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Fidji Simo’s medical leave from OpenAI puts a spotlight on one of the most expansive roles in tech

Emma Hinchliffe
By
Emma Hinchliffe
Emma Hinchliffe
Most Powerful Women Editor
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Emma Hinchliffe
By
Emma Hinchliffe
Emma Hinchliffe
Most Powerful Women Editor
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April 6, 2026, 1:52 PM ET
Fidji Simo's medical leave from OpenAI highlights just how expansive her role has become.
Fidji Simo's medical leave from OpenAI highlights just how expansive her role has become. David Paul Morris/Bloomberg via Getty Images
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Since Fidji Simo joined OpenAI in mid-2025, her work has been nonstop. What started with the title “CEO of Applications,” with a focus on commercializing OpenAI’s technology, quickly became much more than that.

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OpenAI essentially split its organization in two, with Simo overseeing much of the company’s core business while CEO Sam Altman focuses on research and compute. In less than a year, Simo has shepherded the introduction of advertising into ChatGPT, the ongoing creation of an AI “superapp,” the introduction of ChatGPT Health, and the surprise acquisition of the tech news show TBPN. That’s hardly a complete list of her responsibilities; her title is now CEO, AGI deployment.

It’s a remarkable remit for any executive, and becomes all the more so when you learn more about what Simo has been navigating at the same time. OpenAI announced on Friday that Simo would be taking medical leave from the company for “the next several weeks.” Simo has the neuroimmune condition POTS, and experienced a relapse a few weeks before she started at OpenAI. “For my entire time here, I’ve postponed medical tests and new therapies to stay completely focused on the job and not miss a single day of work,” she wrote in a memo Friday. “I took time off for the first time two weeks before the break for some medical tests, and it’s now clear that I’ve pushed a little too far and I really need to try new interventions to stabilize my health.”

Simo has long discussed women’s health, including while she was CEO of Instacart and a Facebook exec. In 2021, she launched an organization called the Metrodora Institute that was built to better integrate care for patients with neuroimmune disorders, especially women. It closed shortly before Simo joined OpenAI; its nonprofit arm is still operating and was rebranded as the Complex Disorders Alliance. Over the past few days, she has posted on X about her medical leave, now that there’s even more interest in her status due to the consequential nature of her job. “If there is one good thing that can come out of having my health issues exposed to the world, it’s raising awareness for complex chronic conditions like POTS, MECFS, Long Covid or EDS,” she wrote, sharing a link to a news article headlined, “What is POTS, the disorder that forced OpenAI exec Fidji Simo to take medical leave?” She’s drawn connections between her work and her health: “I have high hopes that AI will accelerate the path to cures, but patients cannot wait,” she wrote. “Despite all the resources at my disposal and an incredible support system, I still couldn’t avoid a medical leave. We need better solutions for all patients, now.”

Simo’s news wasn’t the only unfortunate update for OpenAI’s executive team. OpenAI CMO Kate Rouch is stepping down to focus on her recovery from breast cancer; she was diagnosed shortly before she stepped into the job. She echoed a similar theme as Simo: “You can’t outwork your body,” she wrote on LinkedIn. “At a certain point, you have to be honest about your limits. I’ve reached mine.” Rouch plans to return to a role with narrower scope when her health allows, while OpenAI searches for a new CMO.

As OpenAI is preparing to become a true, mature tech giant (and go public), it’s tapped a growing group of executives, many of them women. It’s a sad coincidence that two were faced with serious health challenges so shortly before beginning what they likely view as a once-in-a-lifetime opportunity. Simo wrote in her memo: “The timing is maddening because we have such an exciting roadmap ahead that the team is executing on, and I hate to miss even a minute of it.” Both Simo and Rouch are sharing more about their experiences than would be required or typical—something we often see from female execs.

While OpenAI stresses that it has a strong executive bench that is more than capable of executing in Simo’s absence, you only need to take a look at the long list of execs tapped to step in to understand her importance to the business. Cofounder Greg Brockman will lead product, while CFO Sarah Friar, chief revenue officer Denise Dresser, and chief strategy officer Jason Kwon will all take on aspects of Simo’s work.

“I can’t wait to be back in the arena with you all soon,” she wrote.

Emma Hinchliffe
emma.hinchliffe@fortune.com

The Most Powerful Women Daily newsletter is Fortune’s daily briefing for and about the women leading the business world. Subscribe here.

ALSO IN THE HEADLINES

Plus, more OpenAI news. CFO Sarah Friar and Sam Altman reportedly disagree on timing for OpenAI's upcoming IPO, according to The Information. Altman wants OpenAI to go public this year, while Friar has concerns about organizational readiness. 

Savannah Guthrie is back on the Today show. Today's broadcast marked her first true return since the disappearance of her mother, Nancy Guthrie. "Ready or not, let's do the news," she said as she dived in to a relatively normal episode of the morning show. Still, supporters gathered outside Rockefeller Plaza with photos of Guthrie's missing mother, and Guthrie went outside to see them. 

What a weekend for women's sports. A crowd of 18,006 packed Madison Square Garden and set a new U.S. women's hockey attendance record as the New York Sirens defeated the Seattle Torrent. It's been an interesting Final Four. UCLA won its first title—but the biggest story ended up being an altercation between coaches Geno Auriemma of UConn and Dawn Staley of South Carolina, two dynasties that came up short this year. Auriemma ended up apologizing for his behavior after he snapped at Staley for not shaking his hand at the beginning of the game, an interaction that was loaded with years of rivalry. Meanwhile, I was at the Augusta National Women's Amateur—more on that soon! 

Fortieth birthdays are the new weddings. Single women are throwing milestone birthdays that replicate the scope and celebration of a wedding. "Women deserve to celebrate such a milestone with or without a partner," says one event planner who has planned wedding-style 40ths.

ON MY RADAR

How a debut novelist turned the tradwife discourse on its head Elle

Four rules for dressing like a boss, according to powerful women WSJ

My fight back against menopause started in a boxing gym Bloomberg

PARTING WORDS

"That little flicker—it can plant itself in you and blossom into self-doubt, impostor syndrome. You have to stamp it out."

—Emma Grede on women and ambition

This is the web version of MPW Daily, a daily newsletter for and about the world’s most powerful women. Sign up to get it delivered free to your inbox.
About the Author
Emma Hinchliffe
By Emma HinchliffeMost Powerful Women Editor
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Emma Hinchliffe is Fortune’s Most Powerful Women editor, overseeing editorial for the longstanding franchise. As a senior writer at Fortune, Emma has covered women in business and gender-lens news across business, politics, and culture. She is the lead author of the Most Powerful Women Daily newsletter (formerly the Broadsheet), Fortune’s daily missive for and about the women leading the business world.

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