Academic Affairs–  

Chapter 8: Clinician/Educators

In This Chapter

8.1 Criteria & Introduction

In order to accommodate an operational need for certain full-time, part-time and temporary appointments of physicians in clinical departments, the classification of Clinician/Educator has been established. The Clinician/Educator is a highly qualified licensed MD who is appointed to meet such patient care, clinical teaching or related needs as are not met by the University Tenure Line or Medical Center Line faculty. Clinician/Educators are exempt regular staff members appointed for fixed terms of up to five years, which terms may be renewed. Clinician/Educators will normally be appointed to play roles such as the following:

Appointment as a Clinician/Educator does not provide University faculty status or academic staff status; to reiterate, Clinician/Educators are exempt regular staff.

8.2 Clinician/Educator (Affiliated)

Departments will often seek to appoint individuals who are based at and receive salary from another institution, but who provide patient care, clinical teaching or have other teaching duties which advance the missions of Stanford University Medical Center. For these individuals who are not members of the University's exempt regular staff, the appropriate appointment is as a Clinician/Educator (Affiliated). The appointment, reappointment and promotion criteria and review processes are generally the same for these individuals as Clinician/Educators paid by Stanford. Clinician/Educator (Affiliated) is an academic title only, not an employment category. Thus, the sections below that relate to Stanford employees (for example, Section 8.3 relating to University staff policies, Section 8.8 relating to offer letters and Section 8.16 relating to salaries and professional fees) are not applicable.

8.3 University Staff Policies

As noted above, Clinician/Educators are members of the University exempt regular staff. They are not members of the Academic Council, Medical Center Line, or the Academic Staff of the University. The rank of Clinician/Educator was authorized for the specific purpose of creating a category of salaried University employees who can serve on a full- or part-time basis in clinical departments of the School of Medicine. They are exempt staff and are, in general, subject to University policies applicable to such staff, including Administrative Guide Memos 22 (Personnel) and 27 (Benefits), but are not normally subject to the posting and search procedures required for other exempt appointments to the University Staff.

Termination and nonrenewal of Clinician/Educators are handled in accordance with University Staff policies described in Administrative Guide Memo 22.8, or Administrative Guide Memo 22.16 for layoffs. Clinician/Educators may be terminated before the end of their terms for the following reasons: 1: change in programmatic need, including budgetary considerations; and 2) for cause.

8.4 Process for Appointment, Reappointment and Promotion

8.5 New Appointments

Documentation for proposed new Clinician/Educator appointments should be submitted by the Department to the Office of Academic Affairs within the Dean's Office for further review (see Section 8.20). The final decision is made by the Senior Associate Dean for Academic Affairs or his or her designee in the Dean's Office.

8.6 Reappointments

Although reappointments may occur, there is no entitlement to such. Documentation for proposed Clinician/Educator reappointments should be submitted by the Department to the Office of Academic Affairs within the Dean's Office for further review (see Section 8.20). The final decision is made by the Senior Associate Dean for Academic Affairs or his or her designee in the Dean's Office.

8.7 Promotions

Documentation for proposed Clinician/Educator promotions should be submitted by the Department to the Office of Academic Affairs within the Dean's Office for further review (see Section 8.20). The final decision is made by the Senior Associate Dean for Academic Affairs or his or her designee in the Dean's Office.

8.8 Offer Letters

It is the responsibility of the department chair to see that a candidate for appointment as a Clinician/Educator is informed of the conditions of his or her proposed appointment. The purpose of the offer letter is to inform the candidate formally of the title, salary, and other key terms of the appointment being recommended by the department chair, in order to determine whether the candidate will accept the appointment if the recommendation is approved by the School.

The Senior Associate Dean for Academic Affairs must review for approval a draft of the offer letter before it is mailed to the candidate. The procedure of review and approval of the department chair's offer letter before it is sent to the candidate will ensure that the School, department, and candidate are similarly informed on such important matters as title, salary, location, function, space, and other significant commitments and expectations.

The offer letter should contain a statement that the department chair's offer of an appointment is contingent upon review and approval by the School and should provide all the information listed in the Clinician/Educator Appointment: Documentation below (Section 8.20). (See also sample offer letter below).

8.9 Appointment Letters

Clinician/Educators receive fixed-term appointments. A fixed-term appointment is one for which an end date is established at the time the employee is appointed. When the initial appointment has been approved, the Senior Associate Dean for Academic Affairs sends a letter to the Clinician/Educator stating the beginning and ending dates of the appointment and the percent of time. This appointment letter should include a statement to the effect that "Additional terms concerning your appointment are reflected in the offer letter you have received from the Department Chair."

8.10 Reappointment Letters

If and as soon as a reappointment has been approved, the Senior Associate Dean for Academic Affairs will send a letter to the Clinician/Educator stating the beginning and ending dates of the appointment and the percent of time. A statement should also be included that clarifies that salaries are reviewed annually for the year starting September 1. A letter to the candidate, with a copy to the Senior Associate Dean for Academic Affairs, will also be sent by the Department stating the terms and conditions of the reappointment, including any changes from the initial or previous appointment.

8.11 Promotion Letters

If and as soon as a promotion has been approved, the Senior Associate Dean for Academic Affairs will send a letter to the Clinician/Educator stating the beginning and ending dates of the appointment and the percent of time. A statement will also be included that clarifies that salaries are reviewed annually for the year starting September 1. A letter to the candidate, with a copy to the Senior Associate Dean for Academic Affairs, will also be sent by the Department stating the terms and conditions of the promotion, including any changes from the initial or previous appointment.

8.12 Termination and Nonrenewal

A Clinician/Educator holds a fixed-term appointment and his or her appointment therefore terminates at the end of the term unless sooner terminated before the end of the term based on a change in programmatic need (including budgetary considerations) or for cause, or unless a reappointment has been approved. As noted above, although reappointments may occur, there is no entitlement to such. Termination and nonrenewal of Clinician/Educators are handled in accordance with University Staff separation from employment policies described in Administrative Guide Memo 22.8. The Clinician/Educator is to be notified in writing by the Senior Associate Dean for Academic Affairs of the end date of the appointment or reappointment at the time of the appointment or reappointment (as described above). If no reappointment letter is issued, the Clinician/Educator's appointment ends on the date specified in the original appointment letter.

8.13 Criteria

The major criteria for appointment, reappointment and promotion for Clinician/Educators shall be excellence in the overall mix of clinical care, clinical teaching, and institutional service--appropriate to the programmatic need the individual is expected to fulfill. Such programmatic need, including financial viability, should be evaluated and must be established for each appointment, reappointment and promotion.

8.14 Guidelines for Application of Criteria

  1. Evaluation should be of total performance.
  2. Since excellence in both clinical teaching and clinical care are the predominant criteria for appointment, reappointment and promotion in the Clinician/Educator line, complete and persuasive documentation of excellent performance in these spheres must be sought and presented. It is expected that such documentation will depend more heavily on local evaluations (i.e., from those who have had first-hand opportunity to observe these qualities), but also will include distant evaluations. While many of the evaluations will derive from colleagues in the Clinician/Educator's own Department, evaluations should be obtained from colleagues in those other Departments and disciplines with whom the candidate interacts. Evaluations from students, residents and former trainees should also be obtained. Excellence in patient care should be documented by written evaluations from peers, colleagues, referring physicians, consultants and residents.
  3. Factors considered in assessing clinical excellence include the following: clinical knowledge; clinical judgment; procedural skills, if relevant; clinical productivity; clinical outcomes or results; professionalism and humanism; ability to work as part of the healthcare team; and communication with colleagues, staff, students and patients.
  4. Excellence in teaching is essential for appointment, reappointment and promotion. Factors considered in assessing teaching excellence include knowledge of the material, clarity of exposition, positive style of interaction with students, availability, communication skills, helpfulness in learning, and ability to stimulate further education. It is recognized that most clinicians teach in small group sessions or with individual trainees. Teaching may be of medical students, residents and postdoctoral fellows and in postgraduate and continuing education. It is important to get objective evaluations of teaching from as many former trainees as is reasonably practicable.
  5. Individuals in the Clinician/Educator line are primarily assessed for reappointment and promotion on the basis of their achievements in areas of clinical care and clinical teaching, as noted above. However, many administrative duties critical to all aspects of the operation of the School of Medicine require input from, or direction by, Clinician/Educators. Thus, Clinician/Educators are encouraged to participate in administration of the School's programs. Both the scope and the quality of administrative performance may be considered in the reappointment and promotion of Clinician/Educators. Those with significant ongoing administrative duties, such as Service Line Directors and others involved in the operation of Stanford Hospital and Clinics and Lucile Salter Packard Children's Hospital, are understood to have less time for clinical care and clinical teaching compared with colleagues without such duties.
  6. Peer recognition is expected of the maturing Clinician/Educator and this may be expressed by:

8.15 Criteria by Rank and Action Within the Clinician/Educator Line

Appointment as Clinical Instructor of (Subject)

"Individuals appointed as Clinical Instructors in the Clinician/Educator line will have completed their clinical training; this rank typically will be the first appointment for someone finishing that training. They should have demonstrated exceptional qualities and promise to become outstanding clinicians and clinical teachers. If these individuals have not had formal teaching experience, they should have demonstrated a commitment to develop the skills necessary for outstanding teaching. They must have demonstrated excellence or promise of excellence in a combination of clinical performance and clinical teaching appropriate to the programmatic need upon which the appointment will be based."

Reappointment as Clinical Instructor of (Subject)

"Clinical Instructors are assessed for reappointment on the basis of their performance and achievements in the areas of clinical care, clinical teaching and institutional service (if applicable). They may be reappointed based on evidence of progress, high-level performance and continuing programmatic need. There should be evidence that the candidate will continue to successfully fill the programmatic need for which the reappointment is made and to make meritorious contributions to his/her discipline and to the School."

Appointment as Clinical Assistant Professor of (Subject)

"Individuals appointed as Clinical Assistant Professors in the Clinician/Educator line will generally be required to have three years of experience since completion of their house staff training. They should have demonstrated exceptional qualities and promise to become outstanding clinicians and clinical teachers. If these individuals have not had formal teaching experience, they should have demonstrated a commitment to develop the skills necessary for outstanding teaching. They must have demonstrated excellence or promise of excellence in a combination of clinical performance and clinical teaching appropriate to the programmatic need upon which the appointment will be based." An exception may be granted for individuals who have less than three years post basic training that have established excellence and/or uniqueness in clinical care and clinical teaching.

Reappointment as Clinical Assistant Professor of (Subject)

"Clinical Assistant Professors in the Clinician/Educator line are assessed for reappointment on the basis of their performance and achievements in the areas of clinical care, clinical teaching and institutional service, if applicable. They may be reappointed based on evidence of progress, high-level performance, and continuing programmatic need. There should be evidence that the candidate will continue to successfully fill the programmatic need for which the reappointment is made and to make meritorious contributions to his/her discipline and to the School."

Promotion to Clinical Assistant Professor of (Subject)

"Promotion to the rank of Clinical Assistant Professor in the Clinician/Educator line will be considered for those who have demonstrated excellence in clinical care, clinical teaching and institutional service (if applicable) during their terms of appointment as Clinical Instructor. There should be evidence that the candidates will successfully continue to fill the programmatic need for which the appointment is made and to make meritorious contributions to the discipline and to the school." An exception may be granted for individuals who have less than three years post basic training that have established excellence and/or uniqueness in clinical care and clinical teaching.

Appointment as Clinical Associate Professor of (Subject)

"Appointment to the rank of Clinical Associate Professor in the Clinician/Educator line will be considered for those who have demonstrated excellence in clinical care and clinical teaching. There should be evidence that candidates have attained regional recognition as superior clinicians and clinical teachers. There should be evidence that the candidates will successfully fill the programmatic need for which the appointment is made and will make meritorious contributions to their discipline and to the School."

Reappointment as Clinical Associate Professor of (Subject)

"Reappointment to the rank of Clinical Associate Professor in the Clinician/Educator line will be considered for those who have demonstrated excellence in clinical care, clinical teaching, and institutional service (if applicable), during their terms of appointment as Clinical Associate Professor at Stanford. There should be evidence that candidates have attained regional recognition as superior clinicians and clinical teachers. There should be evidence that the candidates will successfully continue to fill the programmatic need for which the appointment is made and to make meritorious contributions to their discipline and to the School."

Promotion to Clinical Associate Professor of (Subject)

"Promotion to the rank of Clinical Associate Professor in the Clinician/Educator line will be considered for those who have demonstrated excellence in clinical care, clinical teaching, and institutional service (if applicable) during their terms of appointment as Clinical Assistant Professor at Stanford. There should be evidence that candidates have attained regional recognition as superior clinicians and clinical teachers. There should be evidence that the candidates will successfully continue to fill the programmatic need for which the appointment is made and to make meritorious contributions to their discipline and to the School."

Appointment to Clinical Professor of (Subject)

"Appointment to the rank of Clinical Professor in the Clinician/Educator line will be reserved for individuals who have demonstrated exceptional performance in clinical care and clinical teaching, and who are widely recognized as leaders in their field. There must be evidence that these individuals have attained national recognition as superior clinicians and clinical teachers, that they have demonstrated continuing excellence and progressive maturation as physicians and teachers, and that they will successfully fill the programmatic need for which the appointment is made and will continue to make outstanding contributions to their discipline and to the School. They may be recognized nationally as leaders of the health care system or of organizational change and measurement of health care systems."

Reappointment as Clinical Professor of (Subject)

"Reappointment to the rank of Clinical Professor in the Clinician/Educator line will be reserved for individuals who have demonstrated exceptional performance in clinical care, clinical teaching, and institutional service (if applicable) during their term of appointment as Clinical Professor at Stanford, and who are widely recognized as leaders in their field. There must be evidence that these individuals have attained national recognition as superior clinicians and clinical teachers, that they have demonstrated continuing excellence and progressive maturation as physicians and teachers, and that they will successfully continue to fill the programmatic need for which the appointment is made and to make outstanding contributions to their discipline and to the School. They may be recognized nationally as leaders of the health care system or of organizational change and measurement of health care systems."

Promotion to Clinical Professor of (Subject)

"Promotion to the rank of Clinical Professor in the Clinician/Educator line will be reserved for individuals who have demonstrated exceptional performance in clinical care, clinical teaching, and institutional service (if applicable) during their terms as Associate Professor at Stanford, and who are widely recognized as leaders in their field. There must be evidence that these individuals have attained national recognition as superior clinicians and clinical teachers, that they have demonstrated continuing excellence and progressive maturation as physicians and teachers, and that they will successfully continue to fill the programmatic need for which the appointment is made and to make outstanding contributions to their discipline and to the School. They may be recognized nationally as leaders of the health care system or of organizational change and measurement of health care systems."

8.16 Salaries and Professional Fees

The Dean determines a Clinician/Educator's salary on recommendation from the department chair in advance of any commitment to the candidate. The salary of a Medical Center Line faculty member with comparable training and experience is commonly used as a guideline in deciding a Clinician/Educator' salary.

Clinician/Educators are eligible to participate in departmental bonus plans. Eligibility for participation and criteria are to be outlined in department plans.

Professional medical services provided by a Clinician/Educator must be billed in accordance with the Rules of Practice for the Faculty Physician (see Chapter 2.103 of this handbook). As a condition of appointment, each Clinician/Educator must assign all professional service income to the appropriate Stanford Hospital and Clinics and Lucile Packard Children's Hospital accounts.

8.17 Concurrent Appointment to the Medical Staff of Stanford Hospital and Clinics and Lucile Packard Children's Hospital

An appointment to the Active or Associate Medical Staff of Stanford Hospital and Clinics and/or Lucile Packard Children's Hospital must be sought and obtained if the candidate will use Stanford Hospital and Clinics and Lucile Packard Children's Hospital facilities in the course of his or her employment as a Clinician/Educator. An appropriate Medical Staff appointment (or appointments) should be arranged by the department chair in advance of the Clinician/Educator appointment. The Medical Staff appointment should be made "coterminous with appointment as a Clinician/Educator" and the candidate should be informed in writing that Medical Staff privileges apply only to medical practice incident to appointment as a Clinician/Educator and are coterminous with that appointment.

8.18 Additional Benefits

Information on additional benefits that are available to Clinician/Educators can be obtained at Clinician/Educator Benefits

8.19 Offer Letter

8.20 Guide to Appointment, Reappointment and Promotion of Clinician/Educators

8.20a Clinician/Educator Appointment, Reappointment and Promotion:  Documentation

8.20b Clinician/Educator Appointment, Reappointment and Promotion:  Review Process

Proposed Rank Appointments Reappointments Promotions
Clinical Instructor Maurice Druzin, Associate Dean Maurice Druzin, Associate Dean N/A
Clinical Assistant Professor Maurice Druzin, Associate Dean Maurice Druzin, Associate Dean C/E A&P Committee
Clinical Associate Professor C/E A&P Committee Maurice Druzin, Associate Dean C/E A&P Committee
Clinical Professor C/E A&P Committee Maurice Druzin, Associate Dean C/E A&P Committee

8.21 Use of the Stanford Name by Clinician/Educator (Affiliated) Members

Membership in the C/E line entitles a Clincial/Educator (Affiliated) member to identify himself or herself as such, and to include his or her C/E (A) title, as appropriate on stationery, business cards and (with advance approval and in limited circumstances) in certain publications; examples of the forms of appropriate use are found below. It does not entitle a C/E (A) member to use the Stanford University or School of Medicine logo or Stanford University or School of Medicine letterhead, except when creating correspondence pertinent to his or her specific Stanford-related C/E (A) duties, activities and responsibilities. For questions about the appropriate use of the Stanford name, please contact the Office of the Senior Associate Dean for Academic Affairs.

8.22 Appropriate Use of the Stanford Name on Stationery of Clinician/Educator (Affiliated) Members

Susan J. Jones M.D.
Department of Medicine
Santa Clara Valley Medical Center
751 S. Bascom Avenue
San Jose, California 95128

 
Clinical Associate Professor (Affiliated)  
phone: (408) 555-1234
Department of Medicine  
fax: (480) 555-5678
Stanford University School of Medicine  
email: sjones@scvmc.org

8.23 Appropriate Use of the Stanford Name on Business Cards of Clinician/Educator (Affiliated) Members

Susan J. Jones, M.D.

Department of Medicine, Santa Clara Valley Medical Center

751 S. Bascom Avenue
San Jose, California 95128
phone: (408) 555-1234
fax: (408) 555-5678
email: sjones@scvmc.org

Clinical Associate Professor (Affiliated)
Department of Medicine
Stanford University School of Medicine

8.24 Appropriate Use of the Stanford Name on Publications of Clinician/Educator (Affiliated) Members (with advance approval only)

"The Effects of Caffeine on Heart Rate"

By Susan J. Jones, M.D., Department of Medicine, Santa Clara Valley Medical Center; Clinical Associate Professor (Affiliated), Department of Medicine, Stanford University School of Medicine

NOTE: Because the production of written scholarship is not, in general, a component of a Clinician/Educator (Affiliated) member's appointment, the use of the Clinician/Educator (Affiliated) title on publications may only be included when the use is approved by the department chair in writing and in advance; such approval should be limited to those rare circumstances when the research relates specifically to a Clinician/Educator (Affiliated) member's Stanford-related duties, activities and responsibilities. A record of the department chair's approval for the use of the Clinician/Educator (Affiliated) title in a publication must be submitted to the Office of the Senior Associate Dean for Academic Affairs prior to submission of the publication.

8.25 Clinician/Educator (Affiliated) Titles

When using their Clinician Educator (Affiliated) titles, Clinician/Educator (Affiliated) members must include the word "Affiliated" (i.e., Clinical Instructor (Affiliated), Clinical Assistant Professor (Affiliated), Clinical Associate Professor (Affiliated), and Clinical Professor (Affiliated)).

 

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