1. Pearls from the oyster bar: How to navigate academic promotions and build a successful career in medical education Anita Blanchard MD AnnaMarie Connolly MD Sandra Dayaratna MD Marjorie Greenfield MD Patricia Huguelet MD Lee Learman MD PhD No conflicts

2. Today Career path basics Panel: pearls for early, mid, and late career development Questions and discussion 3 steps you will take Wrap up

3. Faculty responsibilities vary Clinical work: RVUs Teaching and Service: necessary Research

4. What do YOU want? What is your ideal balance of activities? How can you build a successful career doing what you love to do? Are you headed in that direction? Are your goals compatible with your institution’s goals?

5. Learn how incentives work at your AMC Predetermined salary Productivity model Based on clinical targets or dollars Hybrid—base salary plus incentive RVU productivity Varied measures (patient satisfaction, resource utilization, academic achievements, etc.) Rank?

6. Many institutions offer clinical productivity target offsets or “protected” time Grants/research support Administrative salary lines Service? (ex/IRB leadership) Teaching? **you “buy back” time for other activities**

7. Academic faculty promotion tracks Tenure track Research focus Must receive tenure by year (7) or need to leave Extensions of the tenure clock for birth/adoption, etc? Salary guarantee?

8. Academic faculty promotion tracks Tenure track Research focus Must receive tenure by year (7) or need to leave Extensions of the tenure clock for childbirth, etc? Salary guarantee? “Non-tenure” or “combined service” or “clinician-educator” track 1 or 2 of: Teaching, research, clinical service “Voluntary faculty”

9. Academic appointments/promotion Academic faculty (Tenure or maybe NTT) Instructor Assistant professor Associate professor Professor Clinical faculty (“voluntary” “private” “community” faculty) “Clinical” instructor, etc.

11. Promotion measures aim to improve School’s status -recognize contributions -provide incentives Research excellence national reputation “sustained funding” (required for tenure) Teaching how do you measure excellence? regional/national reputation Service measures of clinical excellence regional/national clinical reputation regional/national committee service

12. Research accomplishments Must demonstrate own originality, creativity, indispensability, and contributions National recognition Publications Grants Invited talks Presentations at national meetings Book chapters Peer review Editorial work Study sections/grant review

13. Which track are you in? Tenure track Faculty non-tenure track Clinical appointment Unsure Other

14. Non-tenure track: excellence in either research, teaching or clinical service Research: same standards as tenure track Teaching or clinical service--recognition at a regional or national level for associate professor and national recognition for professor Evidence of acceptable contributions in one or more of the other areas (teaching, research, or service)

15. Understand the culture and expectations at your institution!

16. Promotion process PROFESSOR OR ASSOCIATE PROFESSOR REQUIRES 1. Nomination by your Chair → Review and approval by your department CAPT → School of Medicine CAPT approval →Approval by steering committee of Faculty Council →Approval by Dean, Provost, President and University Board of Trustees

17. The “non tenure track” promotions packet CV Personal statement Teaching portfolio (maybe) Philosophy, documentation of contributions Letters from “arm’s length” external referees Letters from students, colleagues, etc.

19. Evidence of regional/national reputation Publications Invitations to present nationally (depts. or conferences) Participation in professional societies, especially in leadership positions Writing test questions for CREOG, NBME, etc Program committee for conference Peer review for journals Journal editorial work Invited book chapters, editorials, uptodate…

20. Evidence for Excellence in Clinical Service Publications (esp. first or senior author) New practice methods (with recognition/dissemination) Awards and honors

21. Evidence for Excellence in Teaching Documenting a scholarly approach: evidence of drawing from/building on the work of others dissemination engagement with the community of educators Publications (esp. first or senior author) Including Med Ed Portal Leadership in educational programs New educational methods (with recognition/dissemination) Awards and honors Simpson, D., et al, Advancing educators and education by defining the components and evidence associated with educational scholarship. Med Ed 2007 Oct;41(10):1002- 9. Epub 2007 Sep 5 http://www.ncbi.nlm.nih.gov/pubmed/17822412http://www.ncbi.nlm.nih.gov/pubmed/17822412

22. Evidence for Excellence in Research Publications (esp. first or senior author) Funding NIH study section or other grant review If “team scientist” role must be specified and integral Awards and honors

23. Getting “credit” for national recognition Get known by colleagues at other institutions, professional organizations, etc. Review for journals Any professional activity extending beyond your institution can be valuable

25. Steps to success Understand what is valued for promotion at your institution and the expectations for your focus Get skills Make contacts Get involved outside your institution

26. PANEL: Pearls for early, mid, and late career development Sandra Dayaratna, MD (Moderator) Clinical Assoc. Professor Thomas Jefferson U. Hosp. Sidney Kimmel Sch. of Medicine Panelists: Patricia Huguelet, MD Assistant Professor University of Colorado Lee A. Learman, MD, PhD Senior Associate Dean for Graduate Medical Education and Academic Affairs Florida Atlantic U. Anita Blanchard, MD Professor University of Chicago QUESTIONS AND OPEN DISCUSSION WRAP UP AnnaMarie Connolly, MD Professor Univ. of North Carolina Hospitals

27. 3 Action Steps Write down three steps you plan to take

28. PANEL: Pearls for early, mid, and late career development Sandra Dayaratna, MD (Moderator) Clinical Assoc. Professor Thomas Jefferson U. Hosp. Sidney Kimmel Sch. of Medicine Panelists: Patricia Huguelet, MD Assistant Professor University of Colorado Lee A. Learman, MD, PhD Senior Associate Dean for Graduate Medical Education and Academic Affairs Florida Atlantic U. Anita Blanchard, MD Professor University of Chicago QUESTIONS AND OPEN DISCUSSION WRAP UP AnnaMarie Connolly, MD Professor Univ. of North Carolina Hospitals

29. EXCELLENCE IN CLINICAL ACTIVITY Regularly assumes greater than average share of clinical duties, as measured by patient care or procedure logs, RVUs, clinical billing statistics or other measures of clinical effort.  Continuing, significant participation for an extended period of time in clinical activities that are highly effective.  Development of new techniques, therapies, clinical guidelines, patient care practices or health care delivery systems that have improved the health of patients or populations.  Creative, active participation in the evaluation of the effectiveness of care (quality, outcomes, patient safety, utilization, access, cost).  Recognition for excellence in clinical activity at the local, regional, national or international level through letters of reference, honors, awards, institutional evaluations, invitations to speak, requests to write reviews, etc.  Demonstration of effective leadership at the site of clinical practice – e.g., director of a clinical service, head of a division, chair of a department, head of an interdisciplinary team that creates and manages a clinical pathway and outcomes evaluation, medical staff president.  Assumption of a substantive leadership role at the regional level – e.g., chairing committees, or serving as officer of local or statewide professional organizations.  Assumption of a substantive leadership role at the national or international level - e.g., chairing national symposia and meetings, chairing committees or serving as officer of national professional organizations, journal editor.  Leadership of structured activities that promote quality of care and patient safety and that advance the science and practice of health care quality improvement.  Participation in significant self-assessment activities and audits of one’s own practice that have led to improvements in quality, efficiency or outcomes of care.  Significant involvement in health care advocacy, community service or other activities that shape public policy on health care or that address health disparities.  Evidence of health care-related scholarship (for example, grants, publications, authoritative review articles, national presentations, innovations or other activities that advance the science and practice of health care quality improvement.)  Matrix for promotion : clinical

30. Matrix for promotion: education Regularly assumes greater than average share of teaching duties –in classroom, laboratory, clinical or community settings.  Consistently receives outstanding teaching evaluations or teaching awards.  Recognition as an outstanding and influential role model for students, fellows, residents or other trainees.  Record of successful mentorship of students, residents, fellows or other faculty, as measured by: letters of support from mentees; publications, presentations, grants, awards or other evidence of mentees’ academic success; evidence that mentees have pursued outstanding careers.  Development of mentoring programs that focus on career development or academic promotion of students, residents, fellows or faculty.  Development of innovative teaching methods, such as educational, websites, simulations, videotapes, packaged courses or workshops, etc.  Successful leadership of local, regional or national continuing education courses.  Consistent participation in national educational activities (for example, residency review committees, programs sponsored by professional organizations, re-certification courses or workshops).  Invitations to be a visiting professor at other institutions.  Development of innovative courses, high-quality syllabi, novel lectures, problem-based learning cases, laboratory exercises or other instructional materials.  Demonstration of educational leadership (for example, by serving as a course, fellowship or training program director or assistant dean).  Evidence of teaching scholarship (for example, research, grants, publications or national presentations that focus on understanding the best methods, or outcomes, of teaching).  Completion of advanced faculty development programs that result in a certificate or degree in education, with evidence that the faculty member has applied these new skills or knowledge to improve his or her teaching or pedagogy. 

31. Matrix for promotion : research A consistent level of peer-reviewed or other funding for research awarded in a competitive manner over a sustained period of time.  Demonstrated evidence of originality as an investigator.  Demonstration of significant independent intellectual contributions to successful research programs.  Principal investigator status on competitive peer-reviewed research grants (for example: R03 or R21 awards or mentored K08 or K23 awards from NIH or private foundations for associate professors; R01, P01 or other independent awards for professors).  Development of a significant number of patents.  An ongoing, peer-reviewed publication record with first- or senior-author publications.  A national or international reputation, as evidenced by: external letters of reference; invitations to present at national or international meetings; invitations to write reviews or chapters, or to provide unique expertise as a collaborator on a research project; visiting professorships; service on as a regular member on study sections; organization of national meetings; service as a national consultant or on editorial boards of journals. 

32. PANEL: Pearls for early, mid, and late career development Sandra Dayaratna, MD (Moderator) Clinical Assoc. Professor Thomas Jefferson U. Hosp. Sidney Kimmel Sch. of Medicine Panelists: Patricia Huguelet, MD Assistant Professor University of Colorado Lee A. Learman, MD, PhD Senior Associate Dean for Graduate Medical Education and Academic Affairs Florida Atlantic U. Anita Blanchard, MD Professor University of Chicago QUESTIONS AND OPEN DISCUSSION WRAP UP AnnaMarie Connolly, MD Professor Univ. of North Carolina Hospitals

33. Recommended courses APGO Faculty Development Seminar https://www.apgo.org/faculty/faculty-development-seminar https://www.apgo.org/faculty/faculty-development-seminar APGO Academic Scholars and Leaders Program https://www.apgo.org/faculty/scholars-program/academic-scholars-and- leaders https://www.apgo.org/faculty/scholars-program/academic-scholars-and- leaders AAMC programs www.aamc.org (including programs specifically for URMs and for women in academic medicine)www.aamc.org Stanford Faculty Development for Medical Teachers http://sfdc.stanford.edu/faculty.html http://sfdc.stanford.edu/faculty.html Harvard-Macy programs http://www.harvardmacy.org/http://www.harvardmacy.org/ Clinical research http://www.exxcellence.org/http://www.exxcellence.org/

34. Recommended resources APGO publication Career Development in Academic Medicine, particularly chapters on CVs and Promotion Simpson, D., et al, Advancing educators and education by defining the components and evidence associated with educational scholarship. Med Ed 2007 Oct;41(10):1002-9. http://www.ncbi.nlm.nih.gov/pubmed/17822412http://www.ncbi.nlm.nih.gov/pubmed/17822412 Med Ed Portal (getting published in medical education) https://www.mededportal.org/ https://www.mededportal.org/ AAMC faculty salary survey https://members.aamc.org/eweb/DynamicPage.aspx?webcode=PubHome https://members.aamc.org/eweb/DynamicPage.aspx?webcode=PubHome Sheryl Sandburg Lean In Fisher and Ury Getting to Yes: Negotiating Agreement Without Giving In