Leadership is often portrayed as confidence, decisiveness, and authority. But according to biotech CEO and physician Sheila Gujrathi, true power starts from somewhere far less visible: self-awareness.
In a candid conversation on Leadership Rounds, Gujrathi joined host Dr. Reena Pande to explore the emotional and psychological realities of leadership, the parts rarely discussed in boardrooms but felt deeply by those sitting at the table.
Gujrathi’s journey defies conventional narratives. Raised in a family of physicians, medicine was never presented as an option: it was an expectation. She excelled academically and followed the prescribed path through training, only to realize during fellowship that practicing medicine wasn’t where she felt most alive.
At a time when leaving academic medicine was almost unheard of, Gujrathi made the transition. She first went into management consulting at McKinsey, then ventured into the world of biotech leadership at Genentech and Bristol Myers Squibb. Eventually (some might say inevitably) she landed in CEO roles at multiple startups.
But what gave her the courage to pivot? Discomfort.
“I think part of my courage came from me not fitting into the mold,” she explains. That friction became data. The information she was so astutely gathering about how her leadership style pointed her toward environments where her strengths could be better expressed.
Despite her success, Gujrathi describes a surprising realization once she hit the highest levels of leadership. She’d worked to make her mark in biotech leadership, to find a place where she fit in, but came to understand she didn’t fully know herself. She set out to do some introspection, to become more self-aware and identify roles and opportunities that fit her.
In The Mirror Effect, she introduces the concept of FIDS (Fear, Insecurity, Doubt, and Shame) and the emotional undercurrents that often intensify rather than diminish as leaders gain power.
Ironically, the traits that we associate with earning promotions (perfectionism, personal accountability, relentless drive) can often become liabilities in C-suite roles, where delegation, trust, and influence matter more than individual execution.
Unchecked, these patterns can lead leaders to:
One of the most validating insights from Gujrathi’s framework is her clear articulation of toxic work cultures: fear-based environments, cutthroat competition, and gaslighting.
Naming these dynamics matters. Without language, leaders internalize dysfunction as personal inadequacy. With clarity, they can separate self-worth from system failures.
Just as important, Gujrathi emphasizes that thriving environments do exist. Once experienced, workplace cultures with psychological safety, collaboration, and mutual respect reset expectations forever.
In the final component of her framework, Gujrathi focuses on the tools leaders need to succeed without sacrificing authenticity:
Executive presence, she argues, isn’t about performing dominance. It’s about respectable visibility, grounding, and self-trust, from where you sit at the table to how you speak when challenged.
Underlying Gujrathi’s philosophy is sevā, the practice of service. Leadership, in her view, isn’t martyrdom or ego-driven ambition. It’s a contribution aimed at serving both yourself and those around you.
This belief fuels her work beyond the boardroom, including the founding of the Biotech CEO Sisterhood, now a global network of hundreds of women CEOs supporting one another through growth, exits, and transformation.
Leadership isn’t about becoming someone else. It’s about removing what obscures who you already are.
As Dr. Gujrathi reminds us:
“You don’t need to do anything to belong. You already belong.”
And once embodied, that truth changes everything.
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Sheila Gujrathi, MD is a biotech entrepreneur and executive, healthcare investor, drug developer, and speaker with over 25 years of experience in the biotech and pharmaceutical industries. She has founded, built, and run numerous biotech companies and led the development and approval of life-changing pharmaceutical drugs for patients with immunology and oncology diseases. In addition to founding her own biotech companies, she currently serves as a chairwoman, board director, strategic advisor, and consultant to many start-up companies and investment funds.
She serves as executive chair of Ventyx Biosciences and Lila Biologics and director of Janux Therapeutics. She previously served as chair of Turning Point Therapeutics (acquired by Bristol Myers Squibb for $4.1B), ADARx Pharmaceuticals, and ImmPACT Bio (acquired by Lyell). Dr. Gujrathi is the co-founder and former CEO of Gossamer Bio. Prior to Gossamer Bio, she served as chief medical officer of Receptos (acquired by Celgene for $7.2B). At Receptos, she led the advancement of the pipeline, including Zeposia®, which is approved for multiple sclerosis and for ulcerative colitis. Previously, she was the immunology therapeutic area head at Bristol-Myers Squibb and held multiple roles in immunology and oncology at Genentech. Earlier in her career, she was a management consultant in McKinsey’s healthcare practice.
Dr. Gujrathi received both her M.D. in the accelerated Honors Program in Medical Education and her B.S. in biomedical engineering with highest distinction from Northwestern University where she was the 2024 commencement speaker. She completed her internal medicine internship and residency at Brigham and Women’s Hospital and Harvard Medical School and additional fellowship training in allergy and immunology at the University of California, San Francisco (UCSF) and Stanford University.
Dr. Gujrathi has earned multiple leadership awards, including Corporate Directors Forum Director of the Year; Healthcare Technology Report Top 25 Women Leaders in Biotechnology; Athena Pinnacle Award, and was named among the Fiercest Women in Life Sciences. Most recently, she was inducted into the 2025 American Institute for Medical and Biological Engineering (AIMBE) College of Fellows Class of 2025, and was named a 2025 Bloc100 Luminary honoree. Gujrathi is passionate about making the working world safe and inclusive for women and other minority groups. She is co-founder of the Biotech CEO Sisterhood, a group of transformative, trailblazing female CEOs, and the South Asian Biopharma Alliance.
Learn more at sheilagujrathimd.com and find The Mirror Effect here.
