Post on 16-Dec-2015
Promotion 101
PROMOTION 101: Objectives
Share information about promotion
Emphasis: Promotion to
Associate Professor Clinician-educators
Other topics
TenureResearch titlesPromotion to full ProfessorAppointment types (at-will,
indeterminate)
Promotion 101: Questions
Who are the decision-makers? The Faculty Promotions Committee
What documents do they need? Beyond the CV Dossiers and portfolios
What are your chances? How many publications do you need? Myths and misperceptions
Revealing the secrets and mysteries Street lore Depression
Why “Promotion 101?”
PercentNever reviewed promotion criteria 25Limited/no understanding of criteria 38
Never discussed progress toward promotion with dept chair/div head 35Discussed progress once 31
* 2005 Faculty survey (Junior faculty, MD/PhD: n=512)
Faculty need information
The need for information
PercentDo not have a faculty mentor to assist in career development 48No mentor:
Clinicians (69%) vs. Scientists (32%)
Worried about promotion ?
Why don’t we know more?
Time is short
Establish laboratory, become independent investigator, supervise graduate students, obtain grants (impossible)
Clinical duties and patient “throughput” 70-90 percent of time in direct patient care Find time for scholarship, meet with colleagues For each 10 hrs of clinical time, odds of grant ↓23% SOM increasingly dependent on clinical revenues
2005-06: Clinical revenues > research grant revenues Managed care competition & health plan consolidation Reimbursement rates and profit margins are declining Rising uninsured
“Economic engine; glue holding SOM budget together”
Time is short
Develop courses, reform the curriculum
Comply with regulations & paperwork demands
Perform university and community service
Balance family and work
What ever happened to academic life?
Medical school faculty “can enjoy the element of repose, the quiet pursuit of knowledge, the friendship of books, the pleasures of conversations and the advantages of solitude”
Arnold Rice Rich. Archives of Johns Hopkins Medical Institutions. Quoted by Lundmere in Time to Heal.
When should career planning and promotion review begin?
MYTH: Review begins in the 6th year
TRUTH: Preparation begins early New appointment
Copy of the SOM Rules & discussionAssignment of mentor within 3 months of
hire
Mandatory faculty reviews
Annual review5-year professional planState-mandated Annual Performance
RatingMid-course comprehensive reviewPost-tenure reviewArticle & chart: Promotion 101
Syllabus
Use annual reviews wisely
Have input into teaching, clinical assignments
Identify gaps– between department’s needs and expectations – and yours
Negotiate for resources Verify you are on course
for promotion (Use Rules) Insist on meeting every 6
-12 months (Annual)
Not just your report card …but a bi-directional conversation about your career
Mid-course review
3RD – 4th year as Assistant Professor Dossier preparation and critique List of potential external referees Assessment of promotion readiness Written summary and recommendations
Mentoring Rule & Rationale
“All Instructors, Senior Instructors and Assistant Professors will be assigned at least one mentor (in writing) by the department chair… within 3 months of the start of the appointment period.”
Proven connection to research grants, publications and productivity, academic advancement, overall career satisfaction & retention in academic careers, and department vitality
The decision-makers
Department Chair Vote by DAC
FPC Executive
CommitteeChancellorRegents (Tenure)
Faculty Promotions Committee
Peer, school-wide committeeMYTH: The Faculty Promotions
Committee consists of 5 old, tenured, full professors, mostly bench scientists and Nobel laureates
Faculty Promotions Committee
15 membersAssociate or full ProfessorTenured/not-tenuredAffiliate & University-employed
facultyBalance:
Departments: 5 basic sciences, 10 clinical
Investigators & clinician-educators
MYTH: You have to be excellent in everything
MERITORIOUS* IN ALLTeachingClinical/serviceScholarship
*Praiseworthy…deserving of merit
EXCELLENT* IN ONETeachingResearchClinical activity
*Outstanding…of exceptional merit
MAJORS & MINORS
M E
Meritorious vs. excellent
FPC determines “meritorious” vs. “excellent” based on Information in the candidate’s dossier
(including external letters and the portfolios)
Specific reference to the matrices*
*Appendix, SOM Rules (and syllabus)
Meritorious vs. excellent
Active participation in teaching activities of the department, including (2 or more): presenting series of lectures, coordinating a course, advising students, attending on inpatient or outpatient service, mentoring students/fellows, seminar or laboratory group leader)…
Meritorious teaching evaluationsDevelopment, revision of teaching
materials for students, CME courses…
Invitations to present courses, lectures outside of department, give grand rounds
Greater than average share of teaching duties (e.g., course or fellowship director) …
Consistently receives outstanding teaching evaluations or teaching awards …
Develops innovative teaching methods, such as educational software, videotapes..
Provides educational leadership by writing syllabi, or assuming administrative roles
Consistent participation in national educational activities (RRC’s, board examiner)
Invitations to be Visiting Professor
TEACHING
Meritorious vs. excellent
Establishes an area of research in a clinical area
Collaborator on research, participation in multi-center trial
One or more such efforts are published in journals
Chapters, case reports, review articles … integrate knowledge, add perspective
Innovative QI activities, including documentation of intervention and outcomes
Multiple peer-review publications in area of expertise
Consistent funding for researchServes as national consultantNational or international
reputation
SCHOLARSHIP
Other lessons
No “splash over” All faculty must
teach All faculty must
participate in scholarship
Documentation is vital Teachers, clinicians,
scientists must document “excellence”
DOCUMENTATION
C.V. A list Not enough
Letter from chair Not enough
Supporting evidence Quality, importance,
impact, reach of your work
Dossiers
Letters (internal and external) Teaching evaluations Narratives describing focus, impact of your work
“The focus of my scholarship has been the development and evaluation of tools to ensure that national guidelines for hypertension and diabetes care are adopted and adhered to in this indigent care internal medicine practice.”
“As co-chair of the “Effective Antibiotic Use Task Force,” I led efforts to develop the national evidence-based recommendations for management of coughs, colds and bronchitis in outpatient settings”
Copies of scholarly “products” Annotated bibliographies Excerpts from matrices Well-organized portfolios: REQUIRED
Using the matrices
TeachingProvides
educational leadership by writing syllabi or textbooks or assuming administrative roles
Developed “Sports Medicine” module for orthopedics residents
Director, Combined Sports Medicine Fellowship (2003-6);
Chair, Orthopedics Student Education Committee
Member, National Sports Medicine Residency Curriculum Committee, American Academy of Orthopedics
Clinical & teaching portfolios
Describe what you do every day Take credit for achievementsAdd weight and parityPermits semi-structured evaluationMatch your activities to SOM rulesSee detailed formats (web, syllabus)
Clinical portfolios
Description of clinical activities Sites, numbers of
patients, weekly calendar
Leadership Committees, practice
director QI activities, patient
care pathways that improve patient care
Innovative practices Evidence of regional or
national reputation Quality measures:
Letters from referring colleagues, RN’s
Studies of outcomes, quality of care
Information from patients (letters, patient satisfaction surveys)
Teaching portfolio
Personal teaching goals What and how do you
teach? What is unique How do you assess
learning Classroom activities Clinical teaching activities Other didactic teaching Teaching administration
Course leadership National service (RRC,
board examiner)
Evaluations by learners Curriculum
innovation/products High quality syllabi, problem-
based learning, patient simulations, CD-ROM’s
Scholarship of teaching Outcomes, learning, methods
Mentorship and advising Self-study and improvement Teaching awards, recognition
Mentorship Record
Trainee (Dates)
Project Title
(My role)
Degree(Date)
Funding,Awards
Presentations &
Publications
Mary A. Bartlett
(2002-2004)
The role of acculturation factors in predicting high risk
injury behaviors(Thesis
supervisor)
MSPHJune 3, 2004
Colorado Dept
Transportation
(Project #2001-648-
98247)
Oral abstract presented at
the 32nd Annual
meeting of …
Manuscript:
xxxxx
Mentorship letters
Statements by current or former traineesInformation about your impact
Research methodology Writing and presenting Data analysis Research ethics Management & coordination of research team Professional role model
Scholarship: Required by Rules
All faculty are required to participate in scholarship
The products of scholarship must be in a format that can be evaluated, which would normally mean in a written format
Scholarship: Broadly Defined
Discovery, application, integration, teachingAccommodates almost anything in medicine,
science, writing, public health, ethics, quality improvement, education, health services, policy, community outreach, humanities …
Not just research discoveries, publicationsProducts that can be reviewed:
Publications, CDs, chapters, case reports, reviews, residency training manuals, policy “white papers,” clinical guidelines, evidence-based pathways
Examples: Alternative scholarship
Design of electronic medical record for outpatient setting that facilitated detection of medical errors
Created national guidelines to improve rating and documentation of impairment in occupational medicine practice Accepted by American College
Occupational/Environmental Medicine Used to develop CME program for physician
certification
Examples: Alternative scholarship
Computer-based simulations used widely to teach and assess cricothyrotomy, thoracotomy & other procedural skills
Innovative care system for HIV patients that led to declines in morbidity, mortality and rates of hospitalization
Innovative, competency-based curriculum for residents focusing on end-of-life care, pain palliation and spirituality
Alternative scholarship
Educational manual for students, residents focusing on principles of caring for uninsured patients in homeless and indigent care clinics
Guidebooks and charts for patients, physicians and pharmacists used statewide to improve prescribing and reduce drug resistance in HIV
Computerized, 150-item self-assessment curriculum in chest radiology for community based radiologists (adopted by American College of Radiology)
Alternative scholarship
Series of “white papers” on early recognition of functional decline in geriatric patients for professional societies, HMO’s and national foundations
Guidebooks for migrants and new immigrants to Colorado, focusing on health care access, teen reproductive services, expanded mental health services, diabetes screening (in collaboration with Secretary of Health in Mexico)
Alternative Scholarship
Diabetes management practice guidelines disseminated in Palm Pilot® format
Series of videos (peer-reviewed) and patient and physician education booklets about emotional experiences and stages of recovery in children with burns
Alternative Scholarship
These works justified promotion and were rated by Promotions Committee based on: Originality Grounding in scientific evidence Methodology Quality or outcome measures Use and acceptance by peers
Promotion Time Clock
Up-or-out in 7 years
But: No penalty for
part-time service Extensions
granted Revisions under
consideration
MYTH
Getting promoted “early” is almost impossible
The truth about early promotion
[From the SOM Rules]
“Review for promotion to Associate Professor may occur whenever the faculty member meets the criteria specified…”
“The concept of ‘early’ promotion was discontinued [1997].”
MYTH
Most Assistant Professors don’t get promoted At least not on the first
try
Promotion statistics (2002-2005)
Promotion to Associate Professor 177 candidates reviewed 170 approved (96 percent) Promotion rate for clinician-educators =
96%Promotion to Professor
83 candidates reviewed 77 approved (93 percent)
Tenure 39 candidates reviewed 33 approved (85 percent)
MYTH
Even for clinician-teachers … you need 39 1st-author, peer-reviewed research papers
Publication Totals2000-2005
Clinician Educators (Promotion to Associate Professor; n = 114)
1st/Sr. Peer
Other Peer
All Peer Chapter, etc.
Total Publicatio
ns
Minimum 0 0 0 0 1
Maximum 36 64 85 55 92
Mean 6.5 7.3 13.7 7.3 20.9
Median 4 5 11 6 18
25th Percentile
2 2 5.5 2 10
Promotion to professor
Not required at 7 years – or automaticMeritorious in:
Teaching & clinical activity/serviceExcellent in two:
Teaching, research or clinical activityPLUS
Excellence in scholarshipA national reputation
Final recommendations
Read the Rules (standards)Document everything:
Up-to-date CV Drop-in box Examine: matrices; scholarship
examples; portfolio guidelines Save teaching evaluations and obtain
lettersUse Annual Reviews wisely
Final recommendations
Periodically, write short “bullets” to summarize impact, importance of your work --- as investigator, clinician, educator, consultant, task force member, course director
Think about promotion frequently – not obsessively
Recommendations
Focus on career fulfillmentTake advantage of proven tools:
Mentors – “career incumbents” A network of productive colleagues A quick start Focus; specialized skills: burnout,
PAIDS Be active regionally & nationally