Clinical faculty role, procedures codified at U of T

Toronto, ON – Academic freedom for University of Toronto’s clinical faculty is now more formally protected, say university administrators, after its governing council approved a broad policy governing clinical faculty appointments at its Dec 16 meeting.

The overwhelming majority of U of T’s approximately 1,300 full-time and 2,000 adjunct and part-time clinical faculty are self-employed professionals, not direct employees of the university. The new policy serves to clarify the relationship between these physicians and the university while recognizing their complex working environment. This environment includes the hospitals where they practice, professional self-regulatory arrangements, and the practice plans through which they pool their earnings. The new policy defines clinical faculty and provides mechanisms for appointment, dispute resolution, and protection of academic freedom in the hospital setting. It also protects their university academic appointments from being terminated except for cause.

The policy is one that has been 29 years in the making. In 1975, implementation of the policy and procedures on academic appointments was delayed for clinical faculty, pending further advice from the Faculty of Medicine. In 2002, then-provost Adel Sedra struck a task force to clarify the relationship between clinical faculty and the U of T. Extensive consultation with medical staff associations and medical advisory committees at U of T teaching hospitals, clinical department chairs, hospital administrators, as well as with the U of T Faculty Association, has now resulted in a workable policy, says Dr David Naylor, dean of the Faculty of Medicine.

"Clinical colleagues wanted a direct relationship with the university after three decades of ambiguity," says Dr Naylor. "We now have clear definitions of categories of appointment, dispute resolution processes that involve clinical peers and an unambiguous mechanism to address academic freedom issues in the clinical setting."

The policy has been endorsed by the elected medical staff associations, the CEOs and chairs of the medical advisory committees for the nine affiliated teaching hospitals and the clinical leadership of the Faculty of Medicine.

Under the approved policy, dispute resolution mechanisms for university matters will be modelled after the existing processes including the provision for binding arbitration of university grievances. Clinical faculty will sit on any clinical grievance review panels.

If a grievance involves a matter of academic freedom in the clinical setting, it can now be referred to an academic clinical tribunal. This process, led by U of T, could issue a binding determination of fact, which must be accepted by the parties. The new policy also calls for the creation of a clinical relations committee, which would oversee ratification, review and revisions to the policy and related procedures.

In response to UTFA concerns about representation for clinical faculty, the new policy includes access to a clinical faculty advocate to provide support during dispute resolution. This person, a senior colleague, will be independent of hospital and university administrations and will report directly to the medical staff associations.

The new policy will take effect July 1, 2005.