How Competive Are Tenure-Track Positions in Academic Neurology?

[someqsaboutstuff]

I heard that in neurosurgery they aren't as competitive since tenure isn't as big of a concern for neurosurgeons (for whatever reason). Instead, the real negotiation is for % protected time, and related dept support for your research.


Is it a similar negotiation for neurology? I can still imagine that PP attracts more neurologists, so are TT positions easier to get as a physician scientist vs PhD-only? Broadly curious about the job market for specifically early career neurologist-scientists. Any thoughts are appreciated. Thanks!

---

Members don't see this ad.

 

[Thama]

Tenure track is a much bigger concern for PhDs as they lack physician job security. It's archaic and frequently ignored in academia. I know people with multiple R01s that never bothered going tenure track until they were offered it anyway based on their accomplishments. Like in neurosurgery, protected time is the valuable commodity, not tenure.

 

[Dave1980]

I heard that in neurosurgery they aren't as competitive since tenure isn't as big of a concern for neurosurgeons (for whatever reason). Instead, the real negotiation is for % protected time, and related dept support for your research.


Is it a similar negotiation for neurology? I can still imagine that PP attracts more neurologists, so are TT positions easier to get as a physician scientist vs PhD-only? Broadly curious about the job market for specifically early career neurologist-scientists. Any thoughts are appreciated. Thanks!

Tenure track doesn't exist for clinicians.

NSG is super competitive. Not sure where you are getting your info.

Tenure for research is incredibly hard to get.

 

[someqsaboutstuff]

Tenure track is a much bigger concern for PhDs as they lack physician job security. It's archaic and frequently ignored in academia. I know people with multiple R01s that never bothered going tenure track until they were offered it anyway based on their accomplishments. Like in neurosurgery, protected time is the valuable commodity, not tenure.

And is protected time (for first position) ultimately a function of a strong publication record, K/R award, and having big-name support? (which i would argue basically translates to doing residency at as top a place as possible in order to get the best postdoc/research fellowship position possible)

 

[90sportsfan]

Tenure track doesn't exist for clinicians.

NSG is super competitive. Not sure where you are getting your info.

Tenure for research is incredibly hard to get.

Isn’t this highly variable based on how individual institutions are setup?

I’ve heard a good number of the mid- and lower tier institutions have tenure track positions for clinicians (more educationally focused) although they don’t automatically give you protected research time without federal funding (R01). Of course if you’re at the top tiers, you have to have a K and then get an R01 to be on that track. But I think institutions all handle tenure for clinicians a little bit differently.

There’s a pretty good post on the academic path for physicians on one of these threads.

Although for most clinicians, I don’t think tenure is a big deal. There are a lot of very “senior” academic clinicians who are Assistant Professors, and have been working at their institutions for 20+ years. If you’re a strong clinician and teacher, you won’t have the time to get an NIH grant.

Also it’s a little hard to tell because many institutions just use Assistant/Associate Professor (for tenure and non tenure) designation without “Clinical” in it, so it’s hard to tell if they are tenured. Although at some institutions they do use “Clinical” in the rank so it’s easy to tell if someone is non tenure track.

 

[Dave1980]

Isn’t this highly variable based on how individual institutions are setup?

I’ve heard a good number of the mid- and lower tier institutions have tenure track positions for clinicians (more educationally focused) although they don’t automatically give you protected research time without federal funding (R01). Of course if you’re at the top tiers, you have to have a K and then get an R01 to be on that track. But I think institutions all handle tenure for clinicians a little bit differently.

There’s a pretty good post on the academic path for physicians on one of these threads.

Although for most clinicians, I don’t think tenure is a big deal. There are a lot of very “senior” academic clinicians who are Assistant Professors, and have been working at their institutions for 20+ years. If you’re a strong clinician and teacher, you won’t have the time to get an NIH grant.

Also it’s a little hard to tell because many institutions just use Assistant/Associate Professor (for tenure and non tenure) designation without “Clinical” in it, so it’s hard to tell if they are tenured. Although at some institutions they do use “Clinical” in the rank so it’s easy to tell if someone is non tenure track.

I have trained and worked at a handful of different institutions and I've never heard of any clinical people being tenured or being on a tenure track. Everyone I know basically has a contract that can be terminated at any time with 30 or 90 day notice. If you are a good clinician and do your job you don't have to worry about it. Doctors are a valuable commodity for these institutions and recruiting new talent is hard.

There is no need to worry about tenure.

Protected time for research is a whole different beast.

 

[90sportsfan]

I have trained and worked at a handful of different institutions and I've never heard of any clinical people being tenured or being on a tenure track. Everyone I know basically has a contract that can be terminated at any time with 30 or 90 day notice. If you are a good clinician and do your job you don't have to worry about it. Doctors are a valuable commodity for these institutions and recruiting new talent is hard.

There is no need to worry about tenure.

Protected time for research is a whole different beast.

Yeah those are good points, although I think there still may be some variability, and the age of the faculty may matte, in the sense that I have heard that years ago tenure was not quite as competitive, so older docs may have gotten it when it was easier. Nowadays it is extremely competitive, and many researchers are in the same department as physicians, so it's hard for a physician to get a committee to vote them to tenure when researchers have federal funding (R01s) and hundreds of publications, and they don't.

Agree with you that as physicians, we should just concentrate on being good clinicians and teachers, and we won't have much to worry about, since academic centers really need us a lot more than "tenured" faculty.

I'm a rising MS4 but am interested in academic medicine (95% Rads but Neurology is still on the table), so I've looked into this stuff quite a bit. I am a little worried about the research requirements in academic medicine and tenure/non-tenure issues, so your post is very encouraging! Thanks!

 

[Dave1980]

dont worry about research as you will find out soon that "academic" medicine no longer exists. teaching and research have fallen by the wayside and you are now expected to work at PP levels and get paid an academic salary.

 

[Thama]

And is protected time (for first position) ultimately a function of a strong publication record, K/R award, and having big-name support? (which i would argue basically translates to doing residency at as top a place as possible in order to get the best postdoc/research fellowship position possible)

Protected time comes in 2 ways: as part of a startup package (usually for early career faculty with a very strong track record), and from your grant support. After an initial brief grace period, it's all the latter - the protected time is built into your grants as you essentially "buy" part of your salary. If you're 5 years into your career and have no grants, nobody cares if you have 30 first author publications in good journals - you're going to be 100% clinical to earn your salary.

 

[90sportsfan]

Protected time comes in 2 ways: as part of a startup package (usually for early career faculty with a very strong track record), and from your grant support. After an initial brief grace period, it's all the latter - the protected time is built into your grants as you essentially "buy" part of your salary. If you're 5 years into your career and have no grants, nobody cares if you have 30 first author publications in good journals - you're going to be 100% clinical to earn your salary.

Thanks for your info Thama. Is it your experience also that very few clinicians in academic medicine are tenured/ tenure track? Is it pretty much only the few MD/PhD clinician-scientists or those who have gone to top tier research fellowships and landed a K grant upon completion?

 

[Always_Eating]

dont worry about research as you will find out soon that "academic" medicine no longer exists. teaching and research have fallen by the wayside and you are now expected to work at PP levels and get paid an academic salary.

This really summarizes it all. As a clinician that left a traditional academic-clinical gig ("Clinical Assistant Professor") to pursue research full-time before transitioning to industry, I could not agree more. There is nothing "academic" about Academic Medicine anymore. You are hired as an Instructor or Assistant Professor. If your Chair is old school he/she will expect you to crank out soft clinical "research": review articles, retrospective single-center studies, case reports, etc. More commonly, you will be expected to RVU at private practice levels like Dave says, build the department brand, teach residents/fellows, and do various non-academic but academic in-name things like quality improvement committees and "Assistant Co-Vice Interim Residency Program Director". That is not an academic career if you consider academics to be basic and translational science.

 

[Thama]

Thanks for your info Thama. Is it your experience also that very few clinicians in academic medicine are tenured/ tenure track? Is it pretty much only the few MD/PhD clinician-scientists or those who have gone to top tier research fellowships and landed a K grant upon completion?

Tenure track is mostly irrelevant at this point. It's just more rigorous requirements for promotion in exchange for access to grad students and "tenure", which just means you can't be fired without cause, but if you didn't carry your weight clinically they could still reduce your pay to the minimum for faculty at the institution (usually similar to resident level salary). There's really not even a prestige bonus anymore, as the track you are on isn't advertised anywhere. At my institution, I don't know of a single junior faculty on tenure track personally.

 

[Hank Rearden]

My institution still has tenure track, but the few neurologists on the tenure track do very little clinical work and most are MD/PhDs. As many have said, tenure is not as prestigious as it used to be and if you do a significant amount of clinical work it is somewhat irrelevant. For example, I am not tenure track, spend 75% of my time doing research and 25% clinical. Half of my salary comes from my clinical work and half from grants. If I switched to tenure track I would actually take a pay cut due to the way the clinical revenue does not come back to faculty on the university side. From what I've heard, universities are incredibly variable with the way tenure track is set up and many are phasing it out entirely.

 

[CheGuevaraMD]

Tenure track is mostly irrelevant at this point. It's just more rigorous requirements for promotion in exchange for access to grad students and "tenure", which just means you can't be fired without cause, but if you didn't carry your weight clinically they could still reduce your pay to the minimum for faculty at the institution (usually similar to resident level salary). There's really not even a prestige bonus anymore, as the track you are on isn't advertised anywhere. At my institution, I don't know of a single junior faculty on tenure track personally.

I'm not sure if tenure track positions are "unprestigious" but they are clearly just different jobs than those that most physicians are qualified for. Academic medicine seems to be veering towards the classist law school model: you need to have attended highly ranked programs since high school and earned a PhD to even get an interview for faculty position. Of course, most lawyers leave school and practice at firms downtown, whereas academic clinicians and tenure track-/tenured faculty work under the same roof, which creates all this tension.

It's kind of a shame. Medicine used to really include a practitioner perspective in academic work, but now the field is the same as the rest of academia.

 

[someqsaboutstuff]

Academic medicine seems to be veering towards the classist law school model: you need to have attended highly ranked programs since high school and earned a PhD to even get an interview for faculty position.

Only for positions with significant protected time and/or tenure, right?

 

[CheGuevaraMD]

Only for positions with significant protected time and/or tenure, right?

Yes, but given the competition for grants and journal space, you need that time to produce work that anyone will fund or see.

 

[SeniorWrangler]

I'm not sure if tenure track positions are "unprestigious" but they are clearly just different jobs than those that most physicians are qualified for. Academic medicine seems to be veering towards the classist law school model: you need to have attended highly ranked programs since high school and earned a PhD to even get an interview for faculty position. Of course, most lawyers leave school and practice at firms downtown, whereas academic clinicians and tenure track-/tenured faculty work under the same roof, which creates all this tension.

It's kind of a shame. Medicine used to really include a practitioner perspective in academic work, but now the field is the same as the rest of academia.

My experience is that academic programs are always hiring smart young people to be clinical faculty and generate revenue, with the expectation that most of them will move on, it’s a pyramid with a big base and a skinny top.

Non-clinical faculty are all about grants or the promise of grants, and if your grants go away you get demoted to the base of the pyramid I just mentioned.

 

[90sportsfan]

I'm not sure if tenure track positions are "unprestigious" but they are clearly just different jobs than those that most physicians are qualified for. Academic medicine seems to be veering towards the classist law school model: you need to have attended highly ranked programs since high school and earned a PhD to even get an interview for faculty position. Of course, most lawyers leave school and practice at firms downtown, whereas academic clinicians and tenure track-/tenured faculty work under the same roof, which creates all this tension.

It's kind of a shame. Medicine used to really include a practitioner perspective in academic work, but now the field is the same as the rest of academia.

Is this the case with "academic medicine" or "tenure-track?" Maybe it's just the terminology that's confusing. What people on this thread have said (and from what I've seen online and talking to faculty), "academic" positions seems to be very plentiful (without a PhD), but "tenure track" positions are rare (and are mostly reserved for the PhD types).

I just did a quick google search in my home state, and there are several postings (including my medical school) for "academic" neurology positions. They are not very specific on the "track" though, and based on what's been said on this thread, I'm now almost positive that these are non-tenure track positions.

 

[xenotype]

My experience is that academic programs are always hiring smart young people to be clinical faculty and generate revenue, with the expectation that most of them will move on, it’s a pyramid with a big base and a skinny top.

Non-clinical faculty are all about grants or the promise of grants, and if your grants go away you get demoted to the base of the pyramid I just mentioned.

This exactly. You either generate revenue, and the department skims a healthy amount off (and subsidizes a few specialties like cognitive that need it), or you have grants and pay your own way.