Transcript Promotion and Tenure

Getting Promoted:
It’s not an accident
Louis J. Ling, MD
Professor of Emergency Medicine
Chair, Department P & T Committee
Associate Dean for Graduate Medical Education
University of Minnesota Medical School
[email protected]
Is it important?
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Tenure to keep your job?
Teaching hospital: not necessary
Pride
Respect for the specialty in the school
• If it’s not important to you, go to the pool
For the academic resident
(Pick the right job)
• Where do you want to work?
• What type of academic life do you want?
• Do you mostly want to teach?
• Can you get promoted for teaching?
• Go where they value YOUR skills.
The academic resident
(getting the right job)
• Start looking in your 2nd year
• What do they want from you?
– Do you need a fellowship?
– What is their timing?
– Start your productivity
Keep in contact with the Chair
Visit, make friends, hang out at meetings
How to Play the Game
• Getting into your residency: an accident?
• Getting into med school: obsess about it
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Get a good advisor
Volunteer
Do research
Perform (get good grades)
Your first appointment
• Instructor
– As resident or fellow
– At Harvard
– Time limit often 3 years
• Assistant Professor
– Terminal degree
– Board certified/board prepared
It’s not an accident
• What do PD do ?
• PD usual work does not lead to promotion
• Recruitment, remediation, conferences,
didactics, duty hour monitoring, etc
• For promotion, PD need to do more than
the usual, something new
Long Term Plan
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Clinical Scholar vs Teaching vs Traditional
Understand your school requirements
Pick a mentor/advocate/advisor
Talk to successful peers (other PDs)
Get famous outside your school
Focus your scholarly work
Keep evaluations from everywhere
Keep your CV up to date
Pick a track (with your boss)
• Traditional
– PDs have too much education, no research
• Clinical/Adjunct
– For affiliated faculty
• Clinical Scholar and or Teaching
– Rewards education
– Research requirement varies among schools
Quality Improvement Track
• Shojania, Levinson. Clinicians in quality
improvement, JAMA 301(7):766, Feb 2009
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Interest in QI, Errors, Safety, Teams, SBP
Plan-do-study-act (publish)
Measure changes in care/flow
Attestations or consults from other
institutions
Know promotion requirements
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Every school has written criteria
Set annual goals to reach the criteria
Review your goals every year with chair
Meet chair’s schedule
How many years? More for part-time?
• What is the process in your school?
• What is the process in your department?
Typical Promotion Process
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Chair or department talks to you
Department P and T reviews CV
Collect your dossier
School P and T recommends
Dean recommends
AHC recommends
Board of Regents approves
Tenure requirements
(it’s about the money)
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Tougher than just promotion
Long-term money commitment
May need grant history
More than industry or state or EMF
Federal grants NIH RO-1, AHRQ
Peer reviewed grants RWJF
Tenure less than ever
• 6 yr up or out for research track
• 9 yr up or out for CS
• Less important than ever
Pick a mentor
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Do this anyways
Inside department
Outside department
Someone successful you want to be
Knows what it takes to be promoted
Can be more than one mentor
Talk to successful peers
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Find peers doing the same thing as you
Peers in your department
Other program directors
Around the country
Find out what they did/are doing
Get Famous
• List six (eight at MN) names
• At level of promotion:
• Associate Professor or Professor
Get Famous
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Need letters
Join Committees, Editorial Boards
Write chapters
Become an expert in something
Develop a national peer network
Lecture out of town
Lecture for ACEP, AAEM, SAEM, CORD,
etc
Major Criteria
• Independent Area of Expertise
• Separate from your mentors
• First or last author publications
• Principal investigator on grants
Research Focus and Expertise
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Study Section
Editorial Board
Journal Reviewer
Program Committee
Session Moderator
Keynote Speaker, Visiting Professor
Grand Rounds
Focus, Focus, Focus
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Develop and demonstrate expertise
Pick an area
Write chapters on one or two topics
Limit outside distractions and maintenance
Stay away from admissions, P and T,
And other time sucking commitments
• Volunteer for innovative institution projects
and publish the results
Focus scholarly work
• Measure everything you do
– Resident satisfaction, quality, duty hours
– Outcomes project
– Residents as guinea pigs
• Present at SAEM, AAMC, RIME, GRA,
GEA, ACGME, Regional meetings
• Submit to Academic Medicine, AEM,
Medical Education, new Journal of GME
Keep everything
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Education Portfolio or file folder
Evaluations from everyone
Annual review from chair
Reprints of articles
Education products, CDs, screen shots
Invitations to speak if you decline
Keep CV up to date
Keep More Than Everything
• RRC, LCME Consultation Site Visits
• Best Doctor Awards
• Clinical Expertise or Consults
– Keep dictations, letters or reports
• Invitation to speak that you turn down
– Keep correspondence
Getting by with less than everything
• Talk to YOUR Faculty Dean
• Examine other successful dossiers
• Pick similar track/situations
• Promotion criteria can change
• Interpretation of criteria can change
Keep CV Up to Date
• Use your med school format
• Have a complete CV that has everything
– Include local and department talks
– Include mentees and advisees
– Include public speaking, media events
– Include best doctor type recognition
• Have a concise CV that has the highlights
– For public
CV Bibliography
• Use standard citation format
• Separate peer reviewed from others
• Impact factor
• Explain your role
• 1st and last and corresponding author
– Don’t give it up too soon
The Final Push
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Application Timeline
Dossier
Letters
Lots of copies
• How many up this year?
• Start now
Timeline
• Final Submission date backwards
• Who does what
– Individual: dossier, names, reprints
– Department: votes, chair’s letter
• Find a support person to help
– Chair can assign someone
– Not your residency coordinator
– Ten Copies, collate and staple
Reverse Timeline
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November 1
September 1
August 1
July 1
June 2
June 1 or earlier
March 9
submit to Dean
submit letter names
submit to department
start your dossier
start to collect your stuff
annual review with chair
check with your chair
Dossiers/Portfolio
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More than just a CV
Specific format for dossier
Has to tell your story well
Specific CV format
Keep it up to date
Look at someone’s (successful peer)
example
Dossiers
• Essay summaries of research, teaching,
service
– Describe what you are focused on
– Be specific and give concrete examples
– Give time percentage or hours per week
– Proofread the grammar
Dossiers
• Three reprints of publications
– recent, since your last promotion
– first or second or last author
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– avoid case reports or observations or
editorials
Outside Letters
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Find out how many
Ask peers if its OK
Suggest unknown letter writers
Higher rank than you
Well-respected institutions
– Harvard, Stanford, UC, etc
– Wide geographic area
– They don’t know famous EPs, they do
know famous places, titles and rank
Potential Letter Writers
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Similar interests
Prominent researchers in your field
Editors you have written for
Committee chairs
Department chairs
Full professors
Do not pick Assistant Professors, Instructors,
former residents, former mentors, best friends
Inside institution letters
• Chair letter is automatic
– Offer to ghost write
• A few from within your department
• Some from outside your department
– Use your mentor to connect
– Do not piss everyone off
– Committee work pay off
Break into Small Groups
• What 2 things you are going to do?
• What 2 things are you going to drop?
• What 2 scholarly papers can you do?
• Who can work with you on your project?
• Who do you want to get to know?
• What 2 things are you going to do to
network at this meeting?
Promotion
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Don’t be an Assistant Professor for life
Decide if you want to do this
Plan for it, Count on it
Slow and steady long term plan
Don’t wait until the end to do it
Keep the mad rush at the end organized
Workshop
• Bring your CV
• Bring your questions
• Sample summaries of research, teaching
and service
• Questions