The messages below have been sent to the Tulane community in light of the recent leadership transition at the Internal Medicine/Pediatrics Residency Program. This transition has raised broader concerns in our academic community regarding issues of equity, inclusion and diversity. We understand and share these broader concerns. Tulane University is committed to fostering an equitable, diverse and inclusive community. Discrimination, in any form, has no place and is not tolerated at our university.
Q. What are residency programs?
A. After completing medical school, graduates begin a residency program to advance their training in a specific medical specialty. Residencies can last from three to seven years, depending on the specialty. At Tulane, each residency program has a program director.
Q. How many residency programs are in the School of Medicine?
A. Tulane's Graduate Medical Education program has 16 single specialty residency programs, 3 combined specialty residency programs, and 19 fellowship programs (post-residency training programs) accredited by the ACGME. There are over 530 residents and fellows in these programs.
Q. What was Dr. Princess Dennar’s role with the Internal Medicine/Pediatrics Residency Program?
A. Dr. Dennar served as the program director for that residency program. She remains a valued faculty member in the Tulane School of Medicine.
Q. Is equity, diversity, and inclusion important to Tulane and the School of Medicine?
A. Increasing diversity, equity and inclusiveness, and ensuring that everyone is and feels fairly treated and respected, is not only the right thing to do, but it also is fundamental to advancing learning, research and scholarship and will strengthen our institution. That said, we have much to learn and much to do before we can achieve our goal of creating a truly equitable, diverse and inclusive community.
Q. What is the School of Medicine doing around EDI issues?
A. The School of Medicine has, within its Office of the Dean, a dedicated Office of Multicultural Affairs (OMA) which provides:
In addition, the OMA will be transitioning to a new location that will include a flexible community space open to all members of the School of Medicine.
Q. Are you satisfied with progress on EDI issues?
A. These recent developments have created an opportunity to discuss our progress with respect to our goals of equity, diversity, and inclusion at the School of Medicine. While we have proactively worked to make systemic improvements to ensure equity and to make our learning and working environment more diverse and inclusive, we recognize that we still have more to do.
Several new actions are being taken immediately, including a full EDI review of the School of Medicine to deepen our understanding of the lived experiences of our residents, faculty, staff, and other students with respect to gender and race. We will be soliciting suggestions and, from those, developing specific recommendations regarding EDI issues for consideration by Tulane’s leadership by the end of the academic year. More information about this initiative will be shared from the Office of the Provost soon.
Q. What is the ACGME?
A. The Accreditation Council for Graduate Medical Education (ACGME) is the nonprofit, private body responsible for accrediting all graduate U.S. medical training programs, including residency and fellowship programs.
Q. Did ACGME perform a site visit in June 2018?
A. Yes, ACGME conducted a site visit of the Med-Peds residency program and the Internal Medicine residency program after it received complaints from within the Med-Peds program of alleged gender and race discrimination and potential programmatic non-compliance.
Q. What did ACGME find?
A. The ACGME found no evidence to substantiate the allegations of gender or race discrimination. Separate from the gender and race discrimination claims that prompted the site visit, ACGME found other instances of non-compliance with certain ACGME program requirements for both the Internal Medicine and Med-Peds residency programs related to the working relationship between the Internal Medicine and Med-Peds program directors, as well as oversight issues associated with the Internal Medicine program director also serving as the Designated Institutional Official (DIO) (i.e., the individual charged with overseeing all residency programs). For the Med-Peds residency program only, the ACGME also found that previously identified work-requirement issues had not been adequately resolved. These findings prompted ACGME to issue citations and accredit each program “with warning.”
The School of Medicine has worked to address the identified issues through changes in reporting structures and personnel, along with more structured collaboration among the Internal Medicine, Pediatrics, and Med-Peds program directors. In 2020 and 2021 the ACGME removed the “warning” status for the Internal Medicine and Med-Peds programs, respectively.
Q. What is the GMEC?
A. The Graduate Medical Education Committee is the School of Medicine’s organizational oversight body responsible for ensuring the quality, performance and accreditation status of the School of Medicine’s residency and fellowship programs. Membership includes program directors, residents, the DIO, and academic officers from various participating institutions.
Q. What is a Special Review?
A. The GMEC exercises its oversight of underperforming residency and fellowship programs through a Special Review process. As part of that process, the GMEC appoints a Special Review Committee to review a program’s compliance with the ACGME requirements. A program may undergo a special review for any number of reasons including at the request of any member of the GMEC with the approval of a majority of the GMEC members.
In late April 2020, at the request of the ACGME, the GMEC strengthened its Special Review process by revising its Resident Policies and Procedure Handbook to provide a Special Review process for oversight of underperforming residency and fellowship programs. As part of that policy, the GMEC required “any program designated by the ACGME as ‘Accredited with Warning’ to automatically undergo a Special Review.” Since April 2020, two programs — in addition to the Med-Peds residency program — have entered the Special Review process based on this new requirement.
Q. Why was Dr. Dennar relieved of her administrative duties as program director for the Med-Peds program?
A. The GMEC, a diverse panel of 15 individuals including individuals from other health care institutions, unanimously recommended a change in the Med-Peds residency program leadership following the Special Review Committee’s findings in connection with its review of the Med-Peds residency program.
The GMEC subsequently voted on and approved its recommendations.
On February 11, 2021, Dean Hamm met with Dr. Dennar and provided her with a copy of the Special Review Committee’s Report and notified her of her opportunity to respond to the Special Review Committee’s Findings. Dean Hamm also notified Dr. Dennar that she was being provisionally relieved of her administrative duties as program director on February 11, 2021, pending administrative review.
Dr. Dennar shared an Open Letter to President Fitts on February 16, noting that she did not have enough time to respond fully to the report. The School of Medicine extended her response deadline two weeks, until March 5, 2021. On Sunday, February 28 – in a second Open Letter – Dr. Dennar stated that she did not intend to provide a further response.
On March 1, Dean Hamm offered to reinstate Dr. Dennar to her position as program director of the Med-Peds program, provided that she accepted several support mechanisms to assist her in fulfilling program director duties. These support mechanisms included additional administrative support to help meet all compliance and reporting requirements, ongoing oversight and guidance and executive coaching.
On March 5 – in a third Open Letter – Dr. Dennar stated that she cannot accept Dean Hamm's offer to restore her role of program director.
Q. On Jan. 22, 2021 the Med-Peds program was removed from warning status by ACGME. Why was Dr. Dennar relieved of her administrative duties?
A. The ACGME accreditation status is independent of the recommendations made by the Special Review Committee, and by the GMEC. The GMEC’s decision regarding Dr. Dennar was made based on the evaluation of a broader set of facts than those reviewed by the ACGME in 2020, but similarly related to the program director’s ability to carry out the responsibilities of a program director.
Q. Is Dr. Dennar still employed by Tulane?
A. Yes, Dr. Dennar remains a member of our faculty and continues to serve as the medical director of the Tulane Internal Medicine & PCAT Clinic at the University Medical Center of New Orleans.
Q. Did Dean Hamm state that white residents would not accept a black Program Director?
A. Dr. Hamm emphatically denies these accusations.
|June 5, 2018||ACGME: Tulane receives a letter from ACGME that they have received complaints from Med-Peds residents of alleged sexual and racial discrimination as well as duty hour violations.|
|June 21, 2018||ACGME: One-day visit:
Interviews Internal Medicine and Meds-Peds residents and leaders.
|Sept. 28, 2018||ACGME: Internal Medicine and Med-Peds residency programs placed on “Accreditation with Warning” status from the June 21 site visit.|
|Jan. 14, 2019||ACGME: The School of Medicine, as Sponsoring Institution, placed on “Accreditation with Warning” status.|
|Oct. 22, 2019||ACGME: The School of Medicine’s Institutional site visit.|
|Dec. 3, 2019||ACGME: Internal Medicine residency program site visit.|
|Dec. 4, 2019||ACGME: Meds-Peds residency program site visit.|
|Jan. 15, 2020||ACGME: The School of Medicine, as Sponsoring Institution, placed on “Continued Accreditation with Warning” status.|
|April 3, 2020||ACGME: Internal Medicine residency program removed from Accreditation with Warning status by ACGME.|
|April 3, 2020||ACGME: Med-Peds residency program remains on Accreditation with Warning status and multiple citations from ACGME, including new citations.|
|April 28, 2020||Special Review: In response to ACGME citation, the Resident Policies and Procedure Handbook is revised to require that “any program designated by the ACGME as “Accredited with Warning” will automatically undergo a Special Review.” The decision to strengthen the Special Review procedures was based on ACGME requirements.|
|June 2020||Special Review: A Special Review process is initiated for the Med-Peds residency program. NOTE: two other programs also underwent Special Review at this time because of the new policy.|
|July-Dec. 2020||Special Review: The Special Review Committee appointed to review the Med-Peds residency program interviews program directors, and faculty from the Med-Peds, Internal Medicine and Pediatrics residency programs and residents from the Med-Peds program and prepares its report.|
|Oct. 1, 2020||Dr. Dennar files a lawsuit against Tulane University.|
|Jan. 22, 2021||ACGME: ACGME removes Med-Peds residency program from Accreditation with Warning status.|
|Feb. 11, 2021||GMEC: Dr. Dennar is informed about the recommendation of a change in program leadership in the Med-Peds residency program, placed on interim suspension and notified that she will have an opportunity to respond to the findings and recommendations in the GMEC Special Review Committee Report.|
|Feb. 16, 2021||Dr. Dennar shares, via Open Letter, that she does not have enough time to review the report and will not be providing a detailed response to the GMEC Special Review Committee Report findings and recommendations.|
|Feb. 18, 2021||GMEC: Dr. Dennar is given an extension of time, until March 5, to respond to the GMEC Special Review Committee Report findings and recommendations.|
|March 2, 2021||Dean Hamm offers to restore Dr. Dennar to the position of program director with required support mechanisms to help to ensure that issues raised in the GMEC Special Review Committee Report do not reoccur.|
|March 5, 2021||In a third Open Letter, Dr. Dennar stated that she cannot accept Dean Hamm's offer to restore her role of program director.|