© 2021, Babes-Bolyai University. All rights reserved.Our primary aim was to provide a quantitative snapshot relying on a self-assessment tool developed for the local healthcare environment and formal tasks for top-level executive hospital managers of public healthcare organizations. We used a cross-sectional and descriptive mixed study design that targeted the nationwide population of 701 top-level managers in public hospitals in 2015 in Turkey. As the first step, position description content analysis was conducted based on document analysis to explore their legal tasks and statements, and the job requirements for an executive management position in public hospitals. Second, before designing the data-collection in-strument, we conducted four meetings and group discussions with several hospital managers – with and without medical backgrounds – and five aca-demics who were part of healthcare management and public administration departments. Lastly, we built upon past efforts and the literature, and con-structed a questionnaire. The managers are fully responsible for the healthcare quality, medical, nursing, administrative issues and financial performance of the facility. The participants perceived that they were compe-tent in most of the competencies. The participants’ mean total competency score was 81%, and the competency gap between the required and current competency levels differed from 13% to 22%. This research provides deep insight into the competencies perceived by hospital executive managers in a developing country context. Our results have several practical implications for both healthcare pol-icymakers and new executive hospital managers. There is an urgent need for follow-up self-assess-ment for competencies and ongoing management training programs.