@moonbeam28 Paths generally are:
1) clinical - you can just see patients. You’ll do some teaching of residents and students in clinics but won’t be involved with leading courses persay or being a program admin. In this setup you’d probably be .75-1 FTE clinical and any remaining (if there is any) as “admin” time or education time.
2) education - you see patients but also have some time bought out (by the medical school or by the department) to lead educational initiatives (so will precept residents but also lead a course for the med school or also be an associate program director). In this setup you’d have .5-.75 FTE clinical and the rest for the education work.
3) research - you see patients (and probably precept residents and medical students) but spend the majority of your time doing research (and bringing in outside grants to cover your salary). Most common setup is .2 FTE clinical the rest research (though this varies - rare to see a serious physician-researcher be more than .5 FTE clinical though).
4) admin - you see patients (and again might precept residents or medical students sometimes) but have an admin role within the department (that the department buys out your clinical time so you can do it). This pathway usually includes folks with QI interests. Time varies widely - often start .75 FTE clinical and over the course of several years buy that time down to .5 or .25 FTE clinical and the rest for admin.
5) other - depending on where you work, you may do work outside the system for most of your time (consult for biotech, work for McKinsey) and come back just to do clinical work occasionally (again you may still precept residents and med students). This is usually less a “path” because you’re not so much in academia to be an academic but rather to have a clinical home, but some folks do still gain promotion via this route (especially at the Harvard affiliated hospitals and Stanford). Usually these folks are .25 FTE clinical or less, and they sometime even get their benefits and such through their “other” job.
These are the most common pathways, but depending where you are academia can let you create your own path a bit. Remember though, academic centers will expect you either bring in your own money to support your salary (the “other” pathway or research pathway) or provide a service they deem valuable (educational pathway or admin pathway) if you want to be able to get out of clinical time and maintain your salary. You can’t just say “I wanna do admin work in this area” or “I wanna teach more” because those things don’t bring in money, so they’re using clinical and research revenue to cover your costs, so if you want an educational or admin job you usually have to start more clinical and grow into the role. Also remember for promotional purposes, the most well-trodden pathways are usually easier to traverse (there is, for example, a more obvious, though maybe not “easier,” path to becoming a full professor if you do research where they can count pubs than to be an administrator where deliverables don’t look the same way).
Academia lets you wear many hats if you can convince people that what you’re interested in is important to the department (or if what you’re doing brings in money).
