Revised Expectations and Evaluation of Faculty on the Non-Tenure Clinical Track

Problem: Over 90% of MMS clinical faculty are appointed to the non-tenure, clinical (NTC) track.
Increasing pressures for clinical productivity have presented new challenges for NTC-track faculty. In turn,
it has become increasingly difficult for faculty to meet the expectations required for promotion on this
track (70% of NTC faculty are assistant professors, less than 10% have advanced to full professor).

A working group composed of faculty derived from the Faculty Senate and department chairs was
convened to evaluate the expectations for promotion and to make recommendations to the Dean for
revising the track to better reflect the current realities of academic medicine.

Academic activity on this track can be separated into four basic domains: Clinical Work/Patient Care,
Research/Scholarship, Education and Service/Administration. Current expectations for promotion to
associate professor require that faculty excel in all four domains, and establish local or regional reputation
and impact. Promotion to full professor requires extended excellence in all four domains and a national
or international presence. Surveys of peer institutions revealed that few, if any, still maintain such broadbased
effort expectations. Academic medical institutions have either modified expectations or created
expertise-specific clinical tracks (e.g., independent Clinician-Educator or Clinician-Scholar Tracks).

Proposed Changes: Realizing the benefits of flexibility and a cohesive track structure, we propose that the
NTC track be retained and that promotion expectations be modified as follows:

• Activity in any domain that only meets basic employment expectations will be described as
  Acceptable and will not contribute toward consideration for promotion.
• Performance above and beyond this level will be described as Commendable and will count
  toward promotion.
• A second level of extraordinarily high performance will be described as Exceptional.
• Quantitatively, these levels of achievement will be given point values of 0, 1 and 2, respectively.

A candidate petitioning for promotion to Associate Professor on the NTC track will need to achieve a total
of four points, with at least one point in the Clinical domain, and performance in at least one domain
rated as Exceptional (2).

A candidate petitioning for promotion to the rank of Professor on the NTC track will need to achieve a
total of five points, with at least one point in the Clinical domain, and performance in at least two domains
rated as Exceptional (2).

Candidates and department chairs together will collaboratively make a case for appropriate recognition
in each domain in the required faculty promotion narrative and the chair’s letter.

It should be noted that a score of 2 should be reserved for truly noteworthy achievement and sustained
contributions. By way of comparison, the current system can be viewed as generally requiring a “1” or
better in all four domains; the new system will allow faculty to concentrate their best efforts in specific
domains, if that is more appropriate to their career goals, skills and department needs. Example scenarios
are provided below. Additionally, it will be expected that promotion to full professor on the NTC will
require demonstrated leadership in one or more domains: chairing committees, directorships, conference
organization, etc.

As is currently the case, external letters of support, speaking invitations/grand rounds and service to
professional organizations will establish the scale of reputation and impact. External letters supporting
promotion to Associate Professor should demonstrate local or regional impact. For promotion to
Professor, letters should demonstrate national to international impact. In both cases, no more than three
letters may be from previous trainers or mentors.

Projected Benefits: It is expected that these changes will allow faculty flexibility to chart their academic
career course to match their interests and strengths while maintaining academic rigor. Furthermore, this
system does not restrict faculty to a specific focus based on appointment – a clinician could segue from
an emphasis in education to one in translational research, or vice-versa, without the need for a track
change. Most importantly, it is expected that this revision will promote faculty success, reduce burnout
and retention issues, and motivate faculty to be more participatory in activities that fulfill the mission of
McGovern Medical School with an attainable goal of promotion in recognition of their efforts.

• Example A: An innovative clinician with high clinical productivity and quality, significant committee
  service and activity in resident education with little to no published research seeking promotion to
  Associate Professor might claim Clinical: 2, Service: 1, Education: 1.
• Example B: A strong clinician with moderate clinical productivity and quality, multi-year
  appointment as Medical Director, and several published research papers or quality project reports
  seeking promotion to Associate Professor might claim Clinical: 1, Service: 2, Research: 1.
• Example C: An innovative clinician with high clinical productivity and quality, bedside supervision
  of multiple trainees and additional didactic teaching, multi-year appointment as Residency Director,
  several case studies and one or two peer-reviewed publications and a strong record of hospital
  committee service, seeking promotion to Professor might claim Clinical: 2, Education: 2, Research:
  1, Service: 1.
• Example D: A strong clinician with moderate clinical productivity and quality, little to no exposure
  to trainees, no publications and service on several committees in the last five years would be scored
  Clinical: 1, Education: 0, Research: 0, Service: 1, and would not yet be competitive for promotion.
  (This last case may also represent a faculty better suited to move to a Staff Physician appointment).

Non-tenure Clinical Track Revision Working Group:
Joseph L. Alcorn, Ph.D., Associate Professor, Pediatrics (Neonatology)
Patricia M. Butler, M.B., Ch.B., Vice Dean, Educational Programs & Professor, Psychiatry
Semhar J. Ghebremichael, M.D., Assistant Professor, Anesthesiology
Mark J. Hobeika, M.D., Assistant Professor, Surgery (Immunology & Organ Transplantation)
Susan D. John, M.D., Chair & Professor, Diagnostic & Interventional Imaging
James J. McCarthy, M.D., Chair & Associate Professor, Emergency Medicine
Nancy O. McNiel, Ph.D., Associate Dean, Administrative Affairs
Philip R. Orlander, M.D., Associate Dean, Educational Programs & Professor, Internal Medicine (Endocrinology)
Nahid J. Rianon, M.B.B.S., Dr.P.H., Associate Professor, Internal Medicine (Geriatric & Palliative Medicine)
Mya C. Schiess, M.D., Professor, Neurology
Jennifer L. Swails, M.D., Assistant Professor, Internal Medicine (General Medicine)