Becoming a Successful Chief Medical Officer: A Primer

Abstract

This review examines the key factors to becoming a successful chief medical officer (CMO) in today's health care landscape. It explores the educational paths, leadership training, and real-world challenges CMOs face across academic and nonacademic settings in developed and developing countries. It provides actionable insights into leadership competencies, institutional dynamics, and key performance indicators (KPIs) that define excellence in this top medical leadership role.

Drawing upon literature identified through artificial intelligence-assisted searches and verified via academic databases, the review synthesizes key themes, including educational and leadership prerequisites, mentorship dynamics, and experiential learning. It contrasts the roles and expectations of CMOs in academic centers, nonacademic hospitals, and private hospitals, as well as the unique demands faced in developed versus developing nations. The review also examines strategic leadership competencies such as communication, financial literacy, and quality management. Practical challenges are analyzed, including credentialing, prioritization of education versus clinical duties, and infrastructural limitations in low-resource settings. Finally, we highlight actionable strategies to overcome systemic constraints and outline KPIs relevant to health care contexts.

This work offers a practical guide for aspiring CMOs, health care leaders, and policymakers seeking to strengthen clinical governance and institutional performance.

Keywords

chief medical officer (CMO) - medical leadership - clinical governance - academic medicine - developing nations - quality and safety - credentialing

Declaration of GenAI Use

During the composition of this review, the authors used generative AI tools solely for literature discovery and drafting assistance. Specifically, Open Evidence was consulted on May 15, 2025. The authors reviewed and edited all substantive content, assuming full accountability for the manuscript's intellectual integrity and originality. This disclaimer does not apply to standard software tools for grammar, spelling, or reference formatting.

Authors' Contributions

S.A.B. proposed the idea, collected the data, and wrote the first draft. H.T.S.B. contributed to the concept development and revised the draft. All authors further developed the manuscript and agreed on its final version.

Compliance with Ethical Principles

No ethical approval is required for a narrative review article type of study.

Publication History

Article published online:
16 July 2025

• References

• 1 Harolds JA. Quality and safety in healthcare, part LXX: qualifications and leadership of the chief medical officer. Clin Nucl Med 2021a; 46 (06) 471-473
• 2 Onyango R, Baker MC, Faerberg J, Haberman M, McCoy R, Orlowski J. Evolution of the chief medical officer role in teaching hospitals and health systems. J Healthc Manag 2023; 68 (02) 121-131
• 3 Harolds JA. Quality and safety in health care, part LXIX: introduction to the responsibilities of the chief medical officer. Clin Nucl Med 2021b; 46 (05) 402-404
• 4 Longnecker DE, Patton M, Dickler RM. Roles and responsibilities of chief medical officers in member organizations of the Association of American Medical Colleges. Acad Med 2007; 82 (03) 258-263
• 5 Feussner JR, Landefeld CS, Weinberger SE. Change, challenge and opportunity: departments of medicine and their leaders. Am J Med Sci 2016; 351 (01) 3-10
• 6 Wong BM, Holmboe ES. Transforming the academic faculty perspective in graduate medical education to better align educational and clinical outcomes. Acad Med 2016; 91 (04) 473-479
• 7 Ackerly DC, Sangvai DG, Udayakumar K. et al. Training the next generation of physician-executives: an innovative residency pathway in management and leadership. Acad Med 2011; 86 (05) 575-579
• 8 Heitz C, Hamilton GC. The academic chair in emergency medicine: current demographics and survey results identifying the skills and characteristics desired for the role. Acad Emerg Med 2011; 18 (09) 981-987
• 9 Warren OJ, Carnall R. Medical leadership: why it's important, what is required, and how we develop it. Postgrad Med J 2011; 87 (1023): 27-32
• 10 Fairchild DG, Benjamin EM, Gifford DR, Huot SJ. Physician leadership: enhancing the career development of academic physician administrators and leaders. Acad Med 2004; 79 (03) 214-218
• 11 Imran D, Rog K, Gallichio J, Alston L. The challenges of becoming and being a clinician manager: a qualitative exploration of the perception of medical doctors in senior leadership roles at a large Australian health service. BMC Health Serv Res 2021; 21 (01) 351
• 12 Markuns JF, Fraser B, Orlander JD. The path to physician leadership in community health centers: implications for training. Fam Med 2010; 42 (06) 403-407
• 13 Borges NJ, Navarro AM, Grover A, Hoban JD. How, when, and why do physicians choose careers in academic medicine? A literature review. Acad Med 2010; 85 (04) 680-686
• 14 Stoller JK. Leadership essentials for CHEST medicine professionals: models, attributes, and styles. Chest 2021; 159 (03) 1147-1154
• 15 Watson RT. Rediscovering the medical school. Acad Med 2003; 78 (07) 659-665
• 16 van de Riet MCP, Berghout MA, Buljac-Samardžić M, van Exel J, Hilders CGJM. What makes an ideal hospital-based medical leader? Three views of healthcare professionals and managers: a case study. PLoS One 2019; 14 (06) e0218095
• 17 Rotenstein LS, Huckman RS, Cassel CK. Making doctors effective managers and leaders: a matter of health and well-being. Acad Med 2021; 96 (05) 652-654
• 18 Berns JS, Goldstein JL, Hartmann DM, Simons K, Opas L. The expanding role of designated institutional officials in graduate medical education. Acad Med 2025; 100 (02) 131-136
• 19 Levinson W, Branch Jr WT, Kroenke K. Clinician-educators in academic medical centers: a two-part challenge. Ann Intern Med 1998; 129 (01) 59-64
• 20 Pellegrini Jr VD, Guzick DS, Wilson DE, Evarts CM. Governance of academic health centers and systems: a conceptual framework for analysis. Acad Med 2019; 94 (01) 12-16
• 21 Kirkpatrick I, Bullinger B, Dent M, Lega F. The development of medical-manager roles in European hospital systems: a framework for comparison. Int J Clin Pract 2012; 66 (02) 121-124
• 22 Denis JL, van Gestel N. Medical doctors in healthcare leadership: theoretical and practical challenges. BMC Health Serv Res 2016; 16 (Suppl 2, Suppl 2): 158
• 23 Madede T, Mavume Mangunyane E, Munguambe K. et al. Human resources challenges in the management of diabetes and hypertension in Mozambique. PLoS One 2024; 19 (03) e0297676
• 24 Rahman KMT, Rayna SE, Khan FA. et al. Challenges faced by medical officers in providing healthcare services at Upazila health complexes and district hospitals in Bangladesh - a qualitative study. Lancet Reg Health Southeast Asia 2024; 24: 100398
• 25 Harolds JA. Quality and safety in healthcare, part LXXII: credentialing and privileging. Clin Nucl Med 2021c; 46 (11) 908-910
• 26 Rauch DA. Committee on Hospital Care, Section on Hospital Medicine. Medical staff appointment and delineation of pediatric privileges in hospitals. Pediatrics 2012; 129 (04) 784-787
• 27 Gupta R, Sehgal N, Arora VM. Aligning delivery system and training missions in academic medical centers to promote high-value care. Acad Med 2019; 94 (09) 1289-1292
• 28 Geiling J, Burkle Jr FM, Amundson D. et al; Task Force for Mass Critical Care, Task Force for Mass Critical Care. Resource-poor settings: infrastructure and capacity building: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement. Chest 2014; 146 (4, Suppl): e156S-e167S
• 29 Endalamaw A, Khatri RB, Erku D. et al. Barriers and strategies for primary health care workforce development: synthesis of evidence. BMC Prim Care 2024; 25 (01) 99
• 30 Alhalaseh YN, Elshabrawy HA, Erashdi M, Shahait M, Abu-Humdan AM, Al-Hussaini M. Allocation of the “already” limited medical resources amid the COVID-19 pandemic, an iterative ethical encounter including suggested solutions from a real life encounter. Front Med (Lausanne) 2021; 7: 616277
• 31 Aslam MZ, Trail M, Cassell III AK, Khan AB, Payne S. Establishing a sustainable healthcare environment in low- and middle-income countries. BJU Int 2022; 129 (02) 134-142
• 32 Kehinde T, Biwott J, Sund G, Kynes JM. Machines matter too: including biomedical engineering partnerships in global health initiatives. Lancet Glob Health 2024; 12 (11) e1905-e1909
• 33 Webber CM, Martínez-Gálvez G, Higuita ML. et al. Developing strategies for sustainable medical equipment maintenance in under-resourced settings. Ann Glob Health 2020; 86 (01) 39
• 34 Iserson KV, Biros MH, James Holliman C. Challenges in international medicine: ethical dilemmas, unanticipated consequences, and accepting limitations. Acad Emerg Med 2012; 19 (06) 683-692
• 35 Shahian DM, Nordberg P, Meyer GS. et al. Contemporary performance of U.S. teaching and nonteaching hospitals. Acad Med 2012; 87 (06) 701-708
• 36 Cardinaal E, Dubas-Jakóbczyk K, Behmane D. et al. Governance of academic medical centres in changing healthcare systems: an international comparison. Health Policy 2022; 126 (07) 613-618