Intended for healthcare professionals

Editor's Choice

Looking for leaders

BMJ 2006; 332 doi: (Published 11 May 2006) Cite this as: BMJ 2006;332:0-f

Is medicine equipped to lead?

At last someone has the courage to deride the lack of leadership in
and of the medical profession. In addition I am pleased that the role of
emotional intelligence (EI) as a core characteristic in leadership is
recognised. The research evidence quite clearly links the two.

The call for greater attention to selection for, and development of
EI in medical practitioners, will no doubt be met with scorn as those who
lack it dismiss it as psychobabble. We have few good studies mapping EI to
specific areas of medical practice but I know from observation at close
quarters that it is a key factor in professionalism particularly probity
and self-governance.

On application to medical school our very able students claim to
possess self-awareness which is a key construct in EI and many of us
involved with selection believe most indeed do possess this attribute.
Furthermore, EI can co-exist with general cognitive ability and there is
no reason to suspect that to select those with high levels of EI will run
the risk of admitting those less able as medical practitioners.

As medical educators we need to nurture and develop this ability as
they progress through medical education / training by training, modelling
and mentoring. It appears that the initial level of EI that students'
possess diminishes over time as they become exposed to a culture of
cynicism and pressure to 'drop the caring and get on with the job'. This
benefits no-one. We have to prepare our graduates for work in a highly
politically charged, hostile and anti-intellectual NHS culture and stop
pretending it is the utopia that it may have been in times past.

Peskett & Colleagues (this BMJ issue) call for building a safety
culture - one that is open and fair. This is more important now than ever
before as the pressure mounts to hide lack of real understanding behind
superficial knowledge, use mechanistically performed 'communication
skills' as a proxy for care and compassion and where competence is
something that is prized as an end point rather than a starting point for
development of excellence. The culture within the NHS in general and in
medical schools specifically has to change and all eyes are on medicine to
take the lead or continue to collude with the erosion of humanity in
health care.

Competing interests:
None declared

Competing interests: No competing interests

12 May 2006
Christine Bundy
Senior Lecturer in Psychological Medicine/Health Psychology
Medical School University of Manchester