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Clinical Excellence in Academia: Perspectives From Masterful Academic Clinicians

      OBJECTIVE

      To better understand and characterize clinical excellence in academia by exploring the perspectives of clinically excellent faculty in the top American departments of medicine.

      PARTICIPANTS AND METHODS

      Between March 1 and May 31, 2007, 2 investigators conducted in-depth semistructured interviews with 24 clinically excellent Department of Medicine physicians at 8 academic institutions. Interview transcripts were independently analyzed by 2 investigators and compared for agreement. Content analysis identified several major themes that relate to clinical excellence in academia.

      RESULTS

      Physicians hailed from a range of internal medicine specialties; 20 (83%) were associate professors or professors and 8 (33%) were women. The mean percentage of time physicians spent in clinical care was 48%. Eight domains emerged as the major features of clinical excellence in academia: reputation, communication and interpersonal skills, professionalism and humanism, diagnostic acumen, skillful negotiation of the health care system, knowledge, scholarly approach to clinical care, and passion for clinical medicine.

      CONCLUSION

      Understanding the core elements that contribute to clinical excellence in academia represents a pivotal step to defining clinical excellence in this setting. It is hoped that such work will lead to initiatives aimed at measuring and rewarding clinical excellence in our academic medical centers such that the most outstanding clinicians feel valued and decide to stay in academia to serve as role models for medical trainees.
      ACGME ( Accreditation Council of Graduate Medical Education), AMC ( academic medical center), PBLI ( practice-based learning and improvement)
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      REFERENCES

        • Levinson W
        • Rubenstein A
        Mission critical—integrating clinician-educators into academic medical centers.
        N Engl J Med. 1999; 341: 840-843
        • Levinson W
        • Branch Jr, WT
        • Kroenke K
        Clinician-educators in academic medical centers: a two-part challenge.
        Ann Intern Med. 1998; 129: 59-64
        • Passo MH
        The role of the clinician educator in rheumatology.
        Curr Rheumatol Rep. 2006; 8: 469-473
        • Wright SM
        • Kern DE
        • Kolodner K
        • Howard DM
        • Brancati FL
        Attributes of excellent attending-physician role models.
        N Engl J Med. 1998; 339: 1986-1993
        • Yusuf SW
        The decline of academic medicine [letter].
        Lancet. 2006; 368: 284
        • Carey RM
        • Wheby MS
        • Reynolds RE
        Evaluating faculty clinical excellence in the academic health sciences center.
        Acad Med. 1993; 68: 813-817
        • Jones FR
        • Gold JS
        Faculty appointment and tenure policies in medical schools: a 1997 status report.
        Acad Med. 1998; 73: 212-219
        • Beasley BW
        • Wright SM
        • Cofrancesco J
        • Babbott SF
        • Thomas PA
        • Bass EB
        Promotion criteria for clinician-educators in the United States and Canada: a survey of promotion committee chairpersons.
        JAMA. 1997; 278: 723-728
        • Beasley BW
        • Wright SM
        Looking forward to promotion: characteristics of participants in the prospective study of promotion in academia.
        J Gen Intern Med. 2003; 18: 705-710
        • Atasoylu AA
        • Wright SM
        • Beasley BW
        • et al.
        Promotion criteria for clinician-educators.
        J Gen Intern Med. 2003; 18: 711-716
        • Buckley LM
        • Sanders K
        • Shih M
        • Hampton CL
        Attitudes of clinical faculty about career progress, career success and recognition, and commitment to academic medicine: results of a survey.
        Arch Intern Med. 2000; 160: 2625-2629
      1. America's best graduate schools.
        US News and World Report. 2006; : 36
        • Crabtree BF
        • Miller WL
        Doing Qualitative Research. 2nd ed. Sage Publications, Thousand Oaks, CA1999
        • Schonberg MA
        • Ramanan RA
        • McCarthy EP
        • Marcantonio ER
        Decision making and counseling around mammography screening for women aged 80 or older.
        J Gen Intern Med. 2006; 21: 979-985
        • Green ML
        • Ruff TR
        Why do residents fail to answer their clinical questions? a qualitative study of barriers to practicing evidence-based medicine.
        Acad Med. 2005; 80: 176-182
        • Ratanawongsa N
        • Teherani A
        • Hauer KE
        Third-year medical students' experiences with dying patients during the internal medicine clerkship: a qualitative study of the informal curriculum.
        Acad Med. 2005; 80: 641-647
        • Wright SM
        • Carrese JA
        Excellence in role modeling: insight and perspectives from the pros.
        CMAJ. 2002; 167: 638-643
        • Montero GA
        If Roth were a doctor: physician reputation under the HCQIA.
        Am J Law Med. 2004; 30: 85-100
      2. American Board of Internal Medicine Web site. Using physician peer assessment for continuous professional development.
        (Accessed July 10, 2008.)
      3. American Board of Internal Medicine Web site. Patient and physician peer assessment.
        (Accessed July 10, 2008.)
      4. ACGME Web site. Outcome project.
        (Accessed July 10, 2008.)
        • Wright S
        What do residents look for in their role models?.
        Acad Med. 1996; 71: 290-292
        • Wright S
        • Wong A
        • Newill C
        The impact of role models on medical students.
        J Gen Intern Med. 1997; 12: 53-56
        • Bendapudi NM
        • Berry LL
        • Frey KA
        • Parish JT
        • Rayburn WL
        Patients' perspectives on ideal physician behaviors.
        Mayo Clin Proc. 2006; 81: 338-344
        • Chang JT
        • Hays RD
        • Shekelle PG
        • et al.
        Patients' global ratings of their health care are not associated with the technical quality of their care.
        Ann Intern Med. 2006; 144: 665-672
        • Brainard AH
        • Brislen HC
        Viewpoint: learning professionalism: a view from the trenches.
        Acad Med. 2007; 82: 1010-1014
        • Cohen JJ
        Viewpoint: linking professionalism to humanism: what it means, why it matters.
        Acad Med. 2007; 82: 1029-1032

      Linked Article

      • The Contemporary Medical Community: Leadership, Mentorship, and Career Choices
        Mayo Clinic ProceedingsVol. 83Issue 9
        • In Brief
          Modern medicine is undergoing a revolution in the diagnosis and treatment of diseases and in the processing, use, and distribution of medical information. The core features of this revolution are aimed at providing safe, cost-effective medical care that will improve patient outcomes. Every aspect of this change is associated with vast quantities of research and accompanying publications. However, one element missing from the mix is equally aggressive research directed toward understanding the core values and needs of medical practitioners.
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