changes in pharmacy practice faculty 1995–2001: implications for junior faculty development

Changes in Pharmacy Practice Faculty 1995–2001: Implications for Junior Faculty Development

Cynthia L. Raehl, Pharm.D., FASHP, FCCP

Objective. To compare changes in United States pharmacy practice facultydemographics from 1995–2001 and to discuss the implications for juniorfaculty development.

Methods. Demographic data were extracted from the American Associationof Colleges of Pharmacy institutional research system for academic years1995–1996 and 2000–2001.

Results. In 2000–2001, pharmacy practice was the largest faculty discipline,3.8 times larger than the next three disciplines. Junior pharmacy practicefaculty occupied 65% of all junior full-time pharmacy faculty positions.Tenure track assistant professors decreased 4% from 283 to 271, andnontenure track assistant professors increased 58% from 427 to 677 (x2 =20.0, p<0.05). In 2000–2001, 72% of all pharmacy practice assistantprofessors were nontenure track, up from 59% in 1995–1996. Womenassistant professors in pharmacy practice outnumbered men by 2:1.Challenges faced by new faculty include balancing teaching, practice, andresearch demands; selecting a nontenure or tenure track and understandingits expectations; limiting teaching preparation time; developing productivewriting habits; setting performance goals; managing time; and handling themental and physical stress of academic life. Senior faculty must activelyhelp new members appreciate the many positive aspects of academic life bysharing their strategies and success stories.

Conclusion. Schools and colleges of pharmacy relied heavily on increasingthe number of nontenure track junior pharmacy practice faculty to meetincreased clinical education demands.

(Pharmacotherapy 2002;22(4):445–462)

Most new pharmacy practice faculty membersidentify the American College of ClinicalPharmacy (ACCP) as their major comprehensivepharmacy organization. Although the American

Association of Colleges of Pharmacy (AACP)supports the educational mission of pharmacypractice faculty, it is unable to meet their needsfor practice and scholarly endeavors. Like thenew pharmacy practice professorate, ACCPmembers are predominantly young (91% age ≤50 yrs) and have advanced training (79% have aDoctor of Pharmacy degree), 77% completed aresidency and/or fellowship, and 24% are boardcertified (C. Fields, personal communication,July 25, 2001). The ACCP embraces the triad ofpharmacy practice faculty responsibilities:practice, scholarship including original research,and teaching.1 It provides a clinical practice and

From the Department of Pharmacy Practice, School ofPharmacy, Texas Tech University Health Sciences Center,Amarillo, Texas.

Presented in part at meetings of the American Associationof Colleges of Pharmacy, Toronto, California, July 10, 2001,and American College of Clinical Pharmacy, Tampa, Florida,October 24, 2001.

Address reprint requests to Cynthia L. Raehl, Pharm.D.,Department of Pharmacy Practice, School of Pharmacy,Texas Tech University Health Sciences Center, 1300 SouthCoulter Street, Amarillo TX 79106.

PHARMACOTHERAPY Volume 22, Number 4, 2002

scholarly forum demanded by many of thepharmacy practice professorate. The College haspublished guidelines and rationale for patientcare activities and educational activities.2 Astaunch advocate of research and scholarship,ACCP is a leading scientific society.3

The mission and related services of ACCPclosely align with advanced-trained clinicalpractitioners who hold faculty appointments.Primary practice locales reported by ACCPmembers in December 1999 included 14% in acollege of pharmacy and 20% in a universityhospital (C. Fields, personal communication,July 25, 2001). Another 20% and 7% reportedtheir primary practice location as community andgovernment hospitals, respectively. Becausemany faculty practice in university hospitals andelsewhere, a conservative estimate is that morethan 20–30% of ACCP members are full-timefaculty. Whereas the College has identified careerdevelopment as a major need of its members, fewresources address the specific needs of juniorpharmacy practice faculty.

Today’s imperfect health care delivery system,with its focus on costs and to some extent quality,

challenges pharmacy practitioner educators todocument their value. Health care delivery isstressful and, unlike in the past, rarely consideredfun.4 At the same time, increasing numbers ofstudents and entry-level Doctor of Pharmacy(Pharm.D.) programs demand more time for bothclerkship and didactic teaching. Simultaneously,the pressure to publish and obtain substantialexternal funding persists for tenure trackpharmacy practice faculty. These demands andstressors lead to frustration and stress for juniorfaculty. However, by characterizing juniorpharmacy practice faculty demographics andchallenges, strategies for assisting theirdevelopment as practitioners, educators, andscholars can be implemented. Only by workingtogether and understanding the background ofnew faculty and their challenges will they andtheir school or college realize the long-termbenefits of well-adjusted faculty members.

Methods

Demographic data describing junior pharmacypractice faculty (individuals below the rank of

446

Table 1. Characteristics of 1995–1996 Full-Time Pharmacy Practice Faculty

Tenure Track NontenureFaculty Rank Tenured (%) Nontenured (%) Track (%) TotalsDean 13 (100) 0 0 13Associate dean 19 (73) 2 (8) 5 (19) 26Assistant dean 11 (48) 2 (9) 10 (43) 23Professor 143 (82) 6 (4) 25 (14) 174Associate professor 98 (58) 45 (13) 99 (29) 342Assistant professor 13 (02) 283 (39) 427 (59) 723Instructor 1 (01) 0 68 (99) 69Lecturer 0 0 9 (100) 9

Totals 398 338 643 1379From reference 5.

Table 2. Characteristics of 2000–2001 Full-Time Pharmacy Practice Faculty

Tenure Track NontenureFaculty Rank Tenured (%) Nontenured (%) Track (%) TotalsDean 20 (87) 0 3 (13) 23Associate dean 25 (63) 5 (12) 10 (25) 40Assistant dean 14 (40) 2 (6) 19 (54) 35Professor 158 (75) 8 (4) 44 (21) 210Associate professor 199 (53) 49 (13) 126 (34) 374Assistant professor 17 (02) 271 (28) 677 (70) 965Instructor 0 1 (1) 86 (99) 87Lecturer 0 1 (10) 9 (90) 10

Totals 433 337 974 1744From reference 5.

PHARMACY PRACTICE FACULTY Raehl

associate professor) were extracted from theAACP institutional research system for academicyears 1995–1996 and 2000–2001.5 Additionalpharmacy faculty data were solicited from theNational Center for Education Statistics (NCES),the primary federal entity for collecting andanalyzing data related to education in the UnitedStates and other nations.6 The Roper Center atthe Carnegie Foundation for the Advancement ofTeaching7 and the Higher Education Research

Institute at the University of California, LosAngeles (UCLA)8 were contacted to assessavailability of any pharmacy faculty information.The Bureau of Health Professions was contactedregarding its report to Congress.9 The PharmacyManpower Project was contacted for relevantpharmacy faculty data.10 Simple descriptivestatistics and x2 analyses were used to describethe data.11 The a priori level of significance wasset at a p value of 0.05 or below.

447

Table 3. Changing Demographics of Full-Time Junior Pharmacy Practice Faculty

No. (%)Categories 1995–1996 2000–2001Total no. of junior pharmacypractice faculty 805 1072

Highest degree earnedPharm.D. 669 (83) 923 (86)Ph.D., other doctoral degree 26 (3) 32 (3)Master’s 51 (6) 56 (5)Bachelor's 59 (8) 61 (6)

x2 = 3.40df = 3p=NS

TitleAssistant professor 727 (90) 974 (91)Instructor 69 (9) 88 (8)Lecturer 9 (1) 10 (1)

x2 = 0.24df = 2p=NS

Faculty appointment typeTenure track 14 (2) 17 (2)Nontenure track 504 (63) 772 (72)Nontenured, tenure track 283 (35) 273 (25)

x2 = 20.60df = 2p<0.05

Appointment lengthAcademic year 28 (3) 35 (3)Calendar year 777 (97) 1036 (97)

x2 = 0.06df = 1p=NS

GenderMale 326 (40) 402 (38)Female 75 (59) 669 (62)

x2 = 1.93df = 1p=NS

Age (yrs)< 30 110 (14) 171 (16)30–39 393 (49) 514 (48)40–49 164 (20) 202 (19)50–59 34 (4) 67 (6)> 60 7 (1) 16 (1)

x2 = 6.89df = 4p=NS

From the American Colleges of Pharmacy Faculty Institutional Database.


Results

The only national organization with usabledata on new and junior pharmacy practice facultywas AACP. The NCES, the federal agencycharged with tracking higher education, does notmaintain data on any specific faculty discipline(P. Brown, personal communication, July 24,2001). The UCLA triennial faculty surveyincludes approximately 350 colleges anduniversities. Only one college of pharmacyparticipated in the last 9 years, thus no pharmacyfaculty data are available (W. S. Korn, personalcommunication, July 24, 2001). The Bureau ofHealth Professions did not assess the pharmacyfaculty manpower shortage in its report toCongress (J. Cultice, personal communication,August 20, 2001). Similarly, the PharmacyManpower Project did not specifically collectdata or analyze pharmacy faculty ranks (K. A.Knapp, personal communication, August 20,2001). The Roper Center did not respond torepeated telephone and e-mail inquiries. Asurvey of junior pharmacy faculty satisfaction,data collected in 1999–2000, included 127 juniorpharmacy practice faculty among 195 respon-dents. This was the largest pharmacy-specificstudy conducted at several institutions andprovided limited data on junior pharmacypractice faculty.12

Pharmacy practice faculty of any rank occupied1753 (48.0%) of the 3636 full-time facultypositions in U.S. schools and colleges ofpharmacy in 2000–2001.5 This increased from37% (1383/3123) of 1995–1996 full–time facultypositions. In 2000–2001, pharmacy practice wasthe largest of the nine disciplines in U.S. schoolsand colleges of pharmacy. It had 3.8 times morefull-time faculty members than each of the nextthree largest disciplines—medicinal/pharma-ceutical chemistry/pharmacognosy, pharma-ceutics pharmacy, and pharmacology (each hadabout 450 full-time faculty members). Juniorpharmacy practice faculty accounted for 65% ofthe total 2000–2001 junior pharmacy facultyranks, compared with 61% in 1995–1996.

Pharmacy practice faculty, at all professorialranks, were 50% women, compared with 18–21%for the other three largest disciplines. There weretwice as many women assistant professors as menassistant professors. In the three other largedisciplines, male junior assistant professorsoutnumbered women by 2–3-fold. Pharmacypractice department chairs, charged with juniorfaculty development, were 79% men and 75%

held the title of professor, assistant dean,associate dean, or dean. In contrast, all but twodepartment chairs of the three other largedisciplines were men.

Tables 1 and 2 show the distribution ofpharmacy practice faculty between tenure trackand nontenure track faculty for all ranks. Thenumber of assistant professors on the tenuretrack decreased 4% between 1995–1996 (283)and 2000–2001 (271). Accordingly, the percentageof assistant professors on the tenure track amongall assistant professors decreased from 39% to28% during the 5-year study period. During thesame 5-year period, the number of pharmacypractice nontenure track assistant professorsincreased from 427 to 677, a 58% increase. Thus,the overall increase in number of pharmacypractice assistant professors was due entirely tothe hiring of more nontenure track assistantprofessors. In 2000–2001, 72% of all pharmacypractice assistant professors were on nontenuretrack lines, increased from 59% in 1995–1996.Concurrently, the number of full professors(tenured, tenure track, nontenure track) rosefrom 174 to 210 (21% increase), while thenumber of associate professors (any track)increased from 342 to 374 (9%).

Table 3 provides demographic information forjunior pharmacy practice faculty (assistantprofessors, instructors, lecturers) during the 5-year study period. In 2000–2001 86% of thesefaculty had a Pharm.D. as their highest earneddegree, 91% held an assistant professor(including clinical assistant professor andassistant clinical professor) title, 25% were on thetenure track, 97% had a calendar yearappointment, 62% were women, and 64% wereunder 40 years old. During the 5 years astatistically significant difference in distributionof assistant professors was observed by tenureversus nontenure appointments (x2 = 20.6, df = 3,p<0.05). During that period, major demographicshifts included increasing numbers of nontenureversus tenure track faculty and increasingnumbers of women junior faculty members.

Discussion

The demand for new pharmacy practice facultyis intense. With establishment of new schools ofpharmacy, most of which are teaching intensiveand continued expansion of clinical education inPharm.D. programs, the demand for faculty willintensify further. Pharmacy practice faculty soonwill occupy more than 50% of all full-time U.S.

448


school and college of pharmacy faculty positions.This study shows that growth in pharmacypractice faculty ranks during the last 5 years wasdue entirely to increased numbers of juniorfaculty. In addition, 72% of these new faculty areon nontenure track lines. This is a much higherpercentage than in other academic disciplines,where about one-third of all new faculty werenontenure track appointments.13 Thus,development of junior pharmacy practice faculty,both nontenure and tenure track, is critical.Pharmaceutical educators and their practicepartners in hospitals, clinics, and communitypharmacies share a vested interest in recruitingand retaining qualified pharmacy practice faculty.

The Challenges

Consistent with studies of junior faculty inother disciplines, junior pharmacy practicefaculty often are overwhelmed by the complexityof their new position.12 Practice demands usuallybegin on day 1 as these individuals try toacclimate to practice environments. Often theymust document the clinical and fiscal values oftheir own clinical practice to both the school orcollege and their practice partners.14 Teaching,perhaps limited in scope for the first year, usuallycommences within the first few months ofappointment. These junior faculty membersmust learn to teach using a variety of method-ologies. They quickly assume responsibility forclerkships, large group lectures, small groupdiscussions, problem-based learning, and perhapsWeb-based courses. Whereas they may havesome limited experience providing a few lecturesor coprecepting a small number of students, theyare usually unfamiliar with course coordination,course development, competency assessment,and the overall curricular approach to learning.Furthermore, they often must learn unfamiliartopic content as they are integrated into estab-lished teaching assignments. Even understandingthe mechanics of teaching, such as creatingcourse syllabi and valid testing instruments, isstressful.

Whereas teaching and practice responsibilitiesare evident from the beginning, research andscholarship demands are usually self-identifiedand thus much more stressful.15 Because mostjunior pharmacy practice faculty completepractice-focused residencies,16 lack of researchexperience manifests as difficulty identifyingreasonable initial projects. Beginning originalresearch is a daunting task. New faculty must

learn how to identify feasible projects, submitgrants, obtain institutional review board (IRB)approval, collect and analyze data, applystatistics, and write a compelling peer-reviewedmanuscript. Even more important, tenure trackfaculty must develop a focused research agendathat integrates projects into definable programsrecognizable by external funding agencies andreviewers. Both tenure and nontenure trackjunior faculty may shoulder increased workloaddue to faculty shortages, further exacerbatingstress.

Together with launching academic and practicecareers, junior faculty must learn how to balancehome and family life. They frequently experiencesignificant stress and loneliness. Many struggleto balance the needs of two-career families,children, and perhaps aging parents. More than50% of female and 30% of male physician facultymembers cited work-family conflicts as the mainreason for considering leaving academicmedicine.17 Among 68 pharmacy faculty at onemajor research institution, such conflicts oftenwere reflected as time based.18 Thus, time forfamily, recreation, relaxation, and physical andspiritual endeavors should be scheduled toimprove both professional performance andpersonal satisfaction.

Background of Junior Pharmacy Practice Faculty

Junior pharmacy practice faculty areindividuals below the rank of associate professor.This imprecise definition most often refers topharmacists who recently completed a post-Pharm.D. residency or fellowship. However, asmaller number are pharmacists who arerepositioning their careers and already have somepractice or business experience, as reflected bythe 8% of 2000–2001 junior pharmacy practicefaculty aged 50 years or older. Most juniorfaculty at the assistant professor rank are in theprobationary period preceding either promotionor promotion and tenure to associate professor.Because faculty funding varies widely amongschools and colleges of pharmacy, the remainderof this discussion focuses on the needs of full-time junior faculty—those who devote theirwork life to a mixture of practice, education, andscholarship.

Whether nontenure or tenure track, juniorpharmacy practice full-time faculty are critical topharmaceutical education. Practitioners viewthem primarily as faculty even though they maydevote substantial time to pharmacy practice.

449


Fellow faculty, especially those in other disci-plines, may view them primarily as practitioners.This is particularly true if the individual is aclinician-educator and does little research orscholarship. These different viewpoints and theneed to practice at distant locations can create anidentity crisis for junior faculty.

Given marketplace demands for advanced-trained pharmacists and the significantpharmacist shortage, more entry-level pharmacypractice faculty positions are being filled byindividuals who have completed only 1 year ofresidency in either pharmacy practice or aspecialized field. Although in the past a newfaculty member may have earned both B.S. andPharm.D. degrees, most will have completed anentry-level Pharm.D. program. Colleges andschools remain anxious to recruit new facultywith four qualifications (Pharm.D., practiceresidency, specialized residency, 2-yearfellowship), yet these individuals are increasinglyrare. Academia and industry are staunchcompetitors for such extensively educated andtrained professionals. The Bureau of HealthProfessions identified the competition foradvanced-trained pharmacists among industry(managed care, pharmaceutical corporations),hospitals, and schools as particularly threateningto schools and hospitals given their economicconstraints.9 Relatively small increases inassociate and full professors of pharmacy practiceduring the 5-year period show that schools arerelying on junior faculty to meet expanded needs.Furthermore, there likely will be no moreassociate or full professors to guide junior facultythan exist currently.

Commitment to scholarship and preparation toconduct research vary greatly among new juniorfaculty ranks. In fact, commitment toscholarship often differentiates new tenure trackand nontenure track faculty. Diversity in bothbackground and desired balance of teaching,practice, and research is real. It has to becultivated and nurtured by department chairsand deans. Yet the overall developmental andsocialization needs of new junior faculty areremarkably similar. These pharmacists havechosen academic pharmacy as a career. Theyhave decided, at least for now, to balance two, ifnot three, of the major areas of responsibility:teaching, practice, and scholarship.

Many basic survival skills that new facultymust learn are common to both nontenure andtenure track faculty. Recalling that most newjunior faculty are trained in practice-based

residencies, it is not surprising that they often donot fundamentally understand academia and itsvalue system. They rarely understand even theconcept of tenure, and its institutional andpersonal career value, until they actually havecompleted a promotion step. Thus, the decisionto enter the school or college on the tenure ornontenure track is one of the most importantpreemployment decisions that new faculty (andtheir chairs) make.

Tenure versus Nontenure Track

New faculty first must decide on the relativebalance they desire between skills application(pharmacy practice) and scholarship includingoriginal research. In a study of 310 physicianfaculty equally divided between those who spentmore and those who spent less than 50% of theirtime in patient care, clear differences inresources, attitudes, and career success wereevident.19 Those who devoted more than one-half their time to patient care were 50% morelikely to report that tenure and promotioncriteria were not reviewed during their annualprogress reports and that they did not understandthe criteria.

Academic medicine increasingly appears toaccommodate the needs of a diverse facultythrough several promotional tracks. In the early1990s, medical schools established clinician-educator tracks. Of 113 medical schools queriedin 1989, 78% were redefining tenure trackpromotion criteria, 65% were creating promotioncriteria for nontenure tracks, 64% weredocumenting the process for awarding tenure,52% were creating an advising process forpromotion progress, and 50% were developingthe nontenure track.20 Even though 75% of theschools reported having a tenured clinician-educator track, none of these tracks was exactlyalike.21 By 1996, 45% of responding medicalschools indicated that such a track was in place.22

Medical deans and promotion-committee chairsindicated that teaching skills and clinical skillswere the most important performance areas forpromotion consideration. However, all areas,including academic administration, developingeducational programs, and nonresearch schol-arship, were considered important.22 Anotherstudy concluded that almost 75% of medicalschools had a separate track for full-time clinicalfaculty.23 Most of these tracks did not allowtenure for that faculty; however, 71% requiredscholarship for promotion. Unfortunately, no

450


parallel studies evaluated different appointmentand tenure policies for pharmacy faculty, yetcreation of clinical or medical center tracks formedical school faculty probably allows similarappointments.

Regardless of the track a pharmacy practicefaculty member chooses, scholarship is central toacademic success. Written scholarship is animportant factor in all promotion decisions atmedical schools24 and presumably at pharmacyschools. Assistant professors of medicine at theHarvard Medical School reported scholarshipproductivity in their promotion portfolios onaverage as 3.4 original research articles, 2.4 bookchapters, 1.0 syllabi (agenda outline withsupportive materials for each session includinghandouts, readings, and bibliographies), 0.02computer resources, and 0.04 videotapes.25 Noassistant professors had yet written a textbook oran editorial. Faculty members published both intheir medical specialty and in medical education.Knowing that the academic culture at HarvardMedical School has shifted from promotion basedsolely on original research to broad-basedscholarship may motivate young pharmacyfaculty and their institutions to consider thescholarship of practice and teaching as well asoriginal research. Consistent with an expandeddefinition of scholarship, all faculty endeavorsmay be considered scholarly provided they aredocumented in written format amenable to peerreview.26

Many junior faculty do not appreciate whattenure implies today. The award of academictenure represents a university’s long-termcommitment to an individual faculty member.Tenure is an all-or-none qualitative decision.27 Itis a substantial commitment by the university tosomeone who has demonstrated excellence inperformance. The university also must beconvinced that the individual will continue tomake substantive contributions to the institution.Tenure is not awarded based on time in rank. Nolonger a lifelong employment guarantee, it is stillthe ultimate commitment of university resourcesto a faculty member.28 More important, manyindividuals believe that it is the ultimate peerrecognition.29 It is affirmation by both internaland external peers of their confidence that theindividual will continue to perform in anexemplary manner.

In the past, tenure was thought to providelifelong job security. But as the advent ofposttenure review and complete abolishment oftenure at some institutions portend, it is better

perceived as the pinnacle of peer review. Nodoubt, it offers greater, but not complete, jobsecurity. More important, it preserves thefundamental principle of academic freedom;freedom to pursue scholarship and researchwithout overriding concern for the immediacy ofpublication, grants, and politics.30 Thus, thepolitical and economic security of tenure remainsan important reality and driving force for selectednew pharmacy practice faculty.

The reality is that tenure is predicated ondemonstration of excellence through externalpeer review. Often, written college promotionand tenure guidelines require excellence in twoof the three major performance areas. It is, as itshould be, almost impossible to earn tenure inpharmacy practice without a significantscholarship record, the gold standard of which isthe peer-reviewed published research article.New faculty may pursue the scholarship ofteaching, the scholarship of practice, or thecreation and dissemination of new knowledge(original research). But without writing andsuccessful grant application, peer reviewprobably will not support the award of tenure.31

Tenure also considers a candidate’s citizenshipand professional service record, but these aloneare insufficient for an institution to make a long-term commitment. On the other hand, thefaculty member who demonstrates excellence inteaching or practice (through peer-reviewedpapers, supporting grants, peer support, andinnovative program design, development,implementation, and assessment) and assemblescompelling teaching and/or practice portfoliosmay earn tenure with limited original research.32

This is most likely to occur in institutions with aprimary focus on teaching and is unlikely tooccur in research-intensive universities. Byreviewing the dossiers of individuals who earnedtenure at their home institutions, facultymembers can determine to what extent originalresearch is required of tenure applicants.

Pharmacy practice faculty desiring a focus onskills or practice (usually nontenure track)should approach the practice of pharmacy with ascholar’s inquisitiveness. They should designcontrolled experiments of new practicemethodologies, report new clinical observations,design new systems of caring for patients, orapply new management approaches to the healthcare system. Although they typically do not seethemselves as researchers, they should develop,over time, into scholars of practice or perhapsteaching. In contrast, those who are committed

451


to publish original research and support theirwork through externally funded grants oftenchoose the tenure track. Their major foci will beteaching and scholarship supported to someextent by continued connection with the practiceof pharmacy.

Whether nontenure or tenure track, allpharmacy practice faculty teach. Thus, allschools and colleges demand that newpractitioners learn to teach reasonably well andin a variety of settings. Yet the breadth ofteaching responsibilities is almost universallyunappreciated by new faculty.33 Teaching ismuch more than precepting students orproviding a lecture or two, these being the usualteaching exposure for most pharmacy residents.Nontenure track faculty, like tenure track faculty,must learn to design courses, lead course teams,participate in curriculum redesign, andcontribute to faculty governance. Thus, thedecision to choose a tenure or nontenure trackposition should follow introspective evaluation ofthe relative balance among practice, teaching,and scholarship.

Recognizing the publish-or-perish demand thatdominates many university systems, mostpharmacy schools and colleges offer two or eventhree professorial tracks for full-time pharmacypractice faculty. These tracks may includetenure, nontenure, clinical, or health sciences.Before accepting an employment offer, facultyapplicants should review operational promotionand/or tenure guidelines (school-college,university) with both the chair and a seniorfaculty member. They should make sure theirexpectations and desires are in line withdepartment and institution criteria for success.Similarly, they should obtain a firm expectationof their new partner (clinic, hospital, pharmacy),particularly if their salary (or the school) isremunerated for their practice effort. Selection ofa tenure or nontenure appointment should bebased on a reasonable understanding of institution-specific criteria for promotion and/or tenure.

Understanding Institution-Specific Promotionand Tenure Expectations

At the end of their first year, most new facultycannot describe the specific procedures andrequirements for tenure.34 By the fifth year, onlyabout one-half of junior faculty stated that theyclearly understood tenure requirements thatwould apply to them. Thus, it is imperative thatnew and junior faculty devote considerable effort

to gaining a clear understanding of their collegeand institution requirements. From the first dayof employment, they have to know if they areexpected to demonstrate performance excellencein one, two, or three areas.27 Although perhapsoverly simple, it is helpful to classify both theinstitution’s and their own position as teaching,practice, or research focused.

At research-intensive institutions, tenurecertainly will depend on the number and qualityof peer-reviewed publications, grants record, andpeer review from senior faculty in similarcolleges. At teaching institutions, promotion andtenure most likely will be based on studentcourse evaluations, peer teaching evaluations,and publications supporting teaching as theprime institutional focus.35 Service in the collegeor institution is important but rarely considered asingle area of excellence for promotion or tenure.Writing and contributing to the professional andscientific literature is synonymous with anyfaculty position.

Within the first year of their appointment,faculty must implement documentation systemsand build their career portfolio in all perform-ance areas.36 They have to map their manuscripts,noting expected publication date, journal quality,and order of authorship. For many juniorfaculty, the promotion-tenure schedule mandatessubmission of the complete dossier in year 5 or 6(assuming a 6- or 7-year clock). They similarlyshould plan their teaching activities so that bypromotion time they have assumed responsibilityfor several courses. Documentation of innovativeteaching developments is a constant effort.Junior faculty seeking to prove practiceexcellence to outside reviewers must assembleconsiderable longitudinal clinical and fiscal data.The practice portfolio may contain qualityassurance reports, patient or physician satis-faction surveys, trainee records, and associatedservice contracts. Prepromotion service commit-ments should be limited so that the junior facultymember is positioned to exemplify leadershipand team spirit in one or two focused areas.37

Serving on a few committees is less preferablethan rising to leadership on single committee ortask force.

Because promotion and tenure processes varyamong institutions, new faculty should identify,during their first year, the process steps, keycommittees, and timetables. They mustunderstand the specific roles of department peer-review committees, school or college reviewcommittees, the dean, president or chancellor,

452


and regents or board of trustees. Voting membersshould be identified. The selection and role ofexternal reviewers should be discussed so thatjunior faculty may begin to network withpotential senior colleague reviewers. New facultymust be keenly aware of the key role of theirdepartment review committee and departmentchair. Regardless of the process, it is verydifficult for faculty to be promoted without thesupport of their chair.27 Thus, junior facultyactively should seek critical review from theirchair at least twice/year.

Nontenure track faculty, once considered anacademic underclass, are now integral to healthprofessional schools and colleges.38 Nontenuretrack junior pharmacy practice professors usuallyare committed to being promoted through theprofessorial ranks. Some schools may offernontenure track faculty who have been promotedto associate or full professor extended contractsor multiyear employment. This job security maybe somewhat similar to that offered by tenure.These faculty typically have shown commitmentto the scholarship of both practice and teaching.Thus, junior nontenure track faculty mustappreciate that such a singular focus is usuallynot acceptable. Scholarship remains the foundationfor promotion and tenure. Whereas some insti-tutions allow faculty to switch between non-tenure and tenure tracks, this option is rare andguided by specific criteria and guidelines.

Faculty-Orientation Programs

A faculty-orientation program helps juniorfaculty navigate many paths of responsibility.Many faculty applicants expect a structuredorientation program and may request programoutlines before agreeing to employment.Whereas there is no one universal approach tofaculty orientation, the literature clearly supportsits value.39 Such programs provide long-lastingbenefit to both new faculty and the institution.Five different formats for faculty orientationprograms were described.39 A centralpresemester program may be either voluntary(University of Texas, Austin) or mandatory(Southeast Missouri State University, CapeGirardeau). A semester-long program may bedecentralized (University of Illinois, Urbana) orcentralized (University of Oklahoma, Norman).These programs hold a weekly or biweeklyseminar for professional development. A single3-hour evening orientation, used by theUniversity of Maryland in College Park, oriented

its large adjunct faculty corps.Most faculty-orientation programs supplement

discussions with campus visits, role playing,exercises in creating syllabi and examinationquestions, and perhaps delivering Internet-basedprograms. Successful characteristics of aprogram are as follows:

1. Mandates attendance by all new and juniorfaculties joining the college.

2. Has strong support of and participation bydepartment chairs and deans.

3. Communicates college and departmentgoals and translates these to facultyexpectations.

4. Incorporates orientation to broadresponsibilities of teaching, practice, andscholarship.

5. Requires active learning, is highlyinteractive.

6. Involves positive senior faculty,administrators, and key staff.

7. Includes several third- and fourth-yearfaculty as planners and hosts.

8. Mixes survival skills and culturalizationactivities.

9. Uses face-to-face interactions at the homecampus.

10. Has flexible schedules and provides freetime.

11. Provides social networking with faculty,staff, and students.

12. Identifies resources for teaching, research,and practice development.

13. Explains logistic support for new facultyfrom purchasing to travel.

14. Provides overview of legal principlesgoverning academia.

15. Reviews practice relationships andcontracts affecting faculty.

16. Reviews promotion and tenure process andexpectations.

A combination of both presemester andsemester, or even yearlong, programs is attractive.Attendance at presemester orientations is usuallywell over 50% and sets the stage for continuingattendance during the semester when schedulingconflicts become more common.39 As morepharmacy schools use distant campuses, aninitial face-to-face orientation at the base campusis essential to building networking amongdispersed faculty.

Every program should provide a primer onbasic teaching skills such as incorporating activelearning into the classroom. New faculty should

453


be encouraged to consult with other faculty onteaching mechanics. These collaborative contactsare critical in creating cross-departmental courseteams and decreasing the isolation that plaguesnew faculty. Mixing elements of professionalismwith social activities will help new faculty starton a positive note.

Socialization of New Pharmacy Practice Faculty

Whether tenure or nontenure track, newpharmacy practice faculty share many commonneeds beyond enhancing pharmacy practice skillsthey already possess. These needs are strikinglysimilar for new faculty in other disciplinesranging from astronomy to cellular biology. Apreeminent scholar and researcher of new faculty,Robert Boice, professor emeritus of psychology atState University of New York at Stony Brook,provides rich resources for new pharmacypractice faculty through his books andpublications.40 Socialization of new faculty, theprocess by which faculty become integralmembers of the academic community andunderstand its values and cultures, is wellstudied and eminently applicable to pharmacypractice faculty.

Boice’s works in which he characterized theexemplars or quick starters are helpful.40 Intracking 415 new tenure track faculty, Boiceidentified 21 exemplars (defined as new facultywho succeeded in the eyes of students, colleagues,and administrators). Four characteristics arecommon to these exemplars, also termed quickstarters.

Broad Involvement

Exemplars quickly became involved in schoolor college life.40 New pharmacy practice facultyshould be encouraged to do the same. Theyshould access school and practice networksimmediately. They proactively should seek thecounsel and advice of several colleagues, peers,and mentors on a routine basis. Quick startersdevoted about 1 hour/ weekday to colleaguevisits, telephone calls, and correspondence.40

When they took time to initiate conversationsand appeared less busy, senior colleagues morereadily offered assistance. Yet, new faculty oftenare hesitant to seek out senior colleagues. Chairscan assist in establishing these interactions andshould encourage new faculty repeatedly to takethe initiative in this regard.

Involvement with experienced practitionersshould parallel involvement with senior teachers.

Help establishing a system of practicedocumentation may be obtained from a hospital-based staff pharmacist. Help designing the firstlecture may come from a faculty member inpharmaceutics. Help preparing course materialfor problem-based learning may come fromstudents who completed the course in the lastyear as well as from experienced facilitators.Involvement in professional organizations can becritical in introducing new junior faculty to newcollaborators. By networking with pharmacy andmedical colleagues outside their home department,junior faculty often can create relationshipsleading to projects and manuscripts.

New faculty should learn to balance at leasttwo of the three major components from day 1 ofemployment. They cannot devote their time andeffort solely to the practice site or solely to theschool or college. Research collaborators shouldbe contacted within the first few weeks so thatscholarship programs can be thoughtfullydesigned. And of course, new faculty should getto know their students. Going to class early andvisiting with students, having lunch in thestudent lounge, or attending student socialevents will help new faculty understand theirstudents and make them more comfortable whenthey enter the classroom. Thus, immediateinvolvement in the three main activities ischaracteristic of quick-starting new pharmacypractice faculty.

Moderate Teaching Preparation

New faculty tend to rush into preparingteaching materials. They often fail to take timeto reflect on student preparation, course goals,and the central principles and objectives guidingeach class session. Conversely, some procrastinate.Binge preparation leads to excess pressures,inefficiency, and inconsistency of teachingapproaches.41 Most new faculty are shocked tolearn that overpreparation is fraught withnegative consequences.

They should be encouraged to prepare teachingmaterials daily at brief, regularly scheduled times.Research from nonhealth care disciplinessuggests that for each 1 hour of classroominstruction, faculty should devote no more than 2hours preparation.40 Although this may appearto be a drastic underestimate of time, healthprofession data in this area are scant. In a surveyof 163 junior physical therapy faculty, 56% ofrespondents indicated that they spent 4–8 hoursand 24% reported that they spent more than 8hours preparing per lecture hour.42 This reflected

454


the average for all faculty and did not determinehow quick-starting faculty budgeted teachingpreparation time. Thus, new faculty who spendmore than 8 hours preparing for a single classsession should realize this is greater than desiredor expected. Certainly, this benchmark will helpnew faculty avoid the 20- to 30-hour preparationtimes that lead to excessively detailed teachingmaterials and overemphasis on content delivery.

By beginning preparation early, new faculty canrevisit their teaching materials. Brief, regularpreparation periods encourage them simultaneouslyto accommodate practice demands and attend toresearch needs. These sessions result in improvedteaching and increased productivity in other areas.

Develop Productive Writing Habits

New faculty must start their scholarship on day1. Time committed to writing should be apriority. Nontenure track faculty focusing onpractice excellence may wish to devote theirwriting time to creating a draft proposal forcollecting baseline data before they begin a newclinic. Similarly, writing time can be used tofinish a manuscript from a residency project orcreate a follow-up proposal for IRB approval.Those wishing to establish excellence in teachingshould develop a plan that translates innovativecourse design to peer-reviewed manuscripts.Research-oriented individuals should concentrateon submitting manuscripts from previousprograms within the first year. They also mustlaunch new research programs and commit timeto writing protocols, IRB submissions, andgrants.

Brief daily writing sessions can start with aslittle as 10 minutes/day.41 Faculty cannot wait forlarge uninterrupted blocks of time such as full oreven half-days. Instead, they must learn to useshort sessions to plan papers, refine outlines, oreven construct paragraphs. For the first fewmonths they should force themselves to writeregularly in short sessions and make morepleasurable activities (telephone calls, casuallymeeting with other faculty, answering e-mail)contingent on completing them. After firmlyestablishing a writing habit, they can go to amore flexible schedule that is equally productivebut probably more creative. Writing in the sameenvironment every day will help establish regularhabits. New faculty should be encouraged tochart their daily writing progress, whether pagesor paragraphs, so that output is visible.

Evidence for the success of such a routine

comes from a 6-year longitudinal study of 32 newfaculty that tracked 16 self-proclaimed bingewriters with 16 who primarily wrote in brief dailysessions.41 Regular writers excelled over thebinge writers in all output measures (Figure 1).Of importance, none of the 16 binge writersearned promotion or tenure, whereas all 16regular writers were awarded tenure on schedule.New faculty usually are reluctant to share theirwriting with others, yet they should seek earlyconstructive criticism from experienced writers.This will save countless hours resubmittinggrants and manuscripts.

Department chairs should be familiar withdefense mechanisms as excuses for not writing.The most common complaint is that faculty aretoo busy.27 Discussion usually reveals busynessresults from overcommitment to teaching prepa-ration, to practice activities without associatedpractice goals, or to committee work that is

455

Figure 1. Effects of brief daily sessions on writers’productivity. (From reference 41 with permission.)

0

1

2

3

4

5

6

7

No. of manuscripts accepted

No. of manuscripts submitted

No. of hours of writing/week

No. of pages written/week

Binge Writers Regular Writers


neither expected nor important. Some newfaculty mistakenly believe they can succeed inonly one performance area and do not appreciatethat synergy from writing positively affectsteaching and practice performance. Thus theyshould create specific writing goals and relatethem to their practice. They should beencouraged to begin writing case reports, incisiveliterature reviews, and programmatic descriptions.Then they will learn first-hand that scholarshipresulting from practice improves both thepractice itself and teaching.

Set Priorities and Develop a Compatible WorkRegimen.

New faculty may be tempted to develop asyndrome in which every hour and minute areconsumed by low-priority activities.43 Many ofthese activities easily can be delayed or avoidedall together. New faculty need help in learning toset priorities and mange their time accordingly.40, 41

Many are reluctant to express their need for time-management training. A number of commercialresources may be helpful; however, discussionswith chairs and senior faculty about settingspecific written performance goals with targetcompletion deadlines are more likely to help thangeneric courses. University seminars designedspecifically to help faculty develop time-management skills are rare, although corporateprograms may be available.

The core of any time-management program islearning to set priorities. Long-range goals (e.g.,publication) must be achieved by creating astepped plan to completing projects whilesimultaneously managing day-to-day tasks. Newfaculty have to understand that the mostsignificant academic rewards are earned throughlong-range projects such as completing a researchmanuscript or publishing a practice-based study.Patience is a virtue. New faculty should becounseled not to devote inordinate amounts oftime to day-to-day activities that are immediatelygratifying (clerkship teaching, clinical practice),but balance long-range projects that provideimmense gratification perhaps years afterbeginning them. Senior faculty can help newfaculty members learn the positive aspects ofacademic life by sharing their own success storiesin publication, grant applications, nationalrecognition, travel, and the luxury of pursuingtheir research and practice interests.

Overview of Junior Faculty Years

New pharmacy practice faculty will benefitfrom reading and discussing the literature aboutthese early years. Stresses and pressures areshared by faculty across all disciplines atuniversities across the country. Departmentchairs should stimulate discussions, bothcollectively and individually, so that new facultyunderstand viable solutions for the challengesthey face. New faculty must understand thatothers have adjusted to similar problems.

Most important, new faculty must conversecasually with positive senior faculty so that theyappreciate the long-term benefits of academiclife. Positive senior faculty often are identifiedthrough their reputations as “good citizens” and“team players.” They volunteer for college anduniversity activities but also maintain their ownresponsibilities. They complete these responsi-bilities on time and do so for both the collectivegood and their own career advancement. Theyare usually well known among junior facultyranks as good role models or mentors. Positivesenior faculty are distinctly different from thosewho may be characterized as nay-sayers,complainers, or dead wood.

Longitudinal studies of faculty from otherdisciplines shed light on pretenure orprepromotion years. Through questionnaires andextensive interviews, 45 tenure track assistantprofessors provided perspectives on the 5prepromotion years at Indiana University.34

Findings of this study translate to the lives ofjunior pharmacy practice faculty as follows:

1. Time devoted to classroom teachingpreparation steadily and substantiallydecreases within the first 3 years.

2. Time devoted to clerkship teachingmoderates within the first 2 years.

3. Tenure track faculty steadily increase timedevoted to scholarship, usually by limitingclerkship and practice commitments.

4. Expectations to prove practice valueincrease for nontenure track faculty.

5. Practice-related stress reflects specifichealth care issues and thus fluctuates.

6. Faculty need clear expectations forpromotion or tenure but often do notactively seek it or receive definitiveguidance.

7. Faculty desire increasing guidance fromsenior colleagues but often do not initiatesuch contacts.

8. Anxiety about promotion varies fornontenure faculty, reflecting careeraspirations.

456


9. Anxiety about publications and grantapplications increases steadily for tenuretrack faculty.

10. Overall work stress increases with time,compatible with prepromotion or tenurecycles.

11. Personal satisfaction with practice andteaching increases over time.

As faculty gained experience and efficiency inteaching preparation, their time devoted toscholarship and service increased.34 During theprepromotion period, faculty generally maintainedor even increased their actual contact time withstudents. Teaching generally became moresatisfying and less stressful than scholarship andresearch. Faculty who understood their students’preparation were comfortable trying alternativeteaching strategies. However, they did worryabout how to assemble a teaching portfoliosupportive of promotion and tenure. Over time,faculty emerged into course coordinators or teamleaders and assumed greater responsibility forcurriculum design and analysis.

Tenure track faculty increase time devoted toscholarship and research as time progresses.34

Most junior faculty are concerned withpublication and grants records and may focus onmeeting perceived quantitative criteria versusdeveloping a focused scholarly program. Amidprobationary assessment, whether performedby internal colleagues or external peer review, isoften the first significant prognostic indicatorjunior faculty members receive. They shouldconduct a realistic self-appraisal of their strengthsand weaknesses in all performance areas andadjust the remaining prepromotion yearsaccordingly.

By year 3, most junior faculty will determine ifthe academic career and the institution are goodfits. Many may encounter family or personalsituations prompting changes during that time.The next major stress time predictably occursabout the year before promotion and/or tenure.Overall job stress appears to peak at about year 3and again at years 5 or 6. Although 50% of ajunior faculty cohort reported their healthremained steady over the first 5 years and 10%indicated improved health, 41% reported theirhealth deteriorated.13 Common complaints wereweight gain, loss of stamina, low-grade chronicillnesses, and general anxiety.

Most new and junior faculty work at least 48hours/week.12, 13 Such long hours mandatesetting specific times aside for exercise andrelaxation. It helps to maintain appropriate sleep

and exercise regimens (7–8 hrs sleep/night,aerobic exercise 3 times/wk). Whereaspromotion stresses are intuitively understood, thegreatest stressor is rather surprising. A steadydecline in collegiality and social support wasobserved as the junior years proceeded.34 Juniorfaculty experienced a growing sense of loneliness,especially in their home departments. Thus, theyoften turned to colleagues in other departmentsand institutions for support. Whereas they werequick to complain about not receiving muchsupport from senior faculty, only quick startersactually initiated such networking.41

Setting Performance Goals

Without setting goals, faculty are often busybut nonproductive. The busyness syndrome, ifnot corrected early, is difficult to overcome.Therefore, new faculty must develop reasonablemeasurable performance goals that will guidethem in achieving both short- and long-termgoals. Research clearly shows that setting goalsand developing plans to achieve them increasefaculty productivity and improve accountability.44

By revisiting their goals at least yearly, juniorfaculty will learn to set priorities for activitiesand manage their careers.

When setting goals, junior faculty benefit frominput. Chairs and senior colleagues can makesure the goals are realistic, measurable, timely,and consistent with school or college expectations.36

The three primary performance areas requiregoals with specific objectives and associatedaction plans and target deadlines. These planswill guide junior faculty members in choosingdaily activities not to appear busy, but to beproductive.

Stress Management

Stress is endemic among faculty, and whereassome stress leads to increased productivity, it cancontribute to junior faculty disappointment andoutright despair.27 By discussing natural stresspoints, junior faculty will understand that allsuccessful academics learn to manage stress andthen can relish the professional freedom of theacademic environment. Unfortunately, juniorfaculty rarely discuss these stressors except withother junior faculty. Thus, supportive mentoringby senior colleagues and department chairsbecomes pivotal.

Taking time to know students and lettingstudents become familiar with faculty memberscan minimize classroom stress. Junior faculty

457


who occasionally share career anecdotes andpatient care experiences will become morecomfortable with teaching. They must under-stand that adjustment to teaching responsibilitiesusually requires 3 years or 3 teaching cycles.This “kinetics of teaching” curve is rarelyaccelerated. It acknowledges that year 1 isusually perceived as 75% of steady state; year 2provides opportunity for major modifications andachieves about 85% of desired steady state; andby year 3, 95% of steady state teachingperformance is achieved.

Practice acclimation is usually quickest forjunior faculty who seek input of others. Steppinginto an established site, most new faculty arecomfortable with practice responsibilities andassociated clerkship teaching duties within thefirst 3–4 months. However, many are expected toestablish new practice sites that are often outsidethe traditional academic health sciences centers(new community pharmacy, service learningsites). These innovative practices may take 6–9months to become reasonably well established.Clearly, the greatest stress for all new practi-tioners is not actual patient care. Rather it iscreating, implementing, and modifying systemsthat document fiscal and clinical outcomes ofpractice efforts.45 Thus, new faculty require cleardirection from colleagues, department chairs,directors of pharmacy, and business owners as tohow to set up baseline documentation systems asthe first step of establishing their own clinicalpractice. Experienced physician colleagues cancoach new faculty through early practice phases.Similarly, new faculty should seek out discus-sions with faculty in similar practice settings,particularly those with accepted documentationsystems.

Starting a scholarship program is the moststressful and difficult of the three areas.12

Nontenure track faculty usually beginscholarship with observations or inquiries aboutclinical practice. Case reports, case series, anduncontrolled open-label clinical trials may be thefirst scholarly endeavors. Junior faculty whoestablish baseline clinical and fiscal data beforeembarking on their own clinical practice have ahead start in publishing practice-baseddescriptive reports and evaluative studies.46

Both tenure track and nontenure track facultyshould seek scholarship from their teaching.Educational studies and classroom innovationsare worthy of publication. Articles describingassessment of students or curriculum are partic-ularly intriguing in the current accountability

era. A scholarship-research program statement,although dynamic and certain to change, willguide new faculty in choosing projects.Additional training needs, such as statistics oranalytical skills, should be identified and a skills-development program implemented within thefirst year or 2 of appointment.

Emotional Cycles of New Faculty

Many junior faculty experience emotionalcycles.41 Rushing and binging to finish a project,paper, or even a lecture usually is followed by aperiod of low productivity. The resulting nearmania-depression cycle can be countered byestablishing a regular schedule to handleteaching, practice, and research simultaneously.Junior pharmacy faculty reported the leastsatisfaction and most stress with research.12

Thus, particular effort should be directed toincorporate scholarship into the regular cycle ofactivities and avoid the research binge. Althoughmany junior faculty declare that they need releasetime for scholarship activities, research clearlyshows that total release time is very unproductive.41

Productive researchers learn to handle teachingand practice tasks together with daily attention toscholarship.

A nadir in new faculty emotions often occursabout 6–8 months after starting a new position.Stress from physical moves, starting new projects,and learning to balance many work prioritiesoften peaks after the December and Januaryholidays. The half-way point of the first year isthe optimal time for chairs and senior colleaguesto reach out to new junior faculty. Time-management workshops and stress-managementtechniques can be offered routinely. Discussionof setting priorities and goals can be linked witha candid discussion of learning to say no withoutrepercussion.

Yet, junior faculty place the greatest pressureson themselves. They may be perfectionists or setunrealistic goals. They may be troubled by self-imposed loneliness and professional or socialisolation. Senior colleagues and chairs canthoughtfully bring such issues to open discussionand then resolution.

Faculty Mentoring Programs

Although faculty mentoring programs areuniversally endorsed, no one method has provedeffective. Descriptive reports in the medicalliterature suggest improved longitudinalperformance even with semiannual formal

458


mentoring meetings.47 Boice’s handbook on newfaculty41 is extremely useful for junior facultyself-study but is best used to guide one-on-onediscussion between a junior and senior facultymentor.

In one 6.5-year study, traditional facultymentor pairs were generally ineffective.41, 48

Whether arbitrarily assigned or assigned basedon interests, or from within or outside the samedepartment, most mentoring pairs dissolvedrather quickly. Forced mentoring was ineffective.Only when the pair was reminded frequently tomeet, asked to submit progress reports, orassigned an observer was activity notablyincreased. Alternatives to traditional mentoring(committees, faculty cataloging of publications,yearly portfolio submission) offered some hopeof improved mentoring outcomes.

Effective mentoring, although rare, is usuallyproactive.41 The junior faculty member seeks outa senior colleague specifically for his or herearned reputation as a good mentor. Goodmentoring relationships usually last at least 3years but may dissolve naturally as the juniorfaculty member matures. The most effectivementoring occurs when junior and senior facultywork together as collaborators in teaching andresearch. Because the number of pharmacypractice senior faculty is stagnant, juniorpharmacy practice faculty will be fortunate tohave one good mentor. The wise individual willseek mentors from other disciplines and externalinstitutions. Similarly, the wise department chairwill encourage collaboration between nontenuretrack and tenure track faculty. Pairing nontenuretrack and tenure track faculty members withsimilar interests, such as infectious diseases, canlead to enhanced research productivity andrewarding scholarship for both. Collaborationalso can extend to the practice and teachingarenas.

Junior Faculty Retention

It is clear from this study that both thepharmacy profession and academia rely heavilyon increasing the number of junior pharmacypractice faculty to meet increased demands forclinical education. Yet retaining these facultymembers is a challenge equal to theirrecruitment. A study of 1777 full-time academicorthopedic surgeons suggested that increasedpressures for producing clinical revenue createdstress and contributed to attrition.49 Academicphysician investigators were threatened by

difficulty procuring research grant support andthe need to see more patients to improve clinicalpractice income.50 Physical therapy faculty werelikely to remain in their academic positions ifthey had strong social support and enthusiasmfor scholarly activity.42

Similar issues make retention of juniorpharmacy faculty a challenge. A study of careerburnout among 429 pharmacy faculty shed somelight on job satisfaction.51 Younger faculty hadhigher Maslach burnout inventory scores thanolder faculty. Similarly, burnout was higher forwomen than for men, for assistant professorsthan for other professorial ranks, for tenuredthan for nontenured faculty, and for 12-monththan for 9-month appointees. Faculty whoworked 60 or more hours/week had higherburnout scores than those who worked fewerhours/week.

Recognizing that the most recent survey ofjunior pharmacy faculty revealed an overallslightly above neutral job satisfaction score, 3.20on a 5-point Likert scale, overall ambivalenceabout academic career satisfaction is a concern.12

Junior pharmacy practice faculty had a slightlylower overall satisfaction score of 3.17 comparedwith 3.30 for other disciplines. Statisticallysignificant decreases in satisfaction wereobserved more for women than for men, more forprivate school faculty than for public schoolfaculty, and more for faculty in schools orcolleges in existence for 0–6 years than for thosein established schools. General suggestions toavoid burnout and increase pharmacy practicefaculty retention were published 5 years ago.52

However, the dramatic shift to nontenuredfaculty, more often women then men, demandsrethinking global and institutional specificpolicies. No doubt, faculty-retention programsremain of paramount importance. Family issues,support for research, support for developingteaching skills, mentoring, and involvement infaculty governance all require reexamination.

Citizenship and Collegiality

Junior faculty must be guided in conductingthemselves appropriately in the academic andpractice arenas. Although suggestions on what todo are important, so are suggestions on actions toavoid. A national survey of department chairswas conducted to determine characteristics ofproblem faculty.53 The most frequently notedproblem was general lack of productivityespecially in writing and obtaining grants.

459


Performing minimal duties, often in committeework and student advising, was next. Socialisolation from the chair and other colleagues,junior and senior, was cited as a career detriment.Faculty who were a source of student complaintsor who displayed emotional outbursts generallywere characterized quickly as problems. If a newfaculty member earns a reputation as a nay-sayeror complainer, the chair or other senior facultycolleagues should explore sources of frustrationand help this person develop positive problem-solving skills.

Conflicts among teaching, practice, research,and school service schedules are unavoidable, yetthey can be managed in a positive manner.Special care should be exercised so that juniorfaculty do not miss department and full facultymeetings, which are building blocks of facultygovernance. Inconsistently meeting definedpractice expectations will lead to discontent bothat the practice site and the school. Junior facultywho become nay-sayers or have a negativeattitude will have difficulty succeeding andenjoying their careers. Similarly, those whorespond late to deadlines, or even ignoredeadlines, will be ill perceived by students,faculty, and administrators. New faculty shouldbe counseled to submit materials at least 24hours before they are due. Procrastination andwaiting until the last minute invariably createmore work, result in poor work, and occasionallyresult in missing the deadline entirely.

Citizenship and collegiality lead to a successfulacademic career, as shown by the followingsuggestions:

1. Set clear, measurable, written goals forteaching, practice, and scholarship.

2. Do not overprepare for teaching. Set limits.3. Match your desired career balance with

your appointment; choose tenure trackonly if you want to publish, publish,publish.

4. Document teaching, practice, and scholar-ship in a career portfolio, starting with thefirst year.

5. Combat loneliness; aggressively seekcontact with junior and senior colleaguesweekly.

6. Find a balance between personal andprofessional life and keep it; make time forrelaxation, rest, and exercise.

7. Learn to juggle major performanceresponsibilities simultaneously from thebeginning; do not wait to start scholarship.

8. Write at least 3 times/week at short,

scheduled times.9. Be a good citizen and team player, and have

fun doing so.10. Meet all deadlines and do not procrastinate.

Although rather difficult to define, collegialityand citizenship refer to collaboration andteamwork that promote group success. Inacademia, good citizens routinely contribute todepartment, school, and university success.Sometimes, if not often, faculty must place thegood of the school (or department anduniversity) before the good of their individualprofessional careers. Volunteering to lead acommittee, begin a service project, advise astudent chapter, or serve on a university taskforce illustrate collegiality and citizenship.Collegiality can be learned to some extent.54 Itcertainly can be assessed, usually in qualitativeterms. When junior faculty understand thatpreoccupation with their own career is theantithesis of collegiality and good citizenship,they will enjoy greater career satisfaction andsuccess.

Conclusion

Schools and colleges of pharmacy heavily relyon increasing the number of nontenure trackjunior pharmacy practice faculty to meetincreased clinical education demands. Only withdevelopment of junior faculty will the schools,and thus the profession, keep abreast of healthcare changes. From the beginning, junior facultydemand candid, realistic feedback about theirperformance and expectations for eventualpromotion and/or tenure. With a consciouseffort, they will learn to handle their manyresponsibilities on a daily basis. Others musthelp them understand that the stresses theyendure are common to all disciplines. Juniorfaculty should proactively seek the advice ofsenior colleagues and mentors. With time, it ishoped that they will appreciate how academicpharmacy offers a bright future for advanced-trained practitioners. With that understandingthey will commit to a long academic career andthereby influence generations of futurepharmacists. Academic pharmacy offers a wealthof professional freedom and provides for familyand social needs. It is, to some, the mostrewarding career pathway in all of pharmacy.

Acknowledgments

The author gratefully acknowledges the juniorfaculty who helped establish the Texas Tech University

460


Health Sciences Center School of Pharmacy, thenation’s first new state-funded school of pharmacy inover 40 years. Jennifer Patton, AACP research analyst,provided invaluable data. The following personsreviewed the manuscript and provided valuablesuggestions: Dr. C. A. Bond, Dr. Erin L. St. Onge, Dr.David D. Allen, Dr. Rebecca B. Sleeper, Dr. Arthur A.Nelson, Jr., Dr. Craig D. Cox, Dr. Eric J. MacLaughlin,and Dr. H. Glenn Anderson.

References1. American College of Clinical Pharmacy 1997–1999 Clinical

Practice Affairs, Subcommittee A. A vision of pharmacy’sfuture roles, responsibilities, and manpower needs in theUnited States. Pharmacotherapy 2000;20(8)991–1020.

2. American College of Clinical Pharmacy 1998–1999 ClinicalPractice Affairs Committee, Subcommittee B. Practiceguidelines for pharmacotherapy specialists. Pharmacotherapy2000;20(48):487–90.

3. American College of Clinical Pharmacy 1999 Research AffairsCommittee. The clinical pharmacist as principal investigator: acommentary from the American College of Clinical Pharmacy.Pharmacotherapy 2000;20(5):599–608.

4. Kaiser LR. Waving goodbye to healthcare. Modern Healthcare2000;Feb. 28:32.

5. American Association of Colleges of Pharmacy. Profile ofpharmacy faculty for 1995–1996 and 2000–2001. Alexandria,VA: AACP, 1996, 2000.

6. National Center for Education Statistics . Home page.Available from http://nces.ed.gov. Accessed July 15, 2001.

7. Carnegie Foundation, Roper Center for Public OpinionResearch. Home page. Available from http://www.carnegiefoundation.org/resources/doc/ surveys.html. Accessed July 15,2001.

8. Higher Education Research Institute, University of California,Los Angeles. Home page. Available from http://www.gseis.ucla.edu/heri/faculty.html. Accessed July 15, 2001.

9. Bureau of Health Professions, within the Health Resourcesand Services Administration. Report to Congress. Thepharmacist workforce: a study of the supply and demand forpharmacists. Available from http://bhpr.hrsa.gov. Accessed July16, 2001.

10. Pharmacy Manpower Project. PMP aggregate demand index.Available from http://jarl.cs.uop.edu/pharmacy/adi. AccessedJuly 16, 2001.

11. SAS Institute Inc. SAS, version 6.12. Cary, NC: SAS, 1998.12. Latiff DA, Grillo JA. Satisfaction of junior faculty with

academic role functions. Am J Pharm Educ 2001;65:137–43.13. Finkelstein MJ, LaCelle-Peterson MW. New and junior

faculty: a review of the literature. In: Sorcinelli MD, Austin AW,eds. Developing new and junior faculty. San Francisco: Jossey-Bass, 1992:5–14.

14. Bond CA, Raehl CL, Franke T. The interrelationships betweenmortality rates, drug costs, total cost of care, and length of stayin United States hospitals: summary and recommendations forclinical pharmacy services and staffing. Pharmacotherapy2001;21(2):614–26.

15. Wolfgang AP. Job stress and dissatisfaction among school ofpharmacy faculty. Am J Pharm Educ 1993;57:215–22.

16. American Society of Health-System Pharmacists andAmerican College of Clinical Pharmacy. Supplementalstandard and learning objectives for residency training inpharmacotherapy. Pharmacotherapy 1999;19(11):1336–48.

17. Foser SW, McMurray JE, Linzer M, et al. Results of a gender-climate and work-environment survey at a Midwesternacademic health center. Acad Med 2000;75:653–60.

18. Nair K, Gaither CA. Effects of work, nonwork, and roleconflict on the overall life satisfaction of pharmacy faculty. AmJ Pharm Educ 1999;63:1–11.

19. Buckley LM, Sanders K, Shih M, Hampton SL. Attitudes of

clinical faculty about career progress, career success andrecognition, and commitment to academic medicine. ArchIntern Med 2000;160:2625–9.

20. Bickel J. The changing faces of promotion and tenure at U.S.medical schools. Acad Med 1991;66:249–56.

21. Kelly WN, Stross JK. Faculty tracks and academic success.Ann Intern Med 1992;116:654–9.

22. Beasley BW, Wright SM, Cofrancesco J, et al. Promotioncriteria for clinician-educators in the United States and Canada.JAMA 1997;278:723–8.

23. Jones RF, Gold JS. Faculty appointment and tenure policies inmedical schools: a 1997 status report. Acad Med 1998;73:211–19.

24. Williams RB, Zyzanski SJ, Flocke SA, Kelly RB, Acheson LS.Critical success factors for promotion and tenure in familymedicine departments. Acad Med 1998;73:333–5.

25. Hafler JD, Lovejoy FH. Scholarly activities recorded in theportfolios of teacher-clinician faculty. Acad Med2000;75:649–52.

26. Boyer EL. The scholarship of teaching. Carnegie report. NewYork: Carnegie Foundation for the Advancement of Teaching,1990.

27. Schoenfeld AC, Magnan R. Mentor in a manual: climbing theacademic ladder to tenure. Madison, WI: Atwood Publishing,1994.

28. Edwards R. Can post-tenure review help us save the tenuresystem? Academe 1997;83(3):26–31.

29. Hamilton NW. Peer review: the linchpin of academic freedomand tenure. Academe 1997;83(3):15–19.

30. Perley JE. Tenure, academic freedom, and governance.Academe 1995;81(1):38–9.

31. Batshaw ML, Plotnick LP, Petty BG, Woolf PK, Mellits ED.Academic promotion at a medical school. N Engl J Med1988;318:741–7.

32. Jones RF, Froom JD. Faculty and administration views ofproblems in faculty evaluation. Acad Med 1994;69:476–83.

33. Edgerton R, Hutchings P, Quinlan K. The teaching portfolio:capturing the scholarship in teaching. Washington, DC:American Association of Higher Education, 1991.

34. Olsen D, Sorcinelli D. The pretenure years: a longitudinalperspective. In: Sorcinelli MD, Austin AW, eds. Developing newand junior faculty. San Francisco: Jossey-Bass, 1992:15–25.

35. Jarvis D. Junior faculty development handbook. New York:Modern Language Association of America, 1991:56–70.

36. Williams AG, Hall KJ. Creating your career portfolio: at aglance guide. Upper Saddle River, NJ: Prentice-Hall, 1997.

37. Bensimon EM, Ward K, Sanders K. Department chair’s role indeveloping new faculty into teachers and scholars. Bolton, MA:Anker, 2000.

38. Schneirov R. What does an institution owe its non-tenure trackfaculty? Academic Leader 2001;17:1–2.

39. Fink LD. Orientation programs for new faculty. In: SorcinelliMD, Austin AW, eds. Developing new and junior faculty. SanFrancisco: Jossey-Bass, 1992:39–49.

40. Boice R. The new faculty member. San Francisco: Jossey-Bass,1992.

41. Boice R. Advice for new faculty members: nihil nimus.Needham Heights, MA: Allyn & Bacon, 2000.

42. Harrison AL, Kelly DG. Career satisfaction of physical therapyfaculty during their pretenure years. Phys Ther 1996;76:1202–18.

43. Boice R. Procrastination, busyness, and bingeing. Behav ResTher 1989;27:605–11.

44. Lucas AE. Strengthening departmental leadership: a teambuilding guide for chairs in colleges and universities. SanFrancisco: Jossey-Bass, 1995.

45. Schumock GT, Meek PD, Ploetz PA, Vermeulen LC. Economicevaluation of clinical pharmacy services—1988–1995.Pharmacotherapy 1996;16(96):1188–1208.

46. Kroenke K. Conducting research as a busy clinician-teacher ortrainee. J Gen Intern Med 1996;11:360–5.

47. IllesJ, Glover GH, Wexler L, Leung ANC, Glazer GM. Amodel for faculty mentoring in academic radiology. Acad Radiol

461


2000;7:717–24.48. Boice R. Mentoring new faculty: a program for implementation.

J Staff Program Org Dev 1990;8:143–60.49. Meals RA, Bassewitz HL, Dorey FJ. Academic longevity and

attrition of full-time orthopaedic faculty members. J Bone JointSurg 2000;82-A:1042–8.

50. Cadman EC. The academic physician-investigator: a crisis notto be ignored. Ann Intern Med 1994;120:401–10.

51. Jackson RA, Barnett CW, Stajich GV, Murphy JE. An analysis

of burnout among school of pharmacy faculty. Am J PharmEduc 1993;57:9–17.

52. Lee M, Abate MA, Fjortoft N, Linn A, Maddux MS. Report ofthe task force on the recruitment and retention of pharmacypractice faculty. Am J Pharm Educ 1995;59:28S–33.

53. Boice R . Chair-faculty relations. Academic Leader1992;July:1–2.

54. Himes AC. Collegiality in faculty evaluation and retention.Academic Leader 2001;March:5.

462

changes in pharmacy practice faculty 1995–2001: implications for junior faculty development

Documents