Similar problems and rates of retention of chairs in other specialties have also been described (3). While many chairs move on for enhanced opportunities, other reasons cited for short-term tenure include disagreements with the dean, institutional barriers, and lack of resources (4). There is also, especially for more research intensive departments, the chair's expenditure of his or her recruitment package earlier during the appointment, with the potential for deficits to accrue later on during tenure, a cycle that inherently promotes shorter tenures. On the other hand, it is well acknowledged that most academic leaders are most effective in the early and mid-phases of their position, with diminishing returns over time (5). Accordingly, a decline in the tenure of chairs after 10 years is not necessarily detrimental, especially when departmental problems repeat to rechallenge the chair. Indeed, it is intuitive that for both the department and chair, there comes a point of equipoise, where the chair is able to "move on" with enthusiasm to a new position and this is in everybody's best interests.