Promotion of Academic Hospitalists: Room for Improvement

Introduction: Academic hospitalist medicine has grown rapidly and often focuses on clinical rather than academic productivity. Hospitalist faculty may face challenges achieving academic promotion. Materials and Methods: Academic hospitalist program leaders at hospitals associated with American Association of Medical Colleges (AAMC) were surveyed. Domains included leader, faculty, and program characteristics as well as promotion and faculty development. Results: 146 programs were identified, 11 were excluded; 78 responded (58%) reporting on 3294 faculty. Faculty: Most identified hospital medicine as a career. Promotion: 21% of institutions reported a single promotion track. Among institutions with multiple tracks (79%) faculty were reported to be on the following tracks: educator (48%), clinical (47%), and research (3.3%). Most academic hospitalists were reported to be instructor/assistant professors (70%) and a median of 1.5% were professors. Publications were required for promotion in the majority of institutions regardless of track. 61% of programs had 10 percent protected time or less; 21% had none. Conclusion: Academic hospitalists have to balance clinical duties, teaching, and scholarship. Despite a majority being on a promotion track and a majority needing to produce scholarship, most had little to no protected time. Compared to data from the AAMC, Academic Hospitalists were at lower rank than Department of Medicine peers. Academic hospitalist leaders reported barriers to promotion including lack of expertise and mentorship (74%) and/or insufficient time for research (58%). Taken together, this may limit the ability of academic hospitalists to achieve academic promotion.