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March 16, 2000

10-year tenure review period proposed for clinical faculty in medical school

The tenure review pe- riod for School of Medicine faculty with clinical responsibilities would be lengthened to 10 years, under a proposal that Pitt trustees are expected to consider this summer.

Currently, clinical faculty in the medical school have seven years to qualify for tenure, as do faculty in other Pitt schools.

But given the growing and unpredictable hospital workloads of clinical faculty, seven years for them is no longer feasible, according to medical school administrators.

Steven Kanter, the school's senior associate dean, wrote of the proposal to extend the pre-tenure period: "The demands of clinical work are, at times, unremitting, overwhelming and inflexible (due, in part, to demanding nighttime calls as well as recent governmental regulations that require increased supervision of trainees and impose a greater reporting burden). Thus, it is often impractical to demonstrate, in less than 10 years, the level of productivity and excellence necessary for the award of tenure."

As a result, Kanter said, a "substantial number" of clinical faculty currently end up being removed temporarily from the tenure stream, which effectively results in a 10-year pre-tenure period for them.

Lengthening the period leading to tenure would help Pitt recruit and retain high-caliber young clinical faculty, Kanter argued.

"A traditional seven-year pre-tenure period requires that the award of tenure be considered no later than five years after the date of appointment, with a decision reached by the end of the sixth year," Kanter wrote. "Five years is an inadequate time period for most physician faculty with clinical responsibilities to secure external funding and establish a national reputation." This could result in denial of tenure to promising clinicians as well as awarding of tenure to clinicians who fail to sustain a high level of productivity, he wrote.

The new policy would apply to faculty members with M.D. degrees and clinical workloads. The pre-tenure period for Ph.D. faculty and M.D. faculty without clinical responsibilities would remain at seven years.

Of the tenured Pitt medical faculty who responded to an e-mail survey, 88 percent approved of the proposal, according to Arthur S. Levine, senior vice chancellor for Health Sciences and dean of the medical school.

The proposal also has been endorsed by the University Senate's tenure and academic freedom committee. Faculty Assembly plans to discuss the changes at its April 4 meeting. Copies of the proposal are available prior to the meeting at the University Senate office, 1234 Cathedral of Learning.

Because lengthening the pre-tenure period for clinical faculty will require changing the University's bylaws, Pitt trustees are expected to consider the proposal at their June meeting.

q At their March 13 meeting, Senate Council members talked about the proposal during a discussion of Pitt tenure trends.

In the five Health Sciences schools besides medicine, both the number and percentage of tenured/tenure stream faculty declined between 1974 and 1999 — from 236 and 74 percent, respectively, to 131 and 35 percent — according to Pitt's Office of Institutional Research. When so few professors have tenure, it threatens academic freedom, said dental medicine professor John Baker. (See Baker's letter to the editor, beginning on page 2.) Nicholas Bircher, of the medical school's anesthesiology department, said he tabulated the number of days available for academic work among faculty in his division and found that the average was 2.3 days per year.

"Under those circumstances," Bircher said, "the vast majority of faculty cannot possibly achieve tenure….There really has to be some balance between the amount of revenue that physicians are expected to generate and the amount of academic activity that they're expected to generate."

Provost James Maher pointed out that many non-tenured faculty members in the Health Sciences, especially in the medical school, would not have had faculty status in previous decades.

In 1980, Pitt's School of Medicine employed 347 tenured/tenure-stream professors, representing 57 percent of the school's total faculty. By 1999, that percentage had fallen to 27 percent. But the number of tenured/tenure-stream faculty had increased to 395.

The school currently employs some 1,600 faculty members and enrolls just 650 students. That's compared with an 18-1 student-faculty ratio in Pitt's non-Health Sciences schools, Provost Maher noted.

The latter schools can cover faculty costs through tuition revenue and state funds, but medical schools rely primarily on federal research grants and hospital-based clinical care, Maher said.

He and Senior Vice Chancellor Levine attributed the medical school's unique funding situation and the dramatic increases in non-tenure-stream faculty among Health Sciences schools to the continuing revolution in academic health care delivery.

"Our health care delivery system [UPMC Health System], which is staffed by faculty of the medical school, has tripled in size, volume, obligation and responsibility just in the past three years," Levine said.

"I wish we could turn the clock back, but we can't," Levine continued. "We're part of a national phenomenon which has evolved with more rapidity and more dramatic effect than any of us could have anticipated a decade ago."

If anything, Pitt's medical school is "ahead of the curve" in preserving tenure, Levine said. "Many medical schools throughout the country are giving up on the concept of tenure altogether….Fortunately, we are probably the most solvent major academic medical center in the country and still can afford to have this philosophic discussion of tenure, whereas most academic medical schools — because bankruptcy looms — have forfeited the concept altogether."

— Bruce Steele


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