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U.S. Medical School Full-time Faculty Attrition. Association of American Medical Colleges

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Abstract

In the past several decades, U.S. medical schools experienced remarkable growth of full-time faculty members from 30,000 to more than 140,000. 1,2 Throughout this growth, medical schools and the academic medicine community have maintained high interest in retaining faculty to effectively achieve their clinical, education, and research missions. Direct and hidden costs for faculty attrition are notable and drain the financial, personnel, and facility resources from institutions already under economic pressures. 3 Previous studies related to attrition have focused on assessing long-term retention rates by taking snapshots of faculty members after a certain amount of time elapsed (e.g., five or 10 years) 4,5 These snapshots facilitate institutional benchmarking against national norms because the method is straightforward and easy to replicate. However, such snapshots are not ideal for comparing change in retention rates over time or across distinct groups. Instead, labor market analysts interested in learning about change in retention over time, or differences across groups, employ life table and survival analysis methods by observing time to departure (or attrition). 6 Such methods facilitate a more complete picture of longitudinal outcomes and allow mediating factors to be controlled. As such, this Analysis in Brief presents updated faculty attrition statistics and operationalizes retention rates in terms of time from initial appointment to time of departure in order to draw inferences about factors associated with retention. Methodology Data for this analysis come from the AAMC Faculty Roster, a comprehensive national database on the employment 1 Bunton SA, Henderson MK. A. Some hidden costs of faculty turnover in clinical departments in one academic medical center. Academic Medicine. 2009;84(1):32–36. 4 Alexander H, Lang J. The long-term retention and attrition of U.S. medical school faculty.
IN BRIEF
Analysis
Volume 14, Number 2
February 2014
Association of
American Medical Colleges
U.S. Medical School Full-time Faculty Attrition
In the past several decades, U.S.
medical schools experienced
remarkable growth of full-time faculty
members from 30,000 to more than
140,000.1,2 Throughout this growth,
medical schools and the academic
medicine community have maintained
high interest in retaining faculty
to effectively achieve their clinical,
education, and research missions.
Direct and hidden costs for faculty
attrition are notable and drain the
financial, personnel, and facility
resources from institutions already
under economic pressures.3
Previous studies related to attrition
have focused on assessing long-term
retention rates by taking snapshots of
faculty members after a certain amount
of time elapsed (e.g., five or 10 years)4,5
These snapshots facilitate institutional
benchmarking against national norms
because the method is straightforward
and easy to replicate. However, such
snapshots are not ideal for comparing
change in retention rates over time or
across distinct groups. Instead, labor
market analysts interested in learning
about change in retention over time,
or differences across groups, employ
life table and survival analysis methods
by observing time to departure (or
attrition).6 Such methods facilitate a
more complete picture of longitudinal
outcomes and allow mediating factors
to be controlled. As such, this Analysis
in Brief presents updated faculty
attrition statistics and operationalizes
retention rates in terms of time
from initial appointment to time of
departure in order to draw inferences
about factors associated with retention.
Methodology
Data for this analysis come from the
AAMC Faculty Roster, a comprehensive
national database on the employment
1 Bunton SA, Henderson MK. Handbook of Academic Medicine: How Medical Schools and Teaching Hospitals Work. Washington, DC: Association of American Medical Colleges, 2013.
2 Liu C, Alexander H. The changing demographics of full-time U.S. medical school faculty, 1966–2009. Analysis in Brief. 2011;11(8):1–2.
3 Schloss E, Flanagan D, Culler C, Wright A. Some hidden costs of faculty turnover in clinical departments in one academic medical center. Academic Medicine. 2009;84(1):32–36.
4 Alexander H, Lang J. The long-term retention and attrition of U.S. medical school faculty. Analysis in Brief. 2008;8(4):1–2.
5 Corrice AM, Fox S, Bunton SA. Retention of full-time clinical M.D. faculty at U.S. medical schools. Analysis in Brief. 2011;11(2):1–2.
6 Blossfeld HP, Rohwer G. Techniques of Event History Modeling. New Approaches to Causal Analysis. 2nd ed. Mahwah, NJ: Lawrence Erlbaum Associates, 2002.
Table 1: Retention and Attrition Statistics for New Assistant Professors or Associate Professors Entering Faculty at Institution in 2000
Study Group
New Assistant Professors New Associate Professors
Cohort
Size
Average
Years of
Retention
Years
Until 25%
Attrition
Years
Until 50%
Attrition
Cohort
Size
Average
Years of
Retention
Years
until 25%
Attrition
Years
until 50%
Attrition
All Faculty 6147 8.3 4.0 8.1 1062 9.4 5.2 10.7
Clinical Departments
M.D. or Equivalent 3944 8.2 3.9 7.9 633 9.0 4.9 9.8
Ph.D. or Equivalent 932 8.2 4.5 8.0 175 9.8 6.2 12.3
M.D./ Ph.D. or Equivalent 468 8.3 4.4 8.4 98 9.4 5.0 11.2
Basic Science Departments
M.D. or Equivalent 86 8.3 4.1 8.4 N/AbN/AbN/AbN/Ab
Ph.D. or Equivalent 509 8.9 5.8 9.3 104 10.9 7.6 N/Ab
M.D./ Ph.D. or Equivalent 103 7.6 4.0 7.1 N/AbN/AbN/AbN/Ab
Men 3886 8.3 4.0 8.0 789 9.4 5.0 10.6
Women 2253 8.2 4.0 8.1 272 9.5 5.7 11.1
White (Non-Hispanic/Latino) 4067 8.4 4.0 8.5 804 9.6 5.6 11.2
Asian 1089 7.7 3.9 6.9 129 8.8 4.3 10.0
Black or African-American 230 7.4 3.0 6.7 N/AbN/AbN/AbN/Ab
Hispanic/Latinoa286 7.9 3.9 7.3 42 8.4 3.5 10.2
Tenure Track 1560 9.0 5.8 9.2 349 10.8 7.5 N/Ab
Non-tenure Track 4587 8.0 3.8 7.5 713 8.7 4.3 9.0
a. This group includes those of Spanish origin.
b. Due to a small sample size of <30 or that that less than half of cohort 2000 have left the institution, the statistics for this group is not available.
Analysis IN BRIEF
and demographic backgrounds of
all individual medical school faculty
members at U.S. medical schools
accredited by the Liaison Committee
on Medical Education. Every full-time
assistant, associate, and full professor
was tracked by academic year from their
first appointment to their first departure
from the institution, regardless of
whether individuals had appointments
in different departments.7 The yearly
attrition rates for decennial cohorts, the
average years until attrition occurred,
and the 25th percentile and median
years until attrition occurred (i.e., the
number of years elapsed when 25 percent
and 50 percent of the faculty from an
original cohort had left their home
institution) were all examined for cohorts
from each year from 1970 to 2000.
Demographic information such as race,
sex, department, degree, and tenure track
status were included in the analysis. The
last cohort with results presented in this
analysis was of faculty entering medical
school in the year 2000, as that was
the last year where half of the new full
professors in the initial cohort had left
their institution by the year 2013.
Results
Summary statistics for new assistant and
associate professors who started their
new appointment at an institution in
2000 show that assistant professors left
more quickly than associate professors
(Table 1).8 Results also show that that
faculty with M.D. degrees left institutions
more quickly than faculty with Ph.D.
degrees, and that faculty in clinical
departments left more quickly than their
counterparts in basic science departments.
Women left their institutions at similar
rates as men at the assistant professor
level, but at a slower pace at the associate
professor level. Non-white faculty left
more quickly than white faculty at both
assistant and associate levels.
Next, results show that assistant professors
left their institutions at the fastest rate,
while attrition for full professors occurred
at a much slower rate (Figure 1). From
the 1970 cohort to the 2000 cohort,
attrition rates declined modestly
(i.e., more faculty were retained) for
assistant and associate professors, but
increased modestly (i.e., more faculty
left) for full professors. However, these
trends fluctuated irregularly. (See the
Supplemental Material for an alternate
view of the modest declines in rates of
attrition among assistant professors over
time and for additional results.)
Discussion
These results highlight an alternate
method for understanding faculty
retention that compares attrition rates
across time as well as across groups
(defined by rank, gender, race/ethnicity,
department of appointment, and degree
type). Instead of observing five- or
10-year retention rates, the survival
analysis (time to departure) that is
common with clinical studies of health
outcomes was applied. The department,
degree, rank, and demographic
breakouts presented in this analysis
reflect similar findings to a 2008 analysis
of faculty retention and attrition.4
While attrition rates vary among
medical schools, what constitutes
reasonable retention and attrition
depends on the specific context of a
medical school, department, or faculty
member. Nonetheless, this study may
provide insight into various policy
issues. Decreased retention for full
professors, along with the increasing
number of faculty members in medical
schools, raise questions of how best to
recruit and support junior faculty, as
well as mid-career mentoring plans to
advance associate professors.
Unlike previous findings that women
faculty had lower retention rates,4,9 these
results show that women are comparable
in years of retention with men, and
retained slightly longer in recent years.
However, minority faculty depart
sooner at both assistant and associate
professor level, pointing to challenges for
recruitment, promotion, and mentoring
programs. Further research that
investigates the contribution of various
individual and school factors to faculty
time to attrition is currently in progress.
Authors:
Christine Qi Liu, Ph.D., Senior
Research Analyst, Research and Data
Programs, cliu@aamc.org
Emory Morrison, Ph.D., Director,
Policy Research Studies, Research
and Data Programs,
emorrison@aamc.org
Association of
American Medical Colleges
2450 N Street, N.W.
Washington, D.C. 20037-1127
analysis@aamc.org
www.aamc.org/data/aib
7 Here, departure is defined as an individual faculty who has a break longer than two years in their appointment histories at
the institution.
8 Statistical significance test is not conducted for this analysis since the Faculty Roster database contains the entire popula-
tion of U.S. full-time faculty. See: Steel R, Torrie J, Dickey D. Principles and Procedures of Statistics: A Biometrical Approach,
New York: McGraw-Hill; 1996.
9 Yamagata H. Trends in faculty attrition at U.S. medical schools, 1980-1999. Analysis in Brief. 2002;2(2):1–2.
Figure 1: Median Number of Years Since First Appointment that U.S. Medical School Faculty with
M.D. Degree Left Institution, By Rank
IN BRIEF
Analysis
Volume 14, Number 2
February 2014
Association of
American Medical Colleges
U.S. Medical School Full-time Faculty Attrition
Supplemental Material
Supplemental Figure 1: Retention Rates of New U.S. Medical School Assistant Professors
by Number of Years at Institution
Supplemental Figure 2: Retention Rate of New U.S. Medical School Associate Professors
by Number of Years at Institution
Supplemental Figure 3: Retention Rate of New U. S. Medical School Full Professors by
Number of Years at Institution
Supplemental Figure 4: Number of Years Since First Appointment that 25% of U.S. Medical
School Faculty with M.D. Degree Left Institution, by Rank
Supplemental Figure 5: Number of Years Since First Appointment that 25% and 50% of
U.S. Medical School Faculty with Ph.D. Degree Left Institution, by Rank
... [17][18][19] These data add support for the role of formal mentoring programs at academic health centers to support the biomedical research workforce. 16,20 The CATS program also supports inclusion. The availability of the holistic program open to all faculty members may have facilitated the mentoring of women and URM investigators, who may struggle in academic medicine to access mentors. ...
... The availability of the holistic program open to all faculty members may have facilitated the mentoring of women and URM investigators, who may struggle in academic medicine to access mentors. 7,16,21 Following implementation of the CATS program, the proportion of women amongst all child heath investigators with career development awards increased significantly, and CATS scholars include more than 10% from URM backgrounds. The matrix of mentors may be particularly effective for groups with limited opportunities for dyadic mentoring. ...
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