The Myths, Realities, and Costs of Department Chair Search Practices in Academic Medicine

What if the academic medicine industry were able to reduce the cost associated with the traditional academic search process and predictably and improve candidates’ success?

This can be achieved by leveraging modern leadership assessments, cultural alignment analyses, and equitable search practices. Equally important, what is the actual cost in time, professional morale, and clinical and academic productivity to complete a department chair search, and how do those costs pose a risk to long-term success?

To address these questions, many of today’s leading academic institutions are testing the boundaries of hidebound search processes rooted in mythology. Throughout our executive search work, Russell Reynolds Associates has identified the benefits of dismantling those myths.

Improving success predictability and outcome 

As of December 2021, women accounted for 22% of department chairs (20% of permanent chairs and 28% of interim/acting chairs).1 This number was 14% in 2010. While this increase in gender diversity is cause for celebration, it remains slow, especially when considering just over half of the US population is female. Racial diversity suffers the same fate. For example, we note that US medical school deans (interim and permanent) identifying as URiM (under-represented in medicine) only rose by one percentage point between 2010 and 2021, from 11% to 12%.2 As for department chairs, 77% identified as White3 in 2020, while the 2020 Census established that 57.8% of the US population identified as White.4

Partnering with executive search firms improves the diversity of candidate slates. Search firms with large networks and a history of promoting diversity, equity, and inclusion (DE&I) can optimize the art and science of the search process across sectors and functions, globally. In 2021, Russell Reynolds placed 41.6% racially and/or gender diverse department chairs. In addition to search services, leadership assessment and transition services can enable diverse leaders to thrive in their new roles by providing thoughtful onboarding.

Academic institutions have historically prioritized the triple threat, excelling in patient care, research, and education. Leadership recruitments have typically begun with a CV filtration exercise, seeking specific levels of peer reviewed publications, national recognition in a clinical specialty, or R01 grant funding. This outdated approach has resulted in the selection of some individuals with an outstanding CV, yet were ill-prepared to lead and inspire teams, to build a financially stable operation, or to communicate a forward-looking strategy for the department.

Today’s leaders must demonstrate a track record of leading, developing, recruiting, and retaining teams and people; building relationships across a complex academic institution; developing innovative strategies; driving performance results; fostering DEI; and leveraging business and financial acumen. Forward-thinking institutions recognize the importance of inspirational and inclusive leadership, multidisciplinary collaboration, strategic acumen, an execution orientation, business acumen and financial stewardship. These attributes cannot be easily gleaned from a CV.⁵ Using Russell Reynolds’ propriety Leadership Span (LSpan) model, leadership competencies and capabilities are assessed to provide predictable outcomes for the executive leaders placed.

Time and cost savings

Having completed over 375 searches in academia over the past five years, we have noted no correlation between the size of the search committee and the success of a search. Michigan State University notes that based on their experience, search committees with at least five members and at most nine members are most effective,6 and Emory University recommends between seven and nine individuals to be on search committees.7 In addition, a committee that is too large diminishes each person’s sense of belonging, and contribution falls off sharply.8

Instead of scrambling to over-include, focus on selecting a small group of people that best represent the interests of stakeholders who will be most impacted by the search’s outcome. Since the success of a search is not dependent on the size of the committee, it is in the academic institution’s best interest to evaluate the benefits of a smaller and thoughtfully selected search committee. Benefits of reducing the number of search committee members include:

Carefully consider how to build an efficient and diverse search committee. If the goal is to recruit best in class leadership, then it is critical to include committee members who are best qualified to assess leadership talent. Broader constituents can participate in stakeholder interviews in the early stages of the search and perhaps in interviews later in the process. The committee must be built for speed, decision-making and engagement, considering that exceptional academic department chairs can raise US News and World Report rankings, advance cutting-edge research, and train the next generation of physicians.

Leveraging data gathered from over 6,600 assignments Russell Reynolds completes annually, we have found that, on average, our teams support organizations in concluding senior leadership searches, including department chair searches, in approximately six months.

While searches for niche specialties may take longer, it is safe to conclude that most department chair searches can be completed successfully in half a year’s time. On average, deans are conducting two to three chair searches per year, which equates to roughly 10% of all chairs for each respective organization. Academic medical centers could save hundreds of thousands of dollars in search committee members’ time each year by reducing the length of its chair searches.

While interviewing 10 to 15 candidates can provide a greater sense of visibility and control to search committees, our experience shows that an effective profile calibration process followed by interviews with six to eight candidates yields similar success and helps reduce the overall length of the search.

Steps to ensure an effective profile calibration can include:

We recommend search committees fight the urge to interview more than eight candidates and instead focus on profile calibration to ensure that the search committee only interviews the most fitting candidates. With many pressing priorities for the search committee members, search consultants can help guide the committee toward leaders who are best aligned with departmental needs and the organizational culture.

Summary of benefits to a modernized, sophisticated search committee process

Time and cost savings

Broad-based sourcing

• National access to the top physician leadership talent based on a clearly defined position specification, reaching beyond the personal networks of the committee and relatively ineffective journal advertisements 
• Curated presentation of physician-scientists aligned with department, institutional and U.S. News and World Report rankings 
• Focus on diversity in thought, gender, and underrepresented groups, while tapping into Russell Reynolds’ long-standing relationships with affinity groups and key opinion leaders 
• Direct person-to-person phone calls made by search consultants to persuade passive candidates to consider an opportunity 

Professional time optimization

• Reducing the length from 12-18 months to six months, which enables search committee members to advance organizational goals and contribute to the academic mission 
• Enhanced physician engagement and positive collegial interaction on a professional recruitment process 
• Stakeholder conversations with informed points of view on the field and cultural impact 

Cultural alignment

• Defining the path for professional development and advancement for the institutional for professional readiness instead of political expediency 
• Optimizing the candidate experience and increased probability of recruitment through attention to detail and optimal candidate experience 
• Setting a course for the future strategic objectives through clear cultural alignment 
• Search consultants conduct in-depth 360-degree references to deeply assess a candidate’s alignment with organizational culture

Diversity

• Changing the candidate paradigm through an integrated approach to developing diverse and inclusive candidate slates 
• Not only identify, but also successfully recruit physician leaders from historically underrepresented groups through a positive candidate experience 
• Support search committees to reduce bias in the candidate selection process 
• Develop a position specification that appeals to a diverse audience, while also highlighting the institution’s commitment to DEI and addressing health inequities in the community 

Predictable outcomes

• Using Russell Reynolds’ propriety Leadership Span (LSpan) model, leadership competencies and capabilities are assessed to provide predictable outcomes for newly placed executive leaders 
• This assessment tool empowers search committees to gain additional visibility into a candidate’s likelihood of success, beyond the insights gathered through interview and reference feedback. 

By engaging executive search firms and utilizing modern leadership assessments, academic medical centers can improve cultural alignment, lower burnout rates among faculty members, and increase diversity in leadership all while reducing the cost and time expenditures involved in the process. The benefits in partnering with search executives result in quantifiable time savings and costs, as well as qualitative professional morale among physicians and search committees.

Authors

Sarah Brooks is a member of the Russell Reynolds Associates’ Healthcare Services and Education practices, and leads the firm’s Academic Medicine practice. She is based in New York.

Sarah Eames leads the Russell Reynolds Associates’ Healthcare Services practice. She is also a member of the board & CEO advisory partners and private equity groups. She is based in New York.

Olivia Floto is a member of Russell Reynolds Associates’ Healthcare Services practice knowledge team. She is based in Chicago.

Guillaume Morisset is a member of Russell Reynolds Associates’ Social Impact and Education practice knowledge team. He is based in Boston.

References

_{¹ U.S. Medical School Department Chairs by Chair Type and Sex (aamc.org)}

_{² U.S. Medical School Deans by Dean Type and Race/Ethnicity (URiM vs. non-URiM) (aamc.org)}

_{³ Department Chairs by Department, Gender, and Race/Ethnicity, 2020 (aamc.org)}

_{⁴ US Census Bureau releases 2020 census: How to understand the data (usatoday.com)}

_{⁵ Five Ways To Innovate The Academic Medicine Search Process, RRA}

_{⁶ 4.1 Composition of the Search Committee - Handbook for Faculty Searches with Special Reference to Affirmative Action (msu.edu)}

_{⁷ guide-for-search-committees.pdf (emory.edu)}

_{⁸ Getting the Most from the Search Committee Process | Office of Human Resources (umn.edu)}

_{⁹ Roles in the Search Process | University Human Resources | Oregon State University}

_{¹⁰ AAMC Faculty Salary Report, FY 2021 Executive Summary}