"I Can Open the Door": Sponsorship Roles and Practices in Academic Medicine.

BACKGROUND: Sponsorship provides academic medicine faculty with increased visibility, opportunities, and enhanced professional networks to support their career advancement. However, sponsorship often occurs out of sight, without metrics or tracking mechanisms, and depends on access to influential people who choose to extend such opportunities. Given the importance of sponsorship for career advancement, understanding how leaders think about and use sponsorship is critical for understanding the process by which faculty advance in their careers and attain positions of power. OBJECTIVE: Our aim was to examine how leaders in academic medicine approach and perform sponsorship. DESIGN: We conducted semi-structured qualitative interviews with leaders in a large academic Department of Medicine. PARTICIPANTS: Fifteen leaders ranging from division and section chiefs through higher leadership, including the dean's office. APPROACH: Interviews explored leaders' current sponsorship practices, perception of sponsorship roles and responsibilities, guiding principles, and areas for institutional improvement. Data were coded following an inductive thematic analysis approach. KEY RESULTS: All leaders engaged in sponsorship; some saw it simply as part of their leadership responsibilities, while others viewed it as a passion and core mission. Multiple factors influenced their sponsorship decisions, such as familiarity with sponsees (including previous/potential performance, and career goals), and equity in distribution of opportunities. Leaders relied on robust professional networks and their institutional influence for effective sponsorship. They highlighted inherent bias in sponsorship practices and the need for additional infrastructure to support equitable sponsorship. Barriers to effective sponsorship included inadequate time, uncertainty about best practices, and lack of institutional support. CONCLUSIONS: Academic medicine leaders are committed to sponsorship and frequently engage in sponsorship for their faculty's career development. However, lack of time, clear expectations, and institutional support are barriers to its use. Our findings underscore the need for explicit definitions, transparency, and institutional support of sponsorship to promote equitable career advancement.