Duke UniversityPsychiatry Residency
Brigham & Women'sCL Fellowship
Harvard Medical SchoolFaculty
McLean HospitalDirector of Education, Division of Geriatric Psychiatry
Harvard T.H. Chan School of Public HealthM.P.H.
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How to Move From VP to the C-Suite

Moving from VP to the C-suite requires shifting from running a function well to owning the enterprise alongside peers. Functional excellence is assumed at that level; what decision makers assess is enterprise judgment, composure under ambiguity, influence without authority, and credibility with the board. Most people who make the move begin operating as enterprise leaders before the title arrives, which is how others come to see them in the role.

Many of the most capable vice presidents I meet are puzzled by the same thing. They have delivered consistently, built strong teams, and earned the respect of their CEO. And they keep being described, kindly, as not quite ready. The feedback is vague. The bar seems to move.

The bar is not actually moving. It is located somewhere other than where most VPs are looking. The move to the C-suite is not a reward for being an excellent vice president. It is a bet that you can do a different job, and the people making that bet are looking for evidence you are already doing it.

A Change in Kind, Not Degree

The vice president role, at its best, is about running something well. You own a function or a business line, you set its direction within boundaries others have drawn, and you are judged on its results. Advocacy for your area is part of the job.

The C-suite role is about owning the enterprise jointly. A chief financial officer, chief operating officer, or chief technology officer is still responsible for a domain, but they are expected to think and decide as a steward of the whole. That sometimes means arguing against their own function's interest because the company needs something else. It means holding tradeoffs that have no clean answer. It means being one of a small number of people who can see the full picture and are expected to act on it.

The VP who keeps optimizing their function, however impressively, is demonstrating excellence at the current job. That is necessary and it is not the evidence anyone is looking for.

What Decision Makers Actually Assess

When a CEO and board consider someone for the C-suite, functional competence is a threshold, not a differentiator. Above that threshold, they are weighing a handful of qualities that are harder to see on a résumé.

Enterprise judgment

Can this person reason about the business as a whole? When they bring a proposal, does it account for its effects on other functions, on capital, on risk? Do they ask questions in leadership meetings that go beyond their own area? The executives who are seen as ready tend to be the ones whose contributions would make sense from any chair at the table.

Composure under ambiguity

C-level problems rarely arrive with enough information. Decision makers watch how candidates behave when the data is incomplete, the stakes are high, and the answer is unclear. Steadiness here is not the absence of concern. It is the ability to keep thinking clearly while concerned, and to make a call without needing certainty first.

Influence without authority

Peers in the C-suite do not report to one another. Much of the work happens through persuasion, negotiation, and trust among equals. A VP who can move peers in other functions, especially ones with competing priorities, is demonstrating the skill the role depends on.

Boardroom credibility

Can this person present to directors with clarity and restraint, answer hard questions without defensiveness, and hold their ground when challenged? Much of this is how they handle pressure in a room where they are being evaluated. It is closely related to what is often called executive presence.

Leverage through others

Finally, decision makers want to see that the candidate's results come from a team they built rather than from personal heroics. A VP whose function falls apart when they take a week off is not ready for a broader role, however talented.

The Identity Obstacle

The most common thing holding strong VPs back is not a skill gap. It is an identity that served them well and now constrains them.

Most vice presidents rose by being the best operator in the room. They knew the details better than anyone, solved the hardest problems personally, and were the person others turned to when things broke. That identity is deeply rewarding, and the organization rewarded it for years.

At the C-level, the same instinct becomes a liability. The leader who keeps reaching into operational detail crowds out their own team, signals to the CEO that they are still thinking at the functional level, and leaves no room for the enterprise work the role requires. Stepping back can feel like losing competence. For many leaders it stirs up the kind of doubt explored in imposter syndrome in the C-suite, because the new role offers fewer of the concrete wins that used to confirm their value.

Working through this shift is often the real substance of preparing for a C-level role. It is less about adding skills than about letting go of the ones that defined you, which is why COOs and CFOs promoted from within sometimes find the first year harder than outside hires do.

How to Close the Gap

Start doing the job now

The most reliable path is to begin operating at the enterprise level before the role exists. Bring proposals that solve company problems, not only functional ones. Offer views on issues outside your area, carefully and with evidence. Volunteer for cross-functional work with real stakes. Over time, decision makers start to picture you in the larger seat because they have already seen you in it.

Build your bench deliberately

Develop a successor who could run your function without you. This is both a practical requirement and a signal. It shows you are building leverage, and it removes one of the quiet objections to promoting you: that no one could replace you where you are.

Widen your relationships across the top

Vice presidents often have deep relationships within their function and thin ones elsewhere. C-level work depends on trust with peers in finance, operations, technology, people, and the business lines. Invest in those relationships before you need them. Understand what your peers are measured on, what keeps them up at night, and where your function makes their work harder. When your name comes up in a succession conversation, the views of those peers will carry real weight, and they will be based on how you have treated them when nothing was at stake.

Practice making the enterprise tradeoff

Look for opportunities to argue for something that costs your own function in service of the company. Supporting a reallocation of budget away from your area when the case is strong, or conceding a hire to a peer whose need is greater, is one of the clearest signals that you are already thinking like an enterprise leader. Few things persuade a CEO faster.

Seek candid feedback about perception

Many VPs are being judged on impressions they cannot see. A trusted CEO, a board member who has watched you present, or a coach conducting structured stakeholder interviews can surface how you are actually perceived. The gap between self-perception and how others see you is often where the work lies.

Learn the board

Find opportunities to present to directors and to understand what they care about. Board exposure is one of the clearest differentiators between VPs who are seen as ready and those who are not.

Attend to sustainability

The push toward a C-suite role often coincides with a period of very high load. Leaders who arrive at the top already depleted tend to struggle in the first year, when the demands are steepest. Building habits of recovery and a realistic relationship with workload is part of being ready, not a distraction from it.

When the Promotion Comes

Earning the role is the first transition. Holding it is the second. The early months in a C-level seat bring a new relationship with the CEO, new peers who may have competed for the same role, and in many cases the first sustained contact with the board. The guidance in our piece on the first 90 days of an executive transition applies directly, and leadership transition coaching is designed for exactly this window.

If you are working toward a C-level role, or have recently stepped into one, it can help to think through the shift with someone who has seen many leaders make it. You can schedule a free consultation, a confidential conversation of about thirty minutes, to talk about where you are and what comes next.

Common Questions

What is the biggest difference between a VP and a C-level executive?

A VP is typically accountable for the performance of a function. A C-level executive is accountable for the enterprise, jointly with peers, and is expected to make tradeoffs that may disadvantage their own function for the good of the whole. The shift is from advocate to steward.

What do CEOs and boards look for when promoting to the C-suite?

They assume functional competence and look past it. What they assess is enterprise judgment, composure under ambiguity, the ability to influence peers without authority, credibility in the boardroom, and whether the candidate builds strong teams rather than relying on personal output.

How long does it take to move from VP to the C-suite?

There is no standard timeline, and it depends heavily on the organization, the function, and openings at the top. What tends to shorten the path is demonstrating enterprise-level thinking well before a role opens, so that decision makers can already picture you in it.

Can executive coaching help with a C-suite promotion?

Yes, particularly when the obstacle is not skill but perception or identity: being seen as a functional specialist, struggling to step back from operational detail, or feeling uncertain about holding authority at the top. Coaching can help a leader build and demonstrate enterprise judgment before the role is in reach.

About the author. Dr. Stephanie Collier is a board-certified psychiatrist and certified executive coach. She completed her psychiatry residency at Duke University and a consultation-liaison psychiatry fellowship at Brigham and Women's Hospital, holds a faculty appointment at Harvard Medical School, and serves as Director of Education for the Division of Geriatric Psychiatry at McLean Hospital. Read her full background.

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