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Thinking of taking an F3 year? Advice on leadership.

Advice from the Student and Foundation Doctor Network about making the most of an F3 year, if you decide to take one.

Key recommendations

Key points: 

  • Medical leadership is an important part of career development and F3 is often the first chance many have to explore it in depth.
  • Lots of new opportunities are appearing involving medical leadership so keep your eyes open and use the flexibility of F3 to your advantage.
  • Opportunities to be involved in leadership aren’t just at a formal national level; the NHS faces challenges across the board and the eyes of innovative new leaders are essential.
  • Support in developing your leadership can be obtained from leadership-focused mentors at the FMLM as well as clinicians and managers in your area.

Medical leadership is increasingly acknowledged as an integral part of being a doctor, regardless of your career stage or pathway. This is reflected by the General Medical Council (GMC) requiring all curricula for postgraduate training programmes to embed their generic professional capabilities framework by 2020, one of these capabilities being leadership.

The concept of medical leadership has evolved significantly in recent years and is not isolated from specific roles or characteristics. There is increasing evidence that good clinical leadership improves delivery of care, functioning of healthcare systems and, ultimately, patient outcomes. It is a valuable area to focus on during your F3 year as you may not have encountered this aspect of medicine thus far. There is much to explore, and you may need some time for reflection to determine your own pathway through this diverse aspect of clinical practice. You may want to find out more about medical leadership before considering it as part of your F3 with good starting points being the Faculty of Medical Leadership and Management (FMLM) and the NHS Leadership Academy.

Fellowships

Fellowships offer the chance for a fixed-term, usually non-clinical, placement within an organisation. As part of this, you are often enabled to take on a leadership role, and to spend time learning and developing your unique leadership style and experiencing what medical leadership and management entails. These opportunities allow you to understand the organisational structures of the NHS and learn more about the policies underpinning healthcare. Due to the diversity of medical leadership and management, the opportunities and experiences available are also wide ranging.

Some formal fellowships only take higher specialty trainees, however, there are still a variety of fellowships to investigate from local to national level. These can be competitive as they often place fellows within teams at organisations such as NHS England/Improvement and royal colleges, sometimes requiring you to be based away from your current home. Local fellowships can also involve placements within large organisations but may also offer roles which are more specific and that may be of interest to you; local fellowships often offer you more freedom to engage with core challenges facing service delivery and education. As with other fellowships they offer fixed-term paid contracts which should be looked at based upon your own circumstances.

Qualifications

There are a growing number of postgraduate qualifications in leadership that provide a structured way to gain an understanding of the principles and application of leadership to the clinical environment and the wider NHS. It is likely that, given you will be outside of a training programme, you will not qualify for any regional or local bursaries and would need to self-finance the course fee.

Alternatively, a highly flexible and free option to enhance leadership knowledge and skills and demonstrate tangible evidence is to enrol in NHS Leadership Academy’s Edward Jenner Programme. This is a flexible, e-learning course which introduces you to leadership in the context of the NHS and allows you to explore your potential as a leader. Commercial organisations have also begun to offer similar paid-for flexible programmes.

Informal

Create your own opportunities. Look out for positions and projects available on national committees. For example, the Healthcare Leadership Academy, FMLM trainee steering group or RCP Student and Foundation Doctor Network often have projects you can contribute to which will develop your leadership and project management skills. Equally, find a local supervisor and develop your own project. Approach individuals such as clinical or medical directors at your local trust / health board and enquire whether they could create any opportunities for you, eg a junior clinical director role. Increasingly, there are local junior doctor leadership opportunities and courses – contact your local postgraduate education centre or check on the different deaneries’ websites.

Network

Conferences which focus heavily on leadership and service development (such as the BMJ/FMLM ‘Annual leaders in healthcare conference’) also provide a great opportunity to develop interests, present projects and find out more about an area of medicine which you might not have been able to as a foundation trainee.
Alongside this, there are a growing number of development-based events and short courses for junior doctors interested in leadership and management development run by local regions, trusts and health boards, royal colleges and faculties. These help you develop incrementally and build up links in the junior doctor leadership community. Search websites and ask – often the prospect of a junior doctor interested and enthusiastic about leadership and management can open many doors.
Build your leadership and management portfolio

Leadership and management are being integrated into undergraduate and postgraduate medical curricula and can be a valuable asset as a junior doctor. You can evidence your development and experiences via a variety of ways: using a leadership and management 360 feedback tool, mapping your experiences to the FMLM leadership and management standards, and keeping a record of your event and conference attendance in a leadership passport. The FMLM Trainee Steering Group website has some ideas and tools that may help you, as do other groups and organisations.
Create time for mentoring and coaching

Your F3 year is likely to provide you with more time and flexibility. You could make use of this by finding yourself a leadership mentor (eg via the FMLM system), undertaking coaching or equally helping to mentor more junior clinicians (eg via the FY1 buddy scheme or local schemes). Student doctors are often crying out for advice and mentorship towards the future and you may be able to offer assistance or help bridge the gap for them to gain advice on specialties. Leadership mentorship schemes vary regionally but contacting your local deanery office (even when not in training) is a good start.
Coaching is often unfamiliar to trainees and provision varies by region. It can take the form of mentorship but may also be self-driven involving thinking and writing exercises to aid you in structuring your solutions to problems. Some schemes can be free to access, others require payment. If locuming during your F3 year, you may find yourself with additional funds to allow you to access coaching.