A Time to be Promoted. The Prospective Study of Promotion in Academia (Prospective Study of Promotion in Academia)

Abstract

OBJECTIVES: To determine what clinician-educators consider important for promotion, and what support they find helpful and useful for success. DESIGN: Cross-sectional study. SETTING: Eighty academic medical centers in the United States. PARTICIPANTS: One hundred eighty-three participants of the Prospective Study of Promotion in Academia comprising assistant professors in departments of medicine from 80 different medical schools in 35 states. MEASUREMENTS: Differences between clinician-educators' and clinician-investigators' work activities, promotion preparedness , and faculty support needs. RESULTS: One hundred seven (58%) of the faculty were clinician-educators (CEs), and 63 (34%) were clinician-investigators (CIs); the remaining 13 fit neither category. Participants had been in their faculty position for 4.7 years. Ninety-eight percent of CIs reported a publication expectation for promotion, and 75% of CEs also reported such an expectation. More CIs had career mentors available than CEs (68% vs 32%, P < .001). Seventy-nine percent of CIs indicated >10% protected scholarly work time, compared to only 35% of CEs (P < .001). Fifty-three percent of CIs as compared to 32% of CEs (P < .01) meet more often than yearly with their chief/chair for performance review, and more CIs have seen written promotion guidelines (72% vs 51%, P < .01). Clinician educators believed out of 11 job performance areas, research, written scholarship, and reputation were the 3 most important factors that would determine the success of their application for promotion. Both CEs and CIs sense that CIs are more likely get promoted (82% vs 79%). CONCLUSIONS: Clinician educators are less familiar with promotion guidelines, meet less often with superiors for performance review, and have less protected time than CI colleagues. There is dissonance between CEs' beliefs and previously published data from promotion committee chairs in the importance given to specific aspects of job performance.

Association Between Study Quality and Publication Rates of Medical Education Abstracts Presented at the Society of General Internal Medicine Annual Meeting

“…Publication in peer-reviewed journals is likely to advance the promotion of clinicianeducators and to facilitate the dissemination of effective teaching strategies among medical educators. 1,8,9 Research has shown that consumers of medical education literature find the greatest value in novel, provocative research findings and methodologically sound research; other important features include relevance, feasibility, and connection to a conceptual framework. 21 Use of the MERSQI may enhance methodological quality in evaluating curricula and performing medical education research.…”

“…6 Accordingly, several studies have demonstrated that clinician-educators are less likely than clinician-investigators to achieve high academic rank. 7,8 While many academic centers have developed clinicianeducator tracks with different promotion criteria, 9 half of division directors in general internal medicine still consider publication of original research as very important for the academic advancement of clinician-educators. 10 Of the 79 reports included in the Cochrane review on abstract publication rates, 2 only three have directly assessed the association between abstract quality and subsequent publication.…”

Implications of Academic Medicine's Failure to Recognize Clinical Excellence

“…That said, the fundamental extrinsic reward in academic medicine is promotion which is determined predominantly by success along research metrics. 6,9,11 Academic physicians are thus naturally drawn to activities that will result in scholarship, thereby optimizing their likelihood of being promoted. 4,11,21 In any field, smart individuals will take note of what is rewarded and will direct their activities accordingly.…”

“…6,9,11 Academic physicians are thus naturally drawn to activities that will result in scholarship, thereby optimizing their likelihood of being promoted. 4,11,21 In any field, smart individuals will take note of what is rewarded and will direct their activities accordingly. 22,23 As a result, many academic faculty elect to limit their time spent in teaching and in clinical care so as to spend greater time on the activity that brings acknowledgement and reward.…”

A Fellow’s Perspective on Beginning a Satisfying Career in Academic Medical Toxicology

“…However, rates of academic promotion, the categories under which faculty members are classified and evaluated, and the actual promotion processes vary greatly among universities. In one study following promotions among internal medicine assistant professors, multiple characteristics were predictive of promotion, including the number of first author publications, geographic location (in the U.S., the Midwest is the most favorable), job satisfaction, time spent doing research, and frequency of performance reviews with the department chair [6].…”