Organizational, financial, and environmental factors influencing deans' tenure.

At a time when continuity of leadership in medical schools is most crucial, the tenures of deans continue to decrease. In the present study of factors influencing the tenures of 382 U.S. medical school deans from 1985 to 1994, the authors focused on issues that were likely to have had a greater impact on deans' tenures in recent years. They assumed that longer tenures are associated with less complex organizational factors and more stable environmental factors. Conversely, they assumed that deans and their tenures are adversely affected by an institution's declining financial health, a complex organizational structure, and a changing clinical marketplace where there is rapid growth of managed care. The authors compared the relationships between these factors and the length of deans' tenures during the ten-year period studied. Among the most important findings were the fact that schools that were less healthy financially, that had the same owner as the primary teaching hospital, and that had smaller numbers of faculty tended to have shorter dean's tenures and higher turnovers of deans. While the reason for shorter tenures of deans at schools that are less financially healthy is understandable, the effect of common ownership of the school and teaching hospital is less obvious, but perhaps the greater preoccupation of deans with the clinical enterprise in that circumstance is a significant constraint. The authors hope that the insights from their findings will be useful to future candidates for deanships in their negotiations with university officials and will help all parties reach more explicit agreements on such issues as expectations for financial performance of the medical school and the roles and relationships of the dean and the teaching hospital director.