As a network focussed on supporting leadership development of ‘early career professionals’, we have increasingly been asking ourselves: who exactly are we trying to support? 

We asked a group of health sector professionals if they saw themselves as ‘early career’ or ‘established’ leaders, and the responses surprised us. Most people hesitated, reluctant to claim the title of ‘established’ leader. Even individuals with years of experience leading clinical teams and quality improvement work, resisted identifying as ‘established’ leaders. 

Conversely, the few healthcare managers and clinical consultants in the room were quick to assert their ‘established’ leadership status. Perhaps most striking was one recently qualified healthcare professional who firmly identified as an established leader, pointing to their extensive background in health advocacy.

We might attribute the hesitation to identify as a healthcare leader as another manifestation of imposter syndrome, ‘a feeling of inadequacy that persists despite evidence of success’(1). But could it relate more deeply to professional identity formation? 

Traditional clinical hierarchies fail to define today’s leaders

Current discussion around the development of healthcare professional identity is still centred around clinical experience and traditional hierarchies (2, 3) . This old framework no longer fits. Today’s healthcare professionals do far more than provide care: they’re also communicators, advocates, educators, leaders, and researchers.

Yet much of this leadership goes unrecognised within this outdated clinical hierarchy. Those who fall through the gaps include peer or near-peer champions of medical education and widening participation, people working in leadership roles in quality improvement or policy, and individuals advocating for health within their communities, and many more. In research, those who have completed doctoral training are labelled as ‘early career’, while clinicians typically undertake a doctorate five to eight years after qualification, meaning the term doesn’t translate consistently across professions.

A consistent leadership framework is needed

We need to understand how individuals in the health sector relate to different stages of leadership and identify as leaders, so that we can offer the right support to the right people and build sustainable health and care systems.

The lack of clear pathway for progression in healthcare leadership makes it difficult to separate leadership development from clinical progression. Leadership stages themselves are inconsistently defined. The Healthcare Leadership Model emphasizes that leadership development is not determined by the number of people or teams one leads(4). In contrast, the Faculty of Medical Leadership and Management defines fellowship seniority based on progressively broader leadership activities across teams, organizations, or systems(5). A more comprehensive framework could integrate these approaches by recognising the influence of formal or informal leadership roles and insights gained from self‑assessment and peer evaluation.

Despite these challenges, the boom in leadership outside traditional hierarchies reflects a shift to a toward more collaborative and change‑responsive cultures. However, as the hierarchies flatten, we need now, more than ever, a new way to understand both leadership development and the identities that form around it.

Leadership networks and the power of shared identity

Existing theory around professional identity formation may offer a solution. Although we often think our identity is purely shaped by our own thoughts and experiences, the far more dominant theme in research is the social dimension. By internalising the beliefs, values, and behaviours of our profession, we begin to form a collective identity, or a “feeling of belonging”, that research has linked to greater competence and confidence in health professionals(3).

Using this approach, the very act of forming or joining healthcare leadership communities or networks can develop a collective leadership identity, rooted in a shared sense of belonging. 

We have first-hand experience of developing a collective leadership identity through the establishment of our Aspiring Leaders in Healthcare Network. Our members use the community to share successes, failures and opportunities and are supported by regular meetings to encourage reflective practice.

The only criteria for membership: identify as ‘aspiring leader in healthcare’.  

By allowing individuals to self-select into the group, evaluate their own leadership journeys, respond to their development needs, and engage in a professional peer environment, we are better positioned to identify and support the right people.

Inclusive leadership development 

A key strength of our network lies in its diverse membership, including significant representation from groups currently underrepresented in healthcare leadership. There is an increasing call for a more nuanced understanding of the intersectional impact of culture, socioeconomic status, gender and existing power balances on professional identity development. 

For many, career progression involves navigating stigma or the persistent sense of being ‘an outsider’. Yet cultural identity can also be a source of strength, motivating individuals to seek out roles that challenge stereotypes and counter negative perceptions(6). Leadership development must recognise and value the diverse identities in today’s healthcare workforce. 

Early career leaders do exist, and there is clear appetite for leadership within peer-developed networks like ours. Still, without intentional support from those in positions of influence, inclusive leadership development risks remaining tokenistic. Senior leaders, consider the following questions. Your leadership support is essential; not only for dismantling structural inequities in traditional clinical hierarchies, but also for building sustainable healthcare systems. 

Questions for decision makers:

1. How can I give early‑career leaders access to high‑visibility opportunities?

(Presentations, projects, cross‑organisational work, or roles that showcase their potential.)

2. How can I connect early‑career leaders to key decision‑making forums? 

(Invite them into strategic meetings, taskforces, working groups, or advisory panels.)

3. How can I publicly advocate for and sponsor early‑career leaders?

(Actively endorse their work, recommend them for roles, and use your influence to open doors.)

References

1. Home J. Imposter syndrome: British Medical Association; 2025 [Available from: https://www.bma.org.uk/advice-and-support/your-wellbeing/insight-and-advice/first-times-in-medicine/imposter-syndrome.
2. Berghout MA, Oldenhof L, van der Scheer WK, Hilders CGJM. From context to contexting: professional identity un/doing in a medical leadership development programme. Sociology of Health & Illness. 2020;42(2):359-78.
3. Cornett M, Palermo C, Ash S. Professional identity research in the health professions-a scoping review. Adv Health Sci Educ Theory Pract. 2023;28(2):589-642.
4. Storey J, Holti R. Towards a New Model of Leadership for the NHS. 2013.
5. Evans CPA. View from the faculty: the role of the organisation in developing medical leadership. BMJ leader. 2022;6(4).
6. Slay HS, Smith DA. Professional identity construction: Using narrative to understand the negotiation of professional and stigmatized cultural identities. Human Relations. 2011;64(1):85-107.

Author

Riddhi Shenoy

Having worked as an Editorial Registrar at The BMJ during her National Medical Director’s Clinical Fellowship (2022-2023), Riddhi developed a keen interest inclusive research and reducing health inequalities. This led her to undertaking NIHR-funded integrated academic clinical training alongside ophthalmology specialty training and she has recently commenced her Wellcome Trust funded doctoral programme at the University of Leicester in ophthalmic epidemiology. As publications lead at the Aspiring Leaders in Healthcare Network, she is supporting members to write for this blog series.  

Aspiring Leaders in Healthcare

Aspiring Leaders in Healthcare Network aims to foster a multi-professional community of practice, united by the common goal of nurturing future healthcare leaders across the globe. Our regular online meetings, social media communities and conference huddles connect members to a wider network passionate about leading positive change and improvement in healthcare. 

In this blog series, we showcase our member’s diverse experience of leading with impact at the earliest stages of their careers to empower and inspire the BMJ Leader Blog readership.