Faculty Appointments & Promotions: An Insider’s Guide Brian V. Reamy, M.D. Col (ret), USAF, MC Associate Dean for Faculty & Professor of Family Medicine Uniformed Services University breamy@usuhs.mil

Community of Faculty USU’s strength is based on its faculty Transition after this slide

Community of Faculty Who are they? - Approximately 350 billeted and 3,700 non-billeted - Spread across the entire MHS and civilian institutions - Physicians, nurses, scientists, administrators, NCOs - Tied together by appointment to the faculty - Provide thousands of hours of volunteer clinical teaching

Non-Billeted Faculty We could not survive without these key members of our learning organization Visits to MHS teaching hospitals raised concerns: How do we support our non-billeted faculty? Why do they provide volunteer teaching? What are the barriers to getting faculty appointments?

More Concerns Growing pressures on faculty time Increased demands to provide clinical instruction in the time-pressured outpatient environment Extraordinary deployment tempo creating increased teaching demands on faculty

Concerns led to Action Dr. Rice, (USU President), charged a Task Force in 2009 to review the existing appointment and promotion policies for USU clinical faculty Determine if changes were needed to incentivize and recognize the volunteer clinical faculty

Premise Volunteer faculty teach because they get personal satisfaction, professional growth and recognition How does USU optimize this satisfaction, growth and recognition? How does USU recognize clinical teaching as a core attribute of its faculty?

Recognize with Faculty Appointments….. Why are they important? A significant Professional Credential Career enhancing Increases career and employment opportunities AND Salary Your academic rank = $$$ Increases patient confidence Facilitates research grant monetary awards

Ernest L. Boyer: Scholarship Reconsidered - 1990 Scholarship and Faculty achievement are more than research and publication alone 4 domains: Scholarships of: DISCOVERY INTEGRATION APPLICATION TEACHING

4 Domains – each have value Discovery: original research Integration: what do the findings from original research mean? Application: applying new knowledge to practice to lead to new understanding and new knowledge Teaching: stimulating active learning in students; starting the dialogue at the heart of a learning organization

“Publish or Perish”

National Trends Nationally, more than 3/4 of U.S. medical schools have developed separate and distinct faculty tracks for full-time clinical faculty whose 1° responsibilities are in clinical care The majority of schools that have this type of track modify the professorial title with a “Clinical” prefix such as Clinical Professor of Medicine.

Message received! – Action Plan Add flexibility to our faculty appointment system by restoring Clinical prefixed appointments at USU Validates the importance of clinical teaching and the Scholarships of application, teaching and integration Clarify and decrease variability in the use of “Adjunct” faculty titles Continue to encourage faculty choosing a research-intensive track, practicing the scholarship of discovery

Sounds simple…why can it be so hard? TRADITIONS… Military service helps comprehension…

Universities as Durable Organizations The three mosques of Sankoré, Djinguereber Mosque and Sidi Yahya compose the famous University of Timbuktu. Madrasah means school/university in Arabic and also in other languages associated with Muslim people.

1537 Martin Luther Nails His Thesis to the Door of the Cathedral at Wittenberg

If we take that as a starting point….. 66 institutions existed then that are still around in largely identifiable forms Catholic Church, Lutheran Church, Parliament of Iceland, Parliament of Isle of Man

And 62 universities

So What Does This Tell Us? Society Values Universities and Universities Guard their Traditions to Guarantee their Survival

Key Tradition: Academic Appointment & Promotion Military Appt. & Promotion Academic Appt. & Promotion Distinct ranks: 0-1 to 0-10 Must have commission & degree for appointment Set times between ranks Up or out: must make rank for retirement eligibility Pay correlates w/ rank Merit & Time-in-grade determine promotion Distinct ranks (4): Instructor, Assistant Professor, Associate Prof, Professor Must have terminal degree & serve USU in some way 4 to 8 years between ranks “Up or Out”: must make Assoc Prof by 6 yrs or gone; tenure Pay correlates w/ rank Merit & Time-in-grade determine promotion

Current System: pre-July 2010 Can be confusing – like military promotions would be to someone unfamiliar with our system Regulation = UI 1100>>> www.usuhs.mil Tenure not allowed for military faculty by law ASK QUESTIONS! Your specialty Dept. Chair at USU breamy@usuhs.mil or lmctigue@usuhs.mil

Qualifications for Faculty Membership Scholarly Achievement Scholarship of discovery and integration Scholarship of teaching and application Peer Review of Scholarly Activity Teaching Professional Service Institutional Citizenship USUHS Document 1100

Requirements for Appointments MD, DO or PhD degree Current medical license (if clinician) Currently instructing USUHS students or uniformed residents /fellows at one of the military teaching centers Approval of your Command

Academic Ranks **The higher the academic rank the more rigorous & selective the vetting process.** Clinician-Educator pathway – 4 ranks Instructor Assistant Professor Associate Professor Professor

Assistant Professor – 6 things Clinician-Educator Pathway 1. Teaching USUHS students or uniformed residents / fellows at one of the military teaching centers 2. Medical License & Board Certified 3. CV (USU or academic format) 4. Form 107 – by you or USU Dept. 5. Local Department Recommendation 6. Command Approval/Endorsment

USUHS CV Format

Academic Format American Association Medical Colleges (AAMC) CV builder http://www.aamc.org/members/old/facultyvitae/fall05/cv.htm Add Military history (assignments, duties)

USUHS Form 107 (Revised) http://www.usuhs.mil/chr/USUHS_Forms.htm

Academic Appointment Process II Clinician-Educator Pathway Send CV, Letter of rec/endorsement to USU Department Form 107 USU Dept. Chair Letter of Endorsement Then it is sent to Dean’s Office USUHS Document 1100

Academic Appointment Process III Clinician-Educator Pathway Academic package submission from Dean to Human Resources>>BOR Candidate will be notified of appointment by letter from USUHS Appointments for 3 years – same site Periodic update of Personnel Locator USUHS Document 1100

Ranks > Assistant Professor Much more rigorous & time demanding After USU Dept Review, it is forwarded to University Committee on Promotion & Tenure This Committee makes recommendation to the Dean three times per year. Dean forwards to Board of Regents & President for appointment

Faculty Appointments of Associate Professor In all Universities, Associate Professor means you have made the cut to stay at the institution as permanent faculty. Philosophically it is the difference between participating in scholarly activities and having demonstrated the ability to independently lead them.

Promotion to Associate Professor University promotions are driven by accreditation requirements that mandate “democratic reviewing committees of senior faculty” who comprise the CAPT = committee on Appointments, Promotions & Tenure All appts. require concurrence of the Dean and Board of regents but, academic faculty control the process.

Promotion to Associate Professor Although USUHS is designed to be more friendly to active-duty faculty, (and is to a large extent), civilian academic standards prevail to meet accreditation. Military accomplishment/rank are NOT automatically synonymous with academic rank: O-6 ≠ Professor Time demands of military careers can make academic promotion very challenging.

Associate Professor Clinician-Educator Pathway Assistant Professor rank for at least 4-6 yrs National Recognition – what is this? Education Leader in teaching USU students ,residents, fellows at one of the military teaching centers Board Certified CV (USU format) & Abbreviated CV for Board of Regents Approximately 6 – 15 peer-reviewed publications External Letters of Evaluation- at least 3 letters Personal Statement – 2 pages Submit 4 samples of academic publications Complete Educator’s Portfolio encouraged

Associate Professor Criteria are not applied in a formulaic way – there is much room for judgment. Letters of external review are critical: must have at least 3 external senior faculty say you would make it in their opinion & institution.

Professor Clinician-Educator Pathway Associate Professor rank for > 6 yrs International Recognition Educational leadership at a military teaching center Board Certified CV (USU format) & Abbreviated CV for BOR > 15 publications….more if multiple authors…. External Letters of Evaluation- at least 5 letters Personal Statement – 2 pages Submit 4 samples of academic publications Complete educator’s portfolio encouraged

“Adjunct” Appointments Designed for faculty who episodically and not routinely teach USU students and residents. Occasional contributors to the USU mission. Senior professors of other institutions who help with the USU mission. (Adjunct Assistant Professors, Adjunct Associate Professors, Adjunct Professors)

New initiatives - 7/1/2010: Adding option of Clinical “prefixed” appointments while maintaining the current system “as-is” Clinical prefix = “Clinical Associate Professor of ….” or “Clinical Professor of ...” A mechanism to recognize seniority, clinical experience, and teaching contributions to USUHS when a primary focus on clinical work has not led to significant numbers of publications.

Clinical Prefixed Appointments - Criteria Clinical Associate Professor Excellence in teaching & clinical care Administrative accomplishments when that is substantive part of faculty member’s role Minimum of 6 years as Assistant professor Institutional recognition as clinician & teacher

Clinical Prefixed Appointments - Criteria Clinical Professor Same as for Clinical Associate AND Service-wide or National recognition as clinician and teacher Minimum time in rank as an assistant and/or associate professor of 10 years

Clinical Prefixed Appointments Requirements Form 107 Faculty member’s CV Letter of support from a faculty member of senior academic rank in the applicant’s specialty Letter of support from USU Dept. Chair Review by SOM Committee (CAPT) before forwarding to Dean & President

Action Plan – ongoing new initiatives Develop an electronic portfolio application to ease & unify faculty appointment and promotion Procurement underway (Serensoft®) Increase communication between USU and its non-billeted faculty New position of the Associate Dean for Faculty Serve as the primary conduit and advocate for billeted and non-billeted faculty throughout the MHS Site visits to each of the primary 26 teaching sites in MHS

Conclusion: Don’t Get Frustrated! Ask Questions & Get Help Local Senior faculty Your Specialty Dept. Chair at USU Associate Dean for Faculty & Admin Assistant Brian V. Reamy, MD breamy@usuhs.mil Lisa McTigue lmctigue@usuhs.mil