Why I Left Academic Medicine

A medical student who thinks he wants a career in academic surgery asks, “You were deep into academic medicine and walked away from chairman, program director, etc. Why?” [Background: For over 23 years, I was a full-time surgical chairman and residency program director in three different community hospitals affiliated with medical schools.] Good question. For many years I had always said something like: “No matter what crisis happens with the residents or the chairman’s job, it pales in comparison to having a patient with a complication.” In other words, nonclinical problems were annoying but manageable. Then one day I realized that was no longer so. Patients with complications still caused me many sleepless nights, and that hadn’t changed. What had changed was that resident issues and administrative hassles finally became intolerable. The rules set by the accrediting bodies, the ACGME and the Residency Review Committee (RRC) for Surgery, had always been difficult to comply with, especially for a small program. They became more onerous every year or 2 until it reached the point where I can’t imagine how anyone can stand it. Residents can complain to the RRC anonymously and no matter how factually you refute the complaint, the RRC always believes the disgruntled resident. Add in the work hours rules and the lack of motivation of some of today’s med school graduates and I had had enough. The position of surgical chairman in a community teaching hospital is like that of a football referee. At any given time, half your constituency is not happy with you. The administration pays your salary and expects you to spout the party...