Research on the medical profession and management has typically described how members of the profession are adapting and responding to changing organisational, societal and political pressures. To date, studies examining doctors in leadership roles have sought to understand the influence and adaptation of identity as doctors’ transition into and enact leadership roles and how they integrate, claim and use management and leadership logics. There is little research examining how medical professionals who hold the most senior positions in organisations may craft their jobs in response to their own and colleagues’ expectations. This study sought to understand how medical directors interpret, experience and craft their jobs, specifically in response to their own and senior leader expectations. Findings from 21 interviews with medical directors, chief executives and chairs in the NHS in one UK country found three different categories of medical director job crafting- active, pragmatic and limited. These categories describe medical directors’ approach to and engagement in the role, particularly in relation to job crafting. Interviews with senior executive and non-executive colleagues suggest their perceptions and expectations impact on medical directors’ experience and enactment of the role (and possibility their desire and ability to job craft). This research contributes to our understanding of how medical professionals engage with and enact senior leadership roles and the contribution of executive and non- executive colleagues in providing both opportunity and support. The main contribution of this research is to the literature on hybrid professionals and job crafting.