Tenure Appointments for Faculty of Clinical Departments at U.S. Medical Schools: Does Specialty Designation Make a Difference?

Diversity in Academic Obstetrics and Gynecology

Institutional transformation and moving diversity from the periphery to the core of excellence have increased the representation of both female and racial and ethnic minoritized populations in academic obstetrics and gynecology (OB/GYN). Enabling the recruitment and retention of diverse residents and faculty, measuring their contributions to the department academic and social missions, and providing a supportive environment will be important in the coming years as the changing OB/GYN workforce progresses through their careers.

Characteristics of highly prolific PA authors who contributed research to JAAPA and JPAE

OBJECTIVE

Highly published physician associate/assistant (PA) researchers were surveyed to quantify experienced support patterns that may inform increased support of PA-led research.

METHODS

Publication volume of authors of research articles published in JAAPA and the Journal of Physician Assistant Education (JPAE) between 2011 and 2020 was recorded. PAs in the upper quartile were emailed surveys containing demographics and 25 Likert-scale questions. Descriptive statistics and binomial exact test were completed.

RESULTS

Sixty-five of the 73 PAs were contacted by email; 26 participated; and 35% were female. Social support measures were high; respondents were mentors and mentees, who work collaboratively. Material support and educational support measures were lower and most reported no funding nor pay for research; they did not learn research skills in PA school. However, they feel recognized, and find joy in research.

CONCLUSIONS

Successful PA researchers find joy despite low material support regarding funding, pay, and protected time. Women and racial minorities were underrepresented; research is needed to examine potential barriers.

A Bibliometric Analysis of Scholarly Activity of Authors of Research Articles Published in the Journal of Physician Assistant Education from 2011-2020

INTRODUCTION

The purpose of this study was to analyze bibliometric data and trends of author contributions to the Journal of Physician Assistant Education (JPAE) from 2011-2020.

METHODS

Author data were collected from JPAE research articles published from 2011-2020. Publication history and h-index were obtained from Scopus. Data collected included first authors, last authors, and PA authors as well as trends in publications in JPAE . Descriptive statistics, ANOVA, and Wilcoxon rank-sum tests were completed.

RESULTS

From 2011-2020, 200 research articles were published in JPAE; the volume was constant. Of 698 authors listed, 374 were physician assistants (PAs). Overall, contributing authors had a mean publication number of 19.6 (1-327) compared to 12.1 (1-163) for PAs. First and last PA authors had mean publication numbers of 13.2 and 16.1, respectively, and an average h-index of 3.2 and 4.4, respectively. The overall author h-index was 5.2. The mean number of publications for non-PA last authors was 32.9. Publication to h-index proportion was similar between PAs and other authors. The top 25 th percentile of PA authors published > 9 indexed documents, 3 times the number published by those in the 1-75 th percentile.

DISCUSSION

PA author articles in JPAE from 2011 to 2020 were fewer than those by non-PAs but were as likely to have a proportionate h-index. PAs listed as first and last author were highly published. Trends suggest that when PA first authors work with PA last authors, there may be a more egalitarian relationship, and mentorship patterns may also exist within these groups. Increasing publication numbers from 2011 to 2020 for PA first and last authors indicates increasing academic contribution.

Subspecialty Selection Impacts Research Productivity and Faculty Rank of Academic Orthopaedic Surgeons

BACKGROUND

Faculty promotion and research productivity are important for the overall career trajectory of academic orthopaedic surgeons. The purpose of this study was to investigate the role that subspecialty and demographic factors play in research productivity and academic advancement among orthopaedic surgeons.

METHODS

We conducted a retrospective cross-sectional analysis of academic rank among orthopaedic surgeons in 2018. We identified academic orthopaedic programs in the United States from the Fellowship and Residency Electronic Interactive Database (FREIDA) and collected publicly available data for surgeons, including fellowship training, gender, faculty rank, geographic region, and years since residency, from institutional websites. Research productivity was defined with the Hirsch index (h-index) from Scopus, and the m-index was calculated from the surgeon's h-index and the date of the first publication. Multivariate regression analyses were performed to determine the variables that are associated with associate professorship, full professorship, and the h-index.

RESULTS

In this study, we identified and included 2,879 academic orthopaedic surgeons. Completion of a fellowship in foot and ankle (odds ratio [95% confidence interval]: 2.45 [1.17 to 5.15]), sports medicine (2.15 [1.12 to 4.15]), trauma (2.83 [1.42 to 5.66]), hand and upper extremity (2.20 [1.13 to 4.28]), musculoskeletal oncology (3.28 [1.49 to 7.21]), or upper-extremity reconstruction (3.20 [1.31 to 7.81]) was associated with associate professorship. Completion of a trauma fellowship was associated with full professorship (2.93 [1.27 to 6.77]). Completion of a fellowship in adult reconstruction (difference in least-squares means [95% confidence interval]: 5.01 [1.22 to 8.81]), sports medicine (4.52 [1.00 to 8.04]), spine (5.40 [1.63 to 9.18]), or upper-extremity reconstruction (10.64 [6.15 to 15.12]) or the completion of multiple fellowships (5.12 [1.27 to 8.94]) were independently associated with a higher h-index. Women had significantly lower h-indices than men at the assistant (median [interquartile range]: 3 [1 to 6] versus 4 [2 to 8]) and full professor (17 [12 to 26] versus 22 [13 to 34]) levels. There were no differences in the m-index between men and women at any academic rank.

CONCLUSIONS

Orthopaedic subspecialty selection is independently associated with research productivity and academic rank. The differences in research productivity may be important to consider when evaluating orthopaedic surgeons for promotion. While female surgeons had lower h-indices than their male counterparts, this difference was not seen when using the m-index.

Increasing Pediatricians' Scholarly Productivity on and off the Tenure Track

INTRODUCTION

Physician faculty have increasingly been appointed to nontenure track positions, which provide limited support for scholarly activity. We evaluated how a centralized departmental research group affected the scholarly productivity of faculty on and off the tenure track.

METHODS

A research team providing both mentorship and logistical study support was implemented in 2018. We identified a pre-intervention cohort of physician faculty employed in July 2016, and a postintervention cohort, employed in July 2018. A publication search was conducted for these cohorts in the period 2017 to 2018 and 2019 to 2020, respectively.

RESULTS

Seventy-five faculty were included in the analysis, with approximately two-thirds appointed on the clinical (nontenure) track. In the pre-intervention cohort (n = 59), 15 faculty (25%) had at least one publication in the period 2017 to 2018. In the postintervention cohort (n = 59), 33 faculty (56%) published at least one article in the period 2019 to 2020 (P = .001). Multivariable random-effects regression analysis confirmed that postintervention, odds of publishing in a given year increased for both clinical-track and tenure-track faculty.

CONCLUSION

Both clinical and tenure-track faculty contribute to the academic mission at medical schools, yet scholarly activity is supported and rewarded for tenure-track faculty more often than for clinical-track faculty. Our centralized research team successfully fostered scholarly activity among both clinical-track and tenure-track faculty.

A Primer for Success as an Early Career Academic Plastic Surgeon

The early career academic plastic surgeon strives to be an expert surgeon, an innovative researcher, and an impactful educator. Navigating these challenges is difficult in a healthcare landscape with diminishing public research funding, increasing demand from institutions for clinical productivity, and decreased value of surgical education. To help the junior academic plastic surgeon, this article discusses the fundamental aspects of developing an early academic plastic surgery practice, rooted in clinical care, research, and education.

Advancing our field by academically advancing pediatric rehabilitation medicine physicians

Academic promotion is desired by many faculty practicing at academic medical institutions, but the criteria for promotion often appear opaque to many physician faculty. In nearly all cases, evidence of scholarship is required regardless of academic track. Academic advancement can be stymied by unclear expectations, lack of protected time to engage in scholarly projects, insufficient evidence of dissemination, and limited guidance, mentorship and sponsorship. In addition to being important for promotion, scholarship is an essential aspect of academic medicine because it helps inform and advance the science. Pursuing academic excellence is an important goal for pediatric rehabilitation medicine faculty members because it helps advance the care of children with disabilities and the field itself. Pediatric rehabilitation medicine faculty in the clinician educator or clinician leader tracks are encouraged to understand the criteria for advancement, seek out mentorship, scholarize their career ikigai and identify opportunities to demonstrate academic excellence.

Tenure Trends in Academic Emergency Medicine Departments in U.S. Medical Schools

OBJECTIVE

The objective was to assess the long-term trends in tenure status stratified by sex and underrepresented in medicine (URM) status among emergency medicine (EM) department faculty in U.S. medical schools.

METHODS

This study used the Association of American Medical Colleges Faculty Roster to study trends in tenure status of full-time faculty from 1989 to 2018. The numbers and proportions of faculty by tenure status were studied over the years and compared across sex and URM minority status. Two-independent-sample t-test and simple linear regression were used for statistical comparisons.

RESULTS

The number of EM faculty increased from 177 in 1989 to 5,237 in 2018, with the majority of increase in nontenured (from 120 to 4,485) rather than tenured (from 24 to 198) or tenure track (from 28 to 548) faculty. The proportions of tenure-line faculty increased briefly from 1989 (29.4%) to 1994 (32.5%) and decreased since to 14.2% in 2018. The decreases were greater among men (from 34.5% to 14.9%) or non-URM (from 32.7% to 14.1%) than women (from 24.8% to 13.1%) or URM (from 30.2% to 15.3%). Compared to other academic departments, EM departments had the second lowest proportion of tenure-line faculty in 2018.

CONCLUSION

Emergency medicine faculty size increased rapidly in the past 30 years, with the vast majority of growth in nontenured faculty, regardless of sex or URM status. This highlights the need to review career development and academic promotions for EM particularly among nontenured faculty.

Scholarly productivity of faculty in primary care roles related to tenure versus non-tenure tracks

BACKGROUND

Increasing the number of primary care physicians is critical to overcoming the shortage of healthcare providers. Primary care physicians are increasingly called upon to address not only medical concerns but also behavioral health needs and social determinants of health which requires ongoing research and innovation. This paper evaluated scholarly productivity of faculty in tenure versus non-tenure tracks in primary care roles, defined as family medicine, internal medicine, internal medicine/pediatrics and pediatrics.

METHODS

The study included physician faculty in the clinical departments of Brody School of Medicine serving between the 2014-2015 and 2018-2019 academic years. Department, track, and rank at the beginning of each academic year (e.g., 2014-2015) were correlated with having any publications in the following calendar year (e.g., 2015), as determined from a search of the Scopus database.

RESULTS

A total of 1620 observations and 542 unique faculty were included in the analysis. As of 2018-2019, 19% percent of primary care faculty were either tenured or on tenure track, as compared to 41% of faculty in other departments (p < 0.001). Primary care departments were also disproportionately staffed by junior faculty (60% as compared to 48% in other departments; p = 0.087). The proportion of faculty with any publications was significantly higher for faculty on the tenure track compared to those not on the tenure track (34% vs. 14%, p < 0.001).

CONCLUSIONS

Academic productivity was lower among non-tenure-track physician faculty, as measured by publication in peer-reviewed journals. This was exacerbated among faculty in primary care departments, who were also more likely to hold non-tenure-track appointments. The loss of tenure-track positions disproportionately impacts scholarly activity in primary care and may be limiting progress in care-oriented research. Findings suggest that providing non-tenure faculty the time and resources to be involved in research, in addition to their clinical work, as well as access to research collaborators and mentors can promote scholarly activity among this group.