Dr. Wayne Frederick on Leadership That Inspires Hope

Meet Dr. Wayne Frederick and Jim Hemerling

Many leaders have faced life and death questions. But few have experienced them as persistently or personally as Dr. Wayne A. I. Frederick, MD, MBA, and Fellow of the American College of Surgeons.

During his decade-long, highly public tenure at the helm of Howard University, Frederick successfully balanced crisis management and conflicting demands from students, alumni, and his board. At the same time he laid the foundation for Howard to become the first of the US historically Black colleges and universities to achieve Research One (R1) status. More impressively, he built that legacy against a backdrop of escalating social tensions and even threats to his personal security.

A renowned cancer surgeon living with sickle cell disease, Frederick has also served as interim CEO of the American Cancer Society. This year, he returned to Howard University to once again lead the storied institution at a critical juncture in its history as its interim president (in addition to his other roles as the Charles R. Drew Professor of Surgery and president emeritus).

In a recent conversation with BCG’s Jim Hemerling, Frederick reflected on faith, frailty, and the philosophy that has helped him successfully navigate what is arguably one of the toughest leadership jobs of our time.

This interview has been edited for length and clarity.

Jim Hemerling: Dr. Frederick, you've experienced so much over the years as a surgeon, as president of Howard University, interim CEO of the American Cancer Society, and most recently, in August of this year, returning to Howard University as interim president. If you had to describe your leadership philosophy in one or two words, what would they be?

Dr. Wayne Frederick: The two things that define me are deep faith and the ability to prioritize my most important role: being a father. I’ve seen the frailty of life working with cancer patients, and I am humbled by my interaction with my kids. By centering my own humanity, I’ve learned that if you amplify other people’s humanity, everything else works out.

Jim Hemerling: Of course, Howard University made extraordinary gains during your first presidency (2014–2023). Tell us about that.

Dr. Wayne Frederick: We achieved R1 status, which was a recognition of the research excellence that Howard has always pursued. We made enormous progress in terms of strengthening the university’s infrastructure, both physical and academic. And we did all that while navigating a period of extraordinary scrutiny and pressure.

Jim Hemerling: One crisis you faced involved financial aid. Though the scandal predated your tenure at Howard, you were the public face of the university when it came to light.

Dr. Wayne Frederick: Long before the scandal broke, I had already recognized that something was awry with our financial aid disbursements and had alerted the feds [federal authorities]. I also made the university board aware of the financial irregularities. With the data that we had, we were able to demonstrate that these crimes were going on long before my tenure. It involved a total of 300 people and thousands of dollars over multiple years—money taken away from students who needed help.

I’ve never told this story before, but before this crisis became public, a student who claimed to have proof of these irregularities tried to blackmail me with it to get his grade changed. He basically said, “Listen, I have a D and it needs to be changed.” When I told him I didn’t do that he showed me what he had.

I suspected at the time that he was taping me, and I didn’t want the federal investigation that was already underway to be compromised, so I told him, “That’s unfortunate.”

Jim Hemerling: What did that episode teach you about leadership?

Dr. Wayne Frederick: It reminded me that while leading Howard was a big opportunity, it also had big consequences when things didn’t go right. I couldn’t come out at that time and tell the whole story. I had to take it on the chin. During my tenure at Howard, I did a lot of that—putting myself in front, taking the hit, not blaming other people, not telling the full story. That went back to my faith, and it also went back to what I would want my kids to see. Would I want them to see somebody who scapegoats others, even if rightly so? Or somebody who takes on the responsibility?

Jim Hemerling: What were some of the consequences you faced for being the public face of Howard?

Dr. Wayne Frederick: I’ll tell you, long before the fatal shooting of Brian Thompson [CEO of UnitedHealthcare] or the recent resurgence of protests on campuses, I was telling people that it is a very dangerous environment for people who do these jobs. I still feel very strongly about that.

Unfortunately, I learned that when I was driving home one day, and my son was sitting in the front seat next to me. I pulled up to my mailbox and found a letter in there addressed to me and my wife. It was a death threat that said, “Now we know where you live.”

Jim Hemerling: Wow.

Dr. Wayne Frederick: The FBI and the police were notified, but after that incident, I really started to cover my family in a way that I thought was necessary. My daughter was shaking when we had to have a police car in the courtyard with the lights on. That was not something kids want to be a part of, or expect to be a part of, because of the job their dad is doing.

Jim Hemerling: In 2021 you faced another crisis. Students launched a protest over housing which had suffered from decades of underinvestment in campus infrastructure. They also staged a sit-in tied to those and other long-festering grievances. As stakeholders go, students are tough customers who want results now if not sooner. How did you address their concerns, while balancing the interests of other stakeholders?

Dr. Wayne Frederick: It was a juggling act. Students are here for four years, and they rightly want grievances fixed in that time frame. Saying it will take ten years doesn’t help. Their frustration is real, and you have to balance it by communicating a lot, sometimes excessively, so people know where you’re going.

Within a decade, 90% of the dorms were either new or renovated. But if you’re a student, you only care about your own room. It’s about perspective. Grievances aren’t just about buildings. They’re also about whether people feel you care.

Jim Hemerling: So between death threats and student protests, you still managed to build a lasting legacy at Howard. What did you take from that?

Dr. Wayne Frederick: What I took from it is that you can push through very difficult moments without losing sight of the long-term vision, and that integrity and empathy have to remain at the center of your leadership. Those achievements weren’t just institutional, they were about showing the students, faculty, alumni, and broader community that Howard’s future was strong, even in the face of adversity.

Jim Hemerling: Eventually, you did step down as Howard’s president in 2023. Why leave then?

Dr. Wayne Frederick: After a while, I had to accept that the toll was real. The protests, the scrutiny, the threats. It all added up. I could no longer give the institution everything it needed without compromising my own well-being or my family’s. In leadership, you have to be honest about when it’s time to hand the baton to someone else. That’s not failure; that’s leadership too.

Jim Hemerling: You have lived with a different type of death threat since you were a child. Has that experience helped you through the hard times?

Dr. Wayne Frederick: I’ve had sickle cell my entire life. It’s a disease that’s unpredictable. When you live with frailty, you develop a different kind of urgency. You don’t take time for granted. In leadership, time is one of the most important resources you manage. Leadership, for me, has always been about setting the stage for others to carry the torch forward. It’s about ensuring that the institution or the organization you lead has the tools it needs to keep growing long after you’re gone. And that’s why I focus so much on building something lasting, something that can thrive well into the future. Every action I take has to add value—for the people I’m leading, for the institution, and for my family.

Jim Hemerling: You were born and raised in Trinidad. How did growing up on that Caribbean island shape your leadership approach?

Dr. Wayne Frederick: My parents were very young when I was born. They were overwhelmed by my sickle cell diagnosis, but they did everything they could to support me. They rented a small apartment across from the hospital so that I could easily go to doctors’ visits. My mom was a nurse. She would come home from her shift, take care of my siblings, and then go to the hospital to work another shift just to be with me. My mother’s sacrifices taught me that leadership isn’t about ego or self-interest; it’s about being willing to go the extra mile for others, even when it’s hard.

Jim Hemerling: Your mother’s sacrifices instilled a strong sense of duty and resilience in you?

Dr. Wayne Frederick: Yes, and my grandmother. She tells me stories of me riding around on a tricycle as a little boy, talking about my sickle cell. She said I would stop and ask her to explain it, and I’d ride away, come back, and say, “I’m going to become a doctor to fix that.” She always encouraged me. She always had this belief that the future was full of possibilities. And that’s something I’ve carried with me as a leader. My grandmother’s optimism helped me see that leadership is about inspiring hope, even when the path ahead is uncertain. It’s about trusting in others and lifting them up, and that’s what I strive to do in every role I take.

Jim Hemerling: You chose to become a surgeon, and you focused on oncology. How has that experience, particularly as a cancer surgeon, shaped your leadership philosophy?

Dr. Wayne Frederick: As a cancer surgeon, I’ve seen people at their most vulnerable. I’ve seen patients at the end of their lives, people who don’t want to wake up because of the pain and suffering, but they still cling to hope. The experience taught me you have to try to understand a person’s pain, their hopes, and their need for hope. It’s the same in leadership, whether I’m leading at Howard University or at the American Cancer Society. As a leader, you will face difficult situations, but it’s how you manage those situations with empathy and humanity that makes the difference.

Jim Hemerling: These days you spend more time in the boardroom than in the operating room, and yet I get the sense your surgical mind is ever present.

Dr. Wayne Frederick: My experiences in surgery reinforce a leadership philosophy I hold dear: you have to make decisions, sometimes quickly, and stick with them even when the outcome isn’t clear. As a cancer surgeon, that decisiveness was crucial because the stakes were incredibly high. Similarly, in leadership, we often make tough decisions in uncertain circumstances, but we must do so with clarity and confidence, knowing that our actions will have lasting impacts.

Jim Hemerling: That’s especially true of a university president, which is arguably one of the toughest leadership positions going, with an almost impossible set of stakeholder demands to reconcile. What drove you initially to tackle such a challenging role?

Dr. Wayne Frederick: I’m an alumnus of Howard. They took a 16-year-old kid from Trinidad, 88 pounds with all my clothes on and Diadora sneakers and—over decades—transformed me into its 17th president. My decision to step up wasn’t just about me, it was about the students, the faculty, the alumni, and the legacy of the place.

Jim Hemerling: After you stepped down from Howard University in 2023, you became interim CEO of the American Cancer Society. Why take on another high-profile leadership role so soon?

Dr. Wayne Frederick: When I was approached about taking the role, it felt like something bigger than me. I was already on the board at the time, and Dr. [LaSalle] Leffall, the first Black president of the American Cancer Society, had been someone I greatly admired. To be asked to step in after him was humbling. I felt it was my duty, not just a career move, but something that had been placed in my path by a higher power.

Jim Hemerling: So what did you learn during your time there?

Dr. Wayne Frederick: The biggest lesson for me was about the power of focus and clarity in mission-driven organizations. At Howard, I learned how to navigate complex systems and manage multiple priorities. At the American Cancer Society, I had to apply the same principles, but with an even more intense focus on the organization’s mission. It became clear to me that, in such organizations, values have to come first, always. There’s no mission without a solid foundation, and no progress without keeping that focus sharp.

Jim Hemerling: What challenges did you face?

Dr. Wayne Frederick: Balancing continuity with the need for innovation. As an interim leader, you’re expected to maintain stability and prepare the organization for the future. I had to make sure I was facilitating the next chapter for the organization. It was also important to work closely with the board and senior leadership to ensure that the long-term goals of the American Cancer Society remained intact.

Jim Hemerling: You’ve also served on boards. Between reporting and serving, what have you learned about effective governance?

Dr. Wayne Frederick: Boards are like backseat navigators. The CEO is the driver. If a director reaches over to grab the wheel, you’re going to crash. The board’s job is to give perspective, to say, “There’s a fork in the road” or “You may want to refuel here,” and to provide the resources the institution needs to keep moving. But the moment directors start managing day-to-day, they create more problems than they solve. If a board feels it has to do that, the real issue is whether the right person is in the driver’s seat.

Jim Hemerling: So, here you are back in the driver’s seat at Howard University as interim president after stepping down in 2023. Why come back?

Dr. Wayne Frederick: Returning to Howard wasn’t a decision I made lightly. After stepping down, I felt like I had accomplished a lot, but there was still more to do. Howard University is deeply personal for me. It’s where I began my journey, and it transformed my life in ways that words can’t fully capture. When the request came to return as interim president, I felt it was a calling. It’s not just about the institution. It’s about the community.

Jim Hemerling: You’ve spoken often about being a steward of Howard’s legacy. What did that mean to you as you took on this interim role, and how did your approach change after having been through so much in your first tenure?

Dr. Wayne Frederick: Stewardship is about protecting and enhancing something greater than yourself. Howard has been around for more than 150 years. It has created a Black middle class, helped shape America’s moral compass, and produced leaders who’ve changed the world. I knew I had the wisdom and experience to guide the institution through a transitional period, but I also knew the importance of maintaining clear boundaries. Family comes first. So even though I was stepping back into a leadership role, I had to prioritize my family and make sure they were with me in this.

Jim Hemerling: They obviously were onboard.

Dr. Wayne Frederick: Yes, the first time I was president, I had a lot of ambition and drive, but I didn’t fully understand the toll that leadership would take. Now, with more experience, I know that effective leadership requires balance. You can’t give everything to the job at the expense of your own well-being or your family’s. Coming back as interim president, I knew I had to be a steward of Howard’s legacy but also make sure that I set the right tone for the next generation of leadership.

Jim Hemerling: This second time around at Howard, what do you hope to achieve?

Dr. Wayne Frederick: I want to keep Howard moving in the right direction. There are key initiatives that need attention. It’s important to maintain the momentum of the progress we’ve made. But at the same time, I need to ensure that the foundation is laid for future leadership. I’m here to provide stability, ensure that the values of the institution remain intact, and support the students, faculty, and staff who are the heart of Howard. It’s all about preparing the next leader for success while ensuring Howard’s future is secure.

Jim Hemerling: If we were to write a parallel résumé, one that captured not your positions but your true calling, what would it say?

Dr. Wayne Frederick: It would simply say “father.” That has always been my ultimate calling. Everything else—being a surgeon, a president, a CEO, a board member—flows from that responsibility to live my values and to show my children what integrity and humanity look like in action.

Jim Hemerling: You’ve led public institutions under constant scrutiny, navigated crises, and never lost sight of your sense of calling. What advice would you give to CEOs or presidents who want to remain purpose-driven in the face of pressure?

Dr. Wayne Frederick: First, keep perspective. These are big jobs. They come with power, stress, and influence. But nothing in them is more important than my two kids and my wife. That perspective has helped me stay grounded. When you put family first, it reminds you that even the hardest days at work can’t overwhelm you.

And second, don’t let the role consume you to the point where it stops being joyful. Leadership is stressful. You make tough decisions, people criticize you, the scrutiny is relentless. But it should still be meaningful and energizing. I always wanted to run to work with the same urgency and passion that I ran home.