Professorial Promotions Process website: . org/som/faculty/policies/ goldbook/index.html Modified from Hillis, Jackson & Cofrancesco

Professorial Promotions Process website: http://www.hopkinsmedicine. org/som/faculty/policies/ goldbook/index.html Modified from Hillis, Jackson & Cofrancesco

Department Director sends nomination letter, CV, and suggested list of 10 referees to the Dean after internal department review. Dean reviews material and sends to Professorial Promotions Committee (PPC), a subcommittee of the Advisory Board of the Medical Faculty (ABMF), for review and recommendation. PPC subcommittee assigned confidentially to review, asks for additional 10-25 referee letters and makes recommendation to full PPC. Usually contains content expertise. Professorial Promotions Process

If PPC recommendation to promote, then ABMF reviews recommendation which is then held over to next ABMF meeting for formal vote by voting members of ABMF. If vote is negative for promotion, then must wait at least two years before re-nomination. If vote is to recommend promotion, then recommendation is sent to Board of Trustees for vote of approval. Professorial Promotions Process

THEME: Focus early in a given area and develop a body of work to become recognized as an expert SCHOLARSHIP/RESEARCH: Take the lead in winning funding, developing and implementing projects/programs, and publishing the results. PUBLISH: Publication of original data should take priority over dissemination of existing knowledge. What is the IMPACT of the work ? Key strategy to meet promotion criteria 1

LEADERSHIP: Take advantage of scholarly and leadership opportunities at the national/international level MENTOR: Consistently involve yourself with the teaching/mentoring of students and document both those activities and trainee outcomes Key strategy to meet promotion criteria 2

A well-written impact statement will include a summary of your work a summary of evaluation of your work measurements of impact of program building if not available through publications summary of evaluations of your teaching as compared to other members within your department

All faculty members must meet the same fundamental criteria for appointment or promotion at each rank. However, the specific accomplishments for meeting those criteria differ for each academic career. Paul McHugh, chair PPC, 1991

Multi-track system vs single track system ? .. for it eventually produces strong feelings of discrimination and neglect. Harvard abandoned it. Paul McHugh, 1991

Promotion in academic rank is the usual way of recognizing scholarly achievement, yet how can we find standards that will encompass the several different excellences displayed by the biochemist, the GI surgeon, the bedside teacher, the gifted administrator. How can you be fair to all and yet protect the integrity of the promotional process and the professorate? This is the perennial matter of discussion in our committee. Paul McHugh 1991

From McHugh, 1991 For this purpose, we represent in our decisions faculty achievement in a graded fashion but encompass within each grade a variety of talents and contributions that we entitle scholarship. Discussions over scholarship devolve into three fairly distinct aspects: activities that produce knowledge activities that promulgate knowledge activities that apply knowledge.

Pathways to promotion William Welch. has made a significant discovery that affects what we know in the biological sciences . William Oslerhe or she must be an acknowledged authority on something. Henry Hurd. a national reputation as an innovative administrative leader. . and equally important, is that this administrative enterprise have a public scholarly documentation

Revision of the Silver Book 2005 The Silver Book has been extensively revised in conjunction with the revision of the Policies and Guidelines book (the Gold Book) for full-time faculty of the Johns Hopkins University School of Medicine, which was completed and distributed in July 2005. The revisions of both the Gold Book and the Silver Book are the work of the Committee on Clinician Educators and the Committee on the Promotion of the Clinical Program Builder and Innovator, convened by Dean Edward Miller in 2004 and 2009, respectively. The final version of the Silver Book took into consideration the review, commentary, and suggestions received from a large sample of faculty and from the Medical School Council, the Associate Professor Promotion Committee, and the Professorial Promotion Committee. Members of the Committee on Clinical Educators: Myron L. Weisfeldt, MD, Chairman, Frederic B. Askin, MD, L. Randol Barker, MD, Michael Barone, MD, Joan Bathon, MD, William A. Baumgartner, MD, Henry Brem, MD, Douglas Clark, MD, Janice E. Clements, PhD, Nancy L. Craig, PhD, Stephen L. Desiderio, MD, PhD, George J. Dover, MD, Derek Fine, MD, Frank J. Frassica, MD, John Griffin, MD, Gerald W. Hart, PhD, Argye Hillis, MD, J. Brooks Jackson, MD, Neil R. Miller, MD, David G. Nichols, MD, Laura Sterni, MD, Mary Foy, Staff, Christine White, Staff Members of the Committee on the Promotion of the Clinical Program Builder and Innovator Peter Pronovost, MD, PhD, Chairman, Julie Freischlag, MD, Co-Chair, Janice Clements, PhD, Ronald Peterson, Steve Thompson, J. Brooks Jackson, MD, Estelle Gauda, MD, David Hellmann, MD, George Dover, MD, Frank Frassica, MD, Sewon Kang, MD, Jonathan Lewin MD, Justin McArthur, MD, Phyllis Sharps, PhD, Michela Gallagher, PhD, Diana Scorpio, DVM, Stephen Yang, MD, John Fetting, MD, Barbara Fivush, MD, Eric Aldrich, MD, PhD, R. Samuel Mayer, MD, Elizabeth Hunt, MD, Daniel Brotman, MD, Arjun Chanmugam, MD, Marlene Miller, MD, David Yousem, MD, Misop Han, MD, Laura Morlock, PhD, Emily Boss, MD, Jonathan Orens, MD, Scott Wright, MD, Nisha Chandra-Strobos, MD, Richard Davis, PhD, Francesca Dominici, PhD, Christine White, Staff Members of the Subcommittee Responsible for Revision of the Silver Book: L. Randol Barker, MD, Chairman, Frederic B. Askin, MD, Michael Barone, MD, Jessica L. Beinstock, MD, Douglas Clark, MD, George J. Dover, MD, Derek Fine, MD, Gerald W. Hart, PhD, Argye Hillis, MD, Susan M. MacDonald, MD, Leslie P. Plotnick, MD, Laura M. Sterni, MD, Patricia A. Thomas, MD.

DOCUMENTATION OF ACHIEVEMENTS THAT SUPPORT APPOINTMENT OR PROMOTION AT EACH ACADEMIC RANK I. OVERVIEW All faculty members carry the same title (Professor, Associate Professor, Assistant Professor); i.e. The Johns Hopkins University School of Medicine has a single promotion track. The common elements required for faculty advancement are excellence in scholarship and impact upon ones field. Recognition for scholarship and leadership can be achieved through a variety of career pathways (such as, Researcher/Educator, Clinician/Researcher/Educator, Clinician/Educator, Program Builder/ Educator and Program Builder/Innovator, or other combinations). Education is an important component of all career pathways. All faculty members must meet the same fundamental criteria for appointment or promotion at each rank. However, the specific accomplishments for meeting those criteria differ for each academic career.

Harvard promotional criteria ~ also one track Overview Under the criteria that have been used up to now, each faculty member has been classified as either an Investigator or a Clinician Teacher. However, this has been problematic as individual faculty members engage in a range of activities, often including teaching, research and clinical. The challenge of assigning a faculty member into a single category as either Investigator or Clinician Teacher has often been described as trying to fit a square peg into a round hole. Categorizing individuals in this way may also mean that some accomplishments are omitted, or at least downplayed. The new promotion criteria have no categories such as Investigator or Clinician Teacher. Rather, there is a flexible structure which provides a menu of activities that support the academic mission, allowing assembly of a profile that reflects the unique combination of activities and accomplishments of each faculty member. The new guidelines also provide for explicit recognition of a broad range of faculty contributions, permitting consideration of the sum total of an individuals achievements in the evaluation for promotion. Under the new guidelines, there are three steps in the evaluation for promotion: identification of an area of excellence representing the major area of academic achievement; evaluation for contributions to teaching and education; and, if relevant, assessment of other significant supporting activities.

Johns Hopkins School of Medicine Professors In the last 8 years, 315 faculty (236 men, 79 women) nominated for professorial promotion 272 or 86.3% have been recommended for professorial promotion (200 men and 72 women for success rates of 85% and 91% respectively)

Summary of PPC Activity July 1, 2008 June 30, 2009 Candidates Considered FemalesMalesTotal Recommend 82533 Not Recommended 112 On Hold 11 Still pending as of 6/24/09 51419 Subtotal144155

JHSOM PPC Recommendation Rate for Promotion by Academic Year (AY) AY 08-0933 of 3594.2% AY 07-0841 of 4689.1% AY 06-0729 of 3193.5% AY 05-0627 of 3381.8% AY 04-0534 of 3889.5% AY 03-0438 of 4682.6% AY 02-0333 of 3789.2% AY 01-0234 of 4575.6%

H-Index #1st/last original research articles Original research articles Citations - 1st/last author** Citations - total** Mean 25326814312974 Median 2330618261710 ** Includes all peer reviewed articles Citation Data for all recently promoted Medical Faculty Mean and Median N=43

Faculty Characteristics of Those Promoted (courtesy of Brooks Jackson) 120 Faculty Promoted: MD 51% PhD/Other 36% MD/PhD 13% Years at Associate Professor Rank: Mean: 8 years 74% Men, 26% Women

Faculty: characteristics of those promoted to professor (courtesy of Brooks Jackson) Original research articles: Mean: 61 (13-148) Original research articles as First or Last Author: Mean: 34 (10-86) H/J index Mean 25/16 Books: Mean: 1 (Range 0-8) Book chapters/monographs: Mean: 11 (Range 0-53) Trainees mentored by faculty: Mean: 19 (Range 0-96)

Current PI of an NIH grant 70% NIH study section member 48% Editorial Board member 73% First/last author in highly respected journal (NEJM, JAMA, Lancet, Cell, Science, Nature, Nature Med) 48% President of a national society 31% Faculty Characteristics of 120 faculty promoted

H index a scholar with an index of h has published h papers each of which has been cited in other papers at least h times.Th Subscription-based databases such as Scopus and the Web of Knowledge provide automated calculators. Google has a tool which allows scholars to keep track of their own citations and also produces a h-index

Other metrics to consider J index ~ first/last H/years on faculty c index ~ quality of citation i10-index indicates the number of academic papers an author has written that have at least ten citations from others Had Einstein died after publishing his four groundbreaking Annus Mirabilis in 1905, his h-index would be stuck at 4 or 5

Temporal profile of citations

H index caveats

I want to emphasize that the selection of a Professor is an evaluative opinion that does not emerge from some formula as though it were a matter of what is due, such as advancement in school grades or a rise in rank through attaining a given number of merit badges. This selection rests on a judgment of quality built into such terminology as a leader, an authority, a scholar. Paul McHugh, 1991

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ July 1, 2004 to June 30, 2005 Candidates consideredFemalesMales Approved1025 Not Approved Withdrawn13 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ July 1, 2003 to June 30, 2004 Candidates consideredFemalesMales Approved6 34 Not Approved2 Withdrawn5 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ July 1, 2002 to June 30, 2003 Candidates consideredFemalesMales Approved12 24 Not Approved1 Withdrawn1 2 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ July 1, 2001 to June 30, 2002 Candidates consideredFemalesMales Approved8 26 Not approved5 Withdrawn5 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ July 1, 2000 to June 30, 2001 Candidates consideredFemalesMales Approved17 29 Not approved1 Withdrawn5 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 9/1/99 - 6/30/00 Candidates consideredFemalesMales Approved524 Not approved03 Withdrawn3 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~99/1/97 - 8/30/99 Candidates consideredFemalesMales Approved661 Not approved16 Withdrawn ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~ July 1, 2012 to June 30, 2013 Candidates consideredFemales Males Approved/Reappt Not approved Withdrawn ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ July 1, 2011 to June 30, 2012 Candidates consideredFemales Males Approved/Reappt8 21 Not approved1 1 Withdrawn1 3 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ July 1, 2010 to June 30, 2011 Candidates consideredFemales Males Approved/Reappt8 27 Not approved1 1 Withdrawn0 3 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ July 1, 2009 to June 30, 2010 Candidates consideredFemales Males Approved7 21 Not approved 2 Withdrawn2 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ July 1, 2008 to June 30, 2009 Candidates consideredFemales Males Approved8 25 Not approved1 Withdrawn1 1 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ July 1, 2007 to June 30, 2008 Candidates consideredFemales Males Approved12 29 Not approved Withdrawn 5 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ July 1, 2006 to June 30, 2007 Candidates consideredFemales Males Approved10 19 Not approved Withdrawn2 2 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ July 1, 2005 to June 30, 2006 Candidates consideredFemales Males Approved6 21 Not approved1 0 Withdrawn2 3

Based on typical h and m values found, I suggest (with large error bars) that for faculty at major research universities, h 12 might be a typical value for advancement to tenure (associate professor) and that h 18 might be a typical value for advancement to full professor. Fellowship in the American Physical Society might occur typically for h 1520. Membership in the National Academy of Sciences of the United States of America may typically be associated with h 45 and higher, except in exceptional circumstances.

The PPC sub-committee

As of Sept 2009 there are: 2,350 full-time faculty members [1489 men (63%) and 861 women (37%)] 513 (22%) of 2350 are Professors 412 (80%) of 513 are male Professors 101 (20%) of 513 are female Professors Number of Professors at JHSOM

Johns Hopkins School of Medicine Professors In the last 8 years, 315 faculty (236 men, 79 women) nominated for professorial promotion 272 or 86.3% have been recommended for professorial promotion (200 men and 72 women for success rates of 85% and 91% respectively)

Faculty Characteristics of Those Promoted 120 Faculty Promoted: MD 51% PhD/Other 36% MD/PhD 13% Years at Associate Professor Rank: Mean: 8 years 74% Men, 26% Women

Faculty: characteristics of those promoted Original research articles: Mean: 61 (Range 13-148) Original research articles as First or Last Author: Mean: 34 (Range 10-86) H/J index Mean 25/16 Books: Mean: 1 (Range 0-8) Book chapters/monographs: Mean: 11 (Range 0-53) Trainees mentored by faculty: Mean: 19 (Range 0-96)

Current PI of an NIH grant 70% NIH study section member 48% Editorial Board member 73% First/last author in highly respected journal (NEJM, JAMA, Lancet, Cell, Science, Nature, Nature Med) 48% President of a national society 31% Faculty Characteristics of 120 faculty promoted

Candidates for Professor must have outstanding records of scholarly achievement including teaching, must have achieved national leadership and in most cases, international professional recognition, and must rank among the foremost leaders in their field. Criteria for Promotion to Professor

As required of all faculty members, candidates proposed for promotion must also carry out their academic and/or patient care responsibilities with professional competence, intellectual honesty, high ethical standards, and in a manner consistent with the policies and procedures of the University. Page 25 Gold Book Criteria for Promotion to Professor (continued)

JHUSOM 2005 Gold Book Education: Documenting the scholarship of education also requires demonstration of accomplishments that are public, subject to critical review and analysis of outcomes, and useful to others in the community beyond the School of Medicine. This documentation may take the form of a teaching portfolio, as described in the Silver Book. Course leadership and design, the judgment of students, trainees, and peers, and meritorious publications may also be considered when a faculty members teaching is assessed.

What is a Educators Portfolio? Includes documents and materials which collectively suggest the scope and quality of a faculty members teaching and educator performance. Do not simply list evaluations and lectures (From Seldin)

THE EDUCATORS PORTFOLIO* Developed by the Silver Book Committee June 2005 * The authors are indebted to the model of the Educators Portfolio that we have adapted for this document: Simpson DE, Beecher AC, Lindemann JC, Morzinski JA. The Educators Portfolio. Medical College of Wisconsin, 1995. The Educators Portfolio is a collection of materials that documents the quantity and quality of a faculty members educational activities. Since a criterion for rank at JHSOM is evidence of creative scholarship in the area of primary expertise, those faculty who identify education as their primary expertise will use the Educators Portfolio to convey evidence of creative educational scholarship. This document is designed to help you begin the process of building your Educators Portfolio. keep in mind the purpose for having a portfolio, which may be different for every faculty member. In the first few years of faculty appointment, the portfolio may be a resource for tracking your teaching activities and recording feedback evaluations .for your teaching efforts. As you develop more and reflect on these experiences, you may discover a particular interest or niche in medical education that you would like to pursue. The portfolio review with a mentor at this point can direct your personal development into those areas needed in preparation for this work. More established faculty will have had opportunities to implement and test innovative instructional designs and curricula, and the portfolio can record these efforts in an appropriate manner

Purpose of teaching portfolio Improve Reflective Learning/Reflective Teaching Factual description of a professors Strengths Accomplishments Convey Evidence of Creative Educational Scholarship 1.Quantity of teaching effort 2.Quality of teaching effort 3.Impact of teaching effort 4.Evidence of scholarship Scholarly teaching: using best practice Teaching scholarship: discovering best practice Based on The Educators Portfolio Silver Book Committee (June 2005)

Research : Quality of medical education research and role models in medical education Has published 76 original research articles (58 as first or last author) (NEJM, JAMA, Ann Int Med) H- index 16 citations: 549/845 PI of an Education Foundation grant Education/Teaching: Author of 3 book chapters and 7 peer reviewed communications Course Director for Evidence-based Medicine course for interns Core Faculty for Teaching Skills Workshop in Faculty Development Program Has been an instructor for 17 CME activities at national meetings Has mentored 16 House-staff and approximately 25 fellows Now Director of Fellowship program Primary Care provider (50% effort) + inpatient attending 1 mo/yr teaching house-staff. Dr. Education, MD

Recognition: Associate Editor for Medical Education journal Co-Chair AMA Medical Education Research Consortium Several institutional, state, and national awards for teaching and excellence in medical resident education Has given 35 invited lectures at national/international meetings and universities in last 10 yr Served as visiting professor 4x in past 3 years Dr. Education, MD

Educational Extramural Funding List current, then pending, then previous grants, contracts, etc. (each section in chrono. order) Include ALL of the following information: Dates, title Identification # (if available) Sponsor (e.g. AMA) Total direct cost PI Your role and percent effort Should agree with your effort report and your other support

Purpose of teaching portfolio Improve Reflective Learning/Reflective Teaching Factual description of a professors Strengths Accomplishments Convey Evidence of Creative Educational Scholarship 1.Quantity of teaching effort 2.Quality of teaching effort 3.Impact of teaching effort 4.Evidence of scholarship Scholarly teaching: using best practice Teaching scholarship: discovering best practice Based on The Educators Portfolio Silver Book Committee (June 2005)

CLINICIANS INNOVATION AND QUALITY IMPROVEMENT PORTFOLIO Publication in peer review journals remains the primary measure of scholarly activity. It is highly recommended that faculty publish quality improvement efforts. A. Executive Summary B. Improvement Projects Project 1 (brief description of problem, goal, methods): Role (chair, project lead, member) Internal Scope (# units/clinics/departments/functional units involved in activity) External Spread (# of external organizations/states/countries adopt practice/initiative/methodology) Sustainability (To what extent was improvement built into daily operations? How long has it been sustained?) Time/Effort (% time or length of time I devoted to effort; include project initiation and completion dates) Feedback (Feedback from others on the project, leadership that championed initiative (e.g., departmental chair, QI team leader), frontline clinicians and patients affected by change) Magnitude of Impact (Does the project address a local, hospital-level, or national priority? What is the magnitude of the improvement for patient care or outcomes?) Results (Process or outcome measures, as applicable to initiative (e.g., reduction in complications, adverse events, medication errors, improved compliance to guidelines, improved throughput, reduced LOS))

Converting Descriptive Paragraph to Accomplishment Statements Johns Hopkins Adult Hydrocephalus Program Created the Johns Hopkins Adult Hydrocephalus Program as a Center for Excellence supported by the Johns Hopkins Hospital. Demonstrated outpatient and inpatient volumes that increased by nearly 200% in three years. Generated substantial profits of $1.3 million per year by implementing auditing practices and developing enhanced hospital coding systems. Established cutting-edge clinical research program by initiating new collaborative relationships and cultivating industry support.

Questions ? 53

Documents

Professorial Promotions Process website: . org/som/faculty/policies/ goldbook/index.html Modified from Hillis, Jackson & Cofrancesco