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During the 2002-2003 academic year, and with the support of SDOS Dean Dr. Ira Lamster; Drs. Letty Moss-Salentijn, associate dean of academic affairs; and Richard Lichtenthal, chairman of restorative dentistry, I was privileged to be selected as a fellow in the Executive Leadership in Academic Medicine (ELAM) program for women. ELAM is part of the Institute for Women's Health and Leadership at Drexel University College of Medicine in Philadelphia. This competitive program accepts about 45 physicians, dentists, and researchers per year, all of whom must be at the associate professor level or higher. Four to five of the participants are from dental schools; about half of U.S. dental schools have participated in the program.

The ELAM program strives to increase the number of women leaders at academic health centers. Of the nation's 56 dental schools, ten have women deans; two of those are ELAM graduates. Of the 126 medical schools, nine have women as deans; three are ELAM graduates. The hope is that increasing the number of women in such positions will eventually lead to better studies of women's health issues and have a positive influence on research and teaching.

There are two eight-day sessions in Pennsylvania, one in the fall and one in the spring that focus on the fellow's personal and professional development. Topics include financial analysis, strategic planning, and the interplay of management and leadership. Several intercession assignments must also be completed between the fall and the spring session that aim to help the fellow understand the administrative culture of her institution and focus on an "action project" to benefit her institution. The program culminates in an intensive two-day "emerging issues" forum in which the deans are invited to participate.

My action project focused on improving the clinical experience of the SDOS student. As fourth year program director for the past several years, I have tried to create a comprehensive care program that helps students apply knowledge of the basic sciences to patient care. Fourth-year students are assigned 25 to 30 patients with varying oral health needs and financial capabilities for whom they are responsible for providing all dental care. In addition, students are placed in 15- to 20-person groups with a faculty mentor and attend about 120 hours of interdisciplinary, case-driven discussions that help them apply knowledge acquired in basic science, behavioral and preclinical courses to sensitive, timely and competent patient care.

The results of changes in the fourth year program showed a progressive improvement in both student performance and patient care. Student scores on national boards improved and our clinics have been among the school's most productive in generating income and increasing patient satisfaction. However, internal evaluations also showed that dental students' third year, although a good experience, left them somewhat unprepared for the rigors of the fourth-year comprehensive care experience. My action project allowed me to co-chair the clinical curriculum subcommittee, look for ways to enhance the third year clinical experience and also reevaluate the core competencies in pre-clinical and clinical education. The exercise gave me the chance to work closely with Dean Lamster, Drs. Salentijn and Lichtenthal, as well as several preclinical and clinical course directors.

There were many other highlights of the ELAM experience. For example, in the fall session, we were asked to solve the financial problems of the "Ann Preston School of Medicine" – a school whose name was disguised but was a real, troubled institution. A group of eight fellows, representing the mock "executive board," was given the school's budget report and asked to come up with a five-year strategic plan to save it from ruin. This strategic plan was presented the next day to a very real panel of deans, CFOs, and university presidents. This project not only put into action our newly gained skills in reading and understanding budgets, but truly tested how one makes progress in an organization depending on the number of extroverts, introverts, detail or picture" oriented individuals. We learned that the way things move forward in an institution will likely depend on whether the leader is a visionary who pays little attention to detail or a methodical, process-oriented individual and the interplay of these two traits.

There were several intercession assignments, including interviewing important administrators at the fellow's institution and extensive – and required – networking with an accomplished group of women fellows and ELAM graduates. We also had to prepare financial reports that compared our financial institution to others, an exercise that provided a great deal of insight. Interviews with key administrators at Columbia provided an excellent way to gain insight into the relationship between SDOS and other Health Sciences schools.

A highlight of the spring session is the 1:1/2 day Dean's Forum in which the dean works with his or her fellow on emerging issues at their institution. I learned about the dean's outstanding success in achieving collaboration in SDOS's research efforts. He learned that this program was making a difference by allowing me to focus my action project on the strategic steps important to the pre-clinical to clinical continuum of dental education and to lead the pre-clinical program course directors in putting greater focus on measuring dental student competency.

Participating in ELAM is not for the faint of heart. It takes you away for almost four weeks from work and family. The readings, intercession projects, interviews, financial analyses, and action projects take many hours, leaving few, if any, weekends free. Furthermore, the cost to the department or school is about $10,000 for the fellow's tuition and travel expenses. Still, this experience is well worth the cost. I have never understood better what makes an organization run. It made me think about questions such as: "Should one be an outstanding manager – one who focuses on incremental improvements, plays the game better and produces good outcomes?" or "Should one be a better leader, who identifies unexplored needs, plays the game differently and brings about dramatic change?"

The program makes clear that both competencies are needed and provides tools to develop these critical skills, skills that will ultimately benefit the participant, her institution, and women's health.

Dr. Vicky Evangelidis-Sakellson is associate professor of clinical dentistry in the School of Dental and Oral Surgery.