Update on the Silver Book & Associated Guidelines for PromotionClinician Educator Pathway

November 29, 2007

Lisa Heiser, JHSOM Assistant Dean for Faculty Development

With appreciation to:

Estelle Gauda, MD, Chair, Associate Professor Promotions Committee

Brooks Jackson, MD, Chair, Professorial Promotions Committee

Laura Sterni, MD, Past-president, Medical School Council

Pat Thomas, MD, Associate Dean for Education

Can You Be Promoted on Clinical Excellence Alone?

Consider Hopkin’s $3.2 billion campaign slogan:

(What is it?)

Can You Be Promoted on Clinical Excellence Alone?

Consider Hopkin’s campaign slogan for JHU & Johns Hopkins Medicine:

KNOWLEDGE FOR THE WORLD

“The first president of the university formally took office and laid out plans for a radically different educational institution. Gilman wanted his university to do more than just teach, more than just pass along old knowledge to the next generation. He added a new mission: discovery, the creation of knowledge, and the use of that knowledge for the good of humanity. ‘What are we aiming at?’ he asked in his inaugural speech. ‘The advancement of individual scholars, who by their excellence will advance the sciences they pursue, and the society where they dwell.’ That remains the Johns Hopkins mission today, and today's Johns Hopkins -- the first American research university -- has adopted a simple, but powerful, restatement of Gilman's words: ‘Knowledge for the World.’ ” Inaugurated Feb. 22, 1876

Daniel Coit Gilman

Silver Book Standard for Promotion

To Assistant Professor – requires a clear scholarly commitment and demonstrated creative scholarly contribution.

To Associate Professor – requires national recognition for scholarship.

To Professor – requires national leadership and (in most cases) international recognition for important scholarly contributions.

Areas of Scholarship

JHSOM recognizes scholarship that is achieved as a

Researcher Educator Clinician and/or Program Builder

What is a Clinician Educator?

From Pat Thomas in “How to Get Your Career Going as a Clinician Educator,” October 2007:

Faculty member whose scholarship is not dependent on research, although may do research

<50& of salary support comes from external funding

Consider “cE” vs “Ce” cE: Scholarship related to educational issues Ce: Scholarship related to clinical practice

Promotion to Assistant Professor

Level of achievement in Education Creative scholarship includes:

Publication of one or more peer-reviewed, first authored review, curriculum, or other educational document

Participation in and/or initiation of research that addresses educational issues and that has led to dissemination of findings for scrutiny and use by greater academic community

Promotion to Associate Professor

Level of achievement in Education National recognition includes:

Development, implementation, and evaluation of innovative educational programs with national reputation and impact

Peer-reviewed publication of leading textbooks or chapters in leading textbooks

Promotion to Associate Professorcontinued….

Level of achievement in Education National recognition includes:

Development and dissemination of other educational materials (e.g. websites, course design) identified as important through peer-review

Development of or leadership in educational research projects that have a national reputation and impact

Promotion to Professor

Level of achievement in Education National leadership and international recognition

includes:

Development, implementation, and evaluation and widespread dissemination of innovative educational programs or educational materials (e.g. websites, curricula) with documented national and international impact and reputation

Publication of leading textbooks or chapters in leading textbooks

Development, leadership, and publication of educational research that has a national impact and reputation

Criteria Considered for Academic Advancement in the Silver Book

Accomplishments are organized within six categories:

Teaching Publications and presentations Support for research Recognition beyond the JHSOM Citizenship to the University Clinical Service

Examples of Accomplishments in Teaching for Promotion to Associate Professor

National recognition for scholarship in teaching at the predoctoral, doctoral, or CME level

Scholarly teaching as documented by its impact on learners and by assessment of the teaching by learners, peers, internal or external evaluators, and oneself

Teaching awards from national and international organizations

Direction and evaluation for several years of a course at the undergraduate, graduate or CME level

Invitation to teach in hospitals, other medical schools, programs of professional societies, CME courses

Invited educational consultation or collaboration within or beyond JHSOM

Teaching Skills Courses

Locally: JHU Faculty Development Program (K.Cole)*

Teaching Skills Curriculum Development

Office of Faculty Development* (flier) “Speak Like a Pro”

Homewood: Center for Educational Resources JHU Graduate School of Education *www.hopkinsmedicine.org/fac_development

From: Pat Thomas, “How to Get Your Career Going as a Clinician Educator,” October 2007.

Teaching Skills Courses

Regional/National Evidence-based Medicine (McMasters) Teaching Geriatrics (UCSF) Healthcare Communication (Bayer Institute) Professional societies: Surgeons as Educators

Course (American College of Surgeons) Harvard Macy Institute (2 week courses)

From: Pat Thomas, “How to Get Your Career Going as a Clinician Educator,” October 2007.

Fellowship Training (cE)

Medical Education Fellowship (GIM) Stanford Fellowship in Medical Education Rabkin Fellowship in Medical Education Surgical Research Education Fellowship

(American College of Surgeons)

From: Pat Thomas, “How to Get Your Career Going as a Clinician Educator,” October 2007.

Additional Degrees (cE)

Masters in Education (M.Ed.) Masters in Medical Education (M.Ed.)

Univ. of Pittsburgh Univ. of Cincinnati Univ. of Michigan Univ. of Southern California Univ. of Southern Illinois (online or residential)

Masters of Science Masters of Science in Education with a

concentration in Technology in Education

From: Pat Thomas, “How to Get Your Career Going as a Clinician Educator,” October 2007.

Examples of Accomplishments in Publications for Promotion to Associate Professor

Impact of publications and role of faculty member (e.g., as first or last author) are more important than the number of publications.

National recognition for scholarship in education, clinical service and/or program building through continuing publication of:

Descriptions of and evaluation of innovative curricula programs or teaching methods

Research that addresses educational topics Book chapters Continuing dissemination of clinical expertise by audio

and video learning aids and through computer-based material

Notes on Publications

From Estelle Gauda, Faculty Forum on “Promotions Process,” Spring 2007.

Substantive and continuous publication in refereed journals with special emphasis on the quality of original contributions to the field

Role of the faculty member in the execution of the project involved in the publications

Number of authors and the place of the faculty member among the authors

Textbooks or monographs either as sole author or as editor

Chapters in text books

NO ABSOLUTE # of PUBLICATIONS

Medical Education Organizations

Org. Focus Publication

AAMC:GEARIMEGSA

UME,GME,CME Academic Medicine

ACCME CME

ABSME Behavioral Sciences and Medical Education

Annals of Behavioral Science and Medical Education

AAME Medical Education in Europe

Medical Teacher

NBME Assessment (Stemmler Fund)

From: Pat Thomas, “How to Get Your Career Going as a Clinician Educator,” October 2007.

Specialty Medical Education Organizations

Alliance for Internal Medicine (SGIM,ACP, ASP,CDIM, APDIM)

Internal Medicine Journal of General Internal Medicine,Annals of Internal Medicine

Council on Medical Student Edcuation in Pediatrics(COMSEP)

Pediatrics Pediatric Educator

Association of Professors of Gynecology and Obstetrics(APGO)

Obstetrics/GynWomen’s Health

Assoc. for Surgical Education

Surgery

Consortium of Neurology Clerkship Directors (CNCD)

Neurology

Society of Teachers of Family Medicine

Family MedicineAmbulatory Medicine

Family Medicine

Examples of Content Medical Education Organizations

American Medical Informatics Association (AMIA)

Journal of the AMIA

Association for Teachers of Preventive Medicine (ATPM)

American Journal of Preventive Medicine

End of Life /Palliative Care Resource Center (EPERC)

Website

International Association of Medical Science Educators (IAMSE)

Association for the Study of Medical Education

Medical Education

Examples of Accomplishments in Clinical Service for Promotion to Associate Professor

National recognition for excellence in clinical service or clinical program building may be reflected by:

Reputation as one of the nation’s foremost clinicians in management of a particular disease or condition

Leadership positions in professional societies emphasizing excellence in clinical specialties

Service as a member of or examiner for your specialty board

Development of national or internationally recognized standards of care

Development of a unique or essential clinical program with national prominence

As Assistant Professor, consider these strategies/questions:

What is my focus and area of concentration?

What are important areas for discovery and innovation that I enjoy?

What professional organizations can I join and volunteer in (develop regional and national reputation through volunteering to work on annual meetings, review abstracts; discover collaborators; provide documentation of your leadership & eligibility for awards)?*

What suggestions do my mentors have for opportunities to talk and teach externally (e.g., CME, Grand Rounds), and to write in peer-reviewed national contexts?

(*AAMC, ABSME, NBME, Alliance for Internal Medicine)

Adapted from Pat Thomas, “How to Get Your Career Going as a Clinician Educator,” Oct. 2007

As Associate Professor, consider these strategies:

Focus early in a given area and develop a body of work to become recognized as an expert

Take the lead in developing and implementing projects/programs and publish the results in a timely manner. Apply for funding.

Publication of original data should take priority over dissemination of exiting knowledge

Take advantage of scholarly and leadership opportunities at the national/international level

Consistently involve yourself with the teaching/mentoring of students and document those activities and student outcomes

*From Brooks Jackson, Faculty Forum on “Professorial Promotions Process,” Spring 2007.

Assistant Professor of Medicine- 1999 Joint appts: Departments of Health Policy Research and

Management (1999); Epidemiology (2003)

Scientific Discovery: Focus: health disparities research that affect the care of

individuals with severe mental illness (SMI) Determined that individuals with SMI

have a higher burden of chronic disease (cardiovascular disease and obesity than the general population)

Individuals with SMI have reduced level of physical activity which is greater for those individuals who do not have regular social contacts.

Her findings cross-disciplines: internal medicine, psychiatry, epidemiology and health care delivery

Example: Associate ProfessorClinical research scientist /educator

Associate Professor, continued

Dissemination of scholarly contributions: 22 peer-reviewed publications (10/first author; Annals of Internal

Medicine, Archives of General Psychiatry, Journal of Nervous and Mental Illness); 1 editorial and 1 book chapter)

National recognition: Member multiple national societies. Invited speaker- NIMH Conferences, American Psychiatric Associate

national meeting, Co-chair of Session at Society of General Internal Medicine Annual meeting

Invited member: NIHM study sections, and ad hoc reviewer- Annie Lea Shuster Alumni Speaker ( RWJ Clinical Scholars Program) Awards

Recognition by the Center of Excellence Steering Committee for expertise on medical and mental health co-morbidity

PI: R01, R34 and (2 awards) National Alliance of Research on Schizophrenia and Affective Disorders NASAD)

Ulmer Award, (Johns Hopkins) support research designed to improve the QoC for persons with SMI

Example: Associate Professor Career pathway: Clinician/Research/Educator

National recognition for scholarly contributions: longitudinal data analysis – treatment options for individuals with inflammatory bowel disease

Novel discoveries and techniques:Immunosuppressive therapy increases the long-term outcome of individuals with specific types of inflammatory bowel disease

Scholarly Research: 49 publications, 21 first-authored, 8 reviews; K23 Award- support Ph.D. thesis.

National Leadership: Colitis Society, Member Coordinating Center for: Multicenter Colitis Steroid Treatment Trial, Invited speaker, CME (local and nationally).

Education/mentoring: medical students and postdoctoral fellows

Letters: (3 inside/6 outside) “She has established herself as a distinct clinical and methodological expert ….” “Her papers are quoted frequently among inflammatory bowel disease specialists”

Example: Associate Professor Michele Shermak, MD

Career Pathway: Program Builder/Educator/Clinician

Years at Rank Before Promotion: Assistant Professor – 7.5

Accomplishments that led to Promotion:Associate Professor: The top accomplishment was developing a national reputation in an area of

concentration, which in my case is post-bariatric body contouring surgery Speaking at national meetings about my technical and clinical management

of these patients Writing a number of peer-reviewed articles looking at outcomes and patient

safety issues Becoming increasingly involved in our national professional society, the

American Society of Plastic Surgeons (ASPS) for networking purposes, which led to leadership opportunities on a national level

Became Chief of my Division which was the clincher

Publications at Promotion:To Associate Professor: 24 peer-reviewed articles

12 non-peer reviewed articles 6 chapters

Faculty Characteristics of Those Promoted to Professor in 2002-2006*

Number of:

Original Research Articles: Mean: 61 (Range 13-148)

Original Research Articles as First or Last Author: Mean: 34 (Range 10-86)

Book Chapters/Monographs: Mean: 11 (Range 0-53)

Books: Mean: 1 (Range 0-8)

Trainees Mentored by Faculty: Mean: 19 (Range 0-96)

*From Brooks Jackson, Faculty Forum on “Professorial Promotions Process,” Spring 2007.

Example Professor: David Kern, MD Career Pathway: Clinician Educator

Years at Rank Before Promotion: Assistant Professor – 11 Associate Professor – 16

Accomplishments that led to Promotion: Director, Johns Hopkins Residency Program in General Internal Medicine Director, Osler Center for Clinical Excellence at Johns Hopkins Course Director of several CME Courses Director, Division of General Internal Medicine, Johns Hopkins Bayview Medical Center Director, Community –Based Practices, Johns Hopkins Bayview Physicians Co-Director, Medical Education Track, GIM Fellowship Program Co-Director, Johns Hopkins Faculty Development Program for Clinician-Educators, Director,

Program in Curriculum Development

Publications at Promotion: 27 peer-reviewed research publications

12 peer-reviewed education publications 27 book chapters

3 books/textbooks12 extramural funding grants

Valuable Resources

Gold Bookhttp://www.hopkinsmedicine.org/som/faculty/policies/goldbook/index.html

Silver Bookhttp://www.hopkinsmedicine.org/som/faculty/policies/silverbook/SilverBook2006.pdf

Office of Faculty Development Website, including video library of programs & presentationshttp://www.hopkinsmedicine.org/fac_development/

Associate Professor Promotions Committee Website & Estelle Gaudahttp://www.hopkinsmedicine.org/dev/appc

Professorial Promotions Committee Website & Brooks Jacksonhttp://www.hopkinsmedicine.org/som/faculty/policies/goldbook/index.html

Recently Promoted Clinician Educators