An Introduction to the DFM's Leadership Structure: Part II

In the last issue of the newsletter, I described the role of the Chair of the Department, why we search externally for Chairs, and the relationship of the Chair with the Dean of the Medical School and the University campus. Now I would like to provide an overview of the leadership structure of our Department, including the roles of the Executive Council, Executive Committee, the Department Leadership Team (DLT), and their relationship to the Department Chair.

The Chair of the Department is responsible to both the Dean of the Medical School and the faculty of the Department. The important role of faculty in the University of Wisconsin system is based on a philosophy of faculty governance. Faculty participation in governance and determination of policy and procedures is well established. The process for making decisions regarding the promotion of faculty, decisions to confer tenure, and the legal status of each of the faculty tracks, (Center for Health Sciences (CHS), and the Clinical track (CT) are all examples of these well established policies and procedures. Annually, the faculty of each department are asked by the Dean to vote on whether the Chair's performance merits his or her continuation in this role. This annual vote is considered advisory to the Dean in a decision to reappoint the Chair or to ask for a resignation.

The "legal" faculty of our Department and all departments in the University are those individuals who have tenure. Faculty who are hired on the tenure track, or transfer to this track within a specified amount of time after they are hired, are eligible for tenure if they meet all the requirements for promotion within a specified time, usually six years. The decision to confer tenure to an eligible faculty member is based on a vote of Department faculty with tenure, based on the academic and teaching accomplishments of the individual. Each candidate must then be reviewed by a divisional committee of the University - there are five such divisions, of which biological sciences and social studies are the two our faculty usually select. The Divisional Committee makes the ultimate decision to vote in favor of tenure for each candidate.

The tenured "legal" faculty make up the Executive Committee of the Department, and this group is ultimately responsible for the effective functioning of the Department in consultation with the Chair and the Dean. The tenure faculty in our Department include:

• Bruce Barrett, MD, PhD
• Richard Brown, MD, MPH
• Mike Fleming, MD, MPH
• John Frey, MD
• Craig Gjerde, PhD
• Patrick McBride, MD, MPH and
• Susan Skochelak, MS, MD, MPH

They are expected, on a regular basis, to review the legal responsibilities of the Department and determine which decisions must remain within their purview, and then vote on those that they are willing to delegate to other responsible groups. The Executive Committee also meets periodically to review the progress of all assistant professors to make sure they are meeting expectations for promotion to tenure.

Our Department is made up predominantly of CHS faculty, many of whom are in leadership roles in our residency programs or campuses, and CT faculty who are providing leadership of our clinical practices. Therefore, our Department has created an Executive Council, made up of leaders of our campuses and other major departmental functions, as well as representatives of the academic staff, tenured faculty, and faculty at large. The tenured faculty have conferred decision making for day-to-day functioning of the department, and decisions for things such as residency education, as an example, to this group. The Executive Council meets quarterly and is presided over by the Department Chair. Agendas for this group include:

• Final approval of all faculty hires
• Oversight of budget, compensation
• All other missions of the Department

Thus, in our Department, the Executive Council has much more hands-on responsibility for day-to-day management than the Executive Committee. This model has worked well for us as a Department as it allows the faculty, whether CHS, CT or tenure track, who are appointed to leadership roles, to have the authority and responsibility necessary for oversight of key department activities.

Let me give an example about how differently each of these groups function. When each of the chair candidates visit, the Executive Committee will have the responsibility of determining which candidates they feel have the academic credentials to be conferred tenure at University of Wisconsin, and whether they can support the candidates before the Divisional Committee. Once hired, the Executive Council will be responsible to work with the new chair to accomplish each of the Department missions and any new initiatives the new Chair feels will help to further advance our Department.

Day-to-day functioning of the Department is the responsibility of the Department Chair and the Department Administrator in most medical school departments. However, our Department is so large, with multiple campuses and missions, and clinical practices in numerous towns and cities throughout Wisconsin, that this model is not practically effective. Therefore, we recently established a Department Leadership Team (DLT), about three years ago, to help accomplish this function. The DLT includes:

• David Dadds, MS - Department Administrator
• Bill Schwab, MD - Madison Residency Program Director and Chair of the DFM Graduate Medical Education Committee (GMEC)
• Chris Viney, MS - representing educational programs
• Mary Beth Plane, PhD - representing research
• Sandy Kamnetz, MD - Vice Chair for Clinical Care
• Byron Crouse, MD
• The Department Chair

The DLT functions as an advisory group, an action group and a delegating group. The DLT acts on issues that need timely attention, such as appointing faculty to committees. It also delegates issues, topics and policy development to appropriate department groups such as the DFM Finance Committee or Graduate Medical Education Committee. Finally, the DLT also acts as an advisory group for the Chair when difficult issues arise.

I hope you find this information helpful in understanding how our department and Medical School work. Please let me know if there are other topics that may interest you.