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I haven't heard much about hospital administration, but my guess is that the top ranking hospital administrators (CEOs, presidents, and such) come from the business world but have focused on healthcare for most of their careers. How often do MDs/DOs get into high-level hospital administration positions, and what extra degrees are usually prerequisites for this situation (e.g. MBA or MPH)? Also, would you think the same applies for getting a high position in academia like dean of the medical school, which usually seems to be an MD/DO.