Career Focus

Dealing with difficult bosses

BMJ 1997; 314 doi: (Published 15 February 1997) Cite this as: BMJ 1997;314:S2-7079

Awful boss and formerly appalling junior Carl Gray advises on tackling the ogre in its lair…

Embedded Image

OK, your boss is being really difficult: but just where does the difficulty lie? Pinning it on the boss certainly shows that there are difficulties in your relationship and that there may be problems in the team. Perhaps your boss sees this as the problem of a difficult junior. The boss and junior relationship has many axes including: teacher and student, team leader and member, mentor and mentee, role model and emulator, and manager and worker. Difficulties can arise in any of these and poison the whole relationship, resulting in pain to both parties. Difficulties often originate within one of the standard scenarios listed in box 1. Bad bosses will allow these to happen, but most are avoidable, and happily none disqualifies anyone from later success.


Bosses no longer have roast-a-junior barbecues and the macho days of overt cruelty should be over. The poor old bosses' lot is worse these days what with increased accountability, closer supervision of juniors' activities, regulated hours, and prescribed training syllabuses. Your boss was a junior once and still sometimes feels junior inside, especially when facing enforced change. Some consultants even have to act down and become their own juniors for some of the time, and overwork is slowly driving many bonkers.

The vast majority of bosses are very good and sincerely have their juniors' best interests at heart. Many readers will be able to recall past kindness and interventions on their behalf. Like your most rigorous school teachers, the boss may really know what is goodfor you. Only few bosses are frankly bad and deserve illustrating in detail. Readers can amuse themselves by collecting their own menagerie of employer malevolence; myfavourite types are shown in box 2. Do you recognise them, or yourself? (Figure 1-1) Few actual bosses are such complete stereotypes; almost all will be good in part. “When I was a boy of 14, my father was so ignorant I could hardly stand to have the old man around. But when I got to be 21, I was astonished at how much he had learned in seven years.” Mark Twain's father improved with time, and many monsters in literature and in life mellow with closer knowledge. Richard Gordon's irascible Sir Lancelot was really very kind in Doctor in the Housee. Even the worst historical tyrants were kind to children or animals. Increasing the amount and diversity of communications between people will lead to greater understanding in time. Seeing the boss off duty, or enjoying a drink with his or her peer group at a meeting can be a revelation. An analysis of bad bosses necessarily eulogises the character and characteristics of good ones. Pick a good boss and you avoid the problem - if he orshe has also picked a good junior.


Every junior carries a boss's baton in his or her knapsack and will one day mature. Just as abused children become abusing parents, tortured juniors may become bad bosses in their turn. Juniors are people who need careful management and nurturing.

The junior half of the relationship also needs to make efforts at civilised progress. You can disagree without being insubordinate, and you should certainly not follow orders unless you understand them. Equally you can appreciate the boss without fawning servility, and may even laugh at occasional jokes. Bosses should wash their own cars, although they may in turn wish to bring in a wash leather for the chief executive's vehicle during the discretionary points season.

Juniors may nowadays regard themselves as entitled to “their rights” in the best barrack room tradition, and a formal supervisory system is now in place. But respect must still be earned by diligence and care. Many difficulties can be overcome by a positive outlook. Looking cheerful - especially at interviews - is a step towards actually becoming cheerful.


“To err is human, to forgive divine” (Alexander Pope). We all make mistakes, especially from inexperience, and should learn from them. All mistakes can be admitted and the slate wiped clean, but don't make the same mistake twice. The bad bosses may hold a mistake against you, but in a sense your mistake is their's for allowing you to make it.


Many relationships founder on the rock of personality: it was the same in the 17th century, at least if the verse penned by student Tom Brown for his boss Dr Fell is anything to go by:

“I do not like thee Dr Fell, The reason why I cannot tell; But this I know, I know full well, I do not like thee, Dr Fell.”

Many of us have streaks of malice and prejudice in our make up, often put there in childhood, but these ills should not be allowed out into the world of work.

There are many examples of good working relationships founded on deep respect rather than close friendship. We can change our behaviour at will and even retrain our habitual attitudes, but we can't change our personality. Forget personality: concentrate on behaviour.

Box 1: Standard problematic scenarios

Off to a bad start

Building up to a crisis

Caught in the crossfire/other people's feuds

More than one boss/locum boss/a new boss takes over


Unfair criticism/landed with the blame

Sexual overtures/exploitation

Disparate senses of humour

Unclear instructions/failure to deliver

Categorised as a fool by one mistake

Search failure

Exam disappointment

Promotion denied

A bad appraisal or report or reference

The ways forward

The key to dealing with difficult medical bosses is through the medical model: recognition and diagnosis followed by remedial therapy. And we all know that the results of therapy can be unpredictable.

Once recognised, a problem is well on its way to solution. Is it acute, recurrent,or chronic? Is it specific or all embracing? Is it a word or an action; a behaviour or an attitude?

You have allies in your peer group locally and more widely. You could even have a worldwide worry on the Internet.

Consult the wisest of the wise - the senior juniors in your specialty - or a friendly consultant in another specialty. Why are they always friendly in anaesthetics, radiology, and pathology? (Figure 1-2)


The crux of the issue is deciding whether the problem is you, your boss, or both of you. Then you can decide whether to tackle yourself or tackle the boss, both steps which should be attempted informally before finally tackling the authorities if necessary.

You can't change your personality but you can avoid being lazy, ignorant, and annoying. Assertiveness training works. Try harder in all aspects of your job. Identify and pre-empt the situations that trigger the east wind. It is within your power to learn to live with him or her. Six or 12 months are soon over; one to three years are a hideous prospect; and four or more years are a lifetime of blight.

Box 2: Difficult boss types

Tyrant: controlling evil genius which must have its own way; knows everything and nasty with it; unpleasant to everybody including itself

Ogre: tries to be nasty all the time but without the success of the tyrant; may lapse into pleasantry outside its lair

Weasel: transfixes victim with stare before moving in for kill; family at home needs feeding with nutritious juniors

Volcano: magma beneath the surface occasionally erupts; outwardly quiescent but seething Ghost: not really there except for manifestations, malign influences in mysterious ways

Snake: subtle, slithering, hissing, dissembling, and poisonous

Ruler: an authoritarian; keen on rules, status, and rigmarole

Joker: relentless witticisms and even practical jokes, avoidance of all serious issues, possibly a sad clown avoiding the real world

Alien: lives on a different planet; speaks a strange language; does not understand human ways; beams down occasionally

Statue: admired but inert; does not say much

Cuckoo: sounds good, but places a lot of work in your nest

Pick your moment, and speak or write to your boss. Explain that you feel the difficulty and that a discussion would be helpful. Discuss positive steps that could help you both. Your boss may also be thinking of the reciprocal questions. Can I live with this junior; and for how long? Can I give support until the matter is remedied? Career redirection does work, and medicine is full of people prospering in a second choice of specialty.

Persistent or serious difficulties may eventually need to be referred to the authorities. You have a formal friend in the postgraduate dean and his elves, an informal friend in the medical director of your trust, and representative friends in the BMA and your defence society. No single junior ever shifted a bad boss, although groups of juniors have sometimes done the business, with inevitable casualties. Bad bosses are eventually removed only for other reasons, and the difficulty of one junior is likely to be but a small item on the list. Serious misdemeanours are prosecuted on the basis of tangible evidence, and this can be elusive. Even a compelling dossier can fail to impress senior NHS or university authorities, as the boss has some mysterious value to them which over-rides little local difficulties such as you.


So let's get real. You are not alone. Talk to your friends. Have you got this in perspective? Can you do better yourself? Are there faults on both sides? By all means secure some real criminal evidence - if there is any, but you will find that you are more tractable in your own hands than the boss and the system will ever be. Perhaps you should be content to adapt or at least cope, allowing for improvement with time. Many traditional BMJ obituaries said, “He did not suffer fools gladly,” and this was respected as evidence of high standards, possibly at the cost of some temperamental strife. Today's bosses must indeed maintain high standards throughout their professional activities: in clinical work, in teaching, and in managing their staff. Both bosses and juniors must have high standards, especially in their behaviour towards each other. - carl gray, Department of Histopathology, Harrogate General Hospital, Harrogate, HG2 7ND.

Further reading

Lindenfield G. Assert yourself. London:Harper-Collins, 1992.

View Abstract