There’s often a moment in my coaching work with senior doctors and public health specialists that catches people off guard. It usually comes after a promotion, a new appointment, or a long-worked-towards leadership title. Instead of celebration, the feeling is more like: Is this it? or Why don’t I feel like the leader I thought I would be?
This is the first in a series of 3 linked blogs exploring some of the challenges faced by my senior medical and public health leader clients.
Titles confer authority, but they don’t automatically create leadership identity. In healthcare and public health, we are trained extensively in competence, responsibility, and accountability — but rarely in who we are becoming as leaders. Leadership research consistently shows that effectiveness is not just about role occupancy, but about developing an internalised leader identity that aligns values, behaviour, and impact.
Many leaders tell me they expected confidence to arrive with seniority. Instead, they experience increased ambiguity, relational complexity, and moral pressure. Clinical and public health leadership roles are uniquely demanding: decisions carry ethical weight, system consequences, and public scrutiny. Without conscious identity work, leaders default to what they know best — technical expertise, over-responsibility, and personal sacrifice — rather than adaptive leadership behaviours.
So what does “becoming the leader you want to be” actually involve?
First, it requires shifting from doing leadership to being leadership. This means clarifying leadership values beyond institutional metrics. Research on values-based and authentic leadership shows that clarity about personal values improves decision-making, trust, and resilience under pressure. In coaching, we explore questions such as: What do I stand for when outcomes are uncertain? How do I want others to experience my leadership?
Second, it involves tolerating discomfort. Leadership development is psychologically demanding because it exposes limiting beliefs: I should know the answer, I can’t show doubt, I must work harder than everyone else. These beliefs are reinforced during medical training, where certainty and responsibility are emphasised. Yet adaptive leadership requires learning, experimentation, and acknowledging limits. Coaching provides a structured, psychologically safe space to examine and revise these assumptions.
Third, leadership identity is relational. You don’t become a leader in isolation. Identity is shaped through interaction, feedback, and reflection, particularly across professional and cultural boundaries. This is especially relevant for public health leaders who work through influence rather than formal authority.
Leadership is not static. The leader you need to be now may not be the leader your future roles require. In the next blog, I explore one of the most common psychological traps that prevents this evolution: overworking as a way to prove worth, and why so many capable medical and public health leaders struggle to let it go.
As the world’s only Chartered Coaching Psychologist with a medical and public health leadership background, I provide evidence-based coaching proven to increase senior leader wellbeing scores by an average of 17.4%. To transform your leadership, career, and wellbeing alongside a genuine peer who understands your reality, book a free Confidential Consultation.
