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Promotion 101. PROMOTION 101: Objectives zShare information about promotion zEmphasis: yPromotion to Associate Professor yClinician-educators.

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Presentation on theme: "Promotion 101. PROMOTION 101: Objectives zShare information about promotion zEmphasis: yPromotion to Associate Professor yClinician-educators."— Presentation transcript:

1 Promotion 101

2 PROMOTION 101: Objectives zShare information about promotion zEmphasis: yPromotion to Associate Professor yClinician-educators

3 Other topics zTenure zResearch titles zPromotion to full Professor zAppointment types (at-will, indeterminate)

4 Promotion 101: Questions zWho are the decision-makers? yThe Faculty Promotions Committee zWhat documents do they need? yBeyond the CV yDossiers and portfolios zWhat are your chances? zHow many publications do you need? zMyths and misperceptions yRevealing the secrets and mysteries yStreet lore yDepression

5 Why “Promotion 101?” Percent zNever reviewed promotion criteria 25 zLimited/no understanding of criteria 38 zNever discussed progress toward promotion with dept chair/div head 35 zDiscussed progress once 31 * 2005 Faculty survey (Junior faculty, MD/PhD: n=512) Faculty need information

6 The need for information Percent zDo not have a faculty mentor to assist in career development 48 zNo mentor: yClinicians (69%) vs. Scientists (32%) z Worried about promotion ?

7 Why don’t we know more?

8 Time is short zEstablish laboratory, become independent investigator, supervise graduate students, obtain grants (impossible) zClinical duties and patient “throughput” y70-90 percent of time in direct patient care yFind time for scholarship, meet with colleagues  For each 10 hrs of clinical time, odds of grant ↓ 23% ySOM increasingly dependent on clinical revenues x2005-06: Clinical revenues > research grant revenues xManaged care competition & health plan consolidation xReimbursement rates and profit margins are declining xRising uninsured y“Economic engine; glue holding SOM budget together”

9 Time is short zDevelop courses, reform the curriculum zComply with regulations & paperwork demands zPerform university and community service zBalance family and work

10 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.


12 When should career planning and promotion review begin?  MYTH: Review begins in the 6 th year TRUTH: Preparation begins early yNew appointment xCopy of the SOM Rules & discussion xAssignment of mentor within 3 months of hire

13 Mandatory faculty reviews zAnnual review z5-year professional plan zState-mandated Annual Performance Rating zMid-course comprehensive review zPost-tenure review zArticle & chart: Promotion 101 Syllabus

14 Use annual reviews wisely zHave input into teaching, clinical assignments zIdentify gaps– between department’s needs and expectations – and yours zNegotiate for resources zVerify you are on course for promotion (Use Rules) zInsist on meeting every 6 -12 months (Annual) Not just your report card …but a bi-directional conversation about your career

15 Mid-course review z3 RD – 4th year as Assistant Professor yDossier preparation and critique yList of potential external referees yAssessment of promotion readiness yWritten summary and recommendations

16 Mentoring Rule & Rationale z“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.” z Proven connection to research grants, publications and productivity, academic advancement, overall career satisfaction & retention in academic careers, and department vitality

17 The decision-makers zDepartment yChair yVote by DAC zFPC zExecutive Committee zChancellor zRegents (Tenure)

18 Faculty Promotions Committee z Peer, school-wide committee  MYTH: The Faculty Promotions Committee consists of 5 old, tenured, full professors, mostly bench scientists and Nobel laureates

19 Faculty Promotions Committee z15 members zAssociate or full Professor zTenured/not-tenured zAffiliate & University-employed faculty zBalance: yDepartments: 5 basic sciences, 10 clinical yInvestigators & clinician-educators

20 MYTH: You have to be excellent in everything MERITORIOUS* IN ALL zTeaching zClinical/service zScholarship *Praiseworthy… deserving of merit EXCELLENT* IN ONE z Teaching z Research z Clinical activity *Outstanding…of exceptional merit MAJORS & MINORS ME

21 Meritorious vs. excellent zFPC determines “meritorious” vs. “excellent” based on yInformation in the candidate’s dossier (including external letters and the portfolios) ySpecific reference to the matrices* *Appendix, SOM Rules (and syllabus)

22 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 evaluations Development, 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

23 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 research Serves as national consultant National or international reputation SCHOLARSHIP

24 Other lessons zNo “splash over” yAll faculty must teach yAll faculty must participate in scholarship zDocumentation is vital yTeachers, clinicians, scientists must document “excellence”

25 DOCUMENTATION zC.V. yA list yNot enough zLetter from chair yNot enough zSupporting evidence yQuality, importance, impact, reach of your work

26 Dossiers zLetters (internal and external) zTeaching evaluations zNarratives describing focus, impact of your work y“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.” y“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” zCopies of scholarly “products” zAnnotated bibliographies zExcerpts from matrices zWell-organized portfolios: REQUIRED

27 Using the matrices Teaching zProvides educational leadership by writing syllabi or textbooks or assuming administrative roles z Developed “Sports Medicine” module for orthopedics residents z Director, Combined Sports Medicine Fellowship (2003-6); z Chair, Orthopedics Student Education Committee z Member, National Sports Medicine Residency Curriculum Committee, American Academy of Orthopedics

28 Clinical & teaching portfolios zDescribe what you do every day zTake credit for achievements zAdd weight and parity zPermits semi-structured evaluation zMatch your activities to SOM rules zSee detailed formats (web, syllabus)

29 Clinical portfolios zDescription of clinical activities ySites, numbers of patients, weekly calendar zLeadership yCommittees, practice director yQI activities, patient care pathways that improve patient care z Innovative practices z Evidence of regional or national reputation z Quality measures: yLetters from referring colleagues, RN’s yStudies of outcomes, quality of care yInformation from patients (letters, patient satisfaction surveys)

30 Teaching portfolio zPersonal teaching goals yWhat and how do you teach? yWhat is unique yHow do you assess learning zClassroom activities zClinical teaching activities zOther didactic teaching zTeaching administration yCourse leadership yNational service (RRC, board examiner) z Evaluations by learners z Curriculum innovation/products yHigh quality syllabi, problem- based learning, patient simulations, CD-ROM’s z Scholarship of teaching yOutcomes, learning, methods z Mentorship and advising z Self-study and improvement z Teaching awards, recognition

31 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) MSPH June 3, 2004 Colorado Dept Transportation (Project # 2001-648- 98247) Oral abstract presented at the 32 nd Annual meeting of … Manuscript: xxxxx

32 Mentorship letters zStatements by current or former trainees zInformation about your impact yResearch methodology yWriting and presenting yData analysis yResearch ethics yManagement & coordination of research team yProfessional role model

33 Scholarship: Required by Rules zAll faculty are required to participate in scholarship zThe products of scholarship must be in a format that can be evaluated, which would normally mean in a written format

34 Scholarship: Broadly Defined zDiscovery, application, integration, teaching zAccommodates almost anything in medicine, science, writing, public health, ethics, quality improvement, education, health services, policy, community outreach, humanities … zNot just research discoveries, publications zProducts that can be reviewed: yPublications, CDs, chapters, case reports, reviews, residency training manuals, policy “white papers,” clinical guidelines, evidence-based pathways

35 Examples: Alternative scholarship zDesign of electronic medical record for outpatient setting that facilitated detection of medical errors zCreated national guidelines to improve rating and documentation of impairment in occupational medicine practice yAccepted by American College Occupational/Environmental Medicine yUsed to develop CME program for physician certification

36 Examples: Alternative scholarship zComputer-based simulations used widely to teach and assess cricothyrotomy, thoracotomy & other procedural skills zInnovative care system for HIV patients that led to declines in morbidity, mortality and rates of hospitalization zInnovative, competency-based curriculum for residents focusing on end-of-life care, pain palliation and spirituality

37 Alternative scholarship zEducational manual for students, residents focusing on principles of caring for uninsured patients in homeless and indigent care clinics zGuidebooks and charts for patients, physicians and pharmacists used statewide to improve prescribing and reduce drug resistance in HIV zComputerized, 150-item self-assessment curriculum in chest radiology for community based radiologists (adopted by American College of Radiology)

38 Alternative scholarship zSeries of “white papers” on early recognition of functional decline in geriatric patients for professional societies, HMO’s and national foundations zGuidebooks 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)

39 Alternative Scholarship zDiabetes management practice guidelines disseminated in Palm Pilot® format zSeries of videos (peer-reviewed) and patient and physician education booklets about emotional experiences and stages of recovery in children with burns

40 Alternative Scholarship zThese works justified promotion and were rated by Promotions Committee based on: yOriginality yGrounding in scientific evidence yMethodology yQuality or outcome measures yUse and acceptance by peers

41 Promotion Time Clock zUp-or-out in 7 years zBut: yNo penalty for part-time service yExtensions granted yRevisions under consideration

42 MYTH zGetting promoted “early” is almost impossible

43 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].”

44 MYTH zMost Assistant Professors don’t get promoted yAt least not on the first try

45 Promotion statistics (2002-2005) zPromotion to Associate Professor y177 candidates reviewed y170 approved (96 percent) yPromotion rate for clinician-educators = 96% zPromotion to Professor y83 candidates reviewed y77 approved (93 percent) zTenure y39 candidates reviewed y33 approved (85 percent)

46 MYTH zEven for clinician- teachers … you need 39 1 st -author, peer- reviewed research papers

47 Publication Totals 2000-2005 Clinician Educators (Promotion to Associate Professor; n = 114) 1 st /Sr. PeerOther PeerAll PeerChapter, etc. Total Publications Minimum 00001 Maximum 3664855592 Mean 6.57.313.77.320.9 Median 4511618 25 th Percentile 225.5210

48 Promotion to professor zNot required at 7 years – or automatic zMeritorious in: yTeaching & clinical activity/service zExcellent in two: yTeaching, research or clinical activity PLUS zExcellence in scholarship zA national reputation

49 Final recommendations zRead the Rules (standards) zDocument everything: yUp-to-date CV yDrop-in box yExamine: matrices; scholarship examples; portfolio guidelines ySave teaching evaluations and obtain letters zUse Annual Reviews wisely

50 Final recommendations zPeriodically, write short “bullets” to summarize impact, importance of your work --- as investigator, clinician, educator, consultant, task force member, course director zThink about promotion frequently – not obsessively

51 Recommendations zFocus on career fulfillment zTake advantage of proven tools: yMentors – “career incumbents” yA network of productive colleagues yA quick start yFocus; specialized skills:  burnout, PAIDS yBe active regionally & nationally


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