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If it's true that at many colleges and universities, teaching has historically taken a backseat to research in tenure evaluations and, as a result, in the priorities of many faculty members, the problem has perhaps been amplified at medical schools, where the obligations of patient care can nudge teaching a notch further down the priority ladder.

But as has been the case throughout academe, medical schools (often from the ground up, led by faculty members themselves) have been trying to pay more attention to the quality of instruction.  The new issue of Academic Medicine, which is published by the Association of American Medical Colleges, highlights one important thrust in that effort: the creation of teaching fellowship programs, in which faculty members interested in improving their teaching get stipends and some release time for training in teaching or evaluation skills, curriculum development, or educational research or leadership, among other things.

"Our institutions seem to be finally recognizing that maybe teaching skill is a skill that should be both taught and rewarded, and that if they want to encourage that, they're going to have to empower faculty and reward their educational efforts," says Nancy Searle, program director for faculty development and ambulatory education and an assistant professor of pediatrics and medicine at Baylor College of Medicine. "Fellowships try to do that."

A series of articles in the journal profile fellowship or "teaching scholars" programs that have been instituted at a wide range of medical schools in the last decade or so, including the Medical College of Wisconsin, the University of California at Los Angeles, and the University of Washington. 

An article by Searle and several colleagues suggests that the practice is catching on: A 2005 survey they did found that 42 American medical schools of the 81 that responded had educational fellowship programs, and that four of those had started them in the last year. Another five schools said they hoped to begin one.

The mission, scope and intensity of the programs vary widely: The amount of time that participants spend in them, for instance, ranges from 2 to 36 months and from 10 to 400 hours. But they have in common a goal not just of intensifying the pedagogical instruction and improving the teaching skills of those who participate in the programs, but of turning those participants into advocates for teaching at their institutions -- "change agents," Searle says, "who can go back to their departments and actually make educational changes in a positive way."

The articles acknowledge that most of the programs are early enough in their development that meaningfully gauging their success -- particularly in changing or strengthening the role of teaching in their institutions broadly -- is difficult to do. But the authors note that several of the programs are seeing their graduates move into leadership positions at their schools, suggesting that future administrators and faculty leaders may more fully appreciate teaching, in ways that could shape tenure and other policies.

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