The job of leadership.

Leadership, like beauty, is difficult to describe, but you know it when you see it. This intangible aspect of leadership has often led to the unfortunate perception that it is like perfect pitch—you either have it or you do not and, consequently, it cannot be learned. While the study of leadership is not an exact science (as evidenced by the many different styles of effective leaders) and there is no clear-cut algorithm for everyone to follow, the critical ingredients of leadership can be learned. Leadership means responsibility, not privilege. It is not restricted to individuals in positions of high authority. It is not a position; it is a collection of practices and behaviors, a set of skills. Leaders do not possess special powers and many of them are not charismatic. Anyone willing to put forth the effort and who cares enough to make a difference can develop leadership qualities and become an effective leader. University surgeons, including those in training, are exposed to an environment that is rich in leadershiplearning opportunities. The surgical residency confers increasing responsibility with time and the occasion for senior house officers to mentor junior residents, develop expertise, build credibility, and foster an esprit de corps. The structure of the department of surgery provides the younger faculty an opportunity to learn about fiscal issues and develop management skills. The rapidly evolving health care climate requires that we revisit our values and our purpose, question the status quo, build for the future, and enroll our constituents and inspire them. These challenges are the substance of leadership. They are opportunities that should be leveraged. When experience is combined with formal educational programs and excellent role models, a superb environment for learning to lead is created. Unfortunately, superlative leadership is conspicuously absent in many departments. It is not that the senior leaders lack expertise or credibility. It is not that they do not understand where the department needs to go. It is not even that they sometimes fail to appreciate the contributions of their people. It is that they do not devote enough of their time ensuring that leaders are built from their core of young people. This is partly because other more important issues consume their time. It is also because leadership development is not a high priority. The priorities are developing clinicians and investigators. Excellent clinical surgeons and superb surgical scientists are not necessarily great leaders. Many people assume that leadership skills will be automatically learned on the job through trial and error as the individual takes on new duties and responsibilities. Their theory of professional development assumes that learning to lead is like learning to walk— eventually it will happen and intervention is meddlesome. However, this learning process should not occur without guidance. A poor performance might be interpreted as a lack of leadership talent rather than the need for tutelage. As young leaders acquire experience, they need to be coached and mentored. They need to be managed like a long-term investment. What, in the long run, is more important than building for the future? What is more important than our young people—our most valuable asset? They are the future leaders of American surgery.