In this episode, Dr. Stacey Ishman unpacks one of the most common and frustrating experiences in academic medicine: working hard, staying busy, and still feeling stalled when it comes to promotion. She explains why promotion criteria alone are not enough, how interpretation—not effort—drives advancement decisions, and why many early-career physicians unknowingly drift off track.

This episode is especially for physicians in their first 10 years of practice who feel productive, valued, and praised—but unclear on whether their work is actually moving them toward promotion. Dr. Ishman walks through how promotion committees really evaluate candidates and how to shift from being busy to building a coherent academic narrative.

No need to take notes—check out the blog for a written summary of these insights.

If you want support translating promotion criteria into a strategy that reflects how decisions are actually made, join the Medical Mentor Coaching community.

1. Why Promotion Criteria Create False Security (0:00 – 1:00)
Why written promotion documents feel reassuring—but often fail to explain how decisions are actually made
The difference between published criteria and real-world interpretation

2. The Hidden Problem: Interpretation, Not Access (1:00 – 3:00)
Why most institutions make promotion criteria easy to find
How ambiguity around “reputation” (regional, national, international) creates confusion
Why following the rules doesn’t guarantee advancement

3. Promotion Readiness Is Rarely Explicit (3:00 – 5:00)
Why many faculty never have formal promotion readiness conversations
How changing tracks and criteria over time increase misalignment
The cost of outdated or incomplete advice

4. Track Matters More Than Volume (5:00 – 8:00)
How clinician, educator, researcher, and administrative tracks differ
Why excellent work can look weak if it doesn’t tell a clear story
Examples of work that may or may not count depending on track

5. Adequate vs. Strong Evidence of Impact (8:00 – 9:30)
What promotion committees mean by “strong” reputation
Why expectations vary by institution and rank
Why asking for examples of successful CVs matters

6. Busy Is Not the Same as Aligned (9:30 – 11:30)
Why committees don’t see effort—they see patterns
How scattered excellence stalls promotion
The difference between productivity and trajectory

7. A Real Case of Promotion Drift (11:30 – 13:00)
How a packed CV still failed to support promotion
Why the issue was misalignment, not underperformance
What changed once expectations were clarified

8. The Emotional Cost of Unclear Promotion Systems (13:00 – 14:30)
How stalled promotion erodes confidence and engagement
Why unclear systems—not personal failure—drive frustration and attrition

9. The Truth That Changes the Outcome (14:30 – End)
Why promotion stalls are rarely about not working hard enough
How criteria without interpretation create drift
Action steps to regain clarity and momentum

Promotion committees do not confirm checklists. They interpret patterns. Advancement depends on a coherent academic narrative, evidence of impact at the appropriate level, and visible trajectory over time. When criteria change or interpretation is unclear, even highly productive physicians can drift off course.

If your CV is full but your path feels uncertain, the issue is often structural—not personal. Clarity, alignment, and intentional strategy are what turn busy work into forward momentum.

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