Pragmatic Frameworks for Clinical Compensation in Academic Neurology

Compensation models in academic neurology departments are diverse, aiming to balance clinical workload, academic pursuits, and financial sustainability. We provide a narrative review describing a structured framework for understanding guiding principles behind equitable and transparent academic neurology compensation plans. We explore key principles governing time allocation, as well as comparative analysis of work relative value unit-based and full-time equivalent-based models, highlighting advantages and disadvantages of both. Hybrid models, increasingly adopted in academic centers, offer flexibility by integrating productivity incentives with protected time for nonclinical duties. Ultimately, designing equitable and sustainable compensation in academic neurology, while still preserving the academic mission, requires transparency, acknowledgment of subspecialty demands, and alignment with institutional values. By understanding the strengths and limitations of each model, departments can build systems that support both clinical excellence and the broader academic mission, as well as help recruit and retain faculty.