Purpose. (1) To summarize the judgments of family medicine department leaders regarding the elements leading to success in promotion and/or tenure, and (2) to compare the views of department leaders with those of family medicine faculty who have been successfully promoted. Method. Two surveys were conducted. The first was of 296 associate professor members of the Society of Teachers of Family Medicine in November 1993. The second, conducted in the summer of 1994, was of all 115 U.S. members of the Association of Departments of Family Medicine; surveys were addressed to chairs, directors, or promotion and tenure committee chairs. Both survey instruments requested data regarding each respondent's department, impressions about the promotion and tenure processes at the respondent's institution, and general impressions regarding the characteristics of successful candidates. Comparisons of the responses to the two questionnaires were made using two-tailed t-tests; responses to open-ended questions were analyzed qualitatively by two independent investigators. Results. In all, 75% of the department leaders and 67% of the associate professors returned completed questionnaires. The two groups had similar views about the importance of certain academic activities to success at promotion and tenure. The primary difference between the groups was in their estimates of weekly time available for research and writing activities: the leaders reported that successful candidates spent a mean of 25% of their workweeks on research and writing activities; the associate professors, on the other hand, reported spending a mean of 15% of their workweeks on these activities. The department leaders described six basic groups of critical success factors. The associate professors emphasized lack of time as a major obstacle to success. Conclusion. The findings emphasize the critical importance of protected time for scholarly activities (such as research and writing) if generalists are to be promoted or tenured.
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