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    Principles of Academic Life: Appointment, Promotion, and Tenure

    Guadalupe Federico Martinez, PhD
    Assistant Dean, Faculty Affairs and Career Development
    Assistant Professor, Medicine
    University of Arizona College of Medicine-Phoenix

    Kenneth S. Knox, MD
    Associate Dean, Faculty Affairs and Career Development
    Professor, Medicine and Immunobiology
    University of Arizona College of Medicine-Phoenix

    Faculty affairs deans serve as the on-campus experts for helping faculty successfully navigate academic life at their institution.1 You advise faculty on their probability for success, indicators of readiness for promotion, and what remains to be achieved prior to promotional review.  

    Given the nature of medical school training, the faculty at colleges of medicine are diverse (e.g., employed full-time, contracted, volunteer, basic science, clinical, educator, etc.). A substantial portion of the nonclinical curriculum is often taught by basic scientists or teaching faculty with terminal degrees in physiology, anatomy, microbiology, and other core disciplines. The clinical clerkships are taught by physicians, many who have little dedicated time for research or formal didactic teaching. Therefore, as medical schools continue to adapt to the changing academic and health care landscape, many now offer a variety of professorial tracks that better reflect the day-to-day duties and promotion expectations of clinical and teaching faculty.2 As an expert in these areas, you will be a valuable resource to faculty, chairs, and the dean.  

    Initial Appointment

    Most colleges of medicine have well-staffed faculty affairs offices to facilitate initial faculty appointments and oversee the promotion and tenure process in tandem with a home department. When a faculty member is hired and seeks initial appointment with endorsement from the department chair, several considerations exist:

    • What is the job description of the new faculty member? Knowing the job expectations will allow for placement into the most relevant and appropriate professorial track. This is critically important to begin timely and accurate career progression planning.  
    • Is the faculty member right out of residency or fellowship training? Early-career faculty often provide new energy to a department but can easily lose enthusiasm if not placed into a peer group or mentoring program. Faculty affairs deans can encourage departments to build in development programs while providing supplemental college-level support programs.
    • Is the faculty hired already tenured at another institution? Understanding the guidelines and expectations for tenure at your institution will help recalibrate faculty expectations and timelines for determining tenure. Some colleges of medicine will honor tenure from peer institutions while others will not.
    • Does the faculty member need hospital credentialing or state licensure? When a faculty appointment occurs, the timing of credentialing and licensure is critical. Delays can sometimes impact start dates and cause an unfavorable first impression. 
    • Has the faculty negotiated an appointment at an advanced rank (e.g., associate or full professor or immediate tenure)? Advanced rank or tenured appointments typically require a promotion committee or several tiers of review that could span several months.   


    The following suggestions are offered as a broad, but essential foundation on which to base your advice and direction:

    • Know the guidelines for promotion and hierarchy of accomplishments for each track.1-3 
    • Know your institutional definition of scholarship.3-5 Every institution assigns different meanings and value to scholarship. For instance, with the emergence of clinical tracks, understanding what “counts” as scholarship for those on clinical tracks versus research tracks is important. (Extramural federal funding and peer-reviewed publications may be the only activities heavily weighed and counted as research for those on investigative tracks; publication and/or regional implementation of clinical protocols may be counted for clinical tracks; philosophy around authorship credit for team science might vary; value of media contributions may not yet be established.)  
    • Know your institution’s submission calendar and pertinent policies for each track.1,2 Some promotion and tenure policies have absolute requirements and dossier review timelines, which must be known early in the planning process (e.g., if peer evaluations of teaching need to occur twice yearly for time in rank, this should be well-known among faculty). 
    • Know the hidden rules and traditions as well as the institutional philosophy of what it means to be a faculty member.6,7 For example, the value of certain activities to the promotion committee is important to understand. Additionally, recognize if there is incentive for promotion at your institution and/or partnering clinical sites.

    Gaining this knowledge through dialogue with national and local leadership, sitting ad hoc on promotion and tenure committees, and evaluating both promotion successes and failures are important to be effective and credible in the role. 

    When pondering your office’s approach toward educating and supporting faculty through promotion, consider the following to set the tone with your dean and department chairs:

    • Be visible and available as a resource for both faculty and promotion committees.
    • Implement promotion workshops as stand-alone opportunities or integrate training with existing career development or college-level mentoring programs addressing nuances of each track.
    • Share early and often any changes or updates to institutional timelines, dossier, and CV formats.
    • Communicate consistent and accurate institution-specific information related to the typical time-in-rank when advising on early promotion or mandatory midcycle reviews depending on the track.
    • Establish, promote, and celebrate a culture that encourages faculty to meet with mentors, sponsors, coaches, and department leaders.


    Tenure has an important impact on academic freedom, institutional culture, recruitment, and retention and has traditionally shaped what promotion looks like in the academe and academic medicine. However, national trends suggest the proportion of tenured faculty is declining in clinical departments.8 Tenure often confers job security, as a significant financial commitment is made by the institution to faculty members with a history and promise of sustained, outstanding academic performance. Tenure and post-tenure review guidelines often define the legal aspects and scope of institutional commitments.9 Tenure often is awarded at the time of promotion to associate or full professor, depending on institutional bylaws, but can be awarded separately from promotion in rank. Be aware that the meaning and value of tenure varies widely by institution. Much like promotion, it is imperative to have a strong knowledge of both national American Association of University Professors regulations and institutional tenure guidelines and policies. 

    A leadership role in faculty affairs is professionally challenging and rewarding. As a faculty affairs dean, you must continuously monitor the local and national trends around faculty promotion and tenure to best serve the faculty. In your role, you will have the opportunity to inform leaders of new ways to conceptualize promotion criteria and offer solutions to improve processes. Enjoy!


    1. Coleman TA, Buckley PF, Fincher RME. Developing a career in academic medicine. In: Pangaro L, editor. Leadership Careers in Medical Education. Philadelphia: ACP Press: 2010;73-98.
    2. Coleman MM, Richard GV. Faculty career tracks at U.S. medical schools. Acad Med. 2011 Aug 1;86(8):932-7.
    3. Hoffman LA, Lufler RS, Brown KM, DeVeau K, DeVaul N, Fatica LM, Mussell J, Byram JN, Dunham SM, Wilson AB. A review of U.S. Medical schools’ promotion standards for educational excellence. Teaching and Learning in Medicine. 2019 Nov 19: 184-193. doi:10.1080/10401334.2019.1686983.
    4. Schimanski LA, Alperin JP. The evaluation of scholarship in academic promotion and tenure processes: past, present, and future. F1000Research. 2018 Oct 5;7:1605. doi: 10.12688/f1000research.16493.1.
    5. Cabrera D, Roy D, Chisolm MS. Social media scholarship and alternative metrics for academic promotion and tenure. J Am Coll Radiol. 2018 Jan 1;15(1):135-41.
    6. Tierney WG, Bensimon EM. Promotion and Tenure: Community and Socialization in Academe. Albany, NY: SUNY Press; 1996.
    7. Pololi LH, Krupat E, Civian JT, Ash AS, Brennan RT. Why are a quarter of faculty considering leaving academic medicine? A study of their perceptions of institutional culture and intentions to leave at 26 representative U.S. medical schools. Acad Med. 2012;87(7):859-69.
    8. Xierali IM, Nivet MA, Syed ZA, Shakil A, Schneider FD. Trends in tenure status in academic family medicine, 1977-2017: implications for recruitment, retention, and the academic mission. Acad Med. 2020;95(2):241-247.
    9. Walling A. Understanding tenure. Fam Med. 2015;47(1):43.