This special issue of the Journal of Clinical Psychology in Medical Settings includes papers that address two themes: (1) psychologists’ roles and participation in the Association of American Medical Colleges (AAMC) and its programs, and (2) psychologists in academic administration, with an emphasis on leadership positions in academic healthcare centers (AHCs).

With regard to the first theme, which focuses on the AAMC, the opening paper is authored by Darrell Kirch, President and CEO of the AAMC, and Cori Ast, the AAMC’s Director of Executive Activities. They outline areas of healthcare transformation in AHCs, and opportunities for psychologists to participate in and help lead this transformation. Thoughtful replies to Kirch & Ast are offered by two notable AHC psychologist administrators: John Carr, who served as interim chair of the Department of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine, and John Linton, who is currently the dean of the West Virginia University School of Medicine at Charleston.

AHC psychologists will appreciate learning more about AAMC governance and leadership programs in the paper co-authored by Barbara Cubic and Laura Shaffer, and the manuscript by Donna LaPaglia, Britta Thompson, Janet Hafler, and Sheila Chauvin. Cubic and Shaffer represent the Association of Psychologists in Academic Health Centers (APAHC) to the Council of Faculty and Academic Societies (CFAS) of the AAMC. Their backgrounds and paths to AAMC governance will be of interest to AHC psychologists seeking the broader view of AHCs offered by this and other papers in this special issue. They include an organizational chart of the AAMC, which is a useful resource for readers curious about organizational structure. The manuscript by LaPaglia and colleagues describes AAMC’s Leadership Education and Development (LEAD) program: the first author is a fellow in this program.

Leadership in academia, which is the second theme of this special issue, is addressed by all of the papers in the issue. Three papers address leadership and its intersections with AAMC: the papers by Smith and Grigsby, in addition to those by Cubic and Shaffer, and by LaPaglia and colleagues. The paper by Schmaling and Linton focuses on psychologist leaders in academia, primarily but not limited to leadership roles in AHCs. The articles include narratives by psychologists concerning their paths to leadership. As mentioned above, the articles by Cubic and Shaffer, and by LaPaglia and colleagues, describe the authors’ successful engagement in AAMC governance and one of its programs. In the article by Patrick Smith and Kevin Grigsby, the first author, an AHC psychologist, describes his career development path that led to his current leadership position in a medical school, and how his engagement with the AAMC facilitated progress along the way. The second author, Kevin Grigsby, a former AHC social worker, describes his initially reluctant engagement in administration, as well as his current leadership position in the AAMC. Karen Schmaling and John Linton, former and current deans of health professions and medical colleges, respectively, qualitatively summarize the paths to administration, and the challenges and opportunities therein, as described by six psychologist leaders whose positions range from vice chairs in AHC departments to presidents of universities with AHCs.

These articles share commonalities in the paths to leadership described by accomplished (e.g., Smith & Grigsby) and by aspiring (e.g., LaPaglia) leaders. Formal and informal mentoring and leadership training are commonly cited means of professional development across the articles. Some aspects of psychologists’ training as health service providers may help leaders, such as deep knowledge of human behavior and the values of self-awareness and self-care—the latter identified in several articles as crucial in order to avoid burn-out (Cubic & Shaffer; Kirch & Ast; Schmaling & Linton). Other aspects of psychologists’ training may impede leaders, such as an enduring belief that individuals’ behavior can change, a belief that is sometimes counterproductive as when an administrator delays actions that are in the best interests of the institution for the sake of “protecting” an individual, or giving that person “another chance” (Schmaling & Linton). The narratives also identify common lacunae in psychologists’ background that may need to be addressed in order for them to become successful leaders. For example, by nature or by education, not all psychologists have: broad perspectives that promote systematic and strategic thinking; tendencies to value collaborative and team accomplishments over individual achievements (LaPaglia et al.); or knowledge of (or interest in) an AHC’s mission and operational details, e.g., “staffing models, patient flow analyses” (Smith & Grigsby), or bundled payments and quality committees (Linton).

Several themes in the articles go beyond commonalities regarding leaders’ trajectories and roles in recognizing and capitalizing on opportunities for change and transformation. Kirch and Ast outline the “dramatic transformation” in American healthcare in the use of systems level approaches such as emphasis on population outcomes rather than individual outcomes, and provision of care by collaborative teams. The articles emphasize that psychologists must recognize that healthcare and AHC values have shifted to emphasizing systems approaches. Consistent with this shift is emphasis on interprofessional education, which all the articles mention, and which is intended to facilitate healthcare teams’ collaboration and success. Linton notes that this emphasis has long been part of psychologists’ education and experience. Kirch and Ast attribute the transformation in American healthcare to the Affordable Care Act (ACA), which we note reflects 44th President Barack Obama’s vision; the fate of the ACA is unknown at this time given tumultuous political changes occurring at the federal level.

A final thread that runs through these articles is a sense of timeliness, if not urgency, about psychologists’ involvement in leadership. The articles enumerate ways in which psychologists may be suited for leadership opportunities: psychology is a hub discipline that is closely associated with other disciplines (Schmaling & Linton) in AHCs, which suggests that psychology may no longer find itself at the periphery of academic medicine. Psychologists who have facilitated their own integration into medicine can facilitate the parallel integration of “behavioral health and treatment for mention disorders… [into] population health” (Kirch & Ast). Psychologists can assist AHCs in applying behavioral science knowledge to individuals and organizations (Smith & Grigsby).

Some of the urgency around psychologists’ being more involved in leadership positions may stem from their concern about becoming less professionally relevant, or being excluded from critical decisions about health services and training of health professionals (Hong & Robiner, 2016). Psychologists are a minority profession in AHCs (Garcia-Shelton & Leventhal, 2005)—as acknowledged in the articles in this special issue—and psychologists are aware of their minority position. Additionally, psychologists may be seen by others, and at times see themselves, as “outsiders” in AHCs. They are not physicians and their foundational education and training occur in graduate schools rather than medical schools; these are realities, even though it is true that clinical experience in AHCs is a critical part of many clinical psychologists’ training. The dual challenge of minority and outsider status does present opportunities, however; minorities and outsiders are more sensitive to their status than those in positions of privilege (Case, Iuzzini, & Hopkins, 2012). Difference in their perspectives and knowledge relative to those of “majority insiders” can have advantages. Psychologists may be more flexible when it comes to identifying the need for and the implementation of transformational changes essential for the effectiveness and survival of AHCs and related academic organizations.

Smith and Grigsby note that psychologists and other behavioral scientists in AHCs must find ways to fit into the culture, but must not deprecate themselves because their discipline is not the majority, physician-centered culture that is more biologically-oriented. Their view highlights another central theme throughout this issue, namely, psychology adds unique value—and this is true whether psychology is viewed as peripheral to or is well-integrated into the AHC cultural tradition (Garcia-Shelton & Leventhal, 2005; Hong, Robiner, Dixon, & Miner, 2012). From the vantage point of multicultural psychology, one can describe the challenge for psychology as one of accommodation or adaptation, rather than assimilation (Berry, 1997). As psychologists, we value our distinctiveness while finding ways to fit into, contribute to, and lead in our acquired AHC culture. Multicultural concepts may also be useful for understanding AHC psychologists’ professional resilience (Cubic & Shaffer).

To demonstrate the added value of psychology in AHC settings, it may be necessary for psychologists to engage in explicit proactive professional advocacy to detail our strengths in assessment, research, relationships, behavior and behavior change. Displaying such attributes can advance population health, and simultaneously serve as models of behavior that help “extract the genius of others” (Kirch & Ast) in collaborative healthcare teams.

These articles provide a wealth of ideas that psychologists interested in leadership can pursue. The ideas presented range from: communicating and modeling psychologists’ areas of knowledge and skills; to pursuing formal leadership programs connected to the AAMC such as LEAD (LaPaglia et al.), or similar training from other sources (see Schmaling & Linton for examples); and to increasing one’s involvement in APAHC and AAMC, perhaps by asking to represent one’s medical school on the CFAS (Cubic & Shaffer). It is hoped that these articles inspire psychologists to think of themselves and act as leaders in whatever they do, and to consider formally pursuing leadership positions as among their career objectives.