Organizational Culture and Effective Leadership in Academic Medical Institutions.

In the US, a heterogeneity in archetypes of leadership augments the success of an Academic Medical Institution (AMI) in fulfilling its key missions of clinical service, teaching, training, mentoring, research and scholarship, community engagement, inclusion, and diversity. Effective leadership is profoundly influenced by organizational culture with its dominant foundations in shared attitudes, beliefs, mores, behaviors-scripted and unscripted, as well as explicit and tacit rules and policies that become entrenched in the operational repertoire over time. Modulating organizational culture are an AMI's mission, vision, core and affirmed values, formal governance and its complexity, informal influencers, historical precedent, the rapidly evolving landscape of healthcare, regional and institutional socioeconomics, and faculty prototypes. It is paramount that AMIs endeavor to recruit and position leaders whose values align with those of the institution ("cultural fit"). This treatise highlights the crucial influences that affect organizational culture and its interface with AMI leadership and ensure the success of the organization and its leaders.