Skip to main content
SpringerLink
Log in

The Culture of Academic Medicine: Faculty Perceptions of the Lack of Alignment Between Individual and Institutional Values

  • Original Article
  • Published:
Journal of General Internal Medicine Aims and scope Submit manuscript

Abstract

BACKGROUND

Energized, talented faculty are essential to achieving the missions of academic medical centers (AMCs) in education, research and health care. The alignment of individuals’ values with workplace experiences are linked to meaningfulness of work and productivity.

OBJECTIVE

To determine faculty values and their alignment with institutional values.

DESIGN

A qualitative hypothesis-generating interview study to understand the professional experiences of faculty and organizational approach in five AMCs that were nationally representative in regional and organizational characteristics. Analysis was inductive and data driven.

PARTICIPANTS

Using stratified, purposeful sampling, we interviewed 96 male and female faculty at different career stages (early career, plateaued, senior faculty and those who had left academic medicine) and diverse specialties (generalists, medical and surgical subspecialists, and research scientists).

APPROACH

Dominant themes that emerged from the data.

RESULTS

Faculty described values relating to excellence in clinical care, community service (including care for the underserved and disadvantaged), teaching, intellectual rigor/freedom and discovery, all values that mirror the stated missions of AMCs. However, many faculty also described behaviors that led them to conclude that their AMCs, in practice, undervalued excellence in clinical care, and their social and educational missions. Themes were seen across gender, career stage, race and discipline, except that female leaders appeared more likely than male leaders to identify incongruence of individual values and organizational practices.

CONCLUSIONS

In this study of five diverse medical schools, faculty values were well aligned with stated institutional missions; however, many perceived that institutional behaviors were not always aligned with individual faculty values.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Bogue EG. An agenda of common caring: the call for community in higher education. In: McDonald W, ed. Creating Campus Community: In Search of Ernest Boyer’s Legacy. 1st ed. San Fransisco: Jossey-Bass; 2002;1–19.

    Google Scholar 

  2. Schindler BA, Novack DH, Cohen DG, Yager J, Wang D, Shaheen NJ, Guze P, Wilkerson L, Drossman D. The impact of the changing health care environment on the health and well-being of faculty at four medical schools. Acad Med. 2006;81:27–34.

    Article  PubMed  Google Scholar 

  3. Alexander H, Lang J. The Long-Term Retention and Attrition of US Medical School Faculty. Analysis in Brief, 8(4). Washington DC: Association of American Medical Colleges; 2008.

    Google Scholar 

  4. Shanafelt TD, Sloan JA, Haberman TM. The well-being of physicians. American J Med. 2003;114:513–9.

    Article  Google Scholar 

  5. Shanafelt TD, West CP, Sloan JA, Novotny PJ, Poland GA, Menaker R, Rummans TA, Dyrbye LN. Career fit and burnout among academic faculty. Arch Intern Med. 2009;169(10):990–5.

    Article  PubMed  Google Scholar 

  6. Kahn WA. To be fully there: psychological presence at work. Hum Relat. 1992;45:321–49.

    Article  Google Scholar 

  7. Pololi LH, Dennis K, Winn GM, Mitchell J. A needs assessment of medical school faculty: caring for the caretakers. J Contin Educ Health Prof. 2003;23:21–9.

    Article  PubMed  Google Scholar 

  8. Wright SM, Beasley BW. Motivating factors for academic physicians within departments of medicine. Mayo Clin Proc. 2004;79:1145–50.

    Article  PubMed  Google Scholar 

  9. Pololi LH, Knight SM, Dennis K, Frankel RM. Helping medical school faculty realize their dreams: an innovative, collaborative mentoring program. Acad Med. 2002;77:377–84.

    Article  PubMed  Google Scholar 

  10. Bunton SA. US Medical School Faculty Job Satisfaction. Analysis in Brief:8(5). Washington DC: Association of American Medical Colleges; 2008.

    Google Scholar 

  11. Schwartz SH. Universals in the content and structure of values: theoretical advances and empirical tests in 20 countries. In: Zanna MP, ed. Advances in Experimental Social Psychology. Vol. 1. New York: Academic Press; 1992;1–65.

    Google Scholar 

  12. Halstead JM, Taylor MJ. Learning and teaching about values: a review of recent research. Camb J Educ. 2000;30(2):169–202.

    Article  Google Scholar 

  13. Pendelton D, King J. Values and leadership. BMJ. 2002;325:1352–5.

    Article  Google Scholar 

  14. Pololi L. Career development for academic medicine–a nine step strategy. BMJ Careers. 2006;322(7535):38–9.

    Google Scholar 

  15. Rokeach M. A theory of organization and change within value-attitude systems. J Soc Issues. 1968;24(1):13–33.

    Article  Google Scholar 

  16. Feather NT. Values in Education and Society. New York: Free Press; 1975.

    Google Scholar 

  17. Rokeach M. The Nature of Human Values. New York: Free Press; 1973.

    Google Scholar 

  18. Rokeach M. Understanding Human Values: Individual and Societal. New York: Free Press; 1979.

    Google Scholar 

  19. National Initiative on Gender, Culture and Leadership in Medicine: C - Change. Available at: http://cchange.brandeis.edu accessed Aug 29, 2009.

  20. Biernacki P, Waldorf D. Snowball sampling: problems and techniques of chain referral sampling. Sociol Methods Res. 1981;10:141–63.

    Google Scholar 

  21. Glaser BG, Strauss AL. The Discovery of Grounded Theory: Strategies for Qualitative Research. Chicago: Aldine; 1967.

    Google Scholar 

  22. Charmaz K. Constructing Grounded Theory: a Practical Guide Through Qualitative Analysis. Thousand Oaks: Sage Publications; 2006.

    Google Scholar 

  23. Goldman BM, Kernis MH. The role of authenticity in healthy psychological functioning and subjective well-being. Ann Am Psychother Assoc. 2002;5(6):18–20.

    Google Scholar 

  24. Maslach C. Burnout: the Cost of Caring. Englewood Cliffs: Prentice-Hall; 1982.

    Google Scholar 

  25. Van Maanen J, Schein E. Toward a theory of organizational socialization. In: Shaw B, ed. Research in Organizational Behavior. Greenwich: JAI Press; 1979;209–64.

    Google Scholar 

  26. Weisbord MR. Productive Workplaces: Organizing and Managing for Dignity, Meaning and Community. San Francisco: Jossey-Bass; 1987.

    Google Scholar 

  27. Waterman RH. Adhocracy: the Power to Change. New York: Norton; 1992.

    Google Scholar 

  28. Collins JC, Porras JI. Built to Last: Successful Habits of Visionary Companies. New York: Harper Business; 1994.

    Google Scholar 

  29. Schwartz SH, Rubel T. Sex differences in value priorities: Cross-cultural and multimethod studies. J Pers Soc Psychol. 2005;89(6):1010–28.

    Article  PubMed  Google Scholar 

  30. Pololi L, Cooper L, Carr P. Race, Disadvantage, and Faculty Experiences in Academic Medicine, submitted for publication.

  31. Association of American Medical Colleges. Faculty Roster 2008. Available at: http://www.aamc.org/data/facultyroster/ accessed Aug 29, 2009.

  32. Castillo-Page L. Diversity in Medical Education: Facts & Figures 2008. Washington: Association of American Medical Colleges; 2008.

    Google Scholar 

Download references

Acknowledgements

The authors gratefully acknowledge the critical funding support of the Josiah Macy, Jr. Foundation, Brandeis University Women’s Studies Research Center, and Wanda Jones and Anna Kindermann for leading the interagency agreement to provide supplemental support by the Office of Public Health and Science, Office on Women’s Health and Office on Minority Health; the National Institutes of Health, Office on Research on Women’s Health; the Agency for Healthcare Research and Quality; the Centers of Disease Control and Prevention and the Health Resources and Services Administration.

The authors thank Meg Lovejoy and Marianne MacPherson, who participated in data coding, and Kerri O’Connor for manuscript preparation. The authors are indebted to the medical faculty who generously shared their experiences in the interviews.

Conflict of Interest

None of the authors have any conflict of interest to disclose. The authors had access to all the study data, take responsibility for the accuracy of the analysis, and had authority over manuscript preparation and the decision to submit the manuscript for publication. The funders had no involvement in the design of the study, the collection of data, analysis and interpretation of the data, and the decision to approve publication of the finished manuscript. Dr. Pololi had full access to all of the data in this study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Specific contributions from each author

Pololi: conception, design, data collection, analysis and interpretation, drafting the article, final approval

Kern: interpretation, drafting the article, final approval

Carr: design, data collection, analysis and interpretation, drafting the article, final approval

Conrad: design, data collection, analysis and interpretation, drafting the article, final approval

Knight: design, data collection, analysis and interpretation, drafting the article, final approval

Author information

Authors and Affiliations

  1. Women’s Studies Research Center, Brandeis University, Mailstop 088, Waltham, MA, 02454-9110, USA

    Linda Pololi MBBS, MRCP & Peter Conrad PhD

  2. School of Medicine, Johns Hopkins University, Baltimore, MD, USA

    David E. Kern MD, MPH

  3. Boston University School of Medicine, Boston, MA, USA

    Phyllis Carr MD

  4. East Carolina University, Greenville, NC, USA

    Sharon Knight PhD, RN

Authors
  1. Linda Pololi MBBS, MRCP
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. David E. Kern MD, MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Phyllis Carr MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Peter Conrad PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sharon Knight PhD, RN
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Linda Pololi MBBS, MRCP.

Additional information

Prior Presentation: SGIM 32nd Annual Meeting, 2009: Plenary Research Presentation.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pololi, L., Kern, D.E., Carr, P. et al. The Culture of Academic Medicine: Faculty Perceptions of the Lack of Alignment Between Individual and Institutional Values. J GEN INTERN MED 24, 1289–1295 (2009). https://doi.org/10.1007/s11606-009-1131-5

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11606-009-1131-5

KEY WORDS

Search

Navigation