UAMS College of Medicine
Faculty Development Report
Instructions
If your time and effort distribution contains any percentage within a specific category, fill in the corresponding sections.
The last three sections (Professional Recognition/Service Activities, Academic Citizenship, and Goals) are required.
Faculty Information
FACULTY NAME
REVIEW PERIOD (Enter date range)
DIVISION
Academic Track & Rank
FTE
VA Eighths
Total Time and Effort Distribution: Please attach your most recent FTE sheet from the FacFacts system.
Clinical Service
%
Teaching/Mentoring
%
Research/Scholarly Activity
%
Leadership/Administrative Service
%
Total
%
Clinical Service
wRVUs (RVW):
%
OR Clinical Volume (months on service, # of clinics, # of cases):
Please describe any new clinical programs or activities in the past year:
Quality Improvement Activity for Department, College of Medicine, Clinic or Hospital:
Most significant clinical contribution to the Department during last reporting period:
1
Research/Scholarly Activity
%
Published or ‘In Press’ publications: Provide the full citation for each publication.
Type
Publication Citation
Submitted Publications: Provide the full citation for each publication that has been submitted.
Type
Expected Publication Citation
Abstract Presentations/Posters: Include title, author(s), professional organization and date on which each abstract or
poster was presented.
Current Grants: Include project title, role (PI, Co-I, etc.), budget start and end dates, direct costs, agency, and percent
of your effort on the grant.
Submitted Grants: Include project title, role (PI, Co-I, etc.), date submitted, status, proposed start date, direct costs,
agency, and percent of your salary in budget.
National & Local Clinical Research Protocols: Please provide the name of each protocol, the number of patients you
enrolled in each clinical protocol, and a description of your role in each protocol.
Patents:
Date
Name
Number
Status
2
Editorial Work: Please provide journal name, your role, and the number of publications reviewed.
Study Sections: List
Most significant scholarly contribution this last reporting period:
Teaching/Mentoring
%
Didactic Teaching: Please include date, teaching format (i.e., lecture, TBL session, small group discussion, etc.), and
target audience for each of your didactic presentations. Estimate the number of learners. If you taught multiple sessions
in a course, provide the course name and then each session title. List UAMS didactic teaching first, then any didactic
teaching you provided off campus (e.g., CME activities, presentations at national professional organizations)
Teaching Evaluations: Please include evaluation of your teaching activities, and if available, comparative scores of
others who taught in the same setting/course. For example, for COM courses provide the number of sessions in which
you taught, number of evaluations submitted by the learners, your mean scores on the evaluation questions, and
departmental faculty mean scores.
Clinical Teaching: Describe clinical supervision activities for students, residents, and fellows: (type of clinical teaching
activity, estimate number of learners, total contact time for each type of activity.)
Research Teaching: Describe research supervision for students, residents, postdoctoral fellows: (type of research
supervision, number of trainees, total contact time).
3
Mentoring of junior faculty members: List your mentees. Estimate total contact time.
Curriculum Development: List your curriculum development activities and detail your role in each.
Creating/Grading Examinations: Estimate hours per year.
Most significant teaching contribution during the last reporting period:
Leadership/Administrative Service
%
Department Administrative role(s):
COM/UAMS Administrative role(s):
The Department and the College depend on faculty service and leadership on committees that govern our organization.
This service is valued within the College Promotion and Tenure Policy. It is prudent to serve on committees that most
directly impact your work. Department Chairs are often asked by the Dean to provide recommendations for
appointments to the Standing Committees of the College. (http://medicine.uams.edu/faculty/standing-committees/)
Please note any Departmental committees on which you would like to volunteer to serve.
Please note any College committees on which you would like to volunteer to serve.
4
Professional Recognition/Service Activities
Professional recognition/service activities outside of UAMS including positions in national organizations:
Describe role (e.g., member, officer, etc), awards, honors.
Community Service related to profession: Describe activities.
Most significant service contribution during the last reporting period:
Academic Citizenship
Departmental and College of Medicine Citizenship:
Enter an estimate of the number of events in each category that you attended in calendar 2011-2012.
Dean’s Distinguished Lectures (of 4 total)
Commencement, Convocation, White Coat, COM Faculty
Meetings (of 5 total)
Medical School Applicant Interview Days (of 5 total)
Departmental Seminars (% attended)
Other
Goals
What goals did you achieve this year? Explain how you did or did not meet your goals.
Goal
Outcome
Please list your goals for next year.
Goal
Expected Outcome
5
What is the most important thing the Department should do in the coming year?
Please enter any additional comments you may have.
Faculty Member’s Signature
Date
6