Others are going to tell you the standard spiel, but also the additional truth is that it's also completely dependent upon the culture of the hiring institution/department:

1. Some medical schools value physician faculty who are mostly clinicians. These universities will create advancement pathways for clinicians. But this attitude may only live in some departments/divisions but not others. You're more likely to find it in primary care, but it's not universal in all departments/subspecialty sections in those organizations.
2. Alternatively, some medical schools/departments do not value clinicians much. These places will push that the promotions (and tenure) will go mainly to those physician faculty who generate ongoing high-dollar grant money, do research, have numerous high profile publications, and national visibility. This attitude surprisingly can exist in smaller universities with a lesser research profile, and can cause them to disrespect and force out great clinical faculty from the promotion tracks.

The bottom line is this: if you want to stay in academics with your goals, look for a job that fits #1 and not #2. There are positions out there with clinical promotion tracts that don't require you to come from prestigious schools/programs. Distinguish yourself clinically in your current program, and put extra work into being a great teacher to trainees you work with. If you get the chance to co-author on a case report or 2 with your profs, that would also look great on your CV.