Establishing recognition of an affiliate-based academic department at HMS

The following principles will guide consideration of a request for recognition of an affiliate-based academic department: 

• The recognition of an HMS affiliate-based academic department is predicated upon an established HMS Clinical Academic Department in the corresponding field. In other words, there can be no affiliate-based academic department in the absence of an HMS Clinical Academic Department. Only one academic department in a given field may be recognized by HMS at each affiliate; for example, HMS will not recognize two distinct departments of medicine within a single affiliate hospital. Affiliate-based academic departments can be recognized as component members of an HMS-wide Clinical Academic Department either when the HMS-wide department is created or later, if they meet the required academic and readiness criteria through the process outlined below. In either case, the recognition of this academic status rests on a foundation of demonstrated academic excellence.
• This recognition requires the commitment of institutional and departmental resources to support the department’s academic operations, infrastructure, compliance and academic policy oversight, and the professional development and academic endeavors of faculty and learners.
• Ordinarily, the scope of a proposed affiliate-based academic department situated within a general hospital will comprise a full scope of clinical expertise in that field.
  • In some cases, however, such as with specialty hospitals (e.g., a pediatric hospital) or limited-scope general hospitals (e.g., a general hospital without pediatric services), an affiliate-based academic department of limited scope may be considered if its faculty and programs have academic standing and scholarly impact commensurate with those in similar areas or divisions at HMS affiliate and peer institutions.  
    • Affiliate-based departments of limited scope will have at least several component divisions that would be expected in a full-scope academic department in the field. 
    • Delegated responsibilities to propose and host faculty appointments are limited to the recognized scope of expertise. 

Candidates proposed for faculty appointments are expected to have professional credentials and responsibilities appropriate to the subfields comprising the limited scope (e.g., candidates with an MD or equivalent degree who will be delivering clinical care should be board-eligible or board-certified in an appropriate subfield, and candidates with a PhD should carry out work, whether research or clinical endeavors, that are relevant to the department’s scope of work).

The following criteria must be met for the recognition of an affiliate-based academic department at Harvard Medical School. HMS expects that recognized departments will continue to meet—and will ordinarily exceed—these standards.  These criteria are subject to updates and change.

Demonstrated academic excellence, strengths, and growth potential in the clinical field:
Evidence demonstrates that the proposed department’s academic excellence, strengths, limitations, and trajectory compare favorably with those of similar departments at HMS‑affiliated and peer institutions as well as with other relevant benchmarks.

• Robust educational programming for HMS learners:
  The proposed department hosts one or more ACGME‑accredited postgraduate training program(s); ordinarily, this will include a residency in the field. The department should host at least one recurring course, clerkship, or clinical elective for Harvard medical students. Additional training opportunities for Harvard graduate students (e.g., PhD or Master’s degree candidates) are encouraged and would further demonstrate commitment to the academic mission.
• Substantive faculty size and academic productivity:
  The number, composition, and collective academic strengths of the faculty are—or demonstrate an upward trajectory toward becoming—commensurate with these faculty attributes of counterpart HMS affiliate‑based academic departments (or their corresponding divisions).
• Clinical excellence:
  The department demonstrates that it has met, will sustain, and may exceed all relevant general and field‑specific standards for clinical excellence. Evidence of clinical excellence should address quality and safety; patient satisfaction and timely, equitable access to appropriate clinical services; and a comprehensive breadth of clinical services, including subspecialty services that provide best‑in‑class evaluation, therapeutic management, and continuity of care. In many cases, the department will be at the forefront of clinical innovation in the field, supported by a clearly defined strategic vision and plan. The department’s national standing among its counterparts at peer institutions should be evident through widely accepted indicators of clinical excellence and distinction, such as relevant patient‑outcome benchmarks. Fundamentally, the proposed department is dedicated to integrating research and clinical practice and to ensuring mutual reinforcement between clinical excellence and academic rigor.
• National standing and reputation for impact and scholarly contributions:
  The proposed department’s aggregate research, educational, and clinical achievements within its scope of expertise have attained recognition of national standing in the field and exemplify the integrity, quality, and excellence expected by HMS and Harvard University.

Substantive academic opportunities will benefit the department, the affiliate, and the broader HMS community:
Evidence demonstrates that recognition as an independent academic department will strengthen the academic excellence of the candidate department and HMS affiliate, the corresponding HMS clinical academic department, and the broader HMS community. The anticipated benefits of establishing the department should far outweigh any perceived risks or downsides, which, should they materialize, can be managed adequately.

• Potential for strengthening academic support for faculty and learners at HMS:
  A robust departmental strategic plan exists and includes a commitment of resources to strengthen the learning environment and educational opportunities for Harvard learners. Academic department status will enhance support for faculty recruitment and retention, mentorship, and career advancement at the affiliate and within the broader HMS community.
• Contributions to the enhancement of HMS‑wide academic excellence and collaboration in the field:

The proposed academic department will create and expand opportunities for HMS‑wide educational programming, faculty development, research collaborations, clinical excellence, and related academic activities. The supporting evidence should demonstrate that the whole is greater than the sum of its parts.

Capacity to fulfill roles and responsibilities of an HMS affiliate‑based academic department:
Evidence demonstrates the commitment and ability to fulfill the department’s delegated responsibilities for proposing and hosting affiliate‑based faculty appointments and to achieve its other academic objectives; these include faculty development, mentorship, retention, scholarly activities, collaborative and open research, compliance oversight, and teaching commitments. 

• Faculty appointments and promotions:
  The department demonstrates readiness to fulfill the roles and responsibilities of an HMS affiliate‑based academic department as a member of the corresponding HMS clinical academic department. It has sufficient senior faculty with HMS faculty promotion experience and adequate administrative infrastructure and expertise to manage appointments, reappointments, and promotions effectively in partnership with the HMS Office for Faculty Affairs.
• Academic support for faculty:
  The department and affiliate institution together ensure faculty have appropriate time, resources, and a milieu supportive of contributions to the academic mission consistent with HMS values and standards of excellence. Ladder faculty appointments should be accompanied by a departmental or institutional commitment of resources that support a candidate’s successful career in academic medicine.
  • HMS faculty appointment support and accountability:
    Faculty appointments and renewals should occur only when the department and institution are prepared to provide appropriate resources and the candidate is prepared to be accountable for their use.
  • Dedicated effort for ladder faculty:
    Full‑time ladder faculty¹ will have departmental, institutional, and/or external funding support to devote a minimum of 20% time to teaching of Harvard learners, research, and/or other scholarly engagement, independent of clinical service responsibilities. Faculty will also have sufficient operational flexibility to use this protected time meaningfully.
  • Academic service support:
    Because faculty service contributions are essential to core academic operations, the departmental milieu must be conducive to faculty participation in these activities. The department must describe how faculty will have reasonable time and support to participate in essential HMS and HU service activities, including participation in ad hoc committees and panels, standing committees, and administrative committees.
  • Faculty development and career advancement:

The department must support faculty success in the academic mission by providing faculty development, mentorship, and regularly scheduled career conferences in line with HMS policies.

• Educational mission support:
  • The department must provide meaningful opportunities for Harvard medical student and resident education, including fellowships, programs in clinical research, clinical clerkships for medical students, and availability of all patient populations for teaching purposes (i.e., ordinarily, all beds, patients, and clinical studies overseen by the department should be available for teaching).
  • Faculty members are required to teach Harvard learners² for a minimum of 50 hours annually and must be available for HMS student teaching assignments when called upon.
  • The department must ensure that faculty can fulfill these requirements feasibly by accommodating teaching time in schedules and maintaining a peer and supervisory milieu conducive to excellence in teaching.
• LCME requirements:

The department and institutional leadership must demonstrate readiness, commitment, and a plan to comply with all relevant LCME requirements of an academic department³.

_{[1] Those faculty with a term appointment with an unmodified title.}

_{[2] The definition of Harvard learners can be found in the Harvard Faculty of Medicine Handbook at:  https://facultyhandbook.hms.harvard.edu/4eligibility-appt-terms/expectations-teach/}

_{[3] The LCME standards require that the Dean maintain sufficient authority and oversight over departmental leadership to ensure that academic departments fully support the medical school’s educational mission. This includes the Dean’s ability to: (1) hold department heads accountable for maintaining a high-quality learning environment; (2) ensure that faculty are supported in fulfilling required teaching, scholarly, and service responsibilities; and (3) intervene when academic performance, learner experience, or faculty development obligations are not being met. A direct reporting line to the Dean for the HMS-facing academic role of the department head is therefore essential to meeting LCME expectations for governance, faculty sufficiency, and oversight of the learning environment.}

Sufficient resources for meeting academic obligations:
Endowment funding, institutional commitments, and infrastructure must meet HMS expectations as outlined in the HMS affiliation agreement and be sufficient to:

• Support the department chair in their HMS‑facing role as affiliate‑based academic department head and as a member of the HMS Clinical Academic Department Executive Committee, as outlined below.
  • Manage administration of appointments and promotions as well as faculty recruitment, retention, and oversight of compliance with relevant HMS and Harvard University policies.
  • Sustain contributions to HMS‑wide clinical academic department programming that benefit Harvard learners and faculty in the department.
  • Support the recruitment of full‑time scientists and clinical scholars at the assistant, associate, and full professor levels (adhering to standard Harvard criteria for faculty recruitment) who will dedicate a significant portion of their time to teaching and research.
  • Implement a well‑articulated plan to support allocated time for educational programming, faculty teaching, and scholarly engagement within the affiliate‑based academic department; for full‑time ladder faculty term appointees with unmodified titles, HMS expects the effort allocation described above under “Dedicated effort for ladder faculty.”

Institutional support for the Department Head’s authority and fulfillment of responsibilities of the role:
Oversight of the new department is vested in a Department Head, who holds a full‑time HMS faculty appointment, ordinarily at the rank of professor. The Department Head has authority over all departmental activities within the organization, including department‑level approval of all hospital medical staff appointments for department members; is accountable for the integration of teaching, research, clinical activities, and academic and compliance administration, ensuring the fulfillment of expectations described above under “Educational mission support” and “Academic service support”; and is responsible for the quality of patient care on that service. Responsibilities and governance roles include:

• The Department Head reports to the Dean of the Faculty of Medicine in their role as affiliate‑based academic department head, in addition to appropriate reporting responsibilities to affiliate leadership in their corresponding affiliate‑facing role.
• The Department Head serves as a voting member and active participant of the Executive Committee of the corresponding HMS clinical academic department and will rotate as Executive Committee Chair when appointed by the Dean.
• The Department Head establishes the department’s organizational structure, which subject to the mutual agreement of the Dean and hospital leadership, may include deputy department heads to provide site‑based presence, supervision, mentorship, compliance oversight, and other appropriate academic support to faculty and learners whose effort is located at satellite sites recognized by HMS as “academic hubs.”
• The Department Head works with faculty and institutional leadership to ensure that faculty have sufficient time, resources, continuing education, and leadership support to meet all expectations attached to an appointment in the Harvard Faculty of Medicine; these include compliance with all applicable academic, integrity, professionalism, and other policies and expectations as outlined in the Faculty of Medicine Handbook and in this document. The Department Head ensures that departmental faculty participate in the HMS community as active, present, and engaged academic citizens, including through their contributions to various essential academic operations of the HMS community when called upon. 
• The Department Head provides appropriate attestation and reporting on a regular basis, and at any time upon HMS request, to substantiate that individual faculty and aggregate departmental obligations are met.

Endorsements and assurance of institutional commitments for ongoing support:
Proposals should have the strong endorsement of the candidate department’s affiliate leadership and a clear commitment of support for recognition of academic department status.

• Institutional assurances and resources:
  Assurances from the hospital or sponsoring institution, provided in a letter of endorsement, should detail a commitment to provide and sustain the resources necessary to support the academic plan and the resource expectations described above under “Sufficient resources for meeting academic obligations”; to provide physical space for laboratories, offices, teaching, research, and administrative activities; and to ensure the candidate department’s capacity to meet HMS and Harvard University standards and policies, legal and regulatory requirements, and all expectations for an affiliate‑based academic department or as otherwise addressed in the host institution’s affiliation agreement, including:
  • That the selection of the proposed and future Department Heads will comply with relevant HMS by‑laws and policy for senior administrative leaders (SALs) as well as LCME requirements. These policies include selection of the Department Head following a national search and in consultation with, and with the endorsement of, the Dean of the Faculty of Medicine.
  • That there is appropriate presence and oversight by the Department Head, including attestation of integrity and professionalism for candidates advanced for appointments, reappointments, and promotions, in alignment with the oversight responsibilities described above under “Academic support for faculty” and “Institutional support for the Department Head’s authority and fulfillment of responsibilities of the role.”
    • Department Heads may designate a deputy department head at each site hosting HMS faculty appointments to ensure adequate local support if the Department Head will not have a substantive presence at those sites. If so, these roles should be vetted for formal recognition through the Council for Academic Deans.
  • That there will be ongoing institutional support for jointly conducted HMS/affiliate external department reviews on a cadence appropriate to establishing continuing qualifications for delegated responsibilities to propose and host HMS faculty appointments.
    • Newly established affiliate‑based academic departments will participate in an external department review within three to five years of their start date.
    • Following a positive review, the department will participate in an external department review at least every five to 10 years to identify strengths and opportunities for improvement and to determine that the department continues to fulfill its responsibilities as an affiliate‑based academic department.
    • HMS reserves the right to monitor progress, request interim reports, or modify or suspend delegated appointment authority if deficiencies persist or compromise HMS academic, compliance, or professionalism standards.
  • That the institution will support faculty teaching of HMS students and other Harvard learners, as described above and as outlined in the affiliation agreement with HMS, and must ensure a high‑quality learning environment for all Harvard learners hosted by the proposed department. 
     

HMS clinical academic department endorsement:
The proposed affiliate‑based academic department must seek endorsement from the Executive Committee of the corresponding HMS clinical academic department and provide a satisfactory response addressing any identified concerns.