The Impact of Centers and Institutes on Faculty Life: Findings from a Study of Basic Science and Internal Medicine Faculty at Research-Intensive Medical Schools

Abstract

Purpose 

To examine the impact of organized research centers on faculty productivity and work life for basic science and internal medicine faculty at research-intensive medical schools.

Method 

In 2005, the authors administered a questionnaire to a random stratified sample of full-time faculty in basic science and internal medicine departments at the top 40 research-intensive U.S. medical schools. The survey instrument asked faculty about the extent of their involvement in centers and institutes, the direction and extent of their activities, and their satisfaction with various dimensions of work.

Results 

A total of 778 faculty members completed the questionnaire (72.0%). Basic science faculty with center affiliations produced more research publications and grants while devoting comparable effort to teaching as their non-center-affiliated peers. These faculty reported greater dissatisfaction in workload and in the mix of their activities. Internal medicine MD center-affiliated faculty were more productive in research activities and spent less effort in patient care and more effort in research than their non-center-affiliated peers. These faculty were more satisfied with promotion, opportunities for research, and the pace of their professional advancement.

Conclusions 

Findings indicate that faculty from different departments and with different ranks and backgrounds interact with centers and institutes in multiple ways. For basic science faculty, center involvement appears to be an addition to, not a substitute for, their usual departmental obligations. For internal medicine MD faculty, center involvement appears to serve as an opportunity for protected effort in research away from the demands of clinical practice.

Advancements in biomedical science over the past decades have blurred the boundaries among traditional scientific disciplines and fostered increased collaboration among researchers. One popular organizational configuration to facilitate scientific investigations across disciplines in U.S. medical schools is interdisciplinary research centers and institutes. Research centers have greatly increased in number over the past 30 years,¹ are more interdisciplinary than they were a generation ago,² and have been frequently cited as alternative models to traditional academic departments.³

While recent studies have examined the missions, activities, organizational structure, and governance relationships of these units,^2,4,5 an understanding of how faculty operate in this milieu is a sine qua non for the academic medicine community because the individual researcher ultimately drives scientific discovery. Given that centers and institutes operate across the boundaries of traditional departments, center-affiliated faculty members can find themselves with two ties to the medical school—one through their academic department and one through the research center. Some commentators have asserted that this fluidity of faculty roles and allegiances produces positive benefits while others have argued the opposite effect. In addition, centers may have differing impacts on various stages of faculty careers, with issues that junior faculty face differing from those that more senior academics confront. Yet, the impact of centers and institutes on faculty life has not been thoroughly explored; the literature consists mainly of speculation and anecdote.^6–8 Further, older literature on faculty life in traditional academic departments may offer little guidance, as the roles of faculty in interdisciplinary centers may be very different from those traditional, departmentally affiliated faculty roles.

To provide the academic medicine community insight into these issues, we designed a study to examine the impact of organized research centers on faculty productivity and work life at research-intensive medical schools. We address four research questions in this article:

• In what ways are faculty in basic science and internal medicine departments at research-intensive institutions involved with centers and institutes?
• To what extent, if any, do center-affiliated faculty in these departments differ from faculty without such affiliations in the amount of professional effort spent on various activities and in research productivity?
• In what ways, if any, do center-affiliated faculty in these departments differ from non-center-affiliated faculty in terms of their work satisfaction and perceptions of employment arrangements?
• To what extent, if any, do tenure-track junior faculty with center affiliations in these departments differ from those without center affiliations in their perceptions of the tenure process?

Background

Conclusions from previously published reports and articles on faculty involvement with research centers and institutes help to establish the context for our research. Important findings include:

• Faculty affiliated with centers and institutes have access to better resources, more publishing opportunities, and more interactions with prestigious colleagues than those without such affiliations.⁶
• Center-affiliated faculty spend more time on research and less time on teaching than those without such affiliations: “There is some truth to the adage that faculty in departments are teachers who do research, whereas faculty in centers are researchers who may also teach.”⁸ Further, centers can offer faculty additional research resources, space, equipment, and other perquisites that departments cannot.⁹
• Faculty affiliates can have competing loyalties between their department and center. Conflict may develop between faculty and the academic unit, department head, or dean that can result in divided loyalties and dual authority.⁷
• Center affiliation can be a mixed blessing for junior faculty. While junior faculty may have access to better resources through an affiliation, it “can be disadvantageous for an untenured faculty member’s career, because of the department’s control over tenure and promotion.”⁸

Unfortunately, almost all of these claims are anecdotal rather than empirically based and none focuses on medical faculty. By comparison, our research gathered empirical data on the nature and extent of basic science and internal medicine medical school faculty involvement in centers and institutes, the ways in which these faculty expend their effort, their research productivity, their levels of satisfaction with the dimensions of their work, their perceptions about their work life, and junior faculty’s perceptions of the tenure process.

Method

Sample

The data for this research come from a questionnaire we administered to a random stratified sample of full-time faculty in basic science and internal medicine departments at the top 40 research-intensive U.S. medical schools, as measured by 2002 National Institutes of Health research grant funding. Financial and human resource constraints prohibited us from surveying a sample of faculty in all clinical departments; therefore, we focused on internal medicine because it generates the most research funding among clinical departments. Faculty within the internal medicine sample were further stratified by degree type: MD, PhD, and MD/PhD. Each of the four categories (basic science faculty, internal medicine MDs, internal medicine PhDs, and internal medicine MD/PhDs) was stratified by rank. We considered assistant professors to be junior faculty, while associate and full professors were combined to represent senior faculty. These sampling techniques allow the results to be generalizable to the population of basic science and internal medicine faculty members at the top 40 research-intensive medical schools, but not to the entire population of faculty at all U.S. medical schools.

The total sample consisted of 1,080 faculty and was drawn from the Association of American Medical Colleges (AAMC) Faculty Roster database, a national database that tracks over 95% of all full-time medical school faculty. The total population from which we drew this sample consisted of 21,562 faculty (total population for BS faculty = 7,816; IM MD faculty = 10,574; IM PhD faculty = 1,942; and IM MD/PhD faculty = 1,230). We oversampled internal medicine PhDs and MD/PhDs because of their relatively small percentage of the total population (3.9% and 2.7%, respectively). Once data were collected, we then weighted the responses in the eight categories to correct the distributions in the sample data so that they approximate those of the population from which they were selected. All findings presented in this report are based on the weighted sample results; therefore, in most cases, we report only the percentages of responses, and not the weighted numbers, in both the text and tables.

Instrument

The questionnaire itself drew from previous survey instruments on faculty work life,^10,11 as well as a literature review and our conversations with numerous medical school officials. We then tailored items from these sources to the current study population, centering them on the extent of faculty involvement in centers and institutes, the direction and extent of their activities, levels satisfaction with dimensions of their work, and perceptions of the tenure and promotion process. The questionnaire was primarily administered online, though some participants chose to complete a hard-copy version.^* The AAMC Human Subjects Research Protection Program approved all procedures and data collection forms. We launched the pilot survey instrument in the fall of 2004 to check for validity and reliability, and administered the full survey instrument in the winter of 2005. Participation was voluntary and faculty members’ identities remained confidential.

Data analysis

We analyzed the data using SPSS software Version 13.0.1 (SPSS Inc., Chicago, IL). First, we computed descriptive statistics to provide an overview of the faculty respondents. Next, we conducted comparisons between faculty with and without center affiliations using chi-square and means analyses. In our analyses, we separately compared basic science faculty by rank (junior and senior) and internal medicine faculty by degree and rank (MD, MD/PhD, and PhD, junior and senior faculty). When warranted, we further examined these groupings by tenure status (tenure-eligible and non-tenure-eligible). For internal medicine faculty especially, tenure status may serve as a proxy measure for work environment and characteristics (e.g., clinical scientists versus clinical educators).

Results

Sample versus population

Response rates for the eight different strata ranged from a low of 65.4% for basic science junior faculty to a high of 96.9% for internal medicine MD/PhD junior faculty. The overall response rate for the questionnaire was 72.0%, with 778 faculty members completing the instrument (728 responses [67.4%] were useable in the analysis).

To assess the representativeness of the sample, we compared population characteristics with sample characteristics (Table 1). The study sample is comparable to the population except in a few areas. The percentage of tenured and tenure-track faculty in the sample is about 5–10% higher in each category than the population. These differences likely exist because tenure status for a larger percentage of the population than the sample is unknown (18.5% versus 6.7%). The average date of birth for the sample is around nine years later than for the population. This difference may reflect faculty who have retired but are still in the Faculty Roster database, whereas the survey only included responses from active full-time faculty members.

Table 1: Characteristics of 728 Basic Science and Internal Medicine Faculty Responding to a Questionnaire on the Impact of Centers and Institutes on Faculty Work Life, 2005

Question 1: Faculty involvement with centers

We focused on three approaches to conceptualize faculty involvement with centers. First, we examined the types of centers with which faculty are affiliated. Next, we identified the ways in which faculty use center resources and participate in center activities. Third, we examined the impact of faculty members’ sense of identify with centers and departments to determine the impact that these units may have on faculty work life.

Types of centers.

In the current sample, just over half of the faculty reported that they had an affiliation with at least one center or institute at their medical school (51.1%). Internal medicine MD/PhDs had the highest percentage of faculty affiliated with centers (61.9%), followed by basic science faculty (58.1%), internal medicine PhDs (53.7%), and internal medicine MDs (43.2%). Across all faculty appointments, senior faculty were more likely to have a center affiliation than were junior faculty (57.2% versus 41.5%). Faculty members varied in the number of centers with which they were affiliated. Some faculty were involved with only one center while others were affiliated with as many as nine; the mean number of affiliations was 1.8 (SD = 1.0). These differences did not vary significantly by faculty appointment or degree type.

The primary mission of centers with which faculty affiliated was predominantly research (82.9% overall [48.1% cited basic research, 18.8% translational research, 11.6% clinical research, and 4.4% health services research]). The remaining faculty in the study sample cited their center’s primary mission areas as patient care (8.7%), education (2.2%), service or outreach (0.6%), or other (5.6%).

Centers’ resources.

Previous research has found that many research centers play a role in the recruitment of faculty members to U.S. medical schools by collaborating with departments to provide more resources than academic departments could alone.⁴ We further explored the recruitment and ongoing support that centers offer faculty to understand how and in what ways these units exert influence.

Many faculty responding to our questionnaire reported that the center or institute with which they were affiliated contributed in some way to their individual recruitment package. For faculty who had been recruited to their current institution since 2000 (weighted n = 132), over half received salary support (56.0%) or lab space (52.0%) and just under one third received start-up funds (30.7%) or some other recruitment package contribution (39.1%) from the center (Table 2).

Table 2: Percent of Medical School Faculty Survey Respondents Receiving Recruitment Package Contributions and Continued Resource Offerings from Center or Institute Affiliation, 2005

A second indicator of the roles that centers and institutes play in the lives of faculty members is the continued services or resources they provide. Friedman and Friedman noted that “often faculty who spend all of their time in departments envy the contractual arrangements, secretarial assistance, and other perquisites of [center and institute] participants.”¹² For faculty respondents, just over one third (36.8%) reported that they received continued salary support from centers. As reflected in Table 2, this number varied by appointment and degree, however, as fewer basic science faculty received such support. For those faculty who did receive salary support, on average the center contributed 36.7% of the faculty member’s total salary.

Over three-quarters (84.0%) of faculty affiliates used the center’s research resources such as core facilities and library, and just under half (48.7%) used the center’s seed funding to support their research projects. Faculty also took advantage of centers’ offers to support students: 32.4% used the center’s training grants to fund graduate students and 44.4% taught courses sponsored by the center. In terms of their own continued education, 90.9% of faculty attended seminars sponsored by their center, and another 70.6% attended center retreats or planning sessions. These uses of resources also differed by appointment and degree. Basic science faculty were more likely to use the center’s research resources, which may be a reflection of the nature of their research, while internal medicine MDs were more likely to use secretarial support, to use grants administration to process grants, and to teach courses sponsored by the center.

Faculty sense of identity.

A common concern with the presence of centers and institutes alongside traditional departments is the issue of faculty loyalty and allegiance. Previous research has indicated that some department chairs worry that centers might usurp the primary status of the department as the focal point of a faculty member’s intellectual and academic interests and, therefore, loyalty.⁴ This study, however, demonstrates that, overall, faculty with center affiliations identify more with their department than a center (Figure 1). About two-thirds of basic science and internal medicine MD/PhD faculty felt that their sense of identity was primarily with their department (68.9% and 61.5%, respectively). Internal medicine MDs and PhDs were less strong in their preferences. Forty-three percent of MDs identified primarily with their internal medicine departments, while another 31.7% identified equally with department and center. Thirty-one percent of internal medicine PhD faculty identified primarily with their department, and 27.6% indicated they identify equally with center and department. The weaker department identification among internal medicine PhDs may not be surprising, as they may not have the same status as other faculty members in large internal medicine departments and centers may provide a smaller, more intimate environment in which they can feel at home. Given that the majority of basic science and internal medicine MD/PhD center-affiliated faculty we surveyed still strongly identify with their academic departments, and that the majority of internal medicine MD faculty identify primarily with their academic departments or equally with their department and centers, these results indicate that centers are not taking the place of academic departments in faculty perceptions of identity.

Figure 1: Sense of identity of center-affiliated faculty questionnaire respondents, by appointment type and degree. From a questionnaire on the impact of centers and institutes on faculty work life administered to basic science and internal medicine faculty at the top 40 research-intensive U.S. medical schools, 2005.

Question 2: Faculty professional effort and productivity

Faculty professional effort.

Researchers have suggested that departments and centers often compete for faculty time commitments, that centers and institutes are able to offer reduced teaching loads as an incentive to faculty, and that center-affiliated faculty spend more time on research.⁸ Our research findings confirm some, but not all, of these assertions and add to an emerging picture in which different types of faculty use centers in very different ways.

Controlling for rank, basic science faculty reported spending comparable effort teaching regardless of whether they had a center affiliation (Table 3). Senior basic science faculty differed, however, in the type of teaching that they did. Of those basic scientists at the associate and full professor level, center-affiliated faculty spent less effort teaching medical students than non-center-affiliated faculty (6.1% versus 13.6%, p < .001) but more effort teaching graduate students (15.4% versus 9.4%, p <. 01). Senior basic science center-affiliated faculty also spent more effort on research (53.7% versus 45.0%, p < .05). Across all ranks, basic science faculty with center affiliations spent more total hours on their activities than their counterparts without center affiliations (59.2 hours/week versus 56.1 hour/week, p < .05). The profile of a center-affiliated basic scientist that emerges from our data appears to be an investigator whose center work is in addition to, not a substitute for, her or his departmental duties.

Table 3: Percentage of Medical School Faculty Survey Respondents’ Effort Devoted to Various Activities, by Rank, Appointment Type, Degree, and Center or Institute Affiliation, 2005

For internal medicine MD faculty, significant differences also exist between center-affiliated and non-center-affiliated faculty. For junior faculty, a center affiliation meant less total effort in teaching (14.6% versus 20.1%, p < .05), and less effort in patient care (35.1% versus 47.3%, p < .05), but more effort in research (44.4% versus 19.7%, p < .001). For senior faculty, a center affiliation also allowed less effort in patient care (29.9% versus 40.0% p < .01) and more effort in research (34.7% versus 24.0%, p < .01). We found no statistically significant differences in professional effort between internal medicine MD/PhD and internal medicine PhD center-affiliated and non-center-affiliated faculty. These patterns of professional effort are generally the same for both junior and senior faculty when further broken down by tenure status. Our research design, however, did not permit us to draw statistically significant conclusions about this level of granularity of the data.

These findings indicate that for internal medicine MD faculty, unlike their basic science counterparts, a center affiliation acts somewhat as a buy-out of effort. Junior MD faculty with center affiliations spend less of their overall effort teaching and MDs across rank (especially those on the tenure track) spend less effort in patient care, while spending more overall effort on research than their noncenter peers.

Faculty research productivity.

Previous scholarship also makes the claim that center-affiliated faculty have access to better resources, more publishing opportunities, and more interaction with prestigious colleagues than do those without such affiliations.⁶ Based on these assertions, one might expect center-affiliated faculty to be more productive than their non-center-affiliated peers. Our research found that senior-level basic science and internal medicine MD center-affiliated faculty are, in fact, more productive than their non-center-affiliated peers, as measured by their total number of articles, books, chapters and refereed presentations over the last three years (basic science center affiliates: 17.9 versus nonaffiliates: 14.2, p < .05; internal medicine MD affiliates: 25.8 versus nonaffiliates: 17.5, p < .01).^† We did not find significant differences in productivity between center-affiliated and non-center-affiliated junior faculty.

Another indicator of research productivity is status as a principal investigator for grants and contracts, a pattern that our data confirms. Center-affiliated basic science and internal medicine MD faculty were statistically more likely than their non-center-affiliated peers to be principal investigator on externally funded grants (90.9% versus 59.8% for basic science [χ² = 38.6, df 1, n = 282, p < .001]; and 74.3% versus 57.7% for internal medicine MDs, [χ² = 9.9, df 1, n = 333, p < .01]).

Friedman and Friedman claimed that center-affiliated faculty have more publishing opportunities⁶; while our research cannot corroborate that claim per se, it is apparent that center-affiliated faculty have more grant and publication outcomes. This fact may then create the perception of a privileged culture of affiliation: if more productive faculty join centers, other faculty members who seek involvement with their most successful peers and mentors may do the same. This cycle, therefore, can unwittingly validate the perception of inequality between center-affiliated and non-center-affiliated faculty.^8,12

Question 3: Faculty satisfaction and work perceptions

While productivity illuminates one difference between center and noncenter faculty, measures of job satisfaction also help reveal how center affiliations can affect faculty life. Researchers have noted that a center “offers benefits with respect to work style … It provides an escape from department routine and stresses.”⁶ From this assertion, one might expect to see center-affiliated faculty more satisfied with their jobs.

As a whole, faculty in our sample reported being very satisfied with various aspects of their jobs, regardless of their center affiliation status. For nearly all measures, about three-quarters of all basic science and internal medicine faculty reported being satisfied or very satisfied with their job overall (Figure 2). The specific aspects of job satisfaction, however, differ among the various faculty groups (Table 4), and most significantly between basic science faculty and internal medicine MDs. (For the purposes of this report, we will not focus on internal medicine MD/PhDs and PhDs.) Of the basic science faculty, fewer of those with center affiliations were satisfied with their workload or their required mix of teaching, research, patient care, administration, and service than noncenter faculty. These same faculty were, however, somewhat more satisfied than their non-center-affiliated counterparts in their autonomy. Center-affiliated internal medicine MD faculty were more satisfied with the faculty promotion system, opportunities for research, and the pace of their professional advancement than were non-center-affiliated faculty. Importantly, though, some differences in satisfaction for center-affiliated and non-center-affiliated MD faculty may be further associated with tenure status. While our study was iteratively stratified by appointment, degree, and rank, it was not further stratified by tenure status, thus limiting the claims of significance about this level of analysis. That said, though, our findings suggest that center-affiliated, nontenure-track MDs may have greater levels of job satisfaction than center-affiliated, tenure-track MDs. For nontenure-track faculty who typically have major clinical responsibilities that leave little time for other pursuits, a center affiliation may be the buffer that affords research opportunities and outputs, and, thus, is associated with greater satisfaction in professional advancement. In contrast, tenure-track MD internists with center affiliations may already be afforded protected time by virtue of their tenured appointment, so the marginal benefit of a center affiliation may be less keenly felt.

Figure 2: Percent of faculty questionnaire respondents satisfied with their overall job, by appointment type and degree. From a questionnaire on the impact of centers and institutes on faculty work life administered to basic science and internal medicine faculty at the top 40 research-intensive U.S. medical schools, 2005.

Table 4: Percent Satisfaction of Medical School Faculty Survey Respondents with Various Job Aspects, by Appointment Type and Degree, 2005

These findings again suggest several nuances about faculty interaction with centers. As noted earlier, basic science faculty affiliated with centers are more productive in terms of research publications and grants while devoting comparable effort to teaching as their non-center-affiliated peers. Due to the notion that center involvement for these faculty appears to be an addition, not a substitute, to their usual departmental obligations, these faculty have dual duties. Their center activities are associated with longer hours; even if the outcome of that extra work is positive (e.g., more publications, more funding opportunities), these additional activities may lead to greater dissatisfaction in workload and in the mix of their activities. Despite these pressures, however, center affiliation for basic science faculty is associated with greater autonomy.

For internal medicine MD faculty, a very different picture emerges. Center-affiliated MD faculty at the junior level reported spending less effort teaching than did their non-center-affiliated counterparts. Across rank, center-affiliated MD faculty have more research outputs and spend less effort in patient care and more effort in research than their non-center-affiliated peers. These faculty are also more satisfied with their opportunities for research. MD internists with center affiliations, especially those not on a tenure track, are also more satisfied with the promotion system and the pace of their professional advancement than their noncenter counterparts. The center appears to act as a sanctuary; that is, it serves as an opportunity for protected effort in research away from the demands of clinical practice. That these faculty have higher levels of satisfaction with promotion and career advancement is consistent with the prevailing academic promotion structure that most frequently rewards research productivity in promotion systems.^13,14

Question 4: Junior faculty perceptions of tenure

Because academic reward and promotion structures are rooted in departments and not centers, commentators have speculated about whether centers and institutes have a positive or negative impact on junior faculty. As one researcher claimed, untenured faculty members might “think twice before committing themselves to relationships with [centers and institutes].”¹⁵

While center affiliations may give the impression of difficulties in the tenure and promotion process, evidence from our study suggests that the concern may be overstated (Table 5). We found no significant differences between center-affiliated and non-center-affiliated junior faculty in their perceptions of the difficulties of achieving tenure and promotion, the stress associated with the process, and their own prospects for tenure. These findings suggest that in basic science and internal medicine departments, there may not be the professional trade-offs that some have noted with center affiliation for junior faculty. If anything, the opposite may be true. Of the tenure-track faculty who have center affiliations, 39.7% believed that their center appointment would help, not hinder, their prospective for earning tenure; 50.1% indicated their center involvement was neither a help nor a hindrance; and only 10.1% viewed their center activities as an impediment to their tenure prospects.

Table 5: Junior Medical School Faculty Survey Respondents’ Perceptions Regarding Tenure and Promotion, by Center Affiliation, 2005

Discussion

Based on the results of this research, we offer a clarification and an extension of previous findings regarding the impact of centers and institutes on faculty work life. Remaining cognizant of the fact that our results are generalizable to the population of basic science and internal medicine faculty members at research-intensive medical schools but not to the entire population of medical school faculty, we conclude that faculty from different departments, with different ranks, and with different backgrounds and experiences interact with centers and institutes in multiple ways. Knowledgeable observers and faculty leaders within academic medicine pointedly make distinctions between different disciplines and specialties when discussing policy and research issues surrounding academic faculty. Those clear distinctions are no less important when addressing the issue of faculty interaction with centers and institutes. Our findings support the notion that centers offer very different opportunities and benefits depending on whether one is a basic scientist or clinical internist, or if one is a junior or a senior academic.

On the basis of this study, we suggest four management implications, at the level of the individual faculty, the traditional academic departmental administration, and the institution-wide administration. First, center-affiliated faculty will do well to maintain open communication between their department and their center. Conflict in academic medicine often transcends rigid or traditional job descriptions and organizational charts, and is even more complicated when faculty have dual allegiances to different organizational entities (i.e., both a department and center), each with its own administrative hierarchy. Maintaining open communication with both affiliations is particularly important for junior faculty. Although most junior faculty indicated satisfaction with their center affiliation in regard to their professional advancement, this relationship requires that the faculty member, department chair, and center director work together on issues like adequate mentorship and recognition for center activities in the tenure and promotion process.

Second, these findings have implications for department chairs, particularly internal medicine chairs (and, by extrapolation, possibly for all clinical department chairs), for the management of departmental missions. At a time when clinicians in academic medicine are increasingly feeling pressure to generate patient-care revenues but nonclinical activities like research still play a large role in tenure and promotion, some faculty members may reconsider their continued role as academics if research opportunities are not as readily available as they may have hoped.^16,17 Our findings show that center-affiliated internal medicine faculty members have greater research opportunities and outputs as well as decreased patient care responsibilities compared with non-center-affiliated faculty. For some faculty recruits, department chairs may want to partner with centers as a means of fostering intellectual collaboration and offering those faculty protected time for research. In other words, departments and centers can pool their resources to provide physician–scientists with a rich and varied career environment, which can serve to advance the mission of the department (as well as the overall mission of the academic medical center).

Departments may also consider incorporating center or institute affiliations as a part of their faculty development programs. One component of a faculty development program is frequently the development of scholarly skills. Given the increased research productivity of center-affiliated faculty and the presence of centers and institutes as a core mechanism for organizing faculty life, departments could incorporate opportunities for center interaction and involvement into their policies for continued faculty growth. Activities such as informal collegial interaction (which may lead to collaborative research), attendance at retreats or seminars, and exposure to research resources are often embedded in center culture. Departments can capitalize on the availability of these activities by encouraging faculty to view centers as places to facilitate their scholarly development.

Third, institutional leaders are reminded that center-affiliated faculty spend less time on medical student education than their noncenter peers. Their higher levels of research productivity may occur at the expense of teaching responsibilities. Centers should not be allowed to become safe havens for faculty who have no interest in teaching responsibilities. Teaching, after all, is a core component of academic duty. Also, a vibrant academic enterprise depends upon the continued vitality and sustainability of both departments and centers. Institutional leaders must ensure that departments do not become repositories for “second-class” faculty citizens, orphan research, or undesirable teaching loads. To ameliorate this problem, some schools have set minimum teaching expectations for all faculty members; others have required research centers to contribute to multiple missions of the institution, including community service and education. All centers, departments, and other administrative units should undergo regular and rigorous review to ensure continued contributions to their institutional mission.

Fourth, as many research centers continue to foster interdisciplinary and “team” science, their success as organizational units will depend in part on their activities being successfully incorporated into academic career advancement pathways. Yet being a team player in academe has so far been neither recognized nor rewarded.¹⁸ As a whole, academic medicine must do more to embrace the notion of interdisciplinary research and to recognize that mechanisms for promoting such research, such as centers and institutes, are ever more commonplace. Faculty promotion committees may need to better incorporate interdisciplinary research and center-affiliated activities into the academic reward structure. That research centers and institutes are firmly embedded in faculty life is a given; that they will be increasingly important seems apparent. Medical schools, therefore, must grapple with whether and how research centers and institutes, and the activities that faculty members perform under their aegis, are incorporated into promotional expectations, mission, and outcomes.

Acknowledgments

The authors gratefully acknowledge the Burroughs Wellcome Fund for providing support for this research project and thank Gwen Garrison, Robert Jones, and two anonymous reviewers for their insightful feedback on earlier versions of this manuscript.