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Editorial
7 September 2018
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The medical leadership career map – leadership development for all

by Mr Peter Lees and Dr Kate Langford

Give us the tools and we will finish the job - Winston Churchill, 1941

This month FMLM welcomes 85 new clinical fellows for 2018/19, the largest cohort yet. They will take part in an induction programme made all the more valuable through being constituted of a mix of dental, medical and pharmaceutical professions from all four nations. FMLM offers an increasing range of leadership development which is leading edge, produces sustainable change and avoids death by PowerPoint! The clinical fellow induction programme is a case in point, which over six days exposes those fellows to an impressive faculty, including: senior medical leaders; clinical fellow alumni; Members of Parliament from across the UK; an international expert in leadership; and expert facilitators, including a Shakespearean actor. The core aim is to give clinical fellows a head start in preparing for a year in a very different world - the world of the enlightened side.

As a small, growing organisation, FMLM’s leadership development coverage cannot (yet) be universal, but guidance on development spanning the entire medical leadership career is within our grasp. Indeed, it will become the centre point of FMLM activity over the coming year.

There is no defined pathway to medical leadership positions, which, as evidenced by the number of enquiries FMLM receives on the subject, is a major issue for aspiring leaders. This problem will be compounded by an increasing range of leadership roles as the profession heeds the value[1] of medical leadership[2] and if the enthusiasm of junior colleagues continues to grow.

The hybrid model of medical leadership roles adopted by the UK and many other countries adds significant challenges for individuals if their only training is clinical, with its impressive structures, investment and emphasis. The leap across to the ‘enlightened side’[3]  is not straightforward and it has been suggested that the skills required of the expert clinician may be a hindrance to the more corporate or system roles of substantive medical leadership positions[4] . This, of course, underpins the ubiquitous steep learning curve which accompanies the challenges of leadership at every level. We have questioned before, in these editorials, how this time, which is often in excess of a year, could be reduced. With today’s pace of change, organisations cannot afford to wait for new leaders to bed themselves in over a long period and the right to quality leadership development is crucial.

FMLM has focused on role transitions before, through the Transitions series, but clinical training does not survive solely on helpful tips. The current plans will take transition support to new heights by providing a map to help leaders at all career stages, from medical student onwards, to navigate the personal development required to become an effective leader. This will be presented through a series of questions individual medical leaders will have to address in order to choose a leadership role. This will enable potential leaders to: benchmark their skills and tackle skills gaps; source potential roles and succeed in the interview process; and navigate their first one hundred days. Alongside the map, FMLM will develop a framework for continuing professional development which will support the provision of evidence for appraisal and revalidation, ensuring leadership skills are seen as a valued part of medical work.

As FMLM becomes an independent body in 2019, this is a critical step in its role as the professional home for medical leadership. It builds on, and will be underpinned by, FMLM’s Leadership and Management Standards for Medical Professionals. It will underpin the process of certification for FMLM Fellowship. It is another step in heeding the call by Sir Robert Francis to professionalise leadership in healthcare[5]. Most importantly, it will be an essential service to support the very deserving body of medical leaders at all levels to become the very best in the relentless drive to lead improvement in patient care.

The future is not some place we are going, but one we are creating. The paths are not to be found, but made. And the activity of making them changes both the maker and their destination - John Schaar, sociologist and professor emeritus, University of California Santa Cruz


[1] Veronesi, G., Kirkpatrick, I., & Vallascas, F. (2012). Clinicians In Management: Does It Make A Difference? Leeds University Business School. Retrieved from http://www.cihm.leeds.ac.uk/new/wp-content/uploads/2012/05/Clinicians-and-Boards.pdf

[2] Goodall, A. (2001). Physician-leaders and hospital performance: is there an association? The Institute for the Study of Labor (IZA) IZA  Discussion Paper; 5830 (July 2011) Bonn: IZA.

[3] Lees, P. (2017). The Enlightened Side. FMLM editorial. Retrieved from https://www.fmlm.ac.uk/news-opinion/the-enlightened-side

[4] Rooke, D. (2018). Transformational leadership capabilities for medical leaders. Harthill Consulting. Retrieved from https://bmjleader.bmj.com/content/2/1/3

[5] Francis R. Report of the Mid Staffordshire NHS Foundation Trust public inquiry: executive summary. London: TSO, (2013). Retrieved from https://www.gov.uk/government/publications/report-of-the-mid-staffordshire-nhs-foundation-trust-public-inquiry

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