As the head of a department, you have several leaders within the department of highly variable skills. Also, you have some young and enthusiastic faculty members who are clearly ambitious and are likely leaders of the future. How do you make your current leaders more effective and how should you make the next generation of leaders even better?

Leaders and leadership needs to be encouraged, promoted, and developed. Leadership is not about the title, but is recognizing the need and effecting positive change. While some individuals have more innate skills, leadership can be taught and enhanced. In hospitals, academic or clinical success is the usual proxy for leadership. While such success may involve leadership, many individuals’ success may have little to do with leadership skill. Further, individual academic or clinical activities are not necessarily the best strategy for leadership development.

Three strategies to enhance leadership are formal education, graduated leadership experience, and appropriate mentorship. Many opportunities exist for leadership courses, many designed specifically for clinicians. Leadership courses/training should preferentially be developed internally with external advice as needed. The advantage of internally developed courses is that the curriculum can be specifically developed with the participants in mind. Another advantage of internally developed courses is that leadership training can be multidisciplinary, involving individuals from all facets of hospital activity, including individuals with clinical and non-clinical roles. The exposure to multiple disciplines provides insight into other perspectives within the organization and creates a future expectation of multidisciplinary team collaboration. Whatever route is chosen, courses should have a structured curriculum taught by experts, involving group learning with active participation, working in groups ideally on projects germane to their hospital roles, thereby developing skills relevant to their responsibilities.

A second strategy to developing leaders or potential leaders is to provide leadership opportunities. Leadership needs to be developed at all stages of individuals’ careers. The leadership opportunities should be varied and graduated in responsibility consistent with skill and experience.

Early experience for future leaders could include participating in committees to build a sense of working within groups, leading ultimately to primary responsibility such as chair of a committee. Individuals can then be assigned specific tasks, such as leading task forces, tailored to gaps in their leadership skills. Before assigning leadership of a committee or task force, sit with the individual and self-assess their skills. As they lead, provide frequent feedback and mentoring.

The third important component of leadership development is mentorship. This should involve a structured program specific to the role and skills of the leader (see post on Mentorship). Leaders may struggle with fighting within the team, or even fighting between the leader and the team, thereby drifting from primary tasks or failing to make progress on goals. While mentorship may help, particularly if the leader is fighting with the team, leadership coaching, sometimes even professional and/or external to the organisation, can be invaluable.

In summary, leaders require development. Formal education and leadership opportunities should come in early career with an explicit plan for on-going development.