Medical schools' long-awaited recognition of the varied contributions of their faculty has caused active dialogue and debate. The discourse centers on the best approach for incorporating a broader definition of scholarship, including professional service, into the traditional promotion and tenure processes. At the School of Medicine of the Uniformed Services University of the Health Sciences (USUHS), the majority of the clinical faculty also serve as active-duty uniformed medical officers, and the subject of how to appropriately recognize their varied contributions has long been contended. Concerns have been raised from all constituent groups that broadening the definition of scholarship at the USUHS has the potential to lower the standards of the academy and thus devalue faculty positions. The USUHS has viewed this challenge as a study in the integration of cultures. Institutional cultures include those of the academy, the military, government, basic science, and clinical science, and all the resulting permutations. A nine-year review of scholarship, promotion, and tenure at the USUHS has resulted in a document that supports the diverse missions of the university and appropriately rewards the accomplishments of its faculty. The dialogue continues, as the new document is subject to continuing review and ongoing critical analysis.