Is there a role for ‘teaching’ leadership and management?

There is more and more emphasis on doctors to develop their leadership and management skills, but how do we do this and when is the right time for it to be done?

We know that consultants are encouraged to attend management and leadership courses to help gain their CCT, but by that time it may be too late and elementary mistakes may have already been made.

Feedback from the 3rd National NHS Leadership meeting held by the Clinical Leadership Forum was overwhelmingly in favour of helping junior doctors develop leadership skills earlier in their career.

91% of attendees felt that medical schools should be doing more to teach medical students about leadership and, when asked how they suggested this should be done, 78% said it should be incorporated into the core curriculum, 67% voted for special study modules, 33% suggested an intercalated BSc, and the rest suggested a clinical attachment. 68% of attendees also felt that their local education training bodies should be doing more to help their trainees develop their leadership skills.

In fact steps towards this have already begun. The Barts Leadership and Management in Medicine society came and spoke at the group’s 2nd meeting in 2015 – they have set up a student-selected component within their curriculum and feedback has been extremely positive.

To make education of this mandatory would be a contentious issue however. Although 60% of attendees felt that doctors should be expected to evidence leadership in their portfolios, when asked ‘Should all doctors be involved in management?’ the response was more evenly split with 48% yes, 44% no and the rest as ‘don’t know’.

The current climate requires more and more junior doctors to draw upon their abilities in leadership and management, which at present seems to have developed through experience and osmosis. Is this the time to be taking steps to formalise how we develop these skills, to make us more equipped to negotiate the treacherous waters of clinical medicine and surgery when we do become consultants, or indeed a partner in a GP practice?

Mitali Das
General Surgery Trust Registrar, Epsom and St Helier NHS Trust


Comments (7) Add yours ↓
  1. Mike Kirby Professor

    Like all skills earlier the better ( espcially skiing!!)
    The skills are not intuitive and need to be taught
    The essentials are:
    1. Give a clear direction of travel
    2. Bring the team together and listen!
    3. Communicate clearly with consistent messages
    4. Be flexible but not weak
    5. Take risks when appropriate
    6. Build the team around you
    7.Be humble, but, act with courage
    8. Earn your respect through building trust
    9. Have fun together
    10. celebrate success


    January 26, 2017 Reply
  2. Mark J Speakman Consultant Urologist

    Yes, absolutely there is a need for teaching leadership and management skills.

    The sooner this starts the better; ideally this should be a core part of medical school teaching and something that is developed further as a junior doctor and refined as a consultant. It will not be right for everybody however, but only by starting at medical school will you identify who can refine these skills the most.
    As a doctor we all have to show leadership and we all have a role in the management of our own departments but only some will progress to being a Medical Director or a Chief Executive. It is perhaps surprising that there are many more nurses as Hospital Trust Chief Executives than there are doctors in the UK.
    To quote Steve Jobs; ‘Management is about persuading people to do the things they do not want to do, leadership is about inspiring people to do things they never thought they could’.

    January 27, 2017 Reply
  3. Shalini Fernando Clinical Fellow

    Very pertinent issue, I agree Mitali. I attended the leadership meeting which was very eye opening and I would indeed be very keen for trusts and deaneries to encourage more leadership and management training opportunities. I think if it is incorporated into the core skills needed as a trainee then much can be achieved. Looking forward to the next leadership meeting!

    January 31, 2017 Reply
  4. Shayantiri Jeyakumar GPST1

    I agree that leadership should be taught early. This can then progress throughout a doctor’s career so that by the time they obtain their CCT, they area already leaders and are able to then share their experiences and knowledge with their juniors. The idea of introducing this in medical schools as a student selected unit or equivalent could be a good way for medical students to get started.

    February 1, 2017 Reply
  5. Vaibhav Modgil International Urology Fellow, Fiona Stanley Hospital, Western Australia. Urology SpR West Midlands Deanery, UK.

    Many thanks for this thought provoking blog on such an important, yet often overlooked, area within medical practice.

    To answer the question posed; yes absolutely there is a role for incorporating leadership and management into medical education from a very early stage. As i come to the end of my specialist training its interesting to note that candidates are required to attend a ‘management course’ prior to CCT. This has been the case for sometime now, however one can’t help but feel consistent exposure to leadership and management roles and meetings as part of through training would be a better idea.

    I have often heard consultants I have worked with talk about how doing the urology is the ‘easy part’, it is meetings and managing a team that can become the biggest sources of stress. Leadership and management are, as Mark said above, two very different things. Whilst there is no doubt some are better at one or both than others, there is little doubt in mind many techniques can be learned and improved over years of practice.

    There is an increasing pressure on doctors within the NHS to adopt management and leadership roles within their job plans. Whilst there are many who would rather not engage anymore than they need to, it is extremely important for us to lead and inspire the next generation of junior doctors to take control of their destiny and drive positive change within the NHS.

    It is perhaps more important now than ever before in the NHS for doctors to drive change through effective leadership and management. Through this doctors can play a central role in establishing a culture of pride and accountability within the organisation.

    For this who may have a particular interest in this area and are considering a higher degree in this area, you may find the link below helpful:

    February 6, 2017 Reply
  6. Culley Carson Rhodes Distinguished Professor of Urology

    This blog is not only important in the UK but is also critical in the US. there have been major changes in US medicine not the least is the ACA (Obamacare). Even more, the hospitals and practices once run by physicians are now run by MBAs whose focus is on the bottom line and not patient care or staff satisfaction. This change is born out by the increase in the physician burn out and decrease in job satisfaction. Medicine in general in the US has become more of a job than a calling and profession as it was in the past.
    We as physicians gave up management a generation ago because we were “too busy” caring for our patients.

    Now in the 21st century, we must fight back by treeing the new generation of physicians in management skills and administration so that a physicians voice is heard in the management suites and at the policy levels. All physicians and medical students should be exposed to the concepts of business and management. Such exposure is not overly time consuming but is essential to maintaining medicine as a profession, not just a job.

    February 8, 2017 Reply
  7. Louise de Winter Chief Executive, The Urology Foundation

    I echo all the above. Not only should leadership & management skills be taught as part of the curriculum, but communication skills too. It is vital that doctors communicate clearly with patients and their families about what they can expect from their treatment to mitigate against any misunderstandings, and it is equally vital that doctors communicate effectively with their teams and nurses so that all are clear about the treatment given for a particular patient and why. Finding ways to improve patient care and minimise risk through clear communications and leadership is not a luxury, it’s an absolute necessity. The Urology Foundation runs communications skills and leadership courses aimed at SpRs and consultants with a view to improving patient treatment and care, and these skills, like others, need to be refreshed and updated every so often.

    March 15, 2017 Reply

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