Too many new faculty in academic medicine get lost.
They sign on with academic medical centers with the best intentions. They want to inspire the next generation of providers. They want to solve healthcare problems. They hope to make the world a better place.
Unfortunately, academic medicine provides many distractions.
Unlike our PhD colleagues*, we MDs often fail to teach our trainees anything about academic life. I came from an academic family. I knew about ranks and tenure and other issues, but I still didn't really know how to succeed in The Ivory Tower. Someone gave me the Faculty Handbook, including promotion and tenure (P&T) guidelines, when I showed up at my first job.
Have you ever read a faculty handbook? Have you ever tried to read a faculty handbook? These documents tend to be written with stilted dry language. The handbook for an entire campus also keeps things vague enough that it applies to all departments and sections; this provides little guidance for a new assistant professor. You have to find contacts who can give you the real dirt. How many papers are considered "a significant number?" What sort of funding counts toward the tally? Will case reports be held against you? How do you document your educational efforts?
Mentorship helps (those contacts described above). P&T workshops with department-specific information can help. Unfortunately, none of these can be used as a lasting reference. Clinician faculty, in particular, often lose sight of their goal. Patient care responsibilities and other tasks can distract them from achieving and documenting the things that matter for academia. They get a few years into their first appointment and discover that they are behind the eight ball. Many leave academic medicine at this point.
That's why I have written down wisdom collected from multiple institutions and many colleagues. I have tried to keep this brief guide chatty and useful, rather than an academic tome. Yes, it is vague in that it gives no specifics for any institution; however, it does help faculty members know what to ask their colleagues and mentors.
When you get down to it, P&T is really a game. You have rules, you reach milestones, you keep score, and eventually you can win.
*Instead, our PhD colleagues prepare everyone for an academic career, even though we know there are not enough positions for every trainee and many will have to pursue careers outside of The Ivory Tower.