{"id":3508,"date":"2018-08-30T11:51:33","date_gmt":"2018-08-30T15:51:33","guid":{"rendered":"https:\/\/health.uconn.edu\/faculty-affairs\/?page_id=3508"},"modified":"2022-07-13T14:59:30","modified_gmt":"2022-07-13T18:59:30","slug":"community-based-annual-reappointment-request","status":"publish","type":"page","link":"https:\/\/health.uconn.edu\/faculty-affairs\/faculty-annual-reappointment-requests\/community-based-annual-reappointment-request\/","title":{"rendered":"Community-Based Faculty Annual Reappointment Request"},"content":{"rendered":"<p><strong>Community-based faculty: <\/strong>A clinician who is not employed as salaried faculty by UConn Health or the University, or who is employed by a UConn Health affiliated institution but is not meeting the criteria for an affiliated faculty appointment as described above, shall be eligible for a community-based clinical faculty appointment as Clinical Instructor, Assistant Clinical Professor, Associate Clinical Professor, or Clinical Professor providing he or she contributes to our academic mission by devoting the majority of their teaching to the University of Connecticut School of Medicine, and if asked to teach, documents at least 100 hours per year in the programs of the University of Connecticut School of Medicine. Further, the title Clinical Associate is reserved for those faculty who make intermittent or less than major contributions to the academic programs of the School of Medicine. As such, there is no minimum of teaching time requirement for this rank<\/p>\n<p><em><strong>It is the expectation of all faculty of the UConn School of Medicine to comply with the UConn Health <a href=\"https:\/\/health.uconn.edu\/policies\/wp-content\/uploads\/sites\/28\/2022\/06\/2021-03-COVID-19-Mandatory-Vaccination-Policy.pdf\">COVID-19 Mandatory Vaccine policy<\/a>.<\/strong><\/em><\/p>\n<p><span style=\"color: #ff0000;\"><strong>Once you have completed this form, please attest and click to submit (at bottom).<\/strong><\/span><\/p>\n<hr \/>\n<script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_11' >\n                        <div class='gform_heading'>\n                            <p class='gform_description'><\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_11'  action='\/faculty-affairs\/wp-json\/wp\/v2\/pages\/3508' data-formid='11' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_11' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_11_1\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_11_1\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_11_1'>\n                            \n                            <span id='input_11_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_11_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_11_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_11_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_11_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_11_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_11_6\" class=\"gfield gfield--type-email gfield--input-type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_11_6\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_11_6_container'>\n                                <span id='input_11_6_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_6' id='input_11_6' value=''    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                    <label for='input_11_6' class='gform-field-label gform-field-label--type-sub '>Enter Email<\/label>\n                                <\/span>\n                                <span id='input_11_6_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_6_2' id='input_11_6_2' value=''    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                    <label for='input_11_6_2' class='gform-field-label gform-field-label--type-sub '>Confirm Email<\/label>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/li><li id=\"field_11_12\" class=\"gfield gfield--type-select gfield--input-type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_11_12\" ><label class='gfield_label gform-field-label' for='input_11_12'>UConn School of Medicine Department<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_12' id='input_11_12' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='' selected='selected' class='gf_placeholder'>Choose One:<\/option><option value='Anesthesiology' >Anesthesiology<\/option><option value='Cell Biology' >Cell Biology<\/option><option value='Dermatology' >Dermatology<\/option><option value='Diagnostic Imaging and Therapeutics' >Diagnostic Imaging and Therapeutics<\/option><option value='Emergency Medicine' >Emergency Medicine<\/option><option value='Family Medicine' >Family Medicine<\/option><option value='Genetics and Genome Sciences' >Genetics and Genome Sciences<\/option><option value='Immunology' >Immunology<\/option><option value='Medicine' >Medicine<\/option><option value='Molecular Biology and Biophysics' >Molecular Biology and Biophysics<\/option><option value='Neurology' >Neurology<\/option><option value='Neuroscience' >Neuroscience<\/option><option value='Neurosurgery' >Neurosurgery<\/option><option value='Obstetrics and Gynecology' >Obstetrics and Gynecology<\/option><option value='Orthopedic Surgery' >Orthopedic Surgery<\/option><option value='Pathology and Laboratory Medicine' >Pathology and Laboratory Medicine<\/option><option value='Pediatrics' >Pediatrics<\/option><option value='Psychiatry' >Psychiatry<\/option><option value='Public Health Sciences' >Public Health Sciences<\/option><option value='Surgery' >Surgery<\/option><\/select><\/div><\/li><li id=\"field_11_11\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_11_11\" ><h2 class=\"gsection_title\">Eligibility for Continued Faculty Appointment<\/h2><div class='gsection_description' id='gfield_description_11_11'>A clinician who is not employed as salaried faculty by UConn Health or the University, or who is employed by a UConn Health affiliated institution but is not meeting the criteria for an affiliated faculty appointment as described above, shall be eligible for a community-based clinical faculty appointment as Clinical Instructor, Assistant Clinical Professor, Associate Clinical Professor, or Clinical Professor providing he or she contributes to our academic mission by devoting the majority of their teaching to the University of Connecticut School of Medicine, and if asked to teach, documents at least 100 hours per year in the programs of the University of Connecticut School of Medicine. Further, the title Clinical\nAssociate is reserved for those faculty who make intermittent or less than major contributions to the academic programs of the School of Medicine. As such, there is no minimum of teaching time requirement for this rank. <\/strong> \n\nAdditionally, you are required to review the UConn School of Medicine Academic Policies and Procedures Manual annually to maintain your faculty appointment. <a href=\"https:\/\/health.uconn.edu\/faculty-development\/wp-content\/uploads\/sites\/69\/2025\/09\/UConn-SOM-Academic-Policies-and-Procedures-Manual.pdf\" target=\"blank\">Please review the Manual.<\/a><\/div><\/li><li id=\"field_11_18\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_11_18\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Academic Activity (check all that apply)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_11_18'><li class='gchoice gchoice_11_18_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.1' type='checkbox'  value='Medical Students'  id='choice_11_18_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_18_1' id='label_11_18_1' class='gform-field-label gform-field-label--type-inline'>Medical Students<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_11_18_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.2' type='checkbox'  value='Residents and Fellows'  id='choice_11_18_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_18_2' id='label_11_18_2' class='gform-field-label gform-field-label--type-inline'>Residents and Fellows<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_11_18_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.3' type='checkbox'  value='Graduate Students'  id='choice_11_18_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_18_3' id='label_11_18_3' class='gform-field-label gform-field-label--type-inline'>Graduate Students<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_11_18_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.4' type='checkbox'  value='Contribution to Research'  id='choice_11_18_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_18_4' id='label_11_18_4' class='gform-field-label gform-field-label--type-inline'>Contribution to Research<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_11_18_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.5' type='checkbox'  value='Administrative (related to education)'  id='choice_11_18_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_18_5' id='label_11_18_5' class='gform-field-label gform-field-label--type-inline'>Administrative (related to education)<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_11_18_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_18.6' type='checkbox'  value='Other'  id='choice_11_18_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_11_18_6' id='label_11_18_6' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_11_27\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_11_27\" ><label class='gfield_label gform-field-label gfield_label_before_complex' >Attestation<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='gfield_description' id='gfield_description_11_27'><p style=\"color:#c60d0d\">I attest that if applicable for the rank I hold, I do\/will contribute the majority of my teaching to the academic programs of the UConn School of Medicine, and do\/will document at least 100 hours per year in the UConn School of Medicine Programs, if asked to teach. The rank of Clinical Associate is reserved for faculty who make intermittent or less than major contributions but still have an academic relationship with the School of Medicine. There is no minimum teaching time required for this rank.\nFurther, I attest that I have reviewed the UConn SOM Academic Policies and Procedures Manual (link above).<\/p><\/div><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_11_27'><li class='gchoice gchoice_11_27_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_27.1' type='checkbox'  value='I attest'  id='choice_11_27_1'   aria-describedby=\"gfield_description_11_27\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_11_27_1' id='label_11_27_1' class='gform-field-label gform-field-label--type-inline'>I attest<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_11_28\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  data-js-reload=\"field_11_28\" ><label class='gfield_label gform-field-label' for='input_11_28'>Email<\/label><div class='ginput_container'><input name='input_28' id='input_11_28' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_11_28'>This field is for validation purposes and should be left unchanged.<\/div><\/li><\/ul><\/div>\n        <div class='gform_footer top_label'> <input type='submit' id='gform_submit_button_11' class='gform_button button' value='Submit'  onclick='if(window[\"gf_submitting_11\"]){return false;}  if( !jQuery(\"#gform_11\")[0].checkValidity || jQuery(\"#gform_11\")[0].checkValidity()){window[\"gf_submitting_11\"]=true;}  ' onkeypress='if( event.keyCode == 13 ){ if(window[\"gf_submitting_11\"]){return false;} if( !jQuery(\"#gform_11\")[0].checkValidity || jQuery(\"#gform_11\")[0].checkValidity()){window[\"gf_submitting_11\"]=true;}  jQuery(\"#gform_11\").trigger(\"submit\",[true]); 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