Simone’s OncOpinion

Career development observations and advice for medical professionals from Dr. Joseph V. Simone.

Monday, December 9, 2013

How to Choose a Director of a Cancer Center

This post is the result of watching a major turnover of directors of NCI-designated cancer centers that started a couple of years ago and is still ongoing. Of the 60 comprehensive or clinical cancer centers (omitting for this purpose the six basic science only centers), the following have either appointed a new director or will do so in the near future:

  • USC,
  • UCSD,
  • UCSF,
  • UC-Irvine,
  • Wisconsin,
  • Lineberger-UNC,
  • Fox Chase,
  • UVA,
  • Northwestern,
  • City of Hope,
  • St. Jude Children’s Research Hospital,
  • Michigan,
  • MD Anderson, and
  • Duke.

There may be others I have missed, but that is at least 23% of the centers so far. This seemed a good time to review how leaders of major academic organizations are chosen. It starts with one of “Simone’s Maxims”--


Leaders are often chosen primarily for characteristics that have little or no correlation with a successful tenure as leader. Examples of such criteria include a long bibliography, scientific eminence, institutional longevity, ready availability, a willingness to accept inadequate resources or to not rock the boat. Choosing leaders is not a science, but it is surprising how often management skills, interpersonal skills, and experience are undervalued. This error is most damaging when recruiting leaders of organizations with a clinical mission because of the increasing complexity of health care economics and the interface of the academic mission with hospital functions.


What should one look for? It differs, of course, depending on the position. One should ask what critical skills are absolutely essential for that role at that time and in that particular setting -- there are usually only two or three. It could be scientific taste as much as accomplishment -- that is, a keen sense of excellent versus average science as opposed to the ability to run one’s own program successfully. Or it might be in-the-trenches management experience, inter-personal skills, or the courage to clean house.


My point is that we all want superb investigators, teachers, and clinicians -- preferably able to walk on water, but there are other practical values that are at least as important and often define the success or failure of the leader.


In my own experience, my favorite qualities to look for are leadership experience, an appropriate temperament, good interpersonal skills, and the recognition that promoting the success of his or her team is job number one; success in that endeavor will be the yardstick of success much more than individual success as a scientist or clinician.


Such a person must be willing to sacrifice a lot of time from a personal laboratory or clinical endeavor. Too often leaders are chosen because of a stellar research career or membership in the National Academy of Sciences -- both, though, believe me, are poor predictors of success as a leader of a complex research and clinical organization.