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The purpose of this paper is to explore the use of competences in medical education and training and to discuss some existing standards, curricula and competency frameworks used by the medical profession in both the UK and internationally to inform leadership development.

This research reinforces the message delivered by the medical profession and policy makers in recent years that all doctors should attain management and leadership competences in addition to clinical knowledge and skills to be an effective and safe practitioner. In the UK, this message and research has helped inform the development of a Medical Leadership Competency Framework (MLCF) published by The Academy of Medical Royal Colleges[1] and NHS Institute for Innovation and Improvement[2].

Widespread acceptance of the MLCF is now resulting in the integration of leadership and management competences into all undergraduate and postgraduate curricula.

Other countries with similar histories of low medical engagement in planning, delivery and transformation of services may also benefit from the research undertaken and the MLCF

The paper shows that the MLCF may well inspire more doctors in the future to seek formal leadership positions.

The purpose of this paper is to present an exploration of the leadership competencies developed by UK GPs through having undertaken international work and the ability to transfer these competencies back to the UK.

The approach taken is a cross-sectional survey.

A total of 439 UK-based, ranging from GP specialty trainees to retired GPs who had worked overseas, responded to an online survey of UK general practice and international work. Doctors were asked to report competency development through international work using the domains of the Medical Leadership Competency Framework (MLCF). The most common competencies developed, to a “moderate or significant” degree, related to “personal qualities” (89 per cent) and “working in teams” (87 per cent). To a lesser extent Doctors developed competencies in “setting direction” (60 per cent), “managing services” (59 per cent), and “service improvement” (56 per cent), and found these competencies harder to transfer back to the UK. A common reason for limited transfer of competency was the lack of leadership opportunities for Doctors when returning to UK locum roles. Overseas posts were more common in low/middle income countries, and these Doctors reported a greater range of leadership roles, including in health policy, management and teaching, compared to high-income countries. Most doctors felt that they were able to develop their clinical skills overseas whilst relatively few Doctors performed research, especially in high-income countries.

To the authors' knowledge this is the first cross-sectional survey exploring the international work of UK GPs and leadership development using the MLCF domains.

There is increasing recognition of the importance of incorporating medical leadership training into undergraduate medical curricula and this is now advocated by the General Medical Council (GMC) and supported through the development of the Undergraduate Medical Leadership Competency Framework (MLCF). However to date, few medical schools have done so in a systematic way and training/experience in medical leadership at undergraduate level is sporadic and often based on local enthusiasm. The purpose of this paper is to outline a theoretical curriculum to stimulate and support medical leadership development at undergraduate level.

This study describes a theoretical framework for incorporation of medical leadership training into undergraduate curricula using a spiral curriculum approach, linked to competences outlined in the Undergraduate Medical Leadership Competency Framework. The curriculum includes core training in medical leadership for all students within each year group with additional tiers of learning for students with a particular interest.

This curriculum includes theoretical and practical learning opportunities and it is designed to be deliverable within the existing teaching and National Health Service (NHS) structures. The engagement with local NHS organisations offers opportunities to broaden the university teaching faculty and also to streamline medical leadership development across undergraduate and postgraduate medical education.

This theoretical curriculum is generic and therefore adaptable to a variety of undergraduate medical courses. The combination of theoretical and practical learning opportunities within a leadership spiral curriculum is a novel and systematic approach to undergraduate medical leadership development.

Previously published studies about trainee perceptions of clinical leadership, although small in number, have not assessed the opinions of senior registrars nor established their awareness of the relevant leadership frameworks. The paper aims to discuss these issues.

Survey questions and interview questions were designed and a comparison of the relevant literature was performed. An online survey was sent via e-mail to a potential of 2,126 registrar trainees within the deanery and a series of semi-structured interviews (analysed via a content analysis) were conducted amongst voluntary subjects.

The response rate for the questionnaire was 247/2,126 (11.6 per cent). Respondents recognised the importance of leadership (90.4 per cent), professionalism (99.6 per cent) and promoted team-working (89.8 per cent). In total, 94.3 per cent of respondents have had ideas for improvement in their workplace; however, only 27.9 per cent have had their ideas for change implemented. Of the 85.5 per cent of trainees who are not aware of the leadership frameworks, 89.1 per cent performed leadership activities either daily or sometimes. The priorities of registrars did appear to differ between the junior and senior grades.

Registrar trainees have a desire to engage and a perceived ability to contribute to service improvement; however, a lack of encouragement, awareness and limited training opportunities serve to hamper the development of clinical leadership potential. This study presents itself as a pilot and will hopefully prompt a larger deanery study to gain a thorough assessment of all trainee perceptions, in order to improve the training programme and ultimately create a generation of consultants equipped to engage in clinical leadership throughout their lifelong career in the National Health Service.

Doctors are seen as key to embedding health improvement and patient safety initiatives and there has been much international debate over how best to engage doctors in healthcare leadership and management. This paper explores the current focus on leadership development programmes for doctors through taking a comparative approach to initiatives in New Zealand and the UK. It also considers the challenges to embedding leadership development programmes at all levels of training, education and continuing professional development and highlights some of the implications arising from the two approaches.

The purpose of this paper is to determine the impact of an integrated Medical Leadership Programme (MLP) on a cohort of participating specialty doctors and the NHS services with which they were engaged.

This was a qualitative study designed to obtain rich textual data on a novel training intervention. Semi-structured interviews were conducted with participating MLP trainees at fixed points throughout the programme in order to capture their experiences. Resulting data were triangulated with data from extant documentation, including trainees’ progress reports and summaries of achievements. Recurring discourses and themes were identified using a framework thematic analysis.

Evidence of the positive impact upon trainees and NHS services was identified, along with challenges. Evidence of impact across all the domains within the national Medical Leadership Competency Framework was also identified, including demonstrating personal qualities, working with others, managing services, improving services and setting direction.

Data were drawn from interviews with a small population of trainees undertaking a pilot MLP in a single deanery, so there are inevitable limitations for generalisability in the quantitative sense. Whilst the pilot trainees were a self-selected group, it was a group of mixed origin and ability.

The study has provided valuable lessons for the design of future leadership programmes aimed at doctors in training.

Identifying the effectiveness of an innovative model of delivery with regard to the Medical Leadership Curriculum may assist with medical staff engagement and support health service improvements to benefit patient care.

Medical leadership has attracted significant attention over the recent years as one of the factors that could potentially improve quality in healthcare. In response, various stakeholders in UK medical education have been looking into the most efficient ways of developing leadership among trainee doctors and invested in various courses and programmes. This paper aims to briefly set the theoretical basis for evaluating leadership development in postgraduate medical education.

Critical review of available theoretical and empirical literature and review of the content of a number of leadership and management development programmes available to postgraduate trainee doctors in the UK.

This review suggests that programme evaluation can be approached through four different “frames”: their pedagogical content, the conceptualisation and achievement of leadership, the contribution in quality improvement and the consideration of practical aspects that increase engagement and participation. On this basis empirical methodologies of evaluation can be developed.

The evaluation of leadership initiatives for medical trainees is an important task that has not been adequately addressed in the literature. This paper provides a theoretical approach to developing more robust methodologies of evaluation.

Although medical leadership and management (MLM) is increasingly being recognised as important to improving healthcare outcomes, little is understood about current training of medical students in MLM skills and behaviours in the UK. The paper aims to discuss these issues.

This qualitative study used validated structured interviews with expert faculty members from medical schools across the UK to ascertain MLM framework integration, teaching methods employed, evaluation methods and barriers to improvement.

Data were collected from 25 of the 33 UK medical schools (76 per cent response rate), with 23/25 reporting that MLM content is included in their curriculum. More medical schools assessed MLM competencies on admission than at any other time of the curriculum. Only 12 schools had evaluated MLM teaching at the time of data collection. The majority of medical schools reported barriers, including overfilled curricula and reluctance of staff to teach. Whilst 88 per cent of schools planned to increase MLM content over the next two years, there was a lack of consensus on proposed teaching content and methods.

There is widespread inclusion of MLM in UK medical schools’ curricula, despite the existence of barriers. This study identified substantial heterogeneity in MLM teaching and assessment methods which does not meet students’ desired modes of delivery. Examples of national undergraduate MLM teaching exist worldwide, and lessons can be taken from these.

This is the first national evaluation of MLM in undergraduate medical school curricula in the UK, highlighting continuing challenges with executing MLM content despite numerous frameworks and international examples of successful execution.