Leadership in academic medicine: reflections from administrative exile

Physicians are drawn into diverse leadership roles in academic medicine, but little in our education and training prepares us for these responsibilities. Fortunately, there is growing convergence in the literature on the attributes of successful leaders for knowledge-based organisations. Top-performing leaders seem to be self-effacing team-builders who eschew rapid-cycle strategic planning and management trends, focusing instead on strategic and incremental changes that will gradually transform their organisations. Academic physicians and search committees often concentrate on personal achievement and intellectual or technical mastery in research and clinical care. In contrast, the literature on leadership suggests other-directed skills matter more, eg mentorship, learning and teaching competencies, and so-called emotional intelligence. As a corollary, teaching hospitals, universities, and professional colleges or societies are long-term organisations with a rich history. Leadership in such a context demands stewardship of tradition along with patient pursuit of changes required to ensure that the organisation evolves successfully.