Some residents will wonder whether an academic job is right for them. I hope I can demystify a few issues to help ensure that graduates make the best choice for themselves. I will describe academic roles in general terms, recognizing that each university has individualized criteria for hiring and promoting academic physicians. At the core, however, there are some universal truths.

A university-based academic position is meant to be devoted to discovery, advancement of thinking, and creation of new knowledge. In 10 years, we will be practicing medicine in fundamentally different ways. Those who do the research, create insights, critically observe, make meaningful improvements, and share that knowledge are often collected in academic environments and on a professorship track. These academicians help create and sustain a dialogue that will change practice in meaningful ways.

Those who like to do this work typically need the support of an enriched environment where people with an array of skills help with research, grants, and publication. The university structure is meant to recognize and reward this work. Those with the right preparation and training will be hired at an instructor level. Some physicians who do not publish may stay at the instructor level for an entire career. Some universities do not allow this and believe that everyone must contribute to scholarly advancement or must leave if there is not academic productivity. While not every university has this up-or-out mentality, the academic world generally expects physician faculty to achieve promotion to assistant professor and beyond.

Sarah Hoper, MD, recently joined the staff at Vanderbilt University in Nashville, Tennessee. She is interested in health policy and is the legislative advisor for the Emergency Medicine Residents’ Association (EMRA). Jordan Celeste, MD, is president of EMRA and is an emergency physician in Florida.

Career Path

The assistant professor is typically acknowledged to be one who is fulfilling the academic promise with evident publications, presentations of research work, and other output. Typically, three to five publications are needed. Those on the educational track must similarly be developing a portfolio that demonstrates a quality and quantity of educational work that is meaningful and impactful. It is expected that the academic educator will not just teach but will critically assess and meaningfully improve the way education is conducted, the way curricula are designed, and the way new physicians are trained. When there is evidence that other programs are using an assistant professor’s ideas and concepts, then academic promotion is facilitated. At the very least, there must be output that is judged by peer review or some other means to be worthy of sharing widely.