Update on the Silver Book

1
Update on the Silver Book Associated Guidelines
for PromotionClinician Educator Pathway

• November 29, 2007
• Lisa Heiser,
• JHSOM Assistant Dean
• for Faculty Development

2
With appreciation to

• Estelle Gauda, MD, Chair, Associate Professor
  Promotions Committee
• Brooks Jackson, MD, Chair, Professorial
  Promotions Committee
• Laura Sterni, MD, Past-president, Medical School
  Council
• Pat Thomas, MD, Associate Dean for Education

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Can You Be Promoted on Clinical Excellence Alone?

• Consider Hopkins 3.2 billion campaign slogan
• (What is it?)

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Can You Be Promoted on Clinical Excellence Alone?

• Consider Hopkins campaign slogan for JHU Johns
  Hopkins Medicine
• KNOWLEDGE FOR THE WORLD
• The first president of the university formally
  took office and laid out plans for a radically
  different educational institution. Gilman wanted
  his university to do more than just teach, more
  than just pass along old knowledge to the next
  generation. He added a new mission discovery,
  the creation of knowledge, and the use of that
  knowledge for the good of humanity. What are we
  aiming at? he asked in his inaugural speech.
  The advancement of individual scholars, who by
  their excellence will advance the sciences they
  pursue, and the society where they dwell. That
  remains the Johns Hopkins mission today, and
  today's Johns Hopkins -- the first American
  research university -- has adopted a simple, but
  powerful, restatement of Gilman's words
  Knowledge for the World.

Daniel Coit Gilman
Inaugurated Feb. 22, 1876
5
Silver Book Standard for Promotion

• To Assistant Professor requires a clear
  scholarly commitment and demonstrated creative
  scholarly contribution.
• To Associate Professor requires national
  recognition for scholarship.
• To Professor requires national leadership and
  (in most cases) international recognition for
  important scholarly contributions.

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Areas of Scholarship

• JHSOM recognizes scholarship that is achieved as
  a
• Researcher
• Educator
• Clinician and/or
• Program Builder

7
What is a Clinician Educator?

• From Pat Thomas in How to Get Your Career Going
  as a Clinician Educator, October 2007
• Faculty member whose scholarship is not dependent
  on research, although may do research
• lt50 of salary support comes from external
  funding
• Consider cE vs Ce
• cE Scholarship related to educational issues
• Ce Scholarship related to clinical practice

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Promotion to Assistant Professor

• Level of achievement in Education
• Creative scholarship includes
• Publication of one or more peer-reviewed, first
  authored review, curriculum, or other educational
  document
• Participation in and/or initiation of research
  that addresses educational issues and that has
  led to dissemination of findings for scrutiny and
  use by greater academic community

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Promotion to Associate Professor

• Level of achievement in Education
• National recognition includes
• Development, implementation, and evaluation of
  innovative educational programs with national
  reputation and impact
• Peer-reviewed publication of leading textbooks or
  chapters in leading textbooks

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Promotion to Associate Professorcontinued.

• Level of achievement in Education
• National recognition includes
• Development and dissemination of other
  educational materials (e.g. websites, course
  design) identified as important through
  peer-review
• Development of or leadership in educational
  research projects that have a national reputation
  and impact

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Promotion to Professor

• Level of achievement in Education
• National leadership and international recognition
  includes
• Development, implementation, and evaluation and
  widespread dissemination of innovative
  educational programs or educational materials
  (e.g. websites, curricula) with documented
  national and international impact and reputation
• Publication of leading textbooks or chapters in
  leading textbooks
• Development, leadership, and publication of
  educational research that has a national impact
  and reputation

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Criteria Considered for Academic Advancement in
the Silver Book

• Accomplishments are organized within six
  categories
• Teaching
• Publications and presentations
• Support for research
• Recognition beyond the JHSOM
• Citizenship to the University
• Clinical Service

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Examples of Accomplishments in Teaching for
Promotion to Associate Professor

• National recognition for scholarship in teaching
  at the predoctoral, doctoral, or CME level
• Scholarly teaching as documented by its impact on
  learners and by assessment of the teaching by
  learners, peers, internal or external evaluators,
  and oneself
• Teaching awards from national and international
  organizations
• Direction and evaluation for several years of a
  course at the undergraduate, graduate or CME
  level
• Invitation to teach in hospitals, other medical
  schools, programs of professional societies, CME
  courses
• Invited educational consultation or collaboration
  within or beyond JHSOM

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Teaching Skills Courses

• Locally
• JHU Faculty Development Program (K.Cole)
• Teaching Skills
• Curriculum Development
• Office of Faculty Development (flier)
• Speak Like a Pro
• Homewood Center for Educational Resources
• JHU Graduate School of Education
• www.hopkinsmedicine.org/fac_development
• From Pat Thomas, How to Get Your Career Going
  as a Clinician Educator, October 2007.

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Teaching Skills Courses

• Regional/National
• Evidence-based Medicine (McMasters)
• Teaching Geriatrics (UCSF)
• Healthcare Communication (Bayer Institute)
• Professional societies Surgeons as Educators
  Course (American College of Surgeons)
• Harvard Macy Institute (2 week courses)
• From Pat Thomas, How to Get Your Career Going
  as a Clinician Educator, October 2007.

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Fellowship Training (cE)

• Medical Education Fellowship (GIM)
• Stanford Fellowship in Medical Education
• Rabkin Fellowship in Medical Education
• Surgical Research Education Fellowship (American
  College of Surgeons)
• From Pat Thomas, How to Get Your Career Going
  as a Clinician Educator, October 2007.

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Additional Degrees (cE)

• Masters in Education (M.Ed.)
• Masters in Medical Education (M.Ed.)
• Univ. of Pittsburgh
• Univ. of Cincinnati
• Univ. of Michigan
• Univ. of Southern California
• Univ. of Southern Illinois (online or
  residential)
• Masters of Science
• Masters of Science in Education with a
  concentration in Technology in Education
• From Pat Thomas, How to Get Your Career Going
  as a Clinician Educator, October 2007.

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Examples of Accomplishments in Publications for
Promotion to Associate Professor

• Impact of publications and role of faculty member
  (e.g., as first or last author) are more
  important than the number of publications.
• National recognition for scholarship in
  education, clinical service and/or program
  building through continuing publication of
• Descriptions of and evaluation of innovative
  curricula programs or teaching methods
• Research that addresses educational topics
• Book chapters
• Continuing dissemination of clinical expertise by
  audio and video learning aids and through
  computer-based material

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Notes on Publications

• From Estelle Gauda, Faculty Forum on Promotions
  Process, Spring 2007.
• Substantive and continuous publication in
  refereed journals with special emphasis on the
  quality of original contributions to the field
• Role of the faculty member in the execution of
  the project involved in the publications
• Number of authors and the place of the faculty
  member among the authors
• Textbooks or monographs either as sole author or
  as editor
• Chapters in text books
• NO ABSOLUTE of PUBLICATIONS

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Medical Education Organizations
Org. Focus Publication
AAMC GEA RIME GSA UME,GME,CME Academic Medicine
ACCME CME
ABSME Behavioral Sciences and Medical Education Annals of Behavioral Science and Medical Education
AAME Medical Education in Europe Medical Teacher
NBME Assessment (Stemmler Fund)
From Pat Thomas, How to Get Your Career Going
as a Clinician Educator, October 2007.
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Specialty Medical Education Organizations
Alliance for Internal Medicine (SGIM,ACP, ASP,CDIM, APDIM) Internal Medicine Journal of General Internal Medicine, Annals of Internal Medicine
Council on Medical Student Edcuation in Pediatrics (COMSEP) Pediatrics Pediatric Educator
Association of Professors of Gynecology and Obstetrics (APGO) Obstetrics/Gyn Womens Health
Assoc. for Surgical Education Surgery
Consortium of Neurology Clerkship Directors (CNCD) Neurology
Society of Teachers of Family Medicine Family Medicine Ambulatory Medicine Family Medicine
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Examples of Content Medical Education
Organizations
American Medical Informatics Association (AMIA) Journal of the AMIA
Association for Teachers of Preventive Medicine (ATPM) American Journal of Preventive Medicine
End of Life /Palliative Care Resource Center (EPERC) Website
International Association of Medical Science Educators (IAMSE)
Association for the Study of Medical Education Medical Education
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Examples of Accomplishments in Clinical Service
for Promotion to Associate Professor

• National recognition for excellence in clinical
  service or clinical program building may be
  reflected by
• Reputation as one of the nations foremost
  clinicians in management of a particular disease
  or condition
• Leadership positions in professional societies
  emphasizing excellence in clinical specialties
• Service as a member of or examiner for your
  specialty board
• Development of national or internationally
  recognized standards of care
• Development of a unique or essential clinical
  program with national prominence

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As Assistant Professor, consider these
strategies/questions

• What is my focus and area of concentration?
• What are important areas for discovery and
  innovation that I enjoy?
• What professional organizations can I join and
  volunteer in (develop regional and national
  reputation through volunteering to work on annual
  meetings, review abstracts discover
  collaborators provide documentation of your
  leadership eligibility for awards)?
• What suggestions do my mentors have for
  opportunities to talk and teach externally (e.g.,
  CME, Grand Rounds), and to write in peer-reviewed
  national contexts?
• (AAMC, ABSME, NBME, Alliance for Internal
  Medicine)
• Adapted from Pat Thomas, How to Get Your Career
  Going as a Clinician Educator, Oct. 2007

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As Associate Professor, consider these strategies

• Focus early in a given area and develop a body of
  work to become recognized as an expert
• Take the lead in developing and implementing
  projects/programs and publish the results in a
  timely manner. Apply for funding.
• Publication of original data should take priority
  over dissemination of exiting knowledge
• Take advantage of scholarly and leadership
  opportunities at the national/international level
• Consistently involve yourself with the
  teaching/mentoring of students and document those
  activities and student outcomes
• From Brooks Jackson, Faculty Forum on
  Professorial Promotions Process, Spring 2007.

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Example Associate ProfessorClinical research
scientist /educator

• Assistant Professor of Medicine- 1999
• Joint appts Departments of Health Policy
  Research and Management (1999) Epidemiology
  (2003)
• Scientific Discovery
• Focus health disparities research that affect
  the care of individuals with severe mental
  illness (SMI)
• Determined that individuals with SMI
• have a higher burden of chronic disease
  (cardiovascular disease and obesity than the
  general population)
• Individuals with SMI have reduced level of
  physical activity which is greater for those
  individuals who do not have regular social
  contacts.
• Her findings cross-disciplines internal
  medicine, psychiatry, epidemiology and health
  care delivery

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Associate Professor, continued

• Dissemination of scholarly contributions
• 22 peer-reviewed publications (10/first author
  Annals of Internal Medicine, Archives of General
  Psychiatry, Journal of Nervous and Mental
  Illness) 1 editorial and 1 book chapter)
• National recognition
• Member multiple national societies.
• Invited speaker- NIMH Conferences, American
  Psychiatric Associate national meeting, Co-chair
  of Session at Society of General Internal
  Medicine Annual meeting
• Invited member NIHM study sections, and ad hoc
  reviewer-
• Annie Lea Shuster Alumni Speaker ( RWJ Clinical
  Scholars Program)
• Awards
• Recognition by the Center of Excellence Steering
  Committee for expertise on medical and mental
  health co-morbidity
• PI R01, R34 and (2 awards) National Alliance of
  Research on Schizophrenia and Affective Disorders
  NASAD)
• Ulmer Award, (Johns Hopkins) support research
  designed to improve the QoC for persons with SMI

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Example Associate Professor Career pathway
Clinician/Research/Educator
National recognition for scholarly contributions
longitudinal data analysis treatment options
for individuals with inflammatory bowel
disease Novel discoveries and techniques Immunos
uppressive therapy increases the long-term
outcome of individuals with specific types of
inflammatory bowel disease Scholarly Research
49 publications, 21 first-authored, 8 reviews
K23 Award- support Ph.D. thesis. National
Leadership Colitis Society, Member Coordinating
Center for Multicenter Colitis Steroid
Treatment Trial, Invited speaker, CME (local and
nationally). Education/mentoring medical
students and postdoctoral fellows Letters (3
inside/6 outside) She has established herself
as a distinct clinical and methodological expert
. Her papers are quoted frequently among
inflammatory bowel disease specialists
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Example Associate Professor Michele Shermak, MD

• Career Pathway Program Builder/Educator/Clinician
  
• Years at Rank Before Promotion
• Assistant Professor 7.5
• Accomplishments that led to Promotion
• Associate Professor
• The top accomplishment was developing a national
  reputation in an area of concentration, which in
  my case is post-bariatric body contouring surgery
  
• Speaking at national meetings about my technical
  and clinical management of these patients
• Writing a number of peer-reviewed articles
  looking at outcomes and patient safety issues
• Becoming increasingly involved in our national
  professional society, the American Society of
  Plastic Surgeons (ASPS) for networking purposes,
  which led to leadership opportunities on a
  national level
• Became Chief of my Division which was the
  clincher
• Publications at Promotion
• To Associate Professor
• 24 peer-reviewed articles
• 12 non-peer reviewed articles
• 6 chapters

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Faculty Characteristics of Those Promoted to
Professor in 2002-2006

• Number of
• Original Research Articles Mean 61 (Range
  13-148)
• Original Research Articles as First or Last
  Author
• 
  Mean 34 (Range 10-86)
• Book Chapters/Monographs Mean 11 (Range
  0-53)
• Books Mean 1 (Range 0-8)
• Trainees Mentored by Faculty Mean 19 (Range
  0-96)
• From Brooks Jackson, Faculty Forum on
  Professorial Promotions Process, Spring 2007.

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Example Professor David Kern, MD

• Career Pathway Clinician Educator
• Years at Rank Before Promotion
• Assistant Professor 11
• Associate Professor 16
• Accomplishments that led to Promotion
• Director, Johns Hopkins Residency Program in
  General Internal Medicine
• Director, Osler Center for Clinical Excellence at
  Johns Hopkins
• Course Director of several CME Courses
• Director, Division of General Internal Medicine,
  Johns Hopkins Bayview Medical Center
• Director, Community Based Practices, Johns
  Hopkins Bayview Physicians
• Co-Director, Medical Education Track, GIM
  Fellowship Program
• Co-Director, Johns Hopkins Faculty Development
  Program for Clinician-Educators, Director,
  Program in Curriculum Development
• Publications at Promotion
• 27 peer-reviewed research publications
• 12 peer-reviewed education publications
• 27 book chapters

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Valuable Resources

• Gold Book
• http//www.hopkinsmedicine.org/som/faculty/polici
  es/goldbook/index.html
• Silver Book
• http//www.hopkinsmedicine.org/som/faculty/polici
  es/silverbook/SilverBook2006.pdf
• Office of Faculty Development Website, including
  video library of programs presentations
• http//www.hopkinsmedicine.org/fac_development/
• Associate Professor Promotions Committee Website
  Estelle Gauda
• http//www.hopkinsmedicine.org/dev/appc
• Professorial Promotions Committee Website
  Brooks Jackson
• http//www.hopkinsmedicine.org/som/faculty/polici
  es/goldbook/index.html
• Recently Promoted Clinician Educators