1. Medical School Research Intensity and Academic Rank of Family Medicine Faculty Joseph J. Benich, III Natalie Christain William J. Hueston Medical University of South Carolina

2.  Compared to other academic disciplines, family medicine has less success at securing research grants and fewer publications per faculty member  Grants and papers are required at most institutions for academic promotion  Institutions with more research would be expected to place greater emphasis on these factors in considering promotion Scholarship and Family Medicine

3.  A 1998 study showed that family medicine faculty have more trouble being promoted at academic institutions and are more likely to be at lower ranks  The emphasis on grants and publications at highly productive research institutions could lead to difficulty for family physicians being promoted at these schools Family Medicine: pathway to nowhere?

4. Question 1: Compared to family medicine faculty at other institutions, are family medicine faculty members less likely to attain senior faculty ranks at institutions known for their research intensity? Question 2: Compared to faculty members in other disciplines, are family medicine faculty less likely to attain promotion success at research intense institutions? Research questions

5.  Cross-sectional analysis of faculty rank for faculty members in 30 American medical schools  Goal was to compare family medicine faculty at “highly research funded” schools with those from “medium funded” and “low funded”  University and department web sites were consulted for faculty ranks Methods: Overview

6.  Ten schools were randomly selected from each of the following based on the Blue Ridge Healthcare Group 2010 NIH funding rankings:  Top tertile of NIH funding  Middle third of NIH funding  Lower third of NIH funding Sample selection

7. Schools required to have Departments of Family Medicine (2 schools excluded because they did not) Schools required to have comparison departments (1 school excluded) Schools required to list their faculty members and ranks on their web site (2 school excluded) When schools were excluded, the school that followed them in NIH ranking was selected as a replacement Methods: Eligibility

8.  Departments of Family Medicine were the variable of interest  To provide comparisons for family medicine, we selected 4 other groups:  2 other “generalist” sections: general internal medicine and general pediatrics  1 surgically-oriented specialty (OB/GYN)  1 cognitively-oriented specialty (neurology) Comparison Departments

9.  The total number of faculty at each department or division along with faculty rank were recorded from the university/ department web sites  Faculty who were listed as “clinical,” “adjunct,” or “visiting” were excluded  Web searchers were conducted June-July, 2012 Data Collection

10.  Data were combined for all institutions within the stratum (highly funded, medium funded, and low funded)  Chi-square testing was used to compare proportions of faculty at each rank either across tertiles (for family medicine) or within tertiles (for specialties)  P<0.005 was considered statistically significant Analysis

11. Academic rank in Depts of FM based on research funding

12. FM at professor/associate compared to other primary care divisions

13. FM professor/assoc compared to non-primary care specialties

14.  Attainment of advanced ranks does not appear to differ for faculty in departments from “high intensity” research institutions and others  Family medicine ranks similar to other primary care colleagues and significantly higher than GIM in institutions with high research funding  Attainment of promotion in family medicine lags slightly compared to some other disciplines in institutions with more funding Summary

15.  Family medicine faculty are competitive for promotion regardless of the research intensity of their institution  While family medicine research funding and publications may be lower than other academic disciplines, this is not a hindrance to academic success Implications

16.  Based on data that may be out-of-date  However, data would likely be out-of-date for non-family medicine departments as well  Based on static assessment at one time  Data do not reveal how many faculty went up for promotion, failed and left institution (survivor bias)  Data also do not look at faculty tracks that may allow clinician-educators to advance Limitations

17.  Family medicine faculty can be successful regardless of the institutional emphasis for promotion  This may be due to institutions recognizing other pathways to promotions or  Faculty who have career commitments to research may be selecting institutions where they skills may lead to promotion Conclusions