Leadership is not for the faint hearted

For the past year, I have been a National Medical Director’s Clinical Fellow with the Faculty of Medical Leadership and Management (FMLM) and the Royal College of Physicians (RCP). I applied to the scheme as an ST7 cardiology trainee working in Belfast, wanting to experience a different set of challenges outside clinical medicine. It has been without doubt one of the most extraordinary years of my life.

Throughout the year, I was privileged to be involved in a range of really interesting projects. One of them was delivering the recruitment process for the 2016/17 intake of clinical fellows. This was a surprisingly complex process, public facing and with serious consequences if things went wrong. I led a team of nine other clinical fellows and we set ourselves high standards throughout the process as we wanted this to be a really positive reflection of the clinical fellow scheme as a whole. 

As a team we delivered a 20% increase in applicants and reduced the time to shortlisting by half, with fewer people involved.

One of my core projects at the RCP was developing the chief registrar scheme, which established a new role for physicians in training. The role is  designed to allow them to split their time at their trust between clinical activities (60%), and protected leadership and management activities (40%). 

I was able to get involved with the project at a number of levels: developing strategies and business plans, recruitment and engagement of trusts and trainees, developing and delivering educational components, and providing practical support for the chief registrars.

Through these projects and other work I have learnt a lot about education, finance, project management, business planning and communications, but there are three really core lessons that will stay with me for the rest of my career.

Leadership is not for the faint hearted

It takes courage to stand up, to follow your convictions and to go against the tide. What I realised this year is that it doesn’t just happen; it is an active decision you make because you believe in the importance of what you are doing.  Sometimes that courage or bravery can be very big or obvious but equally as important is making the decision to have a difficult conversation with a colleague or telling the boss they have got it wrong.

Also, you won`t always get it right and when you do there will be still be critics, there will still be different ways of doing things.  I have found that quite challenging because it is different to clinical medicine. It is much more personal and much more about you and the behaviours you have displayed. But it is part and parcel of leadership.

Feedback is your friend (even when it doesn’t feel like it)

I have been through a bit of a journey with ‘feedback’ this year.  At the beginning, I found it quite challenging, I was quite defensive and not really taking it on board.  I quickly realised that wasn’t going to lead to much improvement and I started to open up. For a short period I swung too far the other way and I was treating the smallest of remarks as a damning indictment. In the meantime I have rebalanced and found myself in a nice position in the middle. Now I proactively look for feedback and use it as a tool to improve because I have realised it will teach me something valuable, either about myself or the other person, but generally both. 

It is important to build relationships

It is slightly unusual that I came to an out of programme training scheme to realise this but when you remove all the formal layers of authority, all you are left with is relationships.  I have definitely learnt the importance of taking time to celebrate success as a team, of making an effort to say thank you and recognise contributions, and of acknowledging the need to make sacrifices to maintain a relationship. I really look forward to taking this back to clinical medicine.

There are two sets of relationships which have been incredibly important to my learning this year:  1) the mentoring I have received from people such as Peter Lees, and Jane Dacre, which has been life changing; 2) and the connections I’ve made with the other clinical fellows, from whom I have learnt a lot.

In summary, the biggest learning was that I now believe anything is possible. This past year I have undertaken challenges and put myself into situations that I categorically would not have thought I was capable of 12 months ago. My view of what I can achieve and what is possible has completely changed but regardless of what I do in the future, I will be a better person, doctor and colleague for having done this fellowship.