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hundreds of case-based micro-learning courses across all key radiology

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subspecialties. Today we are honored to welcome Dr.

0:39

Petra Lewis for a lecture on getting promoted as clinician educator Dr.

0:44

Petra Lewis completed her radiology residency at Dartmouth-Hitchcock Medical

0:48

Center after initial training at Guy Hospital London and Johns Hopkins.

0:53

She's a women's imager,

0:54

but is primarily known as an educator both nationally and internationally.

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She has a strong interest in faculty development. At the end of the lecture,

1:02

please join Dr.

1:03

Lewis in a q and a session where she will address questions you may have on

1:07

today's topic.

1:08

Please remember to use the q and a feature to submit your questions so we can

1:11

get to as many as we can before our time is up. With that,

1:14

we are ready to begin today's lecture. Dr. Lewis, please take it from here.

1:19

Hello everyone. Thanks for joining us with this topic, which is, um,

1:22

something I'm super interested in. As you'll see,

1:25

I'm gonna turn my video off now because I can't stand seeing myself talk.

1:29

And uh, I just wanted you to just put a face to the voice as such.

1:33

So getting promoted as a clinician educator,

1:36

one of my creds for giving this talk. Um, I was part of the, uh,

1:41

Geisel Dartmouth, um, a p t committee for a couple of years, um,

1:46

before I had to give it up 'cause of other commitments.

1:49

And I'm also chair of our department promotions committee and I have lectured on

1:53

this, um, nationally. So, you know, first of all,

1:57

why do you want to be promoted? Well, you know,

2:00

I think the sense of personal achievement to be recognized,

2:04

all the work you've done is not to be underestimated.

2:08

It does give you more national standing with national organizations.

2:13

And, you know, really it,

2:15

it is sort of part of the expectations of being in academic practice rather than

2:19

in private practice is that you do ascend the promotion ladder.

2:23

It can also help you getting funding at national levels.

2:26

There are many grants that are not available for assistant professors and need

2:29

you to be at least an associate professor. And when you move to another job,

2:34

if you have already been promoted to a higher rank, you will often come in at,

2:38

you know, significantly higher pay. Um, so that can obviously be an advantage.

2:44

Now talking about pay, there are certain, um,

2:47

institutions where as you get promoted you do get paid more money. Um,

2:51

that unfortunately does not happen at my particular institution,

2:54

but certainly can be something that's helpful with some others.

2:58

And then there are some institutions where when you re uh,

3:01

particularly when you reach the rank of full professor that you get better

3:05

benefits. Perhaps you get more c m e time,

3:07

you may get more c m e money or for me, what would be the greatest attraction?

3:11

And unfortunately also it doesn't happen here is not having to do call anymore.

3:16

Um, there are some clinician educator, um,

3:22

tracks in some institutions that are tenured,

3:25

but the vast majority are not tenured.

3:27

So this is obviously something that if you are on a tenured track, um,

3:31

as an MD can be an advantage for your future career.

3:36

While many institutions don't insist on promotion,

3:41

there are institutions where it is an up or out and you are expected to

3:46

achieve at at least associate professor,

3:49

if not full professor within a certain time period. Or you may either, um,

3:54

be after usually some leeway in terms of years,

3:59

uh, be asked to leave or more likely move to a clinical track from a regular

4:04

academic track. Um, changing tracks is,

4:09

um, usually doesn't have impact on your monetary benefits.

4:14

Um, it can have some impact on your, you know,

4:17

status as an accommodation. And then you do get to change your cards.

4:22

I have to say that it was like five years after, um,

4:25

I got made full professor before they ever changed my cards 'cause I had so many

4:28

to use up.

4:30

But why might you want to not consider getting promoted?

4:34

'cause this is a bit of a, you know, double-edged sword. You know,

4:37

it's a lot of work.

4:38

It's a lot of work to have all the scholarly productivity that you need to be

4:43

in a position to be able to be promoted.

4:45

And that may not be something that fits with your, um,

4:48

your lifestyle or your family commitments. It's also, uh,

4:52

not insignificant amount of work. The promotion process itself,

4:56

it requires you spending a lot of time getting your CV in a order, helping,

5:01

uh, collecting evaluations and such. Like we talk about writing a, um,

5:06

a, uh, career summary or personal statement type letters. So, you know,

5:11

it's quite a bit of work. So you may decide that this is not something you want.

5:15

And we certainly have many people in my department who have remained an

5:20

assistant professor, um, through their entire academic careers. And,

5:23

and that's okay in my particular department, but it might not be on k on yours.

5:27

So you need to know, um, what your institutional standards are. Um,

5:32

you know, I personally think it's just part of the long journey as an academic

5:37

radiologist to, you know,

5:38

work towards promotion and hopefully achieve that goal. Um,

5:43

this is our, um,

5:46

academic promotions and titles criteria at our Geisel School of Medicine at

5:50

Dartmouth.

5:50

And while there are many commonalities between the different promotion criteria

5:55

at the different departments, they do vary some.

5:57

And it is really important that pretty early in your career, um,

6:02

that you find what the criteria are at your institution.

6:06

I do quite a lot of, um, uh, letters of support for, um,

6:12

of folks who are going up promotion from outside institutions.

6:15

And I've really found that there is fair significant variation between the two.

6:20

So download and find out what yours are. Um, unfortunately our criteria,

6:24

and you may find yours also, um,

6:27

are quite long and quite complicated to try and decode. Um,

6:32

so if they have a shortened pricey version, I would seek that out.

6:37

So there are gonna be different tracks at different institutions and, and,

6:41

and commonly they're called something like clinician educator, um, or, you know,

6:46

educated clinician or, or some variation of that. Um,

6:49

clinician investigator tend to be ones that have more of a focus on

6:55

research, investigator educator,

6:57

often people who are doing educational research. Um,

7:00

and then investigator or research tracks. There's gonna be some, uh,

7:05

combination of these.

7:06

So check out what tracks you have at your institution and then whether they're

7:09

tenured versus non-tenured. As I said,

7:12

the majority of at least MD radiologists are gonna be in non-tenured tracks.

7:18

And then as I'm sure you're very well aware, the ranks, uh,

7:21

academic ranks range from instructor through assistant professor to associate

7:24

professor, and then finally to full professor with or without tenure.

7:31

Many institutions, including my own, have what I alluded to before,

7:35

and that's these clinical prefects ranks and they're,

7:38

they're kind of considered as sort of a, a, a lesser academic rank.

7:43

Does it make much difference to you? Really? Um, not a whole lot.

7:48

But if you are, for example,

7:50

a clinical associate professor at one institution and you move to another

7:55

institution that doesn't have clinical ranks,

7:57

they may not keep you an associate professor,

8:00

you may get kind of downgraded to assistant professor.

8:05

And this is really important. Time at rank is not enough. I just had, um,

8:11

uh, one of my faculty here sort of say, oh, well, you know,

8:13

I've been assistant professor for the last seven years,

8:16

it's time I was promoted. But you know,

8:18

unfortunately he had very little scholarly activity that he'd actually done in

8:22

that seven years.

8:23

So you have to document scholarly activity and we're gonna be talking at length

8:26

about what that is. So,

8:29

scholarly activity can be in different realms. It can be in the teaching area,

8:35

investigation or research area.

8:37

It can be patient care and then it can be what's commonly called engagement or

8:41

service. And these are overlapping,

8:44

so they're not completely distinct categories.

8:47

So you can have have research engagement for example,

8:50

or clinical research and so on. So they're not entirely discreet packages.

8:54

And sometimes you are a little sure where to document in, you know,

8:58

whether you document something as education or engagement for examples we'll

9:02

talk about in a minute. But very broadly speaking,

9:05

scholarly activity is the creation and the dissemination of new knowledge.

9:11

And so this has gotta be stuff that's new. It's gotta be created by you,

9:16

you've gotta disseminate to others, and it's gotta further medical knowledge.

9:19

And that is scholarly activity.

9:23

The impact of scholarly activity depends on how far it gets disseminated and

9:28

you get kind of, you know, more brownie points as we'd say in England,

9:31

just spend depending on how far things disseminated.

9:34

So the impacts can be much greater if you are disseminating your

9:39

scholarly activity nationally or internationally than just in,

9:42

in your institutional regionally.

9:45

How long in a rank before promotion? Most institutions,

9:49

it's around five or six years minimum before you can be promoted

9:54

unless under exceptional circumstances in somebody who's incredibly prolific

10:00

and in some, but not all institutions,

10:02

you have to document continued academic activities to stay at your rank.

10:09

Now just talking very, very broad terms,

10:11

kind of 50,000 foot view here.

10:14

To be promoted to an associate professor from assistant, um,

10:19

clinician educator,

10:20

you have to demonstrate excellence in teaching any level learners engagement,

10:25

local or extramural clinical care scholarship.

10:31

And we're gonna go into all of these in different areas and,

10:33

and that you are having regional recognition with a burgeoning national

10:37

recognition. And that's important to be promoted to full professor,

10:42

clinician educator.

10:43

The same criteria applies apart from instead of just

10:48

regional recognition,

10:49

you should have national recognition with burgeoning international recognition.

10:55

And it really takes a long time to develop your portfolio.

10:59

So you don't wanna get kind of five years into, um, your,

11:04

your standing at an institution at a particular rank and then say, okay,

11:08

you know, ooh, five years is up,

11:10

I need to start doing something because it's gonna be really difficult to kind

11:13

of play catch up within a year.

11:16

Now that doesn't mean that if you have a a, you know, many people have a,

11:20

a significant period of time, you know,

11:23

several years where they are, um, not very productive academically.

11:28

It could be because of clinical demands in your department.

11:31

It may be because of family, um, or health circumstances.

11:36

And certainly we've had many people in our department go part-time for several

11:40

years when their kids are young, for example.

11:42

And that doesn't mean you can't catch up, you absolutely can,

11:45

but it's obviously gonna take you longer.

11:47

And promotions committees do take that into account. Alright,

11:51

so let's talk more about what scholarly activity is in the different domains.

11:56

So let's start with research. So research or investigation,

12:01

it may be individual research or it may be team-based. And, um,

12:06

promotions committees are, um,

12:08

more and more recognizing team-based science. Um,

12:13

but you can't just be a cog in a wheel. I mean there, you know,

12:16

I'm sure you've all seen team-based papers out there that perhaps have 20

12:21

or 30 different authors, often just listed alphabetically. Um,

12:25

but you have to show that you have contributed to that paper. So you know,

12:29

you have to be able to prove that you contributed to the body of evidence

12:34

in some way. Um, your research can be lab-based, it can be clinical,

12:39

it can be in education, it can be population-based.

12:44

Now what about grants? Grants obviously count, uh,

12:47

and there is kind some kind of, you know, pre, uh,

12:51

prestige ranking in grants,

12:52

as there are many of these things I'm going to talk about.

12:55

So extramural grants sort of rank more favorably than internal grants.

13:00

Governmental more than industrial or societal grants,

13:05

the total amount of funding, um, they don't, you know,

13:09

most a p t committees don't sit and kind of add up the amount of funding.

13:13

However,

13:13

larger grants do show that you have a much greater reputation

13:18

on a national, international basis for these larger grants.

13:21

And you have very small grants. Um, they do,

13:24

particularly the total funding really only counts if you're the PI or the co-pi.

13:29

If you were, uh,

13:30

an investigator or co-investigator on a large grant and you're only got,

13:35

you know,

13:35

say 0.05 F T e funding or perhaps no f d e funding

13:40

from it, then that doesn't really matter. Um,

13:43

whether you are a principal investigator versus a co-principal versus a

13:48

co-investigator, again,

13:50

the level of prestige and impact that's associated with the having that grant

13:54

will vary. Research innovation can count significantly.

13:59

So if you've had a patent or some other kind of invention or other type of

14:03

entrepreneurial, um, activity,

14:06

this should all be collated on your CV Journal.

14:10

Publications obviously count significantly. Um,

14:14

peer reviewed are going to count more than non-peer reviewed towards the total

14:18

body of your scholarly activity papers more than abstracts or

14:23

electronic exhibits. Generally speaking,

14:25

electronic exhibits seem to count a little bit more than abstracts and ones that

14:29

orally presented tend to count a little bit more than posters, but it is,

14:33

it is not a hard science in that way.

14:36

Original research is more significant than an editorial or review article.

14:41

And books more than chapters, generally speaking,

14:44

books and chapters rank significantly less in peer reviewed publications in my

14:48

experience. Now, there are some institutions, um,

14:53

which we'll want you to report the impact factor or the H factor we'll talk

14:57

about in a minute of your, um, of your journal article. Um,

15:03

you know,

15:03

obviously you publish a first author paper in nature is going to count a lot

15:08

more than a first author paper in say, clinical radiology,

15:11

which has a much lower impact factor. Um,

15:15

and generally speaking, paper journals, um,

15:19

are considered higher than online journals, but that is variable.

15:24

And there's some online only journals that is,

15:26

and there's some excellent online journals, um, out there. Generally speaking,

15:32

the online journals that you pay them to publish, um,

15:37

are not considered that significant by most a p t committees.

15:43

So do numbers count? Well, they do. Um,

15:47

I've yet to see, uh,

15:49

the criteria from a promotions committee come out and give you a

15:54

hard number. Um,

15:57

and this is because both quality and quantity count in terms of publications.

16:01

So, um, I've never seen one say, okay,

16:04

we expect a minimum of seven publications for somebody to be promoted to

16:09

an associate professor and three of them should be first author, et cetera.

16:12

They never do. But there's no question that the number does count. Um,

16:17

generally speaking, being first author, um, and last author,

16:22

which is usually counted as being senior author, um,

16:25

is more prestigious than being sort of, and also ran, um, you know,

16:30

second being better than third, fourth or fifth and so on. Um,

16:33

but as I said before, team science is recognized,

16:37

but you need to show how you contributed to that team science project.

16:41

And as I said,

16:43

both the quality of what you publish and the quantity of what you publish

16:48

counts. And sometimes the, this has been referred to as the Goldilocks analogy.

16:53

Um, if you have too few publications,

16:57

even if individually they're high impact, that can be counted as,

17:02

as somewhat marginal productivity. Um,

17:05

but if you have a very large number of very questionable significance, um,

17:10

papers, perhaps as a sort of also ran author or in very, um,

17:15

lesser ranked low impact fact to journals, that's sort of,

17:19

they count it as salami science. It's sometimes called, in other words,

17:22

you're sort of publishing a little bit here and a little bit there,

17:25

and you've sort of taken the same dataset and sliced it up, um,

17:30

multiple different ways.

17:31

And so you need to have some kind of balance here between quantity and quality.

17:35

Um, just to talk a little bit about the H factor, again,

17:39

this is used by some institutions, not by others. Um,

17:44

my institution doesn't use it, um, but I know that, um, many that do.

17:49

And so the H index is an author level metric as opposed,

17:54

uh, to the impact factor, which is a journal level metric.

17:58

And it includes your productivity in terms of the number of papers you have

18:03

and the citation impact of those papers. So in other words,

18:08

how often they've been cited. Um, and it comes up with a number. So for example,

18:13

last time I looked, my, my H index was 20, which is,

18:17

is actually not too bad for somebody like me who doesn't really do research per

18:21

se, although I do publish. Um,

18:25

there are kind of a range of thresholds depending on the track

18:29

you are on with clinician educator.

18:32

Usually people have lower expectations of an in H index than, um,

18:36

a research track. Um, and the rank, if you want to know where your H index is,

18:42

Google Scholar will calculate it for you.

18:44

You can go into it or the web of science, both, which, uh,

18:47

you should be able to freely access through your institutions and you can look

18:50

out there and there,

18:51

there's stuff out there that gives you an idea of what the average is for your

18:55

rank and track. Alright, let's move on to talking about education.

19:00

Seeing as, you know,

19:00

this is clinician educator and so education is going to be a huge, um,

19:06

part of our portfolios.

19:08

And there are many different ways that our teaching, um,

19:12

can be documented as scholarly activity.

19:16

So teaching formal courses at any level, so undergraduate levels, students,

19:21

residents, fellows, G M E,

19:24

PhD candidates and so on.

19:26

And I'm gonna talk more about how these should be documented in a bit,

19:29

but also your teaching at the bedside, or in our case sort of, you know,

19:33

the PAC side, uh, teaching, um, is important. Um,

19:38

we do,

19:39

we ask our faculty to kind of estimate the amount of hours they spend with a

19:44

resident or fellows, uh, teaching. It's,

19:47

it's usually for full-time faculty person,

19:50

it's well over a thousand hours a year if you are an invited speaker,

19:55

uh,

19:55

either as a visiting professor to an institution or in a C M E course or

20:00

societal courses. These are all important.

20:03

Visiting professors tend to sort of count the highest or the most

20:07

prestigious. Um, but the others are also extremely important,

20:10

particularly if they're national, international courses. Now,

20:15

it's super important,

20:16

and you'll see I say this often that you document this.

20:21

Um, you know, I came to go up for associate professor when I already had,

20:26

you know, 10 years of teaching behind me. I was a bit of a,

20:31

i I did stuff in England and I came back and did stuff in America. So, um,

20:35

I had, I had a long history there and I hadn't documented this.

20:38

And it is super tough to remember who you taught and when

20:43

and when you gave lectures,

20:45

I'm sure that I missed tons out because I just couldn't remember them.

20:49

So we need to, you need to record, you know, what did you teach?

20:52

Who did you teach it to? How much was this a, you know,

20:55

one hour workshop or a 15 minute presentation or two hour workshop?

20:59

What kind of format was this? Was it interactive, didactic workshop, et cetera?

21:04

And then record evaluations, which again, I'm gonna talk about further.

21:10

Curricular development is very important as a scholarly activity for educators.

21:15

And again, if you develop national curricular,

21:18

that's going to be more important 'cause it's widely disseminated.

21:21

Bigger impact, remember more than institutional or departmental curricular,

21:27

but you need to be able to document use. So again, that's that impact. So,

21:32

you know,

21:32

you develop a curricular that has been distributed and you know it's used by,

21:37

you know, five other institutions as well as your own, then that is huge.

21:41

Obviously this is really difficult information to get hold of. So, you know,

21:46

sometimes you couldn't get hold of, uh, downloads, um,

21:50

from a website that you've got something at. You can document that. You know,

21:54

this has now been the, uh,

21:56

departmental criteria for body CT for residents.

21:59

It's been used for the last five years. But, you know, accurate figures,

22:03

particularly when things have been nationally, internationally distributed,

22:06

are often tough to come by. Now,

22:10

we produce a lot of educational materials and we produce these in different

22:14

forms. So obviously there is, you know, the regular publications, books,

22:17

chapters, guidelines, educational research of course is covered, um,

22:22

uh, in the research section I just talked about. But, you know,

22:27

frequently now our educational materials have become digital. Um,

22:31

so they either, they may be online modules, they may be videos on YouTube,

22:35

they may be virtual patients, webpage blogs, et cetera.

22:39

But these all count. And, um, more and more a p t committees. In fact,

22:44

you know,

22:45

I would say the majority that at least I've seen things on are beginning to, um,

22:50

be open to these nonstandard peer reviewed

22:55

formats as evidence of scholarly activity, particularly for clinician educator.

23:02

You may be developing assessment mi uh, materials. These may be, um,

23:06

assessment criteria for, say, evaluating how somebody, uh,

23:11

does a procedure in, um, interventional radiology. Um,

23:16

or you may be developing multiple choice questions for one of a variety of

23:20

different, uh, exam question banks,

23:22

either local ones or the many national ones are now available for radiology.

23:28

Again, peer reviewed is going to be more, um,

23:32

have more kudos than non-peer reviewed. So for example, if you contribute,

23:38

um, multiple choice questions to the American Board of Radiology,

23:42

um, if you work on one of their committees, or if you submit them to RAD Exam,

23:47

which I'm chief editor for or to a c r Dixie,

23:51

those are all peer reviewed and they count as being significant. What again,

23:56

is important for your educational materials is you're wanting to show impact.

24:00

You know, we can all develop a lot of stuff, but it's,

24:02

if it's kind of sitting in our drawer and nobody's using it, um, then that,

24:07

you know, that that is not real. Scholarship.

24:09

Scholarship has to be disseminated, remember. So how can you show use? Well,

24:14

you know,

24:14

it can be as simple as downloads or accesses the number of people who viewed

24:19

your videos online. Um, institute,

24:23

other institutions have adopted use of something you've developed.

24:27

The number of exams been deployed, um, you know, and,

24:30

and a lot of these numbers are available. So, you know, for example, I can,

24:35

you know, somebody was producing questions for RAD exam.

24:37

I can tell them how many of their questions have been used in exams and how many

24:41

times those exams have been taken by residents. And so that these,

24:45

that is really nice, hard data.

24:49

There is a section on, um, cvs, um, for mentorship.

24:54

And mentorship is counted as, as part of education. It's really important.

24:59

Part of our role as clinician educators is to mentor others. Um,

25:03

the mentoring can be on many levels. You can mentor students or residents,

25:07

fellows. Um, you can also mentor junior faculty. Um,

25:12

and, but what is important is that you document true mentoring

25:17

relationships. Um,

25:19

I recently did a review letter for somebody who had this massive list

25:24

of, um, mentees where they'd have 20 a year. Well,

25:28

you can't really mentor 20, um, mentees. I mean,

25:32

if you are a program director,

25:34

I realize that you effectively mentor every single one of your

25:39

residents to some degree, but you can't list, you know,

25:42

40 residents a year that you've been mentoring. Um,

25:46

that's not what they really want here. What they really want,

25:49

a true long-term mentoring relationships. You meet with people, um, many times.

25:54

And what you need to be able to do is show the positive outcome of your

25:57

mentorship. So perhaps the, it was a research type mentorship and you,

26:03

um, had a publication that learner had a publication from it,

26:06

or an abstract presentation.

26:07

Perhaps you've mentored them into following your career path into a

26:12

subspecialty. So you can't just have a straight list of mentees.

26:17

They want to know, okay, but what came out of this mentorship?

26:21

And so that's something that you're gonna have to document, alright,

26:25

evaluations. So evaluations are probably, you know, one of the toughest things,

26:30

um,

26:31

for us to collate and document as a promotions committee to try and, um,

26:36

put it somebody's portfolio together. Um, usually when I say, okay,

26:40

send me all the evaluations that, um,

26:43

for medical students and residents you have, and they say, oh,

26:46

well don't you keep those for me. Well, no, we don't. Um,

26:50

so you need to keep your evaluations.

26:53

So evaluations can be from any learner groups,

26:56

and this include the evaluations and the medical students of your teaching,

27:01

the residents of your teaching. Um,

27:04

the feedback from the talk that you gave R S N A and so on.

27:09

They can be both quantitative and qualitative. Some, um,

27:15

promotions,

27:15

committees want documentation of a lot of qualitative information and others

27:20

don't. Um, but keep it nice to have numbers,

27:25

but nice to have some of those comments as well. Generally speaking,

27:28

when you submit evaluations,

27:29

they're only gonna be probably interested in like the last five years or three

27:33

to five years.

27:34

They don't really want evaluations of what you were as a teacher 10 years ago

27:37

because you'll have changed. So keep your evaluations if you,

27:42

as soon as you get sent them, you get emailed them. Just have a folder,

27:45

put them in because you will be asked for them. Let's move on to clinical,

27:52

clinical. Your promotion as a clinician,

27:55

educator is nothing to do with rvu. Um,

27:59

don't forget that promotion is from the medical school or the

28:03

university. It's not from the hospital. Now, you know,

28:07

they can be one and the same in some institutions,

28:11

but RVU don't count. Um, for example, you know,

28:14

Dartmouth-Hitchcock Medical Center is my hospital I work at,

28:17

that's where I generate my rvu.

28:19

But Geisel Medical School at Dartmouth is not interested in that.

28:24

But they are interested in some facets of clinical, um,

28:27

care because we are clinician educators.

28:30

So developing institutional programs, for example,

28:33

so perhaps you are the one who brought abbreviated breast m r i to the

28:38

institution, and you built that from zero to, you know,

28:41

X hundred patients a year. You develop some kind of a new, um,

28:45

spine imaging program working with a spine center and so on.

28:50

If you can show regional engagement or reputation,

28:53

either perhaps you've developed, um, a regional program,

28:57

you've developed protocols that are used clinically, um, within the region,

29:02

um,

29:02

you can show that you are specifically referred patients in by, um,

29:08

surrounding, um, clinicians. For example,

29:11

national reputation of clinical is really going to come when you start to be an

29:16

invited speaker in that clinical topic. Um,

29:21

as a member of national organizations, particularly if it, uh,

29:25

a more senior role on a committee and then even being part of a governmental

29:29

committee or something like an a c r committee that is developing new guidelines

29:33

in the clinical area.

29:37

Let's move on now to engagement. Um,

29:41

so engagement or service, all kind of the same thing here.

29:45

And engagement can be in any of the areas I've talked about.

29:49

So you can have clinical engagement, research engagement,

29:53

educational engagement and so on.

29:57

Like everything else, it depends on impact of your engagement.

30:01

So national engagement more than regional institution.

30:04

Being a national society membership sort of says a

30:09

little bit, but not very much. So, you know,

30:11

somebody with a big long string of national society memberships is not going to

30:16

necessarily be considered any higher than somebody who has three or four.

30:20

If you don't have any in your subspecialty, however,

30:22

that might look a little bit odd. Committee membership, again,

30:28

national committee membership,

30:30

more impactful and regional institutional departmental.

30:32

And the higher the role you have,

30:35

the more active role you have within that committee,

30:38

being a chair or an officer, for example, rather than the member, um,

30:42

is more impactful for your total portfolio. One of the things that's important,

30:47

and really this is something you end up, um,

30:49

often putting into your personal statement, your career statement,

30:53

is you need to describe the product of that committee.

30:57

So just saying that you were a, um, member of the,

31:02

um,

31:03

say educational committee for AMSA doesn't really say anything about what you

31:08

did or what that committee does. And of course, you know, program, um,

31:12

a P t committees are not necessarily within your specialty.

31:17

So they don't know anything about what AMSA is and what AMSA does.

31:20

You are gonna have to describe that that committee is responsible for

31:24

developing, you know, these resources. And you, um,

31:28

had a, you know, major part in it,

31:31

or this committee developed the new guidelines, um,

31:34

that have defined how some clinical services run and so on.

31:40

You can have engagement in research by being part of a study section

31:45

or a panel being a grant reviewer, being a journal reviewer,

31:49

or more importantly, being a journal editor.

31:53

So talking about journal reviews, um, editor,

31:55

if you are a member of an editorial board that is recognized as being a very

32:00

significant academic role in the sort of research service arena.

32:06

Um, if you are a journal reviewer,

32:09

it's important to note whether it's your standing reviewer.

32:12

You are an ad hoc reviewer and you may want to consider, um,

32:15

giving an estimate of the number of reviews you do a year. You know,

32:19

if you only do one review a year as opposed to 20 reviews a year,

32:22

there's obviously a significant difference.

32:26

Here's some examples of educational engagement.

32:31

You may be part of educational related committees,

32:33

and I'm gonna describe these a little bit more,

32:35

or do educational administration.

32:38

So perhaps you are the education director for, um,

32:41

body imaging or the residency director or associate or assistant director.

32:47

You may be a program chair for a conference or you may be a national

32:52

examiner or examine, uh, developer for American Board of Radiology,

32:57

for example.

33:00

Administrative engagement can be at any level,

33:04

and I'll give you some examples in a minute. Um, national, regional, med school,

33:09

hospital, departmental, we all have these administrative roles that we, um,

33:14

carry and there are many,

33:16

many opportunities nationally to get involved with committees. Um,

33:20

and I'll talk a bit about how you can get involved with them in a minute. So do,

33:24

you know, look out and see if you can find some of these national roles to help.

33:29

So here's some examples of institutional engagement.

33:33

Perhaps you're on a search committee looking for a new, um,

33:38

faculty within the department, or more prestigious, uh,

33:42

chair search committee for another department. You can be a program director,

33:46

associate assistant. There are a number of, um,

33:50

resident education committees such as the program education committee or the

33:55

clinical competency committee that you can be part of.

33:59

You may be the medical director for a regional institution or a section director

34:04

in an academic institution. Um, and there are, uh,

34:07

usually a number of different vice chair roles, uh,

34:10

which count as institutional engagements such as, um, vice chair of education,

34:15

which I am vice chair of research and so on. Um,

34:20

to get involved with these efforts, you really do have to put yourself forward.

34:24

Um, don't rely that somebody's gonna come and, you know,

34:27

reach out to you and say, Hey,

34:28

would you like to be on so and so National Committee? Um,

34:33

that's often not gonna happen. Um, networking is key.

34:37

So, you know, this is, uh, Dr. Chertoff and, um, networking,

34:42

um, at one of the AORs over at Gen and Tonic as we all do.

34:46

So take advantage of your national conferences to network. You know,

34:51

the social occasions are really great for this to be able to, you know,

34:55

talk to people, find out what they do, and just put yourself forward. So say,

34:59

you know, oh wow, that's something, something I'll be really interested in.

35:01

You know, do you have any, um, are you recruiting people to that committee?

35:05

Many of the national organizations like, um, A P D R and a bunch of, um,

35:11

the, um, uh, alliances of a u r,

35:15

like AMSA and AA have signups. You can sign up for committee and get involved.

35:20

Um, use your contacts so you can use your contacts to be able to be a visiting

35:25

professor. We have people reach out here and, you know,

35:27

I really admire the fact that they, you know, drop an email and say, Hey,

35:30

you know, I'm gonna be in your area, um, on, you know, so-and-so date.

35:34

And I just wonder whether you'd be interested in me being a,

35:37

a visiting professor and giving your residents a talk. And, you know, it's like,

35:42

to most institutions, that's great. You have somebody come in,

35:45

they give a great talk to your residents. Um,

35:47

usually in those circumstances we don't pay them anything because they're, um,

35:51

kind of inviting themselves, but they still get to put it on their cvs.

35:55

A visiting professor. Um, they can write off the, uh,

35:59

trip often against their tags. So sort of double whammy there. Um,

36:04

c m E talks, find out who, um, in your department is,

36:09

um,

36:10

part of leadership at some of the national organizations and reach out to them,

36:15

um, and put your,

36:17

send an email to the program chair of upcoming, um,

36:23

national conferences and say you're really interested in giving a talk,

36:26

but don't just say, I'm really interested in giving a talk it,

36:30

but give some examples of, I have some, you know, great talks on so and so,

36:35

um, that you might be interested in. I mean, program chairs,

36:38

being a program chair is a really tough job at trying to recruit new talent,

36:42

recruit new talks, get, you know, new ideas. So don't just say, Hey,

36:46

I'd love to give a talk, but say, I'd love to give a talk on so and so-And-so,

36:52

same again with being a moderator at a meeting. Um, you know,

36:56

reach out to people,

36:58

check somebody in your institution or your department is going to be

37:03

in with, you know, the, the programming crowd at that,

37:07

that at the R S N A or a C r or any of the subspecialty organizations. Um,

37:11

you'll be surprised. People will take you up, journal reviewer,

37:15

write to the editor, say that you're interested committee membership,

37:19

write to the chair of the committees,

37:21

all these things are online and say you're really interested in part of this

37:24

committee. And would they consider you for a post? They might not be this year.

37:27

Maybe it'll be a following year. Um,

37:29

the A B R often recruits for volunteers for part of their exam writing

37:34

committee. Again,

37:35

that's national peer reviewed scholarly activity is considered very prestigious.

37:41

All right,

37:42

now what about coating all the information that we've been talking about?

37:47

This is so important. I know I've already said it, um,

37:50

in reference to evaluations,

37:52

but you need to keep track of what you are doing.

37:56

It is so tough to do it years and years out,

37:59

and it's so much easier to do it as you go along.

38:02

There's a lot of things to track. You know,

38:05

here are educational efforts that you need to track your lectures,

38:09

your valuations, visiting lectures, moderating publications,

38:13

courses you've taught on and so on.

38:16

So you need to keep these tracked as you go along so you're not playing catch

38:20

up. We forget, right? This is the, the old, um,

38:25

EEN Hauser curve of how much we forget. You know, you won't, I can't remember.

38:29

You know,

38:30

I have to sit and think about what talks I gave at a u r in the spring this

38:33

year, um, if I hadn't got 'em written down.

38:37

Just to reiterate, learn evaluations.

38:40

Keep the evaluations you've been sent by all the courses.

38:43

You teach C m e lectures, you know,

38:46

you get sent these and you look at them and say, okay, nobody hated me. Good.

38:49

And then you toss it, don't toss it. Put them in a folder somewhere.

38:54

Track specific learners that you've had mentoring relationships with to see

38:59

what they end up doing. And you will also,

39:01

at some point need some evaluations from learners for your portfolio.

39:06

So if you know where they've gone, it's gonna make it much easier. Now,

39:10

how do you store this information? Well,

39:15

you can do it in a number of different ways. Um,

39:17

you can have a folder in your file cabinet.

39:20

You can have folders on your hard drive. Please make sure they're backed up, um,

39:24

to keep stuff and just have it called promotion,

39:26

and you just toss everything in there to sort out later.

39:29

We'll talk about your CV in a minute. Um,

39:32

just to put forward a little prompt, um, as I got,

39:37

um, with a colleague, a grant,

39:40

a venture grant from the A U R to develop an online faculty

39:45

database, um, which will store all this information. Um,

39:50

it is almost ready for release. It's going to be,

39:52

I think completed in about a month.

39:54

And then that will be available free from the A u R for any department

39:59

to have. Um, it's gonna be,

40:02

we've been using a version of this that I developed,

40:05

so it's much more homegrown version. This version has been done by a programmer,

40:09

so it's much better. Um,

40:10

but we've been using it in our department for eight years and it's terrific.

40:13

And so once you got here,

40:15

you just sort of go into these different sections here,

40:18

and it's gonna come up with, um,

40:21

forms that you fill in and you can document everything, keep there,

40:24

and it will spit out a CV in a specified format at the end of it. So,

40:29

um, if you want to know more about this,

40:31

then drop me an email and I will send um, it to you when it's available.

40:36

Um, keep your CV up to date. As you can see, this is an old one.

40:41

This is when I made the talk. I promise you that my,

40:43

my CV is not eight years out of date,

40:46

but you need to keep your CV up to date because you never know when you're gonna

40:50

be asked for it. And because again,

40:52

it is so much more difficult to get this information after a period of years.

40:57

Um,

40:58

some institutions are requiring people who have a very

41:03

strong education tract to have an educator portfolio

41:08

or an educator supplement. Um, and again,

41:12

this is well worth finding out whether your institution likes it,

41:16

if you have a really strong education background. Uh,

41:19

and there are a number of templates out there for this. There's, um,

41:23

some online at the a u r, um,

41:26

I have a sort of summary version I can send people. Um,

41:31

it's well worth keeping this and keeping it up to date. Um,

41:35

this allows you to expand more,

41:37

a lot more on your educational activities than a, than a regular cv, um,

41:42

allows you to do. All right, I'm just gonna, um,

41:46

finish by talking just a little bit about the process of, um, promotion,

41:51

sort of how the sausage factory works for you.

41:54

And this is obviously gonna vary some from institution to institution,

41:58

but I can at least give you some sort of general details. Um, again,

42:04

check in with your department and with your institution what their specific, uh,

42:08

process is.

42:11

So your department should have a departmental promotions committee.

42:15

If they don't have one,

42:16

ask why they don't have one and get your chair to make one. Now,

42:21

your promotions committee in some combination with the chair

42:26

or other senior faculty should be doing annual reviews. Um,

42:31

and the department promotions committee should be doing a regular review of all

42:36

potential candidates. So as the chair of our promotions committee,

42:40

I keep a running list going of when we've reviewed people,

42:44

how long they've been at that time in rank,

42:46

when we should review them next and so on.

42:49

And I do that all through our database. I just showed you,

42:53

when you review the candidate, the department reviews the candidates.

42:56

They should be advising the faculty as to their progress

43:01

and giving them, you know,

43:02

ideas of how they can develop their portfolio further, um,

43:06

if they are interested in promotion. Um, if they're not,

43:11

then you know, they're not,

43:13

there's no point trying to develop faculty who don't want to be developed. Um,

43:18

they should be advising them what they can do,

43:20

helping them reach out to national contacts,

43:22

helping them get on committees and so on,

43:24

suggesting ways that they may be able to increase their publications,

43:28

suggesting how they might publish abstracts by working with residents and so on.

43:33

And then that promotions committee usually makes recommendations,

43:36

department chair the chair may or may not be a member of that committee at that

43:41

point. There are responsibilities of the chair and their responsibilities of the

43:45

candidate. So these are candidate responsibilities.

43:49

Completely lost my mouse here, so sorry about that. Um,

43:53

so the candidate do this.

43:57

The candidate needs to obviously develop their cv, right?

44:00

That is a not insignificant amount of work.

44:04

The CV is likely to have a very specific format that it needs to

44:08

be in for your particular institution. So get that format. Um,

44:13

if you are coming from another institution with your CV in a different format,

44:17

um, see if you can, uh, persuade, bribe,

44:21

pay a member of admin to convert your CV to the new format because

44:26

it's a really super tedious thing to do.

44:29

And that CV should be reviewed by the promotion committee chair or a

44:34

designated faculty on it. The second thing that the, um,

44:38

major thing that the candidate needs to do,

44:40

and this is always a bit of an obstacle,

44:41

is the career statement or personal statement.

44:44

And I'll talk a little bit more about that in a sec.

44:46

The candidate is expected to get all those teaching evaluations that we talked

44:51

about, um, from any different learners,

44:54

and that includes both the quantitative and, uh,

44:56

data and the verbal comments.

44:59

That's nobody else's responsibility but your own. Um,

45:03

most places they need to submit, uh,

45:05

number of publications in P D F format of your,

45:09

what you consider your best publications.

45:11

The numbers can depend on the institution, um, and the rank you're going for.

45:17

And you also have to supply, um,

45:22

documentation of any grant support.

45:29

Um, be very specific,

45:31

be very careful checking the specific requirements of the CV at your

45:36

institution. Um, so for example, you know, this is from our institution.

45:41

They, it's gotta be an either chronological or reverse chronological order,

45:44

but don't have one section in one and one section in another,

45:48

because that's going to really irritate people.

45:49

And you don't wanna irritate the promotions committee.

45:52

You don't want them to be bugged by stuff. So things like spelling,

45:56

everything needs to be really good. Um,

45:59

do not put stuff on your CV that is nothing to do with work.

46:02

They're not interested in your sports,

46:04

they're not interested in volunteer activities unless they're medically related.

46:10

Um,

46:11

be absolutely scrupulous about making sure that your

46:16

spelling and grammar is correct throughout your CV and your personal statement.

46:20

Get it checked by multiple people. Make sure that all of your, um,

46:26

your, uh, publication references are listed in the same format.

46:31

Making sure that your name is bolded, make it easy for them. Number,

46:35

the references and so on. What's the career statement?

46:40

Um, not required by all institutions, but many of them.

46:43

I actually find these super useful when I'm doing an outside review

46:48

on a faculty because it really summate stuff and it often gives you a lot of

46:52

information that's not within the CV itself.

46:56

So this should be a one to three page summary of what you've done in those

47:01

different, um, domains. And, um,

47:04

I recommend to my faculty that they split it into those domains. They, you know,

47:09

subhead or subheading research, subheading, clinical and so on.

47:13

But what's important is not a reiteration of your cv,

47:17

but the impact. So what impact have you made in these different areas?

47:22

You know, that you, um, you know,

47:25

you developed a protocol which has affected, um, you know,

47:31

provided a whole new resource to, um,

47:33

patients with a certain condition in your area. What, um,

47:37

that you've developed a curriculum that has been used nationally.

47:41

So they're talking about impact here,

47:42

and this is where you can really document it.

47:44

They also usually want to know what impact you plan to make. Um,

47:48

that's usually pretty short.

47:49

You're not expected to write two paragraphs about that, but do include it.

47:53

What are the responsibilities of the chair?

47:55

The chair has to identify peer reviewers within the institution. Um,

48:00

these are the numbers that are required, uh, in my institution.

48:03

They're gonna be vary from yours. Um,

48:05

we need seven outside reviewers for full and five for associate. Um,

48:10

they will select, um, the, uh,

48:13

letters of support need to come from learners.

48:15

Those are usually identified by the candidate. Um,

48:18

and then the chair writes a letter,

48:20

some meeting everything before it goes to the promotions committee.

48:25

So, um, our promotion committee doesn't meet in the summer. Um,

48:29

it meets monthly. This is again, going to depend on your institution,

48:33

so you need to check it out. Um, a promotions committee goes in, um,

48:37

usually somebody, uh, presents it to the committee,

48:40

the chair's there to answer questions, it's discussed, voted on,

48:45

and then that goes up higher into the dean and the dean's, um, advisory board.

48:50

Obviously this is gonna vary a little bit between different institutions. Um,

48:54

how long does this take forever? Um, six to 12 months,

48:59

I reckon most of the time. Usually closer to 12 between somebody saying, oh,

49:04

you know, the promotions committee in the department saying, you know, or I,

49:08

I really think you should go up for associate professor this year.

49:10

And actually coming through. Um,

49:12

the big delays are getting the CV and the appropriate format.

49:15

Writing that career statement, which seems is a, a, a major obstacle to people,

49:20

it seems. And then getting the outside reviews back.

49:23

And so you have to have somebody who's willing to kind of hound these and follow

49:27

them and keep nagging. Um,

49:29

if you don't have somebody in your department who does it,

49:31

then it's gonna be your job, um, to make sure that this, you know,

49:35

don't just assume that this is just gonna happen without you doing it.

49:40

Now what happens if you get rejected promotion?

49:42

It doesn't happen often if your department has done their job and not put

49:45

forward, people forward who are not ready to go forward. But it does happen. Um,

49:49

they usually get very specific feedback and they expect these to be addressed

49:53

before you reapply. So be real careful that you have, um,

49:58

readmission can be, you know, a year later, two years later.

50:02

It's not usually six months later unless it's something fairly basic that needs

50:06

to be sort of just perhaps clarified in your, um, your promotion packet.

50:12

Um, if it gets too far out, they may need to update references,

50:16

letters, or at least, um, get one or two new ones, um,

50:21

from my institution. That letters have gotta be within a year, um,

50:26

up and out, depends on the institution. Um,

50:30

a typical type of expectation is that you apply promotion by your sec year and

50:35

that you continue to contribute to the academic mission. But as I said before,

50:39

there is a potential for movement to a clinically prefixed, um, line.

50:45

One word about mentoring. You need mentors. Um, and for most people,

50:50

they don't have a single mentor.

50:52

They may have somebody who mentors them in educational areas.

50:55

Somebody who mentor research.

50:56

Somebody who mentors them in administration say to develop from assistant

51:00

program director to associate program director. Um, but seek them out.

51:05

Don't wait for them to come to you When your portfolio, um,

51:10

you are thinking that you're wanting to get towards promotion,

51:13

perhaps your department is, you know, all over going to people. But you know,

51:17

if nobody's said to you, are you ready to be promoted,

51:20

then you need to approach them. Um, so get your portfolio,

51:25

get your CV reviewed sooner rather than later by promotions committee member to

51:30

help guide your future progress. So in summary, you know,

51:34

there are absolutely some benefits to being promoted,

51:37

but it is a significant amount of work to do it. Um,

51:42

scholarly activity can be in any of the research,

51:45

clinical education or engagement domains,

51:48

and most people have something in all of those domains.

51:51

But the balance will depend on, you know,

51:54

your body of work and the track you're going up on. Um,

51:58

really think ahead, you know,

52:00

portfolio is developed very gradually over many years.

52:05

Um, and just keep things on, keep, you know, a few papers coming out each year,

52:09

keep looking at new national opportunities and so on.

52:14

Um, there are many,

52:16

many opportunities for scholarly activity if you are a little bit creative. Um,

52:21

and as I said, networking can really help. And then document all your activity.

52:25

Either, you know, document it in database, some other format.

52:28

Keep your CV current in the current institutional format so you don't have to

52:32

redo it completely. Um,

52:35

and then just to summarize the responsibilities,

52:38

the promotions committee has a responsibility to review faculty regularly and

52:43

mentor them, the faculty, your responsibility to develop that portfolio,

52:48

to do all that scholarly activity.

52:49

And then document and edit your CV and your career statement.

52:53

And then the chair and admin will get the reviews, um,

52:56

and collate your submission.

52:59

And then I am open to questions.

53:03

I see there's one q and a here. Let me see what we have.

53:08

Any advice? Um, somebody saying, um,

53:10

any advice on how to approach someone to be a mentor?

53:13

You just go up and ask them. Um, I mean,

53:17

really you have to really put yourself forward. I mean,

53:21

I've been mentor to many people in the education front,

53:23

and sometimes I offer the mentoring, um,

53:26

but other times they ask me to do it. So, you know, they can only say no.

53:30

And they say, I'm sorry, I'm too busy. You know, the,

53:33

there's nothing to be lost. Um, okay.

53:37

What's your favorite part of a clinician educator? Um, if you do it again,

53:40

create a Yes, absolutely. I'm not a big researcher. Um,

53:46

the, um, you know, I'm, I don't like writing papers. I mean,

53:51

I, I've published plenty, but I frankly hate writing papers. Um,

53:55

I'm not really, I'm not a basic science.

53:57

I'm not even really a clinical scientist. I don't enjoy that,

54:00

but I really enjoy the teaching part of it and the faculty development part of

54:05

it. So, yes, um, my favorite part,

54:08

I think my favorite part is faculty development if I had to. But, you know,

54:13

I love resident teaching as well, so I love having, you know,

54:18

I've now got two, um,

54:20

faculty here who were my medical students in the early two thousands.

54:24

Like that's, I think, pretty cool.

54:26

They went off and did other things and they've come back, but, you know,

54:28

they were my students. That's, that, they were my mentees. So that's,

54:31

that's gives me a kick.

54:34

All right, Dr. Lewis, we have one question in the chat box and it's,

54:38

how do you become an editorial journal team member?

54:42

So you wanna reach out to, um, you know, first of all,

54:47

they're gonna want you to be a reviewer before you are an editor.

54:52

Um, but if you already are a reviewer, um,

54:56

for a journal and, you know, regular reviewer reach, reach out to one of the,

55:01

usually they have sectional editors, so you know, radiology for example,

55:05

or a j r have, um,

55:07

sectional editors or associate editors for gi, for example.

55:13

Um, just reach out to them,

55:14

tell them that you are interested in playing part of the editorial board and,

55:18

um, and see what goes with it. You know, if you're not reviewing for them,

55:22

you're not gonna become an editor. But if you're a regular reviewer,

55:26

put your name forward. You know, these,

55:27

these roles become available and they may be,

55:29

they'll keep you on file for a year or two. Um,

55:34

but as I say, you know, people would,

55:36

people are really open to being reached out to.

55:40

Looks like we have another one in the chat. How,

55:42

How do you become a reviewer then? Okay, so if you wanna become a reviewer,

55:45

again, write to the sectional editor. They're always looking for reviewers. Um,

55:51

so you know, every journal is looking for reviewers all the time. So, you know,

55:56

just reach drop, you know, reach out, email, say that, you know, here,

55:59

here's my cv, here's my area of expertise. I would love to review for external.

56:05

Once you start reviewing, then you'll get more reviews.

56:08

Obviously I get more reviews than I really want.

56:12

I think that is everything. Uh, Dr. Lewis,

56:15

thank you so much for your lecture today.

56:17

Thank you all for participating in our noon conference. Uh,

56:20

you can access the recording of today's conference and all our previous noon

56:24

conferences by creating a free m r I online account.

56:28

Be sure to join us again next week for a noon conference on Thursday,

56:31

August 24th at 12:00 PM Eastern with, uh, Dr.

56:35

Donald Resnick for a lecture on meniscus of the knee function and dysfunction.

56:40

You can register for this free lecture@mrionline.com and follow us on social

56:45

media for updates on future noon conferences. Thanks again and have a great day.

56:50

Thank you very much.