How to Develop Leadership in Academic Medicine: Lessons From the PAWLHS Program
Year: 2025
Type: article
Abstract: The concept of leadership emerged relatively late in China, especially in the academic medical field, and has not been widely emphasized. Currently, only a few medical schools in China offer leadership education programs for medical students.1,2 For practicing doctors, there is a lack of systematic leadership discussions and training for potential future leaders.3 Preparing and Advancing Women Leadership in Health Science (PAWLHS), jointly initiated by the University of Michigan and Peking University Health Science Center, and funded by the China Medical Board, is the first female leadership development program specifically for women in the academic medicine field in China. In the fall of 2023, I became one of the first cohort fellows of the PAWLHS program. Before this, I worked in the obstetrics and gynecology (OBGYN) department of a leading general hospital in China. The department’s accumulated expertise and rapid development in recent years have made it a key specialty of our institution. I serve as the deputy director of the maternal fetal medicine (MFM) division. However, as a young department leader, I have many doubts and uncertainties about becoming a good leader. In academic medical institutions like ours, the growth and development of leadership roles lack clear planning and preparation in advance. I later discussed this with some young leaders in other positions, and they expressed the same concerns: How can we prepare to become leaders, and what kind of leaders does our institution need? With these questions in mind, I came to the University of Michigan for a one-year leadership training program through PAWLHS. Moving from “Preparing for leadership” to “Advancing leadership” essentially involves consciously helping individuals to change through a series of systematic and well-planned projects, thereby triggering broader organizational and institutional transformations. Change occurs on two levels: the first is the internal change within the individual, and the second is the external change initiated by the individual. Internal Change In the early stages of the PAWLHS program, I underwent numerous assessments. Self-assessment was a crucial part, and I also received evaluation results from my superiors, peers, and direct reports. I often reviewed these evaluations. The University of Michigan proposed the Michigan Expectations Model based on leadership development requirements, which clearly delineates four domains. I realized my weakness was in one of these domains: People. However, “internal change” requires going a step further—deep exploration. Self-awareness is not easy. Even when presented with the assessment results, the subconscious may prevent you from probing further because it might touch on weaknesses you are unwilling to face and acknowledge. Therefore, this process requires guidance and courage. Only by repeatedly probing and not fearing to accept one’s weaknesses can make change occur. Based on these assessments and insights, mentoring and coaching played a significant role in the program. Around the domain of “People”, my mentor and coach developed actionable strategies and suggestions to help me break down the ‘individual silo’. I reached out to my domestic colleagues and engaged in numerous conversations to establish connections. Change began to happen when I started to implement these strategies. In academic medical institutions in China, a leader may have many missions, with various external demands and expectations, which can be quite extensive. An important step in internal change is to narrow down and focus on your real career goals. Only by doing this can you have the psychological strength to steadfastly achieve your goals amid external noise. These are significant insights and growth that this journey has brought me. External Change The true purpose of leadership is to drive change and foster widespread improvement. One of my career goals is to work on healthcare quality improvement. During the program, I learned many concepts of quality improvement through the rich resources and vivid examples from various departments at the University of Michigan, and I saw how these concepts were implemented and embedded into institutional culture and medical education. I was deeply moved by the young OBGYN residents who shared their quality improvement projects during the Thursday morning Mortality & Morbidity meetings. I used to wonder whether the time invested in quality improvement projects was separate from developing leadership and team management skills. However, after discussions with leaders from diverse backgrounds, I realized that quality improvement is actually an essential part of leadership. It is not a matter of time consumption but rather a mutual achievement. In the program, I focused on promoting lean management in the quality improvement field (by referencing theoretical knowledge and developing courses in Chinese), and also led my team in implementing quality improvement initiatives remotely, learning how to motivate others. This is part of transformational leadership and a small beginning in guiding subsequent changes. Sonya Jacobs is the University of Michigan’s first chief organizational learning officer. She advises the president and executive leadership of the university and helps lead U-M efforts on cultural change regarding ethics, values, and compliance. She organized two important women leadership initiatives: the Rudi Ansbacher Advancing Women in Academic Medicine Leadership Scholars Program and the Leadership Summit for Women in Academic Medicine and Healthcare. Interestingly, she proposed Jacob’s 70-20-10 development strategy. According to this strategy, employees spend 70 percent of their leadership development time learning a new skill through experiential learning, 20 percent through mentoring and coaching, and 10 percent in a formal learning situation. When I reflect on my experience in the PAWLHS program, it perfectly exemplifies Jacob’s theory: 70 percent is about experiential learning, and the remaining 30 percent (including mentoring, coaching, and formal learning) provides strong support for this 70 percent experiential learning. This ultimately leads to gradual individual and widespread changes. Whether it is PAWLHS, UM’s women leadership projects, or broader leadership education programs in the United States, they all provide an excellent paradigm for us to reference when initiating leadership training and development programs in China. What kind of leadership does academic medicine, especially MFM, need in the future? Clinical care, research, and education are the three pillars of academic medicine, making it a multidimensional and multitasking field that demands higher leadership capabilities. Core competencies for leaders in academic medicine include understanding and navigating complex systems, building and leveraging relationships for collaboration, adjusting and driving vision, and ultimately promoting change and innovation. The development of each of these skills involves several stages: preparation, transition, sustaining leadership success, and moving into the next leadership position. The development of leadership is not achieved overnight but is a long journey. In today’s academic medicine, the concept of leadership has not been fully recognized, and its importance lacks widespread awareness. In China, there is also a lack of systematic and conscious leadership training programs or courses specifically for MFM doctors. PAWLHS strives to create a network of leaders who explicitly recognize this need and foster their relationships with existing leaders. Fellows are encouraged to take the insights they learn back to their institutions and implement them. PAWLHS seeks to sow the seeds of wider-scale transformation, aiming to effect change in the very culture of academic medicine itself. Given the current lack of leadership education in the Chinese academic medical fields, its initiation serves as a specific organizational strategy to support leadership development. Developing leadership in maternal-fetal medicine and academic medicine in China is vital for advancing the field and addressing the tremendous need for leadership talent. While initiatives like PAWLHS have made significant progress, localized leadership training programs tailored to China’s unique context are essential to meet growing demands. Key strategies include creating structured programs focused on management, quality improvement, and interdisciplinary collaboration to foster innovation. Hands-on opportunities should also be provided for emerging leaders to lead projects and gain practical experience. Furthermore, to address the long-term need for leadership talent, leadership education should be integrated into the Chinese medical education system, preparing the next generation to drive transformative change and improve healthcare outcomes more effectively. Acknowledgments I would like to express my heartfelt gratitude to the China Medical Board (CMB) for granting me the invaluable opportunity to participate as a fellow in the PAWLHS program. This experience has been transformative, offering profound insights and fostering my growth in leadership and academic development. I am especially grateful to Dr. Timothy R.B. Johnson, Dr. Cheryl A. Moyer, Dr. Jie Qiao, and Dr. Yangyu Zhao for their thoughtful feedback and revision suggestions, which greatly enhanced the quality and depth of this work. Funding None. Conflicts of Interest None. Data Availability Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.
Source: Maternal-Fetal Medicine
Author: Lian Chen
Institution: Peking University Third Hospital
Language: English
Field: Medicine
Domain: Health Sciences
SDG: Quality education
Open Access status: diamond
OpenAlex ID: W4407777670