Medical Education Task Force
Recommendations of the Financial Model Subcommittee
Approved by Dean Gotto, December 2007
Carol Storey-Johnson, M.D., Chair of Financial Model Subcommittee
Background and Rationale
The task of providing course leadership in the current curriculum is a complex one,
requiring personal interest and dedication, and a requisite skill set to succeed at a variety
of organizational and administrative activities. In a series of meetings with course
directors and department Chairs, as a part of both Strategic Planning III discussions and
meetings of the Student Affairs and Education Committee of the Board of Overseers, it is
generally agreed that Course Directors must spend dedicated time on the activities related
to course leadership and that the departments must ensure that this dedicated time is
supported to free the course director from other clinical or research activities. In
addition, another subcommittee of this Task Force is recognizing the importance of
appointing an Associate Course Director to assist in the leadership of each course.
The new courses added to the WCMC curriculum in 1996-1999 are structured to provide
horizontal integration of scientific disciplines and vertical integration of clinical and basic
science content. Course directors of these kinds of courses, in comparison to the former
departmentally based courses, must form productive relationships and negotiate with
many different departments and their faculty members to put into place the sessions that
the courses require. In addition, the role of clerkship directors has evolved to become
much more complex, requiring compliance with LCME standards, the use of multiformat curricular resources and multi-disciplinary formats, and the need for ongoing
curriculum review and revision. Thus, the courses in the current WCMC curriculum are
more challenging to mount and sustain over time than the courses of the past.
Currently, course directors do not participate in a system of direct compensation. They
do receive additional monies in a bonus system established in 1997 as an appreciation
gesture for their work as course director. This bonus system has inconsistencies and is
neither stable nor transparent to the faculty and department Chairs. In addition, the
assignment of associate course directors has begun only recently, and where associate
course directors currently exist, they are not compensated for their leadership activities.
Finally, faculty members who serve in leadership roles as module leaders (these
individuals sit on Course Design Groups), designing sections of the complex courses in
the curriculum, are currently not compensated for their participation.
The current bonus system should be replaced by a preset, clear compensation system that
aligns incentives appropriately to facilitate the assignment of course leadership and that
can be adjusted as needed over time. The new system should provide protected base
salary support for course leaders to free their time to discharge their leadership duties, an
administrative supplemental compensation to reward the course leaders for succeeding in
the complex tasks of course leadership, and a departmental incentive to encourage
departments to choose their faculty members for course leadership roles.
The Dean provides a central allocation of funds to each department to apply to the
support of teaching activities and related administrative services for the Weill Cornell
Medical College. These funds are thus designated for Base College Services. Until
recently, there has been no formal guidance given to departments for the use of these
funds to support the salary of course directors. These Base College Services funds
should be utilized to support appropriate percentages of a course director and associate
course director’s time to ensure that the course leadership is able to perform satisfactorily
in their roles.
Faculty members participate in a wide spectrum of activities other than teaching, usually
in research or clinical practice activities. These productive faculty members are
particularly desirable to involve in course direction since they are up to date in the newest
research and clinical knowledge base. However, the involvement of these faculty
members in course leadership has the net effect of removing them from activities that
produce revenue for the Medical College and for their department. Thus, there is an
inherent disincentive, both personally and for their departments, for productive faculty
members to lead courses. Therefore, to help counter this disincentive, course directors
who have active grants or who receive supplemental compensation for clinical activities
and the departments in which they are appointed should receive additional monies in the
new compensation system to incentivize their participation as course leaders.
It is acknowledged that there is no way to completely compensate for lost revenues in the
research and, especially, in the clinical arenas, for time that faculty members spend in
teaching and course leadership. This simply represents the cost of providing medical
student education in an academic medical center. This cost is best managed by spreading
the teaching activities as broadly over the faculty of the Medical College as is possible.
This can be accomplished by enhancing each faculty member’s expectation to contribute
to the education mission of the Medical College as an obligation of their faculty
appointment. This allows for scarce financial resources to be applied to the support of
course leadership to ensure the stability of the medical student educational program in the
future.
For the purposes of describing the recommendations from this subcommittee which
follow, the WCMC courses can be divided into the following categories: Very Large
Courses (Clerkships) which are in session 240 days per year; Large Courses which are in
session 28-76 days per year (MPS courses require full days so the number of sessions is
doubled); and Short Courses, which are in session less than 28 days. (Note: see
Administrative Supplement charts below for the courses listed in each of these
categories).
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In a series of discussions related to this Task Force and to Strategic Plan III (Education),
it was realized that in order to successfully carry out the duties of course leadership,
individuals in those roles must be freed to devote the following amounts of time to their
course leadership activities:
Clerkship Directors
Course Directors (large courses)
Associate Clerkship Directors
Course Directors (short courses)
30%
20%
20%
10%
Recommendations
On the basis of these considerations, the Financial Model subcommittee
recommends creating a system that includes: dedicated time support (based on
salary support); an administrative supplemental compensation for eligible course
and clerkship directors, associate course directors, and module leaders; and
departmental incentives according to the schedule described below.
I. Base salary support of the course leadership should be provided from the dean’s
central allocation for Base College Services according to the following scale: (Note
that these are minimums. Some course leaders may already be supported by Base
College Services funds at higher levels, which is acceptable.)
Clerkship Directors
Course Directors (large courses)
Associate Clerkship Directors
Course Directors (short courses)
Associate Course Directors (large and short courses)
20-30%
10-20%
10-20%
5-10%
5-10%
This base salary support is not additional compensation directly to the faculty
member, but is an alignment of salary funding source, from the central dean’s
allocation, to ensure that the faculty member is freed up for the appropriate
amount of time to devote to course leadership activities. Thus, each clerkship or
course director or associate course director will be informed that the appropriate
percent of their base salary is being supported by central funds so that they can
discharge their course leadership duties. It is the responsibility of the department
to ensure that this amount of time is freed up from other administrative, research,
or clinical activity.
If specific individual funding constraints prevent this alignment of allocation of
central monies to support the salary of a given course leader, an explanation must
be provided by the Chair that meets the approval of the Dean. In the case of using
alternate sources of base salary funding, the Chair must ensure that the faculty
member’s time is sufficiently free to discharge his/her course leadership activities.
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II. An Administrative Supplement will be paid annually to each eligible faculty
member who is serving as a Course Director, Associate Course Director, or Module
Leader.
In general, faculty members are eligible if:
•
•
•
The course leadership activities are successfully executed as determined by the
Dean’s Office
The time devoted to course leadership meets the pre-determined levels above
The faculty member has some minimal level of external support (research grants
or clinical activity). Exceptions may be approved by the Dean.
The Administrative Supplement is an incremental amount of compensation, over and
above the faculty members’ base salary and supplemental compensation from clinical
activities, that these designated individuals will receive annually. The eligibility of a
faculty member for this administrative supplement will be determined and approved by
the Dean.
III. Course Directors of Clerkships and Large Courses will receive an
administrative supplement comprised of the following:
•
Course Management Bonus: this is a flat rate, based on the year-long length of
the course, paid to all course directors to reflect their work in organizing the
course (recruiting faculty, preparing schedules, grading students etc) (The
Subcommittee recommends the amounts shown in the tables below)
•
Course Length Bonus: this amount is based on the length of each course, and
reflects the time spent by a course director during the academic year in which they
are occupied by course-related matters (attending more classes and course
meetings, scheduling more faculty for teaching, handling faculty and student
issues for a longer time, etc.) This is a per diem rate for the number of days the
course is in session. (The Subcommittee recommends $50/day)
IV. Course Directors of Short Courses will receive an administrative supplement
paid once yearly that is a set management fee assigned for their course. (The
Subcommittee recommends the amounts shown in the tables below)
V. Associate Course Directors will receive an Administrative Supplement paid
annually that reflects a per diem payment for the duration of their course. (The
Subcommittee recommends $25/day). In the circumstance where a course has an
associated Course Design Group, the Associate Course Director will also receive the
additional Module Leader payment.
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VI. Module leaders and Course Design Group members will also receive an
administrative supplement paid once yearly that is a set management fee for the
work that they contribute to the courses. (The Subcommittee recommends $2,000
per individual)
VII. Departments are eligible to receive an incentive payment linked to the
Course Management Bonus and the number of course directors and associate
course directors in their departments.
In general, departments are eligible if:
•
•
Base salary support of course directors and associate course directors is
consistent with the guidelines in Section I.
Course directors and associate course directors have some minimum level of
external support (research grants or clinical activity) Exceptions may be
approved by the Dean.
Department Chairs may use these monies at their discretion. (See Departmental
Incentives, below)
The level of funding for the above recommendations will be reviewed annually
and is contingent upon the availability of resources in the fiscal environment.
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Administrative Supplemental Compensation
Direct Administrative Supplement to Course Directors, Assoc. Course Directors,
and Module Leaders
A. Clerkships
Course/Clerkship
(days)
Medicine (240)
Neurology (240)
Surgery (240)
Ob-GYN (240)
Pediatrics (240)
Primary Care (240)
Psychiatry (240)
Management
$10,000
$10,000
$10,000
$10,000
$10,000
$10,000
$10,000
Per Diem
CD/ACD1
$12,000/$6,000
$12,000/$6,000
$12,000/$6,000
$12,000/$6,000
$12,000/$6,000
$12,000/$6,000
$12,000/$6,000
Subtotal
CD Total 2
ACD Total3
$22,000
$22,000
$22,000
$22,000
$22,000
$22,000
$22,000
$6,000
$6,000
$6,000
$6,000
$6,000
$6,000
$6,000
$154,000
$42,000
1. Per Diem = $50/day for Course Director (CD) and $25/day for Associate Course
Director (ACD)
2. CD Total = Management + Per Diem
3. ACD Total = Per Diem only
B. Module Leaders each receive $2000 (for approx 50 module leaders) = $100,000
C. Large Courses
Course (Days)
Management
BOD (76)
MPS I (70)
MPS III (70)
HSF (64)
MGC (64)
MPS II (60)
Pub Health (60)
BM (44)
HD (28)
$7,500
$7,500
$7,500
$7,500
$7,500
$7,500
$7,500
$7,500
$7,500
Per Diem
CD/ACD
$3,800/$1,900
$3,500/$1,750
$3,500/$1,750
$3,200/$1,600
$3,200/$1,600
$3,000/$1,500
$3,000/$1,500
$2,200/$1,100
$1,400/$700
Subtotal
CD Total 4
ACD Total5
$13,300
$13,000
$13,000
$12,700
$12,700
$12,500
$12,500
$11,700
$10,900
$3,900
$3,750
$3,750
$3,600
$3,600
$3,500
$3,500
$3,100
$2,700
$112,300
$31,400
4. CD Total = Management + Module Leader + Per Diem
5. ACD Total = Module Leader + Per Diem
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D. Short Courses (5-20 Days)
Course/Clerkship
Management
ABS
$5,000
Anesthesia I
$5,000
Anesthesia II
$5,000
Intro Clerkship
$7,500*
Med Sub I
$5,000
Ped Sub I
$5,000
CD Total 6
$5,000
$5,000
$5,000
$7,500
$5,000
$5,000
ACD Total 7
$2,500
$2,500
$2,500
$3,750
$2,500
$2,500
Subtotal
$32,500
$16,250
* Organization of interdisciplinary and allied health clinical disciplines
6. CD Total = Management
7. ACD Total = 50% of CD Total
The eligibility of Course Directors and Associate Course directors who have no
external funding (active grants and/or supplemental compensation for clinical
activity) for compensation for their work in directing courses is subject to the
Dean’s discretion after consultation with the Department Chair.
Departmental Incentives
Departmental Incentive: Linked to the Course Management Bonus and the number
of course directors and associate course directors in the department. Department
Chairs may use these monies at their discretion.
Amounts per course directors/associate course directors:
Clerkships $10,000/5,000
Large Courses $7,500/$3,750
Short Courses $5,000/$2,500
At the Dean’s discretion, these amounts may be capped or adjusted based on the
availability of institutional resources. If an individual has an appointment in more than
one department, the departments will split the money for that individual according to the
proportionate base salary funding from the departments involved.
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