Conversations about promotion and tenure for medical faculty are often animated, sometimes heated, and almost always interesting. These exchanges range from traditional, long-standing concerns to modern-day ones about the changing structure and roles of faculty positions at medical schools. The conversations occasionally end when both parties—who have spent the better part of 30 minutes disagreeing on just about every point—agree that better faculty development programs will solve most of the problems.
Having participated in dozens of such conversations over the years, I often have wondered whether faculty development—essential and valuable as it is—provides a framework that is broad and rich enough to think effectively about faculty careers in academic medicine. Is there value in broadening and deepening our approach to faculty development so that it focuses on individuals rather than programs, captures the dynamic and ongoing needs of advancing a career, and is relevant across the full professional lifespan? I suggest that the notion of career progression could serve these purposes and could enlist faculty development as one tool to facilitate such progression.
Most of us who have designed and implemented faculty development workshops, seminars, or conferences likely have directed our efforts to a particular stage of development—for example, early- or midcareer issues, or to a particular topic—and have not thought comprehensively about the entire professional lifespan. Career progression, on the other hand, is a growth-oriented term that explicitly focuses attention on the progress of the individual faculty member and what he or she accomplishes.
Another advantage of using career progression as an overarching framework is that it has the potential to facilitate thinking about indicators, measures, and milestones. For example, it lends itself naturally to questions such as, What are key measures of career progression? What are the primary indicators that reveal that an individual is progressing well? What early indicators signal that an individual may not be progressing well, and how can these trigger a more thorough analysis?
In this issue of the journal, there are several articles and commentaries that provide important insights about different aspects of the dynamic continuum of career progression for academic medical faculty. Jeffe and Andriole1 discuss career choices of MD–PhD students enrolled in programs with and without funding from the National Institute of General Medical Sciences, including implications for the diversity of the future physician–scientist workforce. Mohr and Burgess2 examined the characteristics of over 7,500 physicians at 135 VA medical centers and report that spending at least part of one's time conducting research has the potential to improve faculty job satisfaction. Coleman and Richard3 examine medical school policies on appointment, promotion, and tenure to understand faculty career tracks in 98 medical schools. And Darbar et al4 examine academic advancement and compensation for part-time faculty in a department of pediatrics.
These articles, along with a related commentary by Cox et al,5 highlight the importance of achieving excellence relative to one's career goals, the critical role that funded programs play to achieve strategically targeted goals, and the value of an environment that fosters critical inquiry.
So, whether we are conversing about how systems to award tenure may or may not foster high-risk research, or how clinician–educators can demonstrate intellectual leadership and independence, I hope that all of us will expand the scope of our dialogue about faculty development and think more profoundly about the full span of faculty members' career progression. This is critically important not only for the well-being of faculty but also for the health of the academic health center as a whole. After all, an institution is not so much a producer of great faculty as it is the product of great faculty.
Steven L. Kanter, MD
1 Jeffe DB, Andriole DA. A national cohort study of MD–PhD graduates of medical schools with and without funding from the National Institute of General Medical Sciences' Medical Scientist Training Program. Acad Med. 2011;86;953–961.
2 Mohr DC, Burgess JF Jr. Job characteristics and job satisfaction among physicians involved with research in the Veterans Health Administration. Acad Med. 2011;86;938–945.
3 Coleman MM, Richard GV. Faculty career tracks at U.S. medical schools. Acad Med. 2011;86;932–937.
4 Darbar M, Emans SJ, Harris ZL, Brown NJ, Scott TA, Cooper WO. Part-time physician faculty in a pediatrics department: A study of equity in compensation and academic advancement. Acad Med. 2011;86;968–973.
5 Cox M, Kupersmith J, Jesse RL, Petzel RA. Commentary: Building human capital: Discovery, learning, and professional satisfaction. Acad Med. 2011;86;923–924.