Factors associated with academic rank among chronic pain medicine faculty in the USA

Background Numerous factors are considered in the academic promotion of pain medicine physicians. In this study, we investigated the importance of research productivity, career duration, leadership, and gender on attaining professorship in chronic pain medicine fellowship programs in the USA. Methods We identified 98 pain fellowship programs in the American Medical Association Fellowship and Residency Electronic Interactive Database. Faculty demographics and institutional characteristics were obtained from institutional websites, and h-index (number of publications (h) cited at least h times) and m-index (h-index divided by research career duration) were calculated from Scopus. A nested mixed effect hierarchical modeling was used to determine factors that were associated with attaining professorship. Results A total of 696 chronic pain medicine faculty members from 98 academic pain fellowship programs were identified, of whom 74.7% were males. For the 15.5% who were full professors, the median h-index was 16.5 (6.0 to 30.0), the median career duration was 20.5 (16.0 to 27.0) years, and the median m-index was 0.7 (0.3 to 1.3). In an adjusted analysis, the top quartile (compared with bottom) h-index (OR 6.27; 95% CI: 2.11 to 18.59), publication citations (OR 1.13; 95% CI: 1.10 to 1.21), division chief position (OR 3.72; 95% CI: 1.62 to 8.50), institutions located in the western region (OR 3.81; 95% CI: 1.52 to 9.57), and graduating from a foreign medical school (OR 1.98; 95% CI: 1.10 to 3.92) were independently associated with attaining professorship (p<0.05), but gender was not (p=0.71). Conclusions Our study shows that, higher h-index, publication citations, division chief position, affiliation at a lower tier medical school, and location in the Western region were independently associated with full professorship, whereas gender was not. The identified variables for professorship may be considered as factors in faculty promotions.