Judging academic pathology chairpersons.

In their article, “Chairpersons of Pathology in the United States: Benchmarks for Academic Publications and Professional Credentials,” Wick and Stoler1 focus on issues that are both provocative and controversial. Prompted by their concern for the falling rate of recruitment of US medical school graduates into pathology residency training programs, Wick and Stoler conducted an objective study to determine the record of publications and board certification status of 126 chairs of academic pathology departments (in this setting an academic pathology department was defined essentially as a US medical school–based pathology department). In addition, by classifying the publications into “basic science” and “clinically oriented” subjects, the authors further characterized the career emphasis of each pathology chairperson. Although some may find fault with the data collection technique and the variables that were measured, most readers will find the results of the study of significant interest. Wick and Stoler concluded that the background and duties of today’s academic pathology leaders may well be in a state of evolution. They point to a series of changes in academic pathology during the last decade, including the variable success rate at obtaining extramural research funding and the falling reimbursements per unit of service for direct patient care activities and clinical laboratory tests provided by pathologists in university hospitals. Nevertheless, they write that academic productivity and scholarship remain at substantial levels among US academic pathology chairpersons, but that clinically oriented research (presumably not extramurally funded) may make up more than half of the group’s publications. Although there are no previous studies of this subject to refer to, Wick and Stoler also comment on the 85% board certification rate, which indicates that a significant majority of US academic pathology chairpersons are trained formally in anatomic or clinical pathology or both and also hold subspecialty board certifications (25% of chairpersons). There are many other variables that could be used to evaluate the role of the academic pathology chairperson ❚Table 1❚. The backgrounds and duties of the individuals who hold these positions often reflect the institutional needs and personal philosophy of the medical school dean or health sciences center president/chief executive officer. Whether they concentrate on extramural research development or clinical practice productivity, increasing emphasis will likely be placed on departmental budgeting and financial management. It seems that for the foreseeable future, search committees for unfilled academic pathology chairperson positions will continue to grapple with the question: “Do we need a scientist with a federally funded laboratory who can delegate practice and clinical laboratory management to directors of anatomic pathology and laboratory medicine? Or should we look for a clinician who can grow practice and laboratory revenues and use the proceeds to ‘acquire’ a research program?”