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Core Clerkship Directors: Their Current Resources and the Rewards of the Role

Ephgrave, Kimberly MD; Margo, Katherine L. MD; White, Christopher MD; Hammoud, Maya MD; Brodkey, Amy MD; Painter, Thomas MD; Juel, Vern C. MD; Shaw, Darlene PhD; Ferguson, Kristi PhD

doi: 10.1097/ACM.0b013e3181d2cdf1

Purpose To conduct a national multidisciplinary investigation assessing core clinical clerkships and their directors, variances in resources from national guidelines, and the impact of the clerkship director role on faculty members' academic productivity, advancement, and satisfaction.

Method A multidisciplinary working group of the Alliance for Clinical Education (ACE), representing all seven core clinical disciplines, created and distributed a survey to clerkship directors at 125 U.S. MD-granting medical schools, in academic year 2006–2007.

Results A total of 544 clerkship directors from Internal Medicine (96), Family Medicine (91), Psychiatry, (91), Pediatrics (79), Surgery (71), Neurology (60), and Obstetrics–Gynecology (56) responded, representing over 60% of U.S. core clinical clerkships. The clerkship directors were similar across disciplines in demographics and academic productivity, though clinical and clerkship activities varied. Departmental staff support for clerkships averaged 0.69 people, distinctly less than the ACE's 2003 guideline of a full-time coordinator in all disciplines' clerkships. Clerkship directors reported heavy clinical responsibilities, which, as in previous studies, were negatively related to academic productivity. However, many clerkship directors felt the role enhanced their academic advancement; a large majority felt it significantly enhanced their career satisfaction.

Conclusions The resources and rewards of the clerkship director role were similar across disciplines. Expectations of clerkship directors were considerable, including responsibility for clinical material and the learning environment. Resources for many fall short of those stated in the ACE guidelines, particularly regarding support staff. However, the findings indicate that the clerkship director role can have benefits for academic advancement and strongly enhances career satisfaction.

Dr. Ephgrave is professor, University of Iowa, Iowa City, Iowa.

Dr. Margo is associate professor, University of Pennsylvania, Philadelphia, Pennsylvania.

Dr. White is professor, Department of Pediatrics, Medical College of Georgia, Augusta, Georgia.

Dr. Hammoud is associate professor, University of Michigan Medical School, Ann Arbor, Michigan.

Dr. Brodkey is adjunct associate professor, University of Pennsylvania, Philadelphia, Pennsylvania.

Dr. Painter is professor, University of Pittsburgh, Pittsburgh, Pennsylvania.

Dr. Juel is associate professor, Duke University Medical Center, Durham, North Carolina.

Dr. Shaw is professor, Medical University of South Carolina, Charleston, South Carolina.

Dr. Ferguson is professor, University of Iowa, Iowa City, Iowa.

Correspondence should be addressed to Dr. Ephgrave, University of Iowa Hospitals and Clinics, Department of Surgery, 200 Hawkins Drive, Iowa City, IA 52242; telephone: (319) 356-8312; e-mail:

© 2010 Association of American Medical Colleges