 I'm going to introduce Dr. Gilliam. So I'll just take a second to introduce Dr. Gilliam and our 41st McLean Clinical Medical Ethics lecture series. As you likely know, this whole year, the lecture series, the topic has been gender equity and ethics. This is our ninth session. We have had a great fall with both in-person speakers and virtual speakers who have joined us and talked about a variety of gender ethics topics, from sexual harassment to publications to research. And we look forward to having eight to nine more speakers in the winter and eight to nine more in the spring. So we will continue on. We're taking the first Wednesday in January off. And then we start in January 11th with Joanne Conroy, the CEO and president of Dartmouth Health. But today, we're really excited to have Dr. Melissa Gilliam back. As you likely know, she has been an alternate introduction. She's well known to us at the University of Chicago and we're excited to host her back. So let me take a second to introduce her and then I'll have her share her slides and start the talk. So Dr. Gilliam is executive vice president and provost at the Ohio State University, where she holds the Angie Axham Chair. As the institution's chief academic officer, she oversees 15 colleges across six campuses with more than 67,000 students and nearly 7,600 faculty members. Prior to joining Ohio State in August, 2021, Dr. Gilliam was vice provost in the Ellen Block, Distinguished Service Professor of Health Justice at the University of Chicago. Her scholarship focuses on adolescent health and well-being. She earned a medical degree from Harvard Medical School, a master's degree in public health from the University of Illinois at Chicago, a master's degree in philosophy and politics from Oxford University and a bachelor's degree in English from Yale University. Dr. Gilliam is also a member of the National Academy of Medicine and it really gives me great pleasure to welcome her back to the University of Chicago today. And with that, I'll let you take it away, Dr. Gilliam. Great. So first of all, thank you so much. It's so nice to see all of you all and so many friends. So really exciting. Hi Deb, how are you? It's good to see you, hi Dorian. And I miss you all so much. It was such a... Oh, hi Anne. It was such a strange thing to leave during the pandemic. So I felt like I barely got to say goodbye. So I'm again really excited to be here. So I was asked to talk about some issues related to gender and gender diversity in academic medicine. And so some of you who have heard me speak will might recognize some of the slides and the points because much of this is what I learned from working with you all and many things that I've thought about from my work here, my work at the University of Chicago. So what I'll do today is talk about this issue from what I call a design perspective. And I'll go a little more deeply into that, but as you know, much of my scholarship and practice and approach administration kind of thinks about the idea of concepts around designing and thinking about different futures than we see currently. And so I'll kind of take you through that. So as you heard from Julie, I am here at Ohio State. So very different type of institution, a land grant, a big 10 institution. And really one of the things that we have to think a lot about here is the entire workforce. And it's really given me an opportunity to think about the medical workforce in academic medicine and how academic medicine and gender and racial equity in academic medicine has always been such an important part of how we think about reducing health disparities, getting better science, getting more innovative science and being able to relate to our patients. So this is a really wonderful topic that you all are examining over the course of the year. And so I wanted to start off just at that point, we have known for a long time that having a diverse biomedical workforce is critically important. We know that people from different backgrounds, different perspectives bring in different ideas. And it's really important for the way that we solve problems and the way that we solve complex problems. And it is critically important to how we will address issues of disparities in health because of people's ability to have various insights into patient populations and different patient experiences. And so when I talk about these issues, I like to talk about this almost as enlightened self-interest. It is good for science, it is good for medicine, it is good for all of the things that we care about. And yet this is really challenging and it's actually very challenging to be part of academic medicine. There is both incredibly high expectations of us in what we do. And yet it is a time when there is limited public trust. There are lots of concerns for how we'll fund the work that we do. And yet we have concerns around various partnerships. It's very hard to recruit and develop a physician scientist. The cost of what we do is quite difficult to manage. And then there's also kind of issues around working in the collaborative ways that we need to work. And so some of the challenges of what we're thinking about as we think about gender and gender issues in medicine are also related to the challenges of academic medicine itself. I talked a little bit about why diversity is so important. And it's not just coming from me. It is also one of the core concepts that the National Institutes of Health has gotten behind because we have an increasingly diverse population. If we want to have a robust STEM and biomedical workforce, we are going to need to think about the pipeline of both the people who participate as well as the leadership. And so it means that we can't lose people along the way. We need all of the talent that we can find. But what we know is that the pathway into these fields is quite leaky. So we are often looking at our colleagues or we're looking at this opportunity to recruit people but all along the way, and you'll kind of hear of me as I speak, talk about issues of women, issues of underrepresented minorities, the intersectionality of these two issues. But what we know is that at each of these stages, the pipeline has weeks such that people get discouraged from pursuing careers in academic medicine. And so that contributes to the problem that we're talking about. So when we talk about that, I think we often think about this as ability or skill, but as I showed in that previous quotation, this really isn't just a skill or ability issue. That would be one thing. In fact, what it shows is that the skill and the ability is quite equally distributed, but the opportunities and some of the discouraging factors are not. And so there's actually quite a literature on issues of what we would call bias or systematic biases that lead to limitations in women and underrepresented minorities in academic fields. But this is just one example. And so what I like about this is that it is, I mean, I don't like the findings but what I like about this study is that it really studies us, those of us who are actually in these fields. And what they did is this is just kind of one of those simple audit studies, but they created a single intervention. It was just kind of an email. And they were asking, I'm posing as a student and I'm asking for help mentoring support. And in it, they just decided to use different names that would signal different races, ethnicity and variation in gender. And what it showed is that just faculty, just on a routine email, they were more likely to respond to a white male inquirer, a quote unquote white male in inquirer because it was a fake candidate than they were to almost anyone else. And this was across disciplines. And what was interesting about this is the race, gender identity of the person who received the email, that actually didn't make a difference. And so it's important, it kind of looks like this, that everyone might have the ability, might seek opportunity, but particular people are chosen. And what that means is that we have to not only think about the ability and the skills and empowering the individuals, but we have to also think about the context and the people and the systems around them. And I included this slide because it's important for us to realize that as we're thinking about all of these issues, there are also these other larger contextual factors such as the pandemic that can cause burnout and can cause dissuade people even from wanting to work and fight and address many of these issues as they affect their own lives. So that's sort of the background, this kind of how do we start to think about issues of academic medicine? How do we think about academic leadership? And so as I've gotten to this point in my career, I find just as many people, some people want to know what I know and kind of about my scholarship and a lot of people want to know, what are you doing and how did you figure out how to get through this part in academic medicine? So I just thought I would take a little bit of a second and tell you about my own pathway through this complex environment that we're in. So I'm the middle child in my family, so the one all the way on the left and I was born in Washington, D.C. And I tell people about that because I think that in retrospect, it was quite an advantage to live in a majority minority city. I think when I was growing up, it was probably about 70% non-white. And so you end up actually feeling quite normal and quite included in many, many environments. And while there was some level of segregation, there was also people who lived all over the city and you didn't feel, I think many of the things that I've learned about subsequently around the historical role that race plays in this country, I think I was a little less aware of it or in some ways growing up where and how I did. One of the things I learned early on and had a lot of exposure to was that, was what it meant to be a working person and being a woman who worked in environments where there were not many people who looked like them. And that was through my mother, who was a journalist. She still does a lot of writing, but she was the first black woman to be a reporter at the Washington Post. And so I grew up hearing her stories of what it meant to be the only one or not have colleagues who necessarily understood what you were doing and also not having colleagues who had little children at home because it was a predominantly male workforce. The other tremendous influence was my father who as an artist I think had sort of, I think what I learned was what it means to have a career where there's no clear pathway in front of you, where you're kind of making decisions, making choices, but not necessarily here's the school or here's the ramp and you have a guaranteed outcome. So I think I learned how to deal with quite a bit of uncertainty from both of my parents. I went to schools that have similar architecture to the one that to the institution that you all are a part of. And then what I became very interested in the topic of teen pregnancy, I think in many ways when I was graduating from residency, I think for me it was thinking about the major social issue of my growing up time and thinking that, not being getting pregnant as a teenager probably had a big part, it had a lot to do with how I got to where I was. Even though that was a pretty simplistic story and actually probably I was at quite low risk, but it did seem like a big social issue that we needed that I could develop my career to. But what was really behind it is the question that I really do think I spent my time on, which is why do some people have different life outcomes than others and what can be done about it. But initially I thought it was the pregnancy itself. And so I had always spent my time in biomedical labs and in basic science labs. And so I thought about this as a biomedical question. And I got very interested in contraceptive development, contraceptive discovery. These are some studies I did on thinking about the pharmacokinetics of the implant. But what was interesting is I was, even there I was saying, well, if you're obese versus normal weight, you're gonna have a different outcome. What is it about different people, different contexts, different situations? But what I also learned at the same time, I began to also talk to young people. I began to do focus groups in communities. And I saw that there was a disconnect. We were thinking about this as a biomedical issue if they just remember to take the pill or if they just use a longer acting method. And what I was hearing from young people in the community was our lives are far more complex. These aren't methods that I want to take. And I started to realize that we really didn't have the tools to hear and listen to young people. So for me, I began to realize that we were not dealing with a full social ecology of teen pregnancy if I was more focused on the clinical and biomedical aspects of what we were doing. And that because of my background as an English major and I had studied politics and philosophy and public health, I was actually quite equipped to at least ask curious and good questions about the policies and the other societal systems. And so one of the things that has just been such a gift has been the curiosity and the way that at the University of Chicago how we've been able to work in an interdisciplinary way. And that's how I ended up starting the center of CI3 at the university. And in it, I began to think, how do we start to explore these outer circles? Not only the individual, but the social and the political. And so CI3 really became a place where we could put young people at the center, listen to them and their own understanding and stories about their health and health condition. And part of this is also the story of saying, your research can actually be done in a way that you think, right? You could sort of your field goes this way and I learned that I could actually build something very different and think about something very differently than it had been thought about before. And so this is kind of a typical project really centering young people and hearing their voices and teaching them about clinical care and having them critique and develop their own systems for how they want to provide care. And I think in many ways it reflected what was almost a personal experience in that I had thought that I understood and had been trained to think that I really understood and could listen to patients and prescribe only to find that we were missing all of these other aspects of young people's lives that were probably bigger determinants. And so I think now 20 years later we have a very strong language around the social determinants but I think I was living through that moment realizing that we've got to bring these factors into the clinical context. And so that's really the part of the story and then the flip was that we have to also understand really the logistics and the barriers to young people's lives. And so this is a partnership that we had with the Comer Mobile Health Unit and then it's called the PediaCare Van that allowed us to say, what if we could work with young people to help them overcome the barriers in their lives by bringing healthcare to them? And so this is a device that we co-designed with young people that was their interpretation of how they'd like to get contraceptive and health information. But again, they were the ones who designed and formed and helped create and then through partnership we developed a new way of working. And then this is a project that we did in India and we're just finishing it. We've just finished it right in the wake of the pandemic but again, working with young people and teaching them to design their own systems, their own solutions and then using our expertise and methodology working with them to design and develop interventions. So I tell you that once you can know a little bit about me and a little bit about navigating academic medicine but also so you can get a sense of why I've been so interested in this idea of designing in a human-centered way and how I think these are lessons that we can actually bring to the administrative sphere but also to our, as we try to think about and disentangle some of the challenges around gender and academic medicine, racial diversity and academic medicine but also diversity in general and academic medicine. When I talk about diversity, I define it very, very broadly. I think we are better for environments that are richly diverse with people who think in different ways, people who behave in different ways even if their ideas that you don't believe or perspectives that you don't agree with I think we are better off for them. And so I really do believe in creating richly diverse environments. And so this is the basic way that when you enter into design process it's sort of you explore and you look for the questions you generate ideas, you prototype and test and then you try to continue to iterate and refine and I'll take you through this a little bit towards the end but the way that I approach things and the way that I encourage us to approach things is more with kind of the questions in mind and then this idea that you can generate multiple solutions. And so when I talk about diversity and this idea of why this is so important and I use that term enlightened self-interest it's because I think that if we bring in diverse cohorts of people with lots and lots of different backgrounds who are thinking in different ways and then we put our energy in saying how do we make sure that we have a rich culture where people feel included a sense of belonging that they can take risks that they can bring their best ideas then we increase collaboration and productivity and then we get more innovation and then we address issues that we care about such as health disparities. The reason this is so important and why I will often talk about culture when in my own office, my own leadership we spend a lot of time on the culture and the experience of individuals is because that's what the research shows us. So this is something called the social cognitive careers theory. And it's a theory about why underrepresented minorities and women do or do not enter into biomedical research careers and so we all have our own backgrounds and the things that we bring to it we have kind of our abilities and other skill sets and then we have a series and that contributes to how we experience and how we learn and we build self-efficacy and we also have expectations of whether good things will happen to us. And that then leads to our interests our goals and our actions around pursuing certain careers. And so a person input or background contextual factor might be I have a parent who is a physician and I had very, very positive experiences or I know all about being a physician or I know all about being a researcher but the tricky arrow is this one up above and this is these proximal and contextual factors that are having direct and indirect impact and influence on our interest goals and actions. And what Lynn Brown and Hackett have said is that for many, many under people who are currently underrepresented in the academy those barriers, those actual perceived barriers and facilitators often are in the form of a negative often negative experience and expectation and perception of how you will be treated in those environments. So your kind of concerns or your actual experience or the narratives or stories who you see around you that those actually have an effect on whether you have an interest or goals. And so if we sort of think about kind of along that pipe, that pathway to these careers it's those atmospheric factors that actually discourage people. Now, the thing about this particular theory is they're talking about people at fairly young ages. And so we know that even your middle school and your high school experience and really your middle school, your early experience around science, math, STEM and whether you have a sense of belonging that you might belong in those careers can have a tremendous effect on whether you actually pursue those careers. And so this is kind of another way of looking at this idea of don't just think about individual ability or individual responsibility. Think about the social and larger contexts in which we're functioning. And so from that, I kind of showed you that in my own research, I think about adolescents and adolescent development as kind of this ecosystem. I think we can think about academic medicine as similarly as an ecosystem, whether they're factors at the individual level, the social, the infrastructure, the policy and the external world as it impinges on us. And if you kind of unwrap that we could think about this as kind of an underlying infrastructure that contains the policies and programs what happens with the people, the climate and then the larger, larger context. And so some people look at that and they say, oh my gosh, there are so many factors how are we ever going to address issues of gender and academic medicine? But for me, I think it gives us more levers. And so one of the big things that people have focused on is how we address the systems and the infrastructure that could help people achieve different behaviors. So instead of just focusing on, did you say that or does she have this ability? How do we think about facilitating the behaviors that we'd like to see? So you're wondering, what is this photo? So let me show you this photo which is a short video that gives you conceptually what I'm talking about. So you get the idea. And so the idea is that you can start to because changing and shifting behaviors so hard, we can actually look for interventions and other ways of working that can actually shift behavior. This is a study that I think a lot of people have seen. This idea that when orchestras went to auditions where they couldn't see who was performing, they fewer of their biases entered in and the number of women in orchestras began to increase. And the other way of sort of thinking about this and again, coming from research at the University of Chicago that we can start to think about ways of shifting behaviors, incentives, but this other, this middle thing, this idea of nudges, contextual factors and other things. The person who really has championed this work is Iris Bonet and she is an economist at Harvard and who has really looked at this idea of connecting design and gender equality. And I found her book really interesting and so I encourage you to read it and dive more deeply into it, but I'll share a few of her ideas as I talk about working through these various levels. So again, we'll kind of start out at that kind of this policy and infrastructure level because I think that's one thing that we have to really do is to start to think about the policies and the opportunities that we might have to, actually wanted to skip this one, the opportunities we might have at a policy level to start to move the, move issues of bias and to increase gender and generational diversity. So one is to really start to look at our path to promotion for physician scientists and really look at each rung of the promotion process and to say, and to really look at the data and to say, at each of these rungs, at each of these levels, do we have equitable processes? And the way that you would do that is really look at your outcome data or people being promoted at the same level. When we have one of the strongest biases we have and not biases, but one of the strongest things that we do in academic medicine is that we say, funded research versus non-funded research and people have to buy out their time, but have we given people the structures and the systems to ensure that they can be competitive at funded research? And are we making those systems and that knowledge equally available to individuals? When we have policies such as sabbatical or remote work or pay, are we looking at those and are we looking and making sure that those are equitable and are they being used equitably? And then I think we can also think about our roles as advocates. One thing that I was involved in at one point was recommendations to a committee I was serving on at NIH and one of the things that came up was the issue of K award salary. And what you realize in that is that that is one of the best ways to become an academic researcher but the salaries are not really equitable with what it means to be a clinician. So that's how you can actually lock people out of these processes. And again, are we using our power and abilities as advocates to really look at the things that might enable us to create careers? And so, we have things at or you all have things at the University of Chicago things like the ability to have tuition access to tuition benefits for your children, tuition benefits training professional development at work. But all of these things that can actually be in policies are things that you might not think are necessarily gender equity issues, but they have in the ways that they get applied and the potential benefits from them can have gendered outcomes. And so this is kind of this idea of thinking about the design of the system, not things that require that rely on personal decision-making but that underlying design as ways of influencing and places to look for ways of influencing equity. One of the, so if we kind of move into this, the next layer we're kind of thinking about sort of the social and other types of interactions. And so one of the reasons I wanted to include this image is because we often think about issues of gender equity, but our identities are far more complex and the factors that influence us influence our behavior, our reactions, how we're treated go far beyond issues of gender. And I know that the focus today is on issues of gender, but many of us hold multiple identities, all of us hold multiple identities. And so I want, even as we sort of talk about issues of gender, our experience of our gender is also being filtered through all of these other identity factors. And the parallel picture is it can feel like a web and people can feel quite trapped by this. And so how do we start to think about these broader issues of diversity? One thing I believe is that we have to hold our leaders accountable as champions of diversity because often leaders are the ones who have the ability to address these issues. So these show up everywhere from hiring the actual who is in roles of leadership. And I think when we talk about leadership, we should be talking about formal leadership, but also informal leadership or leaders at senior levels but also leaders at levels throughout. And when I talk about informal leaders, I mean that our ability, whether it's our ability to lead our families or lead our classrooms or lead our research teams, those might not necessarily have leader roles, but that's where we're developing the skills and abilities and knowledge that we need as we take on subsequent leader role. And so I think this is both holding our leaders accountable to help people in all of those phases of those careers, but also to be the ones who are accountable for policies that could be applied inequitably. But the other piece I talk a lot about is the ability to hold ourselves accountable. And so it is difficult to change other people's behaviors, but much of the work that we have to do around the ways that these various, our various identities influence ourselves and our reactions is actually, we also have to be cognizant of how they can influence us. And then I would also flip that in one other way, which is that leaders also have to hold themselves accountable and for those of us in you who are in leadership positions, really thinking about how you can use your position to address these issues. Other tools and levers at this level is how we use rewards, how we use accolades. I think this is something the University of Chicago has done incredibly well is to really look at, endowed positions, how are those distributed? Who's being rewarded? Because those are the things that show who's valued, who's valued in an organization and that can help to also create a scaffold to elevate people. And then the other role I think for leaders is also when they see power structures or people who are using their power in positions and unfair ways to be the ones who interrupt and address those things so that individuals who might be experiencing bias and other forms of harassment or discrimination don't have to do that work themselves. The other piece here is that the component of just a sense of wellness and stress and burnout, I think at another time this wouldn't seem at another time, this would have seemed like quite a novel idea, but I think we are increasingly understanding this connection between stress, burnout, mental health and people's ability to continue to stay and thrive and survive in an academic medical environment. One of the biggest challenges has been for example, equitable share of dependent care responsibilities and so that's why equity and pay, leave and time off, all of those things can contribute to a sense of wellness, mental health, well-being that again makes people better able to not become part of that leaky pipeline that I described earlier. Another one of, when Iris Brunet talks about structural factors, she talks about something as simple as the images of success that we feature in our environment so that even you don't always have to have an individual, you could actually have a representation of an individual and these are leaders from the University of Chicago that can actually shift people's understanding and biases around gender and gender equity. So again, just a ways in which even when you don't necessarily have the tools or the women leaders in place you can actually start to show that these successful and diverse leaders exist and that helps to decouple one's brain and starts to shift biases. The other piece that as we start to get to that internal level, we also need to think about the individuals themselves and empowering the individuals themselves. So one, they can withstand some of the challenges in these environments because they don't shift overnight but also because ultimately what we're trying to do is be successful scholars, teachers and practitioners. And so that the success of all of us as individuals is everyone's success. And so this idea of building a network and building a supportive network but also training people in some of the unwritten rules and of being successful at what we do. And so I remember very early in my career I was visiting with Jane Hall who's now here at the University of Chicago but she wasn't at the time. And I was telling her about this grant I was trying to write and how difficult it was. And she said, oh, I can help you with that. And so we just work together and I just learned so much about grant writing and reading books just wasn't going to do that. And so I think part of this is we have to have the skills to initiate those relationships to ask those questions but also to really making sure that we are there to support and teach and mentor the next group of people. So I think as leaders there are ways that we can support that. One is giving people information, really teaching people how to do research to be really mindful of how difficult it is to balance being a physician as well as a researcher really providing lots of opportunities for funding sources, those early funding to help people get started so they can scaffold their career. I just use graphic and editing support but think about those sort of things that are more of a support system but where it makes kind of the difference for having a great research grant or a great outcome or a great presentation. And then we can also be intentional around communication and training people to tell their stories. There's a great project out of NIH it's called SciBytes where they actually trained early career scholars just to be able to tell their stories. And I'll just give you a quick example and I promise I will save time for questions. Hi, my name is Anya and I'm a post baccalaureate researcher at the National Institutes of Health. We all know that breathing in smoke and harmful chemicals can damage our lungs but some people experience particularly strong reactions to these sorts of environmental exposures. My lab is trying to figure out why by studying how genetic differences contribute to a deadly lung disease called idiopathic pulmonary fibrosis. In this disease, certain environmental exposures like pollution and cigarette smoke badly damage the lungs leading to inflammation. So it's simple, but basically the idea is that she's taking her lab or her lab-based science and she's telling it in a story that is relatable. And there are lots of these videos and you can take a look at them but some of them are super musing, really well done. But by learning early in her career to explain her science in a way that's translatable, that will be great for presentations, funding and all of those things to make a successful career. So I was just gonna finish by just telling you a tiny bit about this idea of this design process. But I think what I'll do is I'll go ahead and finish up, but by just telling you this final thing, which is what I was hoping to do is give you kind of a number of entry points into ways and places where you can start to explore opportunities to rethink systems, reduce bias, whether that's at the systems level, the cultural level, the empowering people to be more successful in their career. My bias is a little bit more towards academic but that you can imagine these same types of insights for clinical or teaching or other aspects of academic medicine. But the idea is that I think often we look at issues of gender and inequities and diversity in medicine and we get really like, oh my gosh, what are we gonna do? This is also problematic. But when you start to think about this as a place where there are many insights and many levels to redesign, it really opens up so many possibilities for how we can shift the culture, the systems, and ultimately the complement of people in our field. So I will stop there and if people have any questions, I'm happy to take them. Thank you so much, Dr. Gilliam, that was great. So feel free to type questions in the chat or if you wouldn't raise your hand, you can call in, you can ask out loud. I'll just ask the first question. I was really struck by the kind of infrastructure, the video of the stairs and I read a few books myself on how sometimes infrastructure doesn't support gender equity. And then I was reflecting on the kind of structural tensions right now about remote work, which has been so great for some people and the tension to come back in and maintain community. And I was just wondering if you could speak about Ohio State and what you're doing there for that and what you think the positives and negatives are around that kind of infrastructural opportunity but also kind of how it affects us. Yeah, so remote work is kind of, it's an interesting one, right? So just as I was leaving the University of Chicago, we did a lot, Melinda Hale, Melina Hale led a very, worked with HR and a very, very careful process around remote work. And here we were a lot looser about it because we started later. We surveyed people and as you can imagine, people really wanted a great deal of flexibility. And so what we said is we'd like people to be in, at the University about three days a week was kind of the idea would be the idea. My own personal opinion is that probably we should say that a fault is in person and part of it is because I worry about our undergraduate students and I worry about our students and who's there and how many of us have to be here in order to maintain the spirit of the University. I also think there's a bit of a risk because decisions, opportunities get created just spontaneously by bumping into people and I worry about people who are remote just losing out and losing those opportunities and the knowledge and the information. But I think it's good. And I also think I worry sometimes about some of the social isolation. And so I can sometimes see rumors starting and then they come when everybody comes together and sometimes when we get too atomized and we lose a sense of community, those things get lost. And so there's a tension and I think, but I'm comfortable with the tension. And I think that's what we should sit with because I think we're at this is really moving. This is the final thing I will say is I think we have to think about designing and creating the conditions that are created that people are valuing with remote work. So if you're working remotely because it gives you more privacy and you can get more done versus I'm working remotely because I don't have the resources for childcare. We should try to address the issues for childcare versus thinking that someone is getting as much work done if they're at home taking care of children or other dependents. So what I would also say is let's disentangle what people like and then the final piece is just being competitive. So I don't think our IT folks are coming back because we will lose them to other institutions. So there's no easy answer, but I do think to the extent that remote work is a proxy for something else that we might be able to address in other ways, knowing that institutions can't be all things to all people. I would like to know that and see what things we can improve upon. Wonderful, thank you. I see my Vukovic, you type something in the chat. I'm happy to read it out or I see you're on camera if you'd like to ask it in person. You can also go on mute and ask it yourself. Great, hi Melissa, great to see you again. So I'm a current student at the Harris School working on my MA in Public Policy and I've been at UChicago for 20 years as an administrator and I'm looking to make a career pivot change. And so I'm interested in hearing you talk more about the role public policy can relate to better support. Some of the ideas and themes you're discussing. Yeah, so I'm a huge fan of policy solutions and I like them because just sort of philosophically and conceptually because I can come up with an understanding between you and me or I can make a local arrangement, but there are many, many people who will not benefit from that who don't have the institutional power to be able to say advocate for what they need. And so policies and you have to both implement and follow up and implement and follow up and see whether what you intended to happen is really the outcome that you intended and how does it affect individuals? So I do think policy is iterative. So with those caveats in mind, I do think these fundamental policy issues are the way to address so many things. I think first of all, trying, so I do think we have to try to be as inclusive as we can as we create policy. So I think we should be putting to, when we look at things and look at issues we should have teams with lots of different perspectives so that we're not inadvertently harming one person while you're trying to improve the system for the other. But at the University of Chicago, we had the Provost Council on Women where we really tried to look for the policies that could be inequitable. Those were, that's how we ended up with the Bright Horizons on campus and other things that are these kind of interventions and resources that can make big differences. But I think all of the things that people benefit, whether it's the policies around tuition payment for students at the laboratory schools. And then people said, well, if I had a student who couldn't go to the laboratory school, could I have a benefit at another place? All of those things are at the policy level, but they are the things that make tremendous differences in people's lives. So I encourage people to continue to sift through and examine their policies. I'm constantly sort of saying, wait, what doesn't doesn't work. The only thing I would say is that, again, making sure we're looking to see the impact and the influence and the unintended consequences. And I have a lot of stories about that as well. So really making sure that we address those. And finally, I think teaching people to work at the policy and systems level, it's very hard to do, it takes a lot of work, but I do think it is a translatable skill because it affects so many aspects of our lives. So I'm really glad to see you doing the work that you're doing. And yeah, and good luck to you. Wonderful, are there other questions from the audience? I'll ask a question, Julie. Melissa, it's so great to have you here. And I think that so many elements of your talk really struck, you know, hit home with us, especially around nudges and sort of the staircase as Julie described. I'm curious, you know, as you think about advancing women leaders, you know, and especially during this very time where, you know, of mid-career. I've actually spoken to two or three in our institution who are easily recruited away. And how do we really think about retention? Because I worry that we are at risk of losing a lot of people that, and maybe some exit is okay, you know, like for example, you left and have this amazing role. But what's your advice in terms of how to be proactive in order to retain people at these transition points? Yeah, it's interesting, if people often, people often leave not, you know, sometimes because they're, you know, getting a quote-unquote a better deal, but, and sometimes it's clearly a promotion or an opportunity to do something else. But I think what many people value about academic medicine is that you can change your job without changing your address. And so that you can continue to grow and learn without changing your address. And I can see many people on the screen who represent that. So I think the first is that career and that growth possibility. And then I think the second is people leave and stay based on their social and personal situation. So if you feel connected to your colleagues and connected to your environment, then it is actually quite hard to leave. And also, and I can speak to that as well, it was very, very, very hard to leave. So I think we're doing the right thing by having, thinking about childcare and thinking about schooling and thinking about the community that we have around, that you all have around campus. I've gotten better at that, but I still do it. That you have around campus where your friends and your colleagues and your family are all in the environment. I think that is one of the stickiest things. But it is that idea of, am I being seen and am I being seen in the way that I see myself? And so when people feel as if they cannot, if their career and aspirations that they are aiming towards, nobody sees them or appreciates them, then it's much easier for them to leave. So I encourage both the professional, but also that kind of more qualitative, softer and harder to put a finger on, but ultimately critically important. Thank you. Yeah, she has a hand raised, yeah. Hi, Ann. How are you? I'm well, good to see you. We're so glad to have you back and speaking and we're thinking such good thoughts of you on your new position. But I wanted to ask just briefly, if so appreciated your talk. And I'm curious strategies that you use or you want to mention for leaders who want to support women in academics, particularly early career, but sometimes not managing child rearing and what are strategies we can use? You've mentioned, I think a couple and you just talked a little bit about that in the stickiness, but what are some things that as leaders, we can be thinking, you know, what should we be advocating for in order to support women making that transition into early career academics and into success when they're also trying to manage their busy jobs and their academics and their research and child rearing? And do you have thoughts on, I'm sure you do. Yeah, I think there are kind of two things. One is you have to kind of help people build the individual level skills to manage time and all of those other things because you're always gonna feel like you don't have enough of it. And I think there are kind of skills and ways that you can think about that and think about doing high quality work when you have the moment. And then the next is, you know, if you know that your children and your family are okay, then you're okay, right? If you're not trying to split your attention, and so that's why we need not only safe childcare, but after-school care and all of those other things. And also the ability if, so I am very, if someone needs to leave or if someone has something happening or if they need some time off, all of those things having tremendous amount of flexibility. And then also have the ability, how do we create policies so that if someone has to leave the workforce, they can reenter or if they have to work part-time or they have to work three days. So when I first started, I was at UIC, a state institution, and I had my first child and they were like, oh, you have all this vacation time. So I was like, maybe I'll come in four days a week or maybe I'll come in three days a week. I had that kind of flexibility. Now, obviously I was spending a lot of it working, but just knowing that I could have a little more flexibility, I think allowed me to be really productive. So I think those are the areas that I would look at is really how do we give people the support? We had kind of the dependent care grants where you could, if you're at a conference, you could either bring, you could pay for babysitting or bring a babysitter along and we had some grants through the university for that. Those types of things that allow people to have not only the support, but kind of the peace of mind. And then the final is just giving people the social support to say, what you're doing is fine, right? It is okay to be a working mom and that's why I showed the image of my mom because I was like, it wasn't always perfect, but it turned out okay. And I was kind of like, I realized that knowing that and being able to share that story with other people is also really important. I know we're at time, so I, please end the video. I was just gonna say, I loved seeing the pictures of your mom. That was like one of the, I just, that was fabulous. She was super fabulous, just like you. So thanks for sharing. All right. Well, by feeling, we'll wrap up this part of the talk. Usually we stop the recording and then if, I don't know if you have 15 or 20 more minutes, usually we have some time for those. If you're free, if not, we understand. What do I do? I do. I thought I was taking people's time. Oh, no, no. You're fine. Usually we stop the big group session and then I think either or not, they stop the recording. And then sometimes we have like, the ethics fellows come and just get a little bit more personal time with you. Their mentorship because this lecture series is part of their ethics fellowship training. And so, for all the rest of you, well, thank you for joining us. And I'm happy to have you sign off and for the ethics fellows, if you'd like to go on camera and come and just have a little bit more personal time with Dr. Gilliam. We are ready and available to do that now. So, oh yeah, Dr. Narcissus, thank you. Thank you. It's so nice to see you.