Academies Reward Excellence in Teaching

VOLUME 10, NUMBER 4

JORDAN J. COHEN, M.D., PRESIDENT

JANUARY 2001

Academies Reward Excellence in Teaching

Rather than just touting their commitment to teaching, Harvard Medical School and the University of California, San Francisco, School of Medicine (UCSF) are putting their money where their mouth is by creating multimillion-dollar "academies" that promote teaching excellence.

UCSF and Harvard are among a handful of medical schools that have formed educational academies - organizations that they say could transform medical education by reserving substantial funds to directly compensate faculty members for time spent teaching and a host of other initiatives designed to improve the quality of education. The two schools have each committed about $10 million to their respective academies and are tapping foundations and individual donors for additional funds.

The academies come at a time when academic physicians are increasingly worried that teaching is being lost in the shuffle as medical schools and teaching hospitals struggle to cope with decreased funding and escalating pressures to generate clinical and research revenue. "The demand for doctors to teach is increasing, but the time available for teaching keeps going down," says Lowell Tong, M.D., director of medical education in UCSF's Department of Psychiatry. "Faculty definitely feel pressed to work harder."

It's a sentiment echoed by many in academic medicine. "Doctors are feeling squeezed. We're pushed to be more productive and spend more time with revenue-generating patients," says William Shore, M.D., professor of family and community medicine and director of predoctoral education programs at UCSF. He says faculty members torn between conflicting demands are concerned that the education of tomorrow's doctors will be compromised.

David Irby, Ph.D., vice dean of education at UCSF, maintains that the wide-ranging approach of his school's "Academy of Medical Educators" is what is needed to re-emphasize the importance of teaching. "Tinkering around won't change things or further the missions of medical schools. It's time for a radical rethink, and the academy concept does just that." According to Dr. Tong, UCSF's academy not only sends a powerful message about education and teaching but is also a vehicle for faculty development and salary support.

Faculty are selected as members of UCSF's academy following an extensive application and peer-review process evaluating their leadership and mentoring roles, national recognition, and award status. Members receive protected time for teaching through endowed chairs; the school expects to create 30 chairs through the academy over the next five years. The academy also provides advocacy for promotion, faculty development, instructional improvement grants, educational seminars and retreats, and evaluates and implements curriculum reforms.

The Academy of Medical Educators is the brainchild of Daniel Lowenstein, M.D., former professor of neurology and director of the Epilepsy Research Laboratory at UCSF. "At UCSF, a task force charged with developing new approaches to medical education found that academic medical centers need to do better jobs supervising the teaching mission. We realized the problem was structural and could not be solved within the current system," explains Dr. Lowenstein, now the dean for medical education at Harvard. "By focusing solely on advancing the teaching mission, the academy is a new avenue to address education - and to change the system."

Dr. Lowenstein brought the concept with him to Harvard, which started its own program when he arrived on campus last July. Like its UCSF counterpart, the Harvard program, simply called the "Academy," aims to offset the income of teaching doctors; increase the prestige of teaching; and reward gifted, passionate teaching. "The Academy forces us to look at what it means to be an excellent teacher," he says. Initial members will be selected by an executive committee appointed by the medical school dean; thereafter, the Academy will have its own membership committee.

UCSF and Harvard are not alonein their recognition of excellence in teaching through academies. The University of Tennessee Health Science Center, for example, has established an "Academy for Distinguished Teachers," which organizes seminars and workshops on teaching effectiveness, fosters research on effective teaching, and mentors new faculty members. The program, which was established in 1999 and applies to the dentistry, medicine, allied health, and pharmacy schools, will create 12 new positions each year until reaching 36. Members, who are appointed for three-year terms, receive a $5,000 annual stipend.

In addition, the University of Illinois at Chicago College of Medicine (UIC) has established an "Academy for Excellence in Teaching," composed of faculty who have won teaching awards. The UIC academy's purposes include recognizing excellence in teaching; stimulating interest in and visibility of teaching; mentoring junior faculty; and developing a pool of knowledge, skills, and innovation in teaching.

Dr. Irby maintains that while awards and faculty development programs designed to recognize teaching are helpful, they don't go far enough. "To sustain teaching excellence, institutions require the organized structure and financial system that an academy can provide."