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Milieu in Dental School and Practice |
Dr. Masella is Associate Professor, Department of Orthodontics, College of Dental Medicine, Nova Southeastern University. Direct correspondence and requests for reprints to him at the Department of Orthodontics, Nova Southeastern University, College of Dental Medicine, 3200 S. University Dr., Fort Lauderdale, FL 33328; 954-262-7397 phone; 954-262-1782 fax; rmasella{at}nsu.nova.edu.
Key words: internal dental school environment, recruitment period, job description, job performance assessment, grantsmanship, peer collaboration, institutional culture
Submitted for publication 12/10/04; accepted 02/07/05
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This clarion call is noble and important. Fresh academic blood gives new life to dental schools and nourishes aspiring dentists. As the opening quotations indicate, however, mission accomplishment is another story.
Traditional concerns dominate current discussion of dental faculty prospects: salary, professional development, teaching and research, and faculty practice. Senior-to-junior faculty mentoring is emphasized as an effective guidance and support tool in new faculty retention and development.1,4,5 Yet the academic environment presents other workplace challenges that beg familiarity from prospective and new faculty. As informed consent educates and empowers patients and protects doctors, so awareness of work environment reality enhances stakeholder communication, provides understanding of mutual faculty and administrative duties and responsibilities, and maximizes chances of positive faculty career outcomes in dental education.
This article is meant for young dentists and experienced clinicians contemplating or beginning academic careers. Its purpose is to depict the realities of the internal dental school work environment and offer advice on surviving and succeeding in that setting. Some of its suggestions are specific to dental and health professions schools; others relate to most large institutions and bureaucracies. At least one observation seems to defy common sense. Note that proffered guidelines are of two types: experiential and evidence-based. Many are reflections of internationally distinguished nondental educators, well documented in classic texts. Others are statements of contemporary dental educators from recent peer-reviewed publications. My empiricisms derive from personal experience and not from formal research findings. Nonetheless, may the words of Thomas Jefferson give comfort: "Error of opinion may be tolerated where reason is left free to combat it."
The following comments are not meant to diminish enthusiasm for dental education or emphasize the negative side of academics, but are proposed to help faculty careers stay on track. It behooves the educator to step carefully into and through the opportunity-rich academic realm, grateful that dedication and hard work may bring rewards while being aware that pitfalls exist.
| Actions Promoting Faculty Success |
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Besides teaching and research, faculty academic duty also means service. Service consists of dental school and university committee work, extracurricular program support of many types, and on-and off-campus college representation. These activities allow the educator to exercise important written and verbal communication skills and network with colleagues while helping fulfill the institutional mission. Committee assignments usually start out as reasonable time commitments, but may eventually grow to compete with demands of teaching and research.
2. Tactful but effective self-promotion is critical to advancement.
While personal "horn-tooting" is distasteful to most dentists, academics included, shyness does not win points when it comes to getting ahead in academia. Maximum self-definition to the academic community and minimum negative definition from others is essential to career success. "Perception is reality" often describes matters of faculty academic reputation and advancement prospects. While not applying to Nobel laureates or seven-figure grant holders, stakeholder (administration, faculty, students, alumni) perceptions of faculty abilities and value relative to institutional mission may count more than core expertise. Many factors in and out of educator control define these perceptions: quality of relationships with institutional leaders and faculty, communication ability, importance of work product relative to leaders value system, and ability to procure financial support, among others.
Faculty academic and community accomplishments need mention in college, university, and professional association publications. Although they may be included in annual faculty performance evaluations, copies of recently published professional articles may be provided to deans and department chairs, along with quarterly updates on research projects. Getting ones name out is just as important in the academy as in practice.
3. Be prepared to collaborate.
A Ph.D. faculty member in a liberal arts college may work alone. A dental school educator cannot work alone and needs to partner with other faculty and possibly students. As with practicing dentists, faculty in all teaching, research, and service activities will be part of a team. Job performance may be assessed in large or small measure from a team perspective.
4. Personal stock is highest in the recruitment period.
The courtship between institution and prospective faculty provides the period of greatest leverage for potential new hires. This time offers the best chance to secure desired rank, salary, benefits, and development opportunities.6 The process may now include concurrent wooing of the candidates spouse or protégé in a package deal. Jacques Barzun wryly opines that "the modern university needs [and] the modern scholar wants . . . clusters of talent. Genius . . . no longer wants to be sui generis."6
Once employment starts, maximum attraction and special attention soon yield to regular colleague status. The academic candidate should take advantage of what may be a relatively brief time in the sun. As Clifford Geertz states, "The majority of people follow a career pattern in which they are for several years at the perceived heart of things and then, in differing degrees and . . . speeds, are, in the jargon, downwardly mobile."7
5. Faculty, know thyself.
Pre-employment self-assessment is a must before heading off into a job search. Prospective faculty should frankly assess their strengths and weaknesses. Personal passions and turn-offs should be identified. In what specific ways can the doctor make a positive difference in the academic world? What special talents does the neophyte educator bring to the academic table? Of course an organized and well-written personal portfolio details special accomplishments and aptitudes and reflects the applicants professionalism. Sharp institutions recognize faculty strengths and weaknesses, utilizing the former to maximum extent, building the latter through professional development programs.
6. Assess the faculty.
Since faculty partnerships reflect the modus operandi of dental school work life, new educators should make distinctions between colleagues most likely to be productive work partners and those "better worked around than with." Noted medical educator Stephen Abrahamson classified faculty into three categories: "friendlies, neutrals, and hostiles. The friendlies we loved and worked with closely. The neutrals we tried to influence with data and ideas. The hostiles we avoided and prayed we were never afflicted with a disease in their specialty."4
Armed with information from self-assessment, prospective faculty should ask themselves questions such as "Can I find people to work with in this setting? What is the receptiveness of dental faculty to new ideas? What would happen if a new dean or department chair arrived?" Answers help reveal the fertility and desirability of the work environment.
7. Know the institutional culture.
Universities and health professions educational centers have operational philosophies that help define institution-to-employee and employee-to-employee relationships. Institutional culture determines the relative worth attached to people versus bricks and mortar, the level of professional courtesy practiced by faculty, administration, and students, and the importance of faculty, students, and academics in the system. This culture may influence the nature of daily interaction between faculty, happiness of faculty with working conditions, and longevity of employment.
Based on institutional culture, universities and dental schools develop cores of importance or central tenets of academic emphasis. Faculty candidates should be familiar with cultural characteristics of individual dental schools before filing employment applications. University and dental school websites are valuable resources for learning about academic cultures, as are alumni, students, and faculty.
By example, encouragement of dental multidisciplinary and cross-professional course development and presentation provides opportunity for regular communication between health professionals and a broad perspective in selecting course content and teaching methods. However, traditional dental schools may prefer single-discipline courses and view cross-disciplinary contact as nonproductive.
While management variations among health professional schools are legion, common academic models include the collegial, which is characterized by relative subunit independence, some decentralization, and highly structured faculty, administrative, and student roles; managerial, where the university or college is viewed as a business enterprise, with emphasis on the bottom line and top-down leadership;8 and political, where administrative and faculty interpersonal relations are centered on development and maintenance of leader power, primary loyalty is to personal careers rather than institutions or students, and promotion of leader interests drives the system.
8. Have a pre-employment job description detailing duties, responsibilities, and specific parameters of performance evaluation.
"Its such a bureaucracy. And its so old-fashioned in thinking."1 These comments by junior faculty are telling not only in organizational hurdles faced in making changes, but in normal, everyday work activities. New faculty should not assume anything about what constitutes excellent job performance. Pre-hiring communication between dental school bosses and prospective faculty must result in a clearly defined, written job description listing employee duties and responsibilities and job evaluation protocol. Mutual responsibilities of faculty and administration should be understood. It is incumbent on potential new faculty hires to determine what work activities are evaluated in probationary periods and annual or semi-annual performance reviews. Also, who will do the reviewing, and what role will the evaluation of teaching play in the process?
Academic and practicing dentists know that written job descriptions promote optimal employer-employee relations and reduce on-the-job surprises. Disclosure of job performance evaluation protocol enables potential faculty to know how they will be formally judged and what the college considers important faculty activity. While teaching offers the prospect of lifetime impact on grateful students, along with substantial personal gratification, it is usually not the ticket to academic stardom.5,6,9,10 In top American research universities, and to some dental schools and parent institutions, teaching is traditionally the least valued academic activity.4 At some universities, teaching has only recently been equated with other venues of scholarship such as research and publication. The slight to teaching is especially unfair in that a single well-designed and well-constructed course syllabus may represent the academic and scholarship equivalent of many peer-reviewed publications, let alone substantial work in knowledge analysis and integration! There is movement toward elevating the status of teaching, but not much change has reached the trenches.
The job description may consider the need to spend time in class, laboratory, clinic, library, and information technology, in addition to deskwork. The question of flexibility in working hours also needs resolution. Insistence on a daily 8-to-5 schedule along with desk jockey status "so we know where to find you" may indicate propensity for control and micromanagement. Along with parochialism and factionalism, these represent common traits of dentists and dental educators.11
9. Job performance may be a secondary factor in job advancement.
More likely found in, but not limited to, managerial and political institutions, this concept is counterintuitive. How can job performance not count? The answer lies on many fronts; the practical consequence is that mediocrity often trumps excellence in the academy.12 One reason is that job success in the above systems may be determined by "political fit," the perception of leaders about employee usefulness in promoting the system and interests of key players. Using a historical analogy, hiring and promotion of faculty in heavily political systems are akin to the patron-client system of ancient Rome in their quid pro quo, as unwavering, unquestioning employee support for leadership is a mandate that provides privileges and advancement opportunities.13
The quality of interpersonal working relationships may also affect faculty standing. While a deans or department chairpersons personal like or dislike of the employee strongly influences job granting and retention, coworkers may also play important roles in promoting or derailing careers.13 As in dental practice, those few colleagues who believe anothers presence threatens their professional advancement and act to discredit the "opponent" are internal academic realities. To avoid career derailment by pathological personalities, it helps to know them by what they do, not what they say.
Another example of disjunction between faculty job performance and advancement in managerial and political colleges is found in the "family business." Institutional leadership can be closely held, with cronyism the order of the day. Regardless of performance, cronies are OK; non-family or "strangers" (non-cronies) may be viewed as not-OK. Even long-time non-family employees may be regarded as outsiders. Conversely, the internationally prominent scientist or clinician finds acceptance owing to conferred institutional and leader prestige and so rises above the system.6
Finally, a tendency for self-perpetuation among academic leaders may cause hiring, promotion, and tenure decisions to be based on the faculty members cloning potential.12 Department heads may feel more comfortable with similar-thinking people and be threatened by "newcomers with different ideas." A leaders bias for perceived self-clones easily manifests in favored treatment.
10. Satisfy the people in power.
Full-time, nontenured faculty and administrators serve at the deans mercy. Even tenured faculty may be vulnerable in the current environment. Department chairs often have wide latitude in faculty selection and retention. University officers may exercise considerable influence in college activities, including faculty hiring and retention. Many powerful forces are at play in dental schools that can promote or destroy faculty careers. The educators study of institutional culture permits appreciation of the realities of power and necessary relations with powerful people. It is wise to work with the power structure when proposing or leading a change effort.
Dental faculty are not immune to frailties of human nature: becoming "one of them" (grant or promotion recipient, change agent) instead of staying "one of us" may trigger colleague distaste. Beware the sin of achievement! The higher a faculty member rises, the greater the personal institutional visibility, and the more the educator becomes a potential target. If entering the less secure realm of dental school administration, it is important to keep a professorial appointment as a fallback.
11. As in dental practice, pay attention to the written record.
Trotman et al. mention junior faculty problems with "negative departmental politics and issues of trust with administrative staff."1 Back up verbal discussion with the dean or other administrators with a memo detailing the conversation and copy the parties in question. The fledgling academic is advised to heed the saying, "Paper is what matters in a bureaucratic promotion system."12
Most dentists rightly take great pride in dentistry and dental education, believing that the honesty and integrity of practicing dentists and dental educators are far above societys norm. Prudence in faculty-administration relations requires acknowledgment of the infrequent times when the spoken word means little or nothing. This truism is disappointing when the conversation is between two dentists, academic or not.
12. Grantsmanship is the most valued academic skill.
Any lucid observer must conclude that money is the be-all and end-all of higher and health professions education. The recent marriage of private foundation dollars and university postgraduate dental programs, producing reserved slots for corporate contractees, is one of innumerable manifestations of higher educations money addiction. If being an academic big shot is the career goal, the advice is simple: bring in the dough! The faculty member who funnels money into a school finds favor and a glass at least half-full. The more money from government, industry, and foundations, the more secure and vaunted the position. Like the Romans of 2,100 years ago, "Everyone longed for money, everyone judged, or was judged, on the basis of money."13
13. As with life, academic careers have "changing seasons."
Lifetime sustained academic productivity means being prepared to "hit the wall" and bounce back in a different direction. It is likely that personal and professional growth and development will change course over the years. This may correspond to changing institutional and personal priorities, different stages of life, and personal educational needs.9 Regaining the passion and sense of usefulness lost when a major vein of activity plays out may entail pursuit of new avenues such as cross-field integration, consultancy, professional association activity, book authorship, sabbatical leave, and return to student, teacher, and researcher status in another field.
14. Have other dental schools in mind should things not work out.
Dental academics is among the most desirable careers attainable in the American employment realm. Working conditions are likely to be favorable, and time spent with students will prove quite uplifting.
Granting the privilege of dental educator status, dental school can still be a fickle place of employment. In Susanne Lohmanns frank words, "The university is a cruel institution. It takes the best and the brightest, promises them the world, and then it throws most of them to the dogs."12 A new dean may wipe the old slate clean. Job longevity may equate to making more enemies as well as friends. Tying oneself to a single institution for an entire working life may not be a good idea, or even possible, for many of us. Move on if instincts say its time and personal circumstances permit.
15. If you make the organization (dental school) your life, you are defenseless against the inevitable disappointments.
This slight variation on the words of management guru Peter Drucker14 holds for most faculty and administrators. Those remarkable individuals enjoying full-time academic appointments, even deanships, for twenty-five years or more, are deserving of the utmost admiration and wonder. They should be writing how-to books. For mere mortals, staying on until carried out feet-first runs the ante-mortem risk of systematic destruction.
Bureaucracys lethality is perhaps best exposed by a military example. One of the greatest warriors in American history, the late Marine Corps Lt. Gen. Lewis B. "Chesty" Puller, winner of five Navy Crosses, recipient of more combat decorations in more war theaters than any American, and legend to his troops, was relieved of duty because the commandant and other four-stars were jealous of his popularity and hated his honest assessments.15
Make time for family and self, and know when to call it quits.
| Epilogue |
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Ample personal satisfaction awaits the dental educator in helping create new professionals, stimulating individual professional interests, and serving as a model of professional conduct. The latter includes the singular opportunity to define professionalism as a caring and humanitarian activity that respects patients and colleagues and strives to give something back to community and profession. Another gift is the prospect of discovery that advances science and education and benefits humanity. All lie in the educators purview.
Dental schools share some operational characteristics with dental practices, but also present unique workplace challenges. Given the importance of recruiting and retaining dental faculty, accurate informed consent regarding the dental school work environment is crucial. Awareness of reality minimizes surprise and helps the academic secure a positive outcome.
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This article has been cited by other articles:
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M. R. Peterson Academic Tenure and Higher Education in the United States: Implications for the Dental Education Workforce in the Twenty-First Century J Dent Educ., March 1, 2007; 71(3): 354 - 364. [Abstract] [Full Text] [PDF] |
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R. S. Masella Renewing Professionalism in Dental Education: Overcoming the Market Environment J Dent Educ., February 1, 2007; 71(2): 205 - 216. [Abstract] [Full Text] [PDF] |
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