A cross-sectional study of neurosurgical department chairs in the United States

Abstract

OBJECTIVE The position of neurosurgery department chair undergoes constant evolution as the health care landscape changes. The authors' aim in this paper was to characterize career attributes of neurosurgery department chairs in order to define temporal trends in qualities being sought in neurosurgical leaders. Specifically, they investigated the hypothesis that increased qualifications in the form of additional advanced degrees and research acumen are becoming more common in recently hired chairs, possibly related to the increased complexity of their role. METHODS The authors performed a retrospective study in which they collected data on 105 neurosurgeons who were neurosurgery department chairs as of December 31, 2016, at accredited academic institutions with a neurosurgery residency program in the United States. Descriptive data on the career of neurosurgery chairs, such as the residency program attended, primary subspecialty focus, and age at which they accepted their position as chair, were collected. RESULTS The median age and number of years in practice postresidency of neurosurgery chairs on acceptance of the position were 47 years (range 36-63 years) and 14 years (range 6-33 years), respectively, and 87% (n = 91) were first-time chairs. The median duration that chairs had been holding their positions as of December 31, 2016, was 10 years (range 1-34 years). The most common subspecialties were vascular (35%) and tumor/skull base (27%), although the tendency to hire from these specialties diminished over time (p = 0.02). More recently hired chairs were more likely to be older (p = 0.02), have more publications (p = 0.007), and have higher h-indices (p < 0.001) at the time of hire. Prior to being named chair, 13% (n = 14) had a PhD, 4% (n = 4) had an MBA, and 23% (n = 24) were awarded a National Institutes of Health R01 grant, tendencies that were stable over time (p = 0.09-0.23), although when additional degrees were analyzed as a binary variable, chairs hired in 2010 or after were more likely to have an MBA and/or PhD versus those hired before 2010 (26% vs 10%, p = 0.04). The 3 most common residency programs attended by the neurosurgery chairs were Massachusetts General Hospital (n = 8, 8%), University of California, San Francisco (n = 8, 8%), and University of Michigan (n = 6, 6%). Most chairs (n = 63, 61%) attended residency at the institution and/or were staff at the institution before they were named chair, a tendency that persisted over time (p = 0.86). CONCLUSIONS Most neurosurgery department chairs matriculated into the position before the age of 50 years and, despite selection processes usually involving a national search, most chairs had a previous affiliation with the department, a phenomenon that has been relatively stable over time. In recent years, a large increase has occurred in the proportion of chairs with additional advanced degrees and more extensive research experience, underscoring how neurosurgical leadership has come to require scientific skills and the ability to procure grants, as...

An Analysis of Academic Background and Research Activity Among Pediatric Orthopaedic Surgery Division Chiefs and Fellowship Program Directors

“…This trend may not be isolated to orthopaedics, as research has also shown that advanced degrees were common among cardiothoracic and neurosurgery chairs. 24,25 Prior Copyright © 2022 JPOSNA® www.jposna.org research showed that, among orthopaedic surgery department chairs, 15.0% of physicians had an additional degree, which was most commonly an MBA. 20 In the current study, it was also found that the MBA was the most common extra degree among leaders in pediatric orthopaedics.…”

NIH funding trends for neurosurgeon-scientists from 1993–2017: Biomedical workforce implications for neurooncology

“…This finding is aligned with previous studies where H-index was found to be correlated with amount of NIH-funding, total number of grants, and duration of grants in calendar years. [ 55 – 57 , 16 , 58 ]…”

Current and Temporal Trends in Otolaryngology Department Chair Appointment

“…4 Historically, chairs and chiefs within this specialty have typically been male, fellowship-trained, and nearly onethird had earned additional degrees aside from MD. 4 Traditionally, department chairs were recruited from outside institutions; however, this approach appears to have decreased in recent years, 4,5 perhaps due to the familiarity with internal candidates. Characterizations of department chairs have been performed in other surgical subspecialties, 5,6 and to some extent within otolaryngology, 4 though temporal trends in otolaryngology department chair characteristics have not been documented.…”

“…4 Traditionally, department chairs were recruited from outside institutions; however, this approach appears to have decreased in recent years, 4,5 perhaps due to the familiarity with internal candidates. Characterizations of department chairs have been performed in other surgical subspecialties, 5,6 and to some extent within otolaryngology, 4 though temporal trends in otolaryngology department chair characteristics have not been documented. The aim of this study is to present a crosssectional representation of demographic, academic, and professional qualities associated with being appointed department chair or division chief in otolaryngology, and to determine temporal trends.…”