Career transitions: Reflections of former chairs and academic health center leaders.

The 2022 Association of Pathology Chairs Annual Meeting included a live discussion session and a pre-meeting recorded panel webinar sponsored by the Senior Fellows Group (former chairs of academic departments of pathology who have remained active in the Association of Pathology Chairs). The presentation was focused on transition planning for academic health center leaders. Each of the discussion group panelists had served as a pathology department chair as well as in more senior leadership positions, and they provided perspectives based upon their personal experiences.

Communication during a global pandemic: The utility of a professional society listserv and journal.

The Association of Pathology Chairs listserv was studied in order to determine its utility in facilitating communication among pathology departments during the COVID-19 global pandemic. Between March 2020 and March 2022, there were 116 pandemic-related entries generated by 49 members that stimulated 395 responses from 109 members. Due to overlap between individuals providing listserv entries and those responding, there were 123 unique participants.

Women in Academic Pathology: Pathways to Department Chair.

The Association of Pathology Chairs, an organization of American and Canadian academic pathology departments, has a record percent of women department chairs in its ranks (31%), although still not representative of the percent of women pathology faculty (43%). These women chairs were surveyed to determine what had impeded and what had facilitated their academic advancement before becoming chairs. The 2 most frequently identified impediments to their career advancement were heavy clinical loads and the lack of time, training, and/or funding to pursue research.

Generating Discretionary Income in an Academic Department of Pathology.

The 2021 Association of Pathology Chairs Annual Meeting included a chairs' session and a premeeting discussion-group webinar sponsored by the Senior Fellows Group (former chairs of academic departments of pathology who have remained active in the Association of Pathology Chairs) focused on generating discretionary income for departments. Discretionary income was defined as revenue that can be used by the department with few, if any, restrictions. Such income is particularly desirable given limitations on departmental budgets.

The Relationship Between Medical School-Based Pathology Departments and Affiliated Forensic Pathology Training Sites.

Medical school-based pathology departments were surveyed in order to evaluate their relationship with sites providing forensic pathology training. Of 59 departments surveyed, 49 (83%) responded. Most (88%) respondents indicated that training occurs at an affiliated medical examiner/coroner office, and 78% indicated that the facility is 10 miles or less from the academic health center.

Retaining the Value of Former Department Chairs: The Association of Pathology Chairs Experience.

Serving as a clinical department chair in an academic health center is an increasingly complex and difficult position. In 2014, the Association of Pathology Chairs engaged former chairs to assist its members by establishing an ad hoc committee of "Senior Fellows," which then became a permanent Senior Fellows Group. The Senior Fellows Group currently includes more than 50 former chairs, many of whom subsequently served as deans, medical center executives, and in other leadership roles.

Academic Pathology Departments and Associated Children's Hospitals: An Overview of the Relationship.

A survey of academic pathology departments was conducted in order to evaluate the relationship with their associated children's hospitals. Forty percent (88) of US children's hospitals were associated with academic pathology departments. Sixty percent of pathology department respondents indicated that their children's hospital was part of their academic health system.

The Veterans Affairs Healthcare System and Academic Pathology Departments: Evaluation of the Relationship.

A survey was conducted to evaluate the relationship between Veterans Affairs Healthcare Systems and academic departments of pathology in their respective affiliated schools of medicine. Most (73%) of the responding academic departments were within 5 miles of their Veterans Affairs Healthcare Systems; 60% of Veterans Affairs Healthcare Systems supported 1 to 5 full-time pathologist positions at the Veterans Affairs Healthcare Systems while 70% provided 1 to 5 full-time resident positions; only 34% of academic departments had "without compensation" appointments at the Veterans Affairs Healthcare Systems while 20% had fee-based consulting appointments; 62% of academic departments granted academic appointments to full-time Veterans Affairs Healthcare Systems pathologists while few (26%) had split appointments between the academic department and the Veterans Affairs Healthcare Systems; only half of academic departments granted the same academic privileges to Veterans Affairs Healthcare Systems pathologists as they did to full-time university faculty; 60% of the Veterans Affairs Healthcare Systems pathologists were not involved in recruitment of medical school faculty while 58% of medical school faculty were not involved in recruitment of Veterans Affairs Healthcare Systems pathologists; most academic departments reported no research space at the Veterans Affairs Healthcare Systems (68%) and no Veterans Affairs Healthcare Systems research support (72%); only 23% of academic departments reported a sharing agreement that allows the Veterans Affairs Healthcare Systems to perform clinical work for the academic department while 36% reported an agreement that permits the academic department to perform clinical work for the Veterans Affairs Healthcare Systems; only 32% of academic departments indicated that the Veterans Affairs Healthcare Systems Chief of Pathology and Laboratory Medicine Service is a member of the academic department leadership team. All academic departments reported that the Veterans Affairs Healthcare Systems plays a significant role in education of medical students, residents, and fellows.

Serving as a Temporary Pathology Chair: "Boon" or "Boondoggle"?

The 2019 Association of Pathology Chairs Annual Meeting included a discussion group sponsored by the Senior Fellows Group (former chairs of academic departments of pathology who have remained active in Association of Pathology Chairs) that was focused on serving as temporary pathology chair. Such positions include "acting chair" (service while the permanent chair is on leave or temporarily indisposed), "interim chair" (service after departure of the prior chair and before a new chair is appointed), "term-limited chair" (usually one nonrenewable term of less than 5 years), and "terminal chair" (permanent chair being asked to stay until a successor is appointed). Discussion group panelists represented each of these positions and included the perspective of 3 former deans about the rationale for making such appointments.

Life After Being a Pathology Department Chair III: Reflections on the "Afterlife".

The Association of Pathology Chairs Senior Fellows Group provided reflections on activities that have kept them engaged and inspired after stepping down as chair. They offered advice to current chairs who were considering leaving their positions and also to individuals contemplating becoming pathology chairs. A majority (35/41) responded: 60% maintained teaching/mentoring activities; 43% engaged in hobbies; 40% took other administrative positions including deans, medical center chief executive officers, and residency program directors; 31% continued research; 28% wrote books; 20% performed community service; 14% led professional organizations; 14% developed specialized programs; 11% engaged in clinical service; and 11% performed entrepreneurial activities.

What Advice Current Pathology Chairs Seek From Former Chairs.

The 2018 Association of Pathology Chairs annual meeting included a panel discussion of Association of Pathology Chairs senior fellows (former chairs of academic departments of pathology who have remained active in Association of Pathology Chairs) about the type of advice that current (sitting) pathology chairs ask them. To inform the panel discussion, information was obtained from the senior fellows by e-mail and subsequent conference call. Of the 33 respondents, 24 (73%) had provided consultation advice (9, <5; 11, 5-10; 2, 10-20; and 2, >20).

Life After Being a Pathology Department Chair II: Lessons Learned.

The 2016 Association of Pathology Chairs annual meeting featured a discussion group of Association of Pathology Chairs senior fellows (former chairs of academic departments of pathology who have remained active in Association of Pathology Chairs) that focused on how they decided to transition from the chair, how they prepared for such transition, and what they did after the transition. At the 2017 annual meeting, the senior fellows (encompassing 481 years of chair service) discussed lessons they learned from service as chair. These lessons included preparation for the chairship, what they would have done differently as chair, critical factors for success as chair, factors associated with failures, stress reduction techniques for themselves and for their faculty and staff, mechanisms for dealing with and avoiding problems, and the satisfaction they derived from their service as chair.

Life After Being a Pathology Department Chair: Issues and Opportunities.

Although there is a considerable literature on transition of faculty members to the position of department chair, there is a dearth of publications about transitioning from the chair to other activities including retirement. The Association of Pathology Chairs senior fellows (all of whom are former chairs of academic departments of pathology) made this topic a focus of discussion at the Association of Pathology Chairs 2016 Annual Meeting. Of the 33 senior fellows engaged in this discussion, following their time as chairs, a small majority (18) transitioned to other administrative posts within or outside the university, while the others either returned to the active faculty (7) or retired (8).

Studies of the extraction of bilirubin from human amniotic fluid.

The recovery of unconjugated bilirubin from human amniotic fluid was studied using dichloromethane, chloroform/isopropanol (3:1 vol/vol), and chloroform/ methanol (3:1 vol/vol) extraction of human amniotic fluid that had been supplemented with bilirubin at various concentrations. Results were compared with those obtained with conventional chloroform extraction. Mean recoveries were found to be only 28% for chloroform and 25% for dichloromethane.

Studies of the inhibition of serum pseudocholinesterase activity in vitro by commonly used drugs.

We studied the effect of 17 commonly used drugs, including prescription and over-the-counter medications, on the activity of serum pseudocholinesterase (PCE) in vitro. Normal pooled human serum was incubated for 120 minutes at 37 degrees C with therapeutic serum concentrations of prescription and over-the-counter drugs, and the postincubation PCE activity was measured. Morphine, quinidine, and thioridazine depressed PCE activity by more than 5% while no or negligible effect was noted following incubation with acetaminophen, chlordiazepoxide, chlorpromazine, desipramine, doxepin, imipramine, methamphetamine, nortriptyline, phenobarbital, phenytoin, procainamide, salicylic acid, theophylline, and valproic acid.

Valproic acid binding to human serum and human placenta in vitro.

The binding characteristics of the antiepileptic agent and teratogen valproic acid for human serum and human placenta were investigated utilizing equilibrium dialysis of the drugs in serum and in homogenates of whole placenta so that the transplacental transfer of the drug could be better defined. A low-capacity, high-affinity binder and a high-capacity, low-affinity binder for valproic acid were found in serum. However, there was only minimal, nonspecific binding of the drug to placenta.

The effect of lovastatin and thioridazine on the degradation of cocaine in human serum in vitro.

The effect of lovastatin and thioridazine on the degradation of cocaine in human serum was studied by incubating therapeutic and toxic concentrations of either drug with cocaine in human serum at 37 degrees C. Without these other drugs, cocaine concentrations decreased by an average of 88% in 120 minutes. Lovastatin at all concentrations studied showed a negligible effect on the degradation of cocaine in human serum and did not alter the pseudocholinesterase activity of the serum.

The binding of acetaminophen, lidocaine, and valproic acid to human milk.

The binding of acetaminophen, lidocaine, and valproic acid to pooled normal mature human milk was studied in vitro by using equilibrium dialysis. Scatchard analysis revealed high-affinity, low-capacity binding for acetaminophen (Ka [affinity constant of association], 1.47 x 10(4) L/mol; Bo [concentration of binding sites], 9.

Gentamicin and tobramycin binding to human serum in vitro.

The binding of gentamicin and tobramycin to human serum was studied in vitro using equilibrium dialysis of pooled human serum supplemented to various concentrations of either drug. Only minimal and variable non-specific binding was noted for each drug: gentamicin, less than 15% and tobramycin, less than 30%. Conventional Scatchard analysis conducted over an array of drug concentrations failed to identify any specific binding proteins.

The binding of selected therapeutic drugs to human serum alpha-1 acid glycoprotein and to human serum albumin in vitro.

The binding of acetaminophen, lidocaine, phenobarbital, phenytoin, theophylline, and valproic acid to human serum alpha-1 acid glycoprotein (orosomucoid) and to human serum albumin separately in vitro was investigated using equilibrium dialysis of the unlabeled drugs. Each drug was studied at a therapeutic concentration. Alpha-1 acid glycoprotein was studied at one elevated and two physiological concentrations, whereas albumin was studied at one physiological and two low concentrations.

The effect of parenteral nutrition fluids on the binding of therapeutic drugs to human serum in vitro.

The competitive binding of seven therapeutic drugs (carbamazepine, phenytoin, phenobarbital, procainamide, quinidine, theophylline, and valproic acid) to human serum and to five commonly used parenteral nutrition fluids in vitro was studied using equilibrium dialysis. For five of the drugs, all parenteral nutrition fluids bound less drug than human serum-phenobarbital (up to 14% less), phenytoin (up to 46% less), procainamide (up to 43% less), quinidine (up to 25% less), and valproic acid (up to 77% less)-suggesting that the presence of these fluids might increase the free fraction of these drugs in vivo. For carbamazepine, the fluids bound up to 82% more drug, suggesting that the presence of these fluids might decrease the free fraction of this drug in vivo.

The effect of ethanol and pH on the adsorption of drugs from simulated gastric fluid onto activated charcoal.

The effect of ethanol and pH on the adsorption of acetaminophen (ACET), phenobarbital (PHB), phenytoin (PHY), salicylic acid (SA), and theophylline (THEO) from simulated gastric fluid onto activated charcoal was studied. For the ethanol study, each drug was prepared at a concentration of 10 g/L in ethanol; in hydrochloric acid (HCl), 1.2 mol/L; and in HCl, 1.

Procainamide and quinidine inhibition of the human hepatic degradation of meperidine in vitro.

Procainamide and quinidine inhibition of the degradation of meperidine in human liver was investigated by incubation of two concentrations of either drug with meperidine in homogenates of human liver over 24 and 36 h. Meperidine concentrations declined by 26% after incubation for 24 h and by 42% after incubation for 36 h. In the presence of procainamide, however, they decreased by only 15% to 18% at 24 h and by only 26% to 28% at 36 h.