Over the past few decades, there has been a troubling shift in the culture of medicine away from a calling with profound meaning toward mere employment. Part of this is because residents are burnt out — which in turn may stem from a learned sense of powerlessness or lack of autonomy experienced during their training. Furthermore, as Dr. Joseph Gravel astutely points out, we are training residents as though medicine is baseball (a team sport centered on individual success) when in reality, most physicians are now employed by large organizations, and clinical practice more closely resembles football, where collaborative efforts drive success. I believe that by teaching medical trainees leadership skills, we can empower them to provide better patient care, lead teams effectively, and pursue fulfilling careers with passion.
Many residency programs have struggled to find residents to fill their chief resident positions. Some residents report this is due to fear of conflict and the potential for increased stress or burnout. Without formal leadership training, medical students and residents feel powerless and hopeless, focusing their attention on the system’s problems instead of believing in their potential to solve them by taking on a leadership role. Opportunities to engage with hospital leadership and faculty help empower medical trainees while building essential leadership skills, such as effective communication, teamwork and collaboration, advocacy, and conflict resolution.
In my own clinic with 20 physicians, no one was willing to take on the role of medical director after an extensive search lasting over 12 months. Many felt inadequately prepared. Ultimately, when I assumed the role, I realized that most of my fellow medical director colleagues also learned leadership through experience, but no one had received formal leadership training before taking on the position. Most of the skills I utilized in this new leadership position came from my prior experiences as a Teach for America teacher, not from any formal training I received in medical school or residency.
Not only is leadership training crucial for medical trainees to be equipped to effect meaningful change in their local and national health care landscape, but it also fosters resilience and helps future physicians find joy in their practice. A study of 56 graduates of a leadership training program in medical school showed significant long-term improvement in those physicians’ abilities to communicate effectively, motivate others, and practice self-awareness. They also experienced increased productivity and morale; but most importantly, they saw improved patient outcomes.
Some may feel that the focus of medical training should be on patient care instead of leadership training. However, in a profession held in such high esteem, where all staff naturally turn to the physician for guidance, neglecting leadership training is a disservice to both our patients and health care teams. We cannot continue to fail to prepare physicians to be effective managers who can lead system-wide improvements.
Approximately half of U.S. medical schools offer leadership programs, and only 34% of those are required programs for their students. It is crucial to mandate that medical schools and residency programs prioritize the integration of a leadership development curriculum for all their trainees. Numerous resources available in educational repositories, such as the publicly accessible MedEdPORTAL, can be tailored to meet individual program needs, making the implementation of leadership training more feasible.
To empower our future physicians to be leaders and change-makers, we, as their faculty, are obligated to prepare them adequately — not just for patient care, but also to be resilient, motivating, and empowered individuals. Just like a football coach prepares their players by designating captains, teaching them to make quick decisions, positioning everyone for a win, we also must prepare our trainees to work collaboratively toward the same goal of providing the best possible patient care.
Did you receive leadership training? How has it shaped you? Share your experience in the comments.
Dr. Jiang is an academic family medicine physician and medical director at a large medical institution.
Illustration by Diana Connolly
