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CAREER OPTIONS IN ACADEMIC MEDICINE

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CAREER OPTIONS IN ACADEMIC MEDICINE

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    1. 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 “Choosing a Career Direction – Career Options in Academia” “Choosing a Career Direction – Career Options in Academia”

    2. QUOTATION: “When drinking water, think of its source.” 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?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?

    3. 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.

    4. THE ACADEMIC MISSION

    5. 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 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.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.

    6. CATEGORIES OF PRODUCTIVITY

    7. CLASSIFICATION OF THE ACADEMIC PHYSICIAN Some of these categories have overlapping and, occasionally, contradictory definitions.Some of these categories have overlapping and, occasionally, contradictory definitions.

    8. ACADEMIC PHYSICIANS

    9. TRACKS-How you spend you time

    10. WHAT IS THE CURRENT STATE OF AFFAIRS IN ACADEMIC MEDICINE? Remember the Chinese Proverb?

    11. ATTRITION OF YOUNG PHYSICAN-SCIENTISTS 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.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.

    12. WHO’S WATCHING OUT FOR THE PHYSICIAN-INVESTIGATOR PROBLEMS: Lack of base salary support Poorly delineated promotional track Lack of monetary compensation for teaching

    13. THE ECONOMICS OF ACADEMIC MEDICINE

    14. 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 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.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.

    15. 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.

    16. THE FUTURE OF ACADEMIC MEDICINE

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