Department with 80% assistant professors?

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Pure curiosity - the department at my home program has ~40 faculty, ~30 of which are assistant professors (and a few adjuncts/instructors). There are 2-3 full professors and ~5 associate professors.

Most programs aren't this bottom heavy, are they? Does this suggest anything about the department (beyond the obvious "they have a lot of assistant professors...")?

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That's an interesting observation, good question! I'm completing guessing here, but maybe it means a lot of anesthesiologists are moving into academia now (and maybe in turn because private practice isn't all that it used to be)?
 
I think it depends on the nature of the department. At my med school, which was a middle to high tier department, pretty much anyone could get to professor in 5-10 years with even a passing interest in research and publishing a paper or two here and there. My residency and fellowship were both at snobbier places, one required an R01 just to make ASSOCIATE and the other required 30-50 publications in a ~6 year period, again for associate. Getting to professor at both was a lifetime achievement. Needless to say those places had 80% assistants too.

So, I would look at the context of why the department is bottom heavy - is it because they are expanding and just hired a bunch of new staff? Are there unreasonably high requirements for promotion? Do they kick people out if they fail to progress? Staff are usually fairly opinionated about this sort of thing so they will most likely be very willing to talk about how they are scrutinized and promoted.

Another thing to do is look at other departments at the hospital - if they're not as bottom heavy, it might suggest that the anesthesiologists are slacking and the dept is actually somewhat weak, at least academically.
 
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Some "smarter" places have figured out that, if they set higher requirements for promotion, it's going to be much cheaper to pay all those people. Ideally, from a management standpoint, there should be 100% instructors. ;)
 
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Some departments will promote anyone without deficiencies essentially on time alone with modest academic effort, and other places, like mine, have an extraordinary high bar, particularly for full professor, even in the clinical track. There have been faculty that were full professors at their old programs that relocated here as assistant professors. As long as I'm getting paid, I don't really care what my academic rank is, and the difference isn't dramatic.
 
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I think it depends on the institution. Where I trained, everyone became associate level if they stayed long enough and did whatever the boss said. I was offered a clinical track position at a big west coast place. There, promotion to associate prof required I think 2 journal publications or 6 institutional projects over 6 years, and most people stay at the associate level if they stayed in academics for that period of time. According to the chairman there, getting to full prof required an exponential amount of research and publication, was mostly for researchers rather than clinicians, and that even then, full prof wasn't guaranteed job security. Lack of production or poor clinical skill could result in pay cuts and being stuck in the basement, essentially forcing you to leave.
 
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