The Succession Problem: Preparing Your Replacement Before You Need One
Nobody Plans to Leave Until They Do
You're not going anywhere. You've said it yourself. Maybe to your dean, maybe to your team, maybe just to yourself on a Sunday night while prepping for Monday's meetings. You're committed. You're staying.
And then one day, something shifts. An opportunity shows up. A health scare changes your priorities. You hit a wall you didn't see coming. Or you simply realize it's time.
When that day comes, most academic medicine leaders look around and discover the same thing: there's no one ready to step in. Not because there aren't talented people in the department. But because no one was developed to lead it.
Why Succession Planning Doesn't Happen
In most departments, the answer is painfully simple. The current leader never made it a priority.
It's not malicious. It's not even conscious most of the time. It's that academic medicine selects for people who are exceptional at doing the work themselves. Running the lab. Seeing patients. Writing grants. Managing the crisis of the week. Building someone else's leadership capacity doesn't feel urgent when you're buried in all of that.
There's also an uncomfortable psychological piece. Thinking about your successor means thinking about your own departure. For leaders whose identity is deeply tied to their role, that's not a pleasant exercise. So it gets deferred. Year after year.
Ram Charan, Stephen Drotter, and James Noel make this case powerfully in The Leadership Pipeline. Leadership development isn't something that happens naturally. It has to be built, stage by stage, with intention. And the person responsible for building it at the top is you.
What Happens When You Don't
I've seen this play out more times than I'd like. A long-tenured division chief steps down, and the institution scrambles. They run a national search that takes a year. An interim leader holds things together, but momentum stalls. Faculty who might have stayed start looking elsewhere because the direction feels uncertain.
The cost isn't just administrative inconvenience. It's lost grants, lost recruits, and lost trust. The people in your department are watching whether you're building something that outlasts you, or just holding a position.
Start Before You're Ready
You don't need a formal succession plan on paper. You need to be doing three things now:
- Identify two or three people with leadership potential. Not the loudest voices in the room. The people who think about the team, not just their own portfolio. The ones others naturally turn to.
- Give them real leadership exposure. Let them run a faculty meeting. Put them on a hiring committee. Ask them to represent the department to the dean's office. These aren't favors. They're tests, and they're development.
- Have honest conversations about their futures. Ask them where they want to go. Tell them what you see in them. Be direct about the gaps they'd need to close. Most potential leaders in academic medicine have never been told, plainly, that someone is investing in their growth as a leader.
This Isn't About Leaving
Here's the part that trips people up. Succession planning isn't an exit strategy. It's a leadership strategy.
When you develop people who can step into bigger roles, your department gets stronger now, not just later. You create bench strength for committees, for interim roles, for the hundred small leadership moments that happen every week. You also free yourself from being the single point of failure, which is its own kind of relief.
The best academic medicine leaders I've worked with don't wait for a transition to think about this. They treat it as part of the job from day one.
One Move This Month
Pick one person in your department who has leadership potential they haven't fully explored. Give them a meaningful responsibility and the support to succeed at it. Then pay attention to what happens.
That's how succession planning starts. Not with a document. With a decision.
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