Leadership through crisis: Joseph Bosco III, MD, reflects on his AAOS presidency during the COVID-19 pandemic

When Joseph Bosco III, MD, FAAOS, stepped into the role of AAOS president in 2020, he was prepared to focus on executing the Academy’s Strategic Plan. Then, COVID-19 changed everything. “Life gets in the way of execution,” Dr. Bosco recalled. “All presidents had unexpected issues impact their year. In my term, it was the COVID pandemic. Despite the emergency, we still executed our strategic plan. We continued education, research, and advocacy.”

In an interview for AAOS Now, Dr. Bosco, who serves as vice chair of NYU Langone Orthopedics, reflected on his leadership journey, the challenges of steering AAOS during a global crisis, and the lessons he hopes to pass on to future leaders.

Guiding the Academy through a pandemic
As the pandemic disrupted healthcare across the country, AAOS faced the dual challenge of responding to urgent issues while sustaining long-term initiatives. “We spent a lot of time in D.C. advocating for access to care and the responsible administration of medical services during COVID,” Dr. Bosco recalled. Closures, patient delays, and public health uncertainties required constant adaptation.

Yet, even in the face of uncertainty, AAOS maintained its focus on member priorities. “I’m most proud that we didn’t let COVID derail our mission,” he noted. “The organization had the bandwidth not only to navigate the crisis but also to continue pushing forward on education, research, and advocacy. That speaks to the resilience of the Academy.”

He also underscored the value of continuity in leadership. Each presidential year is part of a much larger effort. “You’re really just a steward of the Academy for one year,” he explained. “I inherited an organization in great shape thanks to Kristy Weber, MD, FACS, before me, and when I finished, Daniel K. Guy, MD, FAAOS, picked up where I left off. That continuity is what allows the Academy to thrive even in difficult times.”

Lessons in leadership
Dr. Bosco described his time on the AAOS Board of Directors as transformative. Like many physicians, he entered the profession with little formal leadership training. “Medical school teaches you to sequester yourself and memorize anatomy and the Krebs cycle,” he said. “That’s not leadership.”

However, within AAOS, he gained firsthand experience in managing diverse teams, balancing competing priorities, and shepherding long-term projects. “I learned how to work with people, make teams, and move projects forward over years, not weeks,” he said. “Those are lessons you don’t learn in a classroom.”

He credits AAOS administrators, past presidents, and particularly AAOS CEO Tom Arend with shaping his leadership style. “Watching how Tom handled people was invaluable,” he explained. “Leadership is really about people, and that’s something you only develop through experience.” Those lessons translated directly to his role at NYU Langone, where he serves as vice chair of a 250-member orthopaedic faculty.

Dr. Bosco emphasized that becoming AAOS president is not a sudden leap but rather a gradual progression. His journey began decades earlier on a question-writing committee, where he helped craft examination content for orthopaedic trainees. “You don’t go from zero to 60,” he said. “It starts with something small — sitting in a room writing questions. From there, you serve on more committees, chair a group, maybe join the board and eventually take on leadership in other organizations. Each step builds on the last.”

The cumulative effect of these roles, he explained, is not just experience but credibility. “The Academy is built on service,” he said. “The more you contribute, the more opportunities come your way.”

Advice for aspiring leaders
For younger AAOS members — medical students, residents, and early-career surgeons — Dr. Bosco offered simple but firm advice: Never say no. “People will tell you not to take on too much or to focus on balance. But the truth is, if you want to lead, you have to say yes to opportunities,” he said. “That doesn’t mean doing everything perfectly, but it means showing up and contributing. That’s how you grow.”

Equally important is authenticity. “You can’t fake passion. You have to genuinely love what you do,” he stressed. “For me, this profession gave me and my family everything. I’m just a kid from upstate New York — my grandparents were immigrants. To become president of the Academy was something I never could have imagined. When you’re given so much, you want to give back.”

Above all, Dr. Bosco underscored the value of time. “The one thing we don’t have enough of in life is time,” he said. “You want to be with your family and friends, but when you’re not, spend your time on something meaningful.” For him, meaningful time means contributing to AAOS and improving orthopaedic care. “Ensuring that patients have access to great care and advancing the profession — that’s time well spent,” he said.

Looking ahead
Although his presidential year was defined by the pandemic, Dr. Bosco looks back with gratitude and pride. He praised the leaders who came before and after him for ensuring steady progress during turbulent times. “Your responsibility is to leave the organization stronger than you found it,” he said.

His message to young orthopaedic surgeons is both practical and inspirational. “Never say no. Stay passionate. And remember — you’re not just advancing your own career. You’re advancing this profession for the next generation.”

Bradley Lezak, MD, MPH, is an orthopaedic surgery resident at NYU Langone Orthopedics and a member of the AAOS Now Editorial Board.