263 - Navigating the Path to Academic Promotion: Facilitators and Barriers for Early Career University and Community-Based Pediatric Hospitalists

Publication Number: 263.5818

Elizabeth Nguyen, Lucile Packard Children's Hospital Stanford, Mountain View, CA, United States; Kathleen Boyd, Stanford University School of Medicine, Portola Valley, CA, United States; Vivien Sun, Stanford University School of Medicine, Palo Alto, CA, United States

Background: Academic promotion recognizes a physician’s contributions to their field and offers tangible benefits such as increased salary and career satisfaction. However, the promotion process is institution-specific and may be difficult for individual physicians to navigate. Limited research on academic promotions exists, particularly in the context of how pediatric hospitalists working in university or community-based settings navigate and achieve promotion in their early career.

Objective: To describe and contrast self-reported scholarly achievements, and perceived facilitators and barriers to academic promotion, for physicians promoted to Clinical Assistant or Clinical Associate Professor and physicians reappointed to Clinical Instructor or Clinical Assistant Professor at a single institution.

Design/Methods: We conducted a cross-sectional, voluntary, confidential survey of pediatric hospitalists in the Clinician-Educator line between 6/2024-9/2024. Subjects were invited to participate if they were promoted to Clinical Assistant or Clinical Associate Professor (“Promoted Physicians”), or reappointed to Clinical Instructor or Clinical Assistant Professor (“Reappointed Physicians”), between 9/2020-5/2024. Survey questions were designed by expert consensus and literature review and included both multiple choice and open-ended questions. Quantitative responses were analyzed with descriptive statistics. Qualitative responses were analyzed thematically by two independent investigators. This study was approved by our institution’s IRB.

Results: 19 out of 28 (67%) promoted physicians (PP) and 7 out of 13 (53%) reappointed physicians (RP) responded (total N=26, 63% response rate). 83% percent of RP respondents had full 1.0 full time equivalent (FTE) clinical commitment compared to 16% of PP respondents. PP reported disseminating scholarship locally, regionally, and nationally more frequently than RP (Figure 1). While all participants identified several facilitators and barriers to promotion (Table 1 and 2), only PP mentioned formal mentors as a key facilitator and only RP identified challenges to pursuing a regional reputation and a desire for different standards for promotion for community-based physicians as key barriers.

Conclusion(s): Despite being at the same institution, RP more frequently identified challenges to pursuing a regional reputation as a barrier to promotion compared to PP. More support is needed for all physicians through the promotion process, especially for those with a heavy clinical load and at community-based sites.

Figure 1: Prior to Either Promotion or Reappointment, Number of Times Each Faculty Disseminated Scholarship


Table 1: Facilitators to Promotion, Qualitative Themes Noted by Promoted Physicians vs Reappointed Physicians


Table 2: Barriers to Promotion, Qualitative Themes Noted by Promoted Physicians vs Reappointed Physicians