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Leadership is not a box to be ticked – Dr Emma Coombe

Leadership is not a box to be ticked

by Dr Emma Coombe

If you’re reading this blog, you probably already realise the importance of clinical leadership for your current and future practice as a healthcare student or professional. However, those writing undergraduate curricula and postgraduate training programmes are only just catching up with this training need. This can leave you in the challenging position as a newly qualified clinician of having to ‘learn’ leadership in a very self-directed manner: a bewildering task when faced with the simultaneous challenges of learning the ropes of clinical practice.

When I was newly qualified it seemed to me that you had to bag yourself a job as some kind of fellow (be that leadership, quality improvement, or education), be a representative sitting on a committee, or acquire some other formal role in order to develop leadership skills and demonstrate competency. Seven years since graduating, I have now learned that leadership and opportunities to learn how to lead are all around us in our day to day work as clinicians. Leadership is every day – not a box to be ticked.

Here are my practical tips for learning leadership.


Be curious. Read about how systems are structured within the NHS and beyond. Read about change management theory in healthcare. Develop your knowledge of quality improvement methodology. There is a language to leadership that can give it an air of exclusivity and learning this language can open the door to further opportunities to develop your skills. Imposter syndrome is rife amongst new clinicians and the same challenges apply to those learning to lead. Doing your homework will boost your confidence as well as your credibility. The King’s Fund is an excellent place to start as well as the NHS Leadership Academy and The Institute for Healthcare Improvement.


People are always flattered by someone who takes an interest in their work and the same is true of clinical leaders. Many of a clinical leader’s responsibilities may not be helpful for your professional development so you might have to wait for or seek the right opportunity. Ask for an appointment with the clinical leader nearest to you in your job role. Ask them to explain the specifics of their responsibilities and then ascertain when might be a good chance to shadow them to see them in action. Leave your tribal instincts behind and explore the leadership structure of another professional group too.


Balancing learning about leadership on top of clinical work can be challenging, but being well organised enables you to say yes to as many opportunities as possible that may come your way. Be careful not to take on too much and risk burning out. Take every chance to use study or professional leave to access learning opportunities; for most clinicians it is a requirement of their professional development and therefore can legitimately be done in work time.


Learning to lead requires some looking inwards as well as observing and reflecting on the behaviours of others. Many tools exist to help you examine your own preferences, tendencies, strengths and weaknesses. Take some time to get to know yourself and think about how your characteristics as an individual might affect the way you lead or work within a team. Your 360 degree feedback can be a good place to start. The importance of reflection is drummed into us as clinicians, but don’t be afraid to go back to basics and revisit how to reflect with meaning. Professor Judy McKimm provides a good summary. This works well when you have built up some specific concrete experiences on which to reflect.


Good clinical leaders will always be willing to help grow the next generation, but let me be clear, by networking I do not mean schmoozing or sucking up. Don’t be afraid to let people know you are interested in leadership. Demonstrate your enthusiasm within your department and wider organisation, and before you know it people will be tapping you on the shoulder with your next opportunity. I’ve found that often opening one door can lead to a series of others.

Try and develop networks both locally and virtually and find yourself a mentor and/or coach. You can do this through formal networks if they exist where you work, but if they don’t, don’t be afraid to ask a colleague to be your mentor, if they say no, or they are too busy, ask if they know anyone who might be able to help.

My last word

In learning to lead you will have successes and failures, and sometimes it can be difficult to know which the best course of action is. My last piece of advice is to never forget the reason why you went into healthcare in the first place. If you always bring everything back to putting the patient first, you can never go too far wrong.

Dr Emma Coombe is a Paediatric specialty trainee in Severn, BMA junior doctors representative at University Hospitals Bristol, and trainee representative to the Royal College of Paediatrics and Child Health.



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