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Correspondence to Professor Anthony Montgomery, University of Macedonia, Thessaloniki 540 06, Greece; [email protected]
The purpose of medical education has changed over the last 70 years. In 1950, Sheehan and Taylor in the USA1 suggested that the mission of the medical school was threefold: the training of the physician, the search for new knowledge and the care of the sick. Similarly in the UK, Pickering writing in the BMJ in 1956 suggested that ‘… the primary purpose of the undergraduate medical course within the university is to train the student’s mind so that he can collect and verify facts concerning health and disease in man, and so that he can form balanced judgment on issues that affect both individuals and groups’.2 This individualist picture of a doctor toiling away for the good of science, and by default their patient, has been replaced by a high adrenaline call for physicians to be developed as leaders so that clinicians can be ‘change agents’ that lead the transformation of heath and healthcare, with the additional idea that leadership training is a bridge to help trainees to find meaning and purpose in medicine.3 Currently, the modern doctor is expected to be a leader who will be skilled in people management, team working and patient engagement. Moreover, the burgeoning literature on the development of medical leadership competency frameworks as a way to inform curriculum development is evidence of a desire to empower physicians to be healthcare leaders. In the following paper, I will examine the degree to which we are attempting to remould ‘square’ physicians to fit them into a ‘round’ medical landscape. The purpose of the paper is twofold. First, to assess the degree to which we can realistically expect the ‘average’ medical student to be moulded into a leader, and second, to identify what practical steps we can take to enable medical students to take a leadership role.
So, are we selecting the right people to be physicians?
The movement towards developing medical students as leaders has to be contrasted against the fact that high school exam performance and academic achievement continues to be the primary basis for selection to medical school.4 Not surprisingly, students who perform at the highest scholastic levels are being...