Research ArticleDepartmentsF

Lessons on Leadership from Leads: Leadership Education for Academic Development and Success

José E. Rodríguez, Jenifer Wilson; On behalf of the 2022-2023 LEADS Cohort, José E. Rodríguez, Casey Crump, Phillip T. Dooley, Parastou Farhadian, Luz Fernandez, Jamie Hill-Daniel, Shashank Kraleti, Sarah Kureshi, Jennifer Molokwu, John Snellings, Justin M. Wright, Alexandra Verdieck-Devlaeminck, Myra Muramoto and Valerie Gilchrist
The Annals of Family Medicine November 2024, 22 (6) 571-572; DOI: https://doi.org/10.1370/afm.240497

Leadership is well studied in the business world and is the subject of multiple books and articles.1 Although leadership skills can be taught, there is still the perception that there are “natural leaders.” There are currently multiple leadership training programs for physicians in academic medicine, with many centering on specific identities (minoritized identity, women, etc), individual specialties, or unique skill sets.2-8 Regarding family medicine, the Association of Departments of Family Medicine (ADFM) and Society of Teachers of Family Medicine (STFM) have produced manuscripts on leadership pathways and negotiation for chair positions.7,9

However, leadership in family medicine remains a challenge, as evidenced by the many open chair positions. Family physicians want to see patients, and leadership positions require reduced patient care time. This, among other reasons, can make recruiting family physicians for leadership positions difficult.

The ADFM created the Leadership Education for Academic Development and Success (LEADS) fellowship to increase the quantity and diversity of qualified candidates for chair positions and to prepare mid- to senior-career family medicine faculty for leadership in academic medicine.10 During the 2022-2023 fellowship year, the LEADS fellows heard and discussed multiple axioms regarding leadership and career guidance; we compiled those that we heard during our LEADS meetings and queried our cohort on which were most important and which career stage the axiom most pertained to.

Most of the cohort participated in this ranking (7/12, 58%), and they identified 15 leadership axioms that could be helpful for early-career faculty, mid-career faculty, and senior faculty, as illustrated in Table 1.

View this table:
Table 1.

Leadership Axioms, Frequency, and Career Stage Designation

The early career axioms suggest to new faculty that it is impossible to know certain things about a position before you take it; that although physicians learn to do everything ourselves, physician writers should work on teams; actions have more substantial consequences than words; you should carefully choose what assignments you accept; and that no one ever wishes they spent more time at work, but they do regret not spending enough time with those they love.

The mid-career axioms suggest to those in this stage that moving is a real possibility and may be required to advance; constantly evaluate new opportunities; doing things once and well is better than doing it often but not as well; we need to be present on decision-making bodies to meet our department, specialty, and individual needs; standing with others is vital to get things done and to be happy in our careers; and that listening is more important than talking.

Senior career axioms suggest to those in this stage that having a bad team member can ruin the work environment; developing those behind you to take your place or surpass you is now your job; you need to choose which problems to fix intentionally; leadership requires us to develop skills we did not benefit from earlier in our careers; and that institutions make decisions based on economics and other factors, while individuals take emotions into account.

Because LEADS participants are mid- to senior-career faculty, early- and mid-career axioms represent ideas respondents would have liked to know at that stage. The group shared the senior-career axioms as beneficial to their current career stage.

While it can be challenging to recruit family physicians into leadership positions, LEADS motivated some fellows to seek chair positions and helped others learn about what they want to do with their careers. LEADS also taught us that all family physicians in academic medical centers can lead, even if it is not as a chair. We hope these LEADS axioms are helpful to readers as they reflect and plan their careers in family medicine and may have broad use across all medical specialties.

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