Background: Considerable resources are expended by academic divisions of hospital medicine (HM) to recruit and retain physicians that will be successful. Despite the high stakes for the institution and candidate, there is a lack of data to guide these decisions. Suppositions regarding what attributes contribute to success predominate. We evaluated the relationship between factors known at the time of hiring and subsequent longevity and success in an academic division of HM.

Methods: We conducted a retrospective review of all hospitalist physicians hired by our division since in-ception. Measures of longevity, research productivity, academic promotion and division leader-ship roles were compared to personal and professional characteristics at the time of hiring. We quantified success in those four domains and explored for associations between success and hiring factors.

Results: Average longevity in the Division was 84 months. Female gender was associated with greater longevity (p=0.09). Physicians from the hospital region were no more likely to stay long-term as compared to those from other regions. United States medical graduates were more likely to attain leadership positions than international graduates. No factors were associated with subsequent research productivity although there was a trend toward greater productivity for more than one publication at the time of hiring. Only 11% of hospitalists achieved senior academic rank and there was no association with academic residency, advanced degrees and pre-hiring publication record. There was an inverse relationship between research productivity and administrative leadership.

Conclusions: All women hired during the study period remained in the division for longer than five years. Further evaluation of factors contributing to the retention of this group is an important future direction. Factors commonly sought by academic healthcare institutions such as regional ties, academic residency and advanced degrees were not associated with long term success in academic hospital medicine. Less research productivity was associated with greater divisional leadership involvement, suggesting that scholarship and administrative leadership may represent separate tracks for physicians at academic institutions.