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In this short video, Dionne, who is a 5th year medical school student and a member of Oxford Medical’s Junior Doctor Panel, shares how she has been working to improve her patient communication skills.

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Our Junior Doctor Panel is a small group of medical students and junior doctors working in different roles who share their experiences with us. In return, we support them with their development. Click here to find out more about the Junior Doctor Panel.

The course which Dionne refers to in her video is our Advancing Patient Communication Skills Online Course.

We offer our instant-access, self-guided online courses to Medical Students at 50% off the standard price via our Kickstarter for Undergraduates offer.

Mel, FY3 and member of our Junior Doctor Panel, shares her experience of her recent ST medical interview for an Academic Clinical Fellow post. This includes the steps she took to prepare and, looking back, what helped her the most.

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Our Junior Doctor Panel is a small group of medical students and junior doctors working in different roles who share their experiences with us. In return, we support them with their development. Click here to find out more.

And if you want to find out more about our interview preparation courses for imt, ct or st posts, click here.

Oxford Medical Junior Doctor Panel member, Andrew, reflects on his first 6 months as an FY1. He considers the cultural differences between the surgical and medical specialties he’s experienced, the different types of people he’s encountered and his key learning points. Along the way, he also talks about the benefit of choosing a programme where both Foundation Years are planned to be at one single hospital and how he aims to gain the maximum benefit from his training.

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Our Junior Doctor Panel is a small group of medical students and junior doctors working in different roles who share their experiences with us. In return, we support them with their development. Click here to find out more.

In this video, Bhavik, who is a GPST and member of our Junior Doctor Panel, shares his experiences and some key points he has learned from his rotation placement in paediatrics. He considers the specific challenges of the post, what has helped him most, how he has helped himself and, going forward, how he can use what he has learned.

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Our Junior Doctor Panel is a small group of medical students and junior doctors working in different roles who share their experiences with us. In return, we support them with their development. Click here to find out more.

Dr Melanie Coulson

Melanie is an FY3 Clinical Education Fellow and member of our Oxford Medical Junior Doctor Panel.

I decided to attend the Oxford Medical ST & CT Medical Interview Course to improve my interview techniques in preparation for future medical job interviews, which I am aware are becoming increasingly competitive! I hoped it would improve both my interview knowledge and confidence and allow me to really sell myself and draw on my relevant experiences so far.

As soon as I signed up, I received access to a useful online course to complete in my own time which I could revisit as needed. The online material was structured to provide me with likely components within a training interview. This included information on interview processes, what to include when discussing my own experiences, selling my skill set, and NHS ‘hot topics’. The material sent to me also included a list of practice questions that I could use in my own time.

The 1-day online ‘virtual classroom’ consisted of a morning and an afternoon session. The morning session focused on interview techniques and how to approach and answer different interview questions. There was the opportunity to discuss powerful and relevant answers we could each personally give at our interviews. Discussing these answers allowed me to appreciate that preparing for interviews is very different from preparing for summative exams. The course lead gave us tailored feedback as to how to ensure our answers would achieve the highest marks, both in terms of content and delivery. There were also tips given regarding verbal and non-verbal communication- I found these especially useful when considering how to present myself best on screen for an online interview.

In the afternoon, we were given the opportunity to each receive a short mock interview with REAL previous interview questions and mark schemes. This mock interview provided an accurate simulation of how an online formal interview may be conducted but within a safe environment. The mock was done in front of the rest of the group and therefore also presented an opportunity to give and receive feedback from each other in a constructive manner. This was valuable to me because it allowed me to learn from others’ approaches. I was surprised when watching the other attendees being interviewed at how much I picked up that I could apply/avoid if I am attending an interview in the future.

The whole experience was thorough, well organised, and appropriately pitched. The online ‘virtual classroom’ day was a great opportunity for a small group ‘coaching session’. It was enthusiastically led by an experienced and knowledgeable consultant, who guided us and provided personalised feedback throughout the day. The other attendees were also doctors in training hoping to improve their interview skills.

In general, I believe that most junior doctors have had limited interview exposure, because many foundation programme job allocation processes do not include interviews. Often training programme interviews are the first time many doctors have had to compete at an interview stage since applying for medical school. And these are often highly competitive with high applicant-to-vacancy ratios!

This course improved my interview confidence and hopefully will improve my skills to present myself at my best. I can highly recommend this for anyone with upcoming specialty interviews who wants to excel in the interview process!

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Melanie is a member of our Junior Doctor Panel, a small group of medical students and junior doctors working in different roles who share their experiences with us and with you via blog-posts and webcasts which we include on our website and social media accounts. In return, we support them with their development. Click here to find out more about the Junior Doctor Panel.

What’s the link between South Africa’s shift from apartheid to democracy and cultural change in the NHS? The UK’s parliamentary and health service ombudsman, Rob Behrens, thinks the latter is not only essential, but is actually the easier of the two challenges.

How would he know? Well, in his recent BMJ interview, he compares his experience of being the highest level independent adjudicator for problems in our healthcare system with his earlier career challenge as a UK representative, supporting South Africa’s fundamental transformation.

Hard hitting observations

Behrens doesn’t hold back in sharing his thoughts on the problems facing the NHS. The sub-heading of the BMJ feature states: “A toxic culture of defensiveness and hostility pervades the NHS, and despite many patient safety reviews nothing has fundamentally changed.”

That should make everyone pause, sit up and take notice. Yet, the seemingly endless stream of reports which arise as the output of inquiries into major failures typically lead to dismay, shaking of heads and wringing of hands – but not to change.

Throughout the interview, Behrins goes well beyond the headline of failure to learn from previous problems. He casts the spotlight on hostility and tribalism among clinicians, along with defensiveness and failure to listen to patients and their families. “This leads to a perception that organisational reputation and professional reputation are more important than patient safety. And that is very dangerous.”

It’s important to note that he also to the high-stress impacts of the pandemic, workforce shortages and the further problems related to current industrial action. He observes how these considerable pressures have contributed to an embattled attitude of “bunker-ism”. “I understand that everyone has a massively busy job, that ministers, managers, and clinicians are doing the best that they can. But that doesn’t alter the fact that there are things that are fundamentally wrong that need to be tackled.”

It would be easy to let these comments add to the gloom around the state of our NHS.

The way forward

Thankfully, the ombudsman consistently returns to his theme, that the changes required are merely difficult – not impossible. But this requires attitudinal change with dedicated effort. He summarises the required shift in mindset as being “a disposition to learn rather than just to move on.” This paradigm shift has implications for both leadership and medical education.

“The key thing about leadership is empowering the people who work for you to do the things that need to be done. You can’t do it on your own. You can’t be a general without an army. You have to make sure that your people are with you…”

Medical education must go beyond simply teaching the natural sciences and technical procedures. It must also include the multi-faceted social-scientific aspects of being a doctor. How to have difficult conversations in a constructive manner. How to engage colleagues to recognise and accept shortcomings, whether that be of the system, the team or as individuals. How to plan and achieve real, sustainable change. These abilities are essential at all levels, from front-line junior doctors, through to senior management and to politicians.

Overall, Rob Behrens’ interview is a message of hope, encouragement – and challenge.

What steps are you taking to being part of the solution and the way forward for the NHS?

Stephen McGuire – Managing Director

During our Teach the Teacher Courses, we regularly explore the concept of unconscious-incompetence: the situations where we don’t know what we don’t know. An unconsciously-incompetent doctor comes with potentially serious risks. The risks created by shortfalls in knowledge, skill or attitude could be to patient safety, to team-members wellbeing or even endangerment to the doctor themselves.

The most obvious reason for unconscious-incompetence is lack of experience. We’re all on our personal, unique learning curve. There might be something we’ve never been told or shown; some facts and concepts we’ve never connected; a situation we’ve never encountered. But sometimes, it’s a result of our forgetting curve. This is where we lose skills and knowledge through lack of use. In addition, bad habits can easily creep in over time without us being aware.

Whatever’s at the root of our incompetence, something needs to happen to bring it to our attention. That’s an essential step in prompting us to take action. Something has to go wrong. We have to make a mistake. But, even when something does happen, our incompetence blind-spot can mean we don’t notice the problem. We need someone else to point the issue out to us. This will often be the person who is acting in some way or other as our teacher.

But what if the person who is unconsciously-incompetent is the teacher? All sorts of power dynamics now come into play. Who’s brave enough to stand up and challenge the teacher?

Step up Joy Hodkinson

Joy is a foundation doctor who has had a letter published in the BMJ. “Medicine is blind to body diversity – and it’s limiting doctors’ examination skills” is essential reading for anyone involved in medical education. In her letter, Joy eloquently relays her experience as a volunteer patient on an ultrasound course. She describes her disappointment at being kept away from the cardiac stations, which she was keen to experience, with the explanation that “breasts make it harder to visualise the heart”.

The absurdity of this approach in teaching doctors how to competently perform an echocardiogram examination should be obvious. Joy explains her concerns in detail, how avoidance of embarrassment and awkwardness has real impacts on patient care.

…if medical students are not taught how to examine women then, by definition, our cases do become more “difficult.” The exclusion of women from clinical teaching vignettes is perpetuated, and sexism masquerades as pragmatism.

Joy Hodkinson, BMJ 2023;383:p2591

It’s important to note that Joy spreads the spotlight beyond her own personal feelings and the impacts of medical education shortcomings with regard to female patients. Among other shortcomings, she describes the experience of her male peers being pushed into removing their shirts in front of others to enable fellow students learning. She also mentions limitations on the level of attention given to disability, body size and race.

Better experiences

Thankfully, Joy also relates a positive example of medical education and offers constructive ideas for the way forward.

A genital examination has high potential for embarrassment for both patient and the inexperienced doctor. But Joy describes how the care and support of her facilitators at a teaching session on the skill helped to build her confidence in performing this delicate task.

She recommends teachers taking the same approach to teaching physical examinations as they do for teaching communication skills. That physical techniques needs to shift from being taught as linear processes to being applied in an engaged, responsive and caring manner for patients of all types.

In recent times, it’s becoming increasingly clear that medical education has been too focused on “able bodied, white, heterosexual, slim, middled-aged cis-gendered” men. They only form a small proportion of the patients that a doctor encounters in an average day.

So, well done and thank you Joy for speaking up and making a significant contribution to the discussion.

What steps are you taking to ensure your medical teaching is eliminating the blind spots?

Stephen McGuire – Managing Director

Ella, FY1 doctor and member of our Junior Doctor Panel, shares her experiences of changing from geriatrics to a general surgery rotation. Ella considers what is been like to change to a new team, the differences between working in the two disciplines, the new challenges she’s facing and what can help.

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Our Junior Doctor Panel is a small group of medical students and junior doctors working in different roles who share their experiences with us. In return, we support them with their development. Click here to find out more.

By Dr Melanie Coulson

Melanie is an FY3 Clinical Education Fellow and member of our Oxford Medical Junior Doctor Panel.

Why did I do the course?

I signed up for the 1-day Teach the Teacher: Mentoring Skills for Doctors course to improve my 1-to-1 teaching and mentoring skills. In particular, I was hoping this course would allow me to improve my knowledge of models used when mentoring and then techniques of how to approach situations when I am in a mentor role. I was eager to learn practicalities such as these, as they would then equip me with improved communication skills to explore ideas and concerns my mentees have. I also hoped that this course would provide me with insight into improving my leadership skills.

What did the course involve?

The course package included the Mentoring Skills for Doctors Online Course followed by the one full day of teaching.

The online course was composed of 15 short modules. These were available to use in my own time and I found it useful to revisit these as needed. The online modules included easy to follow videos, animations and reading. Alongside the online modules, there was an optional workbook which was useful to aid reflection on my current teaching and mentoring practice. I am sure these reflections will be useful to read again in the future.

Following this, the online training day was facilitated by ‘an expert’. There was a small group of us who were all doctors who attended. On my training day, the group included an FY2, clinical fellows, psychiatric trainees and senior clinical fellows. The session introduced ideas and practices that we could take forward for use when mentoring. We were given opportunities to practice conversations and techniques on other course delegates within online break out rooms and then discussed any difficulties we were finding as we went along.

What have I learned that I will carry forward into future practice?

I found the combined learning experience gained from both the online course and the training day to have provided several new ideas for how I can support the people I teach.

It was useful during the course to consider the roles we take and their definitions, such as defining the differences between a ‘coach’, a ‘mentor’ and a ‘teacher’. Although my teaching philosophy continues to develop, I have not previously reflected on the specific role that mentoring plays within my teaching. I now therefore have greater insight into the role I take and the impact that it has.

This course encouraged me to self-reflect and consider my practice within the process of mentoring, including how I listen, how I respond to mentee problems/comments and consequently how I then support my mentee to think independently. Considering myself a ‘resource’ for them to learn from will be useful. Using given mnemonics, such as the GROW coaching model, will be one of the ways I will use the course content going forward in my practice. It is this appreciation of the balance of facilitation and encouraging the ‘Growth Mindset’ within myself and my students, that will result in the best outcomes for my future mentees.

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Melanie is a member of our Junior Doctor Panel, a small group of medical students and junior doctors working in different roles who share their experiences with us and with you via blog-posts and webcasts which we include on our website and social media accounts. In return, we support them with their development. Click here to find out more about the Junior Doctor Panel.

By Jacqueline Baxter: Professor of Public Leadership and Management at the Open University UK and Oxford Medical Tutor.

Introversion and extroversion are personality traits that influence how individuals interact with the world. Traits of extroversion and introversion, first introduced by the famous psychologist Carl Jung, are generally characterised by garrulous outgoing and energetic behaviours in extroverts, whereas introverted characters are more likely to be calm, reflective and often prefer the written to the spoken medium.

In the medical profession, leadership roles often require effective communication, collaboration, and decision-making, which are traits commonly associated with extroversion. This has led to a perception that extroverts are more naturally suited for leadership positions not only in the medical field, but across the board. Having worked with doctors for the last 20 years, I have noticed that many of them are introverted in nature, and this can be challenging for them when it comes to stepping up for , or being appointed to leadership roles.

One reason why there may be fewer introverted medical leaders is the nature of medical education and training. Medical schools often emphasize teamwork, communication, and the ability to think on one’s feet—all qualities more closely aligned with extroversion  The rigorous and highly interactive nature of medical training can inadvertently favour extroverted individuals, shaping the leadership landscape in the profession.

In leadership roles within healthcare, there is often a need for assertiveness, networking, and external communication. These requirements may be challenging for introverts, who may prefer more introspective and contemplative approaches to problem-solving. The demands of engaging with diverse stakeholders, from patients to administrative staff, can be mentally draining for introverted leaders, potentially discouraging them from pursuing or thriving in such roles.

However, it’s essential to recognize that introversion does not equate to a lack of leadership skills. Introverts bring valuable qualities to the table, such as deep listening, thoughtful decision-making, and a focus on individualized attention. In a profession where patient-centered care is paramount, these introverted traits can be highly beneficial.

The underrepresentation of introverted medical leaders has implications for the overall dynamics of medical teams and organizational culture. A more diverse leadership team, which includes both introverted and extroverted individuals, could contribute to a richer and more balanced decision-making process. The integration of different communication styles and problem-solving approaches can enhance the overall effectiveness of trusts.

To address this imbalance, medical institutions need to look to implement leadership development programs that cater to diverse personality types. These programs could include training on effective communication for introverts, strategies for networking and relationship-building, and mentorship opportunities tailored to introverted individuals. By recognizing and nurturing the leadership potential of introverts, the medical profession can create a more inclusive and dynamic environment. Recognizing and valuing the unique strengths that introverts bring to the table is crucial for creating a healthcare system that effectively meets the needs of both healthcare professionals and the patients they serve.

Jacqueline Baxter is Professor of Public Leadership and Management at the Open University UK and has worked with Oxford Medical since 2009. Her research interests lie in personality and leadership, and how leaders use strategy development as a learning activity.