Barry Evans has been a specialty registrar in geriatric and general internal medicine since 2014. He has an interest in innovative models of care and that improve the health and quality of life of older people and QI Projects which improve the working lives of doctors in training. Here he discusses the Trainees’ Leadership and Management Weekend. He tweets @barryjames86
Having commenced training in geriatric medicine in 2014, I’m often surprised by the speed at which my training has gone. If the last couple of winters in the NHS are anything to go by, there is no shortage of experience in clinical work for trainees in geriatric or internal/acute medicine, and despite the recently promised ‘cash injection’ for the NHS, there is unlikely to be a shortage of clinical work soon!
This clinical work allows us to see the entirety of the older person’s care journey, as geriatricians work in the community, in A&E, in acute medicine, on wards (medical and surgical!), and in intermediate care/rehabilitation – to name just a few. We are privileged to understand how these frontline services work and are therefore well placed for future innovation in models of care for older people. However, exposure to formal training in clinical leadership can be variable.
As junior consultants, leadership skills are essential, in addition to clinical skills, in order to set up and run the kind of collaborative teams and services that consultants are asked to lead, and enable them to thrive. The curriculum for geriatric training acknowledges this and the word leadership is mentioned a massive 35 times in the most recent edition of the HST curriculum. A quick google of the phrase “medical leadership” identifies a wealth of courses available to doctors which provide generic leadership and management teaching for doctors in training. Arguably, many registrars develop a lot of generic and high-quality leadership and management skills from their daily activities such as managing juniors and running the acute medical take.
The specific leadership skills required for a junior consultant include; at the micro level – managing yourself as an individual; and moving outward to the macro level, considering how and where your service sits within the broader healthcare community. As a registrar much of our time is managed by rotas and consultant activity – as a consultant we manage more of our own time and responsibility as well as taking on greater ownership for the running and leading of our direct teams. Further, even as junior consultants, we are likely to be called upon to set up novel services which innovate how care is delivered for older people in the UK. This does not just involve setting up a service and managing a team, but the day-to-day running of that service, as well as understanding how our service might fit into broader healthcare provisions, considering care priorities and policies at a regional and national level.
So…can all this be taught in a single weekend on a single course? Well in short, probably not. To develop these skills takes time, application of these skills to the ‘real world’ and learning from our successes and mistakes along the way. If, as registrars, we can master these skills, we can provide the ‘big bang’ service developments that will improve care for our patients throughout our careers.
However, all ‘big bangs’ must begin with single sparks. I was lucky enough to attend the BGS Leadership and Management Weekend in 2017 which served as my ‘spark’ to develop many of these leadership skills that we will all need as consultants. Details of the 2018 course can be found here.
In short, the weekend is tailored to registrars in geriatric medicine and run by the BGS with a faculty of leaders in geriatric medicine. Though the course is just two days, the volume of material covered is impressive, with the first day comprising small group tutorials providing a systematic introduction (or ‘spark’!) that sets in motion the learning process to accrue the skills that we will need as consultants. To consolidate this, the second day culminates with a ‘Dragon’s Den’ style business case presentation where rapidly applying these skills consolidates learning.
During my training, I’ve attended several generic leadership and management courses. All were useful, but never had I received such tailored training for future consultants working specifically with older people. An extensive toolkit is provided to attendees to support ongoing development, with important national policy documents as well as useful tools for interviews for consultant posts. I left the weekend feeling invigorated and lucky to have met and collaborated with colleagues from across the UK, all passionate about improving care for older people, and a year later I still refer to a lot of the material provided.
Finally, of all the leadership courses I’ve done, this was an enormous amount of fun. For anyone who has not had a chance to sample Nottingham’s finest curry, the outing on Saturday evening was a great opportunity to relax with delegates and the faculty as well as network and share ideas, inspiration and frustrations (!) from our work. We also shared successful stories and learning from challenges encountered in various projects undertaken to improve the care of older people across the UK.
Working across so many frontline services, registrars in geriatric medicine are well placed to innovate in the care of older people in the future. This course is an excellent two-day investment in acquiring that little ‘spark’ which kindles leadership skill development which could lead, as a consultant, to growing a simple idea into a high quality, modern ‘big bang’ service. I’d encourage any of my colleagues approaching the second half of their training whose years have passed as a registrar as rapidly as mine seem to have, to come to Nottingham, learn lots, have fun and continue the journey towards being not just a consultant, but a future leader in geriatric medicine.
Register for Trainees’ Leadership and Management 2018 Weekend, 22-23 September 2018 at etc.venues in Manchester
British Geriatrics Society 