The need for information about medical schools' efforts to allow faculty who wish to remain fully academic but work less than full time has been growing steadily. Building on the AAMC's 1993-94 survey of faculty appointment and tenure policies, in 1994 the authors surveyed 102 U.S. and Canadian medical schools that had answered yes to the question, "Does the medical school provide for faculty who choose to work less than full-time but whose full professional effort is directed towards the institution?" Seventy-one U.S. and Canadian medical schools reported provisions for "full professional effort" (FPE) faculty, and 32 of these had developed specific procedures for such faculty. Other nomenclatures in use for FPE faculty include "limited full-time," "full status/partial load," and "reduced period of responsibility." Almost half of the 71 survey respondents reported that FPE faculty could be appointed to, or remain on, a tenure track; more than half of these schools said that they lengthened the probationary period on a prorated basis. Women, much more frequently than men, had chosen the FPE option, especially women clinical faculty. While FPE faculty face more challenges than full-time faculty in accomplishing the tasks necessary for promotion in academic medicine, well-structured FPE options can benefit not only individual faculty members and their families but also the institution, which retains the commitment of valued faculty members seeking flexibility.