Junior doctors should start leadership development at medical school

Junior doctor Rebecca Crosby discusses why leadership is so crucial in critical situations.

I always wanted to help people but I also enjoy challenges and was interested in science at school. This made medicine an attractive career for me. I enjoy spending time with patients; you’re constantly learning new things and it’s varied and interesting so no two days are the same, which also makes it exciting.

Although I was nervous about starting my role, it’s exceeded the expectations I had after graduating from university in 2015. I’ve got much more responsibility than I thought I’d have and quite a lot of independence, which is good, but can be challenging.

I see examples of leadership every day; I’ve worked in one of the busiest A&Es in the country and having a good leader on shift is so important to make it all run smoothly, especially when an ambulance is arriving every nine minutes. They remain calm and intuitively aware of what’s going on. They’re also very clear on what’s expected of them and their teams. If you have good leadership, you have better communication between staff, which ultimately leads to better treatment for your patients.

In a cardiac arrest situation, for example, at the start of the day someone is allocated a team leader role so that if it does happen we know who to look to lead the response. If and when it does happen, the team leader will delegate the tasks so that everyone knows their role and the patient receives the best care possible. This role isn’t always given to the most senior person; it’s the person who’s the best fit in terms of training and experience. I can be working with colleagues who have decades of experience and they will know the most about the situation so I’m led by their judgement and expertise. Ultimately it’s what’s best for the patient and not about egos.

Sometimes, people can have a senior position with little leadership experience. As a medical student you’re very closely supervised, but as a junior doctor, you need to use leadership skills on a daily basis. Sometimes you might be the most senior person around so decisions fall to you. This includes leading ward rounds if a senior doctor isn’t available, meeting with patients and taking the lead if a patient becomes acutely unwell on the ward. But despite this, junior doctors don’t have any formal leadership training. I think it’s something that would be really useful and could have helped prepare me for what to expect from my job.

I think junior doctors are very well-prepared in terms of knowledge, but we also need the confidence to say ‘we’re doing this now’ and follow through with conviction, which you have to learn very quickly. Obviously you’re taught a lot of science, but it would be really useful to get an understanding of the infrastructure of the NHS and how it all works together, as well as the skills associated with managing a team. Even now, we have formal teaching weekly but we’ve only had one session on leadership over the last two years. This makes it more difficult when you’re put into a situation where you have to make a decision and lead people – other staff turn to you sometimes to make a decision there and then about a patient. I think it would be really beneficial to bring this type of learning into university teaching, so you can gain an understanding of it and then be able to improve on it throughout F1/F2 level.

I think it’s incredibly important to understand leadership and have experience in it at any level; it’s not about being told what to do by someone senior. I think it’s a group taking responsibility for a situation or concern, not just a hierarchy where people don’t feel they can challenge anything. It may be difficult, but if you start learning about leadership at medical school, it’s then transferable for the rest of your career.

The NHS Leadership Academy and Health Education England believe leadership development for healthcare professionals should start as early as possible.  This is particularly important in medical education as doctors have a particular leadership role to play. That’s why both organisations have teamed up with the Faculty of Medical Leadership and Management to convene an inaugural conference on leadership development in undergraduate medical education ‘Tomorrow’s Leaders – Today’ which was held at the British Medical Association on 28 June 2017. The conference aims to be the first step in sharing current practice and challenges, and exploring how best we can progress this important area of professional development in a crowded curriculum.