The Continued Evolution of Faculty Appointment and Tenure Policies at U.S. Medical Schools

Abstract

For the past several decades, financial uncertainty, changes in health care delivery and reimbursement, and changing workforce needs have prompted medical schools to continually refine their appointment and tenure policies. Studies during the past 30 years have examined the nature of these faculty appointment and tenure policies in U.S. medical schools, and in this article the authors present data from a 2005 survey on faculty personnel policies to extend this analysis. For both basic science and clinical faculty in U.S. medical schools, the authors describe tenure systems, trends in the number and percentage of full-time faculty on tenure-eligible tracks, the financial guarantee of tenure, and probationary period lengths. They review the status of flexible policies and highlight two current faculty policy changes that many institutions have made or are actively contemplating: the recognition of interdisciplinary and team science, and a broadening view of scholarship. Results show that although tenure systems remain well established in medical schools, the proportion of faculty on tenured or tenure-eligible tracks has continued to decline over time. Changes in the financial guarantee associated with tenure have transformed the fundamental concept of tenure at many medical schools, and the percentage of schools that have lengthened the probationary period for tenure-track faculty has steadily increased during the past 25 years. Tenure-clock-stopping policies and part-time tenure policies continue to exist at medical schools, though results indicate low faculty use of the policies, suggesting a disconnect between policy and practice.

Recognizing diverse forms of scholarship in the modern medical college

“…Appreciating its advantages, this body of work has shaped the values of many institutions and some have chosen to incorporate many of these principles into their expectations of and definitions for scholarship. 10 Arguably revolutionary at the time, Boyer's text is more than 20 years old and predates today's focus on terms such as "translation", "integration" and "interdisciplinary". We believe his definitions hold up remarkably well and are germane to the mission of modern medical colleges.…”

“…See the Appendix for examples of work drawn from the literature that fall within Boyer's definitions. 4,10,17 2. Sharing responsibility: promoting diverse forms of scholarship is a shared responsibility.…”

“…4,10,17,18 Despite the popularity of Boyer's model, its adoption has not been met with universal success. Schweitzer describes how the model was adopted at the University of Louisville in the early 1990's as one of several ambitious initiatives launched by the Board of Trustees.…”

“…14 As biomedical science has become more interdisciplinary and collaborative, some medical colleges have placed greater emphasis on scholarly integration. By incorporating recognition of collaboration in their definition or in tenure and promotions policies, 10 these medical colleges have made the tacit acknowledgment that biomedical research has become more specialized and complex. The complexity of modern biomedical research has created a need for investigators to connect with peers in other fields to bring relevant new insights and directions and skill sets to their work.…”

Nurturing Passion in a Time of Academic Climate Change

“…On the basis of survey responses by the majority of academic medical institutions in the United States, there are 21 female professors per medical school (approximately one per department), including both nontenured and basic sciences faculty, compared with 161 male professors. Moreover, between 1995 and 2001, the percentage of tenured women decreased from 14% to 12%, and that for men decreased from 32% to 28% (28).…”