The Johns Hopkins University School of Medicine
Criteria and Process of Professorial Promotion
Role of the Professorial Promotions Committee (PPC)
The chair and members of the PPC (follow this link for a list of committee members)are appointed by the Dean and serve in an advisory capacity to the Dean and the Advisory Board of the Medical Faculty (ABMF). The PPC is the only committee in the School of Medicine that provides a standing report at each regular meeting of the ABMF. The charge to the PPC is not to set the criteria for promotion, but to interpret those criteria with respect to individual candidates as published within the "Gold Book" (i.e., Policies and Guidelines Governing Appointments, Promotions and Professional Activities of the Full-Time Faculty of the Johns Hopkins University School of Medicine) for full-time faculty, and in the "Blue Book" for part-time faculty. In this respect the role of the PPC is analogous to a judicial body, which interprets and applies the law to individual cases, but does not write or amend it. Unlike a court, however, the PPC does not make the final decision regarding an individual's promotion, but serves in an advisory capacity to the Dean and the ABMF for their final decision. Indeed, although uncommon, recommendations by the PPC have been overruled by the ABMF.
Criteria for Promotion
The criteria for promotion to professor at Johns Hopkins are stated explicitly in the Gold Book as follows:
These criteria are intentionally succinct and inherently open-ended; that is, they leave considerable room for interpretation by the PPC. This is perhaps where the analogy to a judicial body best applies; the application of these criteria to individual candidates is necessarily an evolutionary process that is remarkably open-minded and broad. An explicit documentation of this process was provided to the Johns Hopkins Medical Faculty in 1992 when Dr. Paul McHugh, chairman of the PPC at that time, circulated a "Letter of Experience about Faculty Promotion in Medical Schools". This document, often referred to as the "McHugh Letter" (Appendix III) was subsequently published (Academic Medicine 11:877-881, 1994; Appendix IV).
The McHugh Letter deals directly with the diversity of academic achievement that is valued within the University community. To illustrate the recognition of this diversity, Dr. McHugh identified several prototypic pathways by which an individual might achieve the scholarly standards of Professor at Johns Hopkins. In summary, these pathways are named for the biomedical-scientist ("the William Welch pathway"), the clinician-scholar ("the William Osler pathway"), and the administrator-program builder ("the Henry Hurd pathway"). Although not designated as a separate pathway, the role of teaching is clearly defined in each of these pathways, and strongly emphasized in the document. It is important to note that while each of these pathways provides a prototype, they are not mutually exclusive; indeed, most candidates demonstrate varying combinations of achievement in each category. Thus, the PPC review of each candidate is a comprehensive process that takes into account the individual faculty member's total scholarly achievement, which often is greater than the sum of component parts.
It is suggested that those who remain unclear about the diversity of scholarly achievement that is recognized by the PPC in considering candidates should read the McHugh Letter, which clearly, explicitly, and most eloquently captures the essence of the issue. This document has been an important guide in reflecting the perspective and values of the PPC, as recently confirmed upon its re-review at a PPC retreat held in October 1997 to specifically discuss promotion criteria and processes.
The criteria elucidated within the McHugh Letter are quite consonant with those applied in the promotions process today, in that the PPC continues to consider scholarly achievement in its broadest academic sense. Nevertheless, it is important to emphasize that the high level of scholarly distinction necessary to achieve the rank of professor at Hopkins must be based on some form of objective evidence. A promotion to professor is not recommended by the PPC in gratitude for many years of faithful service or for securing large economic benefits to the University, whether from clinical revenue, contributions obtained, or grants funded. Grants are considered from the point of view that they reflect success in a rigorous, scholarly, peer-review process. Total dollar amounts or number of grants per se are as irrelevant to the question of promotion as are the absolute number of publications, book chapters, students taught, patients treated, procedures performed, etc. The PPC values the quality of the candidate's contributions in general, and their scholarly impact in particular, rather than just the quantity of work performed. The PPC tries to evaluate the incremental knowledge imparted by the candidate, whether it applies to teaching, patient care, program building or scientific research. While there are a number of appropriate ways for a university to recognize important, indeed, vital contributions of other than a scholarly nature, the title of professor is, by definition, a recognition of scholarly achievement; to apply it otherwise would be contrary to the most fundamental value of any institution of higher learning, especially Johns Hopkins University: intellectual integrity.
For similar reasons, the PPC explicitly does not consider time at rank as a criterion for or against promotion. The PPC is not biased against candidates who have served a relatively short period of time at lower ranks, and does not recommend promotion merely to reward long service at a lower rank. The fundamental consideration is scholarly achievement rather than the period of time involved. Variation in the length of time needed to achieve the academic standards for professorial promotion at Hopkins is to be expected, considering the wide diversity of faculty interests and activities. The PPC recognizes that faculty with substantial responsibility in providing clinical service and administrative leadership have less time available for scholarly achievement related to these and other activities, which might necessitate a longer period for them to meet the criteria for professor.
Documentation of Scholarly Achievement
Traditional criteria for documenting scholarly achievement emphasize the quality rather than the absolute number of peer-reviewed publications, grants, and awards. These measures are most commonly associated with scientific achievement. As discussed above, the PPC has recognized for many years the remarkably diverse ways by which individual faculty can make scholarly contributions, and the innovative forms that these contributions can take. Correspondingly, the means of documenting these contributions have become increasingly diverse and innovative.
Achievements in teaching and training often are well documented by objective reviews, awards, and invited educational lectures. In addition, items such as audio or videotapes, CD-ROMs, teaching syllabi, slide sets, etc. can provide important information in the evaluation process. The impact of such documents is based primarily on their scholarly content and innovative application, rather than just the format used.
The mentoring activities of candidates also are important in evaluating candidates, particularly in regards to the achievements of their trainees and the candidate's role in the training of these individuals. In many cases trainees recognized for their own achievements are used as referees to document the impact of their mentor. Likewise, clinicians are evaluated for novel contributions to the care and treatment of patients, and for national and international recognition thereof. The above are just a few examples that illustrate an ever broadening array of possibilities by which a candidate's scholarly contributions in education are documented objectively.
One important element in the quality of documentation is whether it has undergone some form of rigorous and objective review. The PPC recognizes that grants, papers, and awards provide excellent evidence of scholarly achievement when they are rigorously peer reviewed. It is clear how candidates emulating the "William Welch pathway" should document their scholarship, and it is relatively easy for the PPC to evaluate the quality of their grants, papers, and awards. In contrast, it is more difficult to document outstanding scholarly achievement in the quality and impact of certain types of activities, for example, one-on-one teaching or one-on-one patient care. The PPC will continue to use every means available to assess and document scholarly achievements, especially for areas not typically associated with external peer-review, principally by evaluating reference letters and the department's nominating letter.
It is important to reiterate that when the scholarly educator communicates his/her teaching excellence or patient care wisdom to a larger audience in some recorded format, the PPC's evaluation of scholarship is made easier and more objective. Peer review of such recorded communication provides even better evidence for the PPC. Correspondingly, letters from outside referees are not just polled as for or against promotion. Letters that provide documentation of the candidate's contributions carry a preponderant weight. Just as it would have little impact for a candidate only to list the number of hours spent in the laboratory, a candidate's mere listing of students taught, lectures given, or patients treated has less impact on the PPC than the objective documentation of substantial impact, innovation and overall accomplishment within these areas. Therefore, while the PPC has always considered any and all material provided to it, accomplishments that can be documented objectively carry more weight. Self-recorded data, such as teaching portfolios, should recognize the importance placed by the PPC on the objective evaluation of the quality of the contributions that are listed by a candidate. A format for the curriculum vitae submitted in support of a candidate's promotion has been developed by the PPC to help guide this process (Appendix V).
Mechanics of the Promotions Process
Each candidate is referred to the PPC following successful review by the appropriate individual departmental promotions process and submission of a written nomination to the Dean by the department director. The packet submitted for each candidate is distributed to the PPC, and includes the nominating letter from the department director, an updated C.V., copies of appropriate documents (e.g., articles, textbooks, slide sets, videos) reflecting achievements of the candidate, and a list of up to a dozen potential external referees. To help standardize this process and ensure that the PPC receives as much relevant information regarding achievements of the candidate as possible, the PPC has outlined formats for the content of the candidate's C.V. (Appendix V) and the director's nominating letter (Appendix VI). In addition to facilitating the promotions process, it is anticipated that this information will further help clarify the criteria used in evaluating candidates.
The PPC meets twice a month year-round. Upon receipt of the nomination packet, the candidate is assigned at the next PPC meeting to a member of the PPC who volunteers to chair a subcommittee that is charged to initially evaluate the candidate and provide a recommendation to the entire PPC. The subcommittee chair, together with the PPC as a whole, chooses two or more other members of the professorial faculty, who are not on the PPC and who do not have a conflict of interest, to serve on the subcommittee. Subcommittee members are chosen to be familiar with the areas of contribution of the candidate, and particularly to represent the types of contribution (i.e. education, clinical excellence/scholarship, administration-program building, scientific achievement) of the candidate. As soon as the subcommittee members agree to serve, they meet to review the available documents and assemble a list of referees in addition to those referees suggested in the department director's nomination letter. The membership of each sub-committee is kept in the strictest confidence; all correspondence and communication of any sort regarding a specific candidate is made by and through the PPC chairman. Likewise, referees are explicitly asked to maintain strict confidentiality to help ensure objectivity and candor in providing an assessment of the candidate.
Optimally, the entire professorial promotion process takes no more than six months. However, it often takes longer due to a number of factors, only some of which are under the control of the PPC. Unfortunately, referee's letters are often slow to return and frequently additional referees are needed, necessitating one or more additional rounds of reference requests. The major role of the subcommittee is to identify areas of achievement and, in some cases, of concern, and to collect all the data required to render a fair decision. The subcommittee then reports back to the PPC as a whole, where each candidate is thoroughly discussed and voted upon at a minimum of two PPC meetings. In some cases the recommendations of the subcommittee are overruled in a positive or a negative direction. It is not unusual for the PPC to request additional information to clarify issues of concern or controversy. The PPC interprets its mission as to make a thoughtful decision as efficiently as possible, but not to sacrifice precision or fairness to expediency.
Following two votes by the PPC, its recommendation is brought before the ABMF for two readings. The first is a detailed presentation of the candidate and the PPC's recommendation, which is provided by the PPC chair with comments by the candidate's department director and other members of the ABMF. At the subsequent meeting of the ABMF, a short summary of the candidate's achievements and the PPC recommendation is provided, and the formal vote by the ABMF is then made. Since the ABMF does not usually meet during July and August, this hiatus may prolong the process an additional two months. Following approval by the ABMF, the candidate is brought for confirmation to the next meeting of the University Board of Trustees. While the deliberations of the PPC are necessarily confidential, it is important that candidates realize that delays often do not reflect any difficulty with their promotion, but rather the logistical problem of acquiring the appropriate information.
Perceptions of the Promotions Process
The PPC is aware that the process of promotion, which is necessarily confidential and yet of enormous importance to an individual's career, can be associated with a great deal of anxiety. Candidates should remember that the PPC is a rotating group of their colleagues who have already achieved professorial status, who have been chosen for their objectivity and judgment, and who are widely representative of the academic community. No member of the PPC serves more than two three-year terms, and many additional members of the professorial faculty participate as members of subcommittees. Most faculty members are reassured about the fairness of the process once they have served on a subcommittee, or on the PPC itself. However, one must have achieved the rank of professor before one can serve in such a way, so that this policy does little to alleviate the anxiety of those who aspire to promotion.
Although the PPC does not function formally as a consensus committee, decisions are most often unanimous. When differences of opinion occur, they almost never divide along parochial lines, for example, such that the "clinicians" vote against a "basic scientist" candidate or vice-versa. Moreover, there is no targeted "success rate" of candidates reviewed by the PPC; the success rate largely reflects the judicious choice of candidates who are nominated. Approximately 85% of candidates are currently successful, and that success rate is equivalent for candidates in each of the "pathways" discussed above. An important concern however, is a widespread perception that candidates in a particular pathway, especially a non-scientific pathway, are less successful in obtaining promotion and therefore might be less likely to be nominated by their departmental director. Although the success rate of candidates in each pathway appears equivalent, this does not exclude the possibility of selection bias in the data as a result of a lower nomination rate for candidates in certain pathways. Therefore, it is important that those involved in the candidate review and nomination process at the departmental level, and particularly those who have joined Hopkins more recently, are aware that 1) the PPC reflects the institutional values of scholarly achievement in the clinical, teaching, and program building pathways as much as the scientific one, and that 2) each candidate is viewed in the totality of their unique combination of achievements.
It is hoped that this report, and discussions it may generate, will help to clarify the criteria and process of professorial promotions at Johns Hopkins.
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