emotionalintelligenceandburnoutin academic … intelligence questionnaire short form (teique-sf) and...

Emotional Intelligence and Burnout inAcademic Radiation Oncology ChairsEmma B. Holliday, MD, assistant professor, Division of Radiation Oncology, University ofTexas MD Anderson Cancer Center, Houston; James A. Bonner, MD, chair, Departmentof Radiation Oncology, University of Alabama, Birmingham; Silvia C. Formenti, MD,chair, Department of Radiation Oncology, Weill Cornell Medical College, New York,New York; Stephen M. Hahn, MD, chair, Division of Radiation Oncology, University ofTexas MD Anderson Cancer Center; Shalom Kalnicki, MD, chair, Department of RadiationOncology, Albert Einstein College of Medicine, Bronx, New York; Fei-Fei Liu, MD, chair,Radiation Medicine Program, University Health Network, Princess Margaret Cancer Centre,University of Toronto, Ontario, Canada; Benjamin Movsas, MD, chair, Department ofRadiation Oncology, Henry Ford Hospital, Detroit, Michigan; Clifton D. Fuller, MD, PhD,associate professor, Division of Radiation Oncology, University of Texas MD AndersonCancer Center; and Charles R. Thomas, Jr., MD, chair, Department of Radiation Medicine,Knight Cancer Institute, Oregon Health & Science University, Portland

...........................................................................................................................E X E C U T I V E S U M M A R YThe importance of emotional intelligence (EI) in physicians has attracted attention asresearchers begin to focus on the relationship of EI to retention, promotion, and pro-ductivity among academic physicians. However, to date, no formal evaluation of EI hasbeen conducted among current department chairs. The objectives of this study were toassess the EI of current chairs of academic radiation oncology departments and to corre-late EI with a self-reported assessment of burnout.

The authors invited 95 chairs of academic radiation oncology departments to partici-pate in a survey, approved by an institutional review board, consisting of the Trait Emo-tional Intelligence Questionnaire Short Form (TEIQue-SF) and the abbreviated MaslachBurnout Inventory (a-MBI). TEIQue-SF scores were evaluated for correlation with re-spondents’ demographics and self-reported burnout scores on the a-MBI. Sixty chairsresponded to the survey, for a response rate of 63.2%. The median (interquartile range)TEIQue-SF for the responding cohort was 172 (155–182) out of a maximum possiblescore of 210. The a-MBI emotional exhaustion and depersonalization subscoreswere low,withmedian (interquartile range) scores of 4 (2.25–6.75) and 1 (0–2.75) out ofmaximum

For more information about the concepts in this article, contact Dr. Holliday [email protected] authors declare no conflicts of interest.

© 2017 Foundation of the American College of Healthcare ExecutivesDOI: 10.1097/JHM-D-16-00001Supplemental digital content is available for this article. Direct URL citations appearin the printed text and are provided in the HTML and PDF versions of this article onthe journal’s website (www.jhmonline.com).

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EMOTIONAL INTELLIGENCE AND BURNOUT IN ACADEMIC CHAIRS

possible scores of 18 and 30, respectively. Higher TEIQue-SF global scores were weaklycorrelated with decreased burnout. The study results show that academic radiation on-cology chairs had a high EI and low rates of self-reported burnout. EImay be of increasingimportance with respect to recruitment and retention of academic medical leaders.

I NTRODUCT IONEmotional intelligence (EI) is a measureof how well an individual perceives andresponds to his or her emotions as wellas those of others (Goldstein, Princiotta,& Naglieri, 2015). To succeed in themedical profession, physicians must rec-ognize and respond appropriately tothe emotions of patients, staff, and col-leagues. Indeed, EI has been linked toimproved leadership in healthcare ad-ministration, nursing, and public health(Knight et al., 2015; Spagnuolo, DeSantis, Torretta, Filippo, & Talucci, 2014;Weiszbrod, 2015). The AccreditationCouncil for Graduate Medical Education(n.d.) requires resident physicians todemonstrate six core clinical competen-cies; two of them—professionalism andinterpersonal/communication skills—require a high degree of EI.

Despite the increasing attention fo-cused on assessing and fostering EI amongphysicians in training, less emphasis hasbeen placed on EI among academic phy-sicians and especially those in leadershippositions. Some hospitals and other largemedical facilities are implementing 360-degree feedback as a method to improvephysician EI (Hammerly, Harmon, &Schwaitzberg, 2014). One survey of plasticsurgery program directors found that onequarter of respondents felt that managingconflict was their greatest professionalchallenge. Although that survey did notmeasure EI directly, results revealed a dis-crepancy in human resources manage-ment and EI: Surgeon respondents weretypically promoted to leadership

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positions on the basis of excellence inpatient care and not necessarily becausethey had the knowledge or skills requiredfor the job (Arneja et al., 2014).

The literature contains limited dataon optimal selection criteria for a chair-person of a clinical academic department(Grigsby, Hefner, Souba, & Kirch, 2004);however, chair search committees areincreasingly focusing attention on EI asan important quality (Clavien & Deiss,2015). No published studies to date haveevaluated the EI of academic departmentchairs. Therefore, this study serves as auseful baseline for future comparisons.

The objectives of this study were todetermine the EI of chairs of academicradiation oncology departments; to deter-mine whether EI differs significantly onthe basis of factors such as gender, geo-graphic region, age, number of years sinceresidency graduation, number of yearssince becoming chair, or department size;and to conduct an exploratory analysis ofthe relationship between EI, as evaluatedby the Trait Emotional Intelligence Ques-tionnaire Short Form (TEIQue-SF), andburnout, as evaluated by the abbreviatedMaslach Burnout Inventory (a-MBI).

METHODSWe initiated this study after obtaininginstitutional review board approval fromthe University of Texas MD AndersonCancer Center in Houston. The targetpopulation included the 95 chairs ofacademic radiation oncology departmentswho were members of the Society ofChairs of Academic Radiation Oncology

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Programs (SCAROP). We then accessedthe 2014–2015 SCAROP membershipdirectory to obtain e-mail addresses ofdepartment chairs. Using the REDCapsurvey tool (http://project-redcap.org),we invited all identified SCAROP mem-bers to complete the online, anonymousquestionnaire (Harris et al., 2009). Weprovided a public link for participation,and at the close of the survey period, wedownloaded the anonymous results foranalysis. The survey period lasted fromJuly 24, 2015, until September 1, 2015.

Survey InstrumentWe designed the content of this surveyafter reviewing other surveys of EI andburnout (Kusano et al., 2014; McKinleyet al., 2015). (The survey is provided asan appendix to this article, publishedonline as Supplemental Digital Content athttp://links.lww.com/JHM/A10). The threesections of the survey included demo-graphics and chair experience, the TEIQue-SF, and the a-MBI.

The TEIQue is a validated instrumentconsisting of 153 questions and results in15 facet and 4 factor scores, as well as1 global score. Facets include adaptability,assertiveness, emotional perception, emo-tional expression, emotion management,emotion regulation, impulsiveness, rela-tionships, self-esteem, self-motivation, so-cial awareness, stress management, traitempathy, trait happiness, and trait opti-mism (Freudenthaler, Neubauer, Gabler,& Scherl, 2008). Several other validatedinstruments are available to test EI. TheMayer–Salovey–Caruso Emotional Intelli-gence Test is one such instrument; it con-sists of 141 items and takes 30–45minutesto complete (Mayer, Salovey, & Caruso,2002). The Emotional Quotient Inventoryconsists of 133 items and takes 30minutes

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to complete (Bar-On, 2004). We chose theTEIQue for this study, owing to the avail-ability of a validated short-form assessmentto encourage participation and comple-tion of the survey while respecting theclinicians’ time. The TEIQue-SF is anabbreviated version of the original TEIQuethat was designed to more succinctlymeasure global trait EI. The TEIQue-SFcontains 30 questions, 2 from each of the15 facets (Cooper & Petrides, 2010;Petrides & Furnham, 2006). Questions areanswered on a 7-point Likert scale (1 =completely disagree to 7 = completely agree).

The MBI is a validated assessment forburnout risk consisting of 22 questions inthe domains of emotional exhaustion,depersonalization, and personal accom-plishment (Maslach, Schaufeli, & Leiter,2001). The criteria for high risk of burnoutinclude coexisting high emotional ex-haustion, high depersonalization, and lowpersonal accomplishment. We used theabbreviated MBI because of its ease of useand to combat survey fatigue (Mazzarello,Clemons, Graham, & Jacobs, 2015). Sev-eral studies of academic chairs in otherspecialties have used abbreviated or mod-ified versions of the MBI (Cruz, Pole, &Thomas, 2007; De Oliveira et al., 2011;Gabbe, Melville, Mandel, & Walker, 2002;McManus, Smithers, Partridge, Keeling, &Fleming, 2003; Saleh et al., 2007).

Instrument ScoringWe scored the TEIQue-SFs for all sur-vey respondents using the key availableonline (London Psychometric Laboratory,n.d.). The TEIQue-SF yields a global traitEI score that ranges from 1 to 7 and iscalculated as the mean of the individualquestion scores. Factor scores for well-being, self-control, emotionality, andsociability also range from 1 to 7 and are

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calculated as the mean of the individualquestion scores pertaining to that factor.Because the data were not normally dis-tributed, we reported median (interquar-tile range [IQR]) global and factor scoresfor the entire cohort and then performedunivariate and multivariate analyses toevaluate for variables (i.e., demographics,chair experience characteristics, or a-MBIburnout score) associated with TEIQue-SFglobal and factor scores.

We scored the a-MBI for all survey re-spondents using the scoring key availableonline (Neurodevelopmental and Behav-ioural Paediatric Society of Australasia,n.d.). The a-MBI used for this study con-sists of 12 questions answered on a7-point Likert scale (0 = never and 6 = everyday or 0 = every day and 6 = never). Threequestions are in each domain, and scoresrange from 0 to 18, with 18 indicatingthe maximum emotional exhaustion,depersonalization, or personal accom-plishment. High scores in emotional ex-haustion and depersonalization areassociated with higher burnout, whereashigh scores in personal accomplishmentare associated with lower burnout. Inaddition, three questions address satis-faction with medicine; scores range from0 to 18, with 18 indicating maximum sat-isfaction with being a physician. Threequestions also address satisfaction withchairing.

Statistical AnalysisWe present summary statistics to de-scribe respondents’ demographic infor-mation in terms of frequency counts,percentages, medians, and IQRs, as ap-propriate. We used the Pearson correla-tion coefficient to examine correlations,and we used the Wilcoxon Rank SumTest to evaluate between-group differences


of continuous variables. We performed allstatistical tests with a predefined level ofsignificance of p < .05, and we used a sta-tistical software package (JMP, version 9,SAS Institute) for all analyses.

RESULTSOf the 95 academic radiation oncologychairs invited to participate, 60 responded,for a response rate of 63.2%. Nine re-spondents (15%) were female, and 51(85%) were male. Representation ofresponding chairs from the four geo-graphic regions (Northeast, Midwest,South, and West) was approximatelyequal. Table 1 presents demographic in-formation and other work characteristicsfor the responding chairs.

Table 2 shows the results of theTEIQue-SF for the responding chairs. Themedian (IQR) was 172 (155–182) outof a maximum possible score of 210.There were no significant differences inTEIQue-SF global scores by age, race/ethnicity, gender, geographic region, ap-pointment type, institution type, insti-tution size, hours worked, percentageeffort, number of institutions worked at,or years of chair experience.

Table 3 shows the results of the a-MBIfor responding chairs. Emotional exhaus-tion and depersonalization subscores werequite low, with median (IQR) scores of 4(2.25–6.75) and 1 (0–2.75) out of maxi-mum possible scores of 18 and 30, re-spectively. Personal accomplishment,satisfaction with medicine, and satisfac-tion with chairing subscores were quitehigh, indicating low rates of burnout inour responding cohort.

Higher TEIQue-SF global scores weresignificantly correlated with lower burn-out on all a-MBI subscores: lower emo-tional exhaustion scores (R2 = .094,


...........................................................................................................................TABL E 1Characteristics of Responding Academic Radiation Oncology Chairs (N = 60)

Characteristic n (%)a

Age in years, median (IQR) 56 (53–61.5)Race/ethnicityAsian 13 (21.7)Black 2 (3.3)Non-Hispanic White 40 (66.7)Hispanic 0 (0)Other 5 (8.3)

GenderFemale 9 (15)Male 51 (85)

Geographic regionb

Northeast 13 (21.7)Midwest 13 (21.7)South 20 (33.3)West 13 (21.7)Canada 1 (1.7)

Appointment typePermanent chair 57 (95)Acting chair 3 (5)

Institution typePublic 33 (55)Private 27 (45)

No. of faculty members, median (IQR) 18 (11–32)No. of residents/fellows, median (IQR) 8 (6–12)Hours worked per week, median (IQR) 65 (60–70)% Administrative duties, median (IQR) 30 (25–50)% Patient care, median (IQR) 30 (20–50)% Teaching, median (IQR) 10 (5–10)% Research, median (IQR) 10 (10–25)No. of institutions worked at, median (IQR) 2 (1–3)Years of chair experience, median (IQR) 8 (3–12)

Note. IQR = interquartile range.aExcept as otherwise indicated.bGeographic regions in the United States were defined according to the U.S. Census Bureau: Northeast

(Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont, New Jersey, New York, andPennsylvania), Midwest (Illinois, Indiana, Michigan, Ohio, Wisconsin, Iowa, Kansas, Minnesota, Missouri,Nebraska, North Dakota, South Dakota), South (Delaware, Florida, Georgia, Maryland, North Carolina, SouthCarolina, Virginia, District of Columbia, West Virginia, Alabama, Kentucky, Mississippi, Tennessee, Arkansas,Louisiana, Oklahoma, Texas), andWest (Arizona, Colorado, Idaho, Montana, Nevada, NewMexico, Utah, Wyoming,Alaska, California, Hawaii, Oregon, Washington)............................................................................................................................


p = .017), lower depersonalization scores(R2 = .247, p < .001), higher personal ac-complishment scores (R2 = .276, p < .001),higher satisfaction with medicine scores(R2 = .090, p = .020), and higher satisfac-tion with chairing scores (R2 = .121, p =


.007). We should note that, althoughp values reached the threshold of signifi-cance, the R2 values themselves were low,indicating a weak correlation. Specifically,our results indicate that approximately9.4%, 24.7%, 27.6%, 9.0%, and 12.1%


...........................................................................................................................T AB L E 2Results of the Trait Emotional Intelligence Questionnaire-Short Form

Score Median Range Interquartile Range Maximum Possible Score

Well-being subscore 37 24–42 35–39 42Self-control subscore 31.5 17–39 28–36 42Emotionality subscore 45 30–54 40–49 56Sociability subscore 32 21–42 29–35 42Global trait emotionalintelligence scorea

172 120–201 155–182 210

aAdditional questions are included in the calculation of the Global Trait Emotional Intelligence Score; it is not asum of the four subscores............................................................................................................................


of variation around the mean for theburnout subscores can be attributedto differences in the TEIQue-SF globalscore in our population of survey re-spondents. Scatterplot matrices areshown in Figure 1.

We found few significant differencesin a-MBI subscores by the demographicvariables. The analysis revealed a signifi-cant correlation between increased hoursworked per week and decreased emotionalexhaustion, satisfaction with medicine,and satisfaction with chairing subscores(R2 = .152, p = .002; R2 = .100, p = .014;and R2= 0.109, p = .010, respectively). Wealso found significant correlations be-tween increased percentage administrativeeffort and decreased depersonalizationsubscores (R2 = .113, p = .009), and be-tween increased percentage teaching effortand increased satisfaction with chairingsubscores (R2 = .069, p = .043). Finally, wefound a significant correlation between

................................................................T AB L E 3Results of the Modified Maslach Burnout Inventory

Subscore Median Rang

Emotional exhaustion subscore 4 0–12Depersonalization subscore 1 0–15Personal accomplishment subscore 21 12–2Satisfaction with medicine subscore 16 9–1Satisfaction with chairing subscore 15 7–18................................................................


increased years as a chair and increasedsatisfaction with medicine subscores (R2 =.079, p = .030). Scatterplot matrices areshown in Figure 2.

D ISCUSS IONChairs of academic radiation oncologydepartments received high scores on theTEIQue-SF EI instrument in this study.The median TEIQue-SF score (172 outof a possible 210) is higher than theTEIQue-SF scores published for physi-cians in other disciplines. In a study ofradiologists in the United Kingdom, re-searchers compared TEIQue-SF scoreswith scores from a normative sampletaken from the TEIQue-SF database(composed of individuals, not necessar-ily physicians, working in the privatesector, public sector, and armed forces;Mackay, Hogg, Cooke, Baker, & Dawkes,2012). Male radiologists had a medianscore of 156.9 (reported in the article as
...........................................................
e Interquartile Range Maximum Possible Score

2.25–6.75 180–2.75 30

4 18–23 248 14–17 18

12–17 18...........................................................


...........................................................................................................................F I GURE 1Correlation Between Global Emotional Intelligence (EI) and the Five Subscores of the AbbreviatedMaslach Burnout Inventory

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5.23, or the total score, 156.9, divided by30, which is the number of questions)compared with 151.5 (5.05) in the nor-mative sample (p < .001). Female radi-ologists had a median score of 158.7(5.29) compared with 148.2 (4.94) inthe normative sample (p < .001; Mackayet al., 2012). In another study in whichthe TEIQue-SF was administered to med-ical students on surgery rotations, the me-dian reported score was 139. That studydid not examine the relationship of EI toburnout, but it did find that participantswith higher EI recovered from self-reportedstress induced by performing an unfamiliarsurgical task (Arora et al., 2011).

We did not observe any differences inEI with respect to respondent-specific var-iables such as age or race/ethnicity or toworkplace-specific variables such as


geographic region, appointment type, in-stitution type, institution size, hoursworked, percentage effort, number of in-stitutions worked at, or years of chair ex-perience. However, researchers usingvarious EI metrics have observed somedifferences between participants. Ortho-pedic surgery residents had a mean scoreof 86 (out of a maximum of 145) on theEI, as measured by the Mayer–Salovey–Caruso Emotional Intelligence Test. Juniorresidents, White residents, and residentsyounger than 30 years had significantlyhigher EI scores (Chan, Petrisor, &Bhandari, 2014). Freudenthaler et al.(2008) surveyed general surgery, pediat-rics, and pathology residents using theTrait Emotional Intelligence Question-naire and reported a mean global EI of101.0 ± 8.1, which is comparable to the


...........................................................................................................................F I GURE 2Correlation Between Hours Worked per Week and Percentage-Effort Characteristics and Subscores of theAbbreviated Maslach Burnout Inventory

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global EI for the general population butless variable (McKinley et al., 2015). Inthis cohort, global EI increased with age,but there were no global EI differencesbetween residents according to specialty orgender (McKinley et al., 2014). We alsodid not observe any gender differences inEI among our cohort of academic radia-tion oncology chairs; however, this resultmight have been due to the low number offemale respondents (n = 9, 15%) inour analysis.

Higher EI scores among our cohortmay have been due to a unique combi-nation of education, experience, andskills required of academic medicalchairs. The importance of EI for physi-cians is increasingly being recognized, as


evidenced by the growing number ofpublished investigations of EI amongmedical students and resident trainees(Chan et al., 2014; Holman, Porter,Pawlina, Juskewitch, & Lachman, 2016;Lin, Kannappan, & Lau, 2013; McKinleyet al., 2015; Yoo & Park, 2015). Re-searchers have conducted many investiga-tions into the role of EI among leaders,as the business community was the firstto document (Goldman, 1995). Thisfocus on the business community makessense—successful leadership often de-pends on the ability to navigate inter-personal conflicts while regulating one’sown emotions, as well as recognizingand appropriately responding to theemotions of others.



Palmer, Hoffmann-Longtin,Walvoord,Bogdewic, and Dankoski (2015) sug-gested that incoming department chairsmay be underprepared to handle theleadership role despite clinical and schol-arly accolades. At the Indiana UniversitySchool of Medicine in Indianapolis, EI isone of six leadership domains (http://faculty.medicine.iu.edu/recruitment/)assessed during standardized recruitmentprocedures for chairs of all departments(the others are leadership and team de-velopment, performance and talent man-agement, vision and strategic planning,communication skills, and commitmentto the tripartite mission). Valuing andnurturing EI in physicians in general andin academic physician leaders specificallyseems to be beneficial. Formally assess-ing EI during a chair-search hiring processmay be challenging. Instruments such asthe TEIQue-SF could be sent via e-mail,and the chair-candidate could return thecompleted assessment along with thecurriculum vitae and letter of interest. TheEI scores could then be evaluated duringthe hiring process along with a chair-candidate’s academic and clinical creden-tials. However, it may be more practicalfor a health system chief medical officer,a medical school dean, or the chair searchcommittee to integrate EI-related ques-tions into the interview and includethe assessment in the overall decision-making process.

Previous studies have shown thatradiation oncology chairs experiencelower rates of burnout than chairs ofmany other medical specialties (DeOliveira et al., 2011; Gabbe et al., 2002;Kusano et al., 2014). One reason for thisdifference may be the high EI among ra-diation oncology chairs. Among our co-hort, we found statistically significant


correlations between higher TEIQue-SFglobal and subscores and lower rates ofburnout on the Maslach Index subscores;however, the correlations were weak, asevidenced by low R2 values. Other re-searchers have found similar correlationsbetween EI and the ability to cope withstress, particularly in professions requir-ing a high degree of emotional labor, suchas education, social work, and healthcare(Czabanowska, Malho, Schröder-Bäck,Popa, & Burazeri, 2014; Psilopanagioti,Anagnostopoulos, Mourtou, & Niakas,2012; Weiszbrod, 2015). A study of EIamong nurses also suggested that thosewith higher TEIQue-SF scores had lowerrates of burnout (Mikolajczak, Menil, &Luminet, 2007).

Although they used a different versionof theMaslach Burnout Inventory, Kusanoet al. (2014) reported similar emotionalexhaustion, depersonalization, and per-sonal accomplishment subscores amongradiation oncology chairs, suggesting rel-ative stability of burnout over time. Wefound more years of chair experience,more hours worked per week, and an in-creased percentage of administrative andteaching efforts to be weakly, though sta-tistically significantly, correlated withlower burnout rates. These results are in-teresting because prior studies suggestedthat administrative issues such as budgetdeficits, faculty recruitment, and retention,as well as increasing bureaucracy were as-sociated with higher stress levels amongradiation oncology chairs (Kusano et al.,2014). One potential reason for oursomewhat counterintuitive associationmay be that these stressors become easierto manage with increased time dedicatedto administrative tasks. In addition, phy-sicians who find personal fulfillmentin tackling the challenges of department


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leadership might be drawn to thesepositions.

To our knowledge, this study is thefirst of its kind to systematically explore EIamong chairs of an academic medical de-partment. This study also is the first to ex-plore the potential relationship betweenEI and burnout among academic medicalleaders. The relatively high response rate of63.2% is also a strength of this study. Thevoluntary and anonymous nature of thissurvey precluded any comparison of re-spondents with nonrespondents. How-ever, the demographics of respondingchairs were similar to those of the entiresurveyed population. For example, 15%of responding chairs were female com-pared with 12.6% of all chairs surveyed.

Study LimitationsLimitations of this study include thepotential for response bias, as those withan interest in this subject matter—and apotentially higher EI—may have beenmore motivated to respond. It is also pos-sible that the chairs who participated hadmore time to respond to the survey invi-tation and thereby were less likely to beburned out. One important limitation tothe demographic portion of our survey isthat we did not ask respondents about thenumber of patients they treated or saw inclinic per week. In addition to the numberof hours worked per week and percentageeffort allocation, this information wouldhave been helpful in assessing burnout,as working 60 hours per week in a high-volume center is different from working60 hours per week in a lower-volumecenter. Remaining a chair also involvessome inherent selection bias, as thosewho are better able to manage their timeand energies may be less likely to burnout and may maintain more emotional


reserve. Moreover, although this studyused well-validated instruments for bothEI and burnout, some inherent limitationsexist in the survey instruments, includingthe possibility that self-reported trait EIquestionnaires such as the TEIQue-SFmaynot accurately reflect EI (Davies, Stankov,& Roberts, 1998). Conceivably, the ab-breviated EI instrument does not collectas much nuanced information as thestandard-length instruments. In addition,because we did not investigate how othermeasures of EI correlate with burnout, ourfindings are specific to the instrumentsused. Burnout questionnaires such asthe MBI also rely on self-reflection andself-awareness, along with honest self-reporting by respondents. Despite theselimitations, we feel this survey providesvaluable baseline information aboutthe EI of academic radiation oncologychairs.

CONCLUS IONThe academic radiation oncology chairs inthis study had high EI, as determined bythe TEIQue-SF, which may have contrib-uted to lower rates of burnout. In the fu-ture, EI may be of increasing importancewhen it comes to recruitment and reten-tion of academic medical leaders.

ACKNOWLEDGMENTSThe authors thank the membership of the Societyof Chairs in Academic Radiation Oncology Pro-grams (SCAROP) for participating in this study.They would also like to acknowledge Sara BethDavis, SCAROP staff liaison, for her assistancewith this study.

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