What to do While Your Clock is Ticking?

What to do While Your Clock What to do While Your Clock is Ticking? is Ticking?

Jan Shorey, M.D.Jan Shorey, M.D.Associate Dean of CME &Faculty AffairsAssociate Dean of CME &Faculty Affairs

UAMS College of MedicineUAMS College of Medicine

““What is life but a series of opportunities What is life but a series of opportunities

we choose to take?”we choose to take?”

Francis C. Wood, M.D.Francis C. Wood, M.D.

Lee Lee Doyle, Ph. D.

It’s Your Move! University of Arkansas for Medical Sciences College of Medicine

4-D Model of Academic Success4-D Model of Academic Success

DREAM DREAM

DESIGNDESIGN

DODO

DOCUMENTDOCUMENT

While Dreaming and Designing, ask yourself about While Dreaming and Designing, ask yourself about

Aligned MissionsAligned Missions

Your personal goalsYour personal goals

Your professional passions and goalsYour professional passions and goals

Expectations of others: Goals and requirements of Expectations of others: Goals and requirements of your Department (your Department (READ THE P&T Guidelines!READ THE P&T Guidelines! www.uams.edu/facultyaffairs - click on Promotion & Tenure)

Expectations of others: Goals of the College and Expectations of others: Goals of the College and University (University (READ THE P&T Guidelines!READ THE P&T Guidelines!))

Key Career Planning QuestionsKey Career Planning Questionswithin the College of Medicinewithin the College of Medicine

1. Are you on “the right track”? (Are you 1. Are you on “the right track”? (Are you appointed on the academic pathway that best appointed on the academic pathway that best suits your goals?)suits your goals?)

2. What is your “time and effort” distribution?2. What is your “time and effort” distribution?

3. Are you turning your “day job” into 3. Are you turning your “day job” into scholarship?scholarship?

4. Who are your mentors?4. Who are your mentors?

5. Who is in your professional network?5. Who is in your professional network?

Are you on “the right track”?Are you on “the right track”?2009 COM P&T Guidelines2009 COM P&T Guidelines

Three new academic pathways; total of 7 academic pathwaysThree new academic pathways; total of 7 academic pathways

••Scholarship is required of BS, CS, CE and is encouraged by not required for Scholarship is required of BS, CS, CE and is encouraged by not required for CACA

••Non-tenure pathways (NTPs) Non-tenure pathways (NTPs) maymay be best for faculty members with young be best for faculty members with young childrenchildren

••NTPs allow for rational appointment of junior faculty members on basic & NTPs allow for rational appointment of junior faculty members on basic & clinical scientists pathways who need 10 years to obtain independent clinical scientists pathways who need 10 years to obtain independent funding funding

••NTPs allow for rational appointment of part time facultyNTPs allow for rational appointment of part time faculty••NTPs allows for rational appointment of faculty members who work at the VA > NTPs allows for rational appointment of faculty members who work at the VA >

5/85/8thth time time

Basic ScientistBasic Scientist Clinical ScientistClinical Scientist Clinical EducatorClinical Educator Clinical AttendingClinical Attending

TPTP NTPNTP[new][new]



NTPNTP







Time & Effort DistributionTime & Effort Distribution

(in Percents)

Basic Scientist-TP

Basic Scientist-NTP

Clinical Scientist

Clinical Educator

Clinical Attending

Range Typically Range Typically Range Typically Range Typically Range Typically

Teaching/Mentoring (Total) 10-35 30 0-30 5 5-10 7.5 10-50 25 0-30 20

Didactic Teaching 1-3 2.5 2-10 5 0-2 1

Bedside Teaching 2-10 5 10-40 20 0-30 20

Research 50-85 60 90-100 90 40-90 75 5-30 10 0-10 5

Clinical Service (Total) 10-50 20 40-80 80 70-100 90Direct Patient Care 10-50 15 40-60 60 70-100 70

Bedside Teaching 2-10 5 10-40 20 0-30 20

Leadership/Admin. Service 0-35* 10 0-10* 5 0-10* 2.5 0-20* 5 0-10* 5

Time & Effort DistributionTime & Effort Distribution

Clinical Scientist Range Typically

Teaching/Mentoring (Total) 5-10 7.5

Didactic Teaching 1-3 2.5

Bedside Teaching 2-10 5

Research 40-90 75

Clinical Service (Total) 10-50 20

Direct Patient Care 10-50 15

Bedside Teaching 2-10 5

Leadership/Admin. Service 0-10* 2.5







Scholarship and Academic Medicine: Scholarship and Academic Medicine:

What Does “the academy” do?What Does “the academy” do?

• • Produces scholarsProduces scholars – – “nurtures, tolerates, “nurtures, tolerates, accommodates scholars,” in contrast to accommodates scholars,” in contrast to mostmost of the of the private practice of medicine and private practice of medicine and mostmost of industry of industry

• • Produces scholarshipProduces scholarship – – Discovery, Discovery,

Integration, Application, TeachingIntegration, Application, Teaching Scholarship ReconsideredScholarship Reconsidered, Boyer , Boyer (1990) (1990) See page 3 of the 2009 UAMS COM P&T GuidelinesSee page 3 of the 2009 UAMS COM P&T Guidelines

• • Teaches othersTeaches others – – students and the publicstudents and the public

• • Ensures the continued existence of the Ensures the continued existence of the academyacademy - - administrative serviceadministrative service

Scholarly Work In Academic MedicineScholarly Work In Academic Medicine

Creates new knowledgeCreates new knowledge

Within any of 4 domains Within any of 4 domains

Clinical CareClinical CareEducation/TeachingEducation/TeachingResearch Research (bench to bedside to community)(bench to bedside to community)

AdministrationAdministration

Work vs. ScholarshipWork vs. Scholarship

Scholarly work requires:Scholarly work requires:

High level of discipline & related expertiseHigh level of discipline & related expertiseInnovationInnovationCan be replicated or elaboratedCan be replicated or elaboratedCan be peer-reviewedCan be peer-reviewed

Scholarship AssessedScholarship Assessed, Glassick, Huber, Maeroff (1997), Glassick, Huber, Maeroff (1997)

Work vs. ScholarshipWork vs. Scholarship

““work” becomes scholarship when it is:work” becomes scholarship when it is:

Made publicMade publicAvailable for peer review and critique according Available for peer review and critique according

to accepted standardsto accepted standardsAble to be reproduced and built upon by othersAble to be reproduced and built upon by others

[the 3 P’s: product, peer-reviewed, published][the 3 P’s: product, peer-reviewed, published]

Lee S. Shulman Lee S. Shulman

Carnegie Foundation for the Advancement of TeachingCarnegie Foundation for the Advancement of Teaching

Scholarship Made Public: Scholarship Made Public: “Publication”“Publication”

Examples of “Tried and True” Methods:Examples of “Tried and True” Methods:

– Peer-reviewed journal articles about original Peer-reviewed journal articles about original contributionscontributions

– Peer-reviewed “review” articlesPeer-reviewed “review” articles

– Textbooks and chapters; monographsTextbooks and chapters; monographs

– Peer-reviewed poster presentations and Peer-reviewed poster presentations and abstractsabstracts

Scholarship Made Public: Scholarship Made Public: “Publication”“Publication”

Examples of Newer Methods:Examples of Newer Methods:

– Peer-reviewed web-based materials Peer-reviewed web-based materials

– CDs and other forms for enduring materialsCDs and other forms for enduring materials

– Educational syllabi and curriculum documentsEducational syllabi and curriculum documents

– Patient education materialsPatient education materials

– Quality improvement projectsQuality improvement projects

– Clinical Practice GuidelinesClinical Practice Guidelines







Who are your mentors?Who are your mentors?

• • Who are your past and present mentors? Where Who are your past and present mentors? Where would you be without them?would you be without them?

• • Does your Department have an organized Does your Department have an organized mentoring program?mentoring program?

• • Many Many (probably most)(probably most) of us need multiple mentors of us need multiple mentors

• • Each party in a mentor-protégé relationship has Each party in a mentor-protégé relationship has responsibilities to fulfill for “the other” responsibilities to fulfill for “the other”







Who is in your professional Who is in your professional network?network?

• “• “local” colleagues within your department, other local” colleagues within your department, other departments, and other UAMS Collegesdepartments, and other UAMS Colleges

• • national and international colleagues in your national and international colleagues in your major field of interestmajor field of interest

• • attend national professional “meetings” in your attend national professional “meetings” in your major field of interestmajor field of interest– – learn new ideas and approacheslearn new ideas and approaches

– – present your work (then publish it too!) present your work (then publish it too!)

– – build your network of colleaguesbuild your network of colleagues

Role Analysis ExerciseRole Analysis Exercise

Instructions included (on the back)Instructions included (on the back)

Conduct this exercise for yourselfConduct this exercise for yourself

Review your findings with your mentor(s), Review your findings with your mentor(s), direct supervisor, and/or Division direct supervisor, and/or Division Chief/Department ChairChief/Department Chair

Other Significant Changes in the Other Significant Changes in the COM P&T GuidelinesCOM P&T Guidelines

• “• “3 + 7” years to achieve tenure3 + 7” years to achieve tenure

– – Assistant Professor may be appointed on a NTP for up to 3 years; Assistant Professor may be appointed on a NTP for up to 3 years; with approval of Chair & Dean, transfer to parallel TPwith approval of Chair & Dean, transfer to parallel TP

– – tenure clock starts at time of approval of pathway change to TPtenure clock starts at time of approval of pathway change to TP

• • Collaborators are vital in contemporary Collaborators are vital in contemporary academic medicineacademic medicine

– – see page 3: document your contributions accurately & obtain see page 3: document your contributions accurately & obtain written corroboration from your collaboratorswritten corroboration from your collaborators


•• New promotion criteria for Basic Scientists who New promotion criteria for Basic Scientists who teach A LOT teach A LOT

•• Clinical Attendings may have significant teaching Clinical Attendings may have significant teaching roles – criteria included for assessing these roles – criteria included for assessing these accomplishmentsaccomplishments

•• Special Faculty Members – see page 7Special Faculty Members – see page 7

• • Mentoring is explicitly valuedMentoring is explicitly valued

• • Leadership and Administrative service is the Leadership and Administrative service is the responsibility of more experienced faculty responsibility of more experienced faculty members, and is explicitly valuedmembers, and is explicitly valued


• • No more title modifiers (e.g., Clinical Assistant No more title modifiers (e.g., Clinical Assistant Professor; Research Associate Professor). Professor; Research Associate Professor). Same title for TP and NTP faculty:Same title for TP and NTP faculty:

– – Instructor Instructor (no academic pathway assigned yet)(no academic pathway assigned yet)

– – Assistant ProfessorAssistant Professor

– – Associate ProfessorAssociate Professor

– – ProfessorProfessor


• • Professional RecognitionProfessional Recognition – 3 letters of – 3 letters of recommendation from recommendation from nationalnational experts experts (Professors) in your field who have neither (Professors) in your field who have neither been your teachers nor your employers been your teachers nor your employers (your network!)(your network!)

• • Professional Recognition for Clinical Professional Recognition for Clinical AttendingsAttendings – the 3 letters may be from – the 3 letters may be from national experts or local experts national experts or local experts

The Challenge:The Challenge:

CREATE YOUR NICHE –CREATE YOUR NICHE – FOR WHICH YOU ARE FOR WHICH YOU ARE PERFECTLY EVOLVED AND INTO WHICH YOU PERFECTLY EVOLVED AND INTO WHICH YOU

ABSOLUTELY LOVE FITTING. ABSOLUTELY LOVE FITTING.

(Determine who you want to be when you grow up)(Determine who you want to be when you grow up)

The PathThe Path

Is yours to designIs yours to design

There are some tested courses and there is helpThere are some tested courses and there is help

Ultimately, it is your workUltimately, it is your work– Examine your head & your heartExamine your head & your heart– Determine your goalsDetermine your goals– Chart your courseChart your course– Document your progressDocument your progress– and most importantly - and most importantly -

Love Your WorkLove Your Work

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What to do While Your Clock is Ticking?