Full-time Faculty Appointment Research Articles

Gender trends in dentistry: Dental faculty and academic leadership.

Gender equality in the healthcare workforce has been a topic of discourse for many decades. In dental academia, women's representation of enrolled students and faculty has risen consistently since the 1980s. However, women in faculty leadership positions may still be lagging when compared to men. The purpose of this study was to evaluate the number of women who occupy the upper echelons of academic rank and title by analyzing cross-referenced data from the American Dental Association and the American Dental Education Association on women dental school graduates in relation to academic appointments. Gender distribution in rank, title, and appointments in the decade from 2011 to 2019, as well as percentage of women graduates over the same period, were collected for descriptive statistics. Multiple linear regression analysis, Cochran Armitage, and chi-square tests were conducted to examine trends over the years and to determine significant differences in overall percentages (p<0.05). The total women faculty percentages ranged from 36% to 40%. While the lower-level rank of instructor retained a higher representation of women (56%-65%), the higher rank of professor had disproportionately lower women percentages (18%-26%). Graduates, full-time faculty, lower-level academic ranks, and higher-level academic ranks for women followed similar upward trends that were statistically significant (p<0.05). When comparing the different groups against each other, the annual increase in women DMD/DDS graduate percentage was higher than women full-time faculty (0.28%), instructor rank (0.92%), professor rank (0.50%), and department chair appointments (0.49%). Our data show that women are still underrepresented at higher academic ranks. However, the upward trends for professors, assistant deans, and program chairs suggest that in recent years, more women faculty may have been encouraged, mentored, or offered higher administrative positions in academic institutions.

Is Dedicated Research Time During Surgery Residency Associated With Surgeons' Future Career Paths?: A National Study.

We examined associations between participation in ≥1 year of research during general surgery residency and each of full-time academic-medicine faculty appointment and mentored-K and/or Research Project Grant (RPG, including R01 and other) awards. Many surgeons participate in ≥1 year of research during residency; however, the relationship between such dedicated research during general surgery residency and surgeons' career paths has not been investigated in a national study. We analyzed deidentified data through August 2014 from the Association of American Medical Colleges, American Board of Medical Specialties, and the National Institutes of Health Information for Management, Planning, Analysis, and Coordination II grants database for 1997 to 2004 US medical-school graduates who completed ≥5 years of general surgery graduate medical education (GME) and became board-certified surgeons. Using multivariable logistic regression models, we identified independent predictors of faculty appointment and K/RPG award, reporting adjusted odds ratios (AOR) and 95% confidence intervals (CI) significant at P < 0.05. Of 5328 board-certified surgeons, there were 1848 (34.7%) GME-research participants, 1658 (31.1%) faculty appointees, and 58 (1.1%) K/RPG awardees. Controlling for sex, debt, MD/PhD graduation, and other variables, GME-research participants were more likely to have received faculty appointments (AOR 1.790; 95% CI 1.573-2.037) and federal K/RPG awards (AOR 4.596; 95% CI 2.355-8.969). Nationally, general surgery GME-research participation was independently associated with faculty appointment and K/RPG award receipt. These findings serve as benchmarks for general surgery residency programs aiming to prepare trainees for careers as academicians and surgeon-scientists.

The national MD-PhD program outcomes study: Outcomes variation by sex, race, and ethnicity

In 2015, a nation-wide effort was launched to track the careers of over 10,000 MD-PhD program graduates. Data were obtained by surveys sent to alumni, inquiries sent to program directors, and searches in American Association of Medical Colleges (AAMC) databases. Here, we present an analysis of the data, focusing on the impact of sex, race, and ethnicity on career outcomes. The results show that diversity among trainees has increased since the earliest MD-PhD programs, although it still lags considerably behind the US population. Training duration, which includes time to graduation as well as time to first independent position, was similar for men and women and for minority and nonminority alumni, as were most choices of medical specialties. Regardless of minority status and sex, most survey responders reported that they are working in academia, research institutes, federal agencies, or industry. These similarities were, however, accompanied by several noteworthy differences: (a) Based on AAMC Faculty Roster data rather than survey responses, women were less likely than men to have had a full-time faculty appointment, (b) minorities who graduated after 1985 had a longer average time to degree than nonminorities, (c) fewer women and minorities have NIH grants, (d) fewer women reported success in moving from a mentored to an independent NIH award, and (e) women in the most recent graduation cohort reported spending less time on research than men. Collectively, these results suggest that additional efforts need to be made to recruit women and minorities into MD-PhD programs and, once recruited, to understand the drivers behind the differences that have emerged in their career paths.

Trends in Academic Dentistry and Oral Health Research Funding by Gender.

Dental and oral health researchers compose a small share of the research workforce, and within this group female researchers form a much smaller share than male researchers. Additionally, a majority of full-time faculty appointments at dental schools are held by men, with women making up only 39% of full-time appointments. These factors suggest that there could be disparities between men and women in obtaining research funding. The focus of our study was to determine whether there are gender differences in award funding obtained from the National Institute of Dental and Craniofacial Research or the National Institutes of Health (NIH). NIH administrative data were analyzed by focusing on Research Project Grants (RPGs), the primary and most commonly used mechanism to support investigator-initiated research projects. Analyses involved 1 or 2 of the following variables: number of unique applicants or awardees, fiscal years 2007 to 2016, average age of unique applicants, awardee's degrees, awardee's age at first R01, and award rates. About two-thirds of RPG applicants and awardees were men. Although there were significantly more male applicants and awardees, there was no significant difference in award rate by gender, and there was no significant award rate variation through time or by degrees. The average ages of RPG applicants were similar for genders for all degrees, except that male dentists and PhD-dentists applying to the National Institute of Dental and Craniofacial Research were older and male MDs and PhD-dentists from dental schools applying to the NIH were older. This study demonstrated that men in the dental/oral health workforce submit more applications and receive more NIH awards than do women; however, there was no difference in award rates between women and men and no difference in ages by gender at which the first R01 awards are received. Analyses of the implications of this study by the academic dentistry and oral health community could lead to establishing opportunities to expand the representation of women in dental and oral health research. Increasing the number of applications submitted by women may help achieve an equitable balance of grantees in the workforce.

Outcomes of Student-Driven, Faculty-Mentored Research and Impact on Postgraduate Training and Career Selection

Objective. To evaluate scholarly deliverables from student-driven research and explore the impact on postgraduate training placement rates, pharmacy faculty appointments and lifetime publications. Methods. A retrospective analysis of Doctor of Pharmacy graduates who conducted student research between the academic years of 2002 and 2015 was performed. Data were collected on research participation, abstracts, presentations, postgraduate training, full-time faculty appointments, and publications. Results. Of 1229 graduates, 300 participated in research during pharmacy school. Fifty-six percent (n=167) submitted at least one abstract and 68 students (23%) published their research. Research participation was associated with a significantly higher likelihood of postgraduate training and specialty training. Research participation positively affected the likelihood of faculty appointment and lifetime publication rate. Conclusion. Students who engaged in elective research had significant scholarly deliverables, including peer-reviewed publications, and were more likely to successfully match in a postgraduate position and achieve full-time academic appointments.

Editorial introductions

Editorial introductions

Recommended Protected Time for Pediatric Fellowship Program Directors: A Needs Assessment Survey

V IEW F ROM THE A SSOCIATION OF P EDIATRIC P ROGRAM D IRECTORS Recommended Protected Time for Pediatric Fellowship Program Directors: A Needs Assessment Survey Geoffrey M. Fleming, MD; Michael M. Brook, MD; Bruce E. Herman, MD; Chris Kennedy, MD, PhD; Kathleen A. McGann, MD; Katherine E. Mason, MD; Pnina Weiss, MD; Angela L. Myers, MD, MPH From the Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tenn (Dr Fleming); University of California San Francisco, San Francisco, Calif (Dr Brook); Department of Pediatrics, Primary Children’s Hospital, University of Utah, Salt Lake City, Utah (Dr Herman); Children’s Mercy Kansas City, University of Missouri–Kansas City School of Medicine, Kansas City, Mo (Drs Kennedy and Myers); Department of Pediatrics, Duke University Medical Center, Durham, NC (Dr McGann); Department of Pediatrics, Case Western Reserve School of Medicine, Cleveland, Ohio (Dr Mason); and Department of Pediatrics, Yale University, New Haven, Conn (Dr Weiss) The authors declare that they have no conflict of interest. Address correspondence to Geoffrey M. Fleming, MD, Department of Pediatrics, Division of Critical Care Medicine, Vanderbilt University School of Medicine, 5112 DOT, 2200 Children’s Way, Nashville, TN 37232 (e-mail: geoffrey.fleming@vanderbilt.edu). A CADEMIC P EDIATRICS 2016;16:415–418 core program requirements: “The program director must devote a minimum of 0.5 FTE regardless of the size of the program.” 14 Core pediatric residency programs have recommendations for additional effort support in a graded increase on the basis of the size of the program and includes PDs, associate PDs, residency coordinators, and liaisons. Currently the “ACGME Program Requirements for Graduate Medical Education in the Subspecialties of Pediatrics” do not delineate any specific required time allotment for fellowship PDs but requires “sufficient pro- tected time.” 2 The goal of this study was to describe current time allotted for PDs in pediatric subspecialty fellowship training programs and to delineate the minimum time required for program administration to meet the regula- tions outlined by the ACGME. P EDIATRIC FELLOWSHIP TRAINING programs are the primary source of subspecialty practitioners who care for our nation’s children. There are 16 Accreditation Council for Graduate Medical Education (ACGME)-accredited pe- diatric subspecialties made up of 837 individual training programs that graduated over 8500 trainees from 2004 to 2013 in addition to those who graduated from combined board specialty programs that include a pediatric training component. 1 Explicit in the requirements for graduate medical education (GME) accreditation is the key role of the program director (PD), who is responsible for over- seeing all educational activities, assessing all trainee and faculty performance, maintaining and distributing all pro- gram policies and procedures, directing programmatic evaluation and process improvement, and monitoring compliance with all ACGME regulations. 2 Prior study has identified inadequate PD time as a barrier to complying with ACGME requirements in the nonpediatric subspe- cialties. 3 Dedicated administrative time has been identified as necessary for innovation and curricular design, and has been linked to ongoing accreditation by the ACGME. 4–12 The ACGME program requirements for core residency programs and many nonpediatric subspecialties now delin- eate program administration time requirements for PDs, associate PDs, and other support staff. The time allotted differs by specialty and varies in specification from hours per week to a percentage of total effort. 13 Current require- ments set forth by the ACGME range from 10% to 50% full-time equivalent (FTE) staff for the core medical and surgical specialties and for many of the subspecialty fel- lowships accredited by the American Board of Medical Specialties. For core pediatric residency programs, support of administrative efforts are specifically delineated in the A CADEMIC P EDIATRICS Copyright a 2016 by Academic Pediatric Association M ETHODS The study was conducted in 2 phases through the use of an anonymous national survey of fellowship PDs. An initial survey was created by the author group using a modified Delphi technique through 5 iterations and con- sisted of 23 items, including demographic data, definition of an FTE in the respondent’s institution, time allotted to administer the program, and the time needed by the respondent to administer their program. The survey was created in REDCap hosted by Vanderbilt University Med- ical Center. 15 This survey was distributed from August 20, 2013, to October 16, 2013, using the Association of Pediatric Program Directors (APPD) Fellowship Program Director (FPD) e-mail list. As a result of an initial low response rate, these data were considered pilot data. Volume 16, Number 5 July 2016

Predictors of full-time faculty appointment among MD–PhD program graduates: a national cohort study

PurposeThe authors sought to identify variables associated with MD–PhD program graduates’ academic medicine careers.MethodsWe analyzed data for a national cohort of MD–PhD program graduates from 2000 to 2005, using multivariable logistic regression to identify independent predictors of full-time academic medicine faculty appointment through 2013.ResultsOf 1,860 MD–PhD program graduates in 2000–2005, we included 1,846 (99.2%) who had completed residency training before 2014. Of these 1,846 graduates, 968 (52.4%) held full-time faculty appointments. Graduates who attended schools with Medical Scientist Training Program (MSTP) funding (vs. no MSTP funding; adjusted odds ratio [aOR], 1.41; 95% confidence interval [CI], 1.14–1.74) and participated in ≥1 year of research during residency (vs. no documented research year; aOR, 1.85; 95% CI, 1.50–2.28) were more likely to have held full-time faculty appointments. Asian/Pacific Islander (aOR, 0.74; 95% CI, 0.60–0.93) and under-represented minority (URM; aOR, 0.68; 95% CI, 0.48–0.98) graduates (each vs. white graduates), graduates who reported total debt of ≥$100,000 (vs. no debt) at graduation (aOR, 0.58; 95% CI, 0.39–0.88), and graduates in surgical practice (aOR, 0.64; 95% CI, 0.48–0.84) and other practice (aOR, 0.66, 95% CI, 0.54–0.81) specialties (each vs. ‘medicine, pediatrics, pathology, or neurology’) were less likely to have held full-time faculty appointments. Gender was not independently associated with likelihood of full-time faculty appointment.ConclusionsOver half of all MD–PhD program graduates in our study had full-time faculty appointments. Our findings regarding variables independently associated with full-time faculty appointments can inform the design of strategies to promote academic medicine career choice among MD–PhD program graduates. Further research is warranted to identify other factors amenable to intervention, in addition to those included in our study, which will foster the further development of a diverse academic medicine physician–scientist workforce nationally.

Career Development Institute with Enhanced Mentoring: A Revisit

The need for innovative methods to promote training, advancement, and retention of clinical and translational investigators in order to build a pipeline of trainees to focus on mental health-relevant research careers is pressing. The specific aim of the Career Development Institute for Psychiatry is to provide the necessary skill set and support to a nationally selected broad-based group of young psychiatrists and PhD researchers to launch and maintain successful research careers in academic psychiatry. The program targets such career skills as writing, negotiating, time management, juggling multiple demanding responsibilities, networking, project management, responsible conduct of research, and career goal setting. The current program builds on the previous program by adding a longitudinal, long-distance, virtual mentoring, and training program, seen as integral components to sustaining these career skills. Career development activities occur in four phases over a 24-month period for each annual class of up to 18 participants: online baseline career and skills self-assessment and goal setting, preparations for 4-day in-person workshop, long-distance structured mentoring and online continued learning, peer-mentoring activities, and post-program career progress and process evaluation. Program instructors and mentors consist of faculty from the University of Pittsburgh and Stanford University as well as successful past program graduates from other universities as peer mentors. A comprehensive website facilitates long-distance activities to occur online. Continued training occurs via webinars every other month by experts discussing topics selected for the needs of each particular class. Personally assigned mentors meet individually bimonthly with participants via a secure web-based "mentor center" that allows mentor dyads to collaborate, share, review, and discuss career goals and research activities. Preliminary results after the first 24 months are favorable. Almost uniformly, participants felt the program was very helpful. They had regular contact with their long-distance mentor at least every 2months over the 2-year period. At the end of the 2-year period, the majority of participants had full-time faculty appointments with K-award support and very few were doing primarily clinical work. The longitudinal program of education, training, mentoring, peer support, and communications for individuals making the transition to academic research should increase the number of scientists committed to research careers in mental health.

Institutions and individuals: what makes a hospitalist "academic"?

As pediatric hospital medicine (PHM) develops and matures, attempts have been made to describe the field and the individuals who practice it.1–3 Defining what PHM practitioners do is complex, and descriptive categories are often presented with dichotomous alternatives regarding responsibilities (eg, teaching or not, research/scholarly activity or not) and scope of practice (eg, limited to inpatient service or broader, full array of resources or not). Frequently, the differences are overly simplified according to the type of institution in which the pediatric hospitalists work, labeled “academic centers” and “community hospitals.”1,3,4 However, the designation of 1 setting as “academic” implies that the alternative (community hospitals) is not academic, a distinction that spills over to labeling individual hospitalists as academic or nonacademic. According to Freed and Dunham,1 academic hospitalists are those with a full-time faculty appointment, whereas hospitalists with a part-time or no faculty appointment are considered nonacademic. Appointments are conferred by universities, however, so this definition of academic largely reverts to the type of institution in which the pediatric hospitalist works rather than the type of work the pediatric hospitalist does. We propose that the alternative to community hospitals is better described as “university/children’s hospitals” than academic centers because hospitalists may perform …

Predictors of Career Choice in Academic Medicine Among Orthopaedic Surgery Residents

In 2013, 1038 applicants, 833 of whom were U.S. graduates, applied for 693 orthopaedic residency spots. Orthopaedic residency program directors thoroughly screen applicant data, selecting those applicants who will be most successful during the residency. Although the most important consideration for program directors is choosing residents who will obtain competence and will pass the orthopaedic board examinations, many applicants are chosen also for their ability to contribute to the field through leadership, research, and teaching. Previous studies have analyzed attitudes of orthopaedic residents toward research and university-based careers1. Primary authorship of a publication and past research experience were associated with a greater interest in future research1. However, to the best of our knowledge, no study has been done to identify predictors of orthopaedic residents who actually obtain faculty positions in a university-based setting. We hypothesized that predictive factors exist for orthopaedic surgery residents who choose a university-based career. This study looked at both academic and socioeconomic criteria to identify factors that predict residents becoming assistant professors, associate professors, full professors, program directors, or program chairs. This study was approved by the institutional review board. It was performed in compliance with the Health Insurance Portability and Accountability Act regulations. ### Identifying Career Outcomes Among Orthopaedic Residency Graduates The orthopaedic surgery department at our hospital compiled a complete and sequential database of sixty residents who graduated from 2001 to 2010 and their career choices. No residents were excluded. If career choice data were not available for a former resident, a Google search was performed to find out the highest academic rank achieved by the graduate. Former residents were contacted by e-mail if they could not be found on a Google search. The careers of orthopaedic surgeons were analyzed and were separated into a university or community-based career choice. University-based orthopaedic surgeons had a full-time faculty appointment …

Editorial introductions

Editorial introductions

The Road to an Academic Medicine Career

To explore the relationship between gender and full-time faculty appointment in a national cohort of contemporary U.S. medical school graduates. The authors analyzed deidentified, individual records for the 1998-2004 national cohort of U.S. medical graduates using multivariate logistic regression to identify predictors of full-time faculty appointment through July 2009. They reported adjusted odds ratios (aOR) significant at P < .05. Of 66,889 graduates, 12,038 (18.0%) had held full-time faculty appointments. Among all graduates, women (aOR = 1.21) were more likely than men to have held faculty appointments. Among only male graduates, those who participated in research during college (aOR = 1.08), who entered medical school with greater planned career involvement in research (aOR = 1.08), and who authored/coauthored a research paper during medical school (aOR = 1.12) were more likely, and those with higher debt were less likely (aOR = 0.96), to have held faculty appointments. Among only faculty appointees, higher proportions of men than women had participated in medical school research electives (63.5% [3,899/6,138] versus 54.2% [3,197/5,900]; P < .001) and authored/coauthored research papers during medical school (44.1% [2,707/6,138] versus 33.6% [1,981/5,900]; P < .001); female faculty had reported higher debt at medical school graduation than had male faculty (P = .014). In this national cohort of U.S. medical graduates, women were more likely than men to have held full-time faculty appointments. However, male and female faculty appointees entered academic medicine with different research experiences and debt, possibly impacting their academic medicine career trajectories.

Do Research Activities During College, Medical School, and Residency Mediate Racial/Ethnic Disparities in Full-Time Faculty Appointments at U.S. Medical Schools?

To determine whether postsecondary research experiences (in college, medical school, and residency) and other variables mediate racial/ethnic disparities in U.S. medical school graduates' full-time faculty appointments in academic medicine. Individualized, deidentified records for 1994-2000U.S. medical school matriculants who graduated with MDs before 2005, completed graduate medical education before 2009, and had data for all variables were examined for potential mediators of racial/ethnic disparities in full-time faculty appointments using the SAS macro "MEDIATE" for estimation and statistical inference. Controlling for gender, parents' occupation, and graduation year, the authors estimatedthe effects of potential mediators in separate models comparing Asian/Pacific Islander (PI) versus underrepresented minority (URM; including African American, Hispanic, and Native American/Alaska Native) graduates and white versus URM graduates. Of 82,758 eligible graduates, 62,749 (75.8%) had complete data; of these, 11,234 (17.9%) had full-time faculty appointments, including 18.4% (7,848/42,733) of white, 18.8% (2,125/11,297) of Asian/PI, and 14.5% (1,261/8,719) of URM graduates. Proportion of total race/ethnicity effect on full-time faculty appointment explained by all mediators was 66.0% (95% CI, 44.7%-87.4%) in a model comparing Asians/PIs with URMs and 64.8% (95% CI, 52.2%-77.4%) in one comparing whites with URMs. Participation in postsecondary research activities, authorship during medical school, academic achievement, and faculty career intentions at graduation were among the significant mediators explaining the effect of race/ethnicityonfull-time faculty appointment. Postsecondary research experiences for URM students are among the mediators of racial/ethnic disparities in full-time faculty appointments and, therefore, may increase academic medicine faculty diversity.

Variables Associated With Full-Time Faculty Appointment Among Contemporary U.S. Medical School Graduates: Implications for Academic Medicine Workforce Diversity

The authors sought to identify variables independently associated with full-time faculty appointment among recent medical graduates. With institutional review board approval, the authors developed a database of individualized records for six midwestern medical schools' 1997-2002 graduates. Using multivariate logistic regression, they identified variables independently associated with full-time faculty appointment from among demographic, medical-school-related, and career-intention variables. They report adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Of 1,965 graduates in the sample, 263 (13.4%) held full-time faculty appointments in 2007-2008, including 14.4% (123/853) of women graduates and 8.6% (17/198) of underrepresented minority (URM) graduates. Women (OR: 1.386; 95% CI: 1.023-1.878), MD/PhD program graduates (OR: 2.331; 95% CI: 1.160-4.683), and graduates who reported a career-setting preference for "full-time university faculty" on the Association of American Medical Colleges' Graduation Questionnaire (OR: 3.164; 95% CI: 2.231-4.486) were more likely to have a full-time faculty appointment. Graduates who chose family medicine (OR: 0.433; 95% CI: 0.231-0.811) and surgical specialties (OR: 0.497; 95% CI: 0.249-0.994) were less likely to have a full-time faculty appointment. URM race/ethnicity was not independently associated with full-time faculty appointment (OR: 0.788; 95% CI: 0.452-1.375). Efforts to increase representation of women graduates in academic medicine seem to have met with greater success than efforts to increase representation of URM graduates. Greater participation of URM students in MD/PhD programs and in interventions during medical school that promote interest in academic medicine careers may increase URM graduates' representation in academic medicine.

Training osteopathic geriatric academicians: impact of a model geriatric residency program.

The need for osteopathic geriatric academic leaders who are educators and researchers is well recognized. The University of Medicine and Dentistry of New Jersey-School of Osteopathic Medicine's Geriatric Residency program, a federally funded Faculty Training Project in Geriatric Medicine and Dentistry, has served as a model program in the osteopathic medical professional since its inception in 1989. Targeting internal medicine and family medicine physicians interested in academic careers in geriatrics, the program promotes interdisciplinary training, which develops clinical, research, and teaching/administrative skills. A survey of program graduates assessed their perceptions about the field of geriatrics and the impact of training on career choice and level of satisfaction. Results indicated that 100% of the former trainees entered the field of geriatrics; 57% hold full-time faculty appointments at an osteopathic medical school, and 43% practice as clinical geriatricians. Of those in an academic setting, all taught medical students and housestaff and were involved in research. All of the respondents wee satisfied with their career choice, although 71% indicated that a higher salary and greater respect for the discipline would further enhance their satisfaction. Greater than half perceived the need for additional geriatricians and ranked complexity of care, lower salaries, inadequate reimbursement, and indebtedness after medical school as significant barriers to entering the field. This program has been successful in training academic geriatricians, it has created role models for students, and it has responded to the shortage of osteopathic academic and clinical geriatricians. Financial incentives and reimbursement that is commensurate with complexity of care would serve to attract more trainees to this important primary care discipline.

Career characteristics of graduates of a Medical Scientist Training Program, 1970-1990

To describe the career characteristics of the graduates of the Medical Scientist Training Program (MSTP) at Duke University School of Medicine. Surveys and information at administrative offices were used to collect data on all the 1970-1990 MSTP graduates in the summer of 1995. Of the 147 graduates, all but three had completed postgraduate training. In addition, data were available for 35 recent graduates (1991-1995), most of whom were in transition from training and fellowship positions to career positions. Of the 144 graduates from 1970 through 1990, 84 (58%) had selected careers in internal medicine or pathology. A total of 106 (74%) were involved in careers in academic medicine or research. Of these, 87 (82%) held full-time faculty appointments and devoted major efforts to basic or clinical research. Of this group, 59 (68%) were primary investigators receiving grant support from the National Institutes of Health (NIH). Of the 12 women graduates, 11 had careers in academic medicine or research, and seven were primary investigators on NIH grants. At the present time, 11 of 43 (26%) of the matriculating MSTP students are women. Five of the seven underrepresented-minority students in the MSTP have entered in the last five years. This study reinforces and extends previous conclusions concerning the success of federally funded MSTPs in producing physician scientists who compete favorably for NIH funding.

A strategy for coping with change: an affiliation between a medical school and a managed care health system.

Case Western Reserve University School of Medicine (CWRU), a private research-focused medical school, and Henry Ford Health System (HFHS), an integrated health system with a preponderance of managed care, have established a formal, broad affiliation that includes substantial commitments that bind the two organizations. Among them are formal full-time faculty appointments at CWRU for qualified professional staff of HFHS, designation of an associate dean for CWRU at HFHS, election of HFHS faculty to key medical school committees such as admission, curriculum, and promotions and tenure, and the commitment of funds to the affiliation by both organizations: a grant from HFHS to CWRU for curriculum development, and investment from CWRU to HFHS. The alliance of two such organizations is made complex by a number of issues. They include differences of institutional cultures as well as traditional issues in academic health centers such as departmental authority over curriculum and faculty appointments, competition for academic preeminence, and competition among hospitals for patients. The affiliation was facilitated by shared commitments to education, agreement on the need to adapt student education to the emerging managed care environment, a shared commitment to health services research, investment in the concept that learners add value to a health care delivery setting, and the desire to develop graduates with knowledge of practice in managed care. The authors conclude that medical schools and integrated managed care health systems gain sufficiently from such an affiliation that the investment of time, effort, and resources is readily justified.

Development of clinician-educator faculty track at the University of Pennsylvania.

As resources grow scarcer , universities have become reluctant to increase the long-term institutional commitments involved in faculty appointments with tenure. The restrict tenured appointments, universities in recent years have adopted more stringent criteria for approving them and in many cases have set a limit on the number of new appointments and promotions with tenure. The educational and service missions of the medical school, however, necessitate a large cadre of clinical faculty members. The establishment and evolution of the clinician-educator faculty track at the University of Pennsylvania provide a case study of a process taking place in many medical schools to meet the need for nontenured full-time faculty appointments.