Publications and extramural activities of general internal medicine and medicine subspecialty clinician-educators: a multicenter study.

PURPOSE: Generalist clinician-educators may have more difficulty than specialists satisfying common promotion criteria (peer-reviewed publication and extramural reputation). This study compared publication rates and participation in extramural activities among subspecialist and generalist clinician-educators, and sought to determine the views of clinician-educators on the use of publication and reputation in determining their promotion. METHOD: A cross-sectional questionnaire was delivered to 526 clinician-educators identified by the chairs at ten randomly selected U.S. medical schools in 2002. RESULTS: A total of 270 clinician-educators responded. Medicine subspecialist clinician-educators reported more peer-reviewed publications than did general internal medicine (GIM) faculty (mean 26.4 versus 10.2, p < .003). Independent predictors of having a greater number of peer-reviewed publications were subspecialty membership (p < .01), less time spent in clinic (p < .01), focus of scholarship (p = .01), academic rank (p < .01), higher quartile of National Institutes of Health funding received by respondent's department (p < .01), and years on faculty (p = .03). A greater proportion of GIM faculty reported spending most of their protected time on scholarly activities less amenable to publication (p = .05). A greater proportion of subspecialists felt peer-reviewed publication should be required for promotion (p < .01), but a minority of both groups felt this should necessarily entail original research. CONCLUSION: Subspecialist clinician-educators generate significantly more peer-reviewed publications than do their GIM colleagues. clinician-educators hold diverse views on the role of publication and reputation in determining their promotion.