Junior doctor exposure to senior management

Editor – We read with interest the article by Omar et al on the perceived barriers to medical leadership in medical students.¹ They describe well the lack of opportunities medical students face in attaining leadership skills in the curriculum. The doctors’ role as clinical leaders is well established now. The General Medical Council (GMC) has clear guidance on the leadership roles for doctors. The Faculty of Medical Leadership management has released a toolkit for junior doctors to help them better engage with managers.²

The doctor–manager relationship has been cited as one of the reasons for discontent among doctors.³ Junior doctors, in particular, can often feel ignored. This may be partly because junior doctors have limited opportunities to interact with senior managers and often have unfavourable perceptions of them. In response to this concern, a number of 10-minute roundtables with managers were organised, bringing together the board with 21 junior doctors. This was exceptionally well received by both managers and junior doctors.⁴ Further, such meetings (including the chief executive and medical, nursing and IT directors, among others) have taken place at Lancashire Teaching Hospitals NHS Foundation Trust, where the meetings have led to a number of improvements which were co-developed with junior doctors and are still in place 3 years later, with excellent feedback.⁵

Undoubtedly, junior doctors are an important part of the NHS and should be involved in decision making and engaged with regularly. Prof Sir Bruce Keogh, former NHS medical director stated that: ‘[Junior doctors] are the backbone of the medical services and, more importantly, they hold the key to the future of our NHS.’⁶ Hence, in our opinion, teaching and training on the medical leadership skills should start during their undergraduate training to prepare them for what lies ahead and should continue during their postgraduate training. In parallel to their exposure to the clinical practice earlier during the undergraduate years, we believe that medical students should be introduced to the hospital management structure and functioning during the medical school course, too.

Omar et al highlighted the need for undergraduate medical leadership training. We believe this should be complemented at postgraduate level and include regular interactions with frontline managers.