In this episode of Lead Change, host Mary K. Mulcahey, MD sits down with Dr. Nancy Spector, Professor of Pediatrics and Senior Vice Dean for Faculty at Drexel University College of Medicine, and Executive Director of the Executive Leadership in Academic Medicine (ELAM) and Executive Leadership in Health Care (ELH) programs. Dr. Spector shares her leadership journey—from her roots as a pediatrician and chief resident to becoming a nationally recognized leader in faculty development, equity, mentoring, and systems-level change. She reflects on formative moments in her career, including the importance of mentorship, peer support, and leadership training early and throughout one’s professional life. The conversation explores the origins and evolution of ELAM, its mission to transform leadership at the highest levels of academic medicine, and its shift from “fixing women” to fixing systems. Dr. Spector discusses inclusive leadership, allyship, infrastructure-building, and the necessity of preparing leaders to manage and lead effectively amid ongoing uncertainty. Throughout the episode, Dr. Spector emphasizes purpose-driven leadership, strategic patience, and the power of creating environments where diverse talent can thrive—ultimately improving medicine, science, and patient care. Key Takeaways Leadership training is essential at every stage of a medical career, not just at senior levels—and should ideally begin in medical school.Peer mentorship is often as powerful as senior mentorship, providing support, perspective, and shared growth throughout one’s career.Effective faculty development goes beyond teaching skills to include career alignment, professional growth, and leadership identity.The future of leadership in academic medicine depends on fixing systems and infrastructure, not asking individuals to adapt to broken models.Inclusive leadership requires partnership and allyship, including engagement across gender, disciplines, and professional roles.Successful leaders focus on alignment with purpose (“the why”), helping individuals and organizations maximize impact.Leading in today’s environment means accepting uncertainty and learning to lead through it, rather than waiting for clarity.A critical leadership skill is the ability to identify gaps, build infrastructure, and then empower others to lead.Maintaining a sense of humor and humility is key to longevity and resilience in high-level leadership roles.