Training for leadership.

part of a curriculum of study, is in vogue in medicine and in many other disciplines. In his 2010 James Mackenzie Lecture, 1 Ritchie defines leadership as 'the ability to influence and motivate people' and describes leaders as people who 'cope with change, they set vision and direction, and stimulate team members to follow that vision'. It may seem ironic that leadership is assuming greater prominence just at the time that the opportunities for self-direction are diminishing, 2 but this is no time for cynicism. Ritchie makes a connection between professionalism and leadership and we should think of these as being intertwined, with leadership being both part of core professional behaviour and a driver for its continual reform. GROWING OUR LEADERS Professionalism is deeply valued, but not so deeply understood: the opposite could become the case with leadership. The Medical Leadership Competency Framework (MLCF) is a reference point for all specialties, 3 and provides a 'leadership compass' that Ritchie exhorts us to use in order to 'grow our leaders'. If we are to do this, how may we proceed? We have conducted a pilot project in the Yorkshire and the Humber Deanery, using a cohort of registrars in the final 6 months of their third year of training. 4 We wanted to see whether an exercise involving identifying and leading a project in the registrars' host practices, supported by a facilitated action learning set of peers, could develop leadership skills. The MLCF identifies five core leadership domains in which all doctors should aim to become competent. 5 The greatest gains in self-reported competence were in the domains of personal qualities, particularly self-awareness, that is itself an important component in the development of insight. Perhaps as a result of this, trainees' self-ratings were lower in some areas toward the end of the programme, showing a greater awareness of personal limitations. When working with others, trainees took tentative steps to develop teams, and found that the experience of creating the impetus and mechanism for change often placed relationships under stress. A note of realism also crept in, with several commenting that teamworking can sometimes delay taking necessary action. Fewer changes were seen in the domains of managing services and setting direction, but realistic opportunities to develop these skills often do not come until later professional life. One of the greatest reported benefits of the pilot was the opportunity for trainees to make …