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Medical college faculty train many years to learn a field, but receive little advice on success in the world of academia. While passing on knowledge and skills to new learners is rewarding, attaining promotion and tenure requires another skill set. Academic success can be approached as a game, one with rules and strategy that those in the know can use to their advantage. This guidebook provides an overview of the promotion game with special attention for clinical faculty; however, much of its advice will be useful for others within the academic health center as well.