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3 Ways Academic Medical Centers Can Prepare for the Next Generation of Leaders

By Philip Jaeger and Mark I. Furman, M.D.
May 2026
| 0 min read

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Key findings

  • As acquisitions, partnerships and restructuring reshape organizations, savvy AMCs are reassessing their current organizational structures and positions, including the scope of responsibilities and accountability.
  • Whatever a potential successor’s primary background may be, successful emerging leaders appreciate how all mission areas fit together, and they bring strong abilities in collaboration, agility and leading through influence.
  • As AMCs grow more complex, the very definition of a role or even a major unit may shift. Therefore, it is paramount to define positions that meet future organizational needs, and identify top internal talent early in their careers.

This article is adapted from Beyond the Triple Threat: The Future of Leadership in Academic Medicine.

Academic medical centers (AMCs) are settling into a “new normal”: federal policy changes, patient demand shifts, accelerating research innovation and evolving workforce expectations. Taken together, these trends have spurred change in every aspect of an AMC, including leadership itself. Today we see organizations adapting how they are developing future leaders to meet this new reality.

AMCs have a natural pipeline of rising talent as aspiring leaders become chiefs, chiefs become chairs, and chairs become deans. Additional pathways have opened up through service-line, institute and center, and system-level leadership roles. The net result is both an increase in avenues to leadership and more opportunities for a broader range of emerging leaders.

So what can AMCs do to ensure that their leadership pipelines have the right people with the right leadership capabilities, whether they are internal or external candidates? Below we look at three key steps.

As acquisitions, partnerships and restructuring reshape organizations, savvy AMCs are reassessing their current organizational structures and positions, including the scope of responsibilities and accountability.

For example, as physician organizations expand through acquisition and organic growth, we are seeing some COO portfolios being carved out of the expanding mandate of the CEO. Meanwhile, in integrated health systems, the scope of authority of a regional hospital CEO compared to the system CEO can vary greatly — even within the same enterprise. And the mandate of a department chair is in flux as AMCs shift structures and accountability for education, research and patient care at the enterprise level.

As we think about aligning leadership capabilities to organizational structure, there are a few important considerations. First, at what point is a single leader best suited to oversee a mission or unit? And, what are the critical leadership capabilities for success? Organizational strategy drives this, but legacy structures, growth projections and the tenures of senior leaders bear considerations as well. Also critical, to be sure, is the capability of any individual leader.

For AMCs, the true “triple threat” leader — a physician with robust research credentials, extensive clinical experience, and a substantial record in education — is an increasingly rare breed. Moreover, fewer roles today require this combination of skills; instead, more AMC’s prioritize a “major,” that is one capability required in a given role.

Whatever one’s major might be, successful emerging leaders appreciate how all mission areas fit together, and they bring strong abilities in collaboration, agility and leading through influence. The best executives, in turn, convene teams to give an enterprise-wide view while empowering and coaching emerging leaders to succeed in their distinct roles. And executives we talk to emphasize that no leader can do it alone, nor are they expected to, anymore.

Most AMCs engage in some sort of succession planning, but it is often near-term and responsive to an imminent transition. Yet, as AMCs grow more complex, the very definition of a position or even a major unit may shift. Therefore, it is paramount to do two things at once: define positions that meet organizational needs for where the system is going, and systematically identify and develop top internal talent early in their careers. By giving “stretch assignments” and prioritizing bedrock capabilities of adaptability, empathy and resilience, executives can build a pool of leaders that can grow as the organization evolves.

More specifically, when it comes to your internal “rising stars,” development comes down to frequent feedback loops, coaching, and regular alignment on the organization’s overarching goals. Have you created a culture that enables success of everyone, and that is a core driver of retention? What behaviors are you modeling? Are there enough incentives to retain your best people?

Often, the strongest leadership solution is an external recruit. When looking outside the organization, it’s important to map the landscape and, because these leaders are in demand, engage in targeted, personalized recruiting. The leading organizations benchmark internal talent against external talent, aware that the readiness of internal options may not align with the changing needs of the organization.

  • As growth and restructuring blur traditional roles, top organizations are reassessing leadership structures to ensure that accountability, authority and individual capabilities are aligned with strategy rather than legacy design.
  • They look at their organizational structure. They approach succession planning as “always-on,” not a one-time, far-away event.
  • They don’t stop once the new leader takes over. Instead, they build and execute a robust plan for ensuring leaders master the critical levers for success, including team alignment, culture, style, communications and organizational structure.
  • They engage the CEO, CHRO and board throughout the process, and integrate succession planning within broader executive leadership development programs to ensure a robust pipeline of talent.
  • They consider candidates with underlying capabilities and behaviors that enable success; they don’t cling to traditional yardsticks like “triple threat” or seniority. And there is an openness to leaders who built their careers outside of academic medicine.

• • •

The future of academic medicine demands a new kind of leader — one who is strategically minded, operationally grounded and deeply committed to sustaining the tripartite mission. But great leaders don't emerge by accident. By investing early in building and developing strong top teams, AMCs can cultivate the leadership bench their institutions — and the patients, students and researchers who depend on them — will need for decades to come.

 

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