was an idea because of the students who had not been successful here that we didn't wanna subject anybody to tremendous amount of financial burden and then not to be successful as physicians. And Dean Humphrey also had the goal of wanting to try to improve the ranking of the University of Chicago in medical school admissions polls, or medical school ranking polls. And so there was an emphasis on excellence but there was a willingness to support diversity. And this came because Dean Madera and Dean Humphrey worked together to provide substantial scholarship money to individuals to come to Pritzker. And the first iteration of providing financial aid, more significant financial aid, we used to be a full need-based scholarship program for financial aid here. And we actually converted over the next few years to a need and merit-based financial aid institution. Because when you wanna try to attract the highest scoring students in the country, one of the things that makes you more attractive as an institution is your financial aid package. And so I would jokingly say to Dean Madera when you see me in the hallway, it's Bill, what can we do to get the best minority medical students in the country to come to the University of Chicago? And I said, well, that's really easy. All you have to do is buy them and then change the name of the medical school to the Harvard Medical School. And what I meant by saying that, of course, is you had to provide excellent and competitive scholarship support to get the very best students to come. But that would do you no good unless the best students in the country applied to your medical school. That is, they knew about you. And I've been going to these recruitment fairs since I joined the faculty back in the early 1990s to try to attract more underrepresented minority students to Chicago. So there's this gigantic meeting every year that takes place. It's called the annual biomedical research symposium from minority students, ABR CMS. And if you can imagine one of these grand ballrooms in a major hotel in a convention center filled with 2,500 underrepresented minority scholars who are in college and some graduate students who are thinking about pursuing the careers in biomedical research and medicine, you couldn't dream this up. They should actually broadcast it on public television or something because you can't imagine that these sorts of things take place because that's not the image that we have of underrepresented minority youth in America. So you go to these things and you see this fantastic presentation of a poster given by one of the scholars at this meeting and you tell them, I'm from the University of Chicago. You should consider going there because I know someone who does work very similar to the work that you're doing. And they'll say, was that the University of Illinois? No. Is that Chicago Medical School? No. Is it the Loyola University of Chicago? No. So all these schools are confused and people really don't have a handle unless you actually know of the University of Chicago. You probably don't know the University of Chicago, especially if you're not from Chicago. And so one of the things I meant by you have to change your name to Harvard Medical School is that you have to advertise, which is something that we really never did at the University of Chicago in recruitment. Under Joe Seidhammer's administration, there was availability to actually attract some of the highest scoring minority students in the country. There's an instrument created by the Association of American Medical Colleges a group, MCAS, the group that runs the MCAT process, MCAT process, which was called the Medmar List, the Minority Registry List. So if you were to sit and take the MCAT as a minority student, you could check a box and that would designate you as an underrepresented minority of one type or another. And what they would then do is assemble a spreadsheet that has your name, address, way to contact you and your score, so that schools could look at the national list of minority people who take the MCAT and then send you a letter. And so I remember in 1979 as I was applying to medical school, I got a few letters from people. In fact, notably Washington University sent me a letter and they said, our deadline for application is coming up, we notice you haven't applied yet. Then I got closer to the deadline and they said, we've only got one week before your application will be late if it comes in our process. We encourage you to apply. And then I got a third letter that says, you missed our deadline and we'd still like you to apply. And then it was a little bit later, like almost December, almost a month and a half after their deadline, and they said, we still notice that you haven't applied. Send your application. So meanwhile, all the great medical schools in the country are sending similar sorts of letters. They didn't send four of them, but wow, she's been very successful. So what happens? University of Chicago, we didn't send any letters. We never used the Medmar Registry List. And I think we came from a place where we think because we're excellent, excellent people know we're excellent, and they'll apply, and we don't really have to do much in the way of education or advertising in order to make this happen. It reminds me of a conversation I just recently had with the economics department here. My capacity as deputy provost. We asked the economics people here, what do you do to try to attract underrepresented minority faculty and women? And they said, in a nice memo, we advertise in the three major journals in the field of economics. That's it. So they make no outreach at all to try to reach people and try to attract people. What they conclude is that if you are a scholar of any merit, worthy of being on our faculty, you will read one of these three journals and you'll see our advertisement. And by doing so, if you choose to apply, there you go. And we don't do anything in addition to try to attract women or underrepresented minorities. Sincerely. There it is. So I think that by advertising, what really ended up happening was we hired some directors of admission that we never had before. And they split the country up. West of the Mississippi, East of the Mississippi, and they made campus visits and did a lot of strong work in terms of putting the University of Chicago's name out on the national agenda. And then Dean Humphrey, to her great credit, spent a lot of time investing in minority organizations nationally to try to increase our visibility at the Student National Medical Association annual meeting, for instance, and at the Latin American Medical Students Association, Latino Medical Students Association, LMSA. So we did a lot at Pritzker, led by Dean Humphrey, to try to really put our name out there. And what's been the result of that? Well, we've attracted a large number of students who have done absolutely phenomenally in our curriculum here and who are from some of the best colleges in the country, the highest scoring students in the country. And if you look at our overall MCAT average over the last several years, it's gone up dramatically. In fact, I think we're number two in the country behind WashU today. So you don't have to necessarily lose excellence when you gain numbers. And so you just have to think of very interesting ways of doing it. Part of it may be that your need-based scholarships or rather that your merit-based scholarships don't always go to underrepresented minority students. A challenge, of course, is trying to find the higher scoring underrepresented minority students in the country, you can do this. But then, if you find really high scoring not underrepresented minority students, you can potentially take an underrepresented minority student with a lower score and still keep your average high. So those are sorts of things that you can think about when you're doing this. So careful acknowledgement of the challenges presented by anti-affirmative actions has been part of the hallmark of the Dean Humphrey administration in support for the residency diversity. And we've had a phenomenal increase in the number of minority residents here, which I think is very attractive in getting students to come because students are taught by residents. We bring residents with us to the Student National Medical Association annual meeting to try to meet and greet students. It's great to have someone who's just a few years ahead in the training process to be able to discuss the University of Chicago with these students. We've been very successful in internal medicine and emergency medicine, orthopedic surgery and pediatrics and bringing residents from those particular areas along with us to that meeting. And then the expansion of pipeline programs that now aren't just college preparation programs but start in the early college development of students and then even high school in the time that Dean Humphrey has been at the helm. So these are the numbers again. And if you look at these numbers in the last few categories here, I mean just amazing. I mean 13 underrepresented, 13 African-American students, 11, 10, 13. New category that's kind of popped up in the last four years is multi-racial category. And so if you look at the total numbers in the class of 2007, they're 28 people who designate themselves as underrepresented minority which is incredible to me at the University of Chicago. Those are the numbers of people who designate themselves as multi-racial. Now those multi-races are not specified so they may not be these three so I didn't feel comfortable adding them in to the total number of underrepresented minorities in that particular listing. But there's a big driver for a lot of the trouble. It's US News and World Report. And if you go to national meetings of some of the medical schools we'd like to compare ourselves to, they'll all tell you we hate the US News and World Report rankings because of the things that it does to us in terms of our admissions process. It makes us choose students in this medical selectivities category who have really high MCAT scores. And then we actually figured this out at Pritzker the hard way. We were in the last days of normal Wagner's time here and I was very successful in working with people and the admissions committee to convince them that you don't need gigantic numbers on the MCAT in order to be successful here at the University of Chicago. And in doing so, I think we dropped our MCAT average that year to 10.2 which is one of the three factors that goes into medical student selectivity. It's class average MCAT score, class average GPA and the selectivity, the number of students you take relative to the number of seats that you have. Those are the three things that kind of factor in those. So there, the other four measures are things that are pretty intransigent. It's the way that deans think of you, it's the way that program directors think of your students, it's the way that your faculty student ratios is involved in this and the amount of NIH support that you have at your institution. And so we had strategies to maximize the position on national rankings for some of those categories. So for instance, NIH dollars. Instead of looking at the total number of dollars per facility per institution, the US News and World Report now looks at number of dollars per faculty. That was prompted by initiatives made at the university to really be fair to smaller institutions like ours. And then this medical student selectivity thing turns out to be the most volatile thing. So that year that we dropped to 10.2 on the MCAT average, it turns out that that dropped us to number 22 or tie for 22. And who that year was 19 was Northwestern. And so in Chicago, of course, when you're here trying to put your best foot forward, being the second best school in the market really doesn't help. And it may hurt your fundraising, it hurts your image, certainly, it may not make you attractive to the most excellent students. And so there was a call to try to figure out how to improve the situation and we responded by going to some merit scholarships. So there are a number of different things that also used to hurt us, one that we were on the quarter system, for instance. And what that means is by the traffic rules for admission to medical school, schools that start before a given medical school can take people off the wait list, their wait list who may have been accepted at a medical school that starts later. And if you do that, then what tends to happen is the last school in has a chance for every other school to compete against it as someone doesn't show up on the first day at Harvard and now we call a student who's on your wait list who may have been one of your top 10 students and then off they go. So it hurt us to start so late and it turns out that if our two of these coincidences occurred in which we decided to change our curriculum a bit and Dean Brookner came up with the idea to actually help to build in to our curriculum time to allow students to do research with a whole initiative in scholarship and discovery. And in order to do this, starting a little bit earlier made a lot of sense. And so if we start a little bit earlier, it doesn't escape our attention that your students don't get a chance to be selected away from your school later in the process. And that also helped. So I don't think it was intentional at all but the fact is that it just fortuitously worked out so that we're now retaining some of our higher scoring students because we're starting earlier. So those are a couple of strategies that helped to maximize our potential in national rankings yet. There was still a drive to maintain diversity and to increase diversity. A lot of support was given to the things that we do in the Office of Multicultural Affairs. I did in the Office of Multicultural Affairs namely pipeline programs. So SMEP or the Minority Medical Education Program eventually morphed into the Summer Medical Enrichment Program. And the idea was that we wanted to change the name so it wouldn't be a target as were programs at Virginia Commonwealth University and other places around the country that were forced to open up programs that were normally or had been historically used to try to attract underrepresented minority students were now then subject to anti-affirmative action movements and were targets. And so MMEP in order to try to avoid that sort of a light changed its name to SMEP and made it a little bit more ambiguous as to who you could accept. So before it was just African-Americans, Native Americans, Mexican-Americans and mainland Puerto Ricans and now it became a little more vague. And in fact, Dr. Northington Gamble who was here last week was the director of programs at that time for the AAMC and when she was in that capacity led this two year sort of discussion about what underrepresented minorities should mean. And so it's now changed in terms of the thinking that the AAMC has for medical schools to make it more individualized for the medical school. So they still use the term URM for underrepresented but it's now underrepresented in medicine as opposed to underrepresented minorities. And so the classification of who counts as a minority has become much more broad in the last few years and it's defined by the individual medical school. So if you're in Boston and there's a large Cape Verdean population in Boston and you can see that there's health disparities in the Cape Verdean population versus the rest of the community in Boston, if you wanna try to recruit people from that community and go to medical school, they may count as an underrepresented minority whereas they may not have if you had maintained the old criteria. So MMEP, SMEP was designed to give people early exposure to MCAT preparation in a six week program. We pay your way, you come here and you learn how to take the MCAT. And then we would entertain you with a few things that would help you understand how important your role in medicine is. And what we found is that we weren't really changing the MCAT score very much of the people who participated. Now nationally this program was very successful and that's 64% of the people who were in the program were eventually accepted to medical school. But you couldn't tell by our data at Chicago that that was happening. We had wonderful people who were teaching. We could change your MCAT score and the physical sciences a little bit and the biological sciences by quite a lot but we didn't do very much in the way of changing the score in terms of the verbal reasoning section and certainly not the writing sample. So when we changed this now in the SMEP program, we actually built in a writing program and we also thought about ways of increasing the reading speed of students and one of the ways that you do it is you have people read a lot. And so we had a book club that was run by one of our residents in surgery here. Geez, the DG Avani book club is what it was called. So she actually was an MD PhD student getting her PhD in English and was a great person who worked with us during the summers as we did that program. The other part of camp that we recognized as a problem is it was designed for third, fourth and post-baccalaureate students initially. So when it was MMEP, we had an older group of people where the main focus was trying to change their MCAT score. But what we realized is we weren't really changing the MCAT score that much and if we actually had these students with higher MCAT scores, they sometimes also suffered because they'd gotten Cs or lower in some of the basic science courses that were prerequisites for medical school and no matter what they did with their MCAT, they weren't gonna get to medical school. So what I thought we would do with SMEP and the last few iterations of it that we did is to move to an earlier group of students. And a couple of other programs around the country, Fisk, for instance, did this as well, focused on the first and second year experience for students and we did this in our SMEP program and I think it turned out to be very successful. And what we try to do is to teach people about how not to make academic mistakes before they made them. And then studying in groups and there was a large emphasis on collaborative learning and the students got to sample a bit of the medical school curriculum, have shadowing experiences and visits with individuals who were at our medical center and we had lots of interface opportunities with medical students. And 125 students came to campus and stayed in the dormitories and we paid them for the experience and it was six weeks long, it was fabulous. And then SMEP morphed into SMDEP. Robert Wood Johnson Foundation, famous for making dental floss, decided that it was important to create minority dentists as well. So now it became the Summon Medical and Dental Education program and we suffer from the fact that we don't have a dental school here on campus. And so I tried to partner with the University of Illinois and they went on their own grant writing mission in the last iteration and neither one of us ended up getting funded as a center for SMDEP. But Dean Humphrey said, well we still need to keep this going. And so what we did was we evolved a new program that's called the Chicago Academic Medicine Program which takes all the best parts of the SMEP program and we use it for first rising college students, rising first year college students, first and second year college students to help them in the same way that we would have done had we had the SMEP program. And instead of having 125 students which we shared on four different campuses with Northwestern, Loyola and Rush, later just Loyola and Northwestern, it's now just 25 to 30 students and these are students who stay on our campus and have that same experience. The YSTP came from a grant that I wrote to the National Institute of Diabetes, Digest Diseases and Kidney Diseases. And what the object there is to expose high school students like Lisa Ford here who got a chance to work in Dr. Janet Rowley's lab, an early opportunity to see science in action learning from first tier researchers. And we've been very successful over the years with that with anywhere from 10 to 13 students who are enrolled per summer and a number of these students have now gone on to higher education beyond college and we're very excited about seeing this program turn into the program that we really wanted to be which is a feeder program for medical school. SOMR, the Pritzker School of Medicine Experience and Research evolved from the need to try to attract the highest scoring students that we would meet in the country when our directors of admission went to these college campuses. And so if we had a way of attracting these high scoring students to come to our campus, the summer that they're applying to medical school, we might distract them from applying to other people's medical schools and show them how wonderful, of course, the University of Chicago is. And so that program has been very successful too. And in fact, we have a student who's actually competed and who was a participant in the camp program. Last summer was in the SOMR program and she is the highest scoring African-American student in the country on the MCAT. And so we are making an impact, I think, in trying to at least attract strong students to us and maybe even by helping to create them. This is a dark picture, but it's a poster that I passed by in the Gordon Center, not the Gordon Center, in the KCBD in the NAP Center for Biomedical Discovery. And this is Barry Apperson and Kevin White and Aaron Solomon who kind of collected a little bit of information about some of the programs that happened in the Biological Sciences Division here. So the RIBS program, that's research in Biological Sciences and there's a collegiate scholars and IMSA scholar program that takes place here. They're ISTEM models, they're CBC fellows here. There's a prep program that's run by Nancy Schwartz, an REU program, there's three REU programs that are run by the National Science Foundation to try to attract underrepresented minority students in campus. Actually, we are in the process in my office and along with Adam Hammond in chemistry of trying to collect all the pipeline programs that we do on campus from the well-intentioned work of our scholars at the University of Chicago in Biological Sciences. We've come up with about 52 different programs that take place and we often kind of step on one another as we try to find mentors and try to find space for students and so I'm hoping through the provost office that we can coordinate some of this activity and we're just in the process now of hiring someone we were now referred to as a graduate recruiter whose job it is is going to be to try to coordinate these activities and make these programs work throughout the campus, not just in the Biological Sciences, more effective. Teach Research is a program that's run by Vinnie Aurora and this helps the students understand that medicine or that research in Biological Sciences isn't just sitting at a lab bench and that there are ways of thinking about research that are more numerical in fashion and so there are students who are involved in a number of different clinically based research projects that Dr. Aurora is doing. And then the students at the Pritzker School of Medicine are engaged in their own sort of drive to create pipeline opportunities for students. So the H program invites high school students from around the Chicago area to come and the medical students put it on a full day of events, actually multiple days of events for the students who come and learn about careers in medicine. Science Chicago was an undertaking that I think you're seeing here where students got the opportunity to come and sponsored by the University of Chicago partnered with the Museum of Science and Industry and the City of Chicago in order to increase the science awareness of the citizenry. And our focus was on high school students on that particular day and you can see that our students were very active and did sheephawk to section and had a chance to have a full day of understanding medical imaging and the cardiovascular system and then understanding about nutrition and I think we generated a fair amount of interest and we hope to do this again in the future. And then the Daniel Hale Williams Sanitary Science Club is another student led initiative that brings students to the DuSable High School which is about a mile and a half from here on Saturdays to talk about careers in biomedicine and to talk about how to help the students develop their own biomedical projects for submission to science fairs and the Chicago Public School System. It's kind of slacked off in the last year or so and we hope to try to get that going again in the near future. So here's a picture I told you. That's my entering medical school class a very dark photograph of it and these are the people who graduated without me when they finished in 1984 and there's not a single African American student in the picture. Lori Frijaro was the only Mexican American student who was in that particular photograph and the rest of the 104 people were non-minorities, non-underrepresented minority. My hope is that we never go back to days in which we have very few underrepresented minorities and that the diversity that we now enjoy at the Pritzker School of Medicine continues long into the future and that everyone who has an opportunity to try to spread the word about what we're doing here, I would hope that you'll take the opportunity because it really is a great place to study if you're an underrepresented minority person. There's a strong, critical mass of outstanding students who are here and I think it's, and do no large part or no small part to the absolute wonderful leadership that we've had in the Pritzker School of Medicine over the last several decades. Thank you. Are there any questions? Doreen? Thanks for the talk, Bill. So one of the things that you noted early on was the issue of brand recognition in terms of perhaps a change of the name of the medical school. One of the things that I noticed in people who were underrepresented minorities that were admitted to medical school around the time that you and I were was that there seemed to be a very strong local contingency. When I entered medical school of, there were only two African Americans, both of whom were from the local Chicago area. We graduated with four because two transferred in and three out of the four were from the Chicago area. Have we tracked that in any of the impact that you have had in the programs that have come out of Pritzker around attracting local candidates into the Pritzker School of Medicine? Well, I think you hit a very important point and that's one of the beauties of the Chicago Academic Medicine Program as it's structured now. When it was part of the Robert Wood Johnson Program and there was a national pool of people, there was no guarantee that people would look at your medical school and say that I'm gonna go to your school versus someone else because they come from the South, they come from the East Coast, and it was very hard keeping them here. But with camp, these students are young in their academic careers and they're all from Chicago. You have to have a Chicago address in order to be in camp the way that we've structured it now or at least to be able to commute to the University of Chicago on a daily basis. And so I think we are going back to that model of trying to find excellence as it exists here. There's a study that's actually been done or commissioned by the Illinois State Medical Society in which people are looking at where residents end up practicing. And the biggest linkage between who stays in Illinois versus who leaves is where you went to high school. And so by getting students who are in the high school phase even if they don't come to Pritzker for medical school, our hope is that they'll come back or the University of Chicago for college, our hope is they'll come to Pritzker for medical school and potentially come and practice in Illinois. So I think you're exactly right. The homegrown contingency is something that we shouldn't overlook in the admissions process. And when I was part of the admissions process, I certainly did hold that in pretty high regard. Bill, in the site Hamel era, I was in the class of 67, which had no African Americans. The only minority was an African from Nigeria who joined our class. But if you saw, two years later, there were already five or six minorities and that remained the case for the next six or seven years. That had nothing much to do with Joe Sightamel. That was Al Tarloff who had recruited a charismatic internist from Harvard. You talked about bringing the Harvard name. Well, Lloyd Ferguson came to Chicago around 68 or 69 as the first minority dean. And in that capacity, Lloyd made a point of going out and selling Chicago and recruiting primarily African American minority students and did so remarkably well for the next seven or eight years until he became ill and died very, very young. But so that was a critical moment in the transition and it was Lloyd who really carried the day. Well, I think you're exactly right. And the photographs that we see of Lloyd Ferguson, he's always smoking, has the pipe there. And it's really unfortunate that he passed so soon because of that illness. But I think you're exactly right. It can take an individual who's very committed in that same sort of way. And I think that with the number of personal statements I've read over the last year, I'm sure that he did the same sort of thing and you develop relationships with people. And when you develop these relationships, they think that someone's gonna support them when they come to the medical school. They're not gonna be there by themselves. And that's hugely important I think in letting people choose one medical school versus another. I mean, the conversations that take place about am I gonna be the only one? And is there gonna be anybody there that will be able to support me in what I'm doing? They may not even need it, but it's nice to know that somebody is there and to help advise and to help to guide them through the process. That's one of the things, and I didn't talk about this at all, is the development of the Bowman Society. It's also under the Humphrey era as well. In which we're really trying to figure out active ways of mentoring people to develop academic medical careers at the University of Chicago. And so the whole idea started from the idea that we weren't really generating enough faculty. And so what can we do to stop the loss of junior faculty? And that's where the idea of the Bowman Society evolved. But when the students found out about the Bowman Society lecture, they said, well gosh, we wanna come too. And the University of Chicago is the teacher of teachers in medicine to a large degree. And so why shouldn't our students learn about the academic process through mentoring at an early stage and what they do? And so now students, and we hope, more house staff become active in the Bowman Society into the future. We're in the sixth year of it now. We tried to get the house staff at Walter Conwell Center, the audience here is the chief resident in medicine. We tried to get the house staff at the University of Chicago active in thinking about it, but it's really hard. Because they have very busy lives and they wanna go home when they're done with their work and they don't know what they don't know about developing academic careers, unfortunately. Sometimes mentorship exists for them in departments, but the hurdle there is to try to get the folks in the departments to think of them as colleagues in academic medicine. Because we may bring them into our faculty, or rather bring them into our residency programs, but we may not be thinking of them quite yet as our colleagues who'll be sitting beside us in department meetings, or we'll be sitting at our lab benches in ways that I think we need to do in order to see them as faculty peers. And so I think our first step was to try to make inroads in the number of medical students that we have. Hopefully some of them will stay for residency training. Some of those residents we hope will stay on for fellowships or will attract people with that critical mass from the residency program to our fellowships. And then we'll finally start moving into the faculty era at Pritzker. And I hope that's gonna evolve just in the same way that the medical students and the residents have gone. I wish I could show you slides about the number of residents in the different programs, but for a long time, we didn't admit as residents into our residency programs, our minority students from Pritzker, a long time. And we've now evolved in the position where we're getting excellent students from Pritzker who are now staying at the University of Chicago, and a number of different fields and David Howes and internal medicine is largely responsible for that. Jim Woodruff in medicine is now coming along. We've had great success in orthopedic surgery over the years with residents and chief residents. And then pediatrics under Lynn Kahana has really picked the pace in terms of its minority representation. So to end with the story, I think all those things kind of factor in to what happens when we take students. And I think it, Lloyd Ferguson was a sterling example of what we could do. I mean, there was Lloyd Ferguson and then there was Ernie Moon for a while and then there was Jim Bowman and then there was Christie Woods who all had that role of trying to attract underrepresented minority students at that time as the associate deans for multicultural affairs or minority affairs. There's quite a bit of conversation around this notion of holistic reviews and admissions both in medical schools and other professional schools and even in the college itself. I think when operationalized, that means that you find a combination of characteristics that are humanism, the cognitive skills, excellence and leadership. What role do you see that playing in the future that is the Pritzker School of Medicine? I think they're already engaged in a very active sort of review of the candidates. You know, the idea that we're only selecting students who have amazingly high MCAT scores, I think it couldn't be further from the truth. There are students who have amazing scores who don't get into Pritzker. And I think in part it's because they fail in having the sort of well-rounded individual characteristics that you describe that would make them outstanding physicians. And so we employ a number of these holistic sort of measures but not to the exclusion of outstanding performance. And what I noticed when I was on the admissions community these last several years is that the pool of students with these amazingly high scores, 40s on the MCAT, were applying. Whereas in previous generations, they had not applied. And I think the idea of having a financial incentive to come represents one of the reasons why these students have come. And then when Joanie and David, formerly Joanie and David, went out to talk to campus, on individual campuses, talk to students, these students would learn about the things that we do. And when they learned about these things, they became attracted to us because we're a fantastic place to train. And so I think it was just the object of getting people with high scores to leave the coasts and to think about the Midwest as some place they could come and work. The other thing I think that goes along with that is that when you have students who have high scores, sometimes it means that they're fairly inwardly focused because in order to have these high scores, you tend to have to focus on studying quite a bit. And I think what we're finding is that you have students who have these amazingly high scores who are also giving and very outwardly directed. Now the thing that goes along with that is typically these people come from very wealthy families because in order to have the time to do this, you do need a supplement to what you do. And so we're seeing the family income for our students increase. And Gerard's back here, and he probably has very well of that idea. But I mean, in data published by Jordy Cohen, if you looked at people in their MCAT performance, their MCAT performance was related to their family income. The higher your family income, the higher your MCAT score. So I mean, we're seeing opportunities for trying to attract people who are well-rounded and who are also excellent, but we may be doing it at the expense of some of the economic diversity that may exist within the population of people who want to come to medical school. Thank you very much. Thank you, Phil, for that wonderful talk. Thank you so much. Thank you. Thanks, Phil.