Mentorship Matters: A New Academic Year Means New Opportunities to Strengthen Faculty Development and Retention
Beginning of a new academic year has always been one of my favorite times in pediatrics. New residents and fellows arrive with tremendous enthusiasm, faculty assume new responsibilities, and emerging leaders step into new roles. There is a renewed sense of optimism and opportunity that reminds us why academic pediatrics is special.
During a recent conversation about the pediatric workforce, a colleague shared that one of the main reasons she chose pediatrics was quite simple: the pediatricians she interfaced with were always smiling. That comment stuck with me considering all the workforce, compensation and burnout challenges facing pediatrics today.
With so much energy given to these issues, it could be easy to forget the tremendous influence our faculty and departmental cultures have on career decisions. Undergraduates and medical students choose specialties because of the people they encounter. Just ask any senior pediatrician why they chose pediatrics and somewhere in their response there will be names of those who inspired their subspecialty choices. Finally, we know faculty stay at institutions because they feel valued, supported and connected to colleagues who care about their success.
Mentorship Matters Now
As we begin another academic year, perhaps this is a good time for all of us to reconsider the role meaningful mentorship, for a moment or career, can play in creating just such an impactful sticky culture.
Mentorship cannot be for junior faculty and new hires only.
Traditionally, we focus our mentorship efforts on residents, fellows and early-career faculty, with deviations for the occasional leadership new hires. Young faculty certainly need experienced mentors who can help them understand promotion pathways, establish academic priorities, develop national relationships, identify leadership opportunities and learn how to navigate the complexities of their health system partners. These are critical for sure, but we cannot relax with promotion, as the market pressures on our mid and late career faculty are at an all-time high.
Mid-career faculty may benefit from mentorship the most. The career paths that once seemed clear are now muddy. Clinical and administrative responsibilities continue to expand, family priorities change and opportunities for advancement can appear quite limited. These are the years when talented faculty begin to privately question their futures.
Senior faculty and leaders will also benefit from trusted mentors, colleagues and advisors as they enter the third trimester of their career. Leadership can be isolating. Chairs, chiefs, vice chairs and senior administrators routinely face difficult personnel, financial and strategic decisions that cannot always be openly discussed within their own departments. Having trusted individuals who can provide perspective, challenge assumptions and offer candid counsel can be key in retention efforts as burnout continues to escalate.
Is your mentorship strategy really working?
Most departments can point to some type of onboarding and/or mentorship initiative program, while fewer can confidently discuss their strategy that ensures all faculty members have a meaningful mentoring relationship.
One-size-fits-all programs often struggle because the relationship becomes an administrative requirement rather than a meaningful professional connection. Effective mentorship requires trust, compatibility, candor and an understanding of what the individual is trying to accomplish. Not all mentoring relationships will work out, but the key to success is to ensure the mentees and potential mentors continue to interface until a good fit is established.
Mentorship is a retention strategy
Our department leadership teams nationally spend a tremendous amount of time discussing compensation, workload, protected time and resources when faculty retention is the topic. While competitive compensation is no longer optional, compensation does not create connection. Faculty also decide to stay because they enjoy the people with whom they work, they believe their contributions matter and they sincerely believe that someone within the organization is genuinely invested in their future.
The mentoring relationship can provide each of these key values on behalf of leaders who do not have the bandwidth to truly support hundreds of faculty members at that level. One of the more concerning things we regularly encounter in child health executive search are talented faculty members who share some version of, “I really don’t want to leave, but I don’t see what comes next for me here.”
Be intentional
We know mentorship contributes to engagement, professional development, leadership succession and retention, so we should treat it with the same intentionality we apply to other critical faculty strategies. This does not require creating another committee or complicated administrative process, but does require leaders to regularly evaluate those receiving and needing meaningful mentorship.
As discussed in my last Millican Minute, outstanding future leaders do not emerge by accident. They are intentionally developed through experience, mentorship, feedback and progressively greater opportunities. Mentorship and succession planning are not separate leadership responsibilities. One feeds the other.
A new academic year – a new opportunity
The beginning of the academic year gives departmental leadership teams a natural opportunity to take inventory of their faculty talent development programs. Which faculty members have strong mentors? Who does not? Are we concentrating mentorship primarily among our junior faculty while overlooking mid-career and senior physicians? Do our emerging leaders have access to people who will challenge and prepare them? And are we doing enough to connect our most experienced faculty with the next generation?
In closing, I take us back to the start and to the wonderful reference of the physician choosing pediatrics due to a simple observation that pediatricians are always smiling. I would submit that behind every smiling pediatrician is a great mentor that assures them that they matter and are meaningfully impacting the lives of kids.
Let’s do what we can as leaders this academic year to ensure that each one of our faculty have such a person associated with their career journey.
Best for an amazing 2026-27!!
Wesley Millican
Past Posts
Defining Your Leadership Legacy
Over the past 25 years working exclusively in academic pediatric executive search and leadership development, I have had the privilege of knowing and learning from four generations of high-impact deans, chairs, division directors and children’s hospital executives. They have built nationally-recognized programs, advanced groundbreaking research, trained generations of pediatricians and guided departments and children’s hospitals through extraordinary periods of growth and change. Their accomplishments are impressive. Their CVs are even more so. But lately, I have found myself increasingly interested in a different question: what actually defines a leadership legacy?
Is legacy something we consciously pursue? Is it measured by the programs we build, discoveries we make, funds we raise and leadership positions we hold? Or is a leadership legacy something much more organic – the cumulative result of thousands of decisions, relationships, opportunities created and people influenced over the course of a career? Perhaps the more challenging question to ponder is: Is the legacy we think we are building while we are leading the same legacy others will remember?
We will all receive a Leadership Legacy – wanted or not
Every chair, chief, physician executive and administrative leader will eventually leave their current role. When that happens, faculty and staff will form and discuss their personal conclusions based on what changed and how they were impacted throughout the leader’s tenure. Some accomplishments will be easy to measure. Programs were created. Faculty were recruited. Research portfolios grew. Clinical programs expanded and philanthropic support increased.
All matter. But after observing the assignment of leadership legacies over decades, I am increasingly convinced that the most enduring measures of a leader’s impact and effectiveness are harder to quantify. Who became a better leader because you invested in them? Who received an opportunity because you recognized potential others had not yet seen? Did people feel valued, challenged and supported? Did you create a culture people wanted to join and were reluctant to leave? Did you make difficult decisions based upon what was best for the mission rather than what was easiest in the moment? And most importantly, was the organization made stronger because you led it?
Personal Legacy or Institutional Legacy?
In a previous Millican Minute, I wrote that succession planning may be the ultimate expression of servant leadership because it requires us to set aside personal legacy in favor of institutional legacy. I have continued thinking about that distinction. Personal legacy asks: “What will people remember about me?” Institutional legacy asks: “What will be stronger because I was here?”
Those with the strongest assigned legacies have been intentional in not attaching their names to ideas and accomplishments and focused on whether the people, programs and institutions entrusted to them were positioned for continued success. They built things designed to outlast them. They developed people capable of surpassing them.
Academic medicine is very good at measuring accomplishments through publications, grants, programs developed, faculty recruited, clinical growth, philanthropy and national leadership positions. But some of the most consequential leadership decisions will never appear on a CV or in the granite-face etchings of institutional partners. Recruiting a young physician others overlooked. Protecting a promising program during a difficult financial period. Giving an emerging faculty member an opportunity before they were the obvious choice. Advocating for someone when doing so was difficult. Changing course when a strategy wasn’t working. Admitting a mistake.
Leadership Journeys Are Rarely Straight Lines
One of the things I find fascinating about accomplished pediatric leaders is how few seem to have begun their careers with a carefully constructed plan to become a pediatric department chair, administrator, physician-in-chief, dean or health system executive. Their leadership journeys often started much more simply. A mentor recognized potential. Someone opened a door. An unexpected opportunity appeared. An institution faced a challenge and needed someone willing to step forward. A physician discovered that improving care for children required changing something larger than what could be accomplished individually. One opportunity led to another and, somewhere along the way, a pediatrician became a leader.
The same is true of the challenging moments in our journeys. Every meaningful leadership career includes disappointments, difficult decisions, failed recruitments, strategies that didn’t work, institutional conflicts and moments of genuine uncertainty. Yet, when we celebrate accomplished leaders, we naturally focus on their victories. I believe we may be overlooking some of their most valuable wisdom. For example, what happened when things went wrong? What did failure teach that success could not? Which decision would they make differently today? Who provided the advice they needed during a difficult period? Which values were they unwilling to compromise? And perhaps most importantly: What do they know today that they wish someone had told them when they first accepted responsibility for leading others?
Wisdom Worth Passing Forward
The last question has led us to something I am very excited to share.
CareerPhysician is launching a new Pediatric Insight Series titled – Legacies in Academic Pediatric Leadership. This new podcast and video series features conversations with accomplished academic child health leaders whose careers helped shape academic pediatrics as we know it today.
I have the privilege of hosting the series, alongside Valerie Opipari, MD, Bruder Stapleton, MD, and members of the Child Health Advisory Council (CHAC) serving as moderators. The first episode drops in September and we can’t wait for you to hear these leaders’ powerful stories.
Our purpose is not simply to celebrate remarkable careers. We want to learn from them. We want to understand the unexpected opportunities and difficult decisions. The mentors who changed careers. The successes and disappointments. The leadership philosophies that evolved and the values that remained constant.
Today’s pediatric leaders are navigating workforce shortages, financial pressures, changing faculty expectations, rapidly evolving technologies and growing demands across every mission. The specific challenges previous generations encountered may have been different, but the need for courage, integrity, adaptability, humility, vision and sound judgment was not.
Their experiences should not leave academic pediatrics when they leave their offices. Their lessons should become part of how the next generation leads. That is the larger purpose of these conversations: not simply looking backward at remarkable careers, but using the wisdom gained from them to help academic pediatrics lead more effectively into the future.
In closing, perhaps our responsibility isn’t to spend too much time trying to define what that legacy will be. Instead, our responsibility is to lead with enough courage, humility and intentionality that the people, programs and missions entrusted to us are better prepared for the future because we had the privilege of serving them. That is a legacy worth pursuing.
I hope you will join Valerie, Bruder and me for our new Pediatric Insight podcast and interview series: Legacies in Academic Pediatric Leadership! We will have the opportunity to listen and learn from remarkable leaders who helped shape academic pediatrics—and whose hard-earned wisdom can help prepare you and the courageous leaders in your tutelage to shape its future.
All the best!
Wesley Millican
If You Stepped Away Tomorrow, How Would Your Leadership Legacy Be Remembered?
Every pediatric chair, chief and administrator will eventually leave. Some retire after decades of service. Others accept new opportunities, return to research, or simply decide it’s time for a new chapter. The question isn’t whether a transition will occur. The question is whether the department will be stronger because of the leader—or vulnerable without them.
Based on twenty-five years exclusively in academic pediatric executive search, I can attest that effective succession planning is perhaps the most critical attribute of high impact leadership teams. Sadly, with faculty workforce challenges, declining reimbursement, growth pressures across all missions, and the countless daily demands placed upon child health leaders today, preparing the next generation can easily slide to the bottom of the list.
And yet, the strongest departments rarely leave leadership transitions to chance. They intentionally build leaders and prepare for succession years in advance.
Do You Have a Long-Game Strategy?
Leaders spend tremendous energy recruiting exceptional faculty, expanding programs, strengthening research portfolios, and improving care. Each is essential, but leadership stewardship extends beyond today’s accomplishments. We all must ensure that someone is prepared to continue—and improve upon—the work after we are gone.
In many ways, succession planning is the ultimate expression of servant leadership. It requires setting aside personal legacy in favor of institutional legacy. Great leaders understand that their greatest accomplishment will not be the programs they created, but the leaders they developed.
Mentorship Matters
Outstanding future leaders do not emerge by accident; they are intentionally developed. Successful department leadership teams are intentional in their faculty engagement, seeking to identify those who naturally demonstrate curiosity, emotional intelligence, integrity, resilience, sound judgment, and the ability to influence others. They have learned that leadership potential appears long before someone is qualified for the title.
Once identified, individuals should be given structured opportunities for professional growth. Committee leadership, strategic initiative oversight, national committee membership recommendations and active participation in budgeting and clinical operations are a few critical ways to support those who will be the future of our programs. Real wisdom, and more importantly the confidence to lead, requires experiences obtained outside the classroom. A continued escalation of experience, mentorship, feedback, and increasingly challenging opportunities is the secret sauce.
Succession Planning Mistakes Observed in Failed Leadership Tenures
- Waiting until leadership vacancies become imminent before identifying successors.
- Assuming exceptional clinicians or researchers will naturally become exceptional leaders.
- Failing to provide meaningful leadership development experience for emerging leaders.
- Keeping strategic decision-making concentrated in your department’s cabinet.
- Viewing succession planning as a replacement exercise rather than an ongoing organizational strategy.
- Neglecting to include succession planning in the annual evaluations of department leadership
Personal Succession Planning Observation
For many leaders, succession planning begins only after the thought of “retirement” and/or “stepping down” enters the conversation. Unfortunately, for many, these words have a negative connotation which leads many in academic child health into a spiral of frustration, burnout and self-preservation. Effective leadership development and succession planning are the vaccines that prevent the deterioration of departments and the leaders who serve them. It’s what allows all to enthusiastically transition to their next chapter knowing the program is in great hands.
Faculty rarely remember buildings and recognition as much as they remember great leaders. The leaders who have the greatest long-term impact don’t simply build excellent departments; they build leaders capable of taking those departments even further. That is a legacy that compounds long after the name is removed from the office door.
A question to ponder as we look to the 2026-27 academic session. “If I, or any leader in my department, stepped away tomorrow, who would be ready—and what have I done to prepare them?”
The answer will provide a clear measure and guidance on the succession planning and leadership development efforts necessary for the future success of your department.
Wesley Millican
Reflections from PAS 2026: Workforce, Medicaid and Compensation — Three Issues Pediatrics Can No Longer Separate
I had the opportunity to attend the 2026 PAS Meeting in Boston and to connect with many new and old friends. This year’s meeting felt different and more serious in a very important way. While scientific discovery and innovation remained central themes, many of the most urgent conversations centered around the sustainability of children’s healthcare. From medical students to emeritus thought leaders, the future viability of the specialty was on the tip of the tongue.
Three themes consistently surfaced across sessions, coffee breaks, the exhibit hall and in awardee acceptance speeches:
- Addressing pediatric workforce shortages
- Medicaid reimbursement reform
- Pediatric faculty compensation shortfalls
It became increasingly clear throughout the meeting that these three issues are no longer separate conversations or initiatives. They are deeply and intimately intertwined. The common sentiment centered on a belief that without significant progress on faculty compensation, workforce and Medicaid solutions, while critical, would likely fall short of transformational change needed in academic pediatrics.
Workforce Themes: Recruitment pipelines are shrinking, burnout remains high with increasing signs of moral injury, retirements are accelerating, and the gaps in access to care for children continues to widen.
Medicaid Themes: Reimbursement continually fails to reflect the complexity of pediatric care, the time-intensive nature of family-centered medicine, care coordination requirements, behavioral health integration, and the growing needs of children with medical complexity. Attendees spoke candidly about how inadequate reimbursement affects hospital margins and missional reinvestments, faculty hiring, outreach programs, and competitive compensation.
Physician Compensation: The “Tie That Binds” Everything Together
If there was one conversation that felt impossible to avoid at this year’s meeting, it was faculty compensation. For years, pediatric compensation discussions occurred quietly in hallways rather than on main stages. This year, the topic was in your face and much appreciated. Without public awareness of the gravity of the situation, change is not possible.
Leaders engaged openly around the widening compensation disparities between pediatrics and adult medicine, their challenges recruiting academic pediatric subspecialists, increasing package competition between institutions, and the limitations of traditional RVU-based compensation models in many subspecialties. It was clear our current compensation models are failing us in attracting the next generation of physicians to the specialty.
Medicaid reimbursement and pediatric faculty compensation are inseparable. Pediatric departments cannot sustainably recruit and retain the subspecialist to build divisions and programs for kids while operating within historically underfunded reimbursement models. It was clear at PAS that compensation is not simply a budgeting issue anymore—it is an access-to-care national crisis.
Lights in the Darkness: Despite the many challenges discussed, my time at PAS also showcased tremendous innovation, collaboration, and resilience. So many great leaders and minds across academic child health seeking positive change for kids. I was particularly encouraged by:
- the national recognition of pediatric workforce challenges,
- increased openness around the need for compensation reform,
- advancements in AI-based digital health tools and recognized efficiencies,
- seeing the recognized need for deeper collaboration between children’s hospitals, universities, and policymakers.
- a continued emphasis on leadership development, mentorship, and recognition of emerging voices in pediatrics.
- Last but not least, a special shout out to Child Health Advisory Council Executive Board Member, Danielle Laraque-Arena, recognized as a George Armstrong Lecture Awardee. Well-deserved!
As a proud sponsor of PAS, AMSPDC and AAAP, we are in a unique position to see positive changes that will surely lift all organizations and pediatricians diligently working for brighter futures for our Nation’s children. We were honored to participate in so many thoughtful conversations at this year’s PAS meeting and believe the future is challenging, but very bright!
Wesley Millican
Four Leadership Imperatives for Academic Pediatrics in 2026
It is increasingly clear that 2026 will be a pivotal moment within the academic child health leadership continuum. Escalating workforce shortages, rising burnout, national policy changes and increasing financial pressures are rapidly reshaping the strategies and tactics leaders must embrace for meaningful advancement across all missions. While solutions are complex and challenging, 2025 has shown us leadership opportunities for high impact.
As we move into the new year, I look forward to sharing perspectives and learning alongside colleagues who are navigating this rapidly changing environment.
Based on what we are seeing, high-impact leaders in 2026 will consistently demonstrate four core behaviors:
1. Be Proactive
Evolving beyond traditional university and HR faculty recruitment and retention practices—many of which remain adult-medicine centric—is required this year. Effective leaders will proactively engage in rethinking faculty talent strategies early in 2026 and will seek to formalize innovative best practices and programs in partnership with their children’s hospital colleagues. Relying solely on advertisements and limited in-house resources will be futile and will continue to drive escalating faculty shortages and retention challenges.
2. Be Present
Faculty are under extraordinary stress and dealing with unprecedented levels of burnout and moral injury. Leaders achieving impact in these areas are viewed as “present” by their faculty in both clinic and hospital settings. Visibility, engagement and accessibility matter more than ever.
3. Be an Advocate
Competitive compensation is an absolute requirement for effective recruitment and retention strategies. All strategies for solving current workforce issues will be a risk if competitive compensation remains unsolved. In 2026, pediatric subspecialty compensation will need to be at or above the 50% for faculty and 75% for leaders. Determined diligence and advocacy with health system and university partners is the only path for getting there. Medical Students and undergraduates are watching!
4. Be a Delegator
Leadership styles are evolving from top-down toward greater delegation and autonomy. Such cultures appear to me to be healthier and suffering from fewer retention challenges, especially with mid-career and younger faculty. The intentional creation of opportunities for growth and development, even in small measures, will be critical.
We believe academic pediatrics can make real strides forward in 2026 but we must be diligent and look forward to seeing the innovative solutions that will evolve from the efforts of effective leaders who understand that strong leadership is no longer optional and is essential to protecting patient care, supporting faculty wellbeing and sustaining the academic mission for the next generation.
Wesley Millican
Competitive Pediatric Leadership Salaries: Why They Now Define Your Recruitment and Retention Strategy
In our work partnering with children’s hospitals, schools of medicine and pediatric departments across the country, I’ve had a front-row seat to a talent acquisition shift that can no longer be ignored. Pediatric workforce dynamics are changing rapidly and compensation strategy has quickly become the most consequential – and often misunderstood – lever in faculty talent recruitment and retention. What once was a slow-building concern is now an urgent, system-level imperative and will be a pre-process priority for all applicants. The top three themes shaping the compensation debate include:
- Shrinking Leadership Pipelines
The most consistent theme heard from pediatric department chairs and division directors centers on “the rapidly declining pools of fully qualified faculty leadership candidates.” Training pipelines in pediatric subspecialties are narrowing, which leaves little hope for enhanced future pipelines. The result is predictable but increasingly acute—longer time-to-fill, more declined offers and heightened competition among institutions for a limited pool of talent.
- RVU Based Compensation Mismatch
Another recurring theme is directed at how poorly traditional RVU-based remuneration frameworks translate to competitive compensation for many pediatric subspecialties. Our highly cognitive, consultative specialties continue to feel undervalued in comparison to their procedural based specialty colleagues. What we often hear from leaders is their physicians are incredibly busy but the numbers and compensation don’t reflect it. It is rarely a performance issue and we must find a better model.
- Painful Costs of Underpayment
The tendency still exists in many health systems to support below-market compensation as a starting point or a negotiation strategy. Choosing to be proactively competitive and innovative in your compensation strategy is now mission critical. Faculty who believe they are undervalued are experiencing burnout and frustrations at higher levels and are highly susceptible to the recruiting advances of neighboring and national programs. Every departure triggers a cascade: search costs, interim coverage, lost revenue, onboarding delays, team disruption, and, in many cases, increased burnout.
We’re at a critical inflection point. Pediatric subspecialty care will not survive within outdated compensation cultures. Health systems that fail to adapt and invest risk deepening child health workforce shortages, limiting access, and a continual undermining of their long-term sustainability. Organizations that are taking a proactive, market-aligned approach to compensation are gaining a clear competitive advantage, not just in recruitment, but in stability, quality and performance.
Looking ahead, compensation is no longer a downstream financial decision. It is a core workforce strategy. Aligning pay with market realities is essential to attracting top talent and retaining our experienced faculty.
Leadership candidates asking about compensation are typically not asking for themselves. They are attuned to the workforce shortages and know what it will take to add faculty. If you are below market, the best applicants will not engage for fear of future years of failed recruiting due to compensation and resources. The stakes are high and the window to engage and innovate with our institutional partners is today.
Wesley Millican