Promotion to Associate Professor in the MCL Linda M. Boxer, Vice Dean Cheryl Gore-Felton, OAA Associate Dean Jim Brooks, OAA Associate Dean

Outline of Topics Regional reputation Proportionality of contributions Summary of criteria Timing of promotion consideration Preparation for the promotion review Outline of promotion process Office of Academic Affairs resources

MCL Associate Professor Promotion to Associate Professor is for a 5-year term, and there is no limit to the number of 5-year terms as Associate Professor Must demonstrate excellence in the overall mix of contributions in clinical care, teaching, and scholarship A regional reputation is required

Regional Reputation Activities that contribute to a regional reputation: Scholarly publications and presentations at regional and national meetings Membership on editorial boards Service on regional or national committees or study sections Leadership or other participation in leading scientific or clinical societies in the field Invited lectureships and visiting professorships

Establishing the Proportionality of Contributions The allocation of an MCL faculty member’s time is determined by the strategic and programmatic needs of the department The proportionality of contributions is determined at the time of appointment and is confirmed in the offer letter All MCL faculty should have a minimum of 20% FTE for scholarship The proportionality of contributions should be discussed at each annual counseling meeting with the chair or chief

Establishing the Proportionality of Contributions-2 The proportionality should be documented in the annual counseling form If the proportionality of contributions changes, the changes should be included in written documentation Evaluation for reappointment and promotion should take into account the proportionality of contributions in each year of the term

Proportionality of Contributions Often the majority of time is spent in clinical care and teaching In some cases, the highest percentage of effort is devoted to scholarly activities (often with peer-reviewed funding) Need to establish and maintain excellence in the area in which the highest proportion of time and effort is dedicated

Applying the Criteria Evaluation should be of total performance Taking into consideration the proportionality of contributions in each year of the current appointment, appropriate weight should be given to the quality and quantity of work in each mission area Documentation that explicitly and tangibly supports both the quality of performance and the quantity of contributions is required

Criteria MCL Associate Professor-Scholarship Written scholarship that advances the field is expected Contributions are usually made through first or senior authorship or may be through other substantive contributions to multi-author works External referees are key to documenting regional reputation and impact in the field

Criteria MCL Associate Professor-Scholarship-2 In most cases, scholarly activities will flow naturally from the clinical responsibilities, and usually the scholarly activities will complement the clinical activities Research may be in any appropriate area such as basic science, clinical trials, clinical or translational research or health policy research The field of research may be more narrowly defined than for the UTL

Criteria MCL Associate Professor-Scholarship-3 Factors considered in assessing scholarship: Scholarly activity and productivity Impact, innovation, and creativity Recognition in the field and investigative independence Ability to work effectively as part of a research team Effective communication with colleagues, staff, and students Professionalism Institutional compliance and ethics

Criteria MCL Associate Professor-Scholarship-4 If a majority of time and effort is dedicated to scholarly activity: Contributions will be made through first or senior authorship Investigative independence is expected since it can be a useful marker of substantive scholarly contributions A record of peer-reviewed external funding is often seen as an indicator of how the work is regarded in the field

Criteria MCL Associate Professor-Scholarship-5 By the time of the promotion review, the candidate’s fundamental scholarly contributions should be well defined and apparent to reviewers at the departmental, School, and University levels It is too early to establish the impact on the field of manuscripts in press

Criteria MCL Associate Professor-Scholarship-6 In some fields, other written works such as books, chapters, reviews, commentaries, development of policies and protocols may be acceptable as long as the contributions are of a nature appropriate to the field, and the impact of the work in advancing medicine or the public health can be established Referees need to document this too

Criteria MCL Associate Professor-Clinical Regardless of FTE breakdown, excellence in clinical care is a requirement for the line Clinical Excellence Surveys (CES) will assess performance in: General clinical proficiency Communication Professionalism Systems-based practice

Criteria MCL Associate Professor-Clinical Proficiency General clinical proficiency: Up-to-date knowledge base Maintains current technical/procedural proficiency Applies sound diagnostic reasoning and judgment Applies evidence from relevant scientific studies Maintains appropriate clinical productivity Seeks consultation where appropriate Demonstrates reliability in meeting clinical commitments

Criteria MCL Associate Professor-Communication Communicates effectively with patients and their families, physician peers, trainees, and other members of the health care team Maintains appropriate medical documentation

Criteria MCL Associate Professor-Professionalism Treats patients with compassion and respect Serves as patient advocate Shows sensitivity to cultural issues Treats physician peers, trainees, and other members of the health care team with respect Is available to colleagues Responds in a timely manner Respects patient confidentiality

Criteria MCL Associate Professor-Systems-Based Practice Effectively coordinates patient care within the health care system Appropriately considers cost of care in medical decision-making Participates in quality improvement activities Demonstrates leadership in clinical program development and administration

Criteria MCL Associate Professor-Teaching Factors considered in assessing teaching: Knowledge of the material Clarity of exposition Positive style of interaction with students Availability and professionalism Institutional compliance and ethics Effective communication skills Helpfulness in learning Ability to work effectively as part of teaching team

Criteria MCL Associate Professor-Teaching-2 Most clinicians teach in small group sessions or with individual trainees Some develop or participate in formal didactic courses Teaching may be of undergraduates, medical students, residents, clinical and postdoctoral fellows, ancillary staff, and in CME

Criteria MCL Associate Professor-Service Service is also relevant for promotion but this is not a primary criterion A major commitment to service activities detracts from the time available for the primary areas of scholarship, teaching, clinical care, and Assistant Professors are discouraged from significant administrative commitments

Respectful Workplace Faculty members are expected to treat all members of the Stanford community with civility, respect and courtesy Application of the criteria for evaluating the quality of scholarship, teaching and clinical care include specific expectations regarding a faculty member’s professional behavior in the workplace and are an important factor in appointment, reappointment and promotion

Duration of Appointments MCL Assistant Professors are appointed for a first term of 4 years Term appointments are frequently made with the clear possibility of reappointment or promotion, but there is no entitlement to such action at the end of term, and it is not automatic Following a successful reappointment, the second term as Assistant Professor is generally for 6 years

Timing of the Promotion Review MCL Assistant Professors may spend a total of 10 years in rank before being reviewed for promotion to Associate Professor Promotion reviews are typically launched one year in advance of the appointment end date and take ~9 months to complete Promotions may be initiated at any time when there is unequivocal evidence that the quality of the contributions meets the criteria for the higher rank

Timing of the Promotion Review-2 There is a mandatory counseling meeting at the seventh year in rank to assess progress toward promotion Materials for promotion review should reflect a record of actual accomplishment in satisfaction of the promotion criteria rather than work in the pipeline (speaks more to promise)

Timing of the Promotion Review-3 There is a range of time that Assistant Professors spend in rank before promotion Many are considered for promotion in the seventh year after the mandatory counseling session to assess readiness for promotion Many others are promoted in the eighth and ninth years

Extensions to Appointment Term New Parent Extensions are generally automatically approved by the Provost if the faculty member is eligible Other special circumstances to extend the term are rare, but have been granted by the Provost MCL Assistant Professors are ineligible for any extensions to their appointment that would take the total appointment time beyond 10 years in rank so extensions are only to the first term (prior to reappointment)

Importance of Annual Counseling Please make certain that progress toward promotion and timing is discussed during every annual counseling meeting with your chair or chief If there are specific questions about your situation, we in OAA are happy to discuss with you and/or with your chair or chief The feedback and counseling that was obtained at the time of reappointment is very important and should be followed

Changes in Faculty Line Line changes are rarely done They are intended to allow appropriate evaluation of a faculty member whose programmatic contributions have drifted to better fit the intent of another line This requires a new appointment that is initiated either with a national search or approval of a search waiver request by the Provost

Changes in Faculty Line-2 This is not a safety mechanism for a failed promotion bid It is not to be pursued during the final year of appointment A faculty member’s programmatic fit in the MCL should be actively considered each year during the annual counseling

Preparation for the Promotion Review Faculty have the responsibility for designing and pursuing a schedule of scholarship that results in publication in advance of the review It is best to have developed a defined area of scholarly emphasis for which you are known prior to the initiation of promotion Independence from your mentor should be established

Scholarly Contributions Scholarly contributions and impact on the field should be well defined and apparent to reviewers at the time of the promotion review Ways to assess this prior to the review: Feedback from counseling meetings and reappointment review Feedback from mentors Extent to which work is known to leaders in the field who are not mentors or collaborators

Team Science With the increasing prevalence of collaborative team science, it is understood that there are many ways for a faculty member to be recognized for individual substantive contributions to multi-author works These may include the conception and design; acquisition of data; analysis and interpretation of data; drafting of the manuscript; critical revision of the manuscript for important intellectual content; statistical analysis; obtaining funding; administrative, technical or material support; or supervision

Team Science-2 Evidence accumulated should provide information regarding the nature of the faculty member’s substantive contributions to multi-author works, as well as the impact that the publications have had in advancing medicine Annotation of the CV and description of role in the Candidate’s Statement will help to demonstrate the role of the faculty member in collaborative projects

Metrics to Assess Impact First and senior-authored publications in high quality journals Peer-reviewed funding helps to assess the ability of the faculty member to carry out an excellent program of scholarly activity Invited presentations outside of the local area Visiting professorships Regional and national service leadership roles

Developing Excellence in Clinical Care Need sufficient FTE devoted to clinical care to establish clinical excellence Feedback on clinical skills from CES at time of reappointment and review of MedHub evaluations Seek feedback from senior colleagues in your specialty

Developing a Record of Excellence in Teaching Didactic lectures with evaluations for every course and lecture; if reviews are not strong, seek guidance from the Teaching and Mentoring Academy, your mentor, or the Center for Teaching and Learning Investigative mentorship—positive letters from trainees will be needed Clinical teaching—MedHub evaluations should be excellent; review these each year

Additional Preparation Mission areas that show room for improvement should receive appropriate attention during annual counseling meetings and through the counseling memo that accompanied the reappointment process Talk to mentors and senior colleagues who have recently been promoted to learn more about the requirements

Review Process You provide your updated CV (with middle author publications annotated to define your role in the research) and Candidate’s Statement Candidate’s Statement is limited to 3 pages; discuss recent achievements in all mission areas and include near-term and longer-range plans You may suggest up to 3 referees

Review Process-2 You provide a list of your current and former research trainees and some of your clinical trainees (you do not select which ones will write letters) Evaluations will be collected on teaching, broadly defined (formal lectures, mentoring, clinical), and clinical activities The counseling memo is provided after the review

Review Process-3 Clinical Excellence Surveys (CES) are requested from physicians, trainees, allied health care providers and administrators MedHub evaluations are collected Letter requirements: 5 to 8 external referee letters (at peer institutions, most are independent, not collaborators or mentors, must be Associate Professors or full Professors) 3 to 5 internal referee letters 3 to 5 (minimum) trainee letters (all research trainees, selection of current and former clinical)

Review Committees The long form is not reviewed by the University Advisory Board Review process: Departmental committee Departmental faculty or A&P committee Department Chair School of Medicine A&P committee Vice Dean and Dean Provost President

Resources on OAA Website Reappointment and Promotion Overview http://med.stanford.edu/academicaffairs/professoriate/reappointment.html SoM Faculty Handbook http://med.stanford.edu/academicaffairs/administrators/handbook.html University Faculty Handbook http://facultyhandbook.stanford.edu

Questions Questions or discussion?