Sponsorship and Career Advancement for Asian Medical Faculty.

Importance: Asian faculty members remain underrepresented in leadership positions within academic medicine, despite comprising a substantial proportion of the workforce. The structural and cultural factors associated with the slower advancement remain underexplored in empirical literature and institutional policy. Objectives: To examine the barriers to career advancement among Asian faculty members, assess perceptions and understanding of sponsorship, and identify institutional strategies to promote broader access to sponsorship opportunities and leadership development. Design, Setting, and Participants: This qualitative study employed 5 focus groups conducted between January 18 and July 17, 2024, supplemented by real-time polling before and after an educational intervention. Thematic analysis of transcripts was used to identify common barriers and recommendations, with poll data providing a descriptive context. In a single, large private nonprofit and research intensive academic medical center in the northeastern United States, self-identified Asian or Asian American midlevel faculty members at the associate professor level participated. Participants were recruited via institutional office outreach, and responses from all recruited participants were included in the study. Data were analyzed from July 25 to September 24, 2024. Exposure: An educational session distinguishing sponsorship from mentorship, followed by a facilitated group discussion and anonymous survey participation using the Poll Everywhere platform. Main Outcomes and Measures: Primary outcomes included changes in participants' self-reported understanding of sponsorship and identification of perceived personal, institutional, and departmental barriers to career advancement. Thematic categories were derived from focus group transcripts and corroborated with quantitative poll responses. Results: Of the 32 participants who completed the survey, 18 (56.3%) initially believed that they had a sponsor; after the intervention, this percentage decreased to 37.5% (12 of 32) once sponsorship was more clearly defined. The participation rate was 93.7% (30 of 32) among those who joined the focus groups. Reported barriers included cultural norms discouraging self-promotion, limited access to decision-makers, intersectional identity challenges, and perceptions of institutional opacity and favoritism. Faculty emphasized the value of transparent nomination processes, intentional sponsor training, and relationship-centered sponsorship models. Conclusions and Relevance: In this qualitative study of midlevel Asian faculty members, participants faced persistent, multifactorial barriers to leadership in academic medicine, amplified by cultural values and institutional norms. Institutions must formalize sponsorship programs, ensure transparent advancement pathways, and foster culturally informed leadership development. Doing so may meaningfully advance deserving Asian faculty members and diversify academic medicine's leadership pipeline.