Update on the Silver Book &
Associated Guidelines for Promotion
Clinician Educator Pathway
November 29, 2007
Lisa Heiser,
JHSOM Assistant Dean
for Faculty Development
With appreciation to:

Estelle Gauda, MD, Chair, Associate
Professor Promotions Committee

Brooks Jackson, MD, Chair, Professorial
Promotions Committee

Laura Sterni, MD, Past-president, Medical
School Council

Pat Thomas, MD, Associate Dean for
Education
Can You Be Promoted on Clinical
Excellence Alone?


Consider Hopkin’s $3.2 billion
campaign slogan:
(What is it?)
Can You Be Promoted on Clinical
Excellence Alone?
Consider Hopkin’s campaign slogan for JHU & Johns Hopkins Medicine:
KNOWLEDGE FOR THE WORLD
Daniel Coit Gilman
Inaugurated Feb. 22, 1876
“The first president of the university formally took office and
laid out plans for a radically different educational institution.
Gilman wanted his university to do more than just teach,
more than just pass along old knowledge to the next
generation. He added a new mission: discovery, the
creation of knowledge, and the use of that knowledge for
the good of humanity. ‘What are we aiming at?’ he asked in
his inaugural speech. ‘The advancement of individual
scholars, who by their excellence will advance the sciences
they pursue, and the society where they dwell.’ That remains
the Johns Hopkins mission today, and today's Johns Hopkins
-- the first American research university -- has adopted a
simple, but powerful, restatement of Gilman's words:
‘Knowledge for the World.’ ”
Silver Book Standard for Promotion



To Assistant Professor – requires a clear
scholarly commitment and demonstrated
creative scholarly contribution.
To Associate Professor – requires national
recognition for scholarship.
To Professor – requires national
leadership and (in most cases)
international recognition for important
scholarly contributions.
Areas of Scholarship

JHSOM recognizes scholarship that
is achieved as a




Researcher
Educator
Clinician and/or
Program Builder
What is a Clinician Educator?

From Pat Thomas in “How to Get Your
Career Going as a Clinician Educator,”
October 2007:



Faculty member whose scholarship is not
dependent on research, although may do
research
<50& of salary support comes from external
funding
Consider “cE” vs “Ce”
 cE: Scholarship related to educational issues
 Ce: Scholarship related to clinical practice
Promotion to Assistant Professor

Level of achievement in Education

Creative scholarship includes:


Publication of one or more peer-reviewed, first
authored review, curriculum, or other
educational document
Participation in and/or initiation of research
that addresses educational issues and that has
led to dissemination of findings for scrutiny
and use by greater academic community
Promotion to Associate Professor

Level of achievement in Education

National recognition includes:


Development, implementation, and evaluation
of innovative educational programs with
national reputation and impact
Peer-reviewed publication of leading textbooks
or chapters in leading textbooks
Promotion to Associate Professor
continued….

Level of achievement in Education

National recognition includes:


Development and dissemination of other
educational materials (e.g. websites, course
design) identified as important through peerreview
Development of or leadership in educational
research projects that have a national
reputation and impact
Promotion to Professor

Level of achievement in Education

National leadership and international recognition
includes:



Development, implementation, and evaluation and
widespread dissemination of innovative educational
programs or educational materials (e.g. websites,
curricula) with documented national and
international impact and reputation
Publication of leading textbooks or chapters in
leading textbooks
Development, leadership, and publication of
educational research that has a national impact and
reputation
Criteria Considered for Academic
Advancement in the Silver Book

Accomplishments are organized
within six categories:






Teaching
Publications and presentations
Support for research
Recognition beyond the JHSOM
Citizenship to the University
Clinical Service
Examples of Accomplishments in Teaching
for Promotion to Associate Professor


National recognition for scholarship in teaching at the
predoctoral, doctoral, or CME level
Scholarly teaching as documented by its impact on
learners and by assessment of the teaching by
learners, peers, internal or external evaluators, and
oneself




Teaching awards from national and international
organizations
Direction and evaluation for several years of a course at
the undergraduate, graduate or CME level
Invitation to teach in hospitals, other medical schools,
programs of professional societies, CME courses
Invited educational consultation or collaboration within or
beyond JHSOM
Teaching Skills Courses
Locally:
 JHU Faculty Development Program (K.Cole)*
 Teaching
Skills
 Curriculum Development

Office of Faculty Development* (flier)
 “Speak


Like a Pro”
Homewood: Center for Educational Resources
JHU Graduate School of Education
*www.hopkinsmedicine.org/fac_development
From: Pat Thomas, “How to Get Your Career Going as a Clinician
Educator,” October 2007.
Teaching Skills Courses
Regional/National
 Evidence-based Medicine (McMasters)
 Teaching Geriatrics (UCSF)
 Healthcare Communication (Bayer Institute)
 Professional societies: Surgeons as Educators
Course (American College of Surgeons)

Harvard Macy Institute (2 week courses)
From: Pat Thomas, “How to Get Your Career Going as a Clinician
Educator,” October 2007.
Fellowship Training (cE)




Medical Education Fellowship (GIM)
Stanford Fellowship in Medical Education
Rabkin Fellowship in Medical Education
Surgical Research Education Fellowship
(American College of Surgeons)
From: Pat Thomas, “How to Get Your Career Going as a Clinician
Educator,” October 2007.
Additional Degrees (cE)


Masters in Education (M.Ed.)
Masters in Medical Education (M.Ed.)






Univ.
Univ.
Univ.
Univ.
Univ.
of
of
of
of
of
Pittsburgh
Cincinnati
Michigan
Southern California
Southern Illinois (online or residential)
Masters of Science

Masters of Science in Education with a
concentration in Technology in Education
From: Pat Thomas, “How to Get Your Career Going as a Clinician
Educator,” October 2007.
Examples of Accomplishments in Publications
for Promotion to Associate Professor


Impact of publications and role of faculty member
(e.g., as first or last author) are more important than
the number of publications.
National recognition for scholarship in education,
clinical service and/or program building through
continuing publication of:




Descriptions of and evaluation of innovative curricula
programs or teaching methods
Research that addresses educational topics
Book chapters
Continuing dissemination of clinical expertise by audio and
video learning aids and through computer-based material
Notes on Publications
From Estelle Gauda, Faculty Forum on “Promotions Process,” Spring
2007.

Substantive and continuous publication in refereed journals with
special emphasis on the quality of original contributions to the field

Role of the faculty member in the execution of the project involved in
the publications

Number of authors and the place of the faculty member among the
authors

Textbooks or monographs either as sole author or as editor

Chapters in text books

NO ABSOLUTE # of PUBLICATIONS
Medical Education Organizations
Org.
Focus
Publication
AAMC:
GEA
RIME
GSA
UME,GME,CME
Academic Medicine
ACCME
CME
ABSME
Behavioral Sciences
and Medical Education
Annals of Behavioral Science and
Medical Education
AAME
Medical Education in
Europe
Medical Teacher
NBME
Assessment
(Stemmler Fund)
From: Pat Thomas, “How to Get Your Career Going as a Clinician Educator,” October 2007.
Specialty Medical Education
Organizations
Alliance for Internal
Medicine (SGIM,ACP,
ASP,CDIM, APDIM)
Internal Medicine
Journal of General
Internal Medicine,
Annals of Internal
Medicine
Council on Medical
Student Edcuation in
Pediatrics
(COMSEP)
Pediatrics
Pediatric Educator
Association of Professors
of Gynecology and
Obstetrics
(APGO)
Obstetrics/Gyn
Women’s Health
Assoc. for Surgical
Education
Surgery
Consortium of Neurology
Clerkship Directors
(CNCD)
Neurology
Society of Teachers of
Family Medicine
Family Medicine
Ambulatory Medicine
Family Medicine
Examples of Content
Medical Education Organizations
American Medical Informatics
Association (AMIA)
Journal of the AMIA
Association for Teachers of
Preventive Medicine (ATPM)
American Journal of
Preventive Medicine
End of Life /Palliative Care
Resource Center (EPERC)
Website
International Association of
Medical Science Educators
(IAMSE)
Association for the Study of
Medical Education
Medical Education
Examples of Accomplishments in Clinical
Service for Promotion to Associate Professor

National recognition for excellence in clinical
service or clinical program building may be
reflected by:





Reputation as one of the nation’s foremost clinicians
in management of a particular disease or condition
Leadership positions in professional societies
emphasizing excellence in clinical specialties
Service as a member of or examiner for your
specialty board
Development of national or internationally
recognized standards of care
Development of a unique or essential clinical
program with national prominence
As Assistant Professor, consider these
strategies/questions:

What is my focus and area of concentration?

What are important areas for discovery and innovation that I
enjoy?


What professional organizations can I join and volunteer in
(develop regional and national reputation through
volunteering to work on annual meetings, review abstracts;
discover collaborators; provide documentation of your
leadership & eligibility for awards)?*
What suggestions do my mentors have for opportunities to
talk and teach externally (e.g., CME, Grand Rounds), and to
write in peer-reviewed national contexts?
(*AAMC, ABSME, NBME, Alliance for Internal Medicine)
Adapted from Pat Thomas, “How to Get Your Career Going as a Clinician Educator,” Oct.
2007
As Associate Professor, consider these
strategies:





Focus early in a given area and develop a body of work to
become recognized as an expert
Take the lead in developing and implementing
projects/programs and publish the results in a timely manner.
Apply for funding.
Publication of original data should take priority over
dissemination of exiting knowledge
Take advantage of scholarly and leadership opportunities at the
national/international level
Consistently involve yourself with the teaching/mentoring of
students and document those activities and student outcomes
*From Brooks Jackson, Faculty Forum on “Professorial Promotions Process,” Spring
2007.
Example: Associate Professor
Clinical research scientist /educator

Assistant Professor of Medicine- 1999


Joint appts: Departments of Health Policy Research and
Management (1999); Epidemiology (2003)
Scientific Discovery:
 Focus: health disparities research that affect the care of
individuals with severe mental illness (SMI)

Determined that individuals with SMI



have a higher burden of chronic disease (cardiovascular
disease and obesity than the general population)
Individuals with SMI have reduced level of physical
activity which is greater for those individuals who do not
have regular social contacts.
Her findings cross-disciplines: internal medicine,
psychiatry, epidemiology and health care delivery
Associate Professor, continued

Dissemination of scholarly contributions:


22 peer-reviewed publications (10/first author; Annals of Internal
Medicine, Archives of General Psychiatry, Journal of Nervous and
Mental Illness); 1 editorial and 1 book chapter)
National recognition:





Member multiple national societies.
Invited speaker- NIMH Conferences, American Psychiatric Associate
national meeting, Co-chair of Session at Society of General Internal
Medicine Annual meeting
Invited member: NIHM study sections, and ad hoc reviewerAnnie Lea Shuster Alumni Speaker ( RWJ Clinical Scholars Program)
Awards



Recognition by the Center of Excellence Steering Committee for expertise on medical and
mental health co-morbidity
PI: R01, R34 and (2 awards) National Alliance of Research on Schizophrenia and Affective
Disorders NASAD)
Ulmer Award, (Johns Hopkins) support research designed to improve the QoC for persons
with SMI
Example: Associate Professor
Career pathway: Clinician/Research/Educator
National recognition for scholarly contributions: longitudinal data
analysis – treatment options for individuals with inflammatory bowel
disease
Novel discoveries and techniques:
Immunosuppressive therapy increases the long-term outcome of
individuals with specific types of inflammatory bowel disease
Scholarly Research: 49 publications, 21 first-authored, 8 reviews; K23
Award- support Ph.D. thesis.
National Leadership: Colitis Society, Member Coordinating Center for:
Multicenter Colitis Steroid Treatment Trial, Invited speaker, CME (local and
nationally).
Education/mentoring: medical students and postdoctoral fellows
Letters: (3 inside/6 outside) “She has established herself as a distinct
clinical and methodological expert ….” “Her papers are quoted frequently
among inflammatory bowel disease specialists”
Example: Associate Professor
Michele Shermak, MD




Career Pathway: Program Builder/Educator/Clinician
Years at Rank Before Promotion:

Assistant Professor – 7.5
Accomplishments that led to Promotion:
Associate Professor:

The top accomplishment was developing a national reputation in an area of
concentration, which in my case is post-bariatric body contouring surgery

Speaking at national meetings about my technical and clinical management
of these patients

Writing a number of peer-reviewed articles looking at outcomes and patient
safety issues

Becoming increasingly involved in our national professional society, the
American Society of Plastic Surgeons (ASPS) for networking purposes, which
led to leadership opportunities on a national level

Became Chief of my Division which was the clincher
Publications at Promotion:
To Associate Professor:
24 peer-reviewed articles
12 non-peer reviewed articles
6 chapters
Faculty Characteristics of Those Promoted
to Professor in 2002-2006*
Number of:
Original Research Articles:
Mean: 61 (Range 13-148)
Original Research Articles as First or Last Author:
Mean: 34 (Range 10-86)
Book Chapters/Monographs: Mean: 11 (Range 0-53)
Books: Mean: 1 (Range 0-8)
Trainees Mentored by Faculty: Mean: 19 (Range 0-96)
*From Brooks Jackson, Faculty Forum on “Professorial Promotions Process,” Spring 2007.
Example Professor: David Kern, MD

Career Pathway: Clinician Educator

Years at Rank Before Promotion:



Accomplishments that led to Promotion:








Assistant Professor – 11
Associate Professor – 16
Director, Johns Hopkins Residency Program in General Internal Medicine
Director, Osler Center for Clinical Excellence at Johns Hopkins
Course Director of several CME Courses
Director, Division of General Internal Medicine, Johns Hopkins Bayview Medical Center
Director, Community –Based Practices, Johns Hopkins Bayview Physicians
Co-Director, Medical Education Track, GIM Fellowship Program
Co-Director, Johns Hopkins Faculty Development Program for Clinician-Educators, Director,
Program in Curriculum Development
Publications at Promotion:
27 peer-reviewed research publications
12 peer-reviewed education publications
27 book chapters
3 books/textbooks
12 extramural funding grants
Valuable Resources





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Gold Book
http://www.hopkinsmedicine.org/som/faculty/policies/goldbook/index.h
tml
Silver Book
http://www.hopkinsmedicine.org/som/faculty/policies/silverbook/Silver
Book2006.pdf
Office of Faculty Development Website, including video library of
programs & presentations
http://www.hopkinsmedicine.org/fac_development/
Associate Professor Promotions Committee Website & Estelle Gauda
http://www.hopkinsmedicine.org/dev/appc
Professorial Promotions Committee Website & Brooks Jackson
http://www.hopkinsmedicine.org/som/faculty/policies/goldbook/index.h
tml
Recently Promoted Clinician Educators