Purpose The purpose of the research was to explore and compare the experiences, leadership and management competencies and development needs of doctor managers in Kenya and the UK. Design/methodology A comparative study d258esign involving fieldwork in Kenya and the UK was adopted. Data were collected using a multi‐method approach: qualitative interviews and a survey with doctor managers. The template method was used for qualitative data analysis while appropriate statistical tests in SPSS were used for quantitative data analysis. Findings The findings of the study add to the knowledge on experiences of doctor managers, competencies and development needs. Ways of addressing some of the difficulties are proposed. Research limitations/implications The study highlights issues of a comparative study across different cultures and the issue of bias that is associated with self reports. Practical and social Implications It is assumed that management decisions have much in common and the training and socialisation of doctors as professionals is somewhat similar. This paper explores if there are any experiences that are transferable and if competency frameworks in healthcare used in developed countries are transferable to a developing country. Originality/value The study gives baseline knowledge and insight into the experiences, competencies and development needs of doctor managers in a developing country and adds to existing knowledge on doctor managers in the UK. This study has also provided currently the only international study comparing the experiences, competencies and development needs of doctors in management.