Just to clarify, what does "prestigious" means in this context? Is it "brand name" as in JHH, Duke, Penn, Yale, UMich, Northwestern, Emory, etc...? And then is "less prestigious" more like, "respected institution" on the order of UVA, Colorado, Maryland, OHSU, Miami, etc...?
I'm curious where the cutoff is. I've always heard things like, "you practically pay Hopkins for the privilege of working there," but I never knew how far down this extends. Are people still falling over themselves to work at UVA?
I ask because I'm an MSTP student interested in an academic career, and I always thought my ideal was working in a translational capacity at a place like BU, Tufts, Einstein, UCI, UCD, etc... (i.e., outside of the brand name, but great connections to high quality labs and industry). I have plenty of experience with the Hopkins, Harvard, and Stanford systems, and to be honest it seems pretty miserable to try to compete there. People endure a lot of abuse just for the name.
One last clarification, how far up can you advance your career on the non-tenure track? It seems like a more-or-less self-limited pathway. Do non-tenure track faculty ever become chiefs, chairs, or execs within the hospital system? What is the "end-goal" of a non-tenure track position? I think I'd get bored of my career if I ever got a position and there wasn't something higher to aspire towards.
Thanks again for the detailed responses. It's all extremely murky down here, and it seems like no one at my institution will give me any advice aside from "publish in Nature and start a lab because it looks good for our MSTP grant."
By prestigious I mean a brand-name hospital w/ an established research program, transplant, and a lot of NIH funding. Besides what you mentioned, MGH, Brigham, Columbia, UNC, Mayo, U of Chicago, WashU, UT Southwestern, Baylor, Colorado (historically one of the best), Pittsburgh, UCLA, USCF, UCSD, University of Washington, Stanford. These places usually pay fairly poorly, to both tenure track and clinical faculty. Clinical faculty are still expected to do research and run clinical trials, etc for the record I don't work at Colorado.
There are many great programs that don't have a US News top 25 brand-name, but have excellent clinical training and NIH funding: Minnesota, Iowa, Indiana, Ohio State, Kansas, Case Western, BU, and the places you mentioned, and many others. Generally these places pay better than the first group, to both research and clinical faculty. They have a harder time recruiting faculty and MSTPs because of their location and lack of name recognition and do better w/ local talent.
Finally there are a few places with a brand name that don't necessarily have NIH-funded research training programs and may be more difficult to launch a tenure-track research career: NYU, Cleveland Clinic are the ones that come to mind. They may pay poorly as well.
Non-tenure track faculty can advance in administrative and other roles for sure. They won't be division heads at their institutions, but they could become involved in med-Ed, QI/safety, become chief of clinical operations, and work into hospital administration executive roles if they're motivated and are given the opportunity. They could also transition to industry, especially if they are involved in clinical trials within their niche. There are a lot of different opportunities.
Just an example:
Clinical track professor at University of Chicago - 180-200k a year (they are currently advertising a position starting at 180k)
Research track at University of Chicago - probably 150K a year or less
Clinical track professor at University of Kansas - 350K a year + incentive
Research track professor at University of Kansas - 250K a year + incentive
Please note that these are generalizations based on my experiences and discussions with others. I'm sure there are plenty of exceptions. If you truly enjoy research, and want to have a successful research career, you will increase your likelihood of success starting at a big-name place and when you're NIH funded, could move to a less prestigious place and make more money if you wanted to. But even that is not a requirement or recipe for success.