Turner E, Yoo J, Salter S, Kimball AB. Leadership Workforce in Academic Dermatology. Arch Dermatol. 2007;143(7):945-955. doi:10.1001/archderm.143.7.948
Growing concern has been voiced at recent Association of Professors of Dermatology meetings that the clinical, teaching, and research demands of academic dermatology may strain and diminish the workforce of current academic dermatologists.1,2 A depletion of faculty members aged approximately 45 years could reduce the pool of potential candidates for chairpersons and other positions of leadership within dermatology. The present study was designed to characterize current dermatology department and division chairpersons and to examine the current number of open dermatology chairmanships in the United States, their rate of turnover, and the presence of suitable candidates.
Anonymous surveys were sent to 122 dermatology department chairpersons and/or chiefs. Chairpersons were identified through medical school Web sites and publications of the American Medical Association.3 Survey questions focused on demographics, tenure, and future plans of current department chairpersons. In addition, questions were asked about prevailing attitudes in the department toward academic medicine, faculty retention, and the adequacy of the pool of candidates for future leadership positions. Analysis was performed using t tests on continuous variables (Excel 2003; Microsoft Inc, Redmond, Washington). P < .05 was considered significant.
Sixty percent of the surveys were returned (n = 73). The reported average age of current chairpersons was 56 years, and the average age at which they became chairperson was 45 years. Chairpersons characterized their career focus as listed in the Table.
Most chairpersons (68%; n = 50) did not feel that there was an average age at which faculty members left academia. However, of the 31% (n = 23) who did feel that academics left at a certain age, 64% (n = 15) believed that faculty members left before age 40 years. Chairpersons identified several leading factors that motivated faculty members to leave academia, including the pressure to publish (cited by 68% of chairpersons [n = 50]), financial concerns (60%; n = 44), and family concerns (31%; n = 23) (Table). Moreover, 66% of chairpersons (n = 48) did not feel academic salaries in their area were competitive with salaries in private practice. By contrast, teaching was the primary reason chairpersons cited for faculty members remaining in academia (Table).
The anticipated average retirement age of the chairpersons was 62 years. Five chairmanship positions (7%) were reported as open at the time of the survey; 14% of chairpersons (n = 10) were planning to resign within the year; and 32% (n = 23) anticipated resigning within 3 years. Therefore, a 10% turnover rate in chairmanships per year is likely to persist. Current chairpersons felt that an average of 1.4 faculty members within their department would be appropriate chairperson candidates within 1 to 5 years.
Of the chairpersons who responded to this survey, 12% were women (n = 9). A few sex differences were noted. Chairwomen were an average of 6 years younger than their male counterparts (mean age, 51 vs 57 years) (P = .06) and had correspondingly shorter tenures (5.5 vs 12.0 years) (P = .06). Both men and women became chairpersons at approximately the same age (women, age 45.9 years; men, age 44.6 years). However, chairwomen anticipated leaving their chair positions at age 59 years, an average of 3 years younger than chairmen (age 62 years).
The results of our survey indicate that a leadership gap is not an imminent concern among current chairpersons. Recent practice profile surveys4 have shown that women occupy nearly 40% of academic dermatology positions. They also tend to be younger, which reflects the overall demographic changes in dermatology. Given the number of women in academic positions, it is reasonable to expect that the number of chairwomen should increase in the future. However, it is notable that while dermatology has one of the highest proportions of women in any area of medicine,5 the proportion of chairwomen remains very similar to the average across fields.
Limitations of this study include the inability to verify or validate the chairpersons' assessments of their faculty. There also may have been more chairs vacant than we could assess; if no chairperson was available to fill out the survey, it may not have been returned. Strengths include the high response rate for a mailed survey.
At present, a premature departure of junior faculty members does not appear to threaten the perceived ability of dermatology departments to fill future leadership positions. Nevertheless, the annual rate of turnover among chairpersons and the current age distribution of academic dermatologists suggest that departments need to continue to devote close attention to the task of retaining and promoting younger faculty members. While some factors that cause people to leave academia may not be easy to reverse, difficulty with publication demands appears to be a common concern and may be a manageable problem that departments can readily address with appropriate mentoring and training.
Correspondence: Dr Kimball, Clinical Unit for Research Trials in Skin (CURTIS), Massachusetts General and Brigham and Women's Hospitals, Harvard Medical School, 50 Staniford St, No. 246, Boston, MA 02114 (firstname.lastname@example.org).
Financial Disclosure: None reported.
Funding/Support: This study was supported by a grant from the Association of Professors of Dermatology, Cleveland, Ohio (Dr Kimball).
Previous Presentation: This research was presented as a poster at the Annual Meeting of the American Academy of Dermatology; March 2006; San Francisco, California.