Medical Colleges Shrink Tenure as Their Teaching Hospitals Grow

August 23, 2010

The tenure track is getting narrower for physicians at academic medical centers and medical schools. The percentage of tenure-track faculty members has fallen by nearly 50 percent over the past quarter century. But the causes seem to be different from those contributing to the well-documented rise of adjunct faculty at universities across the country.

At medical schools, the shift largely reflects an expansion of university research hospitals, which are hiring doctors with a primary focus on patient care rather than teaching and research, according to the Association of American Medical Colleges, which reported the data in the current edition of its monthly newsletter.

In other sectors of higher education, the decline in tenure may reflect a desire among colleges to find low-cost replacements for instructors of lower-level courses.

At medical colleges, by contrast, tenured faculty are typically the ones teaching students in their first two years, said John E. Prescott, chief academic officer at the Association of American Medical Colleges.

Students will encounter more nontenured faculty in their later years, when they enter a specialized medical field and spend more time working alongside doctors in a university hospital, Dr. Prescott said.

"I don't think tenure is going away any time in the near or in the distant future," he said.

The association's report, in the August edition of its newsletter, Analysis in Brief, was written by two association researchers, Sarah A. Bunton and April M. Corrice. The report said that in 2008, all but seven of the 126 schools accredited by the Liaison Committee on Medical Education still offered faculty tenure.

But, the authors said, only 25 percent of newly hired medical-school faculty were in tenure-eligible positions in 2009, down from 46.2 percent in 1984. "If we assume the average percent change in the proportion of faculty in tenure tracks continues to decrease 0.8 percent each year," the authors wrote, "we would see tenure positions disappear for newly hired clinical M.D. faculty by about the year 2040."

Similar trends are being seen throughout higher education. The overall proportion of college instructors who are tenured or on the tenure track has fallen from 57 percent in 1975 to 31 percent in 2007, according to Education Department figures. Updated departmental statistics, due this fall, are expected to show the proportion fell below 30 percent in 2009.

But Dr. Prescott said he takes with "a big grain of salt" the suggestion of tenure disappearing at medical schools by 2040. Most medical schools have no budget to increase their number of tenure positions, but they're also not cutting them, he said.

The data presented by Ms. Bunton and Ms. Corrice reflected that, showing the number of full-time clinical medical-doctor faculty who are tenured or on a tenure track increasing from about 17,000 in 1984 to about 22,000 in 2009. But new hires are increasingly likely to be focused on practicing medicine and patient care, rather than teaching and research and other traditional markers of tenure.