title: Faculty Promotion and Attrition: The Importance of Coauthor Network Reach at an Academic Medical Center.
abstract: BACKGROUND
  Business literature has demonstrated the importance of networking and connections in career advancement. This is a little-studied area in academic medicine.
  
  
  OBJECTIVE
  To examine predictors of intra-organizational connections, as measured by network reach (the number of first- and second-degree coauthors), and their association with probability of promotion and attrition.
  
  
  METHODS
  Prospective cohort study between 2008 and 2012.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  A total of 5787 Harvard Medical School (HMS) faculty with a rank of assistant professor or full-time instructor as of January 1, 2008.
  
  
  METHODS
  Using negative binomial models, multivariable-adjusted predictors of continuous network reach were assessed according to rank. Poisson regression was used to compute relative risk (RR) and 95 % confidence intervals (CI) for the association between network reach (in four categories) and two outcomes: promotion or attrition. Models were adjusted for demographic, professional and productivity metrics.
  
  
  RESULTS
  Network reach was positively associated with number of first-, last- and middle-author publications and h-index. Among assistant professors, men and whites had greater network reach than women and underrepresented minorities (p < 0.001). Compared to those in the lowest category of network reach in 2008, instructors in the highest category were three times as likely to have been promoted to assistant professor by 2012 (RR: 3.16, 95 % CI: 2.60, 3.86; p-trend <0.001) after adjustment for covariates. Network reach was positively associated with promotion from assistant to associate professor (RR: 1.82, 95 % CI: 1.32, 2.50; p-trend <0.001). Those in the highest category of network reach in 2008 were 17 % less likely to have left HMS by 2012 (RR: 0.83, 95 % CI 0.70, 0.98) compared to those in the lowest category.
  
  
  CONCLUSIONS
  These results demonstrate that coauthor network metrics can provide useful information for understanding faculty advancement and retention in academic medicine. They can and should be investigated at other institutions.
authors.affiliation: Office for Diversity Inclusion and Community Partnership, Harvard Medical School, Boston, MA, USA. ewarner@hsph.harvard.edu.|Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA. ewarner@hsph.harvard.edu.
authors.forename: Erica T
authors.initials: ET
authors.lastname: Warner
authors.affiliation: Office for Diversity Inclusion and Community Partnership, Harvard Medical School, Boston, MA, USA.|Department of Global Health and Social Medicine, Harvard School of Medicine, Boston, MA, USA.
authors.forename: René
authors.initials: R
authors.lastname: Carapinha
authors.affiliation: Center for Biomedical Informatics, Harvard Medical School, Boston, MA, USA.|Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
authors.forename: Griffin M
authors.initials: GM
authors.lastname: Weber
authors.affiliation: Office for Diversity Inclusion and Community Partnership, Harvard Medical School, Boston, MA, USA.
authors.forename: Emorcia V
authors.initials: EV
authors.lastname: Hill
authors.affiliation: Office for Diversity Inclusion and Community Partnership, Harvard Medical School, Boston, MA, USA.
authors.forename: Joan Y
authors.initials: JY
authors.lastname: Reede
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data*; D000328:Adult; D002322:Career Mobility; D004522:Educational Status; D005180:Faculty, Medical / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010506:Periodicals as Topic; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014481:United States
keywords: careers; faculty development; promotion; retention