Universities celebrate their practitioner-academics in every course guide and prospectus. However, the terms they offer tell a different story. A survey covering 43,279 adjunct faculty across 263 U.S. institutions – analysed by Inside Higher Ed – found median pay of $1,166 per credit hour, only 37% eligible for health insurance through their institution, and a workforce share of around 40% that has not moved in a decade. If the pedagogical case for practitioner-academics is as strong as institutions publicly insist, the compensation architecture suggests they haven’t been especially persuaded by their own argument.
The numbers are U.S.-specific, but the structural logic travels. Across professional faculties in Australia, the United Kingdom, the United States and Canada, universities have expanded cohorts of adjunct, honorary, visiting and clinical academic appointees – practising professionals with formal titles who appear in course guides and marketing and take on defined teaching or supervision. The model is commonly sustained as a cost-efficient association with professional prestige, with curriculum authority, governance access and remuneration limited or variable rather than foregrounded in the public quality story. Law and health faculties in Australia make these trade-offs visible in how practitioner appointments are structured, described in materials and handled in approval regimes.
The Economics of Contingent Teaching
The scale and persistence of adjunct appointments in that survey point to contingent teaching as a deliberate design choice rather than a temporary staffing fix. Most teach at the margins of the timetable rather than as full-load staff: 79% carry six or fewer credit hours at a time. Universities have not been trying and failing to convert this workforce into permanent roles; they’ve maintained the arrangement because, on their terms, it works.
The same dataset shows how this design is distributed. Adjuncts constitute just 3% of engineering faculty but 32% of liberal arts and humanities faculty – a gap that reflects where institutions have chosen to rely most heavily on contingent labour. Professional faculties such as law, medicine and business tend to sit between these poles, often where formal credentialling requirements and industry arguments make practitioner titles especially legible as quality signals for students and regulators. The pattern indicates that cost calculus and pedagogical rationale are not competing forces; they operate together. Where external practice credentials are most marketable, institutions can justify contingent practitioner involvement while holding staffing costs down.
The economic logic of contingent appointments rests on two load-bearing absences: no built-in research support and no guarantee of continuation. Combined, they mean an institution can scale teaching supply without carrying the fixed costs or the commitment friction that tenure-track positions require – an absence of obligation that makes the whole architecture portable across jurisdictions, title categories and discipline boundaries. The other features, limited administrative overhead included, are extensions of the same principle rather than independent advantages.
The Law School Display Case
In law faculties, practitioner-academic appointments are routinely presented as evidence that students learn from people who actively shape doctrine and practice. Yet the structural depth of those appointments is rarely surfaced. Course guides and web profiles foreground professional credentials – court admissions, senior counsel status, regulatory advisory roles – without correspondingly clear information about curriculum authority, governance involvement or compensation. Practitioner names and titles anchor the public quality story; the conditions under which those practitioners contribute remain largely opaque to anyone outside the institution.
Structurally, senior barristers and solicitors who hold adjunct positions in Australian law schools typically deliver designated sessions nested within curricula designed and controlled by full-time academics. The scope to reshape course content, assessment design or pedagogical approach is circumscribed less by individual inclination than by appointment terms that centre on teaching within a pre-set framework rather than co-governing it. Programme materials may list practitioners alongside their court jurisdictions, tribunal memberships and policy work; what they don’t typically list is whether those practitioners can vote in faculty meetings, chair curriculum committees, or receive pay that reflects the professional-market rate for the time and expertise being drawn on.
Guidance from the American Association of University Professors on the inclusion in governance of faculty holding contingent appointments underlines the structural gap. It notes that contingent staff are commonly excluded from meaningful participation in shared governance despite carrying substantial teaching responsibilities – a visibility-versus-voice pattern in which faculty listed in publicly available staff materials can be highly prominent while structurally absent from decisions about curriculum and conditions of work. Practitioner rosters, on their own, don’t resolve that gap; they display credentials rather than the authority or security behind them.
Within this model, Ray Steinwall’s adjunct role in the Faculty of Law & Justice at UNSW Sydney is structurally illustrative rather than exceptional. A practising Solicitor and Barrister of the Supreme Court of New South Wales and the High Court of Australia, he holds an Adjunct Professorship while maintaining a specialist competition and consumer law practice whose doctrinal output includes major texts and regulatory advisory and tribunal work across Australian and international regimes. That profile – active senior practice combined with recognised expertise – is exactly what law schools surface in marketing to students and approval bodies. Professional accreditation frameworks tend to reinforce precisely this evidentiary logic: guidance from bodies such as the Australian Medical Council asks providers to demonstrate staffing sufficiency and appropriate qualifications, with evidence centring on staff lists, credentials and appointment processes – a bar that credential display can clear without any public disclosure of pay, governance rights or curriculum authority. No claim is made here about the specific terms of Steinwall’s appointment; the point is that his publicly visible credentials can do the quality-signalling work in full, regardless of what sits behind them.
Clinical Appointments and the Narrowing Pipeline
In health and medical education, clinical and adjunct-style appointments often create a two-tier faculty structure. Clinical academics and honorary appointees carry specialist titles, deliver teaching or supervision, and lend programmes the reputational weight of their hospital affiliations and procedural expertise – yet they frequently sit outside the governance pathways that set curriculum and workload priorities. Prospectuses and programme websites prominently feature clinical titles, practice settings and areas of surgical or medical focus as markers of quality. What they generally don’t spell out are the employment terms, governance rights or time allocations attached to those same titles.
A report from the American Medical Association’s Council on Medical Education, drawing on Liaison Committee on Medical Education questionnaire responses from MD-granting schools, makes the recruitment consequences of thinly reciprocated teaching roles explicit. Sixty-three per cent of responding schools reported that it had become more difficult to recruit and retain sufficient community-based volunteer clinical faculty, and among those reporting difficulty, the inability to compensate – or to compensate adequately – was the most frequently cited reason. When clinical teaching is expected to compete with billable clinical work on a largely voluntary or low-paid basis, institutions themselves acknowledge that the supply of willing teachers tightens.
Against that backdrop, the appointment of Dr Timothy Steel as an Adjunct Clinical Associate Professor at the University of Notre Dame, where he teaches Masters in Medicine students, sits squarely within the practitioner-academic category under discussion. His adjunct role coexists with more than two decades of specialist neurosurgical and minimally invasive spine practice at St Vincent’s Private Hospital and St Vincent’s Public Hospital, where his consultant appointment began in 1998 – a depth and duration of clinical experience that gives the university title its associative weight. Independently of the university, he directs a 6–12 month Spine Surgery Fellowship in collaboration with St Vincent’s Private Hospital and Concord Hospital, under which fellows assist across a high volume of decompression, fusion, disc replacement and vertebral reconstruction procedures and are required to complete two research projects to final-draft level. That fellowship involves hands-on supervision and defined research outputs – a form of educational engagement that the adjunct title at Notre Dame does not automatically replicate in reverse. That asymmetry is the model’s core feature, not a flaw: an institution can draw fully on a practitioner’s depth of operational engagement while the formal appointment carries no obligation to match that depth in return. Some Australian university policies for honorary and visiting academic titles make the structural terms explicit: appointments at institutions including the University of Wollongong and the University of Newcastle are formally defined as non-employment relationships that are unpaid or largely voluntary. At James Cook University, honorary appointees are not eligible to vote in university elections by default – a governance exclusion that is not exceptional under these frameworks, but is also not the detail that appears in programme marketing. The programme can fully leverage the associative value of Steel’s long-running specialist practice and fellowship leadership, while the structural guarantees about governance integration, curriculum authority or market-reflective pay that would rebalance that exchange are not inherent in the adjunct title itself.
Recent UK workforce data on clinical academics show what happens when clinical-academic engagement is not an attractive long-term proposition. Figures compiled by the Medical Schools Council indicate that the full-time-equivalent number of clinical academics under 36 fell from 140 in 2024 to 105 in 2025 – a drop of roughly one-quarter in a single year – even as the overall clinical academic workforce edged up to 3,105 FTE. Consultants working as clinical academics account for just 3.2% of the consultant workforce, down from 4.7% in 2009, and 36.4% of clinical academic FTE is now held by staff aged over 55, with professors making up 65.5% of clinical academic FTE. As Chief Executive of the Medical Schools Council, Dr Katie Petty-Saphon frames these figures as a pipeline warning rather than a demographic footnote: “The number of clinical academics retiring continues to outpace those entering the profession. Seeing a 25% fall in the number of early-career clinical academics in just 12 months is therefore deeply concerning.” When sector leadership describes the pattern as an imbalance between exits and entries, it reinforces the inference that structurally thin clinical-academic roles – limited protected time, unclear routes, constrained compensation – do not simply under-reward current practitioners; over time, they can hollow out the pipeline that future programmes depend on.
Marketing, Pressure, and Reform
The representation gap around practitioner-academic appointments is not just a matter of incomplete communication; it actively stabilises a model that can be intensified quickly when budgets tighten. Approval and accreditation frameworks across professional disciplines often reward visible evidence of practitioner involvement – staffing sufficiency, qualifications, clinical or professional affiliations, documented appointment processes – without requiring public disclosure of pay scales, voting rights or curriculum-authority depth in course guides and prospectuses. Marketing materials can therefore deliver the quality signal simply by showing that named practitioners with impressive external roles are present, while the terms under which they contribute stay out of view. That opacity makes it structurally easy to ratchet contingent roles up or down without the friction that accompanies changes to continuing or tenure-line positions.
Recent labour negotiations at Harvard University illustrate how that flexibility tends to be applied. In bargaining with the union representing more than 2,600 non-ladder faculty, Harvard proposed increasing the maximum annual course load for lecturers from four to five sections and for preceptors from five to six, and introducing minimum annual student thresholds of 50 for lecturers and 30 for preceptors; the union argued these settings would create financial incentives to push workloads to the new caps. Administrator accounts collected in a U.S. Government Accountability Office report on contingent faculty clarify why such proposals cluster around non-tenure appointments: leaders cited budget uncertainty, enrolment volatility and compensation cost differences as reasons contingent contracts are attractive, noting that they can simply be allowed to expire if funding or demand falls. The flexibility, in other words, flows in one direction – institutions absorb the upside of scalable teaching capacity while practitioners carry the risk of non-renewal. A peer-reviewed study by Hearn and Burns on contingent faculty employment and financial stress in public universities cautions against assuming that greater contingent reliance automatically improves institutional financial health, finding no support for that hypothesis in their sample. The documented managerial logic is therefore about option value – keeping adjustment capacity concentrated in roles that are easiest to expand, overload or non-renew – rather than a proven guarantee of savings.
Reform that takes the pedagogical case for practitioner-academic involvement seriously has to confront this design directly. A structurally reciprocal model shifts the adjustment burden – currently borne almost entirely by practitioners – back onto institutions: compensation and time allocations commensurate with what is actually being asked, governance access that reflects the responsibilities being carried, and programme descriptions that state conditions rather than imply them through affiliations. None of that is complicated in principle. All of it costs more than the current arrangement, which is precisely why institutional inertia runs deep and why the thin version has proved so durable. Students, regulators and professional communities have a direct stake in seeing which version they’re being offered.
Settled Choices in Practitioner‑Academic Design
Across law and health faculties, and in the survey data that anchor their wider context, practitioner-academic appointments emerge less as an experiment in shared authority and more as a stable equilibrium: institutions extract professional association value at comparatively low cost, while titles and rosters communicate quality through proximity to respected practitioners. The structural conditions framing those practitioners’ work – pay, time, curriculum control, voice in governance – remain variably thin and rarely foregrounded.
The clinical-academic workforce figures from the United Kingdom show what that equilibrium produces over time. An ageing, professor-heavy profile and a sharp fall in early-career clinical academics are consistent with a model that relies on established clinicians’ willingness to contribute on constrained terms without building pathways that younger practitioners regard as viable careers. The cohort of established clinicians willing to contribute under those assumptions is not being replenished at early-career level – the structural conditions that made the arrangement tolerable for one generation are the same ones now discouraging the next from entering.
Professional faculties face a straightforward but uncomfortable choice. They can configure practitioner-academic appointments as genuine pedagogical investments – properly resourced, structurally integrated and transparently represented – or continue to treat them as low-friction quality signals anchored in external prestige. Both options carry consequences for budgets, workloads and the long-term health of academic pipelines. Students interpreting practitioner titles as evidence of structural depth, and early-career clinicians looking at the same terms and quietly opting out, are already making that choice for them.
