Faculty Appointments & Promotions: An Insider’s Guide

Brian V. Reamy, M.D.Col (ret), USAF, MC

Associate Dean for Faculty & Professor of Family MedicineUniformed Services University

breamy@usuhs.mil

Community of Faculty• USU’s strength is based on its faculty

• Who are they?- Approximately 350 billeted and 3,700 non-billeted- Spread across the entire MHS and civilian institutions- Physicians, nurses, scientists, administrators, NCOs- Tied together by appointment to the faculty- Provide thousands of hours of volunteer clinical teaching

Community of Faculty

Non-Billeted Faculty

• We could not survive without these key members of our learning organization

• Visits to MHS teaching hospitals raised concerns:– How do we support our non-billeted faculty?– Why do they provide volunteer teaching?– What are the barriers to getting faculty

appointments?

More Concerns

• Growing pressures on faculty time• Increased demands to provide clinical

instruction in the time-pressured outpatient environment

• Extraordinary deployment tempo creating increased teaching demands on faculty

Concerns led to Action

• Dr. Rice, (USU President), charged a Task Force in 2009 to review the existing appointment and promotion policies for USU clinical faculty

• Determine if changes were needed to incentivize and recognize the volunteer clinical faculty

Premise• Volunteer faculty teach because they get personal

satisfaction, professional growth and recognition

• How does USU optimize this satisfaction, growth and recognition?

• How does USU recognize clinical teaching as a core attribute of its faculty?

Recognize with Faculty Appointments…..Why are they important?

• A significant Professional Credential• Career enhancing• Increases career and employment

opportunities AND Salary– Your academic rank = $$$

• Increases patient confidence• Facilitates research grant monetary awards

Ernest L. Boyer: Scholarship Reconsidered - 1990

• Scholarship and Faculty achievement are more than research and publication alone

• 4 domains:– Scholarships of:• DISCOVERY• INTEGRATION• APPLICATION• TEACHING

4 Domains – each have value

• Discovery: original research• Integration: what do the findings from original

research mean?• Application: applying new knowledge to

practice to lead to new understanding and new knowledge

• Teaching: stimulating active learning in students; starting the dialogue at the heart of a learning organization

“Publish or Perish”

National Trends• Nationally, more than 3/4 of U.S. medical

schools have developed separate and distinct faculty tracks for full-time clinical faculty whose 1° responsibilities are in clinical care

• The majority of schools that have this type of track modify the professorial title with a “Clinical” prefix

such as Clinical Professor of Medicine.

Message received! – Action Plan

• Add flexibility to our faculty appointment system by restoring Clinical prefixed appointments at USU– Validates the importance of clinical teaching and the

Scholarships of application, teaching and integration

• Clarify and decrease variability in the use of “Adjunct” faculty titles

• Continue to encourage faculty choosing a research-intensive track, practicing the scholarship of discovery

Sounds simple…why can it be so hard?

• TRADITIONS…

• Military service helps comprehension…

Universities as Durable Organizations

1537 Martin Luther Nails His Thesis to the Door of the Cathedral

at Wittenberg

If we take that as a starting point…..- 66 institutions existed then that are still around in largely identifiable forms

And 62 universities

So What Does This Tell Us?

Society Values Universities and Universities Guard their Traditions to

Guarantee their Survival

Key Tradition: Academic Appointment & Promotion

Military Appt. & Promotion• Distinct ranks: 0-1 to 0-10• Must have commission &

degree for appointment• Set times between ranks• Up or out: must make rank

for retirement eligibility• Pay correlates w/ rank• Merit & Time-in-grade

determine promotion

Academic Appt. & Promotion• Distinct ranks (4): Instructor,

Assistant Professor, Associate Prof, Professor

• Must have terminal degree & serve USU in some way

• 4 to 8 years between ranks• “Up or Out”: must make Assoc

Prof by 6 yrs or gone; tenure• Pay correlates w/ rank• Merit & Time-in-grade

determine promotion

Current System: pre-July 2010

• Can be confusing – like military promotions would be to someone unfamiliar with our system

• Regulation = UI 1100>>> www.usuhs.mil • Tenure not allowed for military faculty by law• ASK QUESTIONS!– Your specialty Dept. Chair at USU – breamy@usuhs.mil or lmctigue@usuhs.mil

Qualifications for Faculty Membership

• Scholarly Achievement– Scholarship of discovery and integration– Scholarship of teaching and application

• Peer Review of Scholarly Activity• Teaching• Professional Service• Institutional Citizenship

USUHS Document 1100

Requirements for Appointments

• MD, DO or PhD degree• Current medical license (if clinician)• Currently instructing USUHS students or

uniformed residents /fellows at one of the military teaching centers

• Approval of your Command

Academic Ranks**The higher the academic rank the

more rigorous & selective the vetting process.**

Clinician-Educator pathway – 4 ranks• Instructor• Assistant Professor• Associate Professor• Professor

Assistant Professor – 6 thingsClinician-Educator Pathway

1. Teaching USUHS students or uniformed residents / fellows at one of the military teaching centers

2. Medical License & Board Certified3. CV (USU or academic format)4. Form 107 – by you or USU Dept.5. Local Department Recommendation6. Command Approval/Endorsment

USUHS CV Format

Academic Format

• American Association Medical Colleges (AAMC) CV builder

• http://www.aamc.org/members/old/facultyvitae/fall05/cv.htm

– Add Military history (assignments, duties)

USUHS Form 107 (Revised) http://www.usuhs.mil/chr/USUHS_Forms.htm

Academic Appointment Process IIClinician-Educator Pathway

• Send CV, Letter of rec/endorsement to USU Department

• Form 107• USU Dept. Chair Letter of

Endorsement• Then it is sent to Dean’s Office

USUHS Document 1100

Academic Appointment Process IIIClinician-Educator Pathway

• Academic package submission from Dean to Human Resources>>BOR• Candidate will be notified of

appointment by letter from USUHS• Appointments for 3 years – same site• Periodic update of Personnel Locator

USUHS Document 1100

Ranks > Assistant Professor

• Much more rigorous & time demanding• After USU Dept Review, it is forwarded to

University Committee on Promotion & Tenure• This Committee makes recommendation to

the Dean three times per year.• Dean forwards to Board of Regents &

President for appointment

Faculty Appointments of Associate Professor

• In all Universities, Associate Professor means you have made the cut to stay at the institution as permanent faculty.

• Philosophically it is the difference between participating in scholarly activities and having demonstrated the ability to independently lead them.

Promotion to Associate Professor

• University promotions are driven by accreditation requirements that mandate “democratic reviewing committees of senior faculty” who comprise the CAPT = committee on Appointments, Promotions & Tenure

• All appts. require concurrence of the Dean and Board of regents but, academic faculty control the process.

Promotion to Associate Professor

• Although USUHS is designed to be more friendly to active-duty faculty, (and is to a large extent), civilian academic standards prevail to meet accreditation.

• Military accomplishment/rank are NOT automatically synonymous with academic rank: O-6 ≠ Professor

• Time demands of military careers can make academic promotion very challenging.

Associate ProfessorClinician-Educator Pathway

• Assistant Professor rank for at least 4-6 yrs• National Recognition – what is this?• Education Leader in teaching USU students ,residents,

fellows at one of the military teaching centers• Board Certified• CV (USU format) & Abbreviated CV for Board of Regents• Approximately 6 – 15 peer-reviewed publications• External Letters of Evaluation- at least 3 letters• Personal Statement – 2 pages• Submit 4 samples of academic publications• Complete Educator’s Portfolio encouraged

Associate Professor

• Criteria are not applied in a formulaic way – there is much room for judgment.

• Letters of external review are critical: must have at least 3 external senior faculty say you would make it in their opinion & institution.

ProfessorClinician-Educator Pathway

• Associate Professor rank for > 6 yrs• International Recognition• Educational leadership at a military teaching center• Board Certified• CV (USU format) & Abbreviated CV for BOR• > 15 publications….more if multiple authors….• External Letters of Evaluation- at least 5 letters• Personal Statement – 2 pages• Submit 4 samples of academic publications• Complete educator’s portfolio encouraged

“Adjunct” Appointments

Designed for faculty who episodically and not routinely teach USU students and residents.

Occasional contributors to the USU mission.Senior professors of other institutions who help

with the USU mission.

(Adjunct Assistant Professors, Adjunct Associate Professors, Adjunct Professors)

New initiatives - 7/1/2010:

Adding option of Clinical “prefixed” appointments while maintaining the current system “as-is”

Clinical prefix = “Clinical Associate Professor of ….” or “Clinical Professor of ...” A mechanism to recognize seniority, clinical experience, and teaching contributions to USUHS when a primary focus on clinical work has not led to significant numbers of publications.

Clinical Prefixed Appointments - Criteria

• Clinical Associate Professor– Excellence in teaching & clinical care– Administrative accomplishments when that is

substantive part of faculty member’s role– Minimum of 6 years as Assistant professor– Institutional recognition as clinician & teacher

Clinical Prefixed Appointments - Criteria

• Clinical Professor– Same as for Clinical Associate

AND– Service-wide or National recognition as clinician

and teacher– Minimum time in rank as an assistant and/or

associate professor of 10 years

Clinical Prefixed AppointmentsRequirements

• Form 107• Faculty member’s CV• Letter of support from a faculty member of

senior academic rank in the applicant’s specialty

• Letter of support from USU Dept. Chair• Review by SOM Committee (CAPT) before

forwarding to Dean & President

Action Plan – ongoing new initiatives

• Develop an electronic portfolio application to ease & unify faculty appointment and promotion– Procurement underway (Serensoft®)

• Increase communication between USU and its non-billeted faculty– New position of the Associate Dean for Faculty– Serve as the primary conduit and advocate for

billeted and non-billeted faculty throughout the MHS– Site visits to each of the primary 26 teaching sites in

MHS

Conclusion: Don’t Get Frustrated! Ask Questions & Get Help

• Local Senior faculty

• Your Specialty Dept. Chair at USU

• Associate Dean for Faculty & Admin Assistant– Brian V. Reamy, MD breamy@usuhs.mil– Lisa McTigue lmctigue@usuhs.mil