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Under the tenure systems adopted as internal policy by many universities and colleges, especially in the United States, Canada and Australia, tenure is associated with more senior job titles such as Professor and Associate Professor. A junior professor will not be promoted to such a tenured position without demonstrating a strong record of research, teaching, publishing a thesis and administrative service. Typical systems (such as the Recommended Institutional Regulations on Academic Freedom and Tenure allow only a limited period to establish such a record, by limiting the number of years that any employee can hold a junior title such as Assistant Professor. (An institution may also offer other academic titles that are not time-limited, such as Lecturer, Adjunct Professor, or Research Professor, but these positions do not carry the possibility of tenure and are said to be "off the tenure track.")

Academic tenure is primarily intended to guarantee the right to academic freedom: it protects teachers and researchers when they dissent from prevailing opinion, openly disagree with authorities of any sort, or spend time on unfashionable topics. Thus academic tenure is similar to the lifetime tenure that protects some judges from external pressure. Without job security, the scholarly community as a whole might favor "safe" lines of inquiry. Tenure makes original ideas more likely to arise, by giving scholars the intellectual autonomy to investigate the problems and solutions about which they are most passionate, and to report their honest conclusions.

Universities also have economic rationales for adopting tenure systems. First, job security and the accompanying autonomy are significant employee benefits; without them, universities might have to pay higher salaries or take other measures to attract and retain talented or well-known scholars. Second, junior faculty are driven to establish themselves by the high stakes of the tenure decision (i.e., lifetime tenure vs. job loss), arguably helping to create a culture of excellence within the university. Finally, tenured faculty may be more likely to invest time in improving the universities where they expect to remain for life; they may also be more willing to hire, mentor and promote talented junior colleagues who could otherwise threaten their positions. Many of these rationales resemble those for senior partner positions in law and accounting firms.

The cost of a tenure system is that some tenured professors may not use their freedom for the common good. Tenure has been criticized for allowing senior professors to become unproductive, shoddy, or irrelevant. Universities themselves bear this risk: they pay dearly whenever they guarantee lifetime employment to an individual who proves unworthy of it. Universities therefore exercise great care in offering tenured positions, first requiring an intensive formal review of the candidate's record of research, teaching, and service. This review typically takes several months and includes the solicitation of confidential letters of assessment from highly regarded scholars in the candidate's research area. Some colleges and universities also solicit letters from students about the candidate's teaching. A tenured position is offered only if both senior faculty and senior administrators judge that the candidate is likely to remain a productive scholar and teacher for life.

In North American universities and colleges, the tenure track has long been a defining feature of employment. However, it is becoming less than universal. Many colleges and universities—particularly those that do not seek a world-class research reputation—have taken advantage of the large supply of academic job applicants to reduce their tenure commitments. In North American universities, positions that carry tenure, or the opportunity to attain tenure, have grown more slowly than non-tenure-track positions, leading to a large "academic underclass". For example, most U.S. universities currently supplement the work of tenured professors with the services of non-tenured adjunct professors, academics who teach classes for lower wages and fewer employment benefits under relatively short-term contracts.

For these, and other reasons, academic tenure was officially restructured in public universities in the United Kingdom, by the Thatcher government in the 1980s. It is no longer offered in Australia, New Zealand and in most of Europe (whereas most European university systems, especially profound in Germany, do not allow any teaching by young researchers, postgraduates, post doctoral fellows, or residents). In Germany, however, in universities (but not Advanced technical colleges) practice differs often from theory: teaching should be restricted to tenured faculty and a few non-tenure staff members paid for research and teaching. In reality much teaching is done by non-tenured research students and adjunct faculty. In France, tenure is granted early in academic ranks as well as to CNRS and other researchers.

Moreover, it repeatedly is under attack in state universities in the United States. Outside the United States, it is still common to offer a long contract to candidates who pass a less stringent review or confirmation, but with somewhat less job security than in lifetime tenure systems

On the show[]

House has tenure at P-P hospital. This allows him the freedom to make the unabridged comments that are characteristic to his personality (past references by Cuddy and Stacy both state "he was always like that"). As was shown in Babies & Bathwater, House's tenure can only be revoked by a unanimous vote of the board of the hospital. Luckily for House, this includes Cuddy and Wilson. A fact that House as alluded to what keeps him "safe" from losing his job (though, B&B showed even this was fallible).