Intended for healthcare professionals

Career Focus

Stand and deliver

BMJ 2007; 335 doi: (Published 15 September 2007) Cite this as: BMJ 2007;335:s100
  1. Anthony Easton, managing director1,
  2. Graham Easton, GP, broadcaster, and journalist (Gp.easton{at}
  1. 1Easton West Ltd
  2. 2London


Graham and Anthony Easton suggests ways to improve your public speaking skills

Consider your experience when attending a medical conference. You may sense that while others are enthralled by the speaker and subject matter, you alone are distracted by random thoughts, which could include:

  • This guy looks nervous

  • Not another set of blue PowerPoint background slides

  • I'm being made to feel inadequate; there's too much detail

  • This paper is being read out, and I don't feel any relationship with the speaker

  • This may be her pet research topic, but it's not what I came to hear about

  • Where are we and what's the key point?

  • Where did he get that tie/shirt/suit/haircut?

  • How can I close my eyes and catch up on some sleep without everyone noticing?

  • I need the loo, how can I get out of here without drawing attention to myself?

You are not alone. Most doctors feel that medical conferences are something they ought to attend, and struggle to get through. And when it isn't a struggle it's often because they've gone for a well earned rest.

But when you are presenting, do you really want your audience to be thinking like that about your talk? Dare to be different. It doesn't take long to improve your public speaking skills, simply by practising a few new techniques that will help you stand out from the crowd. The key is to learn how to understand your audience and plan a talk tailored to their needs.

Our model has four stages:

  • Preparation and research

  • Designing your talk

  • Delivery

  • Feedback and reflection

For each stage there are three things to focus on, giving 12 competencies in all. These can be used as a quick check list if you only have limited time to prepare, or as a list of disciplines to master (see the box for our top tips).

Top tips

  • Put yourself in your audience's shoes

  • Prepare a presentation, not a paper précis

  • Consider the audience as four new friends with different personalities

  • Get excited about what you are talking about and show it

  • Aim for one word or a picture per slide. Think impact as well as content

Preparation and research

What are you trying to achieve?

The big question is: why am I not just handing out the paper I am presenting? Why am I standing up and talking— why are they looking and listening rather than reading?

The answer is invariably that it is not just about content. You and your talk will be remembered and your reputation will be enhanced not just by detailed and accurate reporting of your research, but by telling your story in an engaging way.

Who am I speaking to?

You must know your audience. Medical audiences are often made up of an array of different personalities and backgrounds; newly qualified juniors, seniors about to retire, and everything in between. Apart from different genders and specialties there are personality types to keep in mind, so you need to be clear who you are talking to.

What's the venue?

Will there be a lectern, microphone, space for a laptop? Will I have to give my slides to someone else to handle or am I expected to operate the technology? How many people, what shape room? All these points and more will dictate how you design your presentation.

Designing your talk

Clear structure

A good introduction is critical and ensures you capture an audience. This skill involves stating on the fingers of one hand the key points of your talk. Use these as way points in crafting the rest of your talk; there are model structures that can help you.

Visual aids for impact

Consider the images you want to use to illustrate the points you are making. A picture is worth 10 000 words. Keep data to an absolute minimum. Don't use over-busy slides and expect everyone to read them all. Consider using just one or two words, or one diagram per slide—or even not using slides at all.

Courtesy to your audience

This is an attitude of mind. What do they want from you? How can you show you understand them and their needs? Think hard about the relevance of your message for your audience. You could ask them directly what their objectives are at the start of your presentation. Use examples or stories that will resonate with their everyday experience.

Delivering with impact

Body language

The subtle clues of body language are just as crucial when you're talking to an audience as they are when you're having a one to one consultation with a patient. So even if you're feeling nervous inside, it's important to learn how to come over bold and engaging on the outside. We use simple techniques to help you.


Too slow and you're boring; too fast and no one can keep up. Varying the pace can keep people's interest. And there's no excuse for not timing your presentation at least once; if you run over time your audience will be looking at their watches instead of you. If the chairperson is any good, he or she should make you stop when your time is up, which means you'll lose the last bit of your talk.

Read or speak

If you choose to use notes, make sure you don't sound like you're simply reading a bedtime story out loud. You won't engage your audience and they will probably fall asleep. Reading as you would speak takes some practice but there are some tips that can help. For example, jotting down bullet points acts as an aide memoire, but means you have to speak as you would normally. Another trick is to write down phrases that you would use in everyday speech; practise reading them aloud and if they don't sound natural, try something else.

Feedback and reflection

Ask the right questions

Honest feedback is crucial if you want to make your talk genuinely useful and engaging. So make it easy for people to say what they really think, perhaps using an anonymous feedback form. Most importantly, encourage feedback that is going to help you improve—ask for specific examples of what went well and what didn't, and constructive suggestions. It's usually worthwhile leaving space for free text too.


When it comes to useful feedback, there's nothing like seeing yourself in action. It sounds scary but if you've used it in medical training, as many doctors now do, you'll know what a huge difference it can make.

Buddy up

Try out your talk on a friend or colleague before you deliver it in anger. Problems and glitches and bits that don't quite work suddenly show themselves. Better to find out now than in front of the grand round.

Finally, if you can sense that everyone is tired at the end of a long day, do you have the courage to cut your talk by half? If someone did that for you, how would you feel about them?

See Graham and Anthony Easton at the national BMJ Careers Fair in the Business Design Centre, Islington, London on Friday 5 October between 11 30 and 12 30 where they will be running a workshop: Improve your public speaking techniques. To book a place go to

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