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Getting Promoted: Its not an accident Louis J. Ling, MD Professor of Emergency Medicine Chair, Department P & T Committee Associate Dean for Graduate Medical.

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Presentation on theme: "Getting Promoted: Its not an accident Louis J. Ling, MD Professor of Emergency Medicine Chair, Department P & T Committee Associate Dean for Graduate Medical."— Presentation transcript:

1 Getting Promoted: Its not an accident Louis J. Ling, MD Professor of Emergency Medicine Chair, Department P & T Committee Associate Dean for Graduate Medical Education University of Minnesota Medical School

2 Is it important? Tenure to keep your job? Teaching hospital: not necessary Pride Respect for the specialty in the school If its not important to you, go to the pool

3 For the academic resident (Pick the right job) Where do you want to work? What type of academic life do you want? Do you mostly want to teach? Can you get promoted for teaching? Go where they value YOUR skills.

4 The academic resident (getting the right job) Start looking in your 2 nd year What do they want from you? –Do you need a fellowship? –What is their timing? –Start your productivity Keep in contact with the Chair Visit, make friends, hang out at meetings

5 How to Play the Game Getting into your residency: an accident? Getting into med school: obsess about it Get a good advisor Volunteer Do research Perform (get good grades)

6 Your first appointment Instructor –As resident or fellow –At Harvard –Time limit often 3 years Assistant Professor –Terminal degree –Board certified/board prepared

7 Its not an accident What do PD do ? PD usual work does not lead to promotion Recruitment, remediation, conferences, didactics, duty hour monitoring, etc For promotion, PD need to do more than the usual, something new

8 Long Term Plan Clinical Scholar vs Teaching vs Traditional Understand your school requirements Pick a mentor/advocate/advisor Talk to successful peers (other PDs) Get famous outside your school Focus your scholarly work Keep evaluations from everywhere Keep your CV up to date

9 Pick a track (with your boss) Traditional –PDs have too much education, no research Clinical/Adjunct –For affiliated faculty Clinical Scholar and or Teaching –Rewards education –Research requirement varies among schools

10 Quality Improvement Track Shojania, Levinson. Clinicians in quality improvement, JAMA 301(7):766, Feb 2009 Interest in QI, Errors, Safety, Teams, SBP Plan-do-study-act (publish) Measure changes in care/flow Attestations or consults from other institutions

11 Know promotion requirements Every school has written criteria Set annual goals to reach the criteria Review your goals every year with chair Meet chairs schedule How many years? More for part-time? What is the process in your school? What is the process in your department?

12 Typical Promotion Process Chair or department talks to you Department P and T reviews CV Collect your dossier School P and T recommends Dean recommends AHC recommends Board of Regents approves

13 Tenure requirements (its about the money) Tougher than just promotion Long-term money commitment May need grant history More than industry or state or EMF Federal grants NIH RO-1, AHRQ Peer reviewed grants RWJF

14 Tenure less than ever 6 yr up or out for research track 9 yr up or out for CS Less important than ever

15 Pick a mentor Do this anyways Inside department Outside department Someone successful you want to be Knows what it takes to be promoted Can be more than one mentor

16 Talk to successful peers Find peers doing the same thing as you Peers in your department Other program directors Around the country Find out what they did/are doing

17 Get Famous List six (eight at MN) names At level of promotion: Associate Professor or Professor

18 Get Famous Need letters Join Committees, Editorial Boards Write chapters Become an expert in something Develop a national peer network Lecture out of town Lecture for ACEP, AAEM, SAEM, CORD, etc

19 Major Criteria Independent Area of Expertise Separate from your mentors First or last author publications Principal investigator on grants

20 Research Focus and Expertise Study Section Editorial Board Journal Reviewer Program Committee Session Moderator Keynote Speaker, Visiting Professor Grand Rounds

21 Focus, Focus, Focus Develop and demonstrate expertise Pick an area Write chapters on one or two topics Limit outside distractions and maintenance Stay away from admissions, P and T, And other time sucking commitments Volunteer for innovative institution projects and publish the results

22 Focus scholarly work Measure everything you do –Resident satisfaction, quality, duty hours –Outcomes project –Residents as guinea pigs Present at SAEM, AAMC, RIME, GRA, GEA, ACGME, Regional meetings Submit to Academic Medicine, AEM, Medical Education, new Journal of GME

23 Keep everything Education Portfolio or file folder Evaluations from everyone Annual review from chair Reprints of articles Education products, CDs, screen shots Invitations to speak if you decline Keep CV up to date

24 Keep More Than Everything RRC, LCME Consultation Site Visits Best Doctor Awards Clinical Expertise or Consults –Keep dictations, letters or reports Invitation to speak that you turn down –Keep correspondence

25 Getting by with less than everything Talk to YOUR Faculty Dean Examine other successful dossiers Pick similar track/situations Promotion criteria can change Interpretation of criteria can change

26 Keep CV Up to Date Use your med school format Have a complete CV that has everything –Include local and department talks –Include mentees and advisees –Include public speaking, media events –Include best doctor type recognition Have a concise CV that has the highlights –For public

27 CV Bibliography Use standard citation format Separate peer reviewed from others Impact factor Explain your role 1 st and last and corresponding author –Dont give it up too soon

28 The Final Push Application Timeline Dossier Letters Lots of copies How many up this year? Start now

29 Timeline Final Submission date backwards Who does what –Individual: dossier, names, reprints –Department: votes, chairs letter Find a support person to help –Chair can assign someone –Not your residency coordinator –Ten Copies, collate and staple

30 Reverse Timeline November 1 submit to Dean September 1 submit letter names August 1 submit to department July 1 start your dossier June 2start to collect your stuff June 1 or earlierannual review with chair March 9check with your chair

31 Dossiers/Portfolio More than just a CV Specific format for dossier Has to tell your story well Specific CV format Keep it up to date Look at someones (successful peer) example

32 Dossiers Essay summaries of research, teaching, service –Describe what you are focused on –Be specific and give concrete examples –Give time percentage or hours per week –Proofread the grammar

33 Dossiers Three reprints of publications –recent, since your last promotion –first or second or last author –important –avoid case reports or observations or editorials

34 Outside Letters Find out how many Ask peers if its OK Suggest unknown letter writers Higher rank than you Well-respected institutions –Harvard, Stanford, UC, etc –Wide geographic area –They dont know famous EPs, they do know famous places, titles and rank

35 Potential Letter Writers Similar interests Prominent researchers in your field Editors you have written for Committee chairs Department chairs Full professors Do not pick Assistant Professors, Instructors, former residents, former mentors, best friends

36 Inside institution letters Chair letter is automatic –Offer to ghost write A few from within your department Some from outside your department –Use your mentor to connect –Do not piss everyone off –Committee work pay off

37 Break into Small Groups What 2 things you are going to do? What 2 things are you going to drop? What 2 scholarly papers can you do? Who can work with you on your project? Who do you want to get to know? What 2 things are you going to do to network at this meeting?

38 Promotion Dont be an Assistant Professor for life Decide if you want to do this Plan for it, Count on it Slow and steady long term plan Dont wait until the end to do it Keep the mad rush at the end organized

39 Workshop Bring your CV Bring your questions Sample summaries of research, teaching and service Questions

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