Leadership Voices

Today’s Leaders, Not Tomorrow’s: Insights from the FMLM Medical Student Elective

Carl Kulimushi (The University of Manchester, Year 2) and Pettiann Bhoorasingh (King’s College London, Year 3) are medical student leaders active in student societies, advocacy, and health equity. They were awarded first prize at the ESLIH 2024 Conference (supported by FMLM) for their project “Redefining Care from the Bedside: The Impact of Patient Leadership”, later presented at the IHI/BMJ International Forum, Europe’s largest healthcare improvement conference. As part of their prize, they took part in the FMLM Medical Student Elective. This article shares their joint reflections from that experience.

“We will nurture and develop a new era of modern NHS leaders, able to lead systems and deliver better outcomes for patients, not just more activity.”  — Rt Hon Wes Streeting MP, NHS ConfedExpo 2025 

Pettian and Carl outside RCSE

Leadership in healthcare can’t be an optional extra. As the NHS enters a new chapter of change and challenge, leadership is being recognised as a skill every health professional needs, not just those in senior roles. But in practice, 'leadership' can still feel like a tick-box: vague, distant, and reserved for those with titles or years of experience. For students, it can feel even harder to access. But during a three-week medical student elective with the Faculty of Medical Leadership and Management (FMLM), we began to see things differently. We listened, observed, and reflected and came away with new questions about what leadership really looks like in medicine today. How can we move beyond the tick-box, not just as students, but as doctors, educators, and system leaders? 

Who are FMLM and What Do They Stand For?

The Faculty of Medical Leadership and Management (FMLM) is the UK’s professional home for clinical leadership. Through standards, fellowships, training, and thought leadership, FMLM supports clinicians at all levels to lead with integrity, vision, and impact. In a time where system-wide change is urgent, its mission is clear: to build a culture of values-driven leadership in healthcare. During the elective, we were introduced to the FMLM Leadership and Management Standards, a national framework of values and behaviours that align with the GMC’s Good Medical Practice. These four domains: self, team, organisation, system, offer a blueprint for clinical leadership across all stages of a career. What surprised us was how relevant they already felt. As students, we weren’t just learning about the framework, we were living parts of it.

  • Leadership of Self: Leadership begins with self-awareness. For us, that’s meant challenging imposter syndrome, developing reflective habits, and learning to lead with authenticity rather than performance. Through mentoring, public speaking, and feedback from peers and faculty, we’ve learned to navigate pressure while staying grounded in purpose.
  • Team Player / Leader: Across our universities, we’ve both led student societies and co-created events to raise awareness on topics like hypertension, mental health, and health inequities affecting African and Caribbean communities. These experiences taught us how to build coalitions, foster belonging, and bring others into shared purpose, not through authority, but collaboration.
  • Organisational Responsibility: Working directly with faculty and national bodies, we’ve had the chance to influence institutional culture. From inclusion-focused roles within our schools to internships with NHS England and Guy’s and St Thomas’, we’ve contributed to real initiatives tackling attainment gaps, representation, and communication in healthcare.
  • System Leadership: Beyond our own campuses, we’ve presented internationally at the IHI/BMJ Forum and helped connect student leaders across the UK through conferences and campaigns. These experiences reminded us that systems leadership doesn’t always come with a title, it starts with perspective, partnership, and a willingness to think beyond silos.

Each domain gave us a language for things we were already trying to practise. The real challenge is this: how are you living them: in yourself, your team, your organisation, your system?

Clinical Fellowships: Leadership in Action

One of the most transformative moments of this elective came from seeing what leadership looks like not in theory, but in action - through the Clinical Fellows we met. These are early-career doctors and healthcare professionals who’ve stepped out of the traditional clinical path, not to leave medicine behind, but to lead from new vantage points. Whether embedded in NHS England, Deloitte, the Department of Health and Social Care, or the CQC, their work spans strategy, innovation, policy, and regulation. But what struck us most was their mindset: bold, values-led, and system-aware.

Shadowing Dr Tafsir Ahmed at the Care Quality Commission brought this to life. We spent the day navigating conversations on AI in general practice, from policy shaping with PwC to myth-busting training for inspectors. It wasn’t a simulation - it was leadership in motion. And what we learned was simple but profound: clinical insight is powerful beyond the bedside. These fellowships aren’t sabbaticals from healthcare, they’re crucibles for the kind of leadership the NHS urgently needs. They reminded us that we don’t have to wait until CCT to influence systems. We can start shaping them now, with curiosity, responsibility, and purpose.

Lessons from the FMLM Board: Leading with Courage

Our conversations with members of the newly restructured FMLM Board were some of the most grounding parts of this elective. They weren’t polished presentations or distant lectures but real, human exchanges with people who’ve led through complexity, pressure, and change. Professor Jacky Hayden shared her view of leadership as “keeping the herd moving roughly west” - a reminder that leadership is less about control, and more about vision, direction, and trust. In her, we saw the calm discipline of someone who knows how to lead without dominating.

Professor Margaret Ikpoh spoke candidly about the challenges of leading during the pandemic, particularly as a Black female leader navigating visibility and vulnerability in parallel. Her reflections were honest and deeply resonant - leadership, in her view, is just as much about holding space for others as it is about making decisions. William Roche’s insights on moral courage, drawn from his experience during the Alder Hey organ retention scandal, offered a powerful example of what it means to speak up when it's not easy and to do so on behalf of others.

What united these leaders wasn’t a single style or formula. It was their integrity. Each brought their own lived experience and let it inform how they show up for others. These meetings reminded us that leadership isn’t a performance, it’s a practice. One built on values, resilience, and the willingness to stay present, even when the stakes are high.

Looking Ahead: Rethinking Leadership, Rewriting the Script

This elective didn’t give us a checklist. It gave us new language and new courage. We arrived thinking leadership was something you grew into with experience. We’re leaving knowing it’s something you practise - daily, imperfectly, and with purpose. It begins not with a title, but with a choice: to notice, to speak up, to challenge, to create. Leadership is about spotting the cracks in the system and deciding you won’t look away. It’s about staying rooted in your values, even when no one else says a word. And it’s about creating space so others can lead too.

We’ve seen that kind of leadership now. And we can’t unsee it. Whether in clinical care, advocacy, policy, tech, or education, the message is the same: the future of healthcare won’t be built by those waiting their turn. It will be shaped by those willing to start before they feel ready. So the real question isn’t whether you’re senior enough. It’s whether you're paying attention and what you're willing to do next. 

What will you notice, challenge, or create before you feel ready?