Medical students are trained in the intricacies of patient care, chronic disease, infections, diagnosis skills, and much, much more. Leadership skills, however, have never been on that list. They should be. To survive and thrive as a physician today, one must know how to lead patient care teams, advocate for care improvements with administration and be engaged in decision making at the healthcare system level. Leadership allows for physicians to advocate and have a seat to advance systemic change. To have a career in medicine without leadership skills is to operate a machine without oil.
Project-Based Learning for Leadership
The need for leadership training for medical students was perhaps best captured in a speech delivered by Dr. Alisha Moreland-Capuia at Accelerating Change in Medical Education, at a student-led Conference on Leadership during the summer of 2017. She is the Executive Director of Avel Gordly Center for Healing and Assistant Professor of Psychiatry at Oregon Health and Science University and said, “It behooves every academic institution to tap into the leadership capacity of each and every one of its medical students because the return on investment is great.” She knows whereof she speaks.
Moreland-Capuia showed her leadership skills early in medical school. While a fourth-year resident, she developed a violence intervention program for hospitals called Healing Hurt People Portland. The program was developed in collaboration with hospitals, county, and state governments. The program coaches young men of color to turn their lives around after they have been stabbed or shot.
“To develop this program as a fourth-year resident, to be given the time, that’s true project-based learning,” Dr. Moreland-Capuia said.
Stanford Medical School agrees with the good doctor. It offers a program that facilitates project-based learning called Leadership Education for Aspiring Physicians (LEAP). The goal of the program is to serve premed students who are “seeking structured leadership development while improving community health and wellness”. Participants develop community projects that can improve health outcomes. The final project “emphasizes health leadership in the domains of service, advocacy, and/or research”.
Universities Teach Leadership
Other universities have embedded leadership training into their curriculum as well. The University of Michigan Medical School wants to give physicians leadership skills so they can succeed in all practice environments.
The school’s Leadership Program web page says, “Our innovative curriculum embeds and integrates leadership training during the entire medical school experience with the goal of preparing students to influence positive change.”
The school’s Associate Dean for Medical Student Education, Rajesh S. Mangrulkar, MD, said in an article in the American Medical Association newsletter, “Leadership is for everyone who graduates. We are not talking about titles and roles. We are talking about a way of being with other people and a way of enacting change.”
Harvard Medical School offers a course called “The Physician as Leader”. According to the syllabus, the course is offered because “The roles of health professionals are evolving rapidly; there is now a greater need than ever for physicians to function effectively in complex organizations.”
The class teaches many different leadership-oriented themes, among them leadership, innovation, and entrepreneurship. Among the skills students learn are:
- How systems and organizations work and how to make them work better
- How to work effectively within and lead complex organizations and teams of healthcare providers
- How to understand and influence group behavior and performance
New York School of Medicine, Conflict Resolution Workshop: A six-hour case-based program that teaches participants to be more aware of their own conflict style and the style of others. Participants learn to assess conflict situations and employ various dynamics to manage them.
University of Pittsburgh Schools of the Health Sciences, Women in Medicine & Science reception: The annual reception gives junior women faculty, fellows, and graduate students the opportunity to “network and interact with successful female role models to facilitate their academic career success, satisfaction, and advancement.”
University of Wisconsin School of Medicine and Public Health: Clinical Investigator Preparatory Program (CIPP): Funded by the National Institutes of Health (K30 Award), the program develops investigators who will lead successful clinical research programs. It provides investigators “protected time, mentoring, and knowledge and skills that will guide academic success”.
What Factors Teach Leadership?
At Michigan it involves action-based learning that teaches future physician five competencies:
- Leading yourself
- Communicating and influencing
- Building teams
- Executing and problem-solving
- Impacting systems
Specific activities include:
- Large-group events
- Case-based learning
- Hands-on sessions
- Capstone projects
- Longitudinal faculty mentorship
A study published in the Journal of the Association of American Medical Colleges interviewed 49 medical leaders and asked what factors in medical school positively influenced their leadership growth. Participants identified the following factors that, in combination, prepared them for leadership:
- Longitudinal learning communities including docents, junior-senior partners, and team Experiences expectations set for students to achieve
- A clinically oriented but integrated curriculum
- Admission policies seeking students with academic and nonacademic qualifications
- Supportive student-student and student-faculty relationships
- A positive overall learning environment
The Literature Agrees
A study published in the journal, Perspectives on Medical Education, touts the benefits of leadership training for physicians. Given that the study focuses on the need in the United Kingdom, it supports the view that physician leadership is a global issue.
“Throughout their careers, doctors are likely to come across complex management and leadership scenarios that many would not have had prior training in. Expectations of doctors are rising and it is becoming increasingly necessary to be able to astutely handle a variety of situations.
“Medical curricula must reflect this change and adapt to include the teaching of key management and leadership skills. Better management skills and leadership (are needed), especially in doctors who were identified as the spearheads of change. This view is backed up by senior professionals who stress that by incorporating it into undergraduate curricula, doctors will be equipped with the skills to flourish in the future. Empowering students of today will enable them as tomorrow’s doctors to tackle the challenges of modern medicine.”