This is my first editorial as editor-in-chief, after serving for almost a year as interim in the role. As the first woman editor-in-chief in the CMAJ’s 111-year history, although not the first to be tapped to steer the journal in an interim capacity, I represent change. In 2022, under-resourced and inadequate health systems in Canada face the ongoing COVID-19 pandemic, alongside a worsening health workforce crisis and increasing health effects of global and local social determinants of health that worsen existing inequities. How can CMAJ be part of addressing these challenges? How can the journal help facilitate much needed change? My vision for CMAJ during my tenure as editor-in-chief is informed by my extensive experience working as a medical editor; my varied experience as a clinician, a researcher, an immigrant, and a patient in 3 very different health systems; and my understanding that collaborative, open-minded and kind leadership is what is needed now to address the serious threats to health that we face globally and in Canada.