PROMOTED-EM: Shifting Focus From Cataloging Barriers to Identifying Hidden Determinants of Advancement for Women in Academic Emergency Medicine.

Gender disparities in academic promotion persist despite decades of research documenting their scope. Women remain underrepresented at senior academic ranks in Emergency Medicine, with only 19% of full professors identifying as women. Existing literature has largely cataloged the barriers driving this gap-disproportionate clinical workloads, non-promotable labor burden, sponsorship deficits, and caregiving responsibilities-but has devoted comparatively little attention to the strategies women use to successfully navigate these barriers. This commentary proposes a shift in research focus: From documenting the problem to systematically studying the hidden determinants of advancement among women who have achieved promotion. We introduce PROMOTED-EM, a qualitative research framework organized across 14 domains of academic career life, designed to elicit the tactical, behavioral, and relational strategies that enabled promotion. By centering the experiences of successfully promoted women in Emergency Medicine while explicitly attending to intersectionality and the limitations of survivor bias, this agenda aims to generate actionable, evidence-based guidance for women faculty, department leaders, and institutions committed to closing the promotion gap.