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Women remain under-represented in leadership positions in both clinical medicine and medical education, despite a rapid increase in the proportion of women in the medical profession. This chapter explores potential reasons for this under-representation and how it can be ameliorated, drawing on a range of international literatures, theories and practices. We consider both the ‘demand’ for and ‘supply’ of women as leaders, by examining: how evolving theories of leadership help to explain women’s’ leadership roles and opportunities, how employment patterns theory and gender schemas help to explain women’s career choices, how women aspiring to leadership can be affected by the ‘glass ceiling’ and the ‘glass cliff’ and the importance of professional development and mentoring initiatives. We conclude that high-level national strategies will need to be reinforced by real shifts in culture and structures before women and men are equally valued for their leadership and followership contributions in medicine and medical education.

The purpose of this paper is to investigate perceptions towards a career in psychiatry among medical students and psychiatrists and identify how recruitment into the specialty may be improved.

This study locally compares medical student and psychiatric doctor responses to a structured online survey and structured interviews with key managerial figures in the Humber NHS Foundation Trust.

Comparison across two main areas (pre-decision exposure to psychiatry and reasons for considering a psychiatric career) found that both students and doctors were influenced to make a choice about a career in psychiatry during medical school. Medical students found compatibility with family life to be more important when considering psychiatry, whereas doctors cited content-based reasons as significant pull factors. Stigma and fear of being harmed deterred some students from choosing a career in psychiatry. Structured interview responses reiterated the importance of pre-medical school and undergraduate mentorship in bolstering future recruitment to psychiatry.

Medical students perceive certain career issues differently to their postgraduate counterparts. Widening the content-based appeal of psychiatry and optimising the medical school experience of the specialty via varied and high-quality placements may be a key step towards tackling the national shortfall in qualified psychiatrists.

This is the first published study comparing medical student and psychiatric doctor perceptions of a career in psychiatry.

The purpose of this paper is to investigate whether, or to what extent, the audit society influences the professional context of Swedish pre‐hospital care.

Data were collected through an in‐depth case study of public supervision within ambulance services in Sweden. A three‐dimensional framework departing from three analytical concepts (knowledge base, formal organization and operational process) was used as a tool for further analysis of the field material.

The paper describes ambulance services under the pressure of frequent audits in a context where the knowledge base of ambulatory work was contested. While some have argued this would make it more receptive to an audit culture, the relational distance between the auditor and the auditees was high, which should indicate the opposite.

The paper explores the audit society and its processes. In this particular case, it could be argued that the impact of an audit culture on professional activities was moderated by the dissociated approach of the auditing team.

Like the Pied Piper, Jamie Oliver ‐ followed by a growing throng of parents and teachers ‐ has forced government action and purse‐strings to raise the financing and therefore the quality of school meals in England. With £280m of new money, it looks as though at last, and at least, children will take in some nutritious food in the course of their young lives. But the reasons for and challenges presented by childhood obesity are multi‐factorial and demand a multi‐disciplinary response. This article considers the various causes of the rise in childhood obesity, and looks at past and planned initiatives aimed at tackling it. It also looks ahead to the potential for future developments that might take the baton carved by Jamie Oliver and pass it on through a range of services.

The rising cost of US health care has precipitated some close examination as to the supply, distribution, and specialty choice of the physician workforce. It is an issue of considerable concern as America struggles to control health‐care expenditures by shifting resources away from specialty medicine. Central to this problem are the various programmes and incentives which have encouraged an excess number of residency positions and specialty training. Examines the consequences of an unregulated medical school structure and provides an overview of current policy alternatives designed to increase the number of primary care physicians, correct the problems of physician maldistribution, and limit the overall number of medical school graduates.

Since 1973, the pharmacy operations division of the Kaiser Permanente Medical Care Program (KPMCP) has used long-term action research programs as the principal method for orchestrating change. This chapter covers the evolution of action research theory within large, complex organizations, with particular attention to health care organizations. Four case examples from KPMCP are discussed in depth and mapped to the recently advanced Roth model of insider action research. This model considers external and internal business context, the perceived need to create new organizational capabilities, as well as insider action research theory and learning mechanisms used in change programs. Issues posed by the Roth model are explored, and new theory is advanced regarding the need for a long-term perspective, the advantages and difficulties posed when managers act as insider action researchers, and the quality of data gathering that takes place during insider action research change programs.

The purpose of this paper is to examine how conflicts about collaboration between staff at different departments arose during the establishment of a new emergency department and how these conflicts affected the daily work and ultimately patient safety at the emergency department.

This qualitative single case study draws on qualitative semi-structured interviews and participant observation. The theoretical concepts “availability” and “receptiveness” as antecedents for collaboration will be applied in the analysis.

Close collaboration between departments was an essential precondition for the functioning of the new emergency department. The study shows how a lack of antecedents for collaboration affected the working relation and communication between employees and departments, which spurred negative feelings and reproduced conflicts. This situation was seen as a potential threat for the safety of the emergency patients.

This study presents a single case study, at a specific point in time, and should be used as an illustrative example of how contextual and situational factors affect the working environment and through that patient safety.

Few studies provide an in-depth investigation of what actually takes place when collaboration between professional groups goes wrong and escalates, and how problems in collaboration may affect patient safety.

Since the 1980s, governments worldwide have been implementing the move from cash to accrual accounting. Scholars initially considered the appropriateness of this accounting reform to be self-evident, but later they have expressed critical views. This paper systematises the existing literature intending to reflect on the adverse effects of adopting accrual accounting in the public sector and identify implications for future research.

The present study builds on a systematic literature review of 106 academic articles published between 1980 and 2021. It is based on the “preferred reporting items for systematic reviews and meta-analyses” (PRISMA) method. Synthesising research through a transparent, rigorous and replicable process makes it possible to identify and discuss the adverse effects of adopting public sector accrual accounting.

Significant issues are linked to organisational impacts and accountability. Resistance to change is the main negative consequence and is more likely in countries that have chosen to adopt accrual accounting without maintaining cash accounting. The new accounting rules make accounting information more complex and arbitrary for citizens and politicians. How these criticalities should be addressed deserves further investigation.

This paper offers a comprehensive literature review on the drawbacks of adopting accrual accounting in the public sector. It could provide a general lesson to be applied to policymakers of other jurisdictions currently considering this transition to prevent the adverse effects and act proactively.