I feel fortunate. I work at a Medical School where the educators are superior. Excellence in Medical Education is rewarded. However I cannot help but feel that we are far from equality in Academic Medicine. The Clinician has the RVU; the Researcher has the grant and the paper. What does the Educator have? Some have discussed the Teaching or Academic RVU. We have not espoused such a system, and I doubt that there are many schools of medicine that have.
I am among the fortunate few who have supportive Chairs and Administration. But this was not always the case. Just a few days after I began my first job, I was precepting a small group for first year medical students and I was told, “I’m not paying you to teach students!” I realized right there just how big a mistake I had made. I didn’t make my intentions clear enough to my boss. And he saw my time teaching as time away from seeing patients (i.e., making money).
So now it comes to that…money. Who will pay the Clinical Educator to teach? To lecture, to stand at the bedside and demonstrate professionalism, to create new content? To be an innovator, to develop a new curriculum? Just a few months ago I was asked to run a 4th year selective course in GI. The course itself is mandatory, students can select one of any number of subspecialties that are participating.
I had to decline (for one of the first times in my career, I said no…). Why? Not because I didn’t want to, but because my time to run the selective was not being reimbursed to my Division. Like many other Clinical Educators, I am spread thin by my own choice. But I could not in good faith take on other responsibilities without “protecting” my time from what I would otherwise be getting paid to do.
How can we prevent this? I do not know. A point here is that the course (the umbrella group that runs the mandatory portion) is funded, but the individuals who are asked to proctor the students and design a curriculum for them, are not.
My mentor says that we would never dare ask a researcher to run a few PCRs for free, but we don’t think twice about asking a doctor to just do this “one” lecture.
What ideas do you have? Has your school come up with a great solution that you can share?
Gut Check Blog 
I don’t think we can ‘quantify’ teaching. I think it comes down to the commitment from leadership to support professional educators. Another issue to address is the training of professional educators. Top tier programs push bench research driven by the demands of NIH training grants. This is unfortunate. Educators and master clinicians need to be trained as such.
So no answer from me but interesting problem.
Thanks for the reply. Clearly the commitment from leadership is important. The more that medical educators are recognized as valued commodities, the more that the medical education community can continue to attract and retain excellent physicians into the ranks in this era of medicine.