Despite the ever-transforming academic health landscape, the leadership recruitment within the field of academic medicine has not evolved significantly over the last few decades. Although the traditional approach to recruitment has undoubtedly led to many effective hires, an opportunity exists to be more efficient, without compromising the quality of results.
In a survey conducted in 2011, the Association of American Medical Colleges (AAMC) highlighted that academic leadership searches at major teaching hospitals take on average seven months to complete, while Department Chair and Center Director searches take almost a year1. Among clinical department chair searches, the use of a search firm shortened the length of the search. The average search duration for clinical chairs at medical schools that did not use a search firm was 12.5 months, but those that used search firms completed their task, on average, in 9.5 months2. Our proprietary data from the last two years continue telling this story as well; the process of recruiting academic medicine leaders has not shortened over the past 10 years, and the academic search process is significantly longer than searches we conduct in other industry sectors.
As academic medicine institutions expand and broaden their core missions to include social determinants of health, population health, personalized medicine, emerging technology, and innovation, the search process needs to efficiently identify and select leaders with the right mix of out-of-the-box thinking and traditional physician leadership qualities to execute on these new initiatives. In addition, the academic search process must proactively address and embed diversity and inclusion strategies within senior recruitment processes. Despite 26 new LCME accredited medical schools opening between 2002 and 20183, the percentage of female Deans, Department Chairs, and full Professors has increased only minimally.
|Percentage of women in position|
|Deans||Department Chairs||Full Professors|
In our firm’s experience of recruiting more than 100 physician executives and functional leaders to academic medical centers and Schools of Medicine in the past five years, we have observed common pain points that institutions face, as well innovative solutions to help address those challenges. We find it useful to think about these priorities using the framework below, which breaks the search process into four main components: people, process, strategy, and culture.
- How can the institution retain a holistic understanding of diversity, equity, and inclusion?
- Where and how can the search process beer incorporate diversity, equity, and inclusion considerations?
- How is the search process impacted from the lack of overall strategy from the institution?
To better understand these challenges and solutions, Russell Reynolds Associates interviewed 14 senior executives from leading academic medical centers. Our conversations brought to light five common challenges that routinely impede the efficiency and efficacy of the academic search process:
- Launching the search in the market without stakeholder alignment or a clear definition of the role
- Failing to outline a clear search process, in which stakeholders understand expectations and responsibilities
- Prioritizing the triple threat of academic medicine, versus leadership competencies
- Succumbing to tunnel vision and focusing recruitment efforts on one candidate too early in the process, without evaluating a diverse group of candidates against the prioritized competencies
- Addressing diversity and inclusion as an afterthought, and only through piecemeal, “band-aid” workarounds
SAY WHAT YOU NEED, EARLY AND OFTEN
Eager to identify the next leader, many institutions launch the search process without alignment on the job specification. This approach often leads to a Search Committee realizing halfway through the search that it is seeking a candidate that can help solve the problems of the past, rather than meet the challenges of the future. In some instances, stakeholders are misaligned around experiential criteria for the ideal candidate. In other instances, a Committee realizes it did not clarify what type of candidate it was searching for in the first place.
Take time upfront to reflect on key competencies of successful, comparable leaders from both inside and outside of the organization. Discuss the pros and cons of specific skills and what has proven to be successful; be targeted and specific. Upon completion, the Committee should be able to articulate the future priorities of the institution and relevant department, in addition to the skills and competencies required in the next leader.
QUESTIONS TO ASK:
- What is the strategic vision for the organization or Department? What are the short and long-term goals the next leader should seek to achieve?
- Will the next leader guide a team through a period of growth, stabilization, or turnaround?
- Has the hiring manager clearly communicated the most important skills and attributes of the ideal candidate to the Search Committee in a group setting, with time for probing questions?
- What key priorities and selling points should be emphasized to a potential candidate?
CONTROL WHAT YOU CAN: DEFINE THE PROCESS
Searches are inevitably delayed when stakeholders do not understand the process, hold differing ideas of expectations and responsibilities, or are ultimately uncoordinated in how to progress candidates from one stage to the next.
The most successful searches start with a clearly defined process, with a rigorous process for establishing the Search Committee, identifying and selecting candidates, conducting multiple rounds of interviews, referencing, and exploring relocation services. The Dean, leadership, Search Committee, and key stakeholders should each understand role and responsibilities across the entirety of the process. A defined process also allows for proactive interview scheduling, which is important, as interview scheduling is one of the most common reasons a search takes longer than anticipated. In addition, it facilitates a positive candidate experience, particularly for senior executive candidates with pressing commitments at their current institutions.
QUESTIONS TO ASK:
- What is the right method to communicate clear expectations and to encourage engagement from the Search Committee, search firm, and interviewers?
- Is communication with the Search Committee and key stakeholders maintained across the entirety of the search?
- Are key Search Committee meetings and interview dates proactively scheduled and communicated?
- Do the candidates have a clear understanding of what will be expected, and when?
ASSESS FOR THE ACADEMIC LEADER OF THE FUTURE, NOT THE TRIPLE THREAT OF THE PAST
Academic institutions have historically prioritized the triple threat of patient care, research, and education. Leadership recruitments have typically begun with a CV filtration exercise, seeking specific levels of peerreviewed publications, national recognition in a clinical specialty, or R01 grant funding. This outdated approach has resulted in some individuals with an outstanding CV, yet were ill-prepared to lead and inspire teams or to build a financially stable operation.
Today’s leaders must demonstrate an ability to lead, develop, recruit and retain teams and people; to communicate effectively with a broad set of stakeholders; to demonstrate business sense; and to possess financial acumen. Forward-thinking institutions recognize the importance of inspirational leadership, business sense, collaboration, and financial stewardship. These attributes cannot be easily gleaned from a CV.
QUESTIONS TO ASK:
- Does the candidate possess financial acumen, including a track record of successfully meeting a budget? How has the candidate served as a financial steward within his/her area of responsibility?
- Does the candidate possess the core leadership competencies of setting strategy, executing for results, leading teams, and building relationships?
- How has the candidate recruited and retained high-performing teams? How has the leader encouraged others to advance each of the academic missions?
- Are the interview questions the right ones? Do these interview questions provide insight into the most important leadership competencies?
AVOID TUNNEL VISION
It may seem appropriate for the Search Committee to pursue one lead candidate early in the process. However, it is critical to maintain momentum with multiple candidates in the process, recognizing that a lead candidate can ultimately withdraw from the process, accept a competing offer, or decline an offer. Restarting a search can create fatigue in the market, and it can be detrimental to a search timeline and organizational priorities.
It is important to maintain an open mind and to trust in the process. Resist the temptation to narrow down to one or two candidates too quickly. Additional interviews across diverse settings, 360-degree referencing, and psychometric assessment may yield more information than a CV or a first meeting. In most instances, the hiring manager would like to select from approximately three finalists before making the final hiring decision.
QUESTIONS TO ASK:
- How is the Search Committee collecting and discussing interview feedback? Is “group-think” leading to a narrow candidate pool?
- What are the processes and methods in place for candidate care and continued engagement?
- What information should be gathered through in-depth referencing?
- Should psychometric assessments be leveraged to test for “quieter” leader attributes that may not be observed in traditional interviews, or to differentiate between candidates?
STRIVE FOR A HOLISTIC APPROACH TO DIVERSITY, EQUITY, AND INCLUSION
Diversity and inclusion (D&I) needs to be addressed early on when creating the search strategy, and at multiple checkpoints throughout the search, including candidate selection meetings.
The most successful institutions take an intentional approach, while actively sourcing relevant candidate pools. It is important to leverage person-to-person sourcing, while engaging the Search Committee to collect or provide relevant candidate recommendations.
Successful recruitment requires that Search Committees not only review a diverse candidate slate, but also select diverse candidates to interview. The Search Committee should be educated on unconscious bias and the institution’s approach to D&I by the time the search is launched.
Search firms or talent acquisition professionals can add value by constantly seeking and meeting high potential diverse leaders in academic medicine, so they are poised to tap into this cultivated pool of candidates and sources, when a hiring need arises.
QUESTIONS TO ASK:
- What type of sourcing is done to uncover diverse candidates, outside of the “usual suspects” for a leadership role? Does the position specification appeal to a diverse and inclusive audience?
- What is the composition of the existing leadership talent pool in terms of diversity, and what challenges should the institution be prepared to address through a targeted search strategy?
- Has a D&I champion been included on the Search Committee, and/or does the Committee represent a diverse group of employees?
- What will candidates learn about the institution’s approach to fostering workplace equity through the interview process?