Committee of Eleven

COMMITTEE OF ELEVEN REPORT ON ISSUES OF FACULTY CONCERN
AT THE COLLEGE OF MEDICINE

During the spring and summer of 2007 the Faculty Officers and other members of faculty governance were made aware of faculty concerns regarding the College of Medicine. In response to these concerns, in September of 2007 the Committee of Eleven voted to initiate a fact-finding study to ascertain and understand these concerns and the depth of the issues. Committee members from the College of Medicine were recused from participation in the study. In order to be totally transparent, the Committee of Eleven wrote to all department heads at the College of Medicine, indicating the rationale for the study, the focus of the study, and the Committee’s authority under the faculty constitution. Meetings were requested with departments, groups or individuals to obtain a diversity of view points. The Committee of Eleven did not approach any individuals directly and thus only met with those groups or individuals that requested a meeting. It has been reported to us that "Inquiries sent to Department Heads last Fall seeking comment did not reach many of the faculty." This is unfortunate, and may reflect a communication issue within the College of Medicine. The letter to department heads read:

As indicated in the letter to the department heads, the Committee of Eleven strongly believes that a hugely successful College of Medicine is critical to the future of the University of Arizona. Indeed, a common theme of all the individuals with whom the Committee communicated was the need for change, and in particular greatly strengthening research and the education of medical students.

During the fall and winter of 2007, members of the Committee of Eleven attended 17 meetings with individuals and/or groups of faculty, and/or department administrators who had requested meetings and received correspondence from additional faculty (four letters, with 2, 22, 31, and 3 signatures, respectively). In aggregate, the Committee received input from over 130 faculty, including 10 department heads, 4 former department heads, and section heads. The majority of individuals participating were from basic science departments, but a significant number of faculty from clinical departments also participated. It is important to note that almost all the faculty with whom the Committee communicated were senior faculty with outstanding credentials and many with a long history with the University.

As indicated in the letter to the department heads the Committee focused on four areas of interest: the impact of the College of Medicine in Phoenix, faculty governance in the College, academic freedom, and research excellence. One of these topics, the impact of the College of Medicine in Phoenix, was not found to be of great concern to those faculty with whom we met and is addressed here only briefly. Moreover, for purposes of discussion the faculty governance and academic freedom issues will be combined because the boundaries between these two areas are not sharp. It became clear very quickly that the College of Medicine – University Physicians Healthcare – University Medical Center (COM-UPH-UMC) relationship is a major issue of concern with a highly negative impact on workload, teaching, research and faculty morale.

The following analysis summarizes the general sense of the concerns expressed by a large number of faculty. In addition, the Dean was encouraged to provide materials relevant to the concerns, and provided a number of useful documents. Multiple views were presented, different individuals/groups had different areas of concern, and some faculty felt that the College was moving forward positively and expressed no concerns. For example, a letter of support of Dean Joiner’s efforts received on January 16, 2008 signed by 22 individuals from two clinical and three basic science departments, including research track, junior and senior tenure track/tenured faculty, theme directors, a clinical section chief, and department heads. The letter states "We fully support Dean Joiner and feel that he has been an outstanding and transformative Dean of the College of Medicine." They conclude that, "Dean Joiner has made the necessary and often difficult changes that are moving the University of Arizona toward becoming a top-tier biomedical research institution…and [we] support moving forward with his vision."

COM-UPH-UMC. Although the details of the relationships between the College of Medicine, UPH and UMC are beyond the scope of this study, the ramifications are not. It is a widely-held belief among clinical faculty that the current structure makes it essentially impossible for them to engage effectively in academic medicine. To paraphrase one group of faculty – after investing 10 hours a day in clinical duties, they did not understand how they could provide high-quality teaching and build a competitive research program. Moreover, some critical issues arise out of the current relationship. For example, if a faculty member is tenured at the University of Arizona, can he/she be terminated if UPH wishes? If so what does tenure at the University of Arizona mean? This issue needs to be addressed and clarified. Similarly, if UPH wishes for a faculty member to practice at Kino instead of the Health Sciences Center, can such a faculty member refuse such a reassignment? More generically, there are apparently a variety of issues related to salary (most faculty are well below the mean of peers), release time for research, and other similar issues. Concerns were also raised about the impact of UPH requirements on recruitment of clinical faculty. It is difficult to imagine that the clinical faculty can substantially increase funded research (supported by NIH or other sources) until the situation is addressed. Because these issues impact the ability of faculty members to carry out their University responsibilities (clinical care, teaching of residents and students, carrying out research), the Committee urges the Administration to focus on these problems and their solutions in a timely manner.

College of Medicine in Phoenix. This is, generally, not of major concern for many of the faculty with whom we met. However, there is a general belief that the Phoenix campus is draining human and financial resources from Tucson thus negatively affecting the ability of the Tucson campus to acquire resources from the legislature and from Phoenix-based funding sources (Piper, Flinn, donors). The political realities in Arizona suggest that there is truth to these concerns. To the extent possible the Dean and Central Administration should vet these issues on a regular basis with the faculty, and do everything in their power to assure that an appropriate balance is achieved.

Faculty Governance/Academic Freedom. A multiplicity of complex changes have been instituted recently or are in the process of being implemented. At the College of Medicine these changes involve fundamental revision of the medical curriculum, a complex new policy for assigning research space based on grant income, reapportionment of faculty salaries based on a complicated formula that incorporates teaching loads, and grant income, and a re-organization of the CoM research enterprise along focused themes that entail space reassignments. These contemporaneous changes are causing considerable discomfort. It is noteworthy that most faculty do not object in principle to having mechanisms that address space and funding, but there is considerable angst and dissatisfaction related to the details of the models and importantly to the strong perception that these changes have been implemented without substantive vetting and dialogue. A list of concerns provided to the Committee of Eleven includes:

Taken in aggregate, the bulleted issues above have resulted in considerable unrest, demoralization and loss of focus on mission among many faculty and department heads. Moreover, the situation is greatly magnified by a widely-held view that faculty input is not valued and that individuals or departments who question or challenge policies are punished. Several senior faculty members said that in their view morale is the lowest that they have seen in the last 30 or so years. What is most distressing is that, at a time when the College and University are under threat of State budget cuts, experiencing low NIH paylines, and the impact of the Phoenix campus on resources, there has been a loss of engagement and buy-in to the vision as well as a dramatic loss of collegiality.

Research. This area is difficult to assess because there are few data to measure quantitatively. It is true that relative to our peers the College has underperformed (especially in federally-funded clinical research), and this may be in large part due to the UPH-UMC issues discussed above. It may be that the theme model, when refined and fully implemented, will provide a means to move up significantly in the research area from our current position. Using the 10 ABOR approved peers with medical schools as comparators, the College of Medicine ranks last in medical school NIH funding for both FY05 and FY06 (FY07 data are not available), and is approximately $10,000,000 below the lowest ranked peer (University of Utah). It is of concern that between FY05 and 06, College funding decreased 14.3% as compared to an average decrease of 4.8% for our peer group. Cleary, we have an opportunity to move in the rankings, but it will require a major increase in NIH funding.

UA Committee of Eleven (roster attached)

February 8, 2008

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