Good post. Academic medicine here. Most physicians in academic medicine are "career line" in that we are not tenured and work to make income for the university. In my academic lifetime, I have see the deterioration of "protected time" to include more and more clinic time and inpatient hospital call. The time that used to be spent teaching, writing papers, applying for grants, etc. is basically going away. I'm a bit older so I have seen my younger colleagues get super frustrated and burned out. Academic promotion which can lead to higher salaries, chance for a dean job, etc. is STILL based on academic research output. If one does not publish, one does not get promoted. Junior faculty get extremely worried as they are seeing patients all day with no more time to teach and absolutely no time to write research papers. I'm seeing people leave academic medicine now for private practice where the salary is significantly higher. How can academic medicine make a difference in the world if we don't have time to publish research or educate medical students and residents? We can see patients all day long without protected time, but we are getting more and more limited in improving health research and outcomes. Such frustration combined with poorly working electronic medical records, administrative bloat, and the COVID-19 pandemic has fueled this problem as well.
Thanks so much for this, Terry. I was part of the Great Resignation from academia. The decision was partly because of a higly toxic work environment at my institution that saw entire programs decimated and dozens of my colleagues leave over the span of a few short years. That instability did a number on my ability to focus on getting tenure. But another part of it had to do with what you're describing here about the publication metric becoming the outcome. I just couldn't see the point of striving to publish endless permutations of modest ideas to satisfy the ever-moving T&P targets. The transition to non-academic employment is interesting -- all those skills you describe come into play, but I found the hardest thing was to being able to articulate them to myself first. It was just "stuff" you do as a professor because... well, because that's what your daily work life requires. I was shocked that the skills that I described in a recent (successful) job application came from the --largely unpaid, thouroughly devalued-- "service" category in my CV.
The current culture around scientific publication is incredibly frustrating, and serving as an editor is actually part of what pushed me out of academic science. So much effort and money put into lines on a CV that could be put towards asking new questions or communicating those results more broadly. I just finished reading “Laboratory Life”, a sociological study of a lab at the Salk in the 1970s, and the author describes papers as the main product of the lab. Not knowledge, or understanding—papers. UGH!
Terry, I heartily agree with all of this. I'm non-tenure-track and came to academia sideways, so I don't have a fancy publication list. My CV and annual review docs look very unusual compared to most folks I work with, but I'm determined to account for the work I have done and the work I do. The irony is that I spend a lot of my time in academia working to reframe/help others reframe what "counts." And yet, the only bits of it that are countable are things like a commentary in review right now (about the exact issues you detailed) that has taken us two years to write. It has been enormously satisfying to write it. But wouldn't it be nice if we hadn't needed to, and could have used all that time, instead, to do the good work we hope the paper helps people advocate for!?! (Don't get me started on the time we've put into trying to get RCN funding to build a strategic coaching program to teach UBE academics how to effectively advocate for and lead the kinds of changes we're calling for...and that you are! We're about 4 years in on that and still no dice. The reviewers hate our systems change pitch. They just want to see lesson plans, it seems.)
Good post. Academic medicine here. Most physicians in academic medicine are "career line" in that we are not tenured and work to make income for the university. In my academic lifetime, I have see the deterioration of "protected time" to include more and more clinic time and inpatient hospital call. The time that used to be spent teaching, writing papers, applying for grants, etc. is basically going away. I'm a bit older so I have seen my younger colleagues get super frustrated and burned out. Academic promotion which can lead to higher salaries, chance for a dean job, etc. is STILL based on academic research output. If one does not publish, one does not get promoted. Junior faculty get extremely worried as they are seeing patients all day with no more time to teach and absolutely no time to write research papers. I'm seeing people leave academic medicine now for private practice where the salary is significantly higher. How can academic medicine make a difference in the world if we don't have time to publish research or educate medical students and residents? We can see patients all day long without protected time, but we are getting more and more limited in improving health research and outcomes. Such frustration combined with poorly working electronic medical records, administrative bloat, and the COVID-19 pandemic has fueled this problem as well.
I saw recently in a paper that ONE THIRD of academic physicians have plans to leave (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2812960#:~:text=Findings%20In%20this%20cross%2Dsectional,associated%20with%20intention%20to%20leave.) NUTS.
The article is very accurate from I have seen at my academic medical center.
Thanks so much for this, Terry. I was part of the Great Resignation from academia. The decision was partly because of a higly toxic work environment at my institution that saw entire programs decimated and dozens of my colleagues leave over the span of a few short years. That instability did a number on my ability to focus on getting tenure. But another part of it had to do with what you're describing here about the publication metric becoming the outcome. I just couldn't see the point of striving to publish endless permutations of modest ideas to satisfy the ever-moving T&P targets. The transition to non-academic employment is interesting -- all those skills you describe come into play, but I found the hardest thing was to being able to articulate them to myself first. It was just "stuff" you do as a professor because... well, because that's what your daily work life requires. I was shocked that the skills that I described in a recent (successful) job application came from the --largely unpaid, thouroughly devalued-- "service" category in my CV.
The current culture around scientific publication is incredibly frustrating, and serving as an editor is actually part of what pushed me out of academic science. So much effort and money put into lines on a CV that could be put towards asking new questions or communicating those results more broadly. I just finished reading “Laboratory Life”, a sociological study of a lab at the Salk in the 1970s, and the author describes papers as the main product of the lab. Not knowledge, or understanding—papers. UGH!
Terry, I heartily agree with all of this. I'm non-tenure-track and came to academia sideways, so I don't have a fancy publication list. My CV and annual review docs look very unusual compared to most folks I work with, but I'm determined to account for the work I have done and the work I do. The irony is that I spend a lot of my time in academia working to reframe/help others reframe what "counts." And yet, the only bits of it that are countable are things like a commentary in review right now (about the exact issues you detailed) that has taken us two years to write. It has been enormously satisfying to write it. But wouldn't it be nice if we hadn't needed to, and could have used all that time, instead, to do the good work we hope the paper helps people advocate for!?! (Don't get me started on the time we've put into trying to get RCN funding to build a strategic coaching program to teach UBE academics how to effectively advocate for and lead the kinds of changes we're calling for...and that you are! We're about 4 years in on that and still no dice. The reviewers hate our systems change pitch. They just want to see lesson plans, it seems.)