Medical Management and Leadership

What got you interested in L+M as a special interest?

For me it initially came about due to Modernising Medical Careers (MMC) back in 2007, I was an SHO at the time and suddenly had to move into a new system which wasn’t easy and find my place, I moved back to Leicester and the Clinical Director for Medicine could see morale was low and wanted to engage the juniors as a group and so set up a meeting and invited interested people to come along. I stuck my hand up, went along and was suddenly given access to someone with power who was willing to support me and help me in making change.  From there I realised that by getting involved in Leadership and Management you could stop feeling like you were always doing your job with one hand behind your back, you could help your colleagues to do their job better and ultimately our patients get better care.

How did you train in L+M and what other avenues are there?

Back when I was undertaking my Registrar training, programmes such as the now well established Chief Registrar programme did not exist, so I undertook a Masters Degree in Medical Leadership. There are now several of these that you can do to Certificate (1 year), Diploma (2 years) or a full masters with a research dissertation (3 years).  I undertook the Royal College of Physicians Masters Course that was linked with the Organisational Psychology department of Birkbeck University (Part of University of London).

If I was to train now or what would I recommend, is to look to do a Chief Registrar programme where you get both non clinical time to do leadership work but also a programme of learning and education to help you develop.  There are also schemes such as the Medical Directors Clinical Fellowship scheme organised through the Faculty of Medical Leadership and Management (FMLM).

Both of these have educational components and practical opportunities for getting involved in a supported way. Given the new curriculum does not now require a formal course (mine did), there may be other less formal options at a local or regional level that would also fulfil the criteria but make sure that you have a supervisor so that report that is needed gets completed.

What challenges did you face?

The short answer is time and money.  Back then funding a full master’s programme was not easy, study leave budgets were capped at not very much and although the Directors of Medical Education at a couple of the trusts I worked at gave me extra, the course was over £7000 per year and then travelling to London, hotel costs, etc…it soon adds up. Looking back, I am not sure how my wife and I managed that aspect.

The second one was time; being a full time medical registrar and then undertaking 4 modules each year with pre work and then assignments was hard work and needed good organisation.  It also required flexible departments where I worked so that I could often pool together the half day for special skill we got then and use that rather than all my study leave to do the course. 

The dissertation was also a challenge, firstly in terms of flexibility to undertake the interviews I did, often with people saying can you come on Friday (3 days notice) and my then Trust which is where I now work saying of course we will manage, a real eye opener for me that made it top of my places to want to work.  Then time to actually write it all up. I remember running out of work and getting home, my amazing wife shoving food in front of me and then sitting at the computer writing for hours each evening to get it all done.

How does this fit into your consultant working?

It has been an integral element from day one, it enabled me to take on projects relatively early in my Consultant time and come with credibility and shown previous interest, I got time in my job plan to lead a deteriorating project Trust wide about a year after I became a Consultant. I then became a TPD for General Medicine and again the skills learnt and confidence gained were key in helping me to do that job well for over 6 years until I step down very soon.

However, it has also been key in getting me to the new role I started in July 2024, I am now the Clinical Director for Older Peoples Services and Acute Care in my Trust, covering the whole of Geriatric Medicine and Acute Medicine Services. This is not something I would have looked to take on without making this my interest.  I now have a significant amount of time in my job plan (3 PA’s) to work as a clinical leader/manager and that all started with this as my special skill.

Then I have not even mentioned my role as the Treasurer and one of the directors on SAM council, again something that has been immensely helped by developing and feeding this skill while a trainee.

Do you have any tips for trainees who may be interested in L+M as a special interest?

Firstly and foremost get involved, I think Acute Medics are well placed at all levels to get involved.  If you see something that you think can be better, approach someone to try and improve it. Often Consultants have worked somewhere for a while so may not be aware of better ways to do something.

Also ask to join meetings, especially as a registrar, what meetings happen in the department, can you get involved, who is the clinical lead or clinical director? Talk to them and ask to shadow them and see what they do when they go to or Chair meetings. Ask them what is on their to do list and see where you can get involved, the more you try and do the more confident you get and understand what went well and what you can do better.

I am always open to being contacted and am easy to track down at SAM conferences or through the SAM admin team.