Dean promotes med student well-being. And he’s fired.

Stuart Slavin MD

Medical students enjoying discussion with Dr. Stuart Slavin.

URGENT: ** Please attend demonstration of support May 11th in St. Louis. **  Just received this letter from a medical student:

Dr. Wible,

I hope you are doing well. I am reaching out to you in less than pleasant circumstances. Dr. Slavin, our most valued leader and educator, has been dismissed precipitously from his position as Dean of Curricular Affairs. He seems to have been targeted unfairly for the recent accreditation decision. There is a general lack of transparency regarding all of this. The newly appointed Dean Behrns also may not share Dr. Slavin’s vision of valuing student mental health and wellness and being a national leader on this front. Please help us in increasing awareness of a demonstration of our continued support for Dr. Slavin tomorrow on the medical campus.

There will be a demonstration tomorrow, Thursday, May 11, 2017, from 12-3 pm on the medical school campus to show support for Dr. Slavin. We will be gathering around the fountain in front of the Learning Resource Center Building at 3544 Hickory St. in St.Louis, MO 63104.

Students For Slavin

Medical students’ posters for demonstration of continued support of Dr. Slavin.

Official Press Release: May 10, 2017, St. Louis, MO.

On the morning of May 8, the students, faculty and staff of Saint Louis University School of Medicine (SLUSOM) received an unexpected email from the School’s newly appointed Dean, Dr. Kevin Behrns. The email informed students about “changes in structure and leadership” and of the dismissal of Dr. Stuart Slavin, Dean of Curricular Affairs.  The decision to terminate Dr. Slavin was a surprise to many as Slavin, a stalwart in medical education thought leadership, nationally renowned for his work on medical students’ well-being, was held in the highest regard by his students. These students were notably absent from the decision to fire him.

 The letting go of Dr. Slavin was the second surprising announcement in as many months for SLUSOM students.  The first came on March 14 when students were notified that the Liaison Committee on Medical Education (LCME) placed the School on probation. Following an October 2016 LCME site review, the School was cited in areas of administration and curriculum management. These findings are contradicted by the School’s favorable student reviews ­— a recent report by the AAMC found that 96% of SLUSOM students are satisfied with the quality of their education, beating the national average by roughly ten percentage points — and the School’s students consistently exceed national averages on licensing exams.

Despite disappointment and confusion over the LCME decision, students looked eagerly toward the opportunity to have a seat at the table as the School worked to improve upon the areas highlighted by the LCME. In the weeks following the probation, medical students sought out an active role in the remediation process while also striving to ensure the aspects of SLUSOM that they valued would remain. However, after hearing initial responses from the medical school administration about how the probationary status would be addressed, medical students became concerned about the uncertainty of Dr. Slavin’s position at the medical school. In order to ensure the administration understood medical students’ support for Dr. Slavin and the work he has done to pioneer an innovative curriculum, over 600 students’ signatures were preemptively collected in support of Dr. Slavin. These signatures were to be delivered at a meeting with Dr. Behrns on Wednesday, May 10; however, news of Dr. Slavin’s dismissal arrived two days before this could occur. Despite Dr. Slavin’s almost universal respect, Dr. Behrns offered no rationale behind the decision, citing only a need for a change in leadership and oversight.

 This is about more than a nice person losing a job. Dr. Slavin has worn many hats at SLUSOM over the last 13 years, and he has been integral to the development of SLU’s recent identity as a leader in medical education, student wellness and mental health. In addition to acting as the Dean for Curricular Affairs, he is also the director of multiple courses, sits on many of the School’s clinical and curricular committees, and lectures throughout the year.  On top of all of this, he provides unwavering support for medical students, being a mentor for many, and has been a pioneer in medical student wellbeing research.

Dr. Slavin is an accomplished and skilled educator, having won multiple teaching awards at UCLA and SLU and consistently evaluated by students as one of the best educators at SLU SOM. He was chosen as a winner for the 2013 Alpha Omega Alpha Robert J. Glaser Distinguished Teacher Award, one of the field’s top honors, for his outstanding contributions to medical education. In addition, he has furthered SLUSOM’s presence and recognition nationally. He has spoken at 16 medical schools in the U.S. and has been the keynote speaker at both national and international conferences. His work has been noticed by many, notably Missouri House Rep. Keith Frederick who stated in his defense of the Show Me Compassionate Medical Education Act that SLUSOM is a “beacon of light” in medical education and has “leapfrogged the LCME” with regards to exploring and addressing medical student mental health. Slavin has also been featured in journals and news outlets, including, the New England Journal of Medicine, Journal of the American Medical Association, The New York Times, and the St. Louis Public Radio.

Although he is a pioneer of integrating wellness into medical education, this is about more than just “wellness”. Wellness is a byproduct of the educational environment, and Dr. Slavin is challenging and transforming the framework of traditional education as a whole. The work Dr. Stuart Slavin has done at SLUSOM has made it a place that not only fosters one’s development as a physician, but also as an individual. All of this was done without diminishing student performance on national licensing exams. Dr. Slavin has made SLU an example other schools look to when exploring how to improve their student wellness.

Dr. Kevin Berhns was appointed Vice President for Medical Affairs and Dean of the School of Medicine on January 1st. In view of that recent appointment, it is understandable Dean Behrns lacks certain understanding of the students, the culture, and the curriculum of SLU. His efforts to engage the student body have been noted and appreciated, but there is still more for him to learn. He has stated that he wants to make SLU a “metric-driven” institution. However, his current actions demonstrate he is not yet privy to one fundamental metric that is important to SLU students, namely student wellness. His decision to remove Dr. Slavin without giving any word to how he will continue Dr. Slavin’s wellness initiatives demonstrates Dr. Behrns’ lack of knowledge of how important these initiatives are to the SLU student body and to the role SLU plays as a leader in this field. It may be vogue and reasonable practice to resort to layoffs when an organization faces adverse and embarrassing circumstances, but the firing of a dean so integral to a school’s identity seems kneejerk and premature. The students seek only to be involved in this process, because it is their consensus that the removal of Dr. Slavin is a profound mistake.

Please support Dr. Slavin with your comment on this blog and/or your attendance at the demonstration.

___

Pamela Wible, M.D., reports on human rights violations in medicine. She is the author of Physician Suicide Letters—Answered.

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33 comments on “Dean promotes med student well-being. And he’s fired.
  1. As a long-time RN with a passion for health and well-being, I am appalled at the firing of a doctor/dean who is standing for the values I cherish. It seems the Semmelweis effect is alive and well in the medical world. Ultimately, we came to know he was correct; we will come to know Dr. Slavin is also.

    Thank you for your courage! Thank you for your being correct and standing up for the health of your students — and thus of all those they will care for in the future! Thank you for showing us how to be healers!

  2. Clare says:

    Thanks for sharing, Dr. Wible! Dr. Slavin is what makes SLUSOM great for me. I can’t imagine not having him there!

  3. Ndidi Ntukogu says:

    I wonder if his revolutionary ideas and practice, rivaled and challenged this age old accreditation body? Perhaps his work was well known and on the cusp of transforming the entire medical education system and the draconian and malignant system wants to keep things as they are? It makes no sense to me why the were placed on probation to begin with and why such a compassionate and beloved educator was the target of such malice, oh, I forgot, this is medicine we’re talking about!

  4. Medical school can be and typically is intimidating and challenging. Exam performance is one element of this intimidation. Students do need encouragement and affirmation and even confirmation along the way. A Dean who truly cares is supremely valuable. A Dean who cares enough to connect and to express support and encouragement is supremely valuable. Becoming and being a Physician is a “Calling.” It is a “Vocation.” Physicians must graduate feeling this “Call.” and following it. Academic performance is not the core of being a good Physician. Caring is. Being aware of other’s needs and special needs is. The care of a shepherding Dean that leads med students thru the valleys of fear, shadows, fright, self-doubt, and near-break-downs is invaluable – and essential – to the proper formation of any medical student. The Dean who was dismissed at SLU is made of the right stuff.

  5. Pamela Wible MD says:

    A few comments sent my way:

    “All of us students here are deeply saddened to see Dr. Slavin leave. He has made a huge positive impact on our school and many of us don’t understand why this has to happen.
    Thanks for reaching out to everyone.” (SLU student)

    “This is such a gripping story. It’s unfortunate that such a highly-esteemed advocate for the progression of mental health in our medical students has been removed from a power of position. To me, it unfortunately is a mirror of what is going on today in our political society, with many officials with well-intentions being removed from positions of power.”

  6. Rahul Jalota says:

    This is such a gripping story. It’s unfortunate that such a highly-esteemed advocate for the progression of mental health in our medical students has been removed from a power of position. To me, it unfortunately is a mirror of what is going on today in our political society, with many officials with well-intentions being removed from positions of power. I guess my question is, what can a medical student do to help reinstate Dr. Slavin? How much power does a medical student have in their education?

  7. Marie Clougherty Vrablik, MD, MCR says:

    This is outrageous. Dr. Slavin was an incredible supporter and advocate for medical student well being, an amazing educator and a truly admired and respected figure when I attended SLUSOM from 2005-2009. I will be writing the school directly to express my displeasure. What a loss to the SLU community and a travesty. As an educator now of medical students and residents in emergency medicine, I am only beginning to realize the personal commitment and sacrifice Dr. Slavin made in order to help his students navigate the difficult path of medical school.

  8. Marie Clougherty Vrablik, MD, MCR says:

    What an outrage. Dr. Slavin was an incredible mentor, educator, advocate and administrator and was a huge supporter for the medical students during my time at SLU SOM from 2005-2009. As an educator of emergency medicine residents and medical students now, I am only beginning to understand the amount of commitment and personal sacrifice that Dr. Slavin must have made to help us, his students, navigate and survive medical school. I will be writing the school directly. This a mistake, SLU. Please listen.

  9. Jeanne Vinsel says:

    Dr Slavin, I am so sorry that you were fired for being kind, compassionate, and caring toward your medical students. Unfortunately the medical administration does not value those qualities. Thank you for being there for your students. Take care.
    Sincerely, Dr Jeanne Vinsel

  10. Dylan Hanami says:

    I wish I could be there at the demonstration of support for Dr. Slavin today, but I’m out of town, unfortunately.
    I’m a graduating 4th year medical student at Saint Louis University, and I honestly do not know what I would have done without Dr. Slavin. Many, if not all, of the students at SLU Med owe Dr. Slavin a huge thank you for advocating for our mental health, and I’m hopeful that Dr. Behrns (the newly appointed Dean) will listen to the student body, and this decision will get turned around.
    We received the news of the LCME probation a few months after Dr. Behrns was hired, and from the perspective of most students, we feel it is unfair, and short-sighted to use Dr. Slavin as a scapegoat during this stressful time. He has only done us good.
    The impact of losing Dr. Slavin at SLU SOM would be detrimental to the success of medical students, and I am genuinely concerned for what this path holds for the future of SLU Med in general.
    Dr. Slavin has shown us unwavering support during difficult times, and I hope that we can show the same unwavering support for him now.

  11. Billie Pawlikowski says:

    If I were still in St. Louis, I would be there in a minute. This is not the culture I remember when Dr. Coy Fitch was the Chairman. I’m very surprised about the turn-around and saddened by the news.

  12. Selver Maric says:

    Not surprise at all, that’s what happens when you want to do the right thing surrounded with the wrong people. Big support for the Dr. Slavin – I hope we will see Ideal Medical School with Dr. Slavin at the Dean position one day.

  13. Rachel Pian says:

    My name is Rachel Pian, I voluntarily left allopathic medical school in the US after 2.5 years of study because of the abusive environment, which had taken QUITE the toll on my physical and mental wellbeing. Now, I am HEALTHY, HAPPY and working as a developer and engineer with a salary that exceeds that of my MD colleagues by tens of thousands of dollars. I am so glad that I made the decision to extricate myself from the human rights violations ongoing in the medical realm. Best of luck to all who are struggling. You’re wearing paper chains!!!!!

    • Pamela Wible MD says:

      Oh hey Rachel! I was wondering what happened to you! CONGRATS. You really made an amazing comeback. So impressed and inspired. I remember talking to you when you had just quit. You absolutely made the right decision it seems. Now you can have a normal life with weekend off and holidays like most people 😉

  14. Lori E. says:

    My daughter attends SLUSOM and you were her advisor. One of the reasons that she excels at this institution is due to the expert and focused guidance which you have provided. I am disappointed that SLUSOM has lost such an inspiring and invaluable individual.

  15. my name is doc mike witort.r,pmd. i have been assisting doctors for almost 20 years.wakeupwell.ORG is my websitefor suicidal doctors and cops. visit it any time day or nite… GOD BLESS DOC

  16. Outraged. Not cool. Love the Ideal Medical School concept – with only loving and humane instructors and staff.

  17. Jenny says:

    Students and alumni both are showing their support for Dr. Slavin. Many emails are being sent. Dr. Slavin was such an integral part of my desire to continue in medicine. I worked with him on the curriculum committee (when I was the student rep) so I saw first hand how tirelessly he advocated for students.

  18. Karen K Miday says:

    This is the saddest thing ever. I believe that if my son, who Is now a doctor deceased by his own hand, had had a mentor like Stuart Slavin,he might be alive today.
    I have met with Dr Slavin in person and via email. He is the best of what every physician should be…. dedicated, intelligient, and deeply compassionate.
    Shame on the medical establishment!
    Karen Miday
    Psychiatrist
    Cincinnati OH

  19. Dr. Slavin was a great influence on me during my time at SLUSOM, I’m proud to have known him and glad that he taught me and looked out for me. I’ll be writing Dr. Behrns a personal letter letting him know my displeasure with the decision.

    Kevin E. Behrns
    Vice President
    Admin. Medical School
    Schwitalla Hall, 2nd Fl Rm 268
    1402 South Grand Blvd.
    St. Louis, MO 63104

  20. Unfortunately the false sense of control underscores decisions that permeate uncertainty and insecurity. Dr. Slavin was my mentor for many years at UCLA. I modeled my “doctoring” after him, and can not think of another individual who has influenced more the careers of doctors in a caring, empathetic, and responsible manner. Dr. Slavin, thank you. I follow in your footsteps daily. And I thrive. And my patients thrive because of your guidance. Sincerely, Casey Schirmer MD

  21. Alex Gamble says:

    Here’s an email I sent to the new Dean of the School of Medicine and the President of SLU regarding the removal of Dr. Slavin. I would encourage anyone concerned about the mental health of medical students in general or SLUSoM students in particular to make your voice audible. I’ll let you know if I hear anything back.

    Good evening,

    My name is Alexander Gamble, and I am an alumnus of both Saint Louis University (’06) and SLU’s School of Medicine (’10). I have today read a number of stories regarding the removal of the Associate Dean of Curricular Affairs, Dr. Stuart Slavin, from the School of Medicine and I am troubled by the lack of transparency in this matter. I am writing to request more information regarding the decision to remove Dr. Slavin from his position and an explanation as to how this decision is meant to fit with the larger mission of the School of Medicine and Saint Louis University.

    In light of the ongoing proceedings regarding the School of Medicine’s current probationary status and in absence of more information, one could be forgiven for assuming that Dr. Slavin’s removal was related to the probation. If these matters are not related, I look forward to a more thorough explanation of why Dr. Slavin is being removed to disabuse me of this notion. If they are related, I think clarification is even more sorely needed, given the pledges made by our new Dean in the School of Medicine regarding the remediation process.

    In his March 14th email to alumni regarding the remediation, Dr. Behrns pledged “to be transparent in this process” as well as stating that “our outstanding faculty will be engaged at every step of the remediation process.” With regard to the former, I would expect some explanation in the name of transparency if this decision is considered as part of the process. In addition to the general reporting available, I looked at the website set up to promote communication and transparency in the remediation process and found no information regarding Dr. Slavin’s removal. With regard to the latter pledge, I expected this to mean that the faculty would be engaged to address the issues raised by the review, not simply removed.

    I also note that Dr. Behrns’ email outlined his guiding principles for the accreditation remediation process:
    – Our primary goal is to prepare our students to be outstanding clinicians, researchers, community leaders, and lifelong learners.
    – We will review our medical student education program from top to bottom to ensure compliance and to seek opportunities for novel educational approaches.
    – We will address in detail the cited deficiencies, but every element of every standard in the LCME guidelines will be reviewed to ensure that we meet or exceed their standards.
    – We will create a culture of discipline and teamwork with accreditation and documentation of our processes.
    – We will work closely with the LCME and other extramural medical education experts to seek input related to redesigning our educational programs to ensure they are world-class.
    – We will become a metric-driven organization.

    It would seem that if these are going to be our guiding principles in this process, Dr. Slavin would be an invaluable asset to the effort. His focus for over a decade has been on fostering the well-being that is a preliminary requirement for the outstanding qualities we hope our students will develop in training. He is widely recognized on both the national and international stages as on the cutting edge or “world-class” in medical education with respect to mental health and issues of student well-being. Just in the past few weeks I was delighted to hear his voice in an audio piece (http://www.nejm.org/action/showMediaPlayer?doi=10.1056%2FNEJMp1615974&aid=NEJMp1615974_attach_1&area=) accompanying a widely-circulated article in the New England Journal of Medicine (http://www.nejm.org/doi/full/10.1056/NEJMp1615974#t=article) regarding physician self-care and recovery. His removal from the School of Medicine was not the next bit of news I was expecting to hear regarding Dr. Slavin.

    No doubt, the probationary status of the Medical School is a serious issue. Serious steps must be undertaken to address the deficiencies raised and ensure the quality of education the students at SLU are receiving, both for themselves and for their future patients.

    That the standard system of American medical education produces depression and suicides above the expected rate in the general population as a regular feature is beyond dispute at this point. And as a product of Saint Louis University’s School of Medicine prior to the changes Dr. Slavin has instituted, I can attest to this fact personally. But I have been proud to hear that rates of depression have dropped precipitously while well-being has improved at my Alma Mater as a result of the steady and intense effort Dr. Slavin has put in to counteract those damaging features (https://www.slu.edu/news/2016/september/slavin-addresses-toxic-stress.php).

    Now, as we undertake the critical and potentially risky effort to hew more closely to the expectations of a system which causes significant morbidity and mortality, it would seem more important than ever to ensure that we are carefully considering the impacts of changes we make on the students who have entrusted themselves to our program and utilizing whatever resources are available to us to succeed in this effort.

    Dr. Behrns’ last guiding principle was to become a “metric driven organization”. While we strive to meet the important standards set by the LCME we should not lose focus on the critical metrics that those standards cannot or simply do not measure. As a practicing Psychiatrist and Palliative Care clinician, I know that some of the most important components of a patient’s quality of life are difficult or at times impossible to measure. In other cases, the medical system itself simply chooses not to value those measures. This does not make them less important to the patient, or critical to their well-being.

    I hope that as we move forward, we do not overlook elements critical to the basic well being and ultimate success of our students simply because the current system does not yet have ways to measure them or has not yet chosen to measure and value them.

    Dr. Slavin has done much to put a critical focus on these elements in a system that has been blind to them for far too long. I would ask for an explanation for why he is now being removed at a time when his work seems even more important.

    I thank you for your time and consideration in this matter and look forward to your response.

    Regards,
    Alexander Gamble, MD
    Saint Louis University, Class of 2006
    Saint Louis University School of Medicine, Class of 2010

    • Pamela Wible MD says:

      Excellent analysis Alexander. Thank you so much for speaking up. We can’t afford to lose our most valuable medical educators who uphold the academic and mental health of the next generation of doctors.

  22. thanks Pam for putting my comment up on your website!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! Doc Mike Witort, r pmd

  23. Mary Ray says:

    The medical establishment is sick!

  24. Shannon says:

    Pamela,
    Thank you for sharing that.  I found that both sad and encouraging.  Sad that he, who seems like an amazing man and educator, was dismissed for seemingly no reason.  Encouraging, that he has the support of many people behind him wanting him to keep doing what he is doing.

    I don’t really know how it works in Missouri or with medical school, but I do know that many nursing instructors here in Oregon are part of teacher’s unions that would prevent something like that from happening without just cause (assuming strong union members).  Although, he does have  students, doctors, and like-minded people united behind him, and that can be a very powerful thing.

    I hope that he does not become discouraged by the whole ordeal.  Even if it does work as everyone hopes, it can be difficult returning to work for someone that has mistreated you; he may be set-up for bullying by school administrators if he stays.  The seeds of well-being that he has planted in the student body and beyond are growing.  Would it be so terrible if he went to a new school and planted those same seeds there?

    Hoping for his long and fruitful career,
    ~Shannon

    • Pamela Wible MD says:

      Regardless of this unfortunate bump in the road I do think Dr. Slavin will have a long and fruitful career. He is an inspiration to many and will likely be swooped up by another medical school shortly. My guess anyway . . .

  25. Jeff Evans MSW says:

    Please have Dr. Slavin or someone contact me. I have research on Being A Leader Course: An ontological phenomenological approach which I lead over a semester (volunteer basis- no charges) in the top Ukrainian Universities. The students (and teachers), according to Hudson’s Index of Contentment, are 44% depressed. After the course 16% remain above the cutting score. The course facilitates the participants’ altering their perception of the future into which they are living. So without changing the circumstances, their world-view is altered which leads to greater contentment regardless of the circumstances in their lives. Interestingly, their circumstances seem to also begin to shift with a shift in their world-view. I am offering to lead an evaluation course in any major university without charge.

  26. Amanda Gerber, MD says:

    This is so frustrating for so many reasons. I graduated from SLUSOM in 2008 and have commented so many times on how amazing my education was at this medical school. The culture was harsh and the “progress committee” and I had many meetings regarding a medical leave of absence. However, Dr. Slavin and Dr. Sweirkosz (now deceased) both worked with me to keep in medical school and helped me to thrive despite the culture. I have a really hard time believing the LCME has any real grounds for probationary status as clearly SLUSOM is producing amazing doctors. I am fearful this is yet another attempt to “keep us all in line” and to prevent the dramatic culture shift that must occur for medical students, residents and doctors to survive and thrive. With the current Medicare and political climate, medicine seems to have approached a tipping point. Change will happen and it is going to hurt and educators like Dr. Slavin are at the front line teaching medical students how to adapt to an ever-changing system. My heart aches for him and the administration at SLUSOM who just lost one of the most loyal advocates of humane medical education. I sincerely hope Dr. Behrns does start listening to medical students and to the faculty who have dedicated their careers to teaching the next generation of students. Dr. Slavin should have been at the head of that table and I fear SLUSOM students will lose because of it.

  27. LaKeischa McMillan says:

    This is a shame. Dr. Slavin was on the right track. He knew how important it is for you as a physician to be whole. You can’t help fix someone else if you are broken.

  28. Roy says:

    I know for a fact that some doctors are texting about patients and allowing other doctors to read what they are saying about us. For example ,,if you have seen a doctor for a problem 2-3 times and what he or she is doing for you doesn’t seem to be working,they get pissed off if you tell them it isn’t working to many times. So you see another doctor and he or she says to wait here for a moment or two. That’s the time it takes for them to run your name on the computer to see what the other doctors have said and what they have done for you. Any remarks from them will help profile you as a nut or whatever and now they treat you as that.They might tell you they can’t see you again and go somewhere else.
    I believe this is wide spread and helps doctors make more money getting rid of patients that take up too much time . Time is money in their pockets and forget about patients time and money EH !
    They don’t give a damn about you or your problems as long as they can make a lot of money.
    Then there are the doctors like mine that talk for 20 minutes about the new house they just bought in a nice place for holidays. I told him one day about our place and he didn’t have time to respond ? I’m to busy he replied.?
    REPORT THESE DOCTORS and GO SOMEWHERE ELSE as there are lots of doctors and in a small town he will just leave as there won’t be enough money for him to stay.

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