Inpatient units in academic departments are typically directed by junior faculty members, who quickly abandon these positions for less demanding, more rewarding jobs. These frequent turnovers in the directorship compromise the clinical, research, and educational functions of the inpatient unit. The authors believe that the average inpatient director's truncated term can be traced to two causes: an exacerbation of the junior faculty member's developmental crisis by factors intrinsic to the inpatient unit and a disparity between the expectations for academic productivity and the opportunities for scholarly activity. These conflicts are elaborated and pragmatic ways of relieving this situation are suggested.