Beeler et al, in a recent NEJM Perspective piece (Unplugging the Pipeline — A Call for Term Limits in Academic Medicine) address a repetitive theme: the lack of diversity at the most senior levels of department chairs and deans. They suggest that one way to create greater access to these positions would be to implement term limits for major leadership roles. This is a common model in colleges and universities. There are in fact schools of medicine (i.e. Mayo Clinic and the Canadian Schools) that operate with a policy of leadership term limits. In the context of our current data for departmental chairs and deans in U.S. schools, the authors spell out a number of potential advantages of a term-limit policy. They also note the need to address the potential downsides of repetitive recruitment, and leadership development. However, to be eligible for these traditional leadership roles in today’s world, faculty must reach senior ranks in the academy. For women, this requires creating an environment where they wish to advance on faculty, developing their own academic potential; and further, where they view a leadership role as desirable and accessible. Academic medicine has long supported structures that have entrenched the status-quo. It is time to reconsider our past, exploring how our written or unwritten policies can be disrupted to create the diverse leadership that we know we need…. and along the way, measuring the impact of those changes.