Distinct journeys and unique stories: how individuals from multiple professions cultivate careers in healthcare leadership.

Introduction: Strong hospital leadership is critical to navigating the challenges of the Canadian healthcare system. Currently, physicians and nurses tend to be selected to fulfil hospital executive roles. To date, we found only limited research exploring who else could or should be in these roles, or how more diverse groups of professionals navigate the journey into these roles. We sought to interview leaders from multiple professional backgrounds to understand how their career journey led them to their executive role.

Methods: We purposively sampled Canadian hospital executives with diverse professional and educational backgrounds. Through semistructured interviews, we explored their individual leadership journeys, and their experiences working with others along the way. Our team worked together to analyse data using a phenomenographic approach.

Results: Fourteen executive-level leaders from diverse professional backgrounds were interviewed. Overall, we noted three main trajectories for people to become hospital leaders: the achievement journey, the unexpected journey and the practical journey. These journeys corresponded to three main identities the champion leader, the discovered leader and the pragmatic leader, respectively. We found that some individuals had multiple trajectories and identities.

Conclusions: Improved diversity in executive hospital leadership may support transformational change in healthcare; however, this promise may not be automatically realised. Critical reflection on current hiring processes, career development and mentorship is warranted to support those with diverse and distinct backgrounds to enter and thrive in these roles.