May 14, 2021
The clinical portfolio is perhaps the easiest of the promotion portfolio parts to prepare, as most surgeons decide to pursue the cardiothoracic specialty because of our passion for its dynamic clinical aspects.
Most early career surgeons have wide interests and follow the three As (affable, available, and able), which typically lead to a broad clinical practice. While this is important early in your career, the goal in academic practice is to establish a niche where you develop clinical and scholarly expertise on one or two disease processes.
The centerpiece of your clinical portfolio is the focused, unique value you bring to the institution through your subspecialty, expertise, or clinical role. This skillset should fulfill a logical local, regional, or national need that either is underserved or has the potential to attract patients to your practice that might otherwise be available.
It is even more important to effectively communicate how you fulfill this need at your institution. Most members of the promotion and tenure committee at your school of medicine are unlikely to be surgeons. Moreover, typically half of the members are scientists not clinicians. Thus, communicating your expertise and what you bring to the institution overall is important. Ask a faculty member from a different discipline to detect unintended assumptions about a reader’s preexisting knowledge. Also, consider asking a trusted department member to review your portfolio.
Most portfolios will require an executive summary or narrative, often written in third person. The executive statement should be carefully organized to highlight your contributions to the institution. For example, indirect or direct patient care, outpatient service, operating room time, clinical leadership and innovation, and clinical performance improvement. Consider these two descriptions as examples:
“Dr. Williams exemplifies quality of care through his attention to patients, enthusiastically and humbly serving this challenging patient population. He was able to overcome institutional resistance to change by implementing a novel patient care program that provides stuffed animals to cancer patients. Furthermore, has won the staff “Dr. Congeniality” award for 3 consecutive years. He serves on twice as many committees as any other faculty member, including the committee for better parking procedures.”
The description above gives the impression that the clinician that may be at odds with the institution and focused on his/her own metrics. Notice how little is communicated in Dr. Williams sample to the one below about Dr. Smith:
“Dr. Smith’s patient satisfaction scores increased from 80% to 95% across all indices. At the end of her first year of practice, she attended training programs focused on robotic lung surgery, gained local and regional recognition, and had an increase in patient referrals that was reflected by an increase in her wRVUs from 10,000 to 13,500. Dr. Smith championed enhanced recovery for thoracic surgery pathways in collaboration with her anesthesia and pulmonology colleagues, and this has helped reduced hospital length of stay by 1 day, reduced readmissions by 10%, and increased patient satisfaction. She received an NIH grant (2020, $1.5 million) to develop institutional telemedicine capacity for postoperative lung resection patients. Her national committee work included co-authorship on a lung surgery position statement, which directly resulted in the recruitment of residents.”
This second example shows a physician who works in harmony with the administration, focusing on appropriate metrics and bringing recognition and funding to the university. Note that Dr. Smith “closes the loop” and demonstrates commitment to improvement; she pursued training and improved her performance. She exemplifies a growth mindset that predicts continued clinical growth and hospital revenue.
While your accomplishments to date are important, demonstrating a trajectory is even more so. This establishes your commitment to the institution and your department. For instance, while you may have helped form a multidisciplinary team at your hospital to reduce prolonged ventilation in postoperative cardiac surgery patients, expanding this across your service line to other institutionally affiliated hospitals demonstrates your leadership and commitment to the health care system.
Additional parts of the Article Series:
- Part 1 - Putting Together an Academic Portfolio for Promotion
- Part 2 - Putting Together an Educator's Portfolio for Promotion
- Part 4 - Putting Together a Social Media Portfolio for Promotion
The opinions expressed in this article are those of the author and do not necessarily reflect the views of The Society of Thoracic Surgeons.