In 2009, Dr. Ralph V. Clayman attained the crowning achievement in academic medicine: He accepted the position as dean of the UC Irvine School of Medicine. He quickly discovered, though, that his tenure as founding chair of the school's acclaimed urology department did not adequately prepare him for the demanding new position. He also realized that his feeling of a lack of preparedness was not unique among academic leadership.
After his five-year term — during which time the medical school attained full accreditation from the LCME, achieved a positive financial balance sheet, opened more than 750,000 square feet of new clinical and educational space and experienced significant growth in its academic profile — Clayman set out to write a guide to academic leadership in an age of uncertainty.
He sent a detailed questionnaire to vice chancellors and deans of U.S. medicals schools who had served at least five years in their position. More than half of the 61 he queried responded. Clayman’s and their insights are found in the pages of The Compleat Dean, which was published in late 2016. The book, which is available on Amazon, has been well received. Indeed, it was the website's No. 1 best seller in the Higher Education Administration category on two separate occasions in January.
In an interview, Clayman discusses his reasons for The Compleat Dean and the larger issues of academic leadership.
Q: What compelled you to write this book?
A: When I became dean, there were many areas in which I had no experience. There were several leadership books that I'd read, but there were only a couple of older books that specifically pertained to being dean of a School of Medicine. In addition, I learned that the median tenure of medical school deans was only four years, so I felt that advice from deans who were "in the saddle" for five or more years could be helpful to anyone starting out in that position.
Q: What can academic leaders outside of medicine learn from this book?
A: To be sure, the book has a much broader audience than deans of medical schools. Indeed, there are common challenges to all leaders regardless of their entity. These lie in the realm of communications, meeting management, hiring, termination, crisis management, strategic planning, culture development and life balance. The book addresses each of these areas and I believe that the advice contained in those chapters might be of value to all individuals in a leadership position.
Q: You mention in the book's early pages that one rarely prepares to be a dean one day. The same can hold true for many academic leadership position. What flaw in higher education management model does this reveal?
A: Great question. Ascendancy to chief of a division or chair of a department is most often based on academic productivity, which rarely requires the management and financial skills important in running a broader successful enterprise. Moving from faculty to chair requires individuals to expand their realm beyond themselves; As a leader their success will no longer be determined by their individual accomplishments but rather by how well each of their faculty members thrive under their direction. Today, there are many leadership courses in various business schools that can be potentially beneficial in this regard.
Q: It can be said that higher education is in a growing state of crisis, and that medical schools are facing profound changes. What are they, and how can academic leadership steer this ship through rocky seas?
A: To meet these challenges requires from the dean a deep dedication to the institution, which is manifested by a dogged persistence and an excessive commitment of time. Of note, the three key traits that were identified among the responding deans were: perseverance, a nurturing-optimistic personality and creativity.
Today the challenges for medical school include: introduction and mastery of the electronic medical record, diminishing state support for public medical schools, reductions in reimbursement for services rendered, an increasingly complex billing structure, introduction of novel educational curricula requiring more faculty time and more expense, reductions in research support and the difficulty entailed in securing peer review funding, an expanding and expensive infrastructure in order to fulfill various mandates (for example, accreditation, billing and collections, grant applications, clinical and hospital review organizations, etc.), and shrinking state support for public medical schools. Most troubling to me is the ongoing crushing debt that our medical students now endure, which threatens their being able to enter the most basic and important areas of medicine: family medicine, pediatrics and obstetrics/gynecology.
Q: You served as dean of UC Irvine's medical school for five years. How did you evolve as a leader over that time? How do those lessons guide you still?
A: My primary take-away as dean was the importance of gaining trust from all stakeholders in the organization. Trust is based on transparency, which in turn is dependent upon clear communications. In that regard, the hardest lesson for me was learning that no matter how well I believed I had communicated, I had to do better and do more.
Q: I’ve heard it said more than once that one of the happiest persons in the world is a former dean. Why is that?
A: As dean, you carry the weight of everybody’s well-being upon your shoulders. Success is plural, but failure is singular and that singularity falls on "the dean." Being dean is a tremendous opportunity and privilege, but it is equally a huge responsibility. Rising to the challenge and succeeding is a 24/7 undertaking — for me it was far and away the most demanding and satisfying challenge of my career. But when that weight is lifted off your shoulders, you realize how simple your former life was and you delight in returning to being a professor once again.
Q: What has the feedback been so far to The Compleat Dean?
A: Honestly, the best feedback I received was from the deans who contributed to the book. They actually thanked me for sending the questionnaire to them as it caused them to think about all aspects of being a dean. More than anyone, they encouraged me to complete the book and they have been very complimentary regarding its publication. I have been delighted that the book has been widely accepted and indeed has appeared twice now as a No. 1 best seller in Higher Education Administration.