What I learnt this week: Intentional Leadership is just Management #WILTW

This is the 90th #WILTW

Health Education East Midlands have recently reconfigured their leadership and management programme for trainees and I assist on delivering some of the curriculum. I generally present the Quality Improvement workshop but was assisting with the Transition to Consultant/GP session this week.

The half-day is framed in understanding leadership, resilience, appraisal and mentoring. I must admit ‘lecturing’ on leadership is something I find very uncomfortable and I am often honest to the participants about this. As a trainee I really brought into the rapidly developing leadership zeitgeist. Numerous events, courses and organisations made you feel as if you really ‘got’ leadership and were part of a vanguard of doctors who wouldn’t make the mistakes previous generations had.

I then went through a phase of thinking the whole thing was a lot of rubbish. “The leadership lie” was a phrase I would use to describe the dissonance between what was taught and what could actually be delivered. My main concern was that a body of experience is needed to not only apply, but probably and more importantly, understand how leadership skills are utilised in the workplace. That’s not to say that early learning isn’t invaluable. In fact there is a real argument for introducing leadership and management concepts in the first year of medical school. But that bringing together a small group of trainees and delivering what is in essence an audit does not then mean you can successful lead a change initiative in a multi-disciplinary setting across a hospital department.


I have since mellowed and actually some of the experiences I had as a trainee, in particular chairing large meetings, have been utterly invaluable to me as a consultant. But am I definitely left with a sense that much of what I do, which some may describe as leadership, is unconsciousness. Body language in tense meetings, phraseology when making referrals, quick corridor conversations when hospital capacity is at a premium may all result in improved outcomes but are never intentional. Setting agenda items, process mapping, allocating responsibilities – these are the conscious management task that take place day in and day out. While I accept that there are domains to leadership my day-to-day observation is that many traits are implicit so the moment we start thinking about being a ‘leader’ we might actually be doing anything but.

What have you learnt this week? #WILTW

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