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CAREER OPTIONS IN ACADEMIC MEDICINE

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  • “ Choosing a Career Direction – Career Options in Academia”
  • Know who you’re talking to and understand from whom the advice you’re being giving is coming from. What is this person’s background? What is their perspective?
  • Origin of Tracks was designed to satisfy institutions by relieving their long-term financial obligations to tenured faculty. At the same time, it was believed that the track system would increase clinical revenue and reward faculty through promotion.
  • Some of these categories have overlapping and, occasionally, contradictory definitions.
  • Graph on the Left: Between 1980 and 2004, the number of scientists within the NIH has roughly remained constant at 14-15 thousand. The budget, however, has doubled during the same period of time. If you look at a graph of the growth of the NIH budget versus time, you can see that the NIH budget has not grown since 1970 but rather experienced fluctuations in revenue.
  • Scholarly Activity : publications, presentations, patients and clinical investigations. Newer Criteria: Development of original programs, mentoring future scholars, involvement in professional societies and organizations. Teaching: Quality (student evaluations, peer review, receipt of awards. Other: advising students, developing curricula, bedside teaching, patient care, continuing education, clinical research. Service: Evidence of nonclinical professional activities through which the faculty member advances the mission of the University. (participation on committees, community work..ect) CANDIDATES FOR PROMOTION MUST DEMONSTRATE EXCELLENCE IN 2 OUT OF 3 CATEGORIES AND BE ABOVE AVERAGE IN THE THIRD TO BE SUCCESSFUL. YOU DEMONSTRATE YOUR EXCELLENCE THROUGH THE CV.

CAREER OPTIONS IN ACADEMIC MEDICINE CAREER OPTIONS IN ACADEMIC MEDICINE Presentation Transcript

  • CAREER OPTIONS IN ACADEMIC MEDICINE ADAM S. MORGENTHAU, MD Co-Director, Sarcoidosis Clinic Assistant Professor of Medicine Division of Pulmonary, Critical Care & Sleep Medicine The Mount Sinai School of Medicine
    • QUOTATION:
    • “ When drinking water, think of its source.”
  • WHAT IS ACADEMIC MEDICINE?
    • Medicine practiced at a University or School
    • Involves patient care +/- research +/- teaching
    • Academic physicians pass knowledge and/or skills onto others, especially trainees
    • GOAL: Trainees create new knowledge that is used to improve patient care.
  • THE ACADEMIC MISSION Research Teaching Patient Care Fleming et al..JAMA Sept 7, 2005—Vol 294, No 9; 1101-1104
  • HISTORY OF FACULTY TRACKS
    • 1900—1970 Faculty excel in Research, Teaching, Patient Care simultaneously (TRIPLE THREAT).
    • 1970 Designated Promotion/Tenure Tracks; Researchers vs. Clinicians
    • 1980s Clinician-Researchers vs. Clinician-Educators
    • Late 1980s
    • Tracks Further Specified based on time spent:
    • Clinical time vs, Educational activities vs. Research
    • Early 1990s
    • Money NOT saved through new Track System because…
    • Old “yardsticks” (number of peer-reviewed articles and number of NIH grants) used to measure progress in new Track System…
    • Therefore…high rate of turnover of clinicians; Institutions lose money
    • Late 1990s
    • Creation of Categories of Productivity
    • Mandatory Documentation of Productivity
    • Track Systems become heterogenous and Institutionally-Dependent
    • 2000s Development of a Classification System for the Academic Physician
    • Fleming et al..JAMA Sept 7, 2005—Vol 294, No 9; 1101-1104
  • CATEGORIES OF PRODUCTIVITY Fleming et al..JAMA Sept 7, 2005 Vol 294, No 9; 1101-1104
  • CLASSIFICATION OF THE ACADEMIC PHYSICIAN Modification of Text: Holcombe, RF. Academic Medicine, Vol. 80, No. 10; Oct 2005; 905-907. ACADEMIC PHYSICIAN CLINICIAN EDUCATOR PHYSICIAN INVESTIGATOR PHYSICIAN SCIENTIST
  • ACADEMIC PHYSICIANS Holcombe, RF. Academic Medicine, Vol. 80, No. 10; Oct 2005; 905-907. CLINICIAN EDUCATOR PHYSICIAN INVESTIGATOR PHYSICIAN SCIENTIST
    • Primary commitment to education ( > 50%)
    • Administration
    • Research in education
    • Clinical care and bedside teaching
    • Research and clinical activities; (percentage of time for each of these varies)
    • Usually clinical research
    • Principal investigator or co-investigator in a clinical trial
    • Funding from foundation or pharmaceutical company
    • Mentors trainees
    • Teaches or serves on committees.
    • MD or MD-PhD trained researcher
    • 70-80% of their time is dedicated to research
    • Usually basic science research
    • NIH funding
  • TRACKS-How you spend you time Association of American Medical Colleges—Careers in Academic Medicine RESEARCH CLINICAL CARE EDUCATION ADMINISTRATION Investigator or Tenure Track Clinician Educator or Academic Clinician or Clinical Educator Teacher Clinician or Educator Track Administrative Positions
    • Mostly research
    • Remaining time on other academic activities
    • Greater than 50% patient care, emphasis on clinical teaching
    • Greater than 50% educating
    • Remaining time on other academic acitivities (Medical education research)
    • Not at all schools
    • Faculty generally serve institution in any path before taking an administrative position
    • Time varies
    Non-tenure Research Track Clinical Service Track or “ Clinical Faculty”
    • 90%-100% research
    • At least 80% time spent delivering health care services
  • WHAT IS THE CURRENT STATE OF AFFAIRS IN ACADEMIC MEDICINE?
    • Remember the Chinese Proverb?
    Perspective The Attrition of Young Physician-Scientists: Problems and Potential Solutions Mark Donowitz, Greg Germino   , Fabio Cominelli and James M. Anderson ‡ Department of Medicine, University of Virginia at Charlottesville School of Medicine, Charlottesville, Virginia      Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland § Department of Cell and Molecular Physiology, University of North Carolina School of Medicine at Chapel Hill, Chapel Hill, North Carolina Gastroenterology 2007; 132; 477-480. Viewpoint: Who’s Watching Out for the [Physician Investigator]? Randall F. Holcombe, MD Dr. Holcombe is associate professor and chief, Division of Hematology/Oncology, and associate director for clinical research, Chao Family Comprehensive Cancer Center, University of California, Irvine, College of Medicine, Irvine, California. Academic Medicine, Vol. 80, No. 10/ Oct. 2005
  • ATTRITION OF YOUNG PHYSICAN-SCIENTISTS Donowitz et al…Gastroenter 2007; 132: 477-480. Annualized Growth of the NIH Budget Loscalzo 354 (16): 1665, Figure 1  April 20, 2006
    • PROBLEMS:
    • Salary differential between physician-scientists and full-time practitioners
    • Loan indebtedness
    • Lack of job security
  • WHO’S WATCHING OUT FOR THE PHYSICIAN-INVESTIGATOR
    • PROBLEMS:
    • Lack of base salary support
    • Poorly delineated promotional track
    • Lack of monetary compensation for teaching
    Holcombe, RF. Academic Medicine, Vol. 80, No. 10/ Oct. 2005 “ If they don’t spend time in the lab, publish in Nature and have an RO1, a researcher can’t be successful.”
  • THE ECONOMICS OF ACADEMIC MEDICINE Weiss et al…Medical Economics Sep. 5, 2003;80:55
  • PLANNING YOUR CAREER IN ACADEMIC MEDICINE
    • There are rules and regulations for promotion at your institution (Dean’s Office, Human Resources, Faculty Affairs Center)
    • There is a timeline for promotion
    Dattel, BJ. Professional Devlopment. Vol. 56. No. 1. PROMOTION SCHOLARLY ACTIVITY TEACHING SERVICE
  • LEADERSHIP IN ACADEMIC MEDICINE: Guidelines for a Successful Academic Career
    • Develop a Vision--- Enhance your strengths, Improve your weaknesses.
    • Cultivate a Plan— Develop essential skills.
    • (personal, team-building, persuasive communication, conflict resolution, negotiation, interviewing, planning, financial management, expertise in profession, knowledge or the organization.)
    • Focus— Evaluate opportunities and prioritize; be a team player .
    • Seek Counsel--- Find a mentor; develop a support system.
    • 5. Periodically Reassess--- Evaluate what you have accomplished, what you expected to accomplish and what you hope to accomplish .
    • 6. Enjoy the Journey— Enjoy the process of developing an academic leadership career.
    Duda, RB. Current Surgery. Vol. 61/No. 2. March/April 2004.
  • THE FUTURE OF ACADEMIC MEDICINE “ President Obama’s administration has committed to significant changes in the current health care system to address three issues: access, cost and quality. Leaders in academic medical centers (AMCs) must acknowledge the root cause of the problems within the current system, recognize potential change initiatives, contemplate the changing role that AMCs will play in the health care system of the future and begin to adapt and respond.”
  • GOOD LUCK!