promotion criteria versus promotion strategy 060126
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[00:00:00] Hello and welcome back to the Academic Medicine Strategy podcast. I'm Stacey Ishman, and today we are talking about promotion criteria versus promotion strategy, which is a gap that almost nobody names and I knew nothing about when I started. And I'm gonna tell you, I had read my institution's promotion criteria.
I knew the subcategories, if it was tenure or not tenure, if it was, which track I was on. Was I clinician educator, clinician research? And I understood it in a general sense. I thought I knew it, and I thought I knew what was required. I started off on the path, and I was saying yes to everything, and I was figuring it all out.
And somewhere around year three when I ran out of protected time, I had this feeling that I was working so hard. This must be the right thing. I was so excited to be on track. I sat down with my chair and it turns out a lot of that wasn't moving my promotion forward. I had this scattershot approach to writing papers and scholarship and abstracts.
I'd done things in all kinds of different areas. There was nobody who was gonna ask me to give grand rounds on what was a [00:01:00] smorgasbord of topics because it wasn't even clear what I wanted to do with my life or how I wanted to be known or how I was gonna contribute to the field or what patients to send to me or what panel to put me on.
I was busy, I was contributing, but I could not have told you with any confidence that I was on track. I just hoped I was. And that gap between knowing the criteria and knowing how to meet them is one of the most common and costly problems in academic medicine. And it's not a faculty problem, it's a structural one So the key is that knowing those requirements is not enough.
Promotion criteria describe what the institution wants at the finish line. They don't tell you how to get there, or what specific clinical load you should be thinking about, or what, how your research should tell a story, or what institutional man- demands will get there, or even what national reputation means.
And so this is one of the first things that I ask departments when I start doing departmental coaching. We have an ac- faculty excellence and retention initiative called the FERI program, and the goal honestly is to help all ships rise. And so [00:02:00] for early career faculty, we're also often starting off with figuring out your values, figuring out your filter, figuring out your one word or your niche, and then we help you figure out a plan.
How do I get there? How do I start the research project? How do I work with the medical students and the residents? How do I get this done? How do I fill out my project sheet? We have a project sheet we help people create. How do I set up my clinical time so it augments my research or at least doesn't detract from it?
And how do I put all those things together? How do I keep track of that research? How do I keep everybody else on track? And so these are the things we talk about, but that translation is important. I talk to every institution and I say, what is the re- requirement for you get to full professor?"
Some places it's a regional reputation. Some places it's service-based. Some places it is a national reputation. That may be at the associate level or the full professor. It is important to know those things upfront. Do I need to worry about national committees at the beginning, or do I just need to work on being on the education group at the medical school I'm working at 'cause that's what I'm gonna try and be doing?
[00:03:00] And oftentimes they don't tell junior faculty what kind of mix you should have.
What kind of mix should you have? What should that look like? If you're doing a mix of clinical work and some quality or some scholarship, and you have maybe a growing research line, you need to understand where is it that I should be putting my focus and my time, and what should I know so easily to say no to, and what should I know to say yes to?
But the results are predictable. If we work hard and we accumulate activities and hope that the committees are the right ones, we're gonna get promoted, and some of us are promoted on schedule, and others are surprised when we're not. And without a dedicated infrastructure and some instruction around how to get there, even the most attentive departments can miss the pattern until it's already a problem.
Now, one of the things to remember is that promotion committees evaluate readiness. What readiness means is misinterpreted by committee members based on their own trajectories or what their institution's informal norms are. So that [00:04:00] interpretation is rarely made explicit and is rarely taught. Faculty who move forward on schedule are often those who have mentors who've helped them interpret the criteria early.
They understand which publications matter. They understand how to put a narrative together. They knew which national committees built their visibility and which ones did not. They knew which ones just took up time, and they understood how to present their work in a coherent narrative, not just lines on a CV Now, faculty without that guidance often figure out late and get frustrated, and some of them even leave.
And this is a resource gap, not a talent gap. It is not the faculty member's fault, but it is something that can be built in the system. And quite honestly, it's oftentimes not your chair or your division ch-chief's fault either, because they have not been told explicitly that this is the way to help bring people through the system.
And that is why we've created systems to do that. Now, promotion strategy is that layer between criteria and career. It's the translation, and it answers where you are right now [00:05:00] and what are the highest leverage activities that... what current commitments are misaligned with advancement and what does readiness actually look like.
And it requires knowing your criteria, but it also requires understanding how your institution interprets those and how the committee thinks the norms apply to you. And what's a realistic production number? Do you... How many medical student evaluations do you need? How many papers do you need to write?
How many podiums do you need to be on? How many times do you need to speak as a visiting professor in order to go to full professor? Those numbers exist in the informal world. They just are oftentimes not written in the criteria. And so that's the promotion strategy. Now, when this support exists, the gap between the two is so closable.
It requires a structured approach that helps you translate it, but it is easily done, especially if you have the right mentors and coaches to get there. And you want to do it early enough so you can be successful in the timeline that makes sense to you. The departments that have access to this kind of support see measurable differences, shorter time through promotion, fewer people [00:06:00] surprised when they're not promoted, and higher faculty retention at the associate level and below.
And the evidence base for this is consistent in the literature. Bland and colleagues did a multi-institutional faculty vitality work, and they demonstrated that medical school faculty productivity and retention are determined less by individual effort than by leadership and institutional characteristics.
That structured career planning was one of the most consistent things that helped the faculty move ahead and kept them, and so that they didn't have to worry about retention problems. There are also national career development programs such as those through the AAMC, where they looked at three thousand two hundred and sixty-eight women faculty, and they matched them to seventeen thousand plus women and forty thousand plus men and found that the participants were significantly less likely to leave academic medicine for up to eight years after appointment as assistant or associate professors.
So just getting promoted was something that kept us in the system and less likely to leave. So what I want you to do this week is pull your promotion criteria, [00:07:00] and if you are senior faculty, pull this and help your mentees and your junior faculty have the structure they need to move forward. And read it not as a checklist, but as a design problem.
What would a department need to give faculty to meet these requirements? And then if you're a junior person, ask your mentor or a member of your department's promotion committee one direct question: What do you think is the most common reason faculty miss their promotion window? And then I want you to list your three highest leverage activities, or if you're a division director or chair, I want you to go back to all of the people in your division, especially those who you think maybe aren't at the top of the list of credibility in terms of how they're gonna look on paper, and figure out the three highest leverage activities so they move their way up on that list.
That's the work that's gonna most directly build their promotion case. And estimate the percentage of their week where they're actually doing it. Have them do a time audit. Have them work with a coach. Have them figure it out. And then identify at least one commitment that's going to consume time without contributing to the promotion [00:08:00] criteria and say no.
It may not be no forever, but it should probably be a no for now because you wanna replace it with something that's gonna help you move ahead. I hope this was helpful, and I hope that this is gonna help you understand that gap between promotion criteria and promotion strategy.
If you wanna hear more tips and tricks like this, or if your department has promotion criteria but no promotion strategy or infrastructure, look at our Faculty Excellence and Retention Initiative, or our FERI program, which is on our website at academicmedicinestrategygroup.com or amedsg.com. We also have one-on-one coaching if you need help or a Kickstarter course that will give you all the information.
Thank you so much for joining me. I look forward to seeing you next week. Please share this with somebody who could benefit from this information, and I hope to see you soon
