How Leaders in Healthcare 2020 gave an enlightened spotlight to junior doctor leadership

By Dr Josie Cheetham

FMLM Trainee Steering Group representative for Wales

On a rather dark and damp day last November, I had been preparing to attend what some may assume to be ‘just another’ virtual conference or learning event. But Leaders in Healthcare has been THE conference for me since I first began to attend three years ago; it is a truly rich and immersive developmental experience.

I had the privilege of being part of FMLM’s Trainee Steering Group (TSG) during this time and we delivered sessions at the conference aimed at encouraging junior doctors to consider their roles as leaders now, as well as in the future.

However, after observing our colleagues over the course of the first and then the beginning of the second wave of the pandemic, we decided that we wanted to hear from junior doctors themselves. We specifically wanted to hear about their leadership experiences, challenges and opportunities and how they thought we, as a trainee leadership community, could move forward and develop stronger, deeper roots for future waves of this pandemic and beyond.

I logged into the virtual conference platform for an active listening and discursive TSG session at the 2020 virtual Leaders in Healthcare conference and I left the session feeling profoundly inspired. The breakout session I had facilitated included a diverse range of junior doctors who worked in a variety of settings during the first wave: from the operating theatre, at home due to shielding, on the shop floor in COVID Emergency Departments, on COVID medical wards, to field hospitals. All of them cited stepping organically into leadership roles almost without realising - remote ‘working from home’ leadership, leading multidisciplinary teams without a formal leadership role, leading to improve the wellbeing of their colleagues at work, stepping into new clinical roles with an inherent leadership aspect to them. We heard the impact of their input and skill: how they transformed and efficient patient care; improved colleague wellbeing and morale; improved departmental systems; and guided colleagues steadily and safely through an arguably chaotic or complicated clinical environment. The TSG members recorded these diverse and inspiring accounts and will share them soon, so do look out for them.

What struck me was how each junior doctor used inherent leadership skills and drive in these pandemic posts to catalyse really innovative and meaningful change within their work and training places. This was trainee leadership in action without any previous training or focus on curriculum outcomes. What was even more inspiring was the rawness of the realisation and recognition of the junior doctors of the utility and power of leadership in their hands. We often encounter intangible words and phrases such as ‘leader’, ‘leadership’ and so on but, as junior doctors, what this means for us right now is not always apparent. Leadership was the common, positive thread through all their pandemic experiences.

I saw a growing realisation and belief in the power of leadership when hosted and crafted by junior doctors, the recognition that they could make unique contributions that could not be recreated by other colleagues - and the tangible impact of their leadership work regardless of the working environment or team in which they found themselves. They saw that junior doctor leadership - their own individualised leadership - is needed by our healthcare system now, during a pandemic, but also thereafter. There was a tangible thirst for discovering more about their role in medical leadership and a desire to develop further based on their lived experiences during the pandemic.

I hope, as a medical leadership community, that we are able and ready to foster this enthusiasm with the resources and mentorship that we have. We need to continue to ensure that junior doctors are enabled to become involved in leadership in ways that are meaningful to the healthcare system they serve following the pandemic, and that they have the space and time in their working days to do this. There have been many observations I will take away from this pandemic, but the unique and profound impact of medical leadership on healthcare delivery, patient relationships and supporting our colleagues has been major among them. There has been a substantial amount of talk about junior doctors ‘stepping up’ during the pandemic. I would suggest junior doctors have instead ‘stepped in’ or ‘stepped further forward’ into leadership activities, with doors opened as a result of the highly dynamic and intense working environments the healthcare community found themselves in this year. They have always had an underlying passion for leadership activities, even if unrealised or not fully crystallised by themselves, but our systems and structures need to open doors and let junior doctors ‘in’.

I left the TSG Leaders in Healthcare session with a real sense of optimism about the future of junior doctor leadership and a redoubled enthusiasm for the TSG and others to help encourage, support and enable my colleagues to continue their organically evolving leadership journeys during the subsequent waves of Covid and beyond. Junior doctors have always had an important and unique part to play in healthcare leadership but have not always had a seat at the table, or a seat high enough to see above the table legs. If positive action points are to be taken from this pandemic period, I would suggest that, if we raise and enable junior doctors to have a full seat at the metaphorical table, the future of our healthcare systems can only be brighter.