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In May 2010, the Association of American Medical Colleges reported that nonwhite professors have a lower promotion rate than white professors. A cohort of 30 underrepresented minority (URM) junior faculty who participated in a structured faculty development program at a public, research-intensive, academic medical center were followed in a 10-year longitudinal study. This paper reports on the career status of 12 of the 30 URM faculty who were eligible for promotion during this period. Ninety-two percent (11/12) of URM faculty eligible for promotion were promoted to associate professor. When asked what factors contributed to their success, these URM faculty identified access and support of senior faculty mentors, peer networking, professional skill development, and knowledge of institutional culture. A faculty development program that addresses these components can promote the success of URM faculty in academic medicine.

In order to create a cohort of investigators who are engaged in health disparities research, scholarship, and practice, and to increase the amount of funding in the university that is invested in research focused on reducing health disparities, the San Diego EXPORT Center implemented 2 major initiatives: (1) the support of underrepresented minority (URM) junior faculty development and (2) the funding for pilot research grants in health disparities. This paper describes the activities employed by the center and summarizes the outcomes of these two initiatives. Ninety-five percent (18 of 19) URM junior faculty completed the faculty development program, and 83.3% (15 of 18) of the completers are advancing in their academic careers at University of California San Diego (UCSD) and are teaching, working with populations at risk and/or conducting research in health disparities. EXPORT awarded 7 investigators a total of $429 186 to conduct pilot research, and 71.4% (5/7) have now obtained $4.7 million in independent extramural funding. The San Diego EXPORT Center has increased the research capacity, strengthened the infrastructure for health disparities research, and created a cohort of successful URM junior faculty who are advancing in their academic careers. These investigators are already changing the climate at UCSD by their leadership activities, research focus, peer-networking, and mentoring of students.

Data from clinical and community studies suggest that children with anxiety disorders frequently present with chronic illnesses and physical health problems including asthma,1-3 respiratory problems,4-5 gastrointestinal disorders,6 and headaches7. The nature of these relationships is likely bidirectional with anxiety contributing directly to physical illness through a general weakening of the immune system or as a byproduct of stress and less directly through unhealthy behaviors that are often exhibited by anxious youth (e.g., alcohol and drug use, poor sleeping and eating habits, and less exercise).8-9 Furthermore, physical illness can often trigger the onset or exacerbate existing anxiety symptoms, such as by increasing the presence of somatic sensations which through misinterpretation may lead to panic attacks or by providing stimuli for additional worries. In general, symptoms of child anxiety are associated with educational underachievement, 10-11 low-self esteem and loneliness,12 and increased risk for later psychiatric disorders including depression, substance use, and suicide attempts.13-15 Chronic physical illnesses are also associated with significant impairment such as bodily pain and discomfort, school absences, activity limitations, lower social competence, higher use of medication and health care visits, as well as increased risk for internalizing and externalizing problems.16-21 Given the impairment independently associated with anxiety and chronic illness, the impact of having both a psychiatric and physical health condition is likely to be considerable. While various cross-sectional studies have assessed the prevalence of anxiety and other psychiatric disorders in children with physical illness 22-25, few studies have investigated the mental health impact of comorbid medical illnesses among children with anxiety disorders. In one study, parents and children with anxiety disorders, recruited from an anxiety disorders clinic, reported higher levels of internalizing problems if the child had an additional diagnosis of asthma compared to children without asthma.26 There was also a trend for children with an additional diagnosis of asthma to present with higher levels of externalizing problems, which is consistent with other studies that have found associations between physical illnesses and oppositional defiant/conduct disorder.27-29 At present, most of the data about the relationship between child anxiety and physical illness come from specialty service settings (e.g., anxiety disorder clinics) and general community samples. However anxiety disorders are also found in public sectors of care including child welfare, juvenile justice, county mental health, alcohol and drug abuse services and special education services.30 These sectors represent a unique context given the increased risk for both physical and mental health problems due to greater exposure to risk factors such as caregiver mental health problems, unstable income, large family size, single parent household, and domestic and/or community violence.31-34 Understanding the prevalence and impact of medical comorbidity is critical to developing interventions for children who are both physically and psychiatrically ill. Such findings may facilitate detection of anxiety problems by medical professionals as well as more effective treatment planning for these children.

Although studies have outlined the benefit of diversity in academic medicine, the number of underrepresented minority (URM) faculty remains low. In 1998, University of California, San Diego (UCSD) School of Medicine with the Hispanic Center of Excellence began a formalized proactive faculty development program. Over the past 10 years, recruitment and retention of URM junior faculty have increased. We undertook a study to explore factors associated with this improvement.Semistructured interviews were conducted with 18 out of 26 URM and 12 out of 26 randomly chosen non-URM assistant and associate faculty members throughout 2005. Interview content, based on a conceptual framework from Joanne Moody, included career path, knowledge and experience with faculty development programs and perceived faculty standing.URM faculty were more likely than majority faculty (44% vs. 8%, p = 0.04) to mention the importance of a role model in choosing their career path. URM faculty participated in faculty development programs at a higher rate than majority faculty (78% vs. 17%, p0.001), were more likely to find out about programs through personal contact (94% vs. 42%, p = 0.001) and reported more personal contacts prior to participation (78% vs. 33%, p = 0.02). URM faculty were older, graduated earlier and were more likely hired into a staff position prior to faculty appointment (61% vs. 17%, p = 0.02).Academic medical centers may find competitive URM candidates in staff positions and alternative faculty tracks within their institution. Informing URM faculty often and personally about opportunities for faculty development may increase their participation in career development programs and improve retention.

Domestic violence affects women across all racial, national, social, and economic groups. In particular, immigrant and refugee families are at risk for domestic violence because of their migration history and differences in cultural values and norms. The Ahimsa for Safe Families Project is an innovative collaborative project that addresses domestic violence in immigrant and refugee communities in San Diego. The project is designed to increase awareness of domestic violence among Latino, Somali, and Vietnamese communities and to develop and implement culturally specific programs aimed at each community. Here the authors describe the Project's needs assessment and community dialogues that guided the development of specific interventions; present the lessons learned; and describe replicable, culturally specific prevention strategies utilized by the Project.

The Project for Attention-Related Disorders (PARD), instituted by the San Diego (Calif.) School District, represents a unique approach to identification, referral, and management of children with Attention-Deficit Hyperactivity Disorder. As a school-based program, PARD coordinates medical, psychosocial, behavioral, and educational interventions for each child, and provides resources for school personnel caring for children with ADHD. Three years after instituting PARD, about 60% to 70% of the children showed improvement after enrollment, evaluation, and treatment. Parental involvement in and acceptance of intervention for their children represented a significant follow-up problem. Both medical and nonmedical interventions such as counseling, special programs, and behavior modification helped improve the educational life of these children.

This article describes the ingredients of successful programs for the development of minority faculty in academic medicine. Although stung by recent cuts in federal funding, minority faculty development programs now stand as models for medical schools that are eager to join the 140-year-old quest for diversity in academic medicine. In this article, the ingredients of these successful faculty development programs are discussed by experts in minority faculty development and illustrated by institutional examples. Included are descriptions of program goals and content, mentoring and coaching, selecting participants, providing a conducive environment, managing the program, and sustaining support. This article is a companion to another article, "Successful Programs in Minority Faculty Development: Overview," in this issue of the Mount Sinai Journal of Medicine.

The purpose of this paper is to review three cultural concepts (acculturation, ethnic identity, bicultural self-efficacy) and their relationship to the known risk and protective factors associated with youth violence. We conducted a review of the relevant literature that addresses these three cultural concepts and the relationship among culture, violent behavior, and associated cognition. The available literature suggests that ethnic identity and bicultural self-efficacy can be best thought of as protective factors, whereas acculturation can be a potential risk factor for youth violence. We examine the connection between these cultural concepts and the risk and protective factors described in the 2001 Surgeon General's Report on Youth Violence, and present a summary table with cultural risk and protective factors for violence prevention. These concepts can assist physicians in identifying risk and protective factors for youth violence when working with multicultural adolescents and their families. Physicians are more effective at providing appropriate referrals if they are aware that navigating among different cultures influences adolescent behavior.