Medical students, junior doctors and The Kings Fund think tank: engaging in leadership
Rebecca Rohrer, Elizabeth Emsley
What is medical leadership, how can it work for you and how can you get involved? These were some of the questions posed by the King's Fund to a group of FMLM trainees and medical students at a King's Fund event this week.
For those who haven't heard of them, The King's Fund is a think tank who for over 100 years have commented on how healthcare is provided and planned in the UK. Two members of their leadership team facilitated a meeting to talk with FMLM members about where medical leadership fits into the NHS as a whole, the opportunities and challenges of gaining medical management experience as a trainee, and importantly how the FMLM can bridge the gap.
There were a number of valuable take aways for medical students.
Medical students and junior doctors are already undertaking small-scale medical management projects
Undertook an audit that led to changes in a service? Helped a junior doctor to get their jobs done more quickly? Managed to manoeuvre your way through a firm with a difficult consultant or firm members? These small management tasks seem to be often underestimated with the focus on large-scale service improvement projects that are less feasible for medical students to undertake. In fact it is these everyday tasks that give you the flexibility to make the mistakes that we all need to be able to make in order to learn. In addition they can build on management skills that you already have - from being on a medical school society or sports team, or perhaps from current or previous work experience.
There needs to be greater championing of every day medical management by seniors
Even though medical students are gaining valuable medical management skills, there seems to be neither the time nor sometimes inclination to develop them formally. Compulsory audits, portfolios and special study modules do make an attempt at this. However there is a danger that the obligatory nature of these may detract from creating a culture whereby people are enabled to use medical management to enact change when they want to. Further, attendance at expensive leadership courses may be a means of learning about management, as well as being an addition to a portfolio. However it is suggested that these small every day projects have a greater potential to make a tangible difference.
Would dedicated curriculum time for service improvement projects be helpful?
The medical students attending the meeting felt strongly that formal teaching about health care system structure, management and service improvement would be beneficial. Dedicated medical school curriculum time would create a baseline of knowledge amongst medical students which we hope will equip those students wanting to improve the services around them. This skillset could then be furthered through projects or once they start clinical placements.
Medical leadership and reorganisation of deaneries
Students and trainees also considered how the reorganisation of local deaneries might affect the way we learn about medical leadership and management. It was proposed that we should consider this change as a repositioning opportunity. Now might be the time to encourage greater integration of medical leadership into the timetables of those students and junior doctors hoping to learn more.
What can you do next? Let us know your thoughts on these issues - what skills would you like to learn and do you have opportunities to do so in your medical school or on placement?
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An interest in Medical Management
Thank you for writing this blog I found it really interesting and I fully support your aims with regards to more medical student education on these issues. Just a quick example, I have never before realised what it is the King's fund does - which is useful to know for future reading.
I believe that a number of medical schools have audits and public health projects as compulsory parts of the course, but from my experience these course aren't explained to the students in a way that encourages us to make the most of them. Most people seem them as irrelevant hurdles that need to be jumped over rather than fascinating learning experiences that could be beneficial for our future careers.
I would like to see medical students receiving at least a few compulsory lectures on the economics of health care, comparisons of different health care systems with pros and cons and perhaps a lecture explaining in detail how the NHS actually works. Right now I could not even explain the hierarchy of the NHS or who the head of the NHS is or what do they do! Which feels like something a medical student should probably know if we are eventually going to be working in the NHS.