Prior research in the field of academic hospital medicine has used promotion as the measure of success, but little is understood about what motivates individual academic hospitalists or how individuals define career success. Conceptual models of career success from outside healthcare emphasize Compensation, Advancement, Career Satisfaction and Job Satisfaction. This study sought to explore perspectives of how academic hospitalists define career success in order to deepen understanding of career success beyond traditional metrics of academic promotion.
We used a semi-structured interview tool of 14 open-ended questions, validated using cognitive interviews. We then performed transcribed interviews with 17 early-career academic hospitalists to thematic saturation. Qualitative analysis focused on hospitalist perspectives about career success, using responses to the question “How would you personally define career success as an academic hospitalist at this stage in your career?” A mixed deductive-inductive approach was used to code themes from quotes in the raw text and map back to the theoretical framework. Number of interviews referencing a theme was used to identify dominant themes of career success. This study was approved by the Colorado IRB.
We interviewed academic hospitalists from the University of Colorado (8), University of New Mexico (6), and Johns Hopkins (3). Subjects primarily identified as clinician-educators, had been academic hospitalists an average of 3.1 years, were 47% (8/17) female, and were 12% underrepresented minorities. Interviews lasted an average of 32 minutes.
26 themes were identified (Figure). The most dominant single theme of “Excitement About Daily Work” mapped to the organizing theme of “Job Satisfaction.” The majority of themes mapped to the organizing theme of “Career Satisfaction.” Within “Career Satisfaction,” dominant themes included “Being Respected and Recognized” and “Dissemination of Work.” The organizing theme of “Advancement” was referenced in less than a third of interviews. No interviews referenced tenure and none of the themes mapped to compensation. Ambivalence toward the “Academic Value of Clinical Work,” “Scholarship,” and especially “Promotion” represented an unexpected thematic family.
The future of academic hospital medicine is predicated upon academic hospitalists finding career success. How hospitalists define career success for themselves is not well-understood. Our study highlights that, while academic hospitalists view some traditional markers of career advancement as relevant to success, including reputation and dissemination of work, they consider other traditional external markers, such as promotion and tenure, less relevant to their personal definition of success. This finding has important implications for academic hospitalist programs, both in terms of how they validate faculty members and in terms of evolving institutional criteria for promotion.