As a powerful professional group responsible for significant decision-making and spend within the NHS, leadership and management ought to be core to the education and training of all doctors. Tim Swanwick, senior clinical adviser and postgraduate dean at Health Education England (HEE), explains why there’s still some way to go before that is the case.
When it comes to leadership development, everyone agrees you should ‘start early’. Indeed, there have been significant efforts to raise the profile of leadership in undergraduate medical education since the publication of the (UK) Medical Leadership Competency Framework in 2010 and the vast majority of medical schools now report leadership and management content within their curricula with the intent to increase provision. There are some noteworthy initiatives across the country, from sessions on personal impact, team-working simulation exercises and special study modules on quality improvement to introduce new degrees in healthcare management and leadership. But despite broad agreement around the benefits of work-based approaches to learning leadership, there remains some ambivalence about the place of leadership within crowded curricula, and no consensus on teaching content, timing and methods.
Universities design and develop their own curricula which, in medicine, must meet the General Medical Council’s (GMC) ‘Outcomes for Graduates’, previously known as ‘Tomorrow’s Doctors’. A new edition is currently out for consultation and the GMC has indicated that in redrafting they will draw on their ‘generic professional capabilities’ framework, launched for postgraduate curricula in May 2017. ‘Leadership and team working’ and ‘patient safety and quality improvement’ are two of the domains it covers. Once the new outcomes are published, medical schools will need to respond by reviewing their curricula.
There’s much to be done and a programme of supporting work has been initiated by Health Education England working closely with the Faculty of Medical Leadership and Management. Following a stakeholder event held in the summer, a national steering group has been convened to take a number of related workstreams forward. A similar initiative is also underway to look at leadership in the undergraduate curricula of other health professions led by the National and West Midlands Leadership Academies.
Leadership development often sits uneasily within the undergraduate medical curriculum, and integration into programmes, historically dominated by the clinical biosciences, is challenging. But it can be done. It needs to be done. For the sake of tomorrow’s patients and populations, we need to develop tomorrow’s leaders, today.
Tim Swanwick is ssenior clinical adviser and postgraduate dean at HEE. He is one of the authors of ‘Twelve tips for integrating leadership development into undergraduate medical education’ published this month in Medical Teacher and available here.