Academic physician faculty are usually employed by an institution such as a medical school, a university, a hospital, or a specialty foundation. They serve as clinicians but also have significant roles as educators, researchers, and/or administrators. Academic physicians can pursue one of several different promotion tracks depending on both the policies of their institution and their individual interests. For example, the primary focus of a faculty member in a “teacher-scholar” track is medical education and, to some extent, medical education research. In contrast, the primary focus of a faculty member in a “research” track is either clinical or bench research. Research faculty will be expected, at some point in their careers, to generate either partial or complete salary support for themselves with grant funding. Although the exact names of these various tracks vary slightly by institution, the basic principles are relatively uniform across universities. Many institutions have what is referred to as an “up or out” policy for their academic faculty, regardless of track. “Up or out” means that unless you meet the criteria for promotion within a certain period of time in years, you may not be able to stay in your current job.