To physicians and faculty members: How difficult would it be to teach without conducting research?

[nih15hopeful]

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Hello all,

The title says it. Is it possible for physicians to become faculty members and get involved in academic medicine (specifically teaching medical students, residents, fellows in the clinic and on the wards) at a major research institution without getting involved in research in any capacity? How difficult would it be to attain such a position?

Thanks!

 

[IlDestriero]

There are non research tracks available at most major institutions, but it is certainly possible that whatever department you are interested in joining does not hire many/any non research faculty.

 

[IlDestriero]

My response from an old thread-

Many medical schools, including all that I looked at for a job, and the two where I have been on the faculty, offered three distinct academic pathways. They are separate and have different promotion requirements. What they are called may differ from university to university.
1. Tenure- Essentially a serious researcher who does limited clinical work as well. Usually 75% or more protected non clinical time. These guys earn their time off by paying their salaries with grants, etc. Grant support and significant academic productivity is required for retention and promotion.
2. The academic-clinicians, primarily clinical people who have 20-50% protected nonclinical time to engage in research. ~50% of our faculty are on this path. The department supports their time off, some have small grants, a couple are significant, and some are quite successful convincing manufacturers to donate their equipment for their projects. Some get money (time) from the university or hospital to devote significant time to important committees or projects, patient safety, quality improvement, etc. Research is required for promotion and Up or Out applies.
3. The clinical-educator path. This represents a growing percentage of the appointments at the medical school. They teach residents and fellows and others rotating through the department, not usually lecturing to the medical students though. Promotion requires zero research commitment/productivity. Though many, myself included, have lectured at meetings, written chapters in textbooks, participated in clinical research, mentored fellows chart reviews, case reports, etc. The purpose of this track is to generate outstanding clinicians and superior educators for the residents and fellows. The other benefit is to have more people on the ground every day getting the clinical work done in the trenches. It also unloads some administrative burden off the research faculty. We've had the non research track for more than a decade. By report the university is very happy with it's success and the number of appointments into this track is increasing. The medical school has 3 goals. Excellence in research, education, and clinical work. The non research path recognizes that one can excel in the area of resident education and be clinically outstanding, without being a research leader. Clearly an asset to a demanding academic department. I do know that some other departments at the university do not have many/any non research track faculty. The individual department chairs have to decide what they want from their faculty, and mine places a very high value on trainee education and the reputation of it's graduates as well as clinical excellence and hires a significant amount of non research faculty. Promotion requires evidence of clinical excellence as well as higher teaching scores than the other tracks. Up or out does not apply. (here)
The reason I am in academic medicine is that I have a desire to participate in resident and fellow education, and I'm good at it. Also, I thrive on the constant supply of interesting and challenging cases available at a world class academic referral center. As an anesthesiologist, it's also fascinating to participate in cutting edge techniques that few facilities/surgeons in the world offer.
Anesthesia is a bit unique as it requires a lot of boots on the ground every day. You don't just have one call and back up person covering an entire service for a week at a time while all the other faculty have 1-2 clinic days and 3-4 research days, you need 20+ faculty every day, working the whole time. If everyone had a tenure track or 50% protected non clinical time we would have a lot of problems with the clinical load and we would make a lot less money because we would have to hire so many more faculty.

 

[candbgirl]

Thanks for that explanation. That is so cool!

 

[nih15hopeful]

@IlDestriero Great post with lots of new-to-me information. Thanks! A few more questions:

1) At what point in a physician's training do these "tracks" present themselves? Do newly trained, post-residency/fellowship physicians have the opportunity to start their careers off as physician-educators, or do physicians have to work their way up, through experience as clinicians, to these types of positions?
2) From a practical standpoint, despite that it's admittedly irrelevant to me at this point in my education, do "new" physicians ("new" if the answer to #1 is "early") apply for these positions through human resources departments of academic institutions' hospitals or is it more a word-of-mouth/connections "game," or a combination of both? I'm just curious how faculty members end up where they are, as from an undergraduate's perspective, it's all very mysterious.

 

[WingedOx]

3. The clinical-educator path. This represents a growing percentage of the appointments at the medical school. They teach residents and fellows and others rotating through the department, not usually lecturing to the medical students though. Promotion requires zero research commitment/productivity. Though many, myself included, have lectured at meetings, written chapters in textbooks, participated in clinical research, mentored fellows chart reviews, case reports, etc. The purpose of this track is to generate outstanding clinicians and superior educators for the residents and fellows. The other benefit is to have more people on the ground every day getting the clinical work done in the trenches. It also unloads some administrative burden off the research faculty. We've had the non research track for more than a decade. By report the university is very happy with it's success and the number of appointments into this track is increasing. The medical school has 3 goals. Excellence in research, education, and clinical work. The non research path recognizes that one can excel in the area of resident education and be clinically outstanding, without being a research leader. Clearly an asset to a demanding academic department. I do know that some other departments at the university do not have many/any non research track faculty. The individual department chairs have to decide what they want from their faculty, and mine places a very high value on trainee education and the reputation of it's graduates as well as clinical excellence and hires a significant amount of non research faculty. Promotion requires evidence of clinical excellence as well as higher teaching scores than the other tracks. Up or out does not apply. (here)

This is a lot of what I've seen, and what a lot of my friends doing academics are going into. Problem is, the pay at academic centers around me is way less than what you'd get at other private hospitals. Not a bad gig for a lot of people coming out of residency though, but I honestly had better job offers that still allowed me a chance at academic affiliation and to do some resident education.

 

[IlDestriero]

@IlDestriero Great post with lots of new-to-me information. Thanks! A few more questions:

1) At what point in a physician's training do these "tracks" present themselves? Do newly trained, post-fellowship physicians have the opportunity to start their careers off as educators, or do physicians have to work their way up, through experience as clinicians, to these types of positions?
2) From a practical standpoint, despite that it's admittedly irrelevant to me at this point in my education, do "new" physicians ("new" if the answer to #1 is "early") apply for these positions through human resources departments of academic institutions' hospitals or is it more a word-of-mouth/connections "game," or a combination of both? I'm just curious how faculty members end up where they are, as from an undergraduate's perspective, it's all very mysterious.

Usually you are hired into a track, though if you come in as a clinical instructor, you are technically trackless until you are promoted, at least at the places I'm familiar with. Straight out of fellowship you would likely be brought in as a clinical instructor at most places and get promoted after a year or two to an assistant professor into one of the tracks. Obviously if it was a research track, your non clinical time as an instructor would be used to find a research mentor, develop a plan, apply for starter grants, etc. If you don't make the expected progress, you would either be extended as an instructor or, more likely, passed over for promotion and let go.
Generally you apply directly to the department where you want to work, to the chairman or division chief. You may need to go through HR to process your paperwork, apply for privileges, process your paperwork for an academic appointment, etc. but they are generally not the primary contact.
As to what gets you an interview, contacts and strong LORs from known entities open a lot of doors. Many specialties are a pretty small field and people have contacts all over. It pays to go to meetings and keep in touch with your old friends and colleagues. You never know when you will need someone to put in a good word for you.

 

[nih15hopeful]

Thanks so much for the insight!

 

[IlDestriero]

This is a lot of what I've seen, and what a lot of my friends doing academics are going into. Problem is, the pay at academic centers around me is way less than what you'd get at other private hospitals. Not a bad gig for a lot of people coming out of residency though, but I honestly had better job offers that still allowed me a chance at academic affiliation and to do some resident education.

Academic income is very variable, as is what they consider full time employment.
Some academic jobs have incentive compensation that is very competitive, especially in relation to hours worked. The base salary also may increase significantly after you're board certified and promoted to Asst Professor, so the initial offer and what you make after a couple years may be very different.
If anyone has an interest in an academic career, they should call around and see what is out there. It might be very different than what your faculty are making at the other hospital across town.
We make more and work less than the affiliated adult hospital faculty.

 

[Goro]

A number of my clinical colleagues do exactly that, both MD and DO. I've seen it at a number of medical schools as well, include one particular research powerhouse.

Hello all,

The title says it. Is it possible for physicians to become faculty members and get involved in academic medicine (specifically teaching medical students, residents, fellows in the clinic and on the wards) at a major research institution without getting involved in research in any capacity? How difficult would it be to attain such a position?

Thanks!