1. Appointments and Promotions: Climbing the Ladder Virginia C. Broudy, M.D. 7/15/09

2. Academic Pathways*  Physician/Scientist: ~ 80% research/20% clinical and teaching  Clinician/Teacher: ~ 80% clinical and teaching/20% scholarly activity  Research Faculty (often PhD) : 100% research  Clinician/Clinician: 100% clinical and teaching * These ratios vary!

3. How can I find my way through this jungle?

4. Ask Yourself Some Questions  What are my strengths and unique abilities?  What do I enjoy?  How do my research/teaching/clinical skills fit into my Division and Department?  What are the criteria for appointment and promotion?

5. Map Goals  Short-term goal: Submit the paper by December 2009  Long-term goal: Obtain an American Cancer Society grant by 2011

6. Discuss goals with your mentor and your fellowship director or division head! They want you to succeed!

7. Annual Conference with Your Fellowship Director or Division Head  Comment on my publications – journals, number, impact  Original research vs. reviews vs. case reports  How can I improve my teaching?  What should I do more/less of?  Am I on track for appointment/promotion?

8. In most divisions, original research published in a peer- reviewed journal, is the key.

9. The appointment and promotion process was revised in 2008-2009

10. Individual Faculty Member  Unique professional profile with research, teaching, clinical, and administrative responsibilities  Relative importance for promotion should reflect time devoted to each activity  Departmental expectations regarding faculty effort, criteria for promotion, and evaluation methods should be aligned

11. Individual Faculty Member  Recognition that we are not all running to the same finish line – “How will you define success for me?” –Department/Division expectation articulated in appointment letter, and reviewed and updated during the annual meeting (Assistant Professor) with your Division Head

12. “At the end of the day, the most important criterion for appointment or promotion is achieving excellence in whatever academic activity is your core activity.” Steve Fihn, MD

13. Criteria for Promotion  Scholarship (discovery, integration, teaching) “Work that has not been disseminated does not meet the definition of scholarship”  Teaching portfolio (trainee and peer evaluation of teaching effectiveness)  Clinical care (peer evaluation)

14. Scholarship  Discovery: basic science, clinical, epidemiology, health services  Integration: meta-analysis, book chapters.. (Steve McGee Evidence- Based Physical Diagnosis, Jan Hirschmann’s work)  Teaching: educational websites…(Carey Jackson’s Ethnomed, David Spach’s AIDS Clinical Care website)

15. Teaching Portfolio  Responsibility of each faculty member  Allows more formal assessment of teaching contributions

16. Teaching Portfolio  Development of curricula for a course, rotation, or clerkship - Learning objectives, instructional materials  Leading a small group session for a HuBio Course  Teaching evaluations / thank you letters  Invited presentations at UW or elsewhere (include brochure if CME course)

17. Doug Paauw, MD Professor of Medicine Teaching Portfolio

18.  Regional or national recognition (at Associate Professor or Professor level)  Administration (for those who have an administrative role)  Professionalism (for everyone) Criteria for Promotion

19. Professionalism: A Core Academic Competence “ A discussion of professionalism should be a component of the annual assessment.” Paul Ramsey, MD

20. How can we assess professional behavior?

21. “I shall not today attempt to further define…pornography…but I know it when I see it.”  Supreme Court Justice Potter Stewart 1964

22. UCSF Approach (Maxine Papadakis)  Include “respect” questions in each attending evaluation form  “This attending treated me with respect”  “This attending treated others (students, residents, patients, nurses, pharmacists…) with respect”

23. The Research Lab  “For faculty engaged in research, intellectual integrity, diligent and unbiased acquisition, evaluation, and reporting of scientific information, adherence to university research regulations, and collegial and fair treatment of trainees and research staff at all levels are elements of professionalism.”  What metric can we use to evaluate professionalism for these faculty?

24. New Appointment and Promotion Criteria  The relative importance for promotion of research, teaching, clinical, and administrative activities should reflect the time devoted to each activity  Professional behavior is now included

25. Academic Ranks  Instructor  Assistant Professor  Associate Professor  Professor

26. “Acting” Appointments  One year appointments, renewed annually  Maximum 4 years in a single rank (Acting Instructor or Acting Assistant Professor), and 6 years overall  The Assistant Professor clock does not tick when you are “Acting” (this is a big advantage)

27. Instructor “Appointment to the rank of instructor requires completion of professional training and the promise of a successful career in teaching and research” UW Faculty Handbook Chapter 24 www.washington.edu/faculty/facsenate/handbook/volume 2.html

28. Instructor  Very rare appointment in the Department of Medicine  Most are appointed as Acting Instructor (entry level faculty position)

29. Assistant Professor “Appointment to the rank of Assistant Professor requires a demonstration of teaching and research ability beyond that ordinarily required of an Instructor” UW Faculty Handbook

30. Assistant Professor  Requires a national search –Position approved by Department Chair –Search Committee of local luminaries –Ads in national journals –Interviews –Takes ~ 9 months (can be accomplished more quickly )

31. Assistant Professor  Two three-year appointments  “Up or Out” after 6 years

32. “Ask not for whom the clock ticks; it ticks for thee.” Modified (more than slightly) from John Donne Most people get promoted; this is not a pyramid. The process is selective, but at the point of hire.

33. Assistant Professor  Promotion process usually starts in the spring of your 5 th year as Assistant Professor  Division Head is in charge of your promotion to Associate Professor

34. What if I work part time? Is the academic clock the same? The first three-year appointment as Assistant Professor is the same. The second three-year appointment is modified as follows:  90% time – 3 years 70-89% time – 4 years 60-69% time – 5 years 50-59% time – 6 years

35. Promotion from Assistant to Associate Professor  Vote of senior Division members  Package of CV, key scientific papers, teaching reviews, letters from internal and external reviewers and cover letter is sent to the Department A&P Committee in the fall of your 6 th year, then to the Dean  You are promoted at the start of your 7 th year

36. Associate Professor “Appointment to the rank of Associate Professor requires a record of substantial success in both teaching and research, except that in unusual cases an outstanding record in one of these activities may be considered sufficient”  The quality of your peer reviewed publications is a major factor, and regional recognition is important

37. Strategies for Success  Know the process  Have clear goals –Research (with publications) –Teaching portfolio –Fit with the mission of your Division and Department –Professionalism part of process Be Flexible – Life Changes!

38. The Academic Adventure is a Grand Adventure  Residents and Fellows who challenge your thinking  Thrill of discovery  Joy of longitudinal patient care  Travel