III. A Statement of Expectations of the Faculty for Teaching Medical Students at Harvard Medical School
The Harvard medical system has evolved over 200 years into a remarkable instrument of higher learning in medicine. Despite a complex organizational structure, the system is based on a common set of values shared by the varied institutions that comprise its corpus. Within them a gifted faculty provides a breadth and depth of expertise that exceeds those of any other medical institution. The faculty has grown exponentially in the past decade and, in addition, changes in the health care system are creating dramatic shifts in the activities of the faculty. The changes that impact the practice of medicine are creating difficulties for educating undergraduate medical students. One of the most important challenges for the faculty is to preserve a teaching mission that is being jeopardized by increasing financial constraints and the pressure to provide efficient and cost-effective patient care.
Appointment to the Faculty of Medicine at Harvard Medical School provides distinct benefits. It affords entree to a broad scholarly community and access to the full range of Harvard University resources. It brings to a faculty member prestige which assists in attracting patients and research funding. Most important, perhaps, it provides an opportunity to teach gifted medical and graduate students and to train residents and postdoctoral fellows of exceptional quality. The commitment to teaching has never been explicitly stated, although in 1988 a Task Force on Faculty Teaching Expectations did articulate the requirement that full- and part-time appointments to the Faculty of Medicine carry certain obligations in teaching and service.
The faculty at Harvard Medical School have been extraordinarily generous in their commitments to its educational programs. Basic science faculty teach medical, dental, and graduate students and postdoctoral fellows. Clinical faculty teach medical and dental students, house staff, fellows, hospital personnel, and practicing physicians. But the current pressures to deliver patient-care services or to expend greater proportions of their time finding research support are forcing some faculty members to make difficult decisions vis-à-vis their time commitments. Therefore, we believe it is necessary to quantify the expectations of the Medical School with respect to teaching medical students in order to move toward a more equitable distribution of our combined efforts in this regard. We further believe that teaching should be an essential element of the scholarly life of a faculty member and should bring no economic or professional disadvantage to one faculty member over another, and that the obligation to teach should be equitably distributed over a collective unit within a given institution.
All faculty at Harvard Medical School are obligated to teach predoctoral medical students if called upon. These guidelines are an attempt by the Council of Masters to assure that the school¹s commitment to teaching undergraduate medical students is fulfilled and distributed equitably.
Each affiliated institution is responsible for developing a mechanism for monitoring, recognizing, and compensating teaching contributions for its faculty. The Medical School recognizes that there will be local variation in the approaches to implementing these faculty teaching obligations.
1. Basic science departments
a. Faculty in preclinical departments who receive some of their salary from HMS are expected to teach in at least one core medical course each year.
b. Full professors who receive most or all of their salary from the school can be asked in return to teach up to 200 hours per academic year.
c. Faculty who are members of basic science departments who do not receive compensation from the school (generally those located in the hospitals) are expected to teach up to 50 hours per year as an obligation of their faculty appointment.
d. The department head is responsible for deciding the relative contributions of different faculty, but the needs of medical student courses as determined by the Council of Masters must be met. Other contributions, including teaching of predoctoral Ph.D. students, may be used by department heads to offset temporarily the obligation to medical student education.
2. Clinical departments
a. Clinical faculty in clinical departments, including instructors, are expected to teach medical students at least 50 hours per year as an obligation of their faculty appointment.b. Full professors in clinical departments are expected to teach at least 100 hours per year as an obligation of their faculty appointment.
c. Basic scientists with faculty appointments in clinical departments (generally based in the hospitals) are expected to teach at least 50 hours per year as an obligation of their faculty appointment.
d. The department head is responsible for deciding the relative contributions of different faculty, but the needs of medical student courses as determined by the Council of Masters must be met. Other contributions, including teaching of residents and fellows, may be used by department heads to offset temporarily the obligation to medical student education.
C. Recommended Guidelines for Faculty Compensation
In its capacity as overseer of the curriculum leading to the M.D. degree, the Council of Masters has responsibility for the overall budget for support of core courses and medical student teaching throughout the four-year program in medical education. Given available resources, the Council of Masters has outlined the guidelines for compensating the efforts of the faculty equitably.
1. Core courses in Years I and II: course directors for preclinical core courses will receive a standard payment per courseweek. Courses with multiple directors will divide this amount with the following exceptions.
a. Full professors in quadrangle departments will not receive extra compensation for preclinical teaching. The course will continue to be budgeted on a per-courseweek basis for course leadership, and tenured, quadrangle-based basic science faculty course directors will be able to request funds from the society master serving as steward for the relevant course if needed to pay other, nontenured course leaders.
b. When a course director needs the entire per-courseweek allotment for his or her own compensation, additional funds to support course leadership may be needed and should be requested from the society master serving as steward for the course.
2. Tutors who are not in quadrangle departments or do not receive compensation from the school are expected to teach for three weeks without compensation. Three weeks corresponds to approximately 50 hours (4.5 hours per week of tutoring plus 12 hours per week of preparation time x 3 weeks = 50). For faculty who teach more than the minimum expectation and/or in more than one course, three weeks of core preclinical course participation will be reckoned as the basic teaching obligation. Those who teach in core preclinical courses beyond that amount of time may receive payment of $n per courseweek.
3. Laboratory instructors and conference leaders who are not in quadrangle departments or do not receive compensation from the school are expected to teach for three weeks without compensation. Those who teach in core preclinical courses beyond that amount of time may receive payment of $n per courseweek beyond three weeks of teaching.
4. Innovation funds are available for new course development but are not to become part of the base course budget. The amounts for "innovation" and for the base budget will be made clear to course directors by the master(s) responsible for the course. Distribution of innovation funds will be overseen by the Council of Masters.
5. Society masters serving as stewards for core courses are responsible for discussing course budgets with course directors and working with course directors if compensation problems arise. The master represents the courses under his or her stewardship at meetings of the Council of Masters. Budget guidelines for preclinical courses are determined annually by the Council of Masters and are communicated to course directors by the master who serves as steward for the relevant course.
6. Exceptions to these guidelines may be required for certain courses and for transitions from current arrangements that may create hardship. The course director should initiate discussion with the master serving as steward.
7. Core clinical clerkships: school funds in support of core clinical clerkships are calculated according to a two-component formula. There is an administrative component for conducting the clerkship each month in which students are enrolled. Second, there is a monthly allotment for each enrolled student. These funds are conveyed to the heads of the clinical departments who are responsible for their allocation and disbursement.
Adopted by the Council of Masters and the
Conference of Department Heads,
Harvard Medical School
Tuesday, April 9, 1996