Lessons From the Medical-School Campus

Brian Taylor for The Chronicle

January 10, 2012

Twenty miles separated my department from the medical-school campus at the university where I began my academic career as an assistant professor of anthropology. Over my eight years there, I met colleagues from the schools of law, architecture, and fine arts. Not once, however, did I sit on a committee with faculty members from the health sciences. I never taught any of their students or attended any of their events.

In 2010, I moved from Oklahoma to Boston where I accepted a faculty position in a department of medicine. Here at my new university, too, the medical campus is physically separate from the college of arts and sciences and other professional schools. The medical campus has its own provost, its own promotion guidelines, and its own academic calendar. The commitment to advancing discovery and educating trainees remains the same, but on the medical campus it is accompanied with diabetes screenings and teeth cleanings.

The clinical mission of the medical campus was not the only unfamiliar aspect of my new work environment. I had to learn a new vocabulary of acronyms and get used to a more formal dress code. I became attuned to the rhythms of the arrival of a new cohort of residents in July and the thrice-yearly deadlines for grant applications to the National Institutes of Health.

After more than a year and a half in a department of medicine, I have come to appreciate several innovations here that I could have benefited from as a faculty member in a traditional arts-and-sciences department. Those innovations are common across many medical schools, but, in my experience, are not as systematically implemented on the liberal-arts sides of universities. Cost is not the primary barrier to their adoption because those innovations involve mostly a shift in focus. More likely, the organizational and geographic separation of academic medical centers from the main campus of the university hinders the transmission of ideas between the two. To overcome those barriers, I offer four helpful approaches that I have learned from the other end of the shuttle-bus route.

Different tracks for different folks. Medical schools recognize different types of faculty members and gear promotion criteria to each one. In most colleges of arts and sciences, all new junior faculty members follow the same path to associate professor. Once tenured, faculty members may rebalance their responsibilities to reflect changed priorities.

Like many departments of medicine, mine allows entering faculty members to choose one of four tracks: clinician educator, clinician investigator, scientist educator, or basic scientist. Promotion committees still consider a candidate's record of grants and publications, whatever the appointment, but their expectations differ for each track. So, for example, an educator may receive credit for designing a curriculum that is posted on the Web and adopted by peers around the country.

Meaningful mentoring. Another way that medical campuses support faculty is through a serious commitment to mentoring. Promotion to full professor requires evidence that you have given back to younger scholars as measured by coauthorship and sponsorship on training grants. Both the annual evaluation form and the official CV template required for promotion include a space to list your mentoring activities.

Several medical schools go beyond the informal assignment of a senior mentor and help junior scholars to build robust mentoring networks that leverage peer support. My university sponsors a structured, long-term mentoring program for a multidisciplinary cohort of early career faculty members. By the end, participants have both achieved milestones on an academic project and broadened their community of mentors.

An expectation of professionalism. The attention to ethical, collegial behavior comes from specific guidelines established by the accreditors of medical schools and graduate medical education. Those standards mandate training in "compassion, integrity, and respect for others" including sensitivity to diversity.

The same principles spill over to faculty performance. Shortly after I arrived, an invited speaker led an interactive workshop on how to deal with disruptive physicians. The topic alarmed me at first, but then I realized that every workplace has its troublemakers, and at least the medical school acknowledges the problem directly. The administration reinforces the message through periodic seminars led by the university ombuds on how research teams can avoid conflict and credit all collaborators fairly.

Health concerns. Medical campuses pay attention to the well-being of faculty members. They sponsor "wellness" committees and survey faculty members for burnout. Weekly departmental guest lectures feature not only research presentations but also workshops on dealing with challenging patients or disappointing clinical outcomes. At a national conference, I learned about one medical school's success in offering semester-long "mindfulness training" to faculty and staff: Deans and center directors meditated and wrote in journals to eliminate stress. Inspired by the example, my colleagues and I hosted a dinner for faculty members complete with massage chairs and a visualization exercise. I expected some pushback or skepticism, but all I heard were requests for the phone numbers of the massage therapists.

Of course, medical campuses have plenty at stake in nurturing their faculty members. Unlike many liberal-arts professors, physicians and scientists can easily pursue alternate careers in private practice or industry, usually with an increase in pay. Attrition imposes significant costs on medical schools because doctors take with them patients while researchers depart with grants. Depending on specialty and region, replacing a medical-school faculty member costs an institution several hundred thousand dollars, not counting losses in morale and productivity of those remaining.

Colleges of arts and sciences tend to pay smaller salaries to their professors, who, in general, cannot easily defect to other research and teaching positions. Still, all parts of the university have an interest in retaining and supporting faculty members. In my former department, I certainly received encouraging advice from my chair, but I did not always see a coherent institutional strategy for promoting mentoring and wellness among all faculty. When I migrated to the medical side of higher education, I became aware of an approach to faculty development that pays attention to more than just teaching skills. I now know that a creative, robust program for supporting career advancement existed just 20 miles down the road.

Peter S. Cahn is director of faculty development and diversity at Boston University's department of medicine and a research associate professor of medicine.