Objective:To explore the causal configurations influencing the career growth of public hospital managers and provide references for promoting their professional development.Methods:From July to December 2023, managers from 9 public hospitals in 3 prefecture-level cities or autonomous prefectures of a central China province were surveyed through a combination of stratified sampling and purposive sampling. The questionnaire included three validated scales: the career growth scale, organizational career management scale, and person-organization fit scale. Using career growth as the outcome variable, and hospital level, organizational career management, person-organization fit, educational background, and employment type as antecedent conditions, fuzzy-set qualitative comparative analysis was applied to identify high-growth configuration pathways.Results:A total of 276 valid questionnaires were collected. Scores for career growth, organizational career management, and person-organization fit were (3.29±0.79), (3.54±0.85), and (3.51±0.85), respectively. The consistency of necessary condition tests for all factors was below 0.9, indicating none were indispensable prerequisites, supporting a configurational analysis of sufficient conditions. Five distinct pathways for career growth of public hospital managers were identified: resource-oriented growth (consistency=0.88), person-organization fit-driven growth (consistency=0.89), organization-dependent growth (consistency=0.91), expertise-driven growth (consistency=0.88), and stable adaptation growth (consistency=0.87). Organizational career management and person-organization fit emerge as core conditions.Conclusions:The study reveals five heterogeneous pathways for managers′ career growth, emphasizing multidimensional complexity. Hospitals should design personalized development plans aligned with pathway characteristics, particularly by strengthening organizational career management and enhancing person-organization fit, to foster managers′ holistic growth and organizational advancement.

Objective:To explore the causal configurations influencing the career growth of public hospital managers and provide references for promoting their professional development.Methods:From July to December 2023, managers from 9 public hospitals in 3 prefecture-level cities or autonomous prefectures of a central China province were surveyed through a combination of stratified sampling and purposive sampling. The questionnaire included three validated scales: the career growth scale, organizational career management scale, and person-organization fit scale. Using career growth as the outcome variable, and hospital level, organizational career management, person-organization fit, educational background, and employment type as antecedent conditions, fuzzy-set qualitative comparative analysis was applied to identify high-growth configuration pathways.Results:A total of 276 valid questionnaires were collected. Scores for career growth, organizational career management, and person-organization fit were (3.29±0.79), (3.54±0.85), and (3.51±0.85), respectively. The consistency of necessary condition tests for all factors was below 0.9, indicating none were indispensable prerequisites, supporting a configurational analysis of sufficient conditions. Five distinct pathways for career growth of public hospital managers were identified: resource-oriented growth (consistency=0.88), person-organization fit-driven growth (consistency=0.89), organization-dependent growth (consistency=0.91), expertise-driven growth (consistency=0.88), and stable adaptation growth (consistency=0.87). Organizational career management and person-organization fit emerge as core conditions.Conclusions:The study reveals five heterogeneous pathways for managers′ career growth, emphasizing multidimensional complexity. Hospitals should design personalized development plans aligned with pathway characteristics, particularly by strengthening organizational career management and enhancing person-organization fit, to foster managers′ holistic growth and organizational advancement.