If you’re aspiring to become the head of a rheumatology department, you’ll most likely need an excellent reputation as a rheumatologist, as well as a significant portfolio in basic or clinical research or educational scholarship. Education and training at a highly regarded academic medical center in rheumatology and experience working for a few years within such a division are also advantageous.
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Typically, division chiefs hold MD or DO degrees, but scientists with PhD degrees can also be competitive candidates. Chaim Putterman, MD, chief, Division of Rheumatology, Albert Einstein College of Medicine and Montefiore Medical Center in Bronx, N.Y., also earned an MBA to better understand and implement the financial, business language and tools that have become increasingly important to running an academic division.
Being in charge also requires managerial skills that typically aren’t taught in medical school, residency or fellowship. “An effective leader has experience on many academic committees, both as a participant and as a leader,” says Bernard R. Rubin, DO, MPH, division head, Rheumatology, Henry Ford Health System, and clinical professor of medicine at Wayne State University School of Medicine in Detroit.
Dr. Rubin also found that volunteering as a board member for a private school and serving on ACR committees provided valuable managerial experience. “These activities have helped me tackle human resource issues,” he says.
Being able to mold and encourage younger faculty is another component of the job. You’ll need to employ succession planning, so encouraging junior faculty to obtain leadership training and assisting them in these endeavors is vital. “You also need to be able to hire well and selectively [to] create a great team,” Dr. Rubin says.
The department chief must be able to think strategically and have a vision for the division going forward. “I make business decisions based on data and facts, avoiding intuition or gut feelings, so faculty will understand the reasons behind my decisions—reinforcing a sense that decisions aren’t arbitrary, but reasoned and well thought out,” Dr. Rubin says.
Advantages & Disadvantages
As someone in a position of authority, you’ll have the ability to effect change and have influence. “You’ll have closer interactions with senior leadership of your department and the medical center, and you’ll hear about new programs being considered that you can promote or discourage,” Dr. Putterman says. “This [interaction] is an important opportunity to highlight your specialty, and gives you an important voice in shaping institutional initiatives.”
On the downside, as you go up the career ladder the amount of time you have to spend on administrative duties and meetings increases. “Although all faculty have administrative responsibilities, these duties usually increase with rank and are especially pronounced in managerial and leadership positions,” Dr. Putterman says. “Meanwhile, you will have less time to see patients and, in some cases, you will no longer see patients—depending upon your preference or your department’s guidelines. Further, “you will have less time to devote to your own personal research program or other professional interests.”
As the department head, you’ll also be the go-to person to handle complaints and disputes. “You’ll have a tremendous degree of responsibility for the daily operations of the systems you lead,” Dr. Putterman says. “You’ll be accountable for other staff members and their actions, even if you aren’t personally involved with them.”
Dr. Rubin adds, “The division chief will sink or succeed based on the success of the faculty he or she has selected, motivated, inspired and encouraged.”
Challenges & Resolutions
Recruitment is currently a major challenge division heads face. To get more medical students and house staff interested in rheumatology, Dr. Putterman says you need to expose them to the field early on. The ACR offers institutions grants that support medical student and resident experiences in rheumatology. Also, department heads should meet with students who are interested in exploring the field of rheumatology, invest their time in medical students’ education and promote rheumatology-related opportunities at their institution.
Attending meetings of ACR division directors has provided Dr. Putterman with the opportunity to network and obtain ideas for recruitment strategies, as well as other topics he’d like input on from others, which he also does by using the ACR Division Directors’ online community. The Division Directors Special Committee is currently working to create a toolbox of best practices for division directors, including recommendations to improve recruitment.
Another challenge is championing the financial worth of a rheumatology division. “Because rheumatology is typically a relatively small specialty, it is much easier for a hospital to overlook allocating resources to that area,” Dr. Putterman says. “Therefore, we need to make sure the institution understands our contributions, such as taking care of the medical needs of patients with musculoskeletal disease before and after orthopedic surgical interventions, being experts in biologic therapies and immunomodulators, and being a significant generator of immunologic tests.”
Additionally, time management skills are crucial for division chiefs. Dr. Putterman suggests identifying individuals you can delegate responsibility to. “You need to identify the strengths and weaknesses of your faculty and administrative staff,” he says. “Allow them to have positions of responsibility and authority within your division. Empowering others strengthens the division, while also providing them valuable opportunities for professional advancement.”
Karen Appold is a medical writer in Pennsylvania.