The Path to Department Chair: Arriving and Thriving (Part 2)

In the January issue of ENTtoday, ENT department chairs shared stories of how they rose to their esteemed positions. This month in Part 2, chairs talk about what it has been like to serve in these roles and offer their advice to otolaryngologists who wish to follow in their footsteps.

Most otolaryngologists do not launch their medical careers with the clear intention to become a department chair in an academic setting. More often, the ascent to the role occurs organically as their professional achievements accumulate and their experience broadens. Even so, the transition to the job can be an eye opener.

An Evolving Role

With nearly 20 years of experience as a department chair of otolaryngology–head and neck surgery, Mark Varvares, MD, is exceedingly familiar with the job. He held the position at the St. Louis University School of Medicine from 2003 to 2015. Then, in 2020, he became interim chair at Harvard Medical School, Massachusetts Eye and Ear, and Massachusetts General Brigham in Boston. One year later, after a nationwide search, the arrangement became permanent.

Dr. Varvares emphasized the all-consuming nature of the job and the personal commitment required to make it work. “The scope of the department chair role encompasses oversight of all aspects of the department,” he said. “This takes priority over all other professional interests that I have.”

While the broad scope of the job is a given, some of its unique challenges tend to morph with the times. Over the years, advancements in science and technology, as well as ongoing changes in the structural framework of the healthcare system, public attitudes toward health, and governmental policy, have all had an influence on the nature of the job.

Sandra Lin, MD, who took over as chair of head and neck surgery at the University of Wisconsin School of Medicine and Public Health in Madison in the summer of 2025, underscores the impact of such changes on the role of department chair over the past several decades. “Of course, [department chairs] have always needed to be leaders,” she acknowledged, “but now, we must understand chain management. We must understand the dynamics between health systems and academic departments, and how to strategize to maximize our clinical mission. We must consider the importance of building a widely diverse workforce. And finally, we must deal with a lot of pressure related to research and research dollars— especially recently.”