Academic hospital medicine can be described as comprising periods of "systole," during which hospitalists provide clinical care, and periods of "diastole," the portion of a hospitalist's time spent in nonclinical activities. Far from being a period of relaxation, diastole is an active component of a hospitalist's work, the time devoted to the pursuit of career advancement. This period is a critical opportunity for career development in terms of medical research, education, quality improvement, or administration. An appropriate balance of systole and diastole may potentially prevent burnout and allow hospitalists opportunities to focus on academic advancement. Although an increasing number of residency graduates opt for a career in academic hospital medicine, few are prepared for the period of diastole. This article describes several career options in academic hospital medicine, specifically, opportunities in education, research, quality improvement, and administrative opportunities. By informing future hospitalists about the career opportunities within academic hospital medicine possible through managing their diastolic time, we hope that future generations of trainees will be better prepared to enter this field.
(c) 2006 Society of Hospital Medicine.