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Leadership at an early stage of training – Dr Cristina Costache

Leadership at an early stage of training

by Dr Cristina Costache

Leadership is defined as an action or ability to lead, but the requirement for a specific age is never mentioned. How I came to stand for the role of chair of my Local Negotiating Committee is a different and long story, fit for a whole blog post, so I will only focus on the positives and challenges of being chair of the Local Negotiating Committee (LNC) of an NHS trust.

As a woman, an EU doctor (that had only been in this country for two years) and, most importantly, a Foundation Year 2 doctor (FY2),, – I was given this cape of LNC chair. I was granted the role of leading a group of doctors more senior than myself. Well supported by our Industrial Relations Officer and my Educational Supervisor, I started this journey expecting the worst, but hoping for the best. All this was alongside my day job, making the biggest step so far towards my career, and fiercely fighting for our profession.

Challenge #1: Hierarchy

It is difficult to keep your back straight and remind everyone that regardless of the hierarchy you may face within your day job, outside of it, you are the chair that glues the LNC together. You are the chair that has to find time in between on-calls, training interviews, exams and teaching. You are the chair that will sacrifice everything for her team and for the doctors that the LNC is looking after. The potential, the motivation, the strength and creativity can all be so easily be dimmed by someone slipping out the phrase, “just an FY2”. I used to say it too. I soon realised, though, that  leading is not about the level of training as a doctor, it is about courage and ability; ability to lead, research information, listen, observe and speak up. I was encouraged by the consultants I got to meet, the ones I had previously asked to take my position. I was also encouraged by my peers. Ultimately, I was encouraged by myself after my first few steps, as I realised that “I can and I will”.

Challenge #2: Criticism

With leadership positions you will be asked to give them up because “you are too junior”, “you need to be safe”, “you need to put your patients first and not burn yourself out” – but who is there to limit your potential? You are your only limit. Also, you are also responsible for your own self-awareness and, sometimes, the maximum that you can do might not be enough. That is alright; you are allowed to grow.

Despite all the criticism, I must mention how much I have grown in such a short period of time. Responsibility makes you organised, more aware and opens up the horizon of your thoughts: how to find the time for everyone for a meeting; how to reach out to everyone; how to approach the employer, sit in front of a table of senior doctors and lead a meeting; how to convince people not to quit by not giving up yourself; the kindness and encouragement with which I was greeted both in our Joint Negotiating Group and in our regional LNC forum; the inspirational people that I got to meet; the list of role models that keeps on growing.

Challenge #3: Failure

At some point, we will all fail. A leadership position can have two effects on your determination: you can either let the failures reduce it to zero, or you can allow the small successes to raise it and make it contagious. If you choose the latter, like I did, then your journey will always be upwards, no matter how many times you fall.

Challenge #4: Knowledge

Finally, you are not expected to know that much at the beginning, you can read, you can ask for help and support, just like in medicine. All that matters is your potential and the abilities that make you a good leader. Make sure you have aims, well-structured plans and that you don’t forget to review and re-review them periodically – there is always more than one solution to a problem and you might not see the best one from the start. Have self-awareness, believe in yourself – and believe in everyone around you!


Cristina Costache, Foundation Year 2 Doctor – Salisbury District Hospital, BMA Wessex Regional Junior Doctors’ Deputy Chair, Salisbury Local Negotiating Committee Chair, Salisbury BMA Junior Doctor Representative



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