The use of clinical faculty in place of professional or administrative staff is gaining ground in many universities. The authors used survey techniques to gather information from 23 different universities regarding the roles of clinical faculty and opportunities and requirements for promotion. Results indicate that the primary role of clinical faculty members continues to be clinical education, followed by classroom education. In keeping with this finding, most important for promotion in the clinical ladder was performance in clinical education and classroom education. All universities identified a variety of other tasks that were also important to be considered for promotion, including service at university, state- and national-level presentations, publications, and administration. Large ranges in these requirements indicated that the clinical faculty member can develop his/her area of expertise or interest in one of multiple categories to ensure success in promotion.