Civility and Academic Advancement: Evaluating Its Roles in United States Medical School Appointment, Promotion, and Tenure Policies.

Civility, encompassing respect and courtesy, is fundamental to healthy workplace environments but remains inconsistently addressed in academic medicine. This study investigates whether United States (U.S.) medical schools include civility as a criterion in Appointment, Promotion, and Tenure (APT) policies. From August to October 2024, we reviewed publicly accessible APT documents from 143 U.S. medical schools and identified 103 eligible schools. We conducted a keyword-based content analysis using 21 civility-related terms grounded in peer-reviewed literature. While 58.3% of documents referenced professionalism and 23.3% referenced respect or collegiality, only 4.9% mentioned terms like "civil," "bully," or "mistreat." Although 26.2% of APT documents referenced codes of conduct, none included accessible links or consequences for uncivil behavior. Our findings align with the American Association of University Professors' (AAUP) position that discourages civility as a promotion criterion. However, excluding civility from APT policies may allow incivility to persist unchecked, which can ultimately negatively impact patient care and the healthcare environment. These results suggest the need for standardized institutional processes to report and address incivility, supporting a safe academic environment.