What a Leader Really Looks Like

I did not know it at the time, but getting involved in rugby early in my high school years was a key factor in my personal development coming into adolescence and then adulthood.?

I have mentioned this before, in previous posts, but I highly suspect that I am on the autistic spectrum.?

Undiagnosed, as I do not think that it will make any difference to me at the moment (and I have some concerns about being stigmatized- a topic for a future blog perhaps). I feel I have managed to find my way in life pretty well so far.?

However, in retrospect, it explains a lot of the difficulties that I experienced in fitting in and navigating the socially challenging high school years (and some of the mindset and behaviour things I continue to learn to manage).?

It also potentially explains how I have experienced and approached leadership roles in my life to date.?

My experiences with leadership

Rugby was the first experience of leadership that I can recall in my life. Pack leader, vice-captain, captain- there were so many roles where one could perform in a leadership capacity.?

It is also a very complex game to learn so, to be honest, I was mainly concerned with learning how not to give away penalties every few minutes.?

Over time as I physically developed and grew accustomed to how to play rugby, I started to gravitate towards some of these leadership roles and at one time or another played the roles I describe above- pack leader, captain, etc.?

I use the words ‘play the role’ very deliberately here because this is what I was doing. I was leveraging the experiences of having played under other leadership figures. Emulating what they did.?

Predominantly most of these leadership figures were either very ‘alpha’ and talked/shouted a lot. Some of them were stand-out individual performers who ‘led by example’.?

I tried to be shouty and talkative, but it did not gel for me. It just did not feel natural. Not that I was necessarily a stand-out individual performer, but I tended to try and lead by example. This worked fairly well for me.?

These experiences stood me in good stead coming into medicine as a career. You do not think about it at the start of the process, as you are so far down the chain that needing to step into leadership roles is a far distant worry.?

Some situations crop up, that just are not thought of as leadership. Working on the orthopaedic ward as a year one junior doctor, often your seniors would all be away in clinic and theatre. So, essentially you were the most senior doctor available on the ward and the first port of call for all patient queries and issues.?

Medical emergencies often pull together a large number of staff, and leadership is also required here. Initially, as a junior doctor, you may be required to step into the role of leader to provide the people present with some kind of guidance on how to manage the situation.?

Then when you become a more senior doctor, you automatically sit in a role where you are required to be a leader. The buck has to stop somewhere, and it tends to be the consultant (or equivalent) that holds overall responsibility for what happens day to day, by default.?

Beyond this, there are formal leadership roles within NHS organizations and in medical education, which individuals can choose to work towards.?

And as we saw during the pandemic, there are a handful of prominent national medical leadership roles. All of these roles are generally performed alongside some form of clinical duties.?

Within my work as a doctor, the first experience of leadership came when I reached the ‘registrar’ level (various terminology used here, much to the GMC’s despair- reg, middle grade, higher trainee- all equally confusing the patients, in my experience).?

I came into my first role requiring the substantial use of leadership skills just before this. I was in my final year of core training, working on the middle-grade rota. At the time there was significant variation in when this transition was made.?

In some places this was a standalone year, to provide some dedicated time consolidating key skills. In other places, you were unceremoniously thrust into the middle-grade role (this transition is managed very differently now, than how it was when I came through- for the better, hopefully).?

Long story made slightly shorter- I struggled during this year, and even thought about quitting Emergency Medicine. This is a very common and well-recognized phenomenon and still tends to be the most common point in training that we lose trainees to another specialty (usually either GP or anaesthetics) or even another country (New Zealand or Australia mostly).?

After a year out of the Emergency Department in anaesthetics and intensive care, I found the transition back into Emergency Medicine very difficult. I was working in a department with (in my opinion) unsupportive senior supervisors, where the expectation was that I would perform at the level of a final year/senior trainee and where I was often just left to cope.?

Spoilers- I somehow managed to stick with it and learned a lot from the experience. I needed time to recover from this experience and took a year out to gain further experience working in a department where I knew I would be supported, and to get my frazzled head back together before getting back into training again.?

In terms of my observations regarding leadership in the Emergency Department environment, for the most part, I felt pressure to become someone that I was not. I faced pressure to be that shouty, outspoken person I described in my rugby example.?

Any feedback I received about this aspect of my work performance was variable, and often my leadership skills were not measured against a consistent benchmark. They were measured against what that person's idea of a ‘leader’ was.?

I found this quite hard to navigate. There is no manual that I am aware of for how to become a leader, so it struck me that perhaps we all have to find a style that meshes well with our personalities and ways of working and behaving.?

Up to this point, I held a belief that there is one way to be a leader and we all have to work towards this. In my mind, this was the archetypal leader- the big personality, alpha personality, loud, confident, decisive.?

I could not help but feel that there must be another way, otherwise, it seemed like I was either going to have to change my personality wholesale, or somehow avoid leadership roles for the rest of my career. This did not seem like a reasonable way forward at all.?

Early as a higher trainee, I went on a leadership and management course. The Royal College of Emergency Medicine had recently introduced a? ‘management portfolio’ that we all had to add evidence to progress through training, and this was one suggested activity.?

At the time of registering for the course I was paying lip service. This seemed like a convenient way to tick a box on my portfolio requirements for the year. On the course, it seemed like most people were thinking the same. Here is a box on my respective training portfolio that I need to tick off.?

I actually really enjoyed the course, getting into the nitty gritty of leadership and management theory (have I mentioned that I have always enjoyed understanding ‘how things work’?). Even getting some time to reflect on my leadership style.?

The shift that occurred here, for me, was the realization that there is no ‘one’ style of leadership like I had originally worried about. I could mould my own, personally effective, way of being a leader.?

What does a leader really look like?

Which brings me to the question, what does a leader really look like? I suspect if I ask this question widely there will be a lot of different answers. And this is great. Think about it like ‘build a bear’ but for leaders. If you were to build your preferred leader, what would he/she/they look like? Let's consider this for a moment.?

For me, a leader has the following attributes.?

CAPABLE IN THEIR OWN RIGHT- no matter the industry or environment, the leader has their own skills and experience to bring to the table. They carry a certain quiet confidence due to this.?

ALWAYS OPEN TO LEARNING- they have an awareness that they do not know it all, nor do they need to. But they are always open to learning from the people around them, and constantly look to both enhance their pre-existing strengths as well as their areas for development.?

GOOD RELATIONSHIP WITH FAILURE- not afraid to try things and fail. Realizes that this is where the growth occurs. Takes the same approach when team members do the same.?

ADAPTABLE- the leader is like a Swiss army knife of skills and approaches. This recognizes that members of the team are all different and have different needs. The situations that arise day to day will also have different needs, and the leader can respond effectively to this.?

WILLING TO SHOW VULNERABILITY- not afraid to show that even though they are the leader, they are still human. Recognizes that they will not be on top form 100% of the time, and does not pretend to be. Also not afraid to show that they have struggled with a particular situation, but role models good ways to respond to them.?

GOOD LISTENING SKILLS- uses active listening to really hear what the team members say to them.?

GIVES CLEAR ADVICE/INSTRUCTIONS- able to communicate clearly and unambiguously using explicit (not rude) language. Avoids vague terms/instructions that may cause confusion.

USES A COACHING APPROACH- avoids micromanaging by seeking to encourage the team to find their own solutions to problems, with support where needed.?

RESPONDS RATHER THAN REACTS- able to deal with situations calmly, avoiding knee-jerk reactions during an emotional response. (Most of the time at least, they are human after all)

REFLECTIVE- reflects objectively on the things that happen, good and bad. Sees all of this as potentially useful information that can inform his/her/their future approaches and that of the team.?

There may be others, these are just the key ones that come to mind as I write.?

All leaders have one job in common- to set the initial direction for the team. What other attributes outside of this set the leaders apart?

If the shop ‘Build a Leader’ existed (not the worst business model I have ever heard of by the way!), what attributes would you choose for your leader, and why??

Is this the kind of leader you want to be, or be led by??

If the type of leader you want to be and want to be led by are different, why do you think that is?

Thank you for reading :)

#leadership #buildaleader #coaching #mindset #everydaymindset