Faculty Accounting

May 5th, 2011 by pcahn

All universities and teaching hospitals are feeling the need to assess their effectiveness. The move to accountability is partly motivated by increased competition for limited funds. A department that can demonstrate its positive impact stands a better chance at attracting faculty, trainees, and public support.

One extreme example of this move to measure productivity is a faculty “balance sheet” issued by Texas A & M University. As reported in the Wall Street Journal, the Chancellor’s office has tallied up all the income a faculty member generates through tuition and grants and then subtracted his or her expenses in salary and benefits. The results are not so predictable. The history department ends up with a $4.6 million surplus, but the Aerospace Engineering department reports a loss of $1.4 million.

Texas also mandates further transparency by requiring all academic departments to post their budgets and student evaluations just three clicks away from the university’s home page. Having access to raw data, though, may not help answer whether public funding is achieving desirable goals. The faculty accounting does not take into account teaching that takes place outside the classroom or allow for periods where faculty are coming up with innovative ideas that will garner future funding. Holding higher education accountable is not objectionable; what is short-sighted is measuring faculty contributions solely in dollars and cents.

Internal Medicine Careers

April 29th, 2011 by pcahn

Attracting more medical students to choose a career in primary care is crucial for the future of the health care system. Any future primary care physicians will emerge from the ranks of internal medicine residents, so it's instructive to learn what motivates their selection to specialize or not.

An analysis published in the Annals of Internal Medicine compares results of a large national survey of Internal Medicine residents from 1990 and 2007. The proportions of respondents who wanted to pursue a career in internal medicine were nearly identical in the two cohorts, but the share who wanted to go into primary care dropped from 9% to 2%.

Other changes in the cohort help explain this decrease. The 1990 respondents faced an average of $63,000 in educational debt while the 2007 group had an average of $101,000 in debt. The younger group was also more than half female, up from 37% in 1990.

The 2007 respondents saw internal medicine as a meaningful field, but were turned off by the work demands and low financial remuneration. The authors conclude that improving the residency experience will be insufficient to increase the numbers of physicians opting for careers in primary care.

Face-to-Face

April 28th, 2011 by pcahn

With e-mail and Skype, it's possible to collaborate with scientists from around the world. But do teams that interact face-to-face maintain an advantage?

Researchers at Harvard Medical School tested this question by examining 35,000 articles with at least one Harvard author published between 1999 and 2003. They then analyzed citation rates for articles where authors worked in physical proximity. Their findings, published in PLoS ONE, show that location does matter.

As the physical distance between the offices of the first and last author got larger, citation rates for the article got smaller. Because citation is a proxy for significance, the study lends weight to the idea that the most impactful collaborations still happen in shared space. Unplanned and casual encounters matter for effective science.

Computer Breach

April 25th, 2011 by pcahn

For the past 15 years, epidemiologist Bonnie Yankaskas has received federal funding to maintain and analyze a database of mammography results from North Carolina women. Two years ago, her employer, the University of North Carolina School of Medicine, discovered that her server's security had been compromised.

Although Dr. Yankaskas had hired a computer expert to oversee the database, the medical school ultimately found her responsible for the breach as project PI. The school first tried to fire the professor. Then they tried to demote her. In a settlement, Dr. Yankasas will retain her title and salary, but retire at the end of the year.

Even without evidence of harm to the subjects in the database, it is clear that the PI is responsible for training and overseeing the personnel who manage the data. Along with the prestige of conducting important research comes the responsibility for maintaining ethical standards.

Wayback Web

April 22nd, 2011 by pcahn

As part of my role in supporting faculty, I've been thinking about new ways to leverage online technology to build connectivity. To better envision the future, I started to wonder what the past web looked like. Knowing how we've changed over time will help clarify trends in Internet use. So, I turned to the Wayback Machine.

This archive takes snapshots of websites over several points in time. When I pointed the search to the Department of Medicine's home page, it turned up several iterations. I've gathered two of them here. They are from 2001 and 2005:

Med00 Med05

One trend I noticed is the increased attention to readability. Both are still text heavy, but the later page adds more white space and bullets. The next step will be to add images. Ultimately, the future will hold more interactivity. Rather than a passive page of information, websites will engage and link the viewer with other users.

Open Access

April 21st, 2011 by pcahn

Conducting a literature review these days rarely involves going to a library. With all major journals indexed online and much of their content available digitally, if I come across a citation I can't access from my office, I question whether I really need to read it.

A study published in FASEB called Open access, readership, citations: a randomized controlled trial of scientific journal publishing attempts to answer if articles made freely available online get cited more often than others. After examining 36 journals, 712 open access articles, and 2533 subscription-controlled articles, the author found no citation bump for open access articles.

What did increase was the number of downloads. This suggests that research published openly online reaches a wider audience. The scholars who contribute to academic literature still benefit from subscription access to journals, so they can choose to cite articles based on relevance and quality. But if researchers would like to measure the impact of their work, they should look to more than just citations.

Retractions

April 20th, 2011 by pcahn

Between 1997 and 2009, 1,164 biomedical research articles were retracted. In over half the cases, the cause was scientific misconduct ranging from lack of IRB approval to manipulated data. Though worrisome, these articles represent a small portion of all the literature indexed in PubMed.

More concerning is that, according to a new study, many of these articles continue to be cited well after the retraction is posted. Only 6% of the subsequent citations acknowledge that the original article was flawed. The vast majority of citations occur in literature reviews. Because any search of PubMed would turn up a large "Redacted" watermark on the original article, it could be that authors are not conducting fresh searches to find citations for the literature review section.

From 27 to 3

April 19th, 2011 by pcahn

Michael Crow, the President of Arizona State University, has made a name for himself by reorganizing large research structures. At his home university, he has created thematic institutes that pay little heed to traditional disciplinary boundaries. In a piece published in Nature last month, he urges the NIH to do the same.

He begins his argument with a bleak account of the return on the U.S.'s investment in biomedical research. Despite leading the world in spending on science, average lifetimes have not increased. Francis Collins, the current head of the NIH, recognizes this disparity, too, and proposes greater investment in translational research.

Crow rejects that solution. He calls for a wholesale restructuring of the NIH. Instead of 27 different institutes and centers each devoted to a particular disease, why not have three that mimic the integration of research itself? They would focus on:

  1. biomedical systems research
  2. health outcomes
  3. health transformation

This way, researches could work together on the complex interactions between genes, environment, and culture that contribute to disease. Even Crow, however, recognizes how difficult it would be to revamp an entrenched system.

Avoiding Burnout

April 14th, 2011 by pcahn

A new article in the journal Educational Research synthesizes studies of emotional exhaustion among faculty members in higher education. "Burnout in University Teaching Staff: A Systematic Literature Review" finds that younger faculty and those with more exposure to trainees suffer greater rates of burnout.

The study does not explore ways to prevent stress from building up, but suggests that mentoring and stress relief activities might help. Allowing for sabbaticals is another possible solution. Taking time to explore a new area or rekindle an old passion will refresh a faculty member when he or she returns to teaching.

Women in Medicine

April 12th, 2011 by pcahn

For the fourth year, the AAMC has surveyed its member medical schools for information on women faculty members. One trend it reveals is that women continue to be clustered at the lower ranks in Internal Medicine departments. The table shows the percent of women at each level.

Rank 2010 2009 2008 2007
Instructor 50
Assistant 41 40 39 38
Associate 29 28 27 26
Full 16 15 15 14

There is some solace in that the numbers are inching up from year to year. The complete report is here.