Tenure Track in Emergency Medicine,☆☆,

Presented at the Society for Academic Emergency Medicine Annual Meeting, Denver, CO, May 1996.
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Abstract

Study objective: Tenure was designed to guarantee academic freedom through lifelong job security. Productive research, especially in the basic sciences, is the main criterion for tenure at most institutions; therefore faculty in more clinically focused specialties may experience more difficulty obtaining tenure. We examined the relationship between academic emergency medicine and tenure. Methods: We used a questionnaire to survey the directors of all 108 approved US emergency medicine residency programs. The surveyed population was asked whether the program was affiliated with a medical school, the number of full-time faculty, and how many faculty members were tenured or on the tenure track. Follow-up mailings were sent to nonresponders. We also conducted a search of the Association of American Medical Colleges (AAMC) database to compare the number of emergency medicine faculty involved in the tenure process in other specialties. Results: One hundred surveys (93%) were returned. At programs in which faculty were eligible for tenure, 9% (95% confidence interval [CI], 4% to 16%) were tenured and 27% (95% CI, 19% to 37%) were on the tenure track. Therefore only 36% of all EM faculty (95% CI, 27% to 46%) were tenured or on the tenure track. Among the 53 residency programs that offered tenure, 45% (95% CI, 32% to 60%) had no tenured faculty. At programs with academic department status, 74% of chairs were tenured, in contrast to only 32% of chiefs at institutions without academic department status (95% CI for difference of 42%, 14% to 71%). The AAMC survey revealed that about one-third as many emergency medicine faculty members were tenured compared with the other specialties. The proportion of faculty on the tenure track, however, was similar between the specialties. Conclusion: Most eligible emergency medicine faculty members are not tenured or on track to become tenured, and fewer emergency medicine faculty are tenured compared with the more traditional specialties. Emergency medicine may be vulnerable to being considered less academic unless its faculty members gain access to the tenure process. [Wright SW, Slovis CM: Tenure track in emergency medicine. Ann Emerg Med November 1997;30:622-625.]

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INTRODUCTION

The importance of obtaining tenure has been ingrained at most American colleges and universities for many years. The two most important reasons are academic freedom and economic security. In addition, tenure historically has served to provide freedom of expression on the part of faculty and protection against unjust actions on the part of the university.1, 2 Tenure is also seen by many as a form of recognition and reward.1

More than 95% of the medical schools in the United States and Canada

MATERIALS AND METHODS

The first part of this study involved a survey of all 108 approved US emergency medicine residency programs, conducted during the fall of 1995. The chair or chief of each program with a Residency Review Committee (Accreditation Council on Graduate Medical Education)–approved emergency medicine residency was sent a questionnaire to determine whether the program was affiliated with a medical school and, if it was affiliated, whether the program was a division or independent academic department in

RESULTS

One hundred properly completed surveys were returned, for a return rate of 93%. Eleven of the 100 surveyed programs (11%) were not affiliated with a medical school and were excluded from further analysis. Faculty at 36 of the 89 medical school–affiliated programs (40%) were not eligible for tenure. Some of these faculty members were based at community or county hospitals that were only loosely affiliated with a medical school, and other faculty members were not eligible for inclusion because

DISCUSSION

The results of our survey and the AAMC search revealed similar proportions of emergency medicine faculty who were tenured or on the tenure track. It is important to note that the mailed survey included only residency programs and included programs with both department and division status. In contrast, the AAMC data included only programs with department status, and schools with and without residency programs were included. In addition, the mailed survey sought data from the chair/chief of the

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From the Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN.

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Reprint no. 47/1/85427

Address for reprints: Seth W Wright, MD, 703 Oxford House, Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN 37212, 615-936-0087, Fax 615-936-1316, E-mail [email protected]

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