What’s my leadership style?

3 people high fashion clothing

Style

We are constantly bombarded by images of the rich and famous exuding style. As I’m writing this, your social media feeds and news websites are awash with the photographs of the great and the good attending the annual Met Gala fundraising fashion event in Manhattan. Many commentators will hail this as the epitome of style. “Fabulous!” “Extraordinary!” “Daring!” But there are also detractors. “Ridiculous!” “Decadent!” “The Emperor’s new clothes!”

Why does style matter? Why does it provoke such reactions? And, more to the point, what’s this got to do with medical leadership?

We’ll come back to these questions shortly, after a short diversion into the world of politics.

Charisma

A few days before the magical/preposterous Met Gala, (delete as appropriate), our weekend news was filled with politicians conducting the post-mortem/celebrating the latest round of election results, (delete as appropriate). One thing that they generally had in common was a desire to demonstrate that they had the upper hand. They want to show that they, rather than their opponents were the answer to the current challenges. A highlight/low-point, (delete as appropriate) came when one high profile interviewee dismissed a candidate for high office as being unsuitable for the role because they have “the charisma of a peanut!”

Why does charisma matter? How do you get it? What is it anyway? And – again – what’s this got to do with medical leadership?

On our various medical leadership courses, we often hear comments like “I want to develop my leadership style,” and, “I wish I had charisma.”

A question of style

When it comes to taking the lead and getting something done, we have choices in how we go about it. This idea of behavioural choice is well established in our language. “Different strokes for different folks.” “Each to their own.” “There are many ways to skin a cat!” But our choices are not always evident to us.

We inevitably learn from the leaders that we have worked with in the past. When it comes to leadership style, they are, in many ways, like the uber-celebrities on the Met Gala red carpet. We recall some unbelievable catastrophes and are pretty certain what behavioural choices we want to avoid. At the same time, we look back fondly on other leaders with admiration and aspire to copy their style. So, quite rightly, we intelligently try to approach leading people in the same way that they did.

However, our awareness is limited by our experience. Going back to common phrases, “All roads lead to Rome,” suggests you’ll get where you want to no matter what choice you make. Is that actually true? The fashionista’s don’t always dress the way that they do on the red carpet. They choose their style to suit the occassion. Sometimes that’s expensive couture. At other times, it’s a t-shirt and jeans. Good leadership requires adapting and using different styles in different situations.

“If all you’ve ever had is a hammer, then everything looks like a nail,” is a useful reminder that there may be ways to get things done that are beyond our experience or awareness. We’re not always aware of the range of “tools” or leadership styles that are available to us.

In clothing, we know that some people wear styles that we can’t imagine ourselves in. At other times we see new things we’d like to try – and we don’t always know what suits us best! So, it helps to step out of the bubble of our personal mindset from time to time and explore the possibilities.

Isn’t this focus on style a bit shallow?

Potentially, yes!

“Style” has many definitions – many of them related to appearance. If your leadership style choices are all about how things look, then – yes – that’s too shallow. And that’s a mistake many people make, particularly when seeking the intangible magic ingredient called “charisma.”

Leadership is about making things happen. When the focus is all about style, how things look and personality it’s unlikely to result in any sustainable change.

Style and substance

If we consider charisma as the “ability to gain and maintain people’s attention,” then that part becomes easier to grasp. We gain and maintain attention when we engage people in an idea that matters to them in a way that matters to them. Having a focus on what matters and what needs to change provides leadership substance. The choice is then: which leadership style to adopt to match the specific situation?

Leadership style and substance is a powerful combination.

What steps are you taking to ensure you keep your leadership fresh?

Stephen McGuire – Managing Director

NEW: Be an Effective Locum Doctor Online Course

Fingers putting last piece of jigsaw in place

After listening to the needs and interests of doctors attending our courses, we’re delighted to introduce the latest addition to our range:

Be an Effective Locum Doctor Online Course.

It’s accredited for 4 CPD points and is ideal for any doctor currently working as a locum or who is thinking about taking the plunge.

Develop you abilities. Maximise your potential.

We’ve also curated new Locum Doctor Development Collections of online courses to provide you with a broader and deeper learning experience at a package price.

Improving my patient communication skills – Dionne

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.


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.

My Academic Clinical Fellow ST Interview – Mel

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.


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.

My first 6 months as FY1 – Andrew

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.


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.

Experience of GPST paediatric rotation – Bhavik

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.


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.

My experience on the ST & CT Medical Interview Course – Mel

Dr Melanie Coulson

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

Melanie Coulson b+w

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!


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.

Apartheid and the NHS

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

Breasts and big blind-spots in medical education

Car rear view mirror

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

Starting a general surgery rotation – Ella

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.


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.