Ego refers to the internalized sense of importance, identity, and self-worth — which in academic and clinical environments often becomes entangled with titles, recognition, authorship, and perceived intellectual superiority.

While a healthy ego can support confidence and leadership, an inflated or fragile ego often leads to dysfunction, rivalry, and resistance to criticism.

• Constructive ego – Drives responsibility, persistence, and high standards.
• Inflated ego – Demands attention, authorship, or deference regardless of merit.
• Fragile ego – Reacts poorly to feedback, competition, or visibility of others.
• Collective ego – Institutional identity based on prestige, resistant to reform.

A senior surgeon insists on being listed first author on a paper they barely contributed to — not out of need, but out of *ego maintenance*.

• Obstructs collaboration.
• Undermines junior researchers and trainees.
• Fuels academic theater and performative leadership.
• Turns critique into conflict.
• Blocks innovation out of fear of being overshadowed.

• Careerism
• Academic Theater
• Gatekeeping
• Institutional Prestige

Bottom line: *Ego can elevate a team — or suffocate it, if left unchecked. The more fragile the work, the louder the ego.*