A mundane but poignant definition of leadership might be simply stated as “Doing the right thing every time… even when no one is watching.” In academic medicine, this aspirational goal is becoming more difficult with each passing year as the corporatization of healthcare infiltrates even the faculty practice, which was traditionally overseen by the Dean of the school of medicine. However, with the expanding clinical enterprise of an academic health system being keenly focused on the financial margin, the imperative for cross-subsidization of the academic mission by the clinical practice of the faculty is now barely palpable. This reality places ever more pressure on “doing the right thing” because the necessary cross-subsidy of education and research is no longer primarily at the discretion of academic leaders but rather corporate health system leaders who now oversee the clinical enterprise. For health professions education leaders, this means that support of the academic mission will require persuasion of a corporate entity that will struggle to identify a tangible return on investment from support of either education or research. Such is the stark challenge of the contemporary leader in health professions education. To be successful in such an environment, the leader should consider issues of person, position, and place to be navigated. The personal attributes of the successful leader include several familiar characteristics, perhaps the most important of which is humility coupled with a strong will for the team (rather than the individual leader) to succeed. Negotiation requires a conscious awareness of the tradeoff between the tangible result and the intangible relationship with the other party. Comfort with ambiguity is an essential trait to be developed since all the data are never in place for any given decision. In the end, principled leadership is essential and should not be compromised under any circumstance. Commitment to the role and the gratifying aspects of one’s prior career will reward the leader with success, peace of mind, and continued fulfillment. The position requires consideration of the term and the exigencies of the post. When managing a unit, the leader’s most important role is as chief talent officer to both recruit as well as retain colleagues who are smarter than you and equally motivated to succeed. Management aspects of the post require special attention. Some are mundane, such as conduct of faculty meetings or stewardship of financial health, but they require nuance and are critically important to tangible success. Strategic visioning of the mission is inherently more exciting and invites creativity, but requires collective input from the team and transparent alignment of incentives with desired outcomes, which can be complex. Finally, we return to the attributes of the place, which are largely colored by the governance structure that either facilitates the needed cross-subsidy of the academic mission or serves as an obstacle to be managed and overcome in order to support education and research. A thoughtful and pragmatic assessment of each of these factors is essential for the success of the contemporary leader in health professions education.

Considerations Unique to Leaders in Health Professions Education

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发表日期：

2026年

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Vincent D. Pellegrini

摘要

A mundane but poignant definition of leadership might be simply stated as “Doing the right thing every time… even when no one is watching.” In academic medicine, this aspirational goal is becoming more difficult with each passing year as the corporatization of healthcare infiltrates even the faculty practice, which was traditionally overseen by the Dean of the school of medicine. However, with the expanding clinical enterprise of an academic health system being keenly focused on the financial margin, the imperative for cross-subsidization of the academic mission by the clinical practice of the faculty is now barely palpable. This reality places ever more pressure on “doing the right thing” because the necessary cross-subsidy of education and research is no longer primarily at the discretion of academic leaders but rather corporate health system leaders who now oversee the clinical enterprise. For health professions education leaders, this means that support of the academic mission will require persuasion of a corporate entity that will struggle to identify a tangible return on investment from support of either education or research. Such is the stark challenge of the contemporary leader in health professions education. To be successful in such an environment, the leader should consider issues of person, position, and place to be navigated. The personal attributes of the successful leader include several familiar characteristics, perhaps the most important of which is humility coupled with a strong will for the team (rather than the individual leader) to succeed. Negotiation requires a conscious awareness of the tradeoff between the tangible result and the intangible relationship with the other party. Comfort with ambiguity is an essential trait to be developed since all the data are never in place for any given decision. In the end, principled leadership is essential and should not be compromised under any circumstance. Commitment to the role and the gratifying aspects of one’s prior career will reward the leader with success, peace of mind, and continued fulfillment. The position requires consideration of the term and the exigencies of the post. When managing a unit, the leader’s most important role is as chief talent officer to both recruit as well as retain colleagues who are smarter than you and equally motivated to succeed. Management aspects of the post require special attention. Some are mundane, such as conduct of faculty meetings or stewardship of financial health, but they require nuance and are critically important to tangible success. Strategic visioning of the mission is inherently more exciting and invites creativity, but requires collective input from the team and transparent alignment of incentives with desired outcomes, which can be complex. Finally, we return to the attributes of the place, which are largely colored by the governance structure that either facilitates the needed cross-subsidy of the academic mission or serves as an obstacle to be managed and overcome in order to support education and research. A thoughtful and pragmatic assessment of each of these factors is essential for the success of the contemporary leader in health professions education.