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September 3, 1997

Promotion Criteria for Clinician-Educators in the United States and CanadaA Survey of Promotion Committee Chairpersons

Author Affiliations

From the Division of General Internal Medicine, Johns Hopkins University School of Medicine (Drs Beasley, Cofrancesco, Thomas, and Bass), and Johns Hopkins Bayview Medical Center (Dr Wright), Baltimore, Md; and Baystate Medical Center and Tufts University School of Medicine, Boston, Mass (Dr Babbott). Dr. Beasley is now with the Department of Internal Medicine at the University of Kansas School of Medicine, Wichita.

JAMA. 1997;278(9):723-728. doi:10.1001/jama.1997.03550090047031

Context.  —Clinician-educators have concerns about their ability to be promoted and the criteria used by medical school promotion committees.

Objective.  —To discover the criteria and methods that medical school promotion committees use to make decisions about the promotion of clinician-educators.

Methods.  —In June 1996 we mailed a questionnaire to chairpersons of all medical school promotion committees in the United States and Canada.

Results.  —Of 142 schools surveyed, 115 (81%) responded; 45% of respondents had a clinician-educator promotion track. On a scale from 1 (minimally important) to 7 (extremely important), the mean importance ratings of aspects of clinicianeducators' performance were the following: teaching skills (6.3), clinical skills (5.8), mentoring (5.7), academic administration (5.3), developing educational programs (5.3), nonresearch scholarship (5.1), clinical research (4.8), service coordination (4.7), and education research (4.5). Methods to evaluate each aspect of performance were rated by respondents for importance and frequency of use. The 4 most important methods for evaluating teaching were awards, peer evaluation, learner evaluation, and teaching portfolio; 70% or more of schools used these frequently or always. The 4 most important methods of evaluating clinical skills were peer evaluation, awards, trainee evaluation, and objective measures, which were used frequently or always by 78%, 65%, 58%, and 29% of schools, respectively. Clinician-educators were expected to have fewer peer-reviewed publications to be promoted than investigators (5.7 vs 10.6, P<.001). Schools with separate clinicianeducator tracks differed little in survey responses from schools without such tracks.

Conclusion.  —Most, but not all, promotion committees now assign high importance to the special contributions of clinician-educators and use a variety of methods to assess these, regardless of whether they have a separate clinician-educator promotion track.