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During the past three weeks, as I have been considering my remarks for today, I have also been in the position of trying to wear three hats: as chairman of a large academic department of medicine; as the president of your society; and as the new president of the Association of Program Directors in Internal Medicine. As these three roles have joined and I approach the end of my term as your president, I feel a bit like jen, the young protagonist of Jim Henson's fantasy The Dark Crystal, facing the approaching hour of the conjunction of three suns and needing to insert a missing shard of crystal so that light would be shed (1). For guidance, I have consulted my predecessors who have recorded their thoughts annually in The Journal of Clinical Investigation, and particularly Irving London and Neal Bricker, who were not only former presidents of this society, but also holders of my chair. In thinking through my present roles and trying to develop a statement that would be enlightening as well as personal, I decided to emphasize the importance of the department chairman's role in both "bringing out the best" in his colleagues and in supporting investigation. The title of my address, therefore, is "Sustaining the Spirit of Inquiry: The Key Role of the Department Chairman Others have commented on evolution and change in departments of medicine, of growing dissatisfaction of chairmen in their roles, and of the complexity and frenetic nature of modern clinical departments (2, 3). Although I find my task often frustrating and at times overwhelming, it is nevertheless a source of tremendous and continued satisfaction, replete with the challenge that comes with the need to define goals and strategies. Traditionally, the goals of academic departments are to provide excellent patient care in the teaching hospital setting, seek excellence in education at all levels, and develop and sustain outstanding basic and clinical research. While my remarks are focused principally on departments of internal medicine, they are not meant to apply exclusively to such departments. Whereas we recognize these traditional goals as the basis for our academic efforts, it is also clear that one needs to seek modern approaches to sustain them. It is increasingly difficult to meet these objectives given our social and economic problems, the pressures of health service delivery with which modern academic medical centers contend, and the multiple demands on our time. Nevertheless, we must sustain these goals, and I believe there is much we can do, as leaders and as faculty members, to ensure that they persist. As we move ahead into the uncertainties of the 1980s, I would suggest the following strategies as a means to achieving our traditional goals: (a) seek unity of purpose for departmental faculty members, while acknowledging different roles for individuals that are both professionally and personally satisfying; (b) attempt to "bring out the best" in the faculty; (c) find the resources to recruit the "best and brightest" young academicians on a regular basis; (d) provide regular review of the performance of individual faculty members and their divisions; (e) ensure efficient and profes-

the journal of clinical investigation/the journal of clinical investigation

Sustaining the spirit of inquiry: the key role of the department chairman. Presidential address delivered before the 75th annual meeting of the American Society for Clinical Investigation, Washington, DC, 1 May 1983.