(Source: Office of the Provost, January 8, 1985)

Introduction

     The University of Pennsylvania has four schools whose activities lie within the health area: the School of Dental Medicine, the School of Medicine, the School of Nursing and the School of Veterinary Medicine. Each of these schools has established a faculty category called "Clinician-Educators," and appropriate Trustee action has been taken in each case. In the School of Dental Medicine, the clinician-educator category was established in 1981; in the School of Medicine, in 1976; in the Schools of Nursing and Veterinary Medicine, in 1983.

     Candidates for appointment or promotion in the clinician-educator faculty are urged to consult the appropriate department chair or the dean of the appropriate health school for additional information concerning membership in the clinician-educator faculty.

Purpose

     The four health schools have found it desirable to make long-term, full-time faculty appointments to individuals whose primary responsibilities are in patient care and in the instructional programs of the University rather than in the research activities engaged in by members of the tenured and tenure-probationary faculties. These faculty members are called "clinician-educators"; such a group is essential for program stability, development and continuity.

Appointment

     All appointments of clinician-educators are full-time untenured appointments to the standing faculty. Hence procedures governing appointments to the standing faculty will be followed.

     In the School of Dental Medicine, a proposal to appoint or promote will be initiated by a recommendation from the department to the Dean. To take effect such a proposal must be reviewed and approved by the School of Dental Medicine's personnel committee (the Committee of Professors) and the Dean.

     In the School of Medicine, the same procedure applies with review being carried out by the Committee on Appointments and Promotions and the Dean.

     In the School of Nursing, which does not have a departmental structure, the proposal to appointment or promote will be initiated by a recommendation from the clinical section through its chair to the Dean. Review will be by the School's Personnel Committee.

     In the School of Veterinary Medicine, the proposal to appoint or promote will be made by the department chair to the Committee on Appointments and Promotions and to the Dean.

     In all cases, the review criteria shall be appropriate for the standing faculty; however, the identifying feature of criteria governing clinician-educator appointments is emphasis upon patient care and teaching performance rather than upon research performance. In all cases further review is carried out by the Provost's Staff Conference with appointment being made by the Trustees on recommendation of the President.

Title

     To assure conformity with approved nomenclature, appointees in the clinician-educator category will hold modified titles as assistant professor, associate professor or professor of (clinical specialty) at the (school or appropriate department, hospital, teaching unit or other base facility). That is, a clear and correct modifier must be attached to the professorial title. This title is to be written in full whenever used in documents, in listings of University personnel, or in correspondence.

Conditions of Employment

     As is the case with other faculty categories, all clinician-educators receive a clear statement of their conditions of employment, including use of facilities and access to patients; the responsibilities of the school or other budgetary unit for payment of salary and specified benefits; the right of persons to due process by mechanisms available to all University faculty in the event of grievances or alleged failure to protect the individual rights accorded a faculty member; and the circumstances under which the appointment may be terminated. This statement will be part of the document governing the appointment. All patient care activities of clinician-educators will be located in facilities under the auspices of or approved by the school in question.

Salary and Benefits

     Clinician-educator salaries shall conform to school policies. All clinician-educators will be entitled to the same faculty benefits from the University as other members of the standing faculty. Leaves of absence are not an unconditional benefit, whether for scholarly or other purposes. They will be granted only when conforming to the University's general policy on leaves and when determined on an individual basis to be in the interest of both the faculty member and the school.

Professional Activity

     A clinician-educator will be required to devote his/her full professional time to activities on behalf of the educational and patient care functions of the school. The faculty member will be subject to University policy on conflict of interest. The one-in-seven day rule will apply except that the clinician-educator will not be permitted to devote any time to employment in extramural patient care. All patient-derived income of clinician-educators must be returned to and managed by the school.

     In the School of Nursing, the one-in-seven day rule will apply, except that the clinician-educator will not be permitted to devote any time to employment in extramural professional practice activities as defined in the individual's contract.

Rights and Privileges

     Except for the untenured and non-tenure probationary nature of the appointment, the restriction on extramural employment noted above and the stipulation that they do not normally vote on matters of tenure or participate in discussion concerning the compensation of tenured faculty, clinician-educators share in all the rights and privileges of the standing faculty of the University. Should grievances arise which are not adjusted administratively, appointees may seek adjudication through the established mechanisms of the school and the University.

Limitations on the Size of the Clinician-Educator Faculty

     In each school there are restrictions on the size of the clinician-educator faculty as follows:

     School of Dental Medicine: At no time shall the voting strength of the faculty members in the clinician-educator category exceed thirty percent of the voting strength of the standing faculty of the School of Dental Medicine as a whole.

     School of Medicine: The percentage of clinician-educators in the faculty of the School of Medicine may not exceed forty percent of the number of standing faculty in that school.

     School of Nursing: At no time shall the voting strength of faculty members in the clinician-educator category exceed forty percent of the voting strength of the standing faculty of the School of Nursing as a whole, and no section shall have more than half its standing faculty membership composed of clinician-educators.

     School of Veterinary Medicine: At no time shall the voting strength of faculty members in the clinician-educator category exceed twenty-five percent of the voting strength of the standing faculty of the School of Veterinary Medicine as a whole. At no time shall more than thirty percent of the standing faculty of any clinical department be in the clinician-educator category.

Timing of Appointments and Shifts of Faculty Category

     In the health schools there are three standing faculty categories at the rank of assistant professor; a seven-year tenure probationary category, a ten-year tenure probationary category, and the ten-year clinician-educator category which is not tenure probationary. Currently, all assistant professors in the Schools of Dental Medicine, Medicine and Veterinary Medicine have initial three-year appointments, but in the School of Nursing the initial appointment is either for three or four years. In all Schools, new assistant professors enter one of the three categories at the time of their initial appointment.

     Clinically oriented assistant professors in the seven-year probationary category must make a decision before the end of the third year of the initial appointment to remain in the category to which they were initially appointed or to transfer to one of the other two categories if such a position is available. Clinically oriented assistant professors in the ten-year probationary or clinician-educator categories may also change categories at this time if a position is available. Those electing the seven-year tenure probationary category will be reviewed for promotion to the rank of associate professor with tenure not later than the sixth year. The decision can only result in either promotion to the rank of associate professor with tenure or termination of appointment and separation from the University subject to the terms of the then existing appointment. No shift from the seven-year category to one of the other two is allowed after the end of the initial appointment. However, clinically oriented assistant professors in either the ten-year tenure probationary category or the clinician-educator category may make one further shift. During the first reappointment, but not later than the end of the sixth year, such an assistant professor may move from the ten-year tenure probationary category to the clinician-educator category or vice versa. No assistant professor may make a change of categories after the end of the sixth year. Assistant professors in either of these latter two categories will be reviewed for promotion to the rank of associate professor during the ninth year. In each case, the decision can only result in either promotion to the rank of associate professor or termination of the appointment and separation from the University subject to the terms of the then existing appointment. A grant of tenure must accompany promotion in the ten-year tenure probationary category; tenure cannot be attained in the clinician-educator category.

     Having achieved the rank of associate professor, transfer between tenure status and clinician-educator status may be made rarely and only if, upon review by the faculty committee responsible for quality and qualifications of faculty and by the Provost's Staff Conference, the individual is found to have met all criteria appropriate to the receiving category at the proposed rank. Transfer from the clinician-educator category to a tenured position requires a full national search. Persons from outside the School faculty with appropriate experience and credentials for initial appointment as associate professor or professor in the clinician-educator category will ordinarily be appointed directly to that category after an appropriate search.

Termination

     Termination of employment of persons who have chosen and entered the clinician-educator faculty will be made only because of (1) failure to secure promotion to associate professor by the end of the probationary period which shall not exceed ten years; (2) retirement (3) failure to provide appropriate practice income commensurate with responsibilities assigned by the appropriate department or section chief; or (4) for "just cause" as customarily determined within the University. The term "practice income" means income derived from professional practice or related professional activities of clinician-educators that is collected and disbursed within the University. The four schools have amplified point (3) in several respects as follows:

     Clinician-educators must generate a level of practice income appropriate to the level of patient-related activity assigned to them within their departments or sections. Levels of patient-related activity are assigned to clinician-educators by department or section chairs after consideration of the individual's academic activities, administrative activities, and other obligations. The practice income generated must be sufficient to cover an appropriate portion of the academic base salary, benefits, and overhead. In cases where patient care is the predominant activity of clinician-educators, the appropriate portion may be the entire amount. In other cases, the appropriate portion may be less than the entire amount because of type of patient, time and effort necessary to develop clientele, or other academic duties assigned within the department or section. Clinician-educators must be informed annually in writing of their clinical responsibilities and the amount of practice income they will be expected to generate each year.

     In order to establish that a clinician-educator has not generated the appropriate level of practice income, a period of observation of a year's duration is required. Written notice of the initiation of a twelve-month period of observation and of potential termination at the end of that twelve-month period must be provided by the department or section chair to the clinician-educator. In the Schools of Dental Medicine, Medicine and Veterinary Medicine, the department chair also notifies the Dean of the initiation of such a period. In the School of Nursing, the Dean and the program director participate with the section chair in notifying the clinician-educator, and the notice is provided by April 1 -- based on the activities of the preceding twelve months. This notice must include a statement of the amount of practice income that the clinician-educator will be obliged to generate during the subsequent year of observation. If at the end of the year of observation, the department or section chair finds that this income has not been generated, the chair (in the School of Nursing the section chair in collaboration with the Dean) must give written notice to the clinician-educator if termination of the appointment is planned. This notice shall include the reasons for termination, a description of the appropriate appeal process, and a statement that termination shall occur at the end of the next twelve-month period.

     A one-year extension of the observation period is possible. Extension for a second twelve-month period may be given by the department or section chair not later than three months prior to the termination of the first twelve-month period of observation if, in the judgment of the chair, there has been sufficient improvement in the amount of practice income generated. If an extension for a second twelve-months of observation is given, by the end of the sixth month of the second twelve-month period of observation the department or section chair with the concurrence of the dean must notify the clinician-educator in writing either of termination at the end of the second twelve months of observation or of cancellation of the notice of termination.

     In the Schools of Dental Medicine, Medicine and Veterinary Medicine, if a clinician-educator believes that a determination by the department chair that he or she had not generated the appropriate level of practice income is incorrect, that the amount of income required to be generated is excessive, or that he or she has been or may be prevented from earning the appropriate level of income by discriminatory patient-care assignments, he or she may, at any time after the commencement of the observation period, but not later than one month after the termination notice, file a written appeal with the Dean and the chair of the appropriate faculty committee.* Within one month of receipt of such a written appeal, this committee shall appoint from its membership an ad hoc committee of five which shall elect its own chair. The ad hoc committee shall investigate and report to the clinician-educator, the chair of the department and the chair of the appropriate faculty committee within one month of its appointment whether termination is or would be in accordance with the standards and procedures set forth above. Either the department chair or the clinician-educator can request review of the ad hoc committee's conclusion by the appropriate faculty committee, which shall conduct such a review within one month. The decision of the ad hoc committee or the appropriate faculty committee (where this committee has reviewed the ad hoc committee's decision) shall be transmitted in writing to the Dean.

     In the School of Nursing, the following appeal mechanism will apply: should the clinician-educator either contest the level of practice income set by the section chair and the Dean or assert that she or he has generated the appropriate level of practice income, the clinician-educator may, not later than one month after the last day of the period of observation and possible termination notice, file a written appeal with the Dean and the Chairperson of the Personnel Committee. Within one month of receipt of such written appeal, the Personnel Committee shall appoint from its membership an ad hoc committee of three which shall elect its own chairperson. The ad hoc committee shall investigate and report in writing to the clinician-educator, the section chairperson, the program director, the chair of the personnel committee, and the Dean within one month of its appointment whether termination is or would be in accordance with the standards and procedures set forth in the initial letter of appointment and in this document.

Scope

     Nothing in this document is intended to change the status of or to increase or decrease the rights and obligations of other persons presently on the full-time faculty of the four health schools.

 School of Social Work

 (Source: Standing Resolution of the Trustees: June 19, 1987)

     Standing Faculty-Clinician-Educators also include full-time faculty members in the School of Social Work engaged in activities at health care institutions. These appointments are governed by the document, School of Social Work: Clinician-Educator Proposal as approved by the Trustees.

* These appropriate faculty committees are as follows:
   School of Dental Medicine: Committee of Professors
   School of Medicine: Steering Committee of the Medical Faculty Senate
   School of Veterinary Medicine: School Committee on Academic Freedom and Responsibility.