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

Scholarly Productivity of US Medical Schools Before and During the COVID-19 Pandemic

OBJECTIVES

The coronavirus disease 2019 pandemic profoundly disrupted scientific research but was accompanied by a rapid increase in biomedical research focused on this new disease. We aimed to study how the academic productivity of US medical schools changed during the pandemic and what structural characteristics of medical schools were associated with trends in scholarly publication.

METHODS

Annual totals of publications for each US Doctor of Medicine-granting medical school were extracted for 2019 to 2021 from the Scopus database, and schools were categorized a priori as experiencing a sustained increase in publications, a transient increase in publications, or no increase in publications. Bivariate tests compared school characteristics among these three groups.

RESULTS

Of 139 Doctor of Medicine-granting medical schools, 79% experienced sustained growth in publications from 2019 to 2021, 6% experienced transient growth, and 14% experienced no growth. Sustained growth in publications was associated with being affiliated with a research-intensive university, larger faculty size, the presence of an Emergency Medicine residency, having higher baseline National Institutes of Health funding, and experiencing higher coronavirus disease 2019 infection rates in the local community during the early months of the pandemic. Among predominantly White institutions, a higher diversity of female faculty was associated with a higher likelihood of experiencing transient rather than sustained growth in publications.

CONCLUSIONS

Our results demonstrate that scientific output increased during the pandemic at most medical schools, despite significant barriers to research experienced by individual investigators. Further attention is needed to enhance equity in research opportunities, considering diverging trends in productivity between more- and less-advantaged schools, however.

Gender Differences in Research Productivity of Academic Physicians Before and During the COVID-19 Pandemic

Objective: The gendered impact of the COVID-19 on scientific productivity has been primarily studied in nonclinical academic fields. We investigated the gendered effect of the pandemic on diverse measures of research participation among physician faculty, who experienced an increase in clinical duties concomitant with pandemic-era challenges to research. Materials and Methods: Physician faculty employed in both 2019 (prepandemic) and 2021 (pandemic era) were identified at one U.S. medical school. Annual outcomes included scientific publications, Institutional Review Board (IRB)-approved protocols, and extramural funding submissions (funding data were unavailable for 2019). Mixed-effects Poisson regression models compared the pandemic impact by gender. Results: The study included 105 women and 116 men, contributing to 122 publications, 214 IRB protocols, and 99 extramural funding applications. Controlling for potential confounders such as faculty rank and track (tenure vs. nontenure), women's publication count increased by 140% during the pandemic (95% confidence interval [CI]: +40% to +310%, p = 0.001) but was unchanged among men (95% CI: -30% to +50%; p > 0.999). The number of IRB protocols decreased from 2019 to 2021, but to a greater extent among men than women. In 2021, there was no gender difference in the number of extramural funding submissions. Conclusions: Among physician faculty at our medical school, women achieved parity with men on multiple measures of scholarly activity, and women's research productivity outpaced that of men in the same faculty track and rank. Targeted initiatives to support research among women faculty, junior investigators, and clinical investigators may have helped avert exacerbation of prepandemic gender disparities in research participation.

Submit It Again! Learning From Rejected Manuscripts

Rejection of manuscripts by academic journals can be devastating for the early-career family medicine faculty members. Taking experience from teaching early-career underrepresented in medicine faculty members writing and scholarship skills, we identify and explain five lessons to be learned from rejected manuscripts. The five lessons are: (1) rejections teach journal scope, (2) rejections teach process, (3) rejection should lead to resubmission, (4) rejections reflect writing effort, and (5) rejections happen to papers, not authors. Early-career family medicine faculty can use these lessons for reassurance and to adapt behaviors to remain in the scholarship arena.

Clinician-Scientist Faculty Mentoring Program (FAME) - A New Inclusive Training Model at Penn State Increases Scholarly Productivity and Extramural Grant Funding

PURPOSE

Clinician-scientists have a high attrition rate at the junior-faculty level, before they gain independent funding. We identified the lack of skill set, clinician-scientist community and collaboration between clinician-scientists and clinicians with predominantly clinical duties, as key problems in our medium-size college of medicine.

METHODS

We designed a novel two-year educational program, the Clinician-scientist Faculty Mentoring program (FAME) specifically to target junior clinician-scientists. The program enrollment included both lab-based, "traditional" and "non-traditional" clinician-scientists, with predominantly clinical duties and limited time for research. The curriculum included the novel educational tools: Emerging technology seminars and mentored work-in-progress research seminars, integrated with mock grant review.

RESULTS

The first class enrolled 17 clinician-scientists with diverse clinical subspecialty, previous research training, and protected research time. After two years in the program, the self-assessment of FAME scholars demonstrated strong improvement in grantsmanship skills, career development, emerging technologies, and the sense of community and collaboration. Compared to the period before initiating FAME, scholars increased annual scholarly output by 65% and new extramural funding by >20-fold ($0.189 vs $4.0 million) following completion of FAME. The "traditional" clinician-scientists, who had >50% research time, increased new extramural funding by ~25-fold ($0.134 vs $3.336 million), whereas "non-traditional" clinician-scientists who had ≤50% research time increased new extramural funding by >13-fold.

CONCLUSION

Results suggest that a training program tailored specifically to clinician-scientists leads to increased scholarly productivity and grant funding regardless of research background. Implementing this type of training program nationally, with inclusion of clinician-scientists with various amounts of protected time for research, will help both "traditional" and "non-traditional" clinician-scientists to obtain a substantial independent extramural funding, fulfill their scholarly potential, and enhance their sense of community. Our model would be particularly useful for small-to-medium sized academic institutions, who have a limited clinician-scientist workforce facing competing health care system needs.

Scholarly productivity and growth of academic hospital medicine full professors

BACKGROUND

Scholarship remains the principal currency for faculty promotion in academic medicine. Reference points for scholarly growth and productivity at academic medical centers (AMCs) are lacking.

METHODS

We identified hospital medicine full professors (HMFPs) at AMCs ranked in research by US News & World Report. Scopus was used to identify each HMFP's publications, citations, and Hirsch-index (H-index). Publications; citations; and first, middle, and senior author papers were measured in 3-year intervals postresidency. Scholarly productivity was analyzed by quintile based on publications, AMC research ranking, years postresidency, and grant funding.

RESULTS

Data were extracted for 128 HMFPs from 54 AMCs. HMFPs were a mean of 20.5 (SD: 5.4) years postresidency. The median H-index was 7.0 (interquartile range [IQR]: 2.0-16.0); the median number of publications was 15.0 (IQR: 4.0-51.0). Top quintile HMFPs had a median of 175.5 (IQR: 101.5-248.0) publications, whereas fifth quintile HMFPs had a median of 0.0 (IQR: 0.0-1.0) (p < .001). HMFPs on faculty at the top 20 AMCs had a median of 35.5 (IQR: 11.0-108.0) publications, whereas HMFPs in AMCs ranked 81-122 had a median of 3.0 (IQR: 1.0-9.0) (p < .001). Grant-funded HMFPs had a median of 177.0 (IQR: 71.0-278.0) publications, while nongrant-funded HMFPs had a median of 11.0 (IQR: 3.0-25.0) (p < .001). At 3, 6, and 9 years postresidency, HMFPs had a median of 0.0 (IQR: 0.0-1.0), 1.5 (IQR: 0.0-5.0), and 3.5 (IQR: 0.0-11.0) publications. Fellowship training, additional degrees, and top 25 residency programs correlated with the top half of scholarly productivity.

CONCLUSIONS

Scholarly productivity among HMFPs varies considerably. At 3, 6, and 9 years postresidency, it is minimal to modest. Grant funding and AMC research rank may establish separate frames of reference for scholarly growth.

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.

An Approach to Faculty Development for Underrepresented Minorities in Medicine

Faculty from groups that are underrepresented in medicine encounter unique challenges to advancement within academic medicine. The authors describe a fellowship created for junior underrepresented in medicine academic faculty in Family Medicine focused on promoting writing skills and scholarship.

Supplemental digital content is available in the text.

Objectives

The diversity of the US physician workforce lags significantly behind the population, and the disparities in academic medicine are even greater, with underrepresented in medicine (URM) physicians accounting for only 6.8% of all US medical school faculty. We describe a “for URM by URM” pilot approach to faculty development for junior URM Family Medicine physicians that targets unique challenges faced by URM faculty.

Methods

A year-long fellowship was created for junior URM academic clinician faculty with funding through the Society of Teachers of Family Medicine Project Fund. Seven junior faculty applied and were accepted to participate in the fellowship, which included conference calls and an in-person workshop covering topics related to writing and career advancement.

Results

The workshop included a mix of prepared programming on how to move from idea to project to manuscript, as well as time for spontaneous mentorship and manuscript collaboration. Key themes that emerged included how to address the high cost of the minority tax, the need for individual passion as a pathway to success, and how to overcome imposter syndrome as a hindrance to writing.

Conclusions

The “for URM by URM” approach for faculty development to promote writing skills and scholarship for junior URM Family Medicine physicians can address challenges faced by URM faculty. By using a framework that includes the mentors’ lived experiences and creates a psychological safe space, we can address concerns often overlooked in traditional skills-based faculty development programs.