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194
R. Martin et al.
colposcopy, specic skills in contraceptive management, facility in supporting the needs of unhoused patients) that align
with the needs of specic populations served by the residency.
Faculty members can seek to actively identify these skills and
interests early in residency and then help a trainee become
procient by the time they graduate.
Residents with an interest in faculty development should
therefore be encouraged (and given time) to participate in
leadership development opportunities within the organization, including attending clinical business meetings and
organizational strategic development sessions; serving on
hospital committees; presenting at hospital grand rounds,
journal club, tumor board, and other institution-sponsored
continuing medical education events; joining faculty meetings and developing relationships with leadership to deepen
their understanding of program culture, processes, and
dynamics from within; and actively supporting engagement
in all aspects of the program. In a typical family medicine
training program, faculty have 3years to “woo” trainees as
potential “faculty candidates,” engaging over multiple points
of partnership and connection.
Residents bridging into a faculty position at their own or
another program can begin preparing for their new role even
before graduation, by using elective time to support their
learning through faculty development initiatives. For
instance, one writer used her elective time as a medical student to rotate with faculty at the residency program where
she subsequently matched and then used elective time during
her residency to create and participate in an academic medicine “track.” These electives gave her an opportunity to rotate
with program leadership and clinical preceptors, begin coprecepting her own junior residents utilizing a video review
feedback program she designed, create and present family
medicine board review sessions and didactic presentations at
the residency program, participate in faculty leadership
meetings, complete scholarly activities, and assist her program director and faculty with rotation development (i.e.,
updating rotation information sheets, goals and objectives,
and rotation resources). When she then joined faculty at that
same residency program upon graduation, she was wellpositioned to help identify needs within the program and
provide creative ideas to help satisfy those needs.
Additionally, “growing your own” helps in recruitment of
students and residents. When a resident is willing to stay on
as faculty, the program must have a culture attractive enough
to make them want to do so, and this testies to the excellent
training that enables a graduate to step into a faculty role
upon graduation. This also demonstrates how well a given
program develops and advances its own, from students to
residents to faculty members. A faculty member who was
part of the program also has myriad examples and a breadth
of lived experience on which to draw during the interview
season, when students inquire about the program’s resources
and culture. They will also have an understanding of the
tools used for assessment (i.e., rotation evaluations, milestones, summative reviews) and how they are presented to
residents within the program.
There are also practical and scal benets to “growing
your own” by recruiting from within one’s own program or
institution. Graduates of a program staying on as faculty are
generally easier to onboard because they are familiar with
program systems such as the electronic medical record and
administrative structures and hierarchies and have a sense of
the institutional culture more generally. It is certainly a wise
approach for a residency clinic’s business to recruit their own
residents because the new attendings can maintain the same
patient panel they developed during residency. This continuity of care, of course, helps with patient safety, access, and
satisfaction. Graduates’ ease of working within the system
also allows their clinical time (and correlating productivityrelated revenue generated) to be optimized right from the
start. This, of course, is all in addition to the huge baseline
savings of retaining one’s own by avoiding the high, often
ve-gure costs of physician recruitment [4, 9, 14].
Family medicine departments and programs frequently
face institutional barriers to hiring faculty beyond the minimum required by the ACGME.One potential way to overcome the scal barrier is to hire new graduates as faculty and
assign a high full-time equivalent (FTE) percentage
(70–80%) of direct patient care initially (which hones clinical skills) with 10–30% administrative/precepting time. The
new graduate will fund their own salary with this type of
portfolio and also participate in invaluable faculty development. PDs can gradually increase administrative/precepting
time as the graduate’s experience/skill grows and as departmental needs arise.
Finally, the impact of residency faculty advisors in this process cannot be overstated. Working closely with residents on a
regular basis, they are well-positioned to identify and promote
potential faculty skills and interests in their advisee. The
encouragement of mentors also goes a long way in building
residents’ condence, as the perceived gap between a trainee
and the faculty members with whom they work may seem
insurmountable. Because they have been through the process
of transitioning out of residency into clinical practice, specically into faculty roles, such advisors can offer consistent,
trust-based mentorship over their residents’ years of training
and early attendingship, to support their sense of self while
keeping them grounded and avoiding “overcondence.”
If every program engages in this sort of continuous, active
faculty development with their residents, there could be a
nationwide surplus (rather than decit) of potential faculty
members. This, in turn, would supply the faculty need for
family medicine programs that stretches nationwide because
turnover and career transitions are a natural part of the academic landscape.
19 Faculty Recruitment: Best Practices
195
Building thePipeline: TheRole ofStudent
Mentorship
Positive experiences with faculty role models and mentors
are known to play a role in inuencing medical students’
decision to pursue a career in family medicine [3, 6]. Faculty
recruitment begins at the student level and ripples outward. It
is probably not an overstatement to say that faculty recruitment really starts and ends with student recruitment. When
students encounter positive family medicine faculty role
models, they are more inclined to think favorably of a program during their residency application and selection. Such
favorable impressions are likely to persist even when these
students later pursue post-residency faculty or clinical positions. As residency leadership, we are always recruiting, at
every level.
Faculty members should therefore be encouraged to take
advantage of any opportunities presented to teach at afliated medical schools or other higher-education institutions.
Aside from the obvious benets to students in such collaborations, this can provide a pipeline for future faculty while
engaging current faculty in their own growth, retention, and
career development. Students often inspire and refresh faculty in their commitment to medical education, and these
relationships frequently facilitate successful residency
recruitment, which, in turn, supports a healthy program with
lower rates of struggling residents.
In our own experience, we have witnessed a number of
excellent family physicians that were rst engaged as students, in some cases even before making their specialty
choice in family medicine. We had one medical student interview with our residency program for a position, who ended
up matching elsewhere, but then requested a job with our
team upon completion of his own residency training because
of how favorable the residency interview experience had
been. Several other faculty members rotated with our program as medical students in their clinical clerkship years—
or even, in one case, learned from our program’s faculty
during the medical school’s rst year “Foundations of
Clinical Medicine” course. These students all eventually
opted to match at our program and were subsequently
recruited to stay on as program faculty upon residency
graduation.
These anecdotes highlight the point that one never knows
which teaching exposures will have an impact, whether on
one’s own program or somewhere else in the region or country. This is especially vital considering the current scarcity of
faculty, teachers, and preceptors in family medicine. It is
important to maintain a generous, open mindset that is constantly aware of and pursuing faculty recruitment opportunities, even if a particular candidate is not specically needed
for one’s own program at present. It can only add value to the
eld when we identify, name, and cultivate faculty members
in family medicine as well as high-quality teaching skills in
learners at every level. Furthermore, once an institution is
saturated with various faculty and other clinicians recruited
in such a positive manner, recruitment becomes easier, provided faculty development continues for residents and
faculty.
It is important to remember that there is generally always
an extremely wide perceived gap between students and faculty members, from the student’s or trainee’s perspective.
Bearing this in mind, teachers should be encouraged to name
the leadership and faculty skills, or even potential, that they
see, and remind learners often that they can be teachers too.
This helps potential junior faculty imagine themselves in that
role. Current teachers can also identify and share resources
available for faculty development across the spectrum of
training levels, to help students and residents bridge that
same gap in their own perspective and see how that gap can
close with proper investment of resources, including quality
training.
Concluding Thoughts: Always Recruit!
It is helpful to recognize that faculty turnover is a natural,
healthy process in the realm of academic medicine. This is
optimally facilitated when we support faculty development,
which can organically lead to cultivation and exploration of
new opportunities and interests for our own trainees.
Connections with potential faculty members can be made
while teaching, at conferences, online, and via other individuals. One should be ready to share one’s vision, program
outcomes, and faculty—when one introduces one’s faculty
to others, their enthusiasm will help one’s program be known
far and wide, and faculty will apply as a result of word of
mouth. Recruitment “outside” of the institution is helpful as
well, whether through community engagement or interinstitutional partnerships.
Even when not actively recruiting, it is vital to stay in
touch with those who reach out because paths will likely
cross again and it may be a better match at a future time.
Alternatively, potential faculty members can be recommended to another program, which builds vibrant partnerships and fosters academic goodwill within the academic
family medicine community. Recruitment and onboarding
processes often take a long time (informal estimates to ll a
family medicine faculty vacancy range from 18 to
24months), which can create prolonged gaps whenever faculty members leave the program. Program directors and faculty leadership must maintain a mindset of continual
succession planning to mitigate these gaps and support a
robust faculty pipeline.
196
R. Martin et al.
Academic family medicine is a small world. Programs
may “steal” faculty from each other (as works best for the
faculty recruit), but they can also “share” faculty candidates
with each other, maintaining the mindset that we are all continually providing faculty development for each other’s
teams.
References
1. America Needs More Family Doctors: 25x2030 AAFP. https://
www.aafp.org/membership/initiatives/25x2030.html
2. AAMC Medical School Enrollment Survey: 2020 Results (published October 2021). 2020. https://www.aamc.org/media/9936/
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3. Avery DM, Wheat JR, McKnight JT, Leeper JD.Factors associated
with choosing family medicine as a career specialty: what can we
use? Am J Clin Med. 2009;6(4):54–8. http://aapsus.org/articles/40.
pdf
4. Buchbinder SB, Wilson M, Melick CF, Powe NR. Estimates
of costs of primary care physician turnover. Am J Manag Care.
1999;5(11):1431–8. PMID: 10662416.
5. Davenport D, Alvarez A, Natesan S, Caldwell MT, Gallegos M,
Landry A, Parsons M, Gottlieb M.Faculty recruitment, retention,
and representation in leadership: an evidence-based guide to best
practices for diversity, equity, and inclusion from the Council of
Residency Directors in emergency medicine. West J Emerg Med.
2022;23(1):62–71. https://doi.org/10.5811/westjem.2021.8.53754.
PMID: 35060865; PMCID: PMC8782137.
6. Gill H, McLeod S, Duerksen K, Szafran O. Factors inuencing
medical students’ choice of family medicine: effects of rural versus urban background. Can Fam Physician. 2012;58(11):e649–57.
PMID: 23152472; PMCID: PMC3498039.
7. Gonzaga AMR, Appiah-Pippim J, Onumah CM, Yialamas MA.A
framework for inclusive graduate medical education recruitment
strategies: meeting the ACGME standard for a diverse and inclusive
workforce. Acad Med. 2020;95(5):710–6. https://doi.org/10.1097/
ACM.0000000000003073.
8. Mercer C. Family medicine faces shortage of doctors willing
to teach. CMAJ. 2018;190(21):E666. https://doi.org/10.1503/
cmaj.109- 5604. PMID: 29807944; PMCID: PMC5973894.
9. Pappas MA, Stoller JK, Shaker V, Houser J, Misra-Hebert AD,
Rothberg MB.Estimating the costs of physician turnover in hospital medicine. J Hosp Med. 2022;17(10):803–8. https://doi.
org/10.1002/jhm.12942. Epub 2022 Aug 17. PMID: 35977052;
PMCID: PMC9547978.
10. Petterson SM, Liaw WR, Phillips RL, Rabin DL, Meyers DS,
Bazemore AW. Projecting US primary care physician workforce
needs: 2010–2025. Ann Fam Med. 2012;10(6):503–9. https://doi.
org/10.1370/afm.1431.
11. Price EG, Gozu A, Kern DE, Powe NR, Wand GS, Golden S,
Cooper LA.The role of cultural diversity climate in recruitment,
promotion, and retention of faculty in academic medicine. J Gen
Intern Med. 2005;20(7):565–71. https://doi.org/10.1111/j.1525- -
1497.2005.0127.x. PMID: 16050848; PMCID: PMC1490155.
12. Society of Teachers of Family Medicine. STFM launches initiative
in response to faculty shortage. Ann Fam Med. 2015;13(3):290–1.
https://doi.org/10.1370/afm.1800. PMID: 26901885; PMCID:
PMC4427434. https://www.annfammed.org/content/13/3/290
13. Terregino CA, Byerley J, Henderson DD, Friedman E, Elks ML,
Kirstein IJ, Leep-Hunderfund AN, Fancher TL. Cultivating the
physician workforce: recruiting, training, and retaining physicians
to meet the needs of the population. Med Teach. 2021;43(Suppl
2):S39–48. https://doi.org/10.1080/0142159X.2021.1935832.
14. The Cost of a Physician Vacancy. Merritt Hawkins, 10 Sept 2018.
https://www.merritthawkins.com/uploadedFiles/merritthawkins_
physicianvacancy_whitepaper_2018.pdf
15. Theobald M, Everard KM, Morley CP. Changes in the shortage
and quality of family medicine clinical training sites. PRiMER.
2022;6:7. https://doi.org/10.22454/PRiMER.2022.960678.
16. Weidner A, Glass J, Cronholm P, Pauwels J. To what extent are
programs recruiting their own graduates as faculty? A CERA
study. Fam Med. 2023;55:467–70. https://doi.org/10.22454/
FamMed.2023.342968.
Faculty Performance
JohnF.Emerson, StephenM.Carek, andPeterJ.Carek
20
Key Points
• Faculty expectations within the multiple domains of academic family medicine should be clearly outlined and
communicated.
• The specic roles and responsibilities of faculty members
within a program should be clearly outlined and
communicated.
• Leaders should develop a system to track clinical, educational, and scholarly contributions, and these data should
be available to faculty.
• Leaders should develop a system to periodically evaluate
faculty performance and provide feedback.
• Leaders should work with faculty to support the development of individual improvement plans.
• The institutionshould have a standard process for corrective action.
• Faculty should be provided opportunities to partner with
mentors.
• Faculty should be provided opportunities for career development based on identied needs and developing areas of
interest.
• The expectations and criteria for academic promotion
should be clearly outlined.
• Leaders should develop a system to support faculty
through academic promotion.
Faculty Roles andResponsibilities
Residency training programs are organized in a variety of
ways to meet the needs of the learners, patients, and communities they serve. For programs to operate effectively, faculty need clear expectations about their unique contributions
to the training program’s mission and effective onboarding to
J. F. Emerson (*) · S. M. Carek · P. J. Carek
USC SOM Greenville, Greenville, SC, USA
e-mail: John.Emerson@prismahealth.org
assure consistency in communication of those expectations
as they embark on their careers [6]. These include a breakdown of specic roles and responsibilities, usually in the
domains of clinical time (both direct patient care and precepting and settings such as outpatient, inpatient, nursing
home, etc.), educational time, and scholarly activity.
The roles of individual faculty members in a residency
program vary and can be classied as the program director,
associate program director, core faculty member, and other
faculty member. Per Accreditation Council for Graduate
Medical Education (ACGME) guidelines, one faculty member is “appointed as program director with authority and
accountability for the overall program, including compliance
with all applicable program requirements.” Appendix 1 is a
sample program director job description.
Associate program directors who support the program
director and faculty refer to the group of faculty responsible
for educating and supervising residentsand who have specic programmatic administrative responsibilities. A subgroup of faculty members, known as “core faculty members,”
have a signicant role in the education, evaluation, and
supervision of residents as they must devote a signicant
portion of their effort to resident education, and selectadministrative duties as outlined by the ACGME. Appendix 2 is a
sample core faculty job description.
The relative effort dedicated to the different types of clinical works, including call frequency, inpatient care delivery,
outpatient clinics, and other clinical works, will vary by
organization and residency program. Developing a system
to create a single work unit (such as shifts or hours) can help
in the creation of an equitable schedule and allow for periodic monitoring and reporting of clinical effort (see
Table 20.1). The amount of time a faculty member is
expected to work clinically will often be based on contracted
hours, usually determined by the healthcare organization,
graduate medical education (GME) ofce, and/or department, and is often represented by a percentage of full-time
equivalent or FTE. Clearly dened targets for a faculty
© The Author(s), under exclusive license to Springer Nature Switzerland AG 2025
R. Kellerman, G. Irwin (eds.), Graduate Medical Education in Family Medicine, Excellence in Medical Education 2,
https://doi.org/10.1007/978-3-031-70741-4_20
197
198
J. F. Emerson et al.
Table 20.1 Example of clinical shift targets for an academic faculty
member
Assumptions:
365days less 104weekend days less 20 paid time off days less 10
continuing medical education days=231 working days
A total of 2 shifts per working day=462 shifts for 1.0FTE at 100%
clinical effort
462×0.7 FTE=323.4 or 323 shifts for a 0.7FTE faculty member
Precepting=one shift (ratio of one preceptor: Three learners).
Personal clinical session=one shift.
Inpatient day=two shifts.
Inpatient night=one shift.
member’s FTE should be easily available for review. A key
component of this process is the determination of the relative weight of the work unit based on the clinical responsibilities that are attended to during the clinical work. For
example, working an overnight shift at the hospital and
directly observing learners in the ICU while simultaneously
overseeing the labor and delivery unit would likely be
weighted differently than the responsibilities of a faculty
member taking back-up calls at home via phone for indirect
supervision purposes. Determination of the relative weight
of clinical services should be a collaborative discussion
between department and residency leadership and the
healthcare organization and open to adaptation as the nature
and type of clinical work may change over time.
For institutions where academic faculty work under a
nancial productivity model, care should be taken to balance
the inherent conicts of the educational mission and the
nancial incentives of increasing patient care responsibilities. Such conicts are most apparent during precepting, as
the experience of residency physicians being supervised
impacts the volume of patients capable of being seen during
a particular session or time period. For instance, a precepting
session with mostly rst-year residents may require a higher
amount of educational activity with less clinical productivity
than that with mostly third-year residents who require less
supervision yet see a higher volume of patients.
A tactic to address this issue is to use faculty relative value
units from individual faculty clinical sessions and exclude
precepting revenue from the productivity equation. This
incentivizes faculty performance during personal visits and
eliminates the potential conict that precepting presents. If
precepting time is utilized for productivity, creating a system
of pooled relative value units (RVU) for faculty could also
help mitigate some of the challenges with allocation of monies. If RVU targets for precepting are used, they should be
developed on a local basis as no national standard is available.
This benchmark could be established using the previous
year’s average or rolling a 3-year average to offset any unusual
year-to-year variations. Additionally, the number of sessions
of each activity may need to be monitored to ensure adequate
precepting coverage and appropriate level of direct patient
Table 20.2 Typical educationalresponsibilities of an academic faculty
member in a residency program
Attending regularly scheduled faculty meetings
Advising learners
Overseeing clinical care delivery
Clinical teaching at the bedside
Delivering educational sessions in the classroom setting
Learner assessment, including completion of periodic learner
evaluations
Participation in program-specic committees
Participation in recruitment activities
Participation in afterhours residency-related activities and social
events
Overseeing curricular components (based on rotation, site, skill set,
or location)
care. Ultimately, it is the responsibility of the residency program leadership and department to intentionally work to balance the dual missions of education and patient care delivery,
recognizing that outstanding medical education can only
occur in an environment of excellent patient care.
For teaching and educational administration, the total
number of hours of administrative time should also be built
into the faculty FTE, monitored, and tracked. Expectations
for the faculty member for education and teaching should be
clearly outlined and communicated. There should be an
opportunity to make periodic adjustments based on the
evolving needs of the program. Table20.2 provides a list of
the key educationalresponsibilities of an academic faculty
member, though there will be signicant variability in expectations based on a program’s unique needs, educational focus
areas, faculty composition, and the needs of the patient population served. In addition to the commonly anticipated
responsibilities, faculty may be called upon to work on special projects or tasks to modify or improve specic components of the program, such as the transition to
competency-based assessment.
Faculty should also be encouraged to participate in activities outside of the residency program in the health system,
local community, or national medical organizations. For
instance, active participation in hospital committees or committees of national organizations provide faculty development opportunities, create opportunities to improve the
functioning of the organization, and allow role modeling as a
community leader for residents.
Steps should be taken to clarify expectations by the program and department for both the frequency and type of
scholarly work. In most departments, faculty will be expected
to participate in scholarly work as part of the program’s
ACGME requirements. However, the breadth and scope of
scholarly activity is wide, and, in an ideal state, departmental
and institutional priorities will help inform areas of scholarly
development and pursuit by the faculty members working in
the department. Faculty experience and interest will also
20 Faculty Performance
Table 20.3 Boyer’s model of scholarship with selected examples [3]
Type of scholarship Purpose
Discovery Build new knowledge through
hypothesis- driven research
Integration Synthesize current knowledge to support
other researchers, clinicians, patients,
policymakers, and/or educators
Application Use knowledge to improve healthcare
delivery through medical systems
Teaching Develop, implement, and evaluate
educational experiences or resources
199
Sample performance measures
(list is not all inclusive)
Present original research through posters at a local conference or residency
fair
Publish a manuscript or abstract
Present a case study and literature review of a clinical problem in the local/
state forum
Publish an op-ed or letter to the editor in a print or digital forum, explaining
the meaning and signicance of a current public health concern
Present the design and results of a clinical quality improvement project
conducted in the residency practice in a residency conference
Describe the design, implementation, and effects of a patient education
program
Prepare/revise an enduring curriculum for use in a residency program with
tracking and presentation of outcomes
Develop and implement a new program for a residency program with
tracking and presentation of outcomes
play a role in the type of scholarship pursued. Factors associated with increased departmental research have been studied
and include department size (with larger departments generally being more productive), having a dedicated PhD
researcher, access to an individual with grant-writing experience, and access to statistical support [10].
However, not all programs have the infrastructure, nor the
imperative to perform classical research, and will opt for
other ways to contribute scholarly work. Scholarship has
been described in the domains of discovery, integration,
application, and teaching [3], recognizing a wide variety of
scholarly contributions may be appropriate for a department
or program (see Table20.3). Faculty should be encouraged
to reect on their current areas of interest and already
assigned work and utilize opportunities to incorporatescholarshipinto the areas they are already invested in to support
the mission of the educational program. This alignment in
work will provide for more meaningful experience and help
reduce the risk of having scholarly work become an additional ask outside of their already scheduled activities.
Programs can consider strategies such as organizing a
local scholarly showcase to provide a venue for the presentation of scholarly work within their organization or region,
and they can also utilize regional collaborative learning networks to provide opportunities for peer–peer interactions
that can promote scholarship through quality improvement.
Faculty Feedback andEvaluation
Faculty need ongoing feedback about their performance
within a residency program to help identify unrecognized
areas of underperformance and to guide faculty development activities. Evaluative feedback regarding performance
should be gathered from all domains of faculty work,
namely, clinical abilities, teaching, scholarship, and admin-
Table 20.4 Example of a faculty evaluation schedule
Self-assessment of faculty performance completed annually: January
Faculty peer evaluation completed annually: January
Resident evaluation of overall faculty performance completed
semiannually: March/September
Resident evaluation of faculty on inpatient medical rotations
completed after each period of service: Variable
Student evaluation of faculty performance: Variable by school
reporting policy
Staff evaluation of faculty completed annually: June
istration, as applicable. There are numerous evaluative
forms and tools that can be used to assist in the evaluation of
performance of medical educators, including clinician educator milestones published by the ACGME [4]. Learners at
all levels should be provided with an opportunity to complete evaluations of faculty performance. Peers and staff
should also be provided with an opportunity to provide
feedback, and there should be a mechanism of self-evaluation to provide a more holistic review of performance (often
called 360-degree reviews). There is no single best way to
solicit or organize feedback, but programs should utilize
available tools or create their own to provide feedback
needed for ongoing development.
Evaluation data should be provided on a scheduled basis,
allowing for aggregation of data to support the anonymity of
any learners or peers completing evaluations. Program or
departmental leadership should review evaluation data periodically and work collaboratively with the faculty member to
analyze the evaluation results and develop a plan for improvement in areas of concern while also celebrating areas of high
performance. These meetings are traditionally held at least
annually but could be held more frequently depending on
programmatic/departmental preference as to allow for more
rapid improvement cycles. Table 20.4 is a sample annual
schedule for faculty evaluations.
200
J. F. Emerson et al.
Faculty Performance Concerns
At times, faculty will have difculty in performance in the
various domains of their work. Performance concerns may
be due to a variety of reasons, including burnout, untreated
mental illness, personal stressors outside of the working
environment, inexperience, lack of training, underdeveloped
skills, mismatched assignment, and substance misuse/abuse,
just to name a few. In these instances, approaching faculty
with empathy and curiosity can help in identifying the root
cause of any performance concern while maintaining support of the individual. There are some circumstances in
which individuals may need to be removed from their role of
a clinician educator such as conrmed instances of harassment, discriminatory behavior, unethical conduct, or other
egregious acts that would warrant immediate corrective
action based on standards or professional practice. Short of
these issues, faculty should be provided with an opportunity
to reect on performance concerns and be supported in personal development and improvement activities. In some
instances, faculty are not ideally suited for academic work,
and it may be the best option to help them transition to a
career that more closely aligns with their personal and professional goals. Learning about a faculty member’s core personal and professional values and helping them develop
alignment is a strategy that can be adopted to help in career
satisfaction, especially when linked to institutional values
[7]. In the event a faculty member has continued issues with
poor overall performance that is impacting the learning environment and leading to patient safety issues, inadequate education, or poor resident and team morale, at times, it will be
appropriate to move faculty out of teaching responsibilities.
through established teaching academies and formal programs through the medical school’s ofce of faculty affairs.
Departmental and program leadership can help facilitate
awareness and networking to support new faculty in identifying resources.
Mentorship can take on a variety of forms, and the goals
of a mentor/mentee relationship can be numerous, including
exploration of opportunities for advancement, exploring
career satisfaction/burnout, and navigating the promotion
process, just to name a few. Some mentor/mentee relationships form organically through shared workplace or networking and work well for both parties without intentionality.
However, in some situations, the goals of the relationship
and expectations for both the mentor and mentee may need
to be outlined to improve satisfaction by both parties and
maximize success [1].
Outside of traditional mentoring or advising, there are
additional strategies to support academic faculty in their
development and career planning. More recently, professional coaching, which involves facilitated personal reection and alignment with personal and professional priorities,
has been described as a strategy to improve career satisfaction and mitigate some of the effects of burnout and physician distress [2]. Another strategy is to utilize scholarly
mapping to outline career trajectory and help faculty determine how they want to focus their energy and time to improve
the chances of success and fulllment [8]. Regardless of the
approach, providing opportunities for faculty members to
connect with and learn from others as they navigate their
careers can be valuable and promote longevity.
The Promotion andTenure Process
Mentoring andCareer Counseling
Mentoring is a shared commitment between a junior faculty
member and a more seasoned faculty member to work
together to explore opportunities for the former in terms of
career growth and development through reection and discussion. These relationships have been shown to not only
improve career satisfaction and scholarly productivity but
also have other potential advantages [5]. Mentors can come
from within a department or outside of the institution, maybe
as a result of relationships forged during prior educational
experiences or though formalized mentoring and development programs. Many academic medical societies, including
the Society of Teachers for Family Medicine, have structured
certicate programs that allow early career faculty the opportunity to join a cohort of peers and work closely with a faculty mentor to improve in their roles as academicians. At the
institutional level, opportunities for mentorship may exist
In academically afliated organizations, the university that
grants faculty appointments will have produced criteria
(sometimes specic to an academic unit) for the initial
appointment and promotion of faculty in either tenured or
nontenured promotion tracks. In general, promotions are
based upon a faculty member’s contribution to their discipline, whereas tenure is based upon the organization’s investment in the faculty member. Understanding the university’s
promotion standards and areas of emphasis is critical to
being able to effectively support faculty through the
process.
When possible, the expectations for faculty as part of
their role in the residency program should be made in alignment with the internal promotion criteria. During annual faculty performance reviews, program and/or departmental
leadership should review the faculty member’s contributions
and compare those to the established institutional criteria.
For those that desire promotion, mentoring should be pro-
20 Faculty Performance
201
vided to help craft a path to promotion, ensuring that
resources are made available and faculty have the best chance
of achieving promotion when their portfolio is presented for
review. In some institutions, departments may form internalpromotional review committees that provide assessment
of performance along with feedback and guidance to a faculty member before they submit materials for consideration
[9]. When possible, collection and organization of key portfolio materials such as learner evaluations, service history,
and other measures of performance should be facilitated by
the department to prevent undue burden on any individual
faculty member. Departments can create portfolio templates
to be completed that help organize materials. Based upon the
predetermined criteria for promotion or tenure, the faculty
member needs to be prepared to demonstrate their impact
upon the missions of the organization in the areas of patient
care, education, and scholarship.
Appendix 1: Sample Family Medicine Residency Program Director Job Description
Job Summary
The residency program director is responsible for administering and maintaining all aspects of the residency training
program, ensuring that the program maintains compliance
with regulatory standards and allows for the provision of safe
and high-quality patient care. This involves overseeing the
development and maintenance of the educational experiences, evaluation methods, administrative systems, and
recruitment of future residents.
Roles andResponsibilities
The following is not an exhaustive list of responsibilities.
This list is intended to provide a representative summary of
the major duties and responsibilities performed.
Educational Delivery
1. Plan a yearly schedule for each resident to meet board
eligibility and ACGME requirements.
2. Monitor the 3-year program for each resident to ensure
adequate training in all required areas at all required levels of responsibilities.
(a) Approve local directors for participating sites of
education.
(b) Monitor resident supervision.
(c) Prepare and submit information to the ACGME when
necessary (e.g., annual program updates).
3. Counsel residents in selecting elective experiences, and
approve elective requests.
4. Develop, or supervise the development of, a yearly formal conference series to follow a planned curriculum.
(a) Include a broad range of topics and speakers.
(b) Monitor attendance, presentation, audience response.
(c) Monitor the quality and appropriateness of material.
5. Advise on the choices of conference topics, speakers, and
other learning sessions.
6. Promote an environment of inquiry and lifelong learning
through scholarly activity, quality improvement projects,
journal clubs, etc.
7. Arrange and conduct orientation of all new residents.
8. Develop, review, enhance, and revise the curriculum
(educational experiences) for residents.
9. Maintain skills through direct patient care and faculty
development.
Evaluation
1. Arrange and monitor evaluations of all residents by faculty and supervisory residents.
2. Provide individual feedback to residents as indicated,
personally or through chief resident(s) or faculty
advisor(s).
3. Implement feedback received from the Clinical
Competency Committee.
(a) Obtain periodic reviews of all residents.
(b) Arrange feedback to all residents.
(c) Arrange and implement special actions, such as
extensive counseling, about performance, probation,
remedial activities, and assignments.
4. Provide feedback to faculty individually or as a group as
indicated from evaluations.
5. Review les with individual residents if requested.
6. Review evaluation forms periodically and revise as
needed.
7. Recommend residents for the board certifying
examination.
8. Attest to satisfactory completion of the training program
and eligibility to practice independently.
Administration
Scheduling
1. Oversee the process for resident scheduling.
2. Oversee the process for faculty scheduling.
3. Review scheduling concerns and special requests that fall
outside of scheduling protocols/policies.
202
J. F. Emerson et al.
Personnel
1. Sign forms for examinations, loan approvals, etc.
2. Prepare letters of recommendation for licensure, fellowships, jobs, and hospital privileges, for current and former
residents.
3. Supply the hospital graduate medical education ofce
with information about residents as requested.
4. Counsel residents about career development and
planning.
5. Assure faculty development.
6. Assign faculty advisors to all residents.
Committees
1. Attend graduate medical education committee and subcommittee meetings.
2. Attend resident selection committee meetings.
Recruiting
1. Assist with interviews for new postgraduate year
(PGY)-1s.
2. Assist with selection of PGY-1s.
3. Arrange for recruitment as needed for PGY-2 and PGY-3
positions.
4. Select chief resident(s).
5. Assist with selection of faculty in the program and
department.
Appendix 2: Sample Family Medicine Residency Core Faculty Job Description
Job Summary
The ACGME denes the role of faculty by stating that
faculty must
Be role models of professionalism
Demonstrate commitment to the delivery of safe, quality,
cost-effective, patient-centered care
Demonstrate a strong interest in the education of residents
Devote sufcient time to the educational program to fulll
their supervisory and teaching responsibilities
Administer and maintain an educational environment condu-
cive to educating residents
Regularly participate in organized clinical discussions,
rounds, journal clubs, and conferences
Pursue faculty development designed to enhance their skills
at least annually
In addition, faculty should be involved in the following:
Patient Care
1. Demonstrate and maintain excellence in the delivery of
patient care as an independent clinician.
2. Oversee clinical care delivery while working with resi-
dent learners in a teaching capacity (precepting).
3. Participate in operational and quality improvement proj-
ects within the clinical environment.
Education
1. Provide both bedside and structured educational delivery
to learners.
2. Attend scheduled educational sessions (journal clubs,
case conferences, morbidity and mortality conferences),
and contribute through engagement and knowledge
sharing.
Residency core faculty members are responsible for assisting
the program director in administering and maintaining all
aspects of the residency training program, ensuring the program maintains compliance with regulatory standards and
allows for the provision of safe and high-quality patient care.
Specic roles and responsibilities are determined in coordination with the residency program director and departmental
leadership.
Roles andResponsibilities
The following is not an exhaustive list of responsibilities.
This list is intended to provide a representative summary of
the major duties and responsibilities performed.
Evaluation
1. Complete timely and accurate periodic evaluations of
learners.
2. Provide both formative and summative feedback to learn-
ers regarding their performance.
3. Assist in the development of individualized learning and
remediation plans.
Recruitment
1. Participate in recruitment events and activities at the
request of the program director.
2. Assist in selection of faculty in the program and
department.
Administrative
1. Advise residents, providing structured feedback on pro-
gression through the training program.
20 Faculty Performance
203
2. Attend period faculty meetings and shared working time
to make programmatic improvements.
3. Oversee components of the core curriculum (block or
longitudinal), including annually reviewing these curricular experiences and providing feedback to the program
leadership.
4. Serve as a member of the program-specic committees at
the request of the program director.
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