Promotion and tenure in family practice in US medical schools

Academic development is recognized as a necessary requirement in family medicine and can be measured in part by assessing the experience with the promotions and tenure process in university departments. In this study a questionnaire was distributed to the chairmen of departments of family practice with direct medical school affiliations. The chairmen were asked to describe the current rank profile of the faculty in their departments and their perception of the importance of various criteria on promotion and tenure decisions at their school. The departments averaged 1.8 full professors (72 percent tenured), 3.0 associate professors (40 percent tenured), 6.1 assistant professors (5 percent tenured), and 1.5 instructors (none tenured). Research quality and quantity were considered the most important positive influences on promotions and tenure decisions. Teaching skills were slightly less important, and patient care and administrative skills were not important influences. This project demonstrates that (1) family practice faculties are relatively underdeveloped with respect to senior, tenured positions, (2) research is highly important to achieve promotion and tenure, but little time is available to the faculty to do that research, and (3) the needs of the departments in the areas of patient care and administration may conflict with the requirements for promotion and tenure.