Several groups affiliated with the Tulane University School of Medicine have over the past week released letters criticizing the recent suspension of a Black doctor from her position following her claims of discrimination at the school.
The letters — one from School of Medicine alumni, one from current residents, and one from a group of medical school students — call on the school to release more information about the process that led to the suspension. The resident letter, published on a website about the suspension, calls for the removal of the Dean of the School of Medicine, Dr. Lee Hamm.
“We know historically what the culture has been at Tulane,” Dr. Byron Jasper, a Tulane School of Medicine graduate who practices family medicine at Baton Rouge General, and who signed the alumni letter, said in an interview with the Lens. “Not just from this one experience, but from previous lawsuits, and from our own experiences. And it seems like transparency can only help this.”
The administrator, Dr. Princess Dennar, was the director of the school’s Medicine Pediatrics residency program, and was the first Black woman to hold the title of program director at the school. She was removed from the position earlier this month and told The Lens she believed the move was in retaliation for a discrimination lawsuit she filed last year.
In October 2020, Dennar filed a suit against the university alleging that top medical school administrators — including Hamm — had discriminated against her and her residents on the basis of race and gender. In an interview with The Lens last week, Dennar — who remains employed by the school as medical director of another residency program — said that she believed the suspension was in retaliation for that lawsuit.
Tulane officials have repeatedly denied Dennar’s claims of retaliation.
In a letter sent to the School of Medicine shortly after Dennar’s suspension, Hamm wrote that the decision was the result of an action by the Accreditation Council for Graduate Medical Education, a nationwide accrediting body for medical school residency programs. The ACGME placed Tulane’s Medicine Pediatrics program on “warning status,” according to Hamm’s letter.
Hamm wrote that the status change triggered an automatic review by an internal medical school committee — the Graduate Medical Education Committee — “comprised of a diverse group of Tulane faculty and medical residents from across the school as well as individuals from other institutions.” The Graduate Medical Education Committee approved Dennar’s suspension.
Still, both Hamm and Tulane President Michael Fitts have said that they will begin initiatives to better understand the experiences of minority students, faculty and staff at the school.
The most recent letter, sent Thursday afternoon to Tulane’s administration, came from a group of Tulane medical school alumni. It asks the university to “reconsider the message” sent with Dennar’s suspension.
“While many were surprised by the suspension … of Dr. Dennar,” the letter says, “the troubling details listed in her [lawsuit] were all too familiar. … When a multitude of alumni representing numerous schools of Tulane unequivocally state they are not surprised that this happened, it speaks volumes about the culture — and lack of leadership oversight — that Tulane School of Medicine has perpetuated and failed to correct.”
Dennar’s lawsuit alleged a pattern of discrimination beginning in 2008, when she interviewed for the program directorship. During that process, the lawsuit alleges, Hamm, who is white, told Dennar, “I’m afraid that white medical students wouldn’t follow or rank favorably a program with a Black program director.”
Hamm has denied the accusations in statements released to the Tulane School of Medicine.
According to the lawsuit, Dennar was denied promotions commensurate with her experience and responsibilities. Meanwhile, the lawsuit also accuses Dr. Jeffrey Wiese, the school’s dean of Graduate Medical Education, of failing to address complaints about racism from a number of Black residents, and undermining Dennar’s authority over her program.
It also says that Dennar was forced to rank applicants to her program with a tool called ATLAS that specifically devalued students from historically Black colleges and universities.
The alumni letter is signed by 25 people affiliated with Tulane’s School of Medicine, School of Public Health and Tropical Medicine, and biomedical science programs. (Three other signatories don’t list an affiliation with Tulane.) Most are alumni, but one is a former residency director, and several are former residents with the Medicine Pediatrics program.
Jasper, who is Black, said that the group represented a diversity of perspectives and experiences.
“These are people from across the country,” he said. “[They have] different medical specialties, different sexual orientations, different ethnicities, and different religious beliefs.”
“These are people who are getting off the sidelines and saying, we want to get things done in a transparent, unbiased, open fashion,” he said. “A lot of us in this letter are trying to get Tulane to not only realize that they need to be more transparent, but they need to reexamine how they are structured.”
Michael Strecker, a spokesperson for Tulane, said that the school was “currently reviewing this letter.”
‘Feeling helpless and with no confidence in change’
The letter from Tulane alumni follows a number of other statements released by members of the Tulane community.
On Monday, a group called the SLAM Coalition released a statement criticizing the suspension and university communications. SLAM is composed of a number of other Tulane School of Medicine student organizations, each of which represents marginalized populations in medicine.
The statement asked “for clear and complete responses” to a series of questions regarding the process that led to Dennar’s suspension, including details on the accrediting body review, the school’s response to Dennar’s complaints of discrimination, and the medical school’s use of the ATLAS ranking system.
On Thursday evening, Hamm sent an email to the School of Medicine acknowledging the SLAM Coalition’s letter, saying that “I take their concerns seriously,” and that he had written back after receiving the letter, offering to meet with coalition leadership on Friday.
Representatives for SLAM told the Lens over email that they were not prepared to comment publicly.
A third letter attributed to 60 unnamed Tulane School of Medicine residents described Dennar as “a fierce advocate for equity and diversity,” saying that her suspension “shattered the hearts of many, leaving us feeling helpless and with no confidence in change.” One resident who signed the letter told The Lens that the signatories were anonymous because of widespread concerns about retaliation.
The letter from those residents also called for greater transparency around the suspension, and specifically asked about the membership of the Graduate Medical Education Committee, the internal committee that made the decision to suspend Dennar. It said that the residents didn’t the School of Medicine leadership’s judgment in setting up such a committee. “We have worked with faculty who belittle the effects of heavy discrimination… and who are not held accountable,” the letter says.
Critics of the School of Medicine questioned Wiese’s role in the committee, since such a review would fall under his purview as dean of Graduate Medical Education.
In response to those concerns, Strecker wrote that “Dr. Wiese is the regular chair of GMEC, but recused himself from this review involving [Medicine Pediatrics.]”
The resident letter includes demands that Hamm “be removed from his leadership position immediately,” and called for new leadership at the highest levels of the School of Medicine, as well as an external review of Tulane’s hiring practices.
“These recent developments have raised concerns in our community, and we recognize and share these broader concerns,” Strecker told The Lens in an email.
Dennar disputes university’s explanation
Dennar, meanwhile, has pushed back against the school’s official explanations for her removal. In a Tuesday letter to university President Michael Fitts, she contested the school’s claims that it came as a result of the accrediting body’s decision to place the school on warning status.
According to both Dennar’s letter and lawsuit, the ACGME visited Tulane because of complaints about overwork and discrimination. Dennar wrote that the “warning status” was issued in part because of her “lack of authority” in overseeing her own program.
Susan White, a spokesperson for the ACGME, said that “communications between the ACGME and its accredited programs and institutions is confidential,” and could not share details of the report.
In a statement released on Wednesday, however, the ACGME wrote that “it has become aware of several serious allegations of racial bias and discrimination in medical education.” White confirmed that the statement referred in part to the Tulane allegations. The statement raised the possibility of site visits or investigations as a result of the allegations, although White declined to comment on plans at Tulane, citing confidentiality.
In her letter, Dennar said that other programs, including one directed by Wiese, had received similar warning statuses, but hadn’t undergone the same internal reviews. She also wrote that her program’s warning status had been lifted in January, two weeks before her suspension.
The alumni letter echoed those statements, writing, “residency programs across the country are placed on probationary status with the ACGME, which is a greater sanction than the warning status, and very rarely does that result in the removal of the program director.”
Dennar also wrote that a report detailing the findings that led to her suspension falsely claimed that she had reviewed the document.
In an email sent Friday to the School of Medicine, Hamm wrote that Dennar would be given additional time to respond, and that no final decision had been made.
Responding to Dennar’s allegations that other program directors had not undergone the similar review, Strecker wrote that Tulane had passed “a new policy that requires residency programs that are on warning status to undergo review” since those other cases.
Though Tulane officials have denied Dennar’s claims of discrimination, they have pledged to work on a diversity and inclusion program.
In a statement sent to the Tulane School of Medicine last week, Fitts outlined a diversity, equity, and inclusion initiative that would “immediately engage a third-party firm to facilitate dialogue” in order to “deepen understanding of the precise experiences of our residents, faculty, staff, and other students relative to race and sex,” and “solicit suggestions and develop targeted recommendations” for the university.
In addition, Fitts wrote, “We will conduct a comprehensive, university-wide [equity, diversity, and inclusion] climate survey in fall 2021. This will provide objective data and metrics to assess our racial climate.”
In her letter, Dennar said that timeline showed the school’s lack of urgency.
“I do not believe racism and sexism can conveniently wait until you have a ‘deepened understanding’ of the Black experience at Tulane or until the fall of 2021.”
That’s a point that Jasper, who signed the alumni letter, stressed as well.
“What happens when the next crisis comes? Do you think they’re going to prioritize coming back to this six months from now, when a bunch of things have happened. Until you make it a priority [right now], it’s not really counting for much with a lot of us.”