AAMC Reporter: February 2008

A Word from the President:
"The State of the Faculty"

At this time last year, I had just returned from the Group on Faculty Affairs (GFA) inaugural professional development conference—an event that represented an important achievement by the dedicated professionals involved in forming the group. Establishing the GFA was an expression of our growing awareness that faculty vitality and a positive institutional culture go hand in hand.

In the year since, I have given a great deal of thought to this topic, especially given the number of occasions on which faculty members have conveyed concern to me about low institutional and personal morale. Collectively, these expressions were a key driver in my decision to talk at last fall's annual meeting about the importance of culture. Without question, faculty are central to institutional culture and our ability to change that culture. What then, is the state of our faculty?

Looking at our vital signs—especially the addition of over 28,000 full-time faculty positions over the last decade—we would say the state of the faculty is strong, even robust. However, a recent analysis of long-term faculty retention data from the AAMC Faculty Roster provides some sobering information. While 10-year attrition rates have been relatively stable since the early 1980s, on average, nearly half (48 percent) of the faculty members at a given medical school in any year between 1981 and 1997 left that institution within a decade. Eight percent switched institutions, and the other 40 percent dropped out of full-time academic medicine entirely!

Unfortunately, these data cannot tell us why so many faculty members leave their institutions. Is it simply to pursue better opportunities elsewhere? Is it because they perceive their current work environment to be inhospitable? Were promises made during the hiring process, but not fulfilled after they arrived?

What we do know is that such "churn" can be costly. Studies demonstrate that turnover costs can exceed $3 million annually at an individual school. Additionally, churn can exact a considerable toll on morale. In my experience, even the perception that colleagues are leaving is unsettling to faculty. If viewed as indicating an underlying instability, it also may harm morale and eventually damage an institution's cultural fabric.

Therefore, as an important next step in promoting faculty vitality, we must go beyond our traditional tendency to think of faculty strength in quantitative terms such as overall numbers, grant dollars per investigator, or clinical earnings. It becomes critical to understand the motivations and desires of faculty members as individuals. As a starting point, we must avoid making simple assumptions about what constitutes faculty satisfaction, especially since many traditional motivators may not matter as much as commonly assumed. For example, some may expect that higher salaries are linked to higher satisfaction, yet research indicates that academic physicians and scientists value other factors more. Equally important motivators include relationships with colleagues, students, and patients; institutional commitment to core values; meaningful feedback regarding expectations and performance; and opportunities for mentoring, among others. A recent news story illustrates this point. Two highly accomplished faculty relocated to medical schools in New Orleans—not in spite of post-Katrina obstacles— but because of them and the challenge of rebuilding the city's medical infrastructure.

To help us think of faculty vitality in new ways, a new resource with great promise is undergoing early development. Working with the Collaborative on Academic Careers in Higher Education (COACHE), the AAMC recently piloted the AAMC-COACHE Medical Faculty Job Satisfaction Survey at 10 medical schools. Faculty members at these schools rated the importance of their satisfaction with factors such as institutional climate, collaboration, mentoring, governance, and clinical practice (as well as traditional drivers such as pay, benefits, and promotion policies).

The results of this pilot were quite interesting. While the survey revealed several pockets of high satisfaction, it also identified a tension between the values faculty members held important and their actual workplace experience of those values. For example, 78 percent of faculty respondents said they would again choose an academic career if asked to "do it all again," but only 65 percent reported they would do so at their current medical school.

Additionally, a tool such as the AAMC-COACHE satisfaction survey may help us address the important matter of context. While many institutions commendably conduct their own satisfaction surveys, these individual instruments cannot provide a national context for understanding what the data mean. With this in mind, the AAMCCOACHE pilot provided schools with benchmarking data for comparing their survey results to a peer group as well as to national norms. This approach will help them understand the factors that can make their institution a "great place to work," as well as the areas in which they might develop a more positive organizational culture. Over time, such data could become a key indicator of institutional progress by helping schools track important trends in faculty satisfaction.

As we move forward toward a culture that promotes greater faculty vitality, it seems that a tool such as the AAMC-COACHE program could be highly beneficial. In fact, I can visualize a future in which institutions and individuals rely as meticulously on faculty satisfaction data as they now do on faculty salary data! And while it sometimes may be disconcerting to acknowledge pockets of dissatisfaction when they exist, we must have the courage to accept what they indicate if we are to bring about real change.

So what is the state of the faculty? While it is clear much work lies ahead, I believe the state of the faculty is fundamentally strong. After all, it is the extraordinary work by our faculty colleagues that achieves the missions of our great institutions. It is therefore up to us to create exemplary work environments that truly enable faculty members to find meaning in and to be fulfilled by their work.

Darrell G. Kirch, M.D., AAMC President and CEO

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