MEDICAL FACULTY SENATE
Excerpts from a Report Discussed at SEC

Faculty--2000 Project: A Faculty-Based Vision for the Medicine of Tomorrow

Profound changes in the delivery of health care during the last decade are contributing to equally profound changes in the scholarly, educational and service missions of academic health systems throughout the nation. The University of Pennsylvania Health System has been remarkably successful in adapting to these changes and is recognized as one of the leaders in the nation in this regard. Nevertheless, these changes have created extraordinary challenges for its faculty, academic physicians and non-physician scientists alike. Perhaps the clearest effect of the altered environment is the difficulty faced by junior faculty in meeting the increased demands for clinical service and extramural funding, while at the same time maintaining scholarly and educational productivity. It is thus timely and important to undertake a review of the role of faculty within the Health System. This undertaking is initiated and organized by the Steering Committee of the Faculty Senate of the School of Medicine and is known as Faculty - 2000.

The goal of this review is to develop a faculty-based vision for delivering new knowledge and outstanding health care. This goal is realized by having faculty explore and identify strategies and tactics that enable them to achieve their research, clinical and educational missions within the context of an academic health system that requires outstanding service and management skills in an environment of constrained financial resources. The focus of the inquiry will be the mission, structure, organization and size of the Standing Faculty (Tenured and Clinician-Educator tracks). Its scope will include women, minorities, and husband/wife team faculty; the role of the faculty in the research track; and issues of concern to senior faculty near the end of their careers will be discussed. The methodologies that emerge for advancing faculty missions must work within the framework of our current faculty tracks and resources. The inquiry is open to new ideas from all quarters of the Health System and University, and will engage a large portion of the School's faculty over the next year. The recommendations that emerge will undergo the normal review processes within the School of Medicine.

This review is undertaken in four Working Groups, and the Faculty-2000 Steering Committee has developed a clearly defined set of charges to each, given briefly below. The lists of Issues identified are by no means exhaustive, but give the flavor of each working group's task.

The Clinician Educator Faculty Working Group is charged with critically examining the current and future state of the Clinician Educator (CE) track within the School of Medicine. It needs to consider the history, size, composition, standards and contributions of the CE track here at Penn and at other comparable institutions. It needs to consider issues like those outlined below, and provide specific recommendations for the future of the track that can be considered for implementation at the School and University levels.

Issues: What is the purpose of the CE track, and should it be preserved as a distinct career pathway of the Standing Faculty within the School of Medicine? Are the current criteria for promotion within the CE track the most appropriate? Is the distinction between the CE track and Tenured tracks appropriately defined? Should there be defined categories of CE faculty such as clinician investigators, clinician teachers, and clinician managers? Is teaching appropriately measured and weighted in the promotion process? Should current limits on the size of the CE faculty in the School be modified or eliminated? Should there be some form of tenure for CE faculty? Should Health System physicians be allowed to practice without restrictions at the core hospitals of the Medical School? What new opportunities should be developed to improve financial support for the teaching missions of School of Medicine faculty? How do we define CE productivity? How do we maintain the highest level of scholarship for the CE faculty? What is the impact of market forces on CE faculty, and what strategies can be developed to use them to advantage? As we transit from an academic to a corporate culture, will there be more control exerted over CE faculty responsibilities, and what are the implications of this?

The Tenured Faculty Working Group is charged with critically examining the current and future state of the Tenure Track within the School of Medicine. It needs to consider the size, composition, standards and contributions of this track here at Penn. It needs to consider issues like those outlined below, and provide specific recommendations for the future of the track that can be considered for implementation at the School and University levels.

Issues: What exactly does it mean to be a tenured faculty member? Is the size of the tenure faculty appropriate for its missions? How is "productivity" defined for this faculty? Are the criteria for appointment and promotion appropriate? Is the tenure probationary period appropriately defined? Is the definition of tenured faculty in basic science and clinical departments defined in the same way? Should there be an incentive plan for tenured faculty? What is the role of unfunded research for faculty in this track? Should expectations for income generated by this faculty be specified in a more structured manner? What is the teaching role for tenured faculty? How is teaching compensated? Is there a shift occurring in this teaching role as new teaching technologies are introduced? Should obligations for teaching by this faculty be defined in a more formal way? What is the impact of Graduate Group teaching for tenured faculty? What really are the contributions to promotion for teaching in this track? How can tenured faculty better deal with regulatory and compliance issues? Is the infrastructure for grant preparation, processing, and administration adequate and appropriate? How will the lines of authority and control impact tenured faculty as the Medical Center transits from an academic to corporate culture, and will the "free agent" status of tenured faculty in our current grant-based society undergo significant changes in the future? What would be the implications of these changes?

The Working Group on Issues of Concern to Faculty with Special Opportunities directs its inquiry on issues related to Women Faculty, Minority Faculty, Husband/Wife Team Faculty, the Practitioner Scholar Faculty and the Research Faculty. This working group needs to consider the size, composition, standards and contributions of these various faculty groups. It needs to discuss issues like those outlined below, identify strategies and tactics that help assure success of these faculty members, and provide specific recommendations that can be considered for implementation at the School and University levels.

Issues: How effective are departments and faculty in the recruitment and retention of women, minority and husband/wife team faculty? What mechanisms can be identified to better assure the retention of women and minority junior faculty? Does the School provide a proactive and aggressive environment that supports all junior faculty, especially women and minorities? How can the School facilitate the recruitment and retention of faculty with disabilities? Should there be greater flexibility in defining job requirements for these faculty members? Should productivity for these faculty be defined any differently from the rest of the faculty? Does the recruitment process for husband/wife team faculty coordinate the process properly? Should the process be coordinated across the campus or just in the School? What impact would the establishment of "Day Care" or "Elderly Care" within the School and Hospital have on faculty? Does the School view parental leave as a natural occurrence in the life of faculty, and encourage them as a non-detrimental events in career development? What is the current definition of the "Practitioner Scholar" faculty, and what roles do they play within the School? Are the criteria for appointment and promotion appropriately defined for this faculty? What is the current mission of the Research Track faculty? Are the criteria for appointment and promotion in this track appropriately defined? How do we distinguish between Tenured and Research Track faculty? Should there be a Research Track, and does it fill an identifiable role within the School and Health System? Again, this list is far from exhaustive, but provides a flavor of the issues involved.

The Working Group on the Senior Faculty needs to evaluate issues of concern to faculty nearing the end of their academic careers. It needs to explore thoroughly how various departments and other institutions treat senior faculty. It needs to collect data on the age distribution of current faculty to determine if a "bubble" of senior faculty is moving through the School. This evaluation is essential given the significant increase in the size of the faculty during the past decade. The issues identified below need to be considered further. The goal of this working group is to identify strategies and tactics by which faculty can reach the end of their careers with a sense of dignity and accomplishment, and how the school can most effectively utilize the talents of its Senior Faculty. The working group needs to provide specific recommendations that can be considered for implementation at the School and University levels.

Issues: How does the School currently educate faculty on the process of ending their careers, and is it effective? How can increased publicity and accessibility be achieved for retirement education programs for faculty? How can faculty retirement planning be initiated early and be presented as an attractive, planned and personal choice activity? How do departments deal with the financial problems that arise when senior faculty begin to lose income earning power from clinical practices or grant supported research? Are "phase out" service plans widely known and understood by faculty? Are "early retirement" plans widely known and understood by faculty? What is the current definition and scope of age discrimination? Are faculty compensation plans at retirement sufficiently strong, or should they be strengthened? What sort of culture clashes might occur as more junior faculty, especially in the clinical departments, end up supporting an ever-growing cadre of senior faculty? How can the School best utilize the talents and expertise of senior faculty? Are there unique teaching niches that can be filled by senior faulty? Should senior faculty assume a more intense mentoring role?

[Ed note: Please see also SEC Actions in this issue.]


Almanac, Vol. 46, No. 7, October 12, 1999

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