When should you start planning your road to promotion and tenure in academic medicine?

The bad news: before you are hired.

The good news: unless your tenure clock expires in the next couple of years, you still have time to make things work.

The first step in planning involves knowing yourself and what you want. Yes, some intensive navel gazing will have to happen so you can identify your skills and passions. You probably have many skills, but not all of them are equal. What can you do best? Even more importantly, what do you love to do? What tasks at work fly by quickly in full color? Which parts of the job are chores that drag on in black and white? Academic medicine involves a lot of work and effort; you do not want to spend 60 hours or so each week miserable and unfulfilled!

It is always best if your institution has hired you to do what you want to do. In an ideal world, you will have some idea of your skills and passions before you job hunt. After all, taking a tenure-track position with the expectation of building a laboratory research program will leave to tragedy if you hate being in the lab! Trying to change the position to fit you better is never as easy as making a good match in the first place.

So what if you are a couple of years into a position and you have just now figured it out? It is time to talk with your supervisors. You need to know if what you want to accomplish will get you ahead in your current job. Most institutions have some flexibility with faculty, especially in clinical departments. You may end up deciding a job search is in order.

Once you know what you want to accomplish, it’s time to make sure you can make it happen.