Back to Front PageVOLUME 6, NUMBER 4

Mature Faculty Bring Benefit of Experience to Medical Schools

By Barbara A. Gabriel

On Jan. 1, 1994, a small revolution in the battle against age discrimination was won by mature tenured faculty members in our nation's medical schools. Previously held to a mandatory retirement age of 70, faculty members were guaranteed the right to choose their own retirement dates with the enactment of an amendment to the Age Discrimination in Employment Act.

Concerned that tenured faculty members' new essential guarantee to lifetime employment would negatively affect the ability of medical schools to hire new faculty and that the quality of education would suffer as faculty members' abilities diminished with age, some academicians raised red flags about the new law's potential effects on medical education. Seven years later, however, these fears remain largely unrealized.

While the proportion of faculty members in our country's 125 medical schools over age 70 is still only 3.4 percent, their ranks have more than doubled from 1,331 individuals at the end of 1993 to 3,070 individuals at the end of 2000. And now many point to their presence as an asset to the teaching and research missions of the institutions at which they remain.

At the age of 73, Daniel D. Federman, M.D., remains active as the senior dean for alumni relations and clinical teaching and the Carl W. Walter Distinguished Professor of Medicine and Medical Education at Harvard Medical School. Before 1994, Dr. Federman says he witnessed the "wistfulness" of his colleagues as they turned the expected retirement age of 70. "There were surgeons who happily retired from operating but easily could have continued teaching," he recalls, "and many were sorry that they could not."

Dr. Federman points out that since Harvard Medical School's financing is often based on research and patient care, it is not constrained by a limited availability of university funds nor a limited number of faculty slots, allowing the school to hire new faculty when appropriate without having to wait for a "changing of the guard." He adds that Harvard confers teaching privileges on faculty members based on annual evaluations that take into account performance, program changes, and new scientific directions. "So we're not bound to let people teach," he explains.

Dr. Federman, who has served as dean for students and alumni as well as dean for medical education at Harvard, says that the extensive experience of older faculty augments their teaching skills. "I often perceive weaknesses in the younger faculty due to their very narrow or subspecialized experiences." He adds that veteran faculty bring a clinical perspective to their work that differs from that of their junior counterparts. "In the clinical faculty, I see a maturity of clinical thinking and decision-making that derives from continued active experience with patients. I see an interest in ethics, geriatrics, end-of-life care, and pain management - in other words, in a number of things that have suddenly come to be emphasized in education. Leadership in those areas quite often comes from this older group."

Arthur P. Grollman, M.D., who at age 67 is a professor of medicine and of pharmacological sciences and the Evelyn G. Glick Professor of Experimental Medicine at the State University of New York at Stony Brook School of Medicine, feels that the age discrimination that occurred with obligated retirement before 1994 persists today. "Even though the retirement age has changed, people's attitudes haven't," says Dr. Grollman. "Today there's a more subtle age discrimination. You have a particular administrative position taken away, or you may be asked to step down as the head of a program. And it seems to happen exactly at age 65 or 70."

Like Dr. Federman, Dr. Grollman says the lifting of the retirement age has not impeded the influx of "new blood" into medical school departments. "If a dean is willing to permit some flexibility in department budgets, there will never be a problem with hiring new faculty," says Dr. Grollman. He explains that deans who allow the hiring of replacements before older faculty members retire instead of steadfastly waiting for individuals to leave can retain both fresh and experienced faculty. "My observation is that rather than diminishing with age, people's abilities are actually enhanced by experience," affirms Dr. Grollman.

He adds that experienced faculty can make major contributions in administrative positions. This past March, at age 69, John E. Chapman, M.D., stepped down from his post as dean of the Vanderbilt University School of Medicine after serving in that capacity for 25 years. Now the vice chancellor for medical alumni affairs, Dr. Chapman occupies an administrative position in which he is instrumental in serving the needs of Vanderbilt medical school graduates, 70 percent of whom graduated under his deanship. "I will be making alumni integral to the school as well as making the school's performance integral to the interests of alumni," he says.

The former dean maintains that the primary result of the lifting of the retirement age on Vanderbilt's medical school has been greater flexibility. "Now the decision to retire or lessen responsibilities is based on the facts of performance rather than the chronological calendar." Dr. Chapman doesn't foresee his own retirement. "I keep telling people that the first 25 years are the hardest," he says.

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19 July 2001