Leadership

The impact you have on yourself and the impact you have on people around you

Although it can be scary to take on a leadership role, it is an essential role of junior doctors and a great opportunity to develop your skills. The scenarios in which junior doctors frequently lead include the ward round, MDT discussions & teaching students. Never undervalue your role in these scenarios.

What it means to be a leader

The aim of a leader is to motivate a group to achieve a common goal. Rather than defining leadership, it is more helpful to understand what makes a good or effective leader. Becoming an effective leader takes time & all of us will try different styles of leadership to find the one that suits us best. The best way to understand these styles is to look at what senior colleagues do & adopt the practices which you feel are most effective.

An effective leader isn’t:

  • The font of all knowledge
  • The most experienced person in the team
  • Above the rest of the team

Rather, they are self-aware & demonstrate emotional intelligence to manage and motivate their team members. They are reliable and honest, allowing their team to have faith in their abilities. Finally, they are effective communicators and decision-makers allowing everyone to appreciate the path forward.

Common leadership scenarios as a junior doctor

  • Organising the handover list & leading the ward round as the junior, you are relied on by senior colleagues to guide them as to who/where the patients are and details of their problem list.
  • MDT Discussions – your role is to present the patient & coordinate the allied healthcare professionals towards common goals e.g. discharge planning 
  • First responder to cardiac arrest/ peri-arrest call – you may be the first clinician to see an acutely unwell or deteriorating patient. This is a golden opportunity for you to escalate whilst doing an initial assessment to identify severity & be able to present to seniors the issue at hand. 
  • Teaching medical students – you have a huge impact on how much students get out of a placement. Leading them to both assist you and learn at the same time is a difficult skill to master but an essential one.  
  • Quality improvement projects – take the opportunity to point out things that aren’t working well and your motivation to improve them. Your senior colleagues may not have realised the problem or had an opportunity to think about how to improve it. Leading a QIP is essential for maximum points on applications. 
  • Morbidity & Mortality meetings – as the junior, you will often prepare the cases for discussion at the M&M and guide the learning points. 

Local Leadership Opportunities

  • Mess President – organising events and facilities in the mess for junior doctors
  • Trainee Representative – liaising with seniors in the medical education team or trust to raise concerns from junior doctors. Usually, there is one for each grade.
  • Local Negotiating CommitteeLNC which is usually easy to get into for BMA members
  • “Champions/Leaders” – often in things like QI, antimicrobials, VTE, sepsis and other clinical activities. You’ll see them advertised in hospitals.
  • Sports captain – e.g. in your local university or hospital team. Could be a regional or national sport but usually, this is uncommon.
  • Society in Medical School – being part of the committee. Could be a regional or national society
  • Non-medical societies or charities – if you do some voluntary work for your local community or in creative arts

National or Regional Leadership Opportunities

Being an effective leader

Show an interest
It helps when you know your team members by name & that you understand their hobbies and/or plans for the weekend. It helps break the ice & helps you feel more comfortable approaching them. Bringing in baked goods really helps get the conversation flowing!

Socialise with team members
Getting coffee/lunch together, or organising socials after work, provides an opportunity to help you all get to know each other. This can help you be more effective as a team and understand where each other are coming from.

Be courteous & supportive
Look out for your colleagues & recognise their contributions. Being appreciative goes a long way & recognising that a colleague might be struggling & helping them goes even further. Aim to always have a debrief after difficult situations or unwell patients, as spending time on reflection can be cathartic but also a great learning opportunity. Remember that you are working with your multidisciplinary team, therefore reminding them that you’re all working towards providing the best care for your patient can be really effective.

Ensure you ask for help & be responsible
Remember you are not expected to know everything, but instead support and motivate people. As long as you take the time to listen and help colleagues, they will respect you as a leader. Never be afraid to call on people to help you – this is much better than making a mistake.

Avoid arrogance & being overly critical
This will get you in trouble or mark you out as someone irritating to work with. The result is people are not motivated to listen to you or help you. Here is further advice on how to manage difficult colleagues and what to do when you disagree with them – however, the key is to be diplomatic.

Avoid micromanaging
It is easy to want to control everything to ensure it gets done to the standard you want. However, this quickly leads to burnout and will annoy your colleagues. Giving them space to work in their own way is important, but ensure you are present should they need support. More importantly, provide them with some responsibility under supervision so they can grow: allowing students to clerk patients, allowing your F1 to assess an unwell patient etc.

Ensure you delegate well
Consider the skills and motivation of your team, but also their personal workload and their development needs. When delegating you are not getting rid of work, but providing an opportunity for team members to develop their skills and learn. As the leader, it is important you provide oversight and that you support those with difficulties.

Final take-home messages

  • Communication is key!
  • Build trust through honesty, being supportive and setting an example
  • Remember never to underestimate your role as a leader (just because you’re junior)
  • Take every opportunity you can to take on leadership roles during foundation training and develop your skills. Your leadership responsibilities will increase as you become more senior and you should be pro-active in trying to be the most effective leader you can be, whatever stage of training you are.

Further Reading

Written by Dr Jennifer Wallace (SHO), Dr Adam Foster (FY1) & Dr Akash Doshi (ST4)

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