September 2002
Let's face it. Academics is a long haul. The traditional three-year fellowship just barely manages to lay the foundation for a career in pulmonary medicine. Often, the trainee is expected to simply absorb the necessary lessons to succeed in academics without these lessons ever being clearly spelled out. Without a clear understanding of the academic process, the demands placed upon a senior fellow or junior faculty can seem overwhelming. In the first of this two-part series, we will try to answer the questions: What is an academic? And what defines "success" in academics? What is required for promotion? What is tenure? Next month, we will deal with the questions of Where am I going? and How do I get there? by laying out a general career road map and talking about why people leave academics and importantly, present strategies to deal with the potential pitfalls and avoid some of the bumps in the road.
Let me begin by saying, this is a very good job. The freedom to think creatively and learn is priceless. I can honestly say that I am never bored at work. The key is to figure out ways of moving between the different facets of the job without becoming too crazy.
Part I: The Making of an Academic: Teaching, Research, and Service
To many trainees, a career in academics means teaching and education. This is not surprising since they are most likely to encounter their role models in teaching and clinical environments. In fact, there are three main areas within which a faculty member must demonstrate excellence and achievement in order to be promoted: research, teaching and service. This column focuses on giving a practical job description for an academic physician-scientist, and is written from the perspective of someone who has recently survived the promotion process.
Research. For physicians in research or tenure tracks, productivity as measured in terms of publications and grant support, may outweigh all other areas when it comes time for promotion and salary negotiation. At its most basic level, your goal in research is to: Discover, Tell the Truth, Publish and Get Grants. What constitutes research? Theoretically, "research" refers to the inquiry activities of the faculty member, but as Boyer (1990)* points out in Scholarship Reconsidered, this definition of research generally does not reflect its reality in most institutions of higher education. The notion of research as only bench research dominates many research institutions and generally enjoys more prestige and prominence in the academic community. However, there are other forms of inquiry and knowledge creation. In fact, the recognition of the need for high quality patient-oriented research in part led to the creation of the K23 Mentored Patient-Oriented Research Career Development Award by the NIH.
Still, not all research activities are considered equally significant. For instance, writing text books or review articles may also be considered as some form of intellectual inquiry. However, although these kinds of activities demand a considerable amount of time and energy, they are not given equal weight in the eyes of promotion committees looking for evidence of achievement based on original scholarly work. Again, it all depends on what kind of track you are in. For individuals whose career focus is teaching, reviews and textbooks may suffice as evidence of scholarly activity. Indeed, a well-written and thoughtful review can sometimes change the whole direction of a field.
Teaching generally includes actual in-class time working with students, as well as time spent preparing for class. I would also include mentoring in this category, although in many institutions, there is no official way of quantifying the time spent on this important activity. Depending on the specific institution, such time could also include office hours as well as time spent revising old or creating new courses, precepting clinical clerks, leadership roles in training programs, etc. Although teaching is looked upon as an important and valued role for medical school faculty, it is a relatively underfunded mandate, i.e., teaching doesn't bring in much salary support. While negative or absent teaching evaluations may hinder one's promotion, outstanding evaluations by themselves are usually insufficient to overcome deficiencies in research productivity.
Service in the context of academia generally refers to service to the institution. What qualifies as service, again, varies greatly upon the specific institution. A cherished principle in academics is that of "shared governance." This refers to the right of faculty (usually tenured) to have an active voice in managing the missions of the institution (e.g., exercise of control over the curriculum, involvement in advising students) usually through participating in the faculty senate. The degree of involvement expected of the faculty member usually varies according to the size of the institution. A small college may expect its entire tenured faculty to participate. In larger institutions, meetings of the entire faculty may be infrequent. Hence, service means service to the particular department of which the faculty is a member. Such duties might include participation on departmental or division-level committees. Other institutions expect service also to include leadership in community service activities in the institution's city or state. Finally, service also includes service to the professional community. Meaningful participation in professional organizations, such as the American Thoracic Society, is not only gratifying to the individual, but also is favorably viewed by promotion committees. It is important to become known outside of your local community, and participation in professional society activities can be a useful way of accomplishing this.
Perhaps the most difficult and controversial area to deal with is that of clinical service. Unlike faculty in non-medical school departments, most medical school faculty are also expected to fulfill clinical obligations . Clinical dollars are necessary for all departments to survive, and there is a large contribution made as "Dean's tax" to the university. In addition, there are large sums of money granted to hospitals (often part of and owned by the university) as GME dollars. Frankly, without a good clinical service, these sources of income would not exist, but again, this important role of clinician in a teaching setting has been undervalued.
Hence, you will note that clinical activity is not one of the main areas in which promotion committees usually judge files. To faculty members of non-medical school departments, in particular, clinical activity may not be viewed as either creative or scholarly. This has led to the creation of parallel tracks within research-dominated institutions. To discuss these issues, you need to understand what the promotion and tenure process are all about.
Part II: Promotion and Tenure
At its most basic level, promotion from assistant to associate professor (or from associate to full professor in some institutions) is equivalent to earning tenure. What is tenure?
Tenure: the act, right, manner, or term of holding something (as a landed property, a position, or an office); especially: a status granted after a trial period to a teacher that gives protection from summary dismissal (Merriam-Webster's Online-Collegiate Dictionary). In its truest sense, this means that you have earned the long-term commitment of salary, personnel, and research resources. This commitment lies at the heart of the creative freedom so cherished in academia. Together with academic due process and faculty self-governance, tenure is looked upon as a vital right that protects academic and intellectual freedom in institutions of higher education. In other words, tenure is a fringe benefit, a reward of prestige and job security as well as an acknowledgement of excellence that is supposed to offset other, often more lucrative career possibilities that the faculty member has passed up in order to pursue a life of scholarship.
Tenure may imply security of appointment as defined as the right not to be dismissed, involuntarily retired early, or subjected to discriminatory reduction of salary before the expiration of the term of an academic appointment except on certain clearly defined criteria and due process. Whether or not this carries a salary guarantee has become increasingly controversial as research universities have come under increasing financial pressures. The situation for medical schools is further complicated by the fact that the number of fully funded tenured slots available usually does not begin to cover the actual number of medical school faculty. Furthermore, most medical school faculty are paid more than their non-medical colleagues, in part because of the clinical responsibilities we carry. Thus, in some institutions, only part of your salary may be "tenured" i.e., paid by the University. In fact, none of your salary may be guaranteed. The fraction of your salary that is considered "hard money" is what people refer to when talking about "FTE" or full-time equivalent.
The concept of tenure has been further diluted by the creation of so-called "parafaculty." In fact, not all universities have tenure faculty appointments for medical faculty. These parallel tracks are characterized by titles such as lecturer, senior lecturer, clinical associate professor, professor (teaching) and are awarded to faculty who perform a vast array of academic work once accomplished by tenure-line faculty, including teaching and clinical responsibilities. However, these titles often are not associated with the same prestige , tenure, or commitment accorded traditional tracks. Be that as it may, these faculty enable a medical school to accomplish the vital function of maintaining clinical training programs.
The academic clock. Assistant professors and perhaps clinical instructors in tenure or tenure-equivalent tracks are on probation. Practically, this means you have a certain amount of time (typically 7 years) to demonstrate that you are worthy of being granted tenure. At certain points during this time, your progress will be reviewed and you will be required to prepare a file documenting how you have spent your time and what you have accomplished. Who reviews your file and determines what meritorious performance is? The senior academics in your division, your department and your school. Each must review your file and determine whether you meet the standards set by your institution.
Be aware that in many institutions, your fourth year review is really the make-or-break point at which the university will decide whether you are on track to be promoted or whether there is no realistic hope of achieving tenure at the end of your probation. By the sixth year, the decision of whether to grant tenure will be made and then you are given a year (the seventh) to find another position or change tracks. In reality, what usually happens for those who are good clinicians and teachers (and thereby necessary for the medical school to function), is that they are switched to one of the parallel tracks, rather than dismissed. Still, this can be very traumatic and demoralizing. Better to determine whether you are in the correct track and pro-actively ask to change tracks.
Review your progress annually. As discussed, the criteria and standards according to which you are judged are institutional- and track-specific. Therefore, it is critical that you meet regularly (i.e., at least annually) with your advisor and division chief to determine whether your job description actually matches the track you are in. If you are in a tenure-track position, then most likely, publications and funding will be key, if not the only, determinants of success. An NIH RO1 speaks loudly to promotion committees. If you do not have adequate protected time to perform research and write grants, then perhaps you should not be in a tenure-track position. Again, this is a good time to review your funding/salary sources to see what are you really being paid to do. Since many positions, even tenure-track positions, are not fully funded with "hard money" or "FTE"s, how are you being paid? If the bulk of your salary is derived from clinical revenues, then essentially, you are being paid to attend on the clinical service and perhaps should not be in a tenure track position.
Indeed, there may be an array of promotion tracks to fit different career paths, e.g., teaching scholar, research scholar, clinical scholar, etc. These tracks may have different requirements for promotion. It is critically important that the junior faculty be familiar with the requirements of their particular track early in the course of their career.
So, why do people step off the ladder? There are a multitude of reasons why trainees leave academia. For some, the steady, more lucrative, and most of all more certain financial opportunities offered by clinical practice cannot be passed up, especially for those with families to support. With others, the frustrations of starting a new academic-based career coupled with the long years of training involved are not worth what seems to be uncertain rewards of remaining in academia. The unfamiliar complexities of academic life can seem overwhelming and daunting. The bottom line is, you are smart and hard-working. After all, a training program or university hired you to be a fellow/junior faculty. But, you do have a limited amount of time to prove your academic worth. You should find out the relevant requirements and expectations for promotion and be thinking about these matters from an early point in your career, rather than near the end when the promotion clock is ticking. Success depends on having a job that insures adequate protected time to perform those activities required for promotion. Given the complexities of the promotion process, it is imperative that you have a clear understanding of what your track is and the institutional requirements for promotion within that track. The specific answers and definitions in each area will differ from institution to institution. Hopefully, you now have a basic understanding of these concepts and will be armed with the information needed to begin discussing your job description with your chief. In other words, are you doing what it takes to be promoted? And, equally critical, does your job description match your salary source(s)? If not, what can be done to change the situation? In addition, you should also ask to meet with your department chair -- this is the individual who will be "standing up" for you at the higher committee levels.
In next month's column, we will provide a an Academic Roadmap and discuss some practical strategies for success.
The author thanks Drs. Sharon Round and Rita Ryan for their critical reading of the article and suggestions
