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Leadership skills: Need of an hour for medical faculty
*Corresponding author: Dr. Sanjiv Kumar, Professor, Leadership and Global Health, The INCLEN Trust International, New Delhi, India. drsanjivkumardixit@gmail.com
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Received: ,
Accepted: ,
How to cite this article: Kumar S. Leadership skills: Need of an hour for medical faculty. Ann Natl Acad Med Sci (India). 2025;61:342-6. doi: 10.25259/ANAMS_85_2025
Abstract
This article addresses the critical gap in leadership training for medical educators, who are often promoted based on seniority and publications rather than on demonstration of leadership skills. Most of the senior positions in medical institutions are occupied by ‘accidental’ and not genuine leaders. It results in a negative impact on patient care, quality of medical education, and institutional effectiveness, as well as high staff turnover and decreased efficiency. The paper highlights the urgent need for medical educators to not only possess leadership skills themselves but also to impart them to the next generation of medical professionals, in line with new competency-based guidelines issued by the National Medical Commission. Most of the available courses on leadership do not have the desired impact. To bridge this gap the author under the National Academy of Medical Sciences designed and facilitated courses for senior medical educators based on their needs and address the reasons of failure of the leadership courses.
Keywords
Addressing gaps in leadership training
Leadership in medicine
Leadership skills in medical academics
INTRODUCTION
Leadership training is vital for the success of any organization in today’s volatile, complex, and unpredictable world. Therefore, considerable time and money are allocated to such training courses.1 The medical teachers are highly adept and laborious professionals. They undergo multiple screenings for technical competencies before being considered for leadership positions. However, they are promoted based on seniority and the number of publications, rather than leadership skills. They are neither taught leadership skills during medical training nor in in-service continued medical education. Most become ‘accidental’ leaders.2 A leader builds an institution and is focused on continuous quality improvement in all activities of their institution. The senior faculty may develop leadership skills by reading, observation, or through in-service courses.3 A report by the Institute of Medicine recommended that academic health institutions develop leaders at all levels who can manage the organizational and system changes necessary to improve health through innovation in medical education, patient care, and research.4 The leaders need to help define the future, align people with a vision, and remove obstacles to allow people to see this vision.4
CONSEQUENCES OF POOR LEADERSHIP
The lack of leadership skills in medical educators has a significant negative impact on the quality of medical education, staff, research, the institution, and the healthcare system, ultimately affecting people’s health. Leaders in medical education without leadership skills are unable to perform key tasks [Table 1], resulting in staff and institutions performing below their capacity. Inadequate leadership skills lead to mistakes, wastage time, increased costs, and decreased efficiency and effectiveness. Many institutions send their faculty for external training, which may lead to disruption in routine work and loss of time in receiving trainings, which are not related to their work and context.5,6 Lack of leadership skills reduces workforce capacity, increases employee turnover and the cost of the healthcare system, and shifts focus away from organizational goals, objectives, and strategies.7,8 The future belongs to healthcare education leaders who demonstrate excellence in teamwork, clinical skills, patient-centered care, balance accountability, and autonomy.9
| No. | Major functions of senior medical faculty | Required leadership skills |
|---|---|---|
| A. Leadership soft skills | ||
| 1 | Manage self: If one cannot lead oneself, one cannot lead others. The leader should look after their own health, family commitments, and reflect to identify areas for improvement. A leader is a role model. | Managing and leading self |
| 2 | Educator: The most important role of an educator is to make a positive impact on the lives of their students. | Mentoring & motivating |
| 3 | Institution building: They should establish the vision and branding of the institution. They should hire, motivate, and retain talent. They can bring changes to the management and transform an institution. They should create a leadership culture in the organization | Visioning, talent management, engaging colleagues, organizational culture, and its management |
| 4 | Ensure clinical excellence and support national health programs: The leader should strive to improve clinical skills for healthcare delivery as a clinician. They should inspire faculty and residents, and paramedical staff to do so. As teachers, they should assign new tasks to their team members and challenge their comfort zone to enable them to acquire new skills. | Technical competencies, programmed management |
| 5 | Quality assurance: They should ensure that quality improvement is perceived as a journey and not a destination. | Commitment to excellence, result focus, and eye for details |
| 6 | Focus on important activities: Senior medical faculty have multiple responsibilities. They must prioritize and focus on strategic areas. They may delegate routine work to others in their team and monitor it. |
Priority setting, time management, And delegation |
| 7 | Future-proof the institution: They should prepare students, faculty, and other staff to meet future needs. They should anticipate and manage change. | Strategic management and leading change |
| 8 | Promote research: They should support institutional and collaborative research. They should build and strengthen the research ecosystem. They should simplify processes and procedures. | Networking, negotiation, advocacy, and collaboration |
| 9 | Prepare the institution to deal with emergencies: Natural and man-made emergencies have become more common. They require prompt decision-making even with inadequate information. The seniors must communicate with the staff and community to keep them informed about the ongoing activities. |
Leadership in emergency, problem solving, decision making, communication, & emotional intelligence |
| 10 | Ensure continuous learning: Medical professionals require lifelong learning for self and others. The leaders should create a learning culture in their institutions. | Creating a culture of excellence and continuous learning |
| 11. | Dealing with conflicts: Conflicts are a normal part of any institution. When a conflict is mismanaged, it can cause great harm, but when handled properly, conflict provides an opportunity to learn and strengthen the organization. | Conflict prevention and management |
| 12 | Maintaining public image of the institution: It is important to maintain a good image of the institution in day-to-day work and during a crisis. Leaders need to maintain good relations with the media. | Communication skills |
| B. Operational skills | ||
| 1. | Implement guidelines of regulatory bodies, including the National Medical Commission (NMC) | Good knowledge of the rules, regulations, and requirements for various regulatory bodies, Eye for details, rules, and regulations |
| 2. | Overseeing procurement and finances: as per government guidelines: There are Government Financial Rules and guidelines for Auditing of accounts, which need to be strictly followed. To supervise purchases through the Government e-Market Place, | |
| 3. | Managing human resources and staff unions: Using human resources, including unions, is one of the most important tasks of an effective leader | |
| 4. | Compliance with rules, regulations, and standard operating procedures, including setting up of committees for grievance redressal of patients and a separate committee for staff, sexual harassment committee, etc. | |
MEDICAL EDUCATORS NEED TO POSSESS AND IMPART LEADERSHIP SKILLS TO STUDENTS AND FACULTY
National Medical Commission has issued revised guidelines for Competency-Based Medical Education on 12-09-2024, highlighting the need to prepare learners in medical education for the evolving needs of medical practitioners in view of changing demography, socioeconomic context, perception, values, advances in medical education, expectations of stakeholders, emerging healthcare issues, emerging diseases, and advances in science and technology. It has identified seven roles of Indian medical graduates.9 Five of these roles pertain to leadership skills (teamwork, excellence, accountability, leadership, and critical thinking) in addition to their role as clinicians. The seventh skill, communication, is essential for performing all the other roles, as shown in Figure 1.
- Seven roles of medical graduates in India.
GREAT LEADERS BUILD INSTITUTIONS
The medical educators are responsible for various tasks, including teaching, clinical care, research, managing people, mentoring faculty and residents, and dealing with bureaucrats, politicians, and media. They require good communication skills for these roles. They set the vision, mission, and values, and ensure the engagement of concerned people towards that vision. They hire and retain talent. Great leaders establish systems, processes, and procedures to enable everyone to perform to their best capacity. Great leaders build institutions that continue to perform excellently long after they have left. They are modest yet have strong will, and have been referred to as level five leaders by James P. Collins (2001).9,10 They groom and mentor future leaders. Effective leaders understand how to influence others by leveraging intrinsic motivators. It is time-consuming, so one must continue motivating the team, monitor progress, and celebrate successes, however small. They give credit and appreciation to their team members. Senior medical faculty believe in lifelong learning and acquiring skills to excel at their job. Table 1 lists the leadership soft skills and operational skills needed for senior medical educators and covered in the recent leadership training of senior medical educators by the National Academy of Medical Sciences (NAMS).
WHY LEADERSHIP TRAININGS FAIL- WHAT TO DO ABOUT IT?
Leadership trainings are frequently conducted in institutions. They are expensive, both in terms of financial resources and the opportunity cost to the participants. According to a study published in the Harvard Business Review, in 2015 alone, close to $356 billion globally and $160 billion in the USA were spent on employee leadership training. However, these trainings don’t lead to better organizational performance, because people soon revert to their old ways of doing things. Only one in four managers reported that training was vital to business outcomes.11 Even well-trained and motivated employees could not apply their new knowledge and skills when they returned to their units, which were entrenched in established ways of doing things.1 Anita Woolley of Carnegie Mellon showed that organizations need “fertile soil” in place before the “seeds” of training interventions can grow.1 A study by Mohapatra et al. (2024) identified and reviewed 20 leadership training programs in India.12 The study concluded that to improve leadership training, there is a need to develop customized course contents and methodology to address the requirements of the participants, local context vis-à-vis globally connected research ecosystems.12
NATIONAL ACADEMY OF MEDICAL SCIENCES LEADERSHIP COURSE AND ITS UNIQUENESS
National Academy of Medical Sciences (NAMS), New Delhi, under the visionary leadership of Dr. S. K. Sarin, the then President of NAMS, identified the need for leadership training among senior medical faculty. Training the senior faculty not only enhances their leadership skills but also helps them create a ‘leadership culture’ in their institutions to groom future leaders. The author, under his leadership and with support from the NAMS Secretariat, was asked to design and facilitate these training courses. The training methodology used builds on the ‘Leadership in Health Research’ training of the International Clinical Epidemiology Network (INCLEN) Leadership and Management Program (LAMP) and other courses.2 Since global experience shows that most of these leadership trainings fail, the training is designed to address the reasons that lead to the failure of leadership training programs across the world [Table 2]. Most training programs assume a ‘one size fits all’ approach, failing to align with individual needs and work contexts. They impart the same set of skills regardless of the organizational culture or the CEO’s mandate.13 The most important phase in leadership training is the post-workshop phase, when leaders return to their workplace and work on areas that need improvement and maximize their leadership strengths ‘in vivo.’ A mentor within the institution or outside can help them review their progress and suggest a way forward. NAMS training courses address factors that lead to leadership training failure [Table 2].
| Reasons for the failure of training | What needs to be done to address these | How have these reasons been addressed in NAMS training |
|---|---|---|
| 1. Not aligned to individual needs | Align the training to the individual’s and organization’s needs | Self-assessment to assess the baseline skills of individual participants to personalize the training |
| 2. Lack of reflection on participants’ leadership style and skills | Align training to individual style and skills through reflection. | Training designed using the Fact, Reflect, Act, and Review model13 to help participants reflect on their current skills and chart their own path to excellence. |
| 3. No application of the acquired skills at the workplace after training | Follow-up after the workshop | Each participant prepares a personalized plan based on the baseline assessment and implements it on the job |
| 4. Emphasis on teaching knowledge, not on applying learned skills in the workplace | Emphasize that leadership is about changing your own behavior while dealing with staff and addressing problems | Implement a personal plan and experience sharing during the meet-the-leader sessions |
| 5. Not linked to post-training mentoring | Follow-up and coaching gives best results | Implemented partially during post-workshop follow-up sessions conducted online. |
| 6. Failure to measure results at workplace | Need for long term follow-up to sustain and monitor progress | Participants monitor progress and follow-up online. |
NAMS: National Academy of Medical Sciences
CONCLUSION
To meet the needs of healthcare in the 21st century, leadership skills are vital. These skills are included in the role of doctors in India in the revised guidelines of competency-based medical education by the NMC. Unfortunately, leadership skills are neither imparted in medical colleges nor appropriately dealt within most of the in-service courses. Leadership is not knowledge; it is about changes in behaviour with respect to dealing with people and resources within and outside an institution. As healthcare evolves, medical educators need to guide students in fulfilling current and future patient care demands. To be effective, the methodology adopted in NAMS training courses addresses the reasons for the failure of leadership training. The impact of training courses does not show desired results in the short term as it takes time for leaders to mobilize their teams. However, a leader needs to be persistent in their efforts, and results will follow. They need to review progress and realign strategies if required. Leadership skills certainly help at work, but they also improve one’s personal, family, and social life. Dr. D. Behera, President (NAMS), has directed that NAMS leadership training has been received well and should continue. There is a need to have many more such courses designed in a similar way to succeed. The aim should be to train every medical faculty to become a leadership trainer to impart leadership skills to future generations of medical practitioners in the country, as per NMC guidelines. One-time training may not sustain the skills among senior faculty; there is a need to have follow-ups at regular intervals.
Ethical approval
Institutional Review Board approval is not required.
Declaration of patient consent
Patient’s consent not required as there are no patients in this study.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
Use of artificial intelligence (AI)-assisted technology for manuscript preparation
The authors confirm that there was no use of artificial intelligence (AI)-assisted technology for assisting in the writing or editing of the manuscript and no images were manipulated using AI.
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