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Show , Spring 2005 page 23 being the primary job qualification - not a degree in pedagogy (the skill/art of teaching). Sir William Osier said in 1919, "The problem is that a competent medical man may not be a competent medical teacher." New young doctors are thrown into the world of teaching without being trained on how to teach. Assistant Dean of Curriculum and Professor of Clinical Pathology Larry Reimer said, "Through medical school and postgraduate programs, physicians have specific instruction on how to provide patient care and how to do research but not on how to teach." Many are naturally gifted mentors, but some struggle and out of frustration never improve. The university offers a yearly retreat for academic physicians to cultivate teaching skills, and there is other help offered on lower campus as well. However, neither is required. Improvement of teaching skills can be taxing and demanding with few rewards and little incentive. And if teachers are fortunate enough to have the praise and approval of their peers and colleagues, they still can't please everyone. Whitman explains, "In terms of intrinsic rewards, the 'thank you' and appreciation physician faculty get from patients may not be matched by students." Academic physicians continue to feel pressured to generate revenue for the School of Medicine through applying for grants to supplement their salaries, providing services (seeing patients and doing lab work on patient specimens, etc.), and publishing articles. Medical student tuition only covers a fraction of the School of Medicine's overhead. Costs could remain uncovered, even with the government funding and private donations. The need for physicians to cover marketable bases is increasing, but the budget for them is not. In addition, academic physicians are expected to publish articles in professional journals, contribute to textbooks, and continue research on topics legitimate enough to maintain grants from different funds such as the National Institute of Health. If grant funding falls through, major complications in salaries ensue. At the departmental level, administrators are forced to make difficult decisions, while administrative and secretarial support is potentially lost. Laboratory support also may be lost. According to the University's Reduction in Force & Severance Policy, the University of Utah must find or create job opportunities for these displaced employees, and this process is difficult and time consuming. As a result of this difficult balance, many physicians break off from the University system and enter private practices. To some, the benefits of working for an institution such as the University of Utah do not equal the perks of entrepreneurial medicine. The University of Utah allows and encourages volunteers appointed to adjunct or auxiliary faculty positions. When these volunteers teach, financial tension is relieved in the Health Sciences Center. Many teaching are professionals employed or practicing elsewhere, whose involvement is geared toward broadening their careers, enjoyment of teaching, association with other professionals, or an Some physicians may feel alone in their dual roles. increase of experience reflected in their curriculum vitae. Others are members of different departments in the Health Sciences Center, crossing over into further research and expertise. Adjunct appointments are a big part of the School of Medicine and hospital. As a teaching hospital, the University Hospital employs students or residents to provide clinical services. Students are the doctors, just on smaller salaries. Despite this support, the medical school continues to face a challenge. Given the many levels at which classroom management can face problems in the School of Medicine, finding the balance between teaching and clinical duties is paramount. Without one, the other may be of less value. Concerns on whether the physicians of the future are receiving the highest quality of training are legitimate, and the public's expectations on the School of Medicine, as well as increased utilization of campus resources, may possibly induce improvement in national ranking and performance. |
