Picking a promotion track is similar to picking a major in college. You are given some time to get oriented and then you are expected to commit to a path. For example, many institutions allow junior faculty to remain “undecided” on their promotion track for as many as six years. If you are truly not sure what you want out of academic medicine or are not sure which track is right for you, then you should definitely stay undecided at the beginning of your junior faculty career. However, if you already have some idea of which track interests you, then it makes sense to commit to it relatively early, whether you end up sticking to it or not. Although not simple, most universities will allow you to change tracks. By far the most efficient strategy, which is especially important if you hope to devote significant time to your family during your first few years as a faculty member, is to pick your track early and stay on until promotion.
Each university has an Office for Medical Faculty Affairs (OMFA), usually staffed by a dean or deans and administrative assistants. If the office has a website, you can look over the promotion criteria for the track you are considering even before you’ve completed your final job negotiations. To understand the promotion criteria for each track at your own institution, you should visit the office within the first three months of starting any new faculty job. Attend faculty seminars on the subject of promotion and tenure. Bring those promotion criteria to your annual review with your immediate supervisor to be sure that you are, literally, “on track.”