Does Promotion in Academic Environments Matter?

William N. Levine, MD, FAAOS | Linda Suleiman, MD

July 20, 2022

Academic promotion at each academic center is variable across the country. Each academic center sets standards by the University on what academic contributions are deemed impactful for promotion. Most orthopaedic surgeons entering academic jobs out of fellowship will start their career as a clinical instructor or assistant professor. When evaluating academic jobs, it is important to identify where you feel you will be impactful. Most institutions have two relevant tracks that are delineated by tenure vs non-tenure and physician scientist vs clinical educator. To be promoted through the academic ranks there will either be a research focus or an education focus. Institutions determine your promotion based on your contribution to one’s profession beyond just carrying out your day-to-day responsibilities, such as patient care, administrative work or teaching. Since 2020, many institutions have added a third track that involves community engagement or work related to diversity, equity, and inclusion. There has been criticism in the past that academic institutions have not valued faculty impact on community programming, mentorship, and health equity. This newer track has placed importance and value on this work that has historically been accomplished mostly by underrepresented in medicine (URiM) faculty.

Academic promotion benefits can vary by each orthopaedic department and institution. Many departments have financial incentives to academic promotion, added resources related to research support, and in some instances, clinical support. When beginning a new academic position, it is important to know what these benefits are early in your appointment. You should take time to meet with your Chair and determine what the typical timelines are for promotion, criteria used by the Committee on Appointment and Promotion (COAP), and differences in financial reimbursement per academic rank (typically, the academic salary goes up with each designation from Assistant to Associate to Professor).

It is rare for clinical orthopaedic faculty to achieve tenure. A tenure track position historically was developed for faculty in the arts and sciences where specific salary support benefits and research freedom are protected. However, orthopaedic surgeons serve dual roles, many serving in a hospital system with patient volume expectations and revenue generation, in addition to being experts in their field academically. Thus, tenure has almost become non-existent for academic clinicians since there is no conferring relative “freedom” of ideas. In addition, those who have been promoted to higher academic positions such as professors still secure salary funding through research grants. Overall, in the field of orthopaedic surgery, academic promotion can provide national and international recognition of your impact and contribution to the profession.

DISCLOSURES: Dr. Levine is on the Columbia faculty, serves as Board or committee member for the American Shoulder and Elbow Surgeons, and is on the editorial or governing board for the Journal of the American Academy of Orthopaedic Surgeons. Dr. Levine serves as an unpaid consultant to Zimmer Biomet. Dr. Suleiman serves on the Northwestern Faculty and as a Depuy consultant.

Read the AAOS Code of Conduct for Discussion Group Terms, Conditions and Disclaimers HERE.

Copyright© 2022 by the American Academy of Orthopaedic Surgeons

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