Maximizing

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Maximal Teaching Impact on a Minimal Budget

• Roger W. Geiss, M.D.
• University of Illinois College of Medicine -
  Peoria
• CDS Plenary Session
• Colorado Springs, CO
• July 18, 2007

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Characteristics of the University of Illinois
College of Medicine Peoria (UICOMP)

• Community-based medical school
• One of four campuses of U of I College of
  Medicine
• 50 students/class (M2-M4)
• High degree of dependence on clinical (volunteer)
  faculty
• Low level of state support

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How low is it?
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University of Illinois College of Medicine (a
division of the University of Illinois - Chicago)
Year 1
Years 2-4
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UICOMP Department of Pathology

• Path Faculty
• full-time 2
• part-time 1
• volunteer 23
• FTEs
• 1996-7 3.5
• 2006-7 2.5
• 2007-8 2.3

• Contact hours (2006-7)
• full-time path faculty 103
• part-time path faculty 27
• volunteer path faculty 50
• other faculty 10
• TOTAL 190

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Challenges

• Full-time faculty
• decrease in number
• increased pressure to engage in research
• Clinical (volunteer) faculty
• increased pressure to generate clinical income
• authority over volunteer faculty rests with
  hospitals and private practice groups
• Perceived attitude that teaching will take care
  of itself
• Very limited funds for critical needs
• faculty development
• maintenance of equipment and facilities
• Need to make up for deficiencies in M1 year
• No pathology residency program
• Possible future expansion of class size (50 ? 62)

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UICOMP
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OSF ST FRANCIS MEDICAL CENTER
860 BEDS
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PROCTOR HOSPITAL
METHODIST MEDICAL CENTER OF ILLINOIS
165 BEDS
360 BEDS
GRAHAM HOSPITAL
PEKIN HOSPITAL
140 BEDS
125 BEDS
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UICOMP
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Challenges

• Full-time faculty
• decrease in number
• increased pressure to engage in research
• Clinical (volunteer) faculty
• increased pressure to generate clinical income
• authority over volunteer faculty rests with
  hospitals and private practice groups
• Perceived attitude that teaching will take care
  of itself
• Very limited funds for critical needs
• faculty development
• maintenance of equipment and facilities
• Need to make up for deficiencies in M1 year
• No pathology residency program
• Possible future expansion of class size (50 ? 62)

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University of Illinois College of Medicine (a
division of the University of Illinois - Chicago)
Year 1
Years 2-4
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Challenges

• Full-time faculty
• decrease in number
• increased pressure to engage in research
• Clinical (volunteer) faculty
• increased pressure to generate clinical income
• authority over volunteer faculty rests with
  hospitals and private practice groups
• Perceived attitude that teaching will take care
  of itself
• Very limited funds for critical needs
• faculty development
• maintenance of equipment and facilities
• Need to make up for deficiencies in M1 year
• No pathology residency program
• Possible future expansion of class size (50 ? 62)

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Solutions

• Past/present
• longer work hours for full-time faculty
• lecture-heavy curriculum
• lectures 122 hours
• laboratories 66 hours
• small-groups 2 hours
• independent study 1 hour
• use of multiheaded microscopes in laboratories to
  minimize number of lab instructors needed
• engagement of non-pathologist faculty to teach
  pathology
• use of teaching assistants (M3, M4 students) in
  laboratories
• Future (some culture change required)
• team-based learning
• expanding/strengthening use of learning
  objectives
• faculty and student guidance
• promotion of independent study
• Wish list
• additional full-time faculty
• additional equipment
• increased involvement by (certain segments of)
  volunteer faculty

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Solutions

• Past/present
• longer work hours for full-time faculty
• lecture-heavy curriculum
• lectures 122 hours
• laboratories 66 hours
• small-groups 2 hours
• independent study 1 hour
• use of multiheaded microscopes in laboratories to
  minimize number of lab instructors needed
• engagement of non-pathologist faculty to teach
  pathology
• use of teaching assistants (M3, M4 students) in
  laboratories
• Future (some culture change required)
• team-based learning
• expanding/strengthening use of learning
  objectives
• faculty and student guidance
• promotion of independent study
• Wish list
• additional full-time faculty
• additional equipment
• increased involvement by (certain segments of)
  volunteer faculty

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Incentivizing volunteer faculty

• Intangible incentives
• main incentive
• personal satisfaction and fulfillment
• student-teacher interaction
• refreshment of knowledge base
• respect from colleagues for teaching medical
  students
• help in recruiting into specialty
• clinical faculty appointment itself
• Tangible incentives
• CME for teaching
• faculty privileges (perks)
• library privileges
• on-campus parking
• discounts, reimbursements
• faculty development opportunities
• inclusion in departmental/institutional social
  events
• recognition (institutional and/or departmental
  level)
• eligibility for teaching awards from students,
  faculty
• specific awards for community-based faculty

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Incentivizing volunteer faculty

• Intangible incentives
• main incentive
• personal satisfaction and fulfillment
• student-teacher interaction
• refreshment of knowledge base
• respect from colleagues for teaching medical
  students
• help in recruiting into specialty
• clinical faculty appointment itself
• Tangible incentives
• CME for teaching
• faculty privileges (perks)
• library privileges
• on-campus parking
• discounts, reimbursements
• faculty development opportunities
• inclusion in departmental/institutional social
  events
• recognition (institutional and/or departmental
  level)
• eligibility for teaching awards from students,
  faculty
• specific awards for community-based faculty

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The Bottom Line

• Volunteer faculty possess a wide variety of needs
  and desires.
• A menu approach to support, whereby the
  individual can select the type or types of
  support most useful to her/him, would address the
  problem of diversity of needs.
• Careful selection of a program of support will
  need to be based on the value to the individual
  and the resources available.
• Ref Langlois JP Support of community
  preceptors what do they need?
• Family Medicine 1995 27 641-645.

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Additional references on incentivizing volunteer
faculty

• Dodson MC Motivation and reward factors that
  affect private physician involvement in an
  obstetrics and gynecology clerkship. Obstetrics
  Gynecology 1998 92628-633.
• Fulkerson PK, Wang-Cheng R Community-based
  faculty motivation and rewards. Family Medicine
  1997 29105-107.
• Kumar A, Kallen DJ, Mathew T Volunteer faculty
  what rewards or incentives do they prefer?
  Teaching and Learning in Medicine 2002
  14119-123.
• Pessar LF, Levine RE, Bernstein CA, et al
  Recruiting and rewarding faculty for medical
  student teaching. Academic Psychiatry 2006
  30126-129.
• Vath BE, Schneeweiss R, Scott CS Volunteer
  physician faculty and the changing face of
  medicine. Western Journal of Medicine 2001
  174242-246.

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QUESTIONS?
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QUESTIONS?

• ANSWERS?

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What is the minimally acceptable level that you
can provide, and still live with yourself?

• --C. Pillinger, M.D.
• 1/13/07

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