Archive for August, 2010

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Backing Up

Tuesday, August 31st, 2010

It’s a researcher’s nightmare: you are close to completing a large project, and your computer crashes, taking the data or the analysis with it.

Graduate student John Boldt thought he could avoid the problem by storing his nearly finished thesis on a laptop and a backup on an external hard drive. He left them in his car when he went for a run. When he came back, both copies were stolen.

Sometimes when I lose a piece of writing I’m working on, it’s a blessing in disguise. I’m forced to go back and recreate my thoughts. The second time is usually more succinct. Still, I don’t like that feeling of seeing all my efforts get deleted.

I back up on a shared drive, but usually only once a week. I’ve also tried thumb drives to ferry files back and forth between my work and home computer. There’s an on-line service called Dropbox that gives users 2GB free storage on the cloud. I’m not sure there’s a single best way to back up as long as it becomes a consistent habit.

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Attracting PCPs

Monday, August 30th, 2010

The number of primary care physicians in the United States is already too low to meet the demand. With the implementation of  reforms to bring health care access to millions more, the shortage of PCPs will become even more acute.

Time Magazine reported on this looming problem last week. Experts estimate that we will be short 30,000 primary care doctors by 2015. With fewer than 7% of current medical students interested in practicing general internal medicine or family medicine, the problem will only escalate.

Like other media that report on the problem, Time blames the rise in debt that medical students accrue. Even though the average primary care physician can expect to make almost $200,000 a year, that is less than half what a cardiologist can earn and a small part of the $500,000 in loans that a student might have to repay.

Money is no doubt a consideration for medical students choosing a specialty.  I doubt many applicants for dermatology residency slots chose to pursue medical studies because of a passion to treat skin diseases. Rather, dermatology offers a higher pay with more control over schedules. For younger generations, practicing medicine should not be incompatible with building a life.

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Trends in Tenure

Friday, August 27th, 2010

More than other professional organizations I am familiar with, the Association of American Medical Colleges produces frequent, relevant research reports. They benefit from a trove of data from member institutions and the services of statisticians. Occasionally their findings generate national headlines. Other times the intended audience is more insular.

In a recent analysis, AAMC researchers show that the preponderance of medical schools offer tenure for their clinical and basic science faculty. Boston University School of Medicine is one of just 7 (out of 126) LCME-accredited medical schools that do not offer any form of tenure. The others include the Mayo Medical School but also a few Caribbean-based schools. Newly accredited schools seem to be favoring the tenured/tenure-track model.

While the number of medical schools offering tenure to clinical faculty remains steady, the overall proportion of faculty who are tenured or tenure-track had declined. This is mostly attributable to the growth of "para-faculty" who are not eligible for tenure. Having multiple tiers of faculty invites feelings of second-class citizenry and risks slotting women and minority faculty in lower status positions. If a school allows for tenure, it should be offered uniformly. I'd like to read more about how the lack of tenure at a place like BU has affected recruitment and retention.

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Transgender Patients

Thursday, August 26th, 2010

This July Erin Vaught went to the Ball Memorial Hospital emergency room in Muncie, Indiana coughing up blood. Instead of treating her condition, the medical staff ridiculed her and taunted her because Erin is transgender.

As a result of the incident and subsequent publicity, Ball Memorial Hospital is now making lesbian, gay, bisexual, and transgender sensitivity training mandatory for its employees. The restitution also included the hospital president apologizing to Vaught.

Ball Memorial Hospital's response serves as a a model for other medical institutions. The hospital admitted wrongdoing, worked with community organizations to design a curriculum, and required training for all staff.

Of course, it's better to avoid such offensive incidents in the first place. And LGBT patients are not the only ones with particular needs. The incident shows that at Boston Medical Center, where our mission is to provide "exceptional care without exception," ongoing sensitivity training is still useful to put the slogan into action.

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The Mindset List

Wednesday, August 25th, 2010

Every back-to-school season Beloit College releases its Mindset List. This list describes the world as seen by the entering class of freshmen. Some of the perspectives on the mind of the class of 2014:

  • Fergie is a pop singer, not a princess.
  • DNA fingerprinting and maps of the human genome have always existed.
  • Czechoslovakia has never existed.
  • Nirvana is on the classic oldies station.
  • They have never worried about a Russian missile strike on the U.S.

Students born in 1992 may have  historical knowledge of the Cold War or life before the human genome, but they have no personal experience with it. For professors, it is important to know the audience. Seeing the world through their eyes allows us to tailor the concepts we teach. One of the most effective pedagogical tools is to drastically interrupt a deeply-held expectation.

These students still have a ways to go before graduate school, but their worldview is not so far off from that of the entering class of medical students.

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Making Vitas More Vital

Tuesday, August 24th, 2010

When it comes time to promotion, the CV is a crucial document. Members of the Appointments and Promotions Committee can see scholarly activity at a glance and weigh a candidate's achievements against departmental criteria.

For researchers, the measures are fairly straightforward: number and quality of publications and grants. CVs capture those data effectively. But for educators, it is more difficult to encapsulate quantity and quality on a CV. Awards help, but there are not enough awards to recognize all the outstanding teaching that goes on at an academic medical center.

One solution is the educator's portfolio. This packet supplements the CV with more detailed examples of pedagogical effectiveness. These examples could include student evaluations, letters of thanks, student outcomes, mentoring activities, and invitations to teach a course again.

Of course, putting together a portfolio assumes that the candidate has been keeping track of all these things. That's why it's a good idea to keep a file marked "Promotion" and add everything relevant as it comes across your desk. When it comes time to put together the CV and portfolio, it will be just a matter of editing.

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Losing Weight

Monday, August 23rd, 2010

Stephens College in Columbia, Missouri is going on a diet. An alumna of the all female, liberal arts institution was talking to the college president about the rise of obesity in the United States.

The conversation turned to the president's own excess pounds and how difficult it is to balance work and exercise. The alumna challenged the president to lose 25 pounds in exchange for a $100,000 gift. The president agreed but proposed that the alumna give $1 million if the college staff could lose a collective 250 pounds by the end of the year.

With the financial motivation, the campus is making it easier to live healthfully: starting walking clubs, adding more nutritious food to the cafeteria, and setting an example for other employees.

Particularly at an academic medical center, the lessons of this experiment are even more relevant. The institution can make it easier to opt for healthy choices, but individuals must prioritize their own health. It's not an either/or because being healthy allows faculty and staff members to work more effectively.

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Room for Improvement

Friday, August 20th, 2010

The hierarchical system of academia encourages faculty to aim for the next rank, the more prestigious title, or the higher-tier journal. We tend to admire our senior colleagues who have seemingly collected all the awards and assume that they operate on auto-pilot. They are like the Monopoly players who snatch up Boardwalk and Park Place, build hotels, and just wait for the rent to come flowing in.

But even high-flying faculty require development training. Kerry Karukstis, professor of chemistry and chair of the faculty at Harvey Mudd, writes about three ways universities can help those at the peak of their careers climb even higher.

She mentions time for renewal and training, leadership skills, and networking opportunities. Not surprisingly, these are some of the same needs that early career faculty require. Her essay, though, points to the benefits of tailoring development programs to the career stage of the faculty member.

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Remembering Markoff

Thursday, August 19th, 2010

BU's public relations team may be loathe to acknowledge it, but the most visible news coverage the university has received lately is the suicide of former student Philip Markoff. Markoff was the BU medical student accused of stalking and killing women he met on Craigslist. He was in jail awaiting trial when he killed himself.

Like a lot of sensationalized news stories, this one attracted extra attention because it involved a middle-class, blond suspect. It seemed especially incongruous that a medical student, pledged to do no harm, would engage in murderous acts.

At the time he was arrested, I heard questions about the rigor of BU School of Medicine's admissions process. Those seem misplaced to me. No admissions committee can delve into an applicant's psyche, particularly when Markoff was so skilled at deceiving everyone, including the people closest to him.

If anything, Markoff's case illustrates the need to look beyond standardized test scores in medical school admissions. At the same time, his example shows how no admissions process is infallible.

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Great Workplaces

Wednesday, August 18th, 2010

Unlike the U.S. News and World Report rankings, the Chronicle of Higher Education's honor roll of Great Colleges to Work For contains some trustworthy information. Colleges agree to participate in the project, and then the Chronicle administers a satisfaction survey to thousands of faculty and staff. They ask about compensation, fairness, diversity, and other issues that affect worklife.

The winners are not ranked, but rather listed as scoring well in certain categories. I expected that the more resource-rich colleges would be the ones rated the highest. However, of the most honored institutions, very few I had ever heard of. Wake Tech Community College? Juniata College?

It appears that faculty and staff satisfaction depended on several elements that do not require any monetary investment. They spoke of college leaders who solicited community input and then made transparent decisions. One school with a culinary program offers discounted gourmet meals to employees. A college president in Florida cancels class--without warning--one day each year for faculty and students to enjoy themselves.

As diverse as these institutions are, the formula seems to hold: treat faculty with respect, and they will reward the institution.

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