Bridging the Gap Between Surgical Leadership and Business Strategy

Timothy McCulley, MD, brought extensive surgical and administrative experience to his role as chair of ophthalmology at UTHealth Houston’s McGovern Medical School. After years leading clinical teams at UCSF School of Medicine and Johns Hopkins University School of Medicine, he returned to his home state of Texas to strengthen a department in transition. But with new responsibilities in financial planning and operations, McCulley recognized a critical gap in his business training. That’s when he enrolled in the Surgical Leadership Program at Harvard Medical School.

A Focus on Financial Fluency

In his role as department chair, McCulley found himself navigating new terrain: budgets, staffing models, satellite planning, and long-range financial decisions. While he had some exposure to these functions at Johns Hopkins, much of the infrastructure was already in place.

“When I came here, the structure and support systems weren’t as developed,” he explains. “I didn’t have much background in the business aspect of running a department, and I needed something to help fill in the gaps.”

The financial modules within the Surgical Leadership Program were especially valuable. “I learned more about categorizing expenses—direct, indirect, fixed, and variable—and how they show up on differently on various balance sheets. It helped me contribute more meaningfully to financial conversations and decisions.”

Like many physicians who rise into administrative roles, McCulley found that formal financial training had been largely absent from his medical education. There’s often an assumption that these skills will be acquired along the way, but the reality is that many leaders find themselves learning on the job. The program helped bridge that gap, offering foundational knowledge that proved immediately useful in his new role.

Making the Capstone Count

The Surgical Leadership Program culminates in a capstone project, a key component designed to help participants apply what they’ve learned to a real-world challenge in their professional setting. For McCulley, the capstone aligned perfectly with his department’s most pressing need: expanding clinical access by opening a satellite clinic outside the Texas Medical Center.

Unlike some participants who develop entirely new initiatives, McCulley took a reverse approach, leveraging an active project and using the capstone framework to refine and present it more effectively. “We were already doing the work, but the capstone helped me make a clean presentation that I have reused internally,” he says.

The project also served as a strategic opportunity to integrate lessons from the program, particularly around operations and resource planning. The clinic is now scheduled to open in early 2026.

Translating Insight into Action

In addition to technical skills, the program offered leadership lessons that have influenced McCulley’s day-to-day decision-making. One case study on the Space Shuttle Challenger disaster left a particularly strong impression.

“The idea that people voiced concerns, and leadership ignored them, really stuck with me,” he reflects. “Now when someone flags a potential problem, even if it seems minor, I make sure we investigate. You can’t afford to ignore background noise.”

These insights reinforced the importance of proactive communication and attentive leadership, qualities McCulley sees as essential for running a large, dynamic department. While he believes that the program is especially valuable for those transitioning from mid-level to senior leadership, he continues to recommend it to colleagues preparing for department chair roles. 

Written by: Pamela Searle