What is career success for academic hospitalists? A qualitative analysis of early-career faculty perspectives

BACKGROUND: Understanding the concept of career success is critical for hospital medicine groups seeking to create sustainably rewarding faculty positions. Conceptual models of career success describe both extrinsic (compensation and advancement) and intrinsic (career satisfaction and job satisfaction) domains. How hospitalists define career success for themselves is not well understood. In this study, we qualitatively explore perspectives on how early-career clinician-educators define career success. METHODS: We developed a semistructured interview tool of open-ended questions validated by using cognitive interviewing. Transcribed interviews were conducted with 17 early-career academic hospitalists from 3 medical centers to thematic saturation. A mixed deductiveinductive, qualitative, analytic approach was used to code and map themes to the theoretical framework. RESULTS: The single most dominant theme participants described was “excitement about daily work,” which mapped to the job satisfaction organizing theme. Participants frequently expressed the importance of “being respected and recognized” and “dissemination of work,” which were within the career satisfaction organizing theme. The extrinsic organizing themes of advancement and compensation were described as less important contributors to an individual’s sense of career success. Ambivalence toward the “academic value of clinical work,” “scholarship,” and especially “promotion” represented unexpected themes. CONCLUSIONS: The future of academic hospital medicine is predicated upon faculty finding career success. Clinicianeducator hospitalists view some traditional markers of career advancement as relevant to success. However, earlycareer faculty question the importance of some traditional external markers to their personal definitions of success. This work suggests that the self-concept of career success is complex and may not be captured by traditional academic metrics and milestones.