Promotion Preparation Tips for Academic Family Medicine Educators

When it comes to academic promotion, many medical schools value basic and clinical science research over medical education research. Promotion criteria often emphasize research and scholarship over teaching and service.1,2 Equal recognition for teaching or clinical achievement remains an ongoing discussion in credit toward promotion. Academic rank continues to be linked to a higher base salary, further incentivizing promotion.3-5 A 2020 Council of Academic Family Medicine Education Research Alliance (CERA) survey of department chairs showed that only 28.6% of family medicine faculty have protected scholarship time, and family medicine faculty with protected scholarship time were more likely to be promoted.2

Historically, clinician-educators are promoted less often and less quickly as compared to faculty in both clinical and basic sciences research tracks.6-8 The barriers cited for this include low percentage of time spent on research and teaching versus high percentages of time spent in patient care, with fewer opportunities for mentorship on career progression.6,7

The positive influence of mentorship, faculty development, and explicit promotion criteria are several existing themes identified in the literature that support successful promotions. Mentored faculty are promoted significantly sooner than their nonmentored colleagues.9-11 A robust program of faculty development enhances faculty success with promotion while a lack of faculty development is cited as a factor in the decision to leave academic medicine.10

With this background in mind, this study engaged the academic family medicine community in order to identify tips in promotion preparation for academic family medicine educators based on professional experience.

This qualitative, survey-based study utilized a convenience sample that included family medicine educators and members of Society of Teachers of Family Medicine (STFM) Medical Student Education (MSE) Collaborative recruited using the group listserv. The survey was sent out to the entire listserv by email and was designed to solicit specific tips for promotion based on the respondents’ own experiences. No participants were excluded and all ranks were included as the authors wished to gather tips from all stages in the promotion process. Participants were incentivized to contribute as they were invited to present their recommendations for promotion preparation as a part of a preconference session at the STFM Annual Spring Conference and to contribute as authors to a peer-reviewed publication. The Wake Forest School of Medicine Institutional Review Board approved this research.

The survey was sent electronically by email and contained a description of the preconference session objectives and four open-ended questions:

1. What tips do you have for identifying measurable achievements from promotion preparation criteria?
2. What tips do you have for CV preparation?
3. What tips do you have for personal statement preparation?
4. What tips do you have for apprising and selecting external reviewers?

Respondents had the option to provide tips for any number of the four subcategories.

This study qualitatively analyzed responses using principles of grounded theory and constant comparison.12 Two of the primary authors (M.K. and M.P.) read all survey responses for familiarization. They independently identified themes and subthemes. They next iteratively compared themes and subthemes to the point of saturation. Disagreements were discussed until a consensus could be reached.

We obtained 14 survey responses. Responses were received from four professors, six associate professors, two assistant professors, and two other faculty (director of faculty life, senior lecturer). Respondents represented 13 different institutions from the Southeast, Northeast, Midwest, Northwest, and Southwest regions of the country. Ten of the 14 respondents have served on promotion and tenure (P&T) committees, as external reviewers, and/or mentored faculty on promotion. Central themes that emerged from all data sets included the importance of timely and thorough documentation, detailed planning, and being knowledgeable about institutional-specific criteria. Table 1 presents the consensus tips in promotion preparation.

While there is variation in promotion criteria between institutions, this study identified themes to guide family medicine educators. The tips complement institution specific guidance and emphasize the importance of knowing one’s own institutional criteria early as the most important first step. Our study suggests that planning ahead with documentation and networking is important for all those pursuing promotion. Additionally, using a network to optimize promotion preparation, albeit mentors reviewing documentation or strategically selecting external reviewers (should your institution allow) is highlighted.

We hypothesize that the proposed tips can be used as family medicine educators focus on promotion when completing annual review materials, setting goals, negotiating new roles and responsibilities, or advocating for protected scholarship time. Faculty mentors and developers can use the tips to guide faculty through promotion preparation. Those with faculty development responsibilities can use the tips as a resource to assist in their coaching efforts.

Limitations of this study included the small convenience sample size and focus of educators of undergraduate medical education. Incentivizing responses with collaboration for a preconference workshop likely promoted selection bias. Future studies could address this by: (1) recruitment across additional national collaboratives, (2) targeted recruitment of faculty affairs and development experts (such as members of the Association of American Medical Colleges Group on Faculty Affairs), and (3) inclusion of responses from faculty attendees at national conference when presenting this topic. Additionally, to build on the groundwork laid by this study, the recommendations identified in this survey could be included in a validation survey of content experts.

The tips identified in this study assist those family medicine educators seeking promotion and may provide a structured tool for promotion preparation across institutions. Family medicine educators considering promotion and those who support the promotion process can utilize the tips as collected knowledge as a guide through the promotion journey.