In this chapter, the author discusses leadership and governance issues
in implementing curricular reform at the eight schools that participa
ted in The Robert Wood Johnson Foundation's ''Preparing Physicians for
the Future: Program in Medical Education.'' Leadership is defined as
the roles played by key individuals within a school in facilitating si
gnificant curricular change; institutional governance is the administr
ative structure through which the curricular changes were administered
. The characteristics of successful leaders as well as problems caused
by poorly chosen leaders are described. The author also discusses how
leaders handled resistance to change and the role of students in over
coming this resistance at some institutions. The second half of the ch
apter focuses on governance structures. The author briefly discusses t
he role of curriculum committees, how student, and faculty committees
at some schools worked to implement change, and the implementation at
each of the eight schools of a centralized education budget. He conclu
des with a list of characteristics of successful leadership and succes
sful governance in the process of curriculum reform.