the promotion as an associate professor ( ap ) represents the final academic step followed only by a full professorship at german universities .
the academic degree of an associate professor is invested by faculties to persons , which have received a doctorates degree , have qualified as a professor by writing a habilitation thesis and obtained postdoctoral lecture qualification .
the academic degree as an ap can not be distinguished by outsiders to a full university professor as the special prefix 
however , at most of the german medical faculties the nomination for an associate professor does not only involve the completion of a certain time frame , but is also connected to a continuous and outstanding research performance as well as academic teaching . as pabst and strate
have already noticed in 2000 and as an actual wikipedia description of german associate professors (  auerplanmiger professor  ) further delineates , that the title of an associate professor is invested above average especially in medicine , next to medical doctorates (  dr.med .
 ) and assistant professors (  privatdozent  ) ( http://de.wikipedia.org/wiki/professur ) , . the requirements for assistant professors to become an associate professor , however , differ substantially between the 35 german medical faculties . in the year 2000
several points for a standardization and simplification of the preconditions to become an associate professor have already been discussed .
the basis for these postulations has been a first appraisal of different parameters of the regulations for associate professors at german medical faculties at that time . to establish a solid comparability
, we performed a systematic qualitative as well as quantitative scoring of different parameters of the requirements to become an associate professor at german medical faculties for the first time .
inquiries of the regulations to become an associate professor ( ap ) the ap - regulations have been downloaded of the respective internet sites of the different german medical faculties or have been ordered and sent via e - mail . in the case
that special information could not be gained from the regulations , medical faculties have again been contacted via e - mail or telephone for respective details . using this technique 35 out of 36 ( 97% ) ap - regulations could be included into this evaluation . in one case ,
the authors could not obtain the regulation neither electronically nor via telephone as the respective document must be used as an internal university document for assistant professors only .  
the following seven parameters are preconditions for the appointment of an ap at german medical faculties , which have been analyzed , evaluated and described .
the regulations have been evaluated with special interest to the quality of the performance of the candidates .
the respective criteria have been summarized in groups of similar requirements and have then been assessed with a simple scoring system with increasing precision of the information or requirement description as similarly published recently , . herein , the ap - regulation of the medical faculties could reach scores between 0 and 20 points .
scientific publication 0 points : no detailed information available1 point : no information of necessary numbers 2 points : information on quality  published in appropriate scientific journals or listed in current contents 3 points : information on authorship and quality  preferably as single author or manuscripts with creativity that attest scientific competence 4 points : information on authorship and quality  sufficient and/or adequate quantity of publications in renowned international scientific journals  6 - 12 original articles in renowned international scientific journals 5 points : detailed information on quantity , quality and authorships  10 publications , thereof 6 as first author in peer reviewed journals  8 - 10 high ranked original articles predominantly as first author  10 publications as first author , thereof 5 in renowned scientific peer reviewed journals  12 original articles , 8 first authorships , impact factor 10 in renowned scientific peer reviewed journals 0 points : no detailed information available 1 point : no information of necessary numbers   2 points : information on quality  published in appropriate scientific journals or listed in current contents   3 points : information on authorship and quality  preferably as single author or manuscripts with creativity that attest scientific competence   4 points : information on authorship and quality  sufficient and/or adequate quantity of publications in renowned international scientific journals  6 - 12 original articles in renowned international scientific journals   5 points : detailed information on quantity , quality and authorships  10 publications , thereof 6 as first author in peer reviewed journals  8 - 10 high ranked original articles predominantly as first author  10 publications as first author , thereof 5 in renowned scientific peer reviewed journals  12 original articles , 8 first authorships , impact factor 10 in renowned scientific peer reviewed journals 2 .
research performance 0 points : no detailed information available1 point : unclear description of achieved research work2 points : qualified research work or successful research for several years 3 points : qualified research work with raised third - party funds4 points : qualified research work with raised third - party funds and presentation of future research projects and possible perspectives at the respective institution in research and teaching 0 points : no detailed information available 1 point : unclear description of achieved research work 2 points : qualified research work or successful research for several years   3 points : qualified research work with raised third - party funds 4 points : qualified research work with raised third - party funds and presentation of future research projects and possible perspectives at the respective institution in research and teaching 0 points : no detailed information available or optional documentation1 point : documentation without specifications 2 points : with quality requirements ( successful in teaching)3 points : with quantitative requirements such as one semester with documentation of at least 15h lecture activity 4 points : with quantitative requirements such as several semesters with at least 4 semesters required courses or 4 years of active practical activity in teaching 5 points : with quantitative requirements such as several semesters and additional evaluation of the didactic ability by students or faculty members   0 points : no detailed information available or optional documentation 1 point : documentation without specifications   2 points : with quality requirements ( successful in teaching ) 3 points : with quantitative requirements such as one semester with documentation of at least 15h lecture activity   4 points : with quantitative requirements such as several semesters with at least 4 semesters required courses or 4 years of active practical activity in teaching   5 points : with quantitative requirements such as several semesters and additional evaluation of the didactic ability by students or faculty members   4 .
scientific conference presentations /posters 0 points : no detailed information on scientific presentations or posters1 point : list on scientific presentations or posters2 points : detailed list on scientific presentations or posters with information on quantity , quality and authorship or specification on the five most important presentations 0 points : no detailed information on scientific presentations or posters 1 point : list on scientific presentations or posters 2 points : detailed list on scientific presentations or posters with information on quantity , quality and authorship or specification on the five most important presentations 5 .
reduction of the minimum time as an assistant professor 0 points : no reduction possible or no description1 point : the reduction of the minimum time as an assistant professor is possible by being listed on the nomination list to a full university professorship or other excellent or extraordinary achievements 0 points : no reduction possible or no description 1 point : the reduction of the minimum time as an assistant professor is possible by being listed on the nomination list to a full university professorship or other excellent or extraordinary achievements 6 .
recommendation of candidates by faculty members   0 points : recommendation is not necessary ; application by candidate itself is possible1 point : the recommendation of respective candidates by one or more members of the faculty is expected 0 points : recommendation is not necessary ; application by candidate itself is possible 1 point : the recommendation of respective candidates by one or more members of the faculty is expected 7 .
evaluation of the capabilities being an associate professor   0 points : no evaluation necessary or no detailed information available 1 point : evaluation by to internal reviewers of the faculty 2 points : evaluation by several reviewers , thereof one reviewer has to be from another university or medical school ( external review )   0 points : no evaluation necessary or no detailed information available   1 point : evaluation by to internal reviewers of the faculty   2 points : evaluation by several reviewers , thereof one reviewer has to be from another university or medical school ( external review )
the ap - regulations of all 35 german medical faculties in 2010 have been 3.70.6 years old ; with the oldest one being 15 years old and four faculties presented actual regulations from the year 2010 . from the 35 included
ap - regulations 7 have been valid for the entire university ( 20% ) , while the majority ( n=28 ) has been especially designed for medical faculties ( 80% ) .
the total score for the requirements to become an associate professor at german medical faculties is 13.50.6 ( 95% confidence interval 12.2  14.7 ) , while three faculties could reach 19 of 20 possible scoring points .
the 35 included ap - regulations of german medical faculties have been analyzed and scored for seven main items as summarized in table 1 ( tab .
1 ) . in agreement with all analyzed actual regulations , only the criterion of a respective teaching activity has been designated by all medical faculties ( 100% ) . in 94% candidates mandatorily need adequate research achievements .
furthermore , 29 out of 35 medical faculties claim an evaluation of the candidates and at 24 locations ( 69% ) the candidate may only apply for a nomination with a recommendation of a faculty member .
reduction of the minimum time as an assistant professor is possible at 16 medical faculties after second to third place listing on the nomination list in an appointment process for a full university professorship . scientific publication . in only two ap - regulations
most of the medical faculties ( 51% ) could reach the highest score value ( 5 points ) in this category , with detailed information on quantity , quality and first or last authorships ( see table 2 ( tab .
are requested of the assistant professors for a successful application in the respective minimum time .
three medical faculties ( 8.6% ) do not give any information on the required research work ( 0 points ) and in seven ap - regulations ( 20% ) only imprecise information is given ( 1 point ; 20% ) .
after reaching successful postdoctoral lecture qualification or nomination for an assistant professorship , eight medical faculties ( 22.9% ) claim ongoing scientific work for several years .
detailed information on the respective research performance with successful raise of third - party funds is given in 31.4% .
four medical faculties additionally demand a perspective concept on future research and teaching performance of the candidates at the respective institutions ( 5 points ; see table 2 ( tab . 2)).teaching activity .
the actual evaluation of the teaching activity in the included ap - regulations feature detailed information on form , extent and content of the required teaching modalities for becoming an associate professor . while ten years ago only ten medical faculties ( 28% ) have given some information on the minimum teaching qualifications , the actual analysis of the ap - regulations reveals , that specific information is given in more than 80% ( n=28 ) of the regulations , reaching score values of 3 ( see table 2 ( tab .
the candidates are allowed to perform every kind of teaching ( lectures , seminars , practical courses ) . at six medical faculties , the ap - regulations claim an additional evaluation of the lectures by students or other faculty members ( see table 2 ( tab .
the minimum time requirements , however , differ substantially and are markedly increased at some universities since the year 2000 , ranging from 1.5 to 4 semester periods per week ( spw ) . at some medical faculties , candidates , which act predominantly in patient care , are allowed to reduce the minimum spw by 50% .
a further criterion for a successful teaching performance is the mentoring of doctorate or diploma theses . at 21 medical faculties this is a favored or demanded issue , correlating with an increase of 87.5% in comparison to the year 2000 data , .scientific conference presentation / posters .
an additional criterion for the successful nomination of an associate professor are scientific presentations or posters .
54.3% of medical faculties do not attach importance on the active participation on scientific congresses or meetings ( see figure 1 ( fig .
a ( detailed ) listing of all oral or poster presentations is required for the ap - application .
the nomination of an associate professor can be invested from universities to persons , who have shown outstanding performance and qualifications .
the nomination requires a successful and independent performance in research and teaching over several years .
after the nomination for an assistant professor or reaching postdoctoral lecture qualification , german medical faculties expect different minimum times before these candidates may apply for the associate professor nomination , averaging 4.50.3 years ( 95% confidence interval 3.8  5.8 ) .
this period of time might be reduced for candidates , which have shown extraordinary scientific performance at 54.3% of german medical faculties .
this is especially the case , if the candidates have been listed on the nomination list in an appointment process for a full university professorship ( secundo et tertio loco ) .
furthermore , it can also be reduced , when an outstanding scientific price could be won in the area of expertise or in medicine in general .
at one medical school , the ap - regulations point out that the rejection of a first place listing ( primo loco ) in an appointment process might directly lead to the nomination as an associate professor.recommendation of candidates by faculty members .
at 25 medical faculties ( 28.6% ) assistant professors , which have fulfilled the respective requirements , are not allowed to apply for the ap - nomination .
the application process may only start by a recommendation of members or representatives of the faculty or full university professors .
these persons are requested to write a recommendation letter or favor the candidates with corresponding documents for the ap - nomination . in all other faculties
the candidates are allowed to hand in all documents which are required for the nomination process on their own ( see figure 1 ( fig .
the abilities and performance for assistant professors , which apply for the nomination to become an associate professor , have to be evaluated by reviewers at most medical faculties .
an evaluation is not necessary or is not described in the ap - regulations ( 0 points ) at five medical faculties .
the evaluation of the candidates by internal reviewers only , is necessary at three faculties ( 1 point ) .
the majority ( n=27 ) , however , requires an evaluation process , which is supported by an external reviewer from a different university . on average
21 reviewers have to evaluate the candidates , focusing not only on the required issues , but also on the general ability for a nomination as an associate professor .   scientific publication . in only two ap - regulations
most of the medical faculties ( 51% ) could reach the highest score value ( 5 points ) in this category , with detailed information on quantity , quality and first or last authorships ( see table 2 ( tab .
are requested of the assistant professors for a successful application in the respective minimum time .
three medical faculties ( 8.6% ) do not give any information on the required research work ( 0 points ) and in seven ap - regulations ( 20% ) only imprecise information is given ( 1 point ; 20% ) .
after reaching successful postdoctoral lecture qualification or nomination for an assistant professorship , eight medical faculties ( 22.9% ) claim ongoing scientific work for several years .
detailed information on the respective research performance with successful raise of third - party funds is given in 31.4% .
four medical faculties additionally demand a perspective concept on future research and teaching performance of the candidates at the respective institutions ( 5 points ; see table 2 ( tab .
the actual evaluation of the teaching activity in the included ap - regulations feature detailed information on form , extent and content of the required teaching modalities for becoming an associate professor . while ten years ago only ten medical faculties ( 28% ) have given some information on the minimum teaching qualifications , the actual analysis of the ap - regulations reveals , that specific information is given in more than 80% ( n=28 ) of the regulations , reaching score values of 3 ( see table 2 ( tab .
the candidates are allowed to perform every kind of teaching ( lectures , seminars , practical courses ) . at six medical faculties , the ap - regulations claim an additional evaluation of the lectures by students or other faculty members ( see table 2 ( tab .
2 ) ) . the minimum time requirements , however , differ substantially and are markedly increased at some universities since the year 2000 , ranging from 1.5 to 4 semester periods per week ( spw ) . at some medical faculties , candidates , which act predominantly in patient care ,
a further criterion for a successful teaching performance is the mentoring of doctorate or diploma theses . at 21 medical faculties this is a favored or demanded issue , correlating with an increase of 87.5% in comparison to the year 2000 data ,
an additional criterion for the successful nomination of an associate professor are scientific presentations or posters .
54.3% of medical faculties do not attach importance on the active participation on scientific congresses or meetings ( see figure 1 ( fig .
1 ) ) . in other respects , at 16 medical faculties a ( detailed ) listing of all oral or poster presentations
reduction of the minimum time for the nomination as an associate professor . the nomination of an associate professor can be invested from universities to persons , who have shown outstanding performance and qualifications .
the nomination requires a successful and independent performance in research and teaching over several years .
after the nomination for an assistant professor or reaching postdoctoral lecture qualification , german medical faculties expect different minimum times before these candidates may apply for the associate professor nomination , averaging 4.50.3 years ( 95% confidence interval 3.8  5.8 ) .
this period of time might be reduced for candidates , which have shown extraordinary scientific performance at 54.3% of german medical faculties .
this is especially the case , if the candidates have been listed on the nomination list in an appointment process for a full university professorship ( secundo et tertio loco ) .
furthermore , it can also be reduced , when an outstanding scientific price could be won in the area of expertise or in medicine in general .
at one medical school , the ap - regulations point out that the rejection of a first place listing ( primo loco ) in an appointment process might directly lead to the nomination as an associate professor .
assistant professors , which have fulfilled the respective requirements , are not allowed to apply for the ap - nomination .
the application process may only start by a recommendation of members or representatives of the faculty or full university professors .
these persons are requested to write a recommendation letter or favor the candidates with corresponding documents for the ap - nomination . in all other faculties
the candidates are allowed to hand in all documents which are required for the nomination process on their own ( see figure 1 ( fig .
evaluation of the capabilities being an associate professor . the abilities and performance for assistant professors , which apply for the nomination to become an associate professor ,
an evaluation is not necessary or is not described in the ap - regulations ( 0 points ) at five medical faculties .
the evaluation of the candidates by internal reviewers only , is necessary at three faculties ( 1 point ) .
the majority ( n=27 ) , however , requires an evaluation process , which is supported by an external reviewer from a different university . on average
21 reviewers have to evaluate the candidates , focusing not only on the required issues , but also on the general ability for a nomination as an associate professor .
the 35 included ap - regulations of german medical faculties have been analyzed and scored for seven main items as summarized in table 1 ( tab .
1 ) . in agreement with all analyzed actual regulations , only the criterion of a respective teaching activity has been designated by all medical faculties ( 100% ) . in 94% candidates mandatorily need adequate research achievements .
furthermore , 29 out of 35 medical faculties claim an evaluation of the candidates and at 24 locations ( 69% ) the candidate may only apply for a nomination with a recommendation of a faculty member .
reduction of the minimum time as an assistant professor is possible at 16 medical faculties after second to third place listing on the nomination list in an appointment process for a full university professorship . scientific publication . in only two ap - regulations
most of the medical faculties ( 51% ) could reach the highest score value ( 5 points ) in this category , with detailed information on quantity , quality and first or last authorships ( see table 2 ( tab .
are requested of the assistant professors for a successful application in the respective minimum time .
three medical faculties ( 8.6% ) do not give any information on the required research work ( 0 points ) and in seven ap - regulations ( 20% ) only imprecise information is given ( 1 point ; 20% ) .
after reaching successful postdoctoral lecture qualification or nomination for an assistant professorship , eight medical faculties ( 22.9% ) claim ongoing scientific work for several years .
detailed information on the respective research performance with successful raise of third - party funds is given in 31.4% .
four medical faculties additionally demand a perspective concept on future research and teaching performance of the candidates at the respective institutions ( 5 points ; see table 2 ( tab . 2)).teaching activity .
the actual evaluation of the teaching activity in the included ap - regulations feature detailed information on form , extent and content of the required teaching modalities for becoming an associate professor . while ten years ago only ten medical faculties ( 28% ) have given some information on the minimum teaching qualifications , the actual analysis of the ap - regulations reveals , that specific information is given in more than 80% ( n=28 ) of the regulations , reaching score values of 3 ( see table 2 ( tab .
the candidates are allowed to perform every kind of teaching ( lectures , seminars , practical courses ) . at six medical faculties , the ap - regulations claim an additional evaluation of the lectures by students or other faculty members ( see table 2 ( tab .
the minimum time requirements , however , differ substantially and are markedly increased at some universities since the year 2000 , ranging from 1.5 to 4 semester periods per week ( spw ) . at some medical faculties , candidates , which act predominantly in patient care ,
in addition , one medical school demands the further education in didactics . a further criterion for a successful teaching performance is the mentoring of doctorate or diploma theses . at 21 medical faculties this is a favored or demanded issue , correlating with an increase of 87.5% in comparison to the year 2000 data , .scientific conference presentation / posters . an additional criterion for the successful nomination of an associate professor
54.3% of medical faculties do not attach importance on the active participation on scientific congresses or meetings ( see figure 1 ( fig .
a ( detailed ) listing of all oral or poster presentations is required for the ap - application .
the nomination of an associate professor can be invested from universities to persons , who have shown outstanding performance and qualifications .
the nomination requires a successful and independent performance in research and teaching over several years . after the nomination for an assistant professor or reaching postdoctoral lecture qualification ,
german medical faculties expect different minimum times before these candidates may apply for the associate professor nomination , averaging 4.50.3 years ( 95% confidence interval 3.8  5.8 ) .
this period of time might be reduced for candidates , which have shown extraordinary scientific performance at 54.3% of german medical faculties .
this is especially the case , if the candidates have been listed on the nomination list in an appointment process for a full university professorship ( secundo et tertio loco ) .
furthermore , it can also be reduced , when an outstanding scientific price could be won in the area of expertise or in medicine in general .
this may reduce the time by four years . at one medical school , the ap - regulations point out that the rejection of a first place listing ( primo loco ) in an appointment process might directly lead to the nomination as an associate professor.recommendation of candidates by faculty members . at 25 medical faculties ( 28.6% )
assistant professors , which have fulfilled the respective requirements , are not allowed to apply for the ap - nomination .
the application process may only start by a recommendation of members or representatives of the faculty or full university professors .
these persons are requested to write a recommendation letter or favor the candidates with corresponding documents for the ap - nomination . in all other faculties
the candidates are allowed to hand in all documents which are required for the nomination process on their own ( see figure 1 ( fig .
the abilities and performance for assistant professors , which apply for the nomination to become an associate professor , have to be evaluated by reviewers at most medical faculties .
an evaluation is not necessary or is not described in the ap - regulations ( 0 points ) at five medical faculties .
the evaluation of the candidates by internal reviewers only , is necessary at three faculties ( 1 point ) .
the majority ( n=27 ) , however , requires an evaluation process , which is supported by an external reviewer from a different university . on average
21 reviewers have to evaluate the candidates , focusing not only on the required issues , but also on the general ability for a nomination as an associate professor .   scientific publication . in only two ap - regulations
most of the medical faculties ( 51% ) could reach the highest score value ( 5 points ) in this category , with detailed information on quantity , quality and first or last authorships ( see table 2 ( tab .
are requested of the assistant professors for a successful application in the respective minimum time .
three medical faculties ( 8.6% ) do not give any information on the required research work ( 0 points ) and in seven ap - regulations ( 20% ) only imprecise information is given ( 1 point ; 20% ) .
after reaching successful postdoctoral lecture qualification or nomination for an assistant professorship , eight medical faculties ( 22.9% ) claim ongoing scientific work for several years .
detailed information on the respective research performance with successful raise of third - party funds is given in 31.4% .
four medical faculties additionally demand a perspective concept on future research and teaching performance of the candidates at the respective institutions ( 5 points ; see table 2 ( tab .
the actual evaluation of the teaching activity in the included ap - regulations feature detailed information on form , extent and content of the required teaching modalities for becoming an associate professor . while ten years ago only ten medical faculties ( 28% ) have given some information on the minimum teaching qualifications , the actual analysis of the ap - regulations reveals , that specific information is given in more than 80% ( n=28 ) of the regulations , reaching score values of 3 ( see table 2 ( tab .
the candidates are allowed to perform every kind of teaching ( lectures , seminars , practical courses ) . at six medical faculties , the ap - regulations claim an additional evaluation of the lectures by students or other faculty members ( see table 2 ( tab .
however , differ substantially and are markedly increased at some universities since the year 2000 , ranging from 1.5 to 4 semester periods per week ( spw ) . at some medical faculties , candidates , which act predominantly in patient care ,
a further criterion for a successful teaching performance is the mentoring of doctorate or diploma theses . at 21 medical faculties this is a favored or demanded issue , correlating with an increase of 87.5% in comparison to the year 2000 data ,
an additional criterion for the successful nomination of an associate professor are scientific presentations or posters .
54.3% of medical faculties do not attach importance on the active participation on scientific congresses or meetings ( see figure 1 ( fig .
1 ) ) . in other respects , at 16 medical faculties a ( detailed ) listing of all oral or poster presentations is required for the ap - application .  
the nomination of an associate professor can be invested from universities to persons , who have shown outstanding performance and qualifications .
the nomination requires a successful and independent performance in research and teaching over several years . after the nomination for an assistant professor or reaching postdoctoral lecture qualification
, german medical faculties expect different minimum times before these candidates may apply for the associate professor nomination , averaging 4.50.3 years ( 95% confidence interval 3.8  5.8 ) .
this period of time might be reduced for candidates , which have shown extraordinary scientific performance at 54.3% of german medical faculties .
this is especially the case , if the candidates have been listed on the nomination list in an appointment process for a full university professorship ( secundo et tertio loco ) .
furthermore , it can also be reduced , when an outstanding scientific price could be won in the area of expertise or in medicine in general .
at one medical school , the ap - regulations point out that the rejection of a first place listing ( primo loco ) in an appointment process might directly lead to the nomination as an associate professor .
at 25 medical faculties ( 28.6% ) assistant professors , which have fulfilled the respective requirements , are not allowed to apply for the ap - nomination .
the application process may only start by a recommendation of members or representatives of the faculty or full university professors .
these persons are requested to write a recommendation letter or favor the candidates with corresponding documents for the ap - nomination . in all other faculties
the candidates are allowed to hand in all documents which are required for the nomination process on their own ( see figure 1 ( fig .
evaluation of the capabilities being an associate professor . the abilities and performance for assistant professors , which apply for the nomination to become an associate professor ,
an evaluation is not necessary or is not described in the ap - regulations ( 0 points ) at five medical faculties .
the evaluation of the candidates by internal reviewers only , is necessary at three faculties ( 1 point ) .
the majority ( n=27 ) , however , requires an evaluation process , which is supported by an external reviewer from a different university . on average 21 reviewers
have to evaluate the candidates , focusing not only on the required issues , but also on the general ability for a nomination as an associate professor .
in 2000 , a qualitative evaluation of the ap - regulations at german medical faculties revealed many differences and a great variety of requirements .
one of the major findings in the actual evaluation is that the regulations among the medical faculties became more homogenous ( small 95% confidence interval ) and but also increased markedly in a 10 year interval ( mean score 13.5 points ) . as nagelschmidt and colleagues already discussed in their analysis of habilitation theses ,
the same holds true for the ap - regulations , that the available requirements does not display the reality at the respective locations , but are rather a guideline .
high scoring points might display apparent high requirements for the ap - nomination as well as clearly and definitely formulated ap - regulation at the respective faculty .
low scoring points display unclear and imprecise regulations , however , giving the nomination committee the much wider leeway in decision - making but does also hinder the standardization process for ap - regulations in germany .
the evaluation by pabst and strate   discussed three main points of critique of the ap - regulations from the year 2000 , which will be highlighted with the results of the actual analysis :   time as an assistant professor : in the last 10 years we could not find any standardization in that issue .
the minimum times for assistant professors still vary from two to six years until an ap - application may be possible
. however , the possibility of a time reduction by a nomination listing seems to be established at more then 50% of german medical faculties
.scientific publication : the research performance might be best documented by the respective numbers of publications of the ap - candidates .
this is mentioned by 88% of the ap - regulations in the actual evaluation and is therefore the third most important precondition for an ap - nomination .
while in 2000 only 17 medical faculties gave detailed information on this issue , only two of 35 ap - regulations do not describe this in the here presented analysis .
furthermore , the fixed orientation on impact factors as predominant criterion for the evaluation of the publication performance in 2000   plays an only subordinated role today .
the actual evaluation of publications complies rather to peer reviewed articles as well as the numbers of first or last authorships .
due the achievement - oriented granting of funds at german medical faculties and german universities , which is geared to quantifiable parameters , it seems to be only of less interest for authors to publish in journals without an impact factor .
evaluation of the candidates and their performance : as a last point of criticism the external evaluation of the candidates abilities and performance has been mentioned in 2000   involved with the fact to reduce the time liability and to perform the evaluation only by the internal ap - board of the respective medical school . in a 10-years comparison
this issue seems not to be provided at all , although only three medical faculties did not change their ap - regulations in that time .
in the course of an objective nomination process , the external review of the candidates still seems to be of great importance .
time as an assistant professor : in the last 10 years we could not find any standardization in that issue .
the minimum times for assistant professors still vary from two to six years until an ap - application may be possible
. however , the possibility of a time reduction by a nomination listing seems to be established at more then 50% of german medical faculties .
scientific publication : the research performance might be best documented by the respective numbers of publications of the ap - candidates .
this is mentioned by 88% of the ap - regulations in the actual evaluation and is therefore the third most important precondition for an ap - nomination .
while in 2000 only 17 medical faculties gave detailed information on this issue , only two of 35 ap - regulations do not describe this in the here presented analysis .
furthermore , the fixed orientation on impact factors as predominant criterion for the evaluation of the publication performance in 2000   plays an only subordinated role today .
the actual evaluation of publications complies rather to peer reviewed articles as well as the numbers of first or last authorships . due the achievement - oriented granting of funds at german medical faculties and german universities , which is geared to quantifiable parameters
, it seems to be only of less interest for authors to publish in journals without an impact factor .  
evaluation of the candidates and their performance : as a last point of criticism the external evaluation of the candidates abilities and performance has been mentioned in 2000   involved with the fact to reduce the time liability and to perform the evaluation only by the internal ap - board of the respective medical school . in a 10-years comparison
this issue seems not to be provided at all , although only three medical faculties did not change their ap - regulations in that time .
in the course of an objective nomination process , the external review of the candidates still seems to be of great importance . in the classic thought of an academic career at german universities , the nomination as an associate professor displays the next - to - last step . to become an associate professor does not only stand for a certain quality characteristic to the community , but is also of great importance for the career chances of the respective persons .
the frequency with which german medical faculties perform nomination processes for a doctorates , assistant as well as associate professors degree is suspiciously surveyed by other faculties and sometimes deprecatingly commented , , . in this context
it was also argued of an inflation and loss of value of the invested academic degrees in medicine .
furthermore , the academic proof of the qualification for assistant professors or postdoctoral lecturers has been critically challenged and their abrogation has been discussed . this problem and discussion , however , led to the point that academic medicine itself addressed this problem and performed corresponding studies , , , , , .
independent studies could show that the achievement of academic degrees significantly supports the personal career .
their abrogation , however , was not favored by a majority , despite considerable quantitative and qualitative preconditions and a strong integration into direct patient care , .
on the contrary , an analysis of 616 medical assistant professors from 1998 resulted in the wish of an urgent reform of the current system of ap - requirements by 80% of the interviewees , .
the first steps in standardization of the requirements , especially for assistant professors , are currently launched   and despite significantly increasing requirements , the number of successful nomination processes for assistant professors is still constantly high ( http://www.landkarte-hochschulmedizin.de/home.aspx ) .
in addition , 48% ( n=2998 ) of all assistant and associate professors in 2009 served in the section of medicine and health care sciences .
the frequency of successful academic nomination processes might also be based on the above - average scientific activity of medical faculties , underscoring the favorable granting of german medical faculties in the initiative of excellence of the german federal government in 2006/2007 , in which the german university medicine participated disproportionately high . as long as the requirements for specific academic degrees in medicine itself
are not regulated uniformly , a fair and constructive comparability and criticism to other areas of expertise can not be established .
taken together , the requirements for the nomination of associate professors have been markedly increased and got much more detailed in a ten years analysis , although there is no scoring data available from the year 2000 . here , the total score might imply an only small range of preconditions for becoming an associate professor , however , a deeper look inside the currently valid ap - regulations of german medical faculties shows an exceeding heterogeneity . in this context
it should be clarified whether the high location bound requirements and the general heterogeneity of the ap - regulations are admissible and justified in the focus of the career chances and equality of opportunities of the candidates .  
furthermore , the equalization of the preconditions for assistant professors is on a good way .
based on a standardized quantitative and qualitative scoring system , this work might be the basis for the ongoing discussion and consensus declarations of german medical faculties on this topic .
 background : first quantitative evaluation of the requirements for the promotion as associate professor ( ap ) at german medical faculties material and methods : analysis of the ap - regulations of german medical faculties according to a validated scoring system , which has been adapted to this study.results : the overall scoring for the ap - requirements at 35 german medical faculties was 13.50.6 of 20 possible scoring points ( 95% confidence interval 12.2 - 14.7 ) . more than 88% of the ap - regulations demand sufficient performance in teaching and research with adequate scientific publication . 
 furthermore , 83% of the faculties expect an expert review of the candidates performance . 
 conference presentations required as an assistant professor as well as the reduction of the minimum time as an assistant professor do only play minor roles . 
 conclusion : the requirements for assistant professors to get nominated as an associate professor at german medical faculties are high with an only small range . in detail , however , it can be seen that there still exists large heterogeneity , which hinders equal opportunities and career possibilities . 
 these data might be used for the ongoing objective discussion . 
Introduction
Methods
Results
Associate professorship requirements
Discussion
Conclusion
Competing interests