Health Care Leadership Acumen: An Early Prescription for a Sustainable Career

The recent Annals of Internal Medicine article by Houchens and colleagues (1) highlights a troubling but familiar trend: Burnout is widespread among internal medicine physicians, affecting professionals across care settings and clinical roles. Even with strict diagnostic criteria, nearly 10% of respondents met burnout thresholds in all 3 domains of the Maslach Burnout Inventory: emotional exhaustion, depersonalization, and low personal accomplishment. While this prevalence is lower than some prior estimates, the study reinforces an uncomfortable truth: No group is immune. 

As a medical educator and clinician, I see burnout long before physicians reach mid-career. The transition from training to practice remains a fragile inflection point. We ask a great deal of students to master the science of medicine, to uphold high standards of professionalism, and to care deeply. But we often neglect to prepare them for the complexity of the systems they will be working in. Are we equipping future physicians not just to heal but to survive and thrive within today’s health care environments? 

Burnout is a multifaceted issue with no single solution, but I believe one practical, upstream intervention is clear. We must incorporate leadership and business acumen training early in medical education. This is not about creating administrators. It is about cultivating self-awareness, system fluency, and communication skills that help physicians navigate their careers with resilience and purpose. 

What if we shift that paradigm? What if leadership training, starting with self-awareness, became an essential part of medical education? 

Studies support this direction. One survey of final-year students found that more than 90% desired more training in leadership, communication, and career management skills before entering residency (2). Another pilot program that embedded leadership and management education into an undergraduate medical curriculum found that students not only embraced the content but also showed measurable gains in their confidence and competence (3). 

Embedding these competencies early in training may help close the expectation gap that so often feeds burnout. By giving students tools to align their personal values with their professional choices, we may reduce the disillusionment that often arises during the leap from school to practice. It would also reinforce professional identity in a way that is both humanistic and pragmatic, rooted in the realities of medicine today. 

If we want a future where physicians are not only surviving but flourishing, then leadership development should no longer be viewed as optional. Thoughtfully weaving leadership and business acumen into the early stages of the medical journey could be a critical step toward helping physicians thrive. Leadership education does not diminish the call to heal. On the contrary, it supports it. Compassion, without the capacity to act within systems, can lead to moral distress. Physicians must be collaborators, advocates, and strategic thinkers not just for their patients but also for themselves and their teams. As Houchens and colleagues (1) remind us, burnout remains a persistent, structural challenge in internal medicine. If we are serious about changing that trajectory, we must look earlier and think more broadly. 

References

1. Houchens N, Greene MT, Sen S, et al. Burnout prevalence among U.S. internal medicine physicians. A cross-sectional study. Ann Intern Med. 2025;178:1207-1208. [PMID: 40324201] doi:10.7326/ANNALS-24-02896
2. Behling F, Adib SD, Haas P, et al. Not taught in medical school but needed for the clinical job – leadership, communication and career management skills for final year medical students. BMC Med Educ. 2024;24:1126. [PMID: 39390423] doi:10.1186/s12909-024-06091-w
3. Nicolaou N, Nicolaou C, Nicolaou P, et al. Development of a leadership and management module for the undergraduate medical curriculum. BMC Med Educ. 2024;24:1310. [PMID: 39543575] doi:10.1186/s12909-024-06004-x

Amelie Oshikoya, MD, MHA

Amelie Oshikoya, MD, MHA is an associate professor and the chair of primary care at the Orlando College of Osteopathic Medicine. She also serves as a regional site director, building partnerships with hospitals to create clinical clerkship opportunities for students, and sits on the AdventHealth Master of Health Administration advisory board. She is passionate about medical education, health care administration, leadership development, and helping future physicians build sustainable and fulfilling careers in health care.