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Stanford Report, June 4, 2003

Medical education earmarks take effect next fall A new formula will reward faculty and departments for teaching efforts


By RUTHANN RICHTER

For the first time in decades, the School of Medicine is revising its formula for financing education in an effort to give a head start to the new curriculum launching in the fall.

The new formula is designed to provide direct funding for teaching and to reward faculty and their respective academic units for their contributions to the teaching

program, said Julie Parsonnet, MD, senior associate dean for medical education. The new system also aims to ensure that money allocated for education is used for that purpose, she added.

"Under the new formula, there are resources identified for use in education, and these resources are huge. It’s significant," said Michael Hindery, senior associate dean for finance and administration.

Hindery and Parsonnet outlined the new finance system at the medical school’s Faculty Senate meeting May 21. The system, which will go into effect this fall, was developed over the last nine months by an 11-member school committee.

Under the new formula, the school will direct 90 percent of medical student and graduate student tuition to academic units for educational purposes, up from the current 80 percent, Parsonnet said. In addition to that allocation, which amounts to $15.4 million in the next fiscal year (2004), the school will commit another $1 million next year toward creative approaches to education and to help in the transition to the new curriculum. These funds are in addition to other school resources devoted to education, such as funding for the library, facilities, student affairs and financial aid, Hindery said.

Philip Pizzo, MD, dean of the medical school, noted that in the past, finance issues have been an obstacle to curriculum changes. "We felt it was important to make the change now to facilitate reform and provide the resources for these new education initiatives," he said.

Previously, funds were allocated to academic units based on the number of students and course units. The new formula also will recognize these factors, but increases in class size and units will be weighted to favor smaller classes. While the old system favored large lecture courses, the new system is designed to encourage multi-disciplinary teaching, teaching in small groups and individual mentoring.

"The new formula is meant to reflect a reality of teaching — which is that a class of 80 students isn’t four times more work than a class of 20," Parsonnet said.

Don Regula, MD, associate professor of pathology and course director for pathology, said he believes this is a positive approach. "It addresses a problem we’ve had from the beginning — that the clinical years were underfunded because they involved teaching in smaller groups," he said. Individual mentored research also has been viewed by some as an underfunded activity.

The funds will be allocated to each academic unit according to the contributions of the faculty. Some 75 percent of the money initially will go to the academic unit of the course director, while the remaining 25 percent will go to academic units of other faculty members who contributed to the class. By tying funding to faculty contributions, the system aims to create more incentive for teaching and clearly acknowledge faculty time and effort involved in education, Parsonnet said.

Academic units will be directed to use their funds strictly for educational purposes, such as faculty salaries and course materials. In the past, the school did not make it clear that these allocations were to be used for education-associated expenses, so departments typically pooled them with other general operating funds, Hindery said.

The response to the new system from course directors and administrators in the academic units has been mixed, as it involves a major change to a system that has been in place for years.

"There is, of course, some anxiety because this is a change, and people are uncertain what the financial impacts will be," Hindery said.

Regula noted that there will be "growing pains" as the system is implemented during the course of the year. "The first year will be difficult, and there will be problems, and we’ll fall back into a mode of fixing it," he said.

The formula will be reviewed as the year progresses and adjustments will be made as needed, Pizzo said.





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