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Jonathan Darling
Hello. I'm Jonathan Darling, and I'm Vice President for Education and Professional Development at the RCPCH. Welcome back to our leadership podcast series. This podcast comes out of our belief that better leadership skills are good for all of us, not just a few, and that we can learn from people's stories and experiences. So, do you want to be a better leader? Then join us on this and future podcasts, as we learn together.

I'm excited to introduce today's guest Dal Hothi. Dal is consultant paediatric nephrologist at Great Ormond Street Hospital for Children in London. Her roles have included the Associate Medical Director at GOS, Officer for lifelong careers at RCPCH and director for the Faculty of Medical Leadership and Management (FMLM). So welcome Dal.

Dal Hothi
Thank you.

Jonathan
Thanks for joining us, and perhaps to start off with, if you can tell us a little bit about your career journey so far.

Dal
I think I would say I have a portfolio career, and I think that's a concept that's emerging more and more in our medical careers, and my interpretation of portfolio careers, I'm amalgamating different elements and bring them together in my career. And my three elements are probably being a doctor, so that paediatric nephrologist piece, but also I am a coach and a development practitioner and pioneer leader.

So, I try to bring those three elements into my working life, my journey to that, I think it's fair to say, because it's a portfolio career, I've had to carve my own path rather than following a predetermined pathway. So, example include that when I was a trainee doctor, I undertook a PG certificate in clinical governance just to try to really expose myself to the world of management and healthcare. As part of my nephrology training, I applied for a fellowship in Toronto. So really try to sort out alternative experiences in different healthcare systems, and that really made a difference in the way I practice medicine.

I think then I've met various mentors along the way. One great example would be Peter Lachman, who really taught me a lot about quality improvement and safety, and then that took me to the space of quality and safety roles in the organization. So, I think my journey has, in essence, been an amalgamation of experiences that led to other experiences, and then that just opens the door to perhaps expanding the rate of our work, rather than just being a very clean standard doctor.

Jonathan
And when you did some of those things earlier on, like your PG certificate, were you thinking of being involved in leadership at that stage? Or when did it become something that was part of what you were doing in your work?

Dal
Yeah, I was reflecting on this when I was thinking about our podcast today. I don't think I ever saw myself as a leader. I'd say I was an accidental leader to be honest. I got involved in the PG cert (certificate) because I was really interested in how the systems worked behind the scenes. So, I was very familiar with what happened on the shop floor, but I wasn't familiar what happened behind the scenes, and I think that's just as important, if I'm a doctor, to know what keeps the system going. So, I really wanted to get involved in that.

I think as a trainee doctor, you are absolutely terrified of making a mistake and causing harm to a patient. So, I was very interested in safety, and how can I make sure I'm as safe as possible? So, I think there was questions that are arising for me, and I was just following those trail of questions and taking myself to new opportunities. As a result of that, I started saying I'm an accidental leader, and I think that's true.

I almost followed a question, got some development in that area, and that led me to opportunities. And so yes, I'm a consultant, that's a leadership role. I took on quality and safety roles. That's technically a leadership role, but I never thought I was a leader at that point. I thought I was just taking on technical roles were complementary to my role as a doctor. So, it wasn't leadership until I perhaps became the Associate Medical Director, and I thought, oh, this is a leadership role, and it felt different that point. And I think from that point, I probably made a distinction from accidental leader, where roles almost seem to fall or opportunities seem to emerge, and I'm not scared of change, so I just yeah, never experienced, let's go for it.

But the Associate Medical Director role, I really had to think about my leadership. It was almost about I needed to transition from just an accidental leader to an authentic leader. What kind of leader do I want to be? Am I a good fit? What are my values? What matters to me? How do I add value to the organization, but also the NHS? So different questions started to emerge, what's ethical, what's not ethical? What's responsible, what's not responsible?

So, I think I started to think about leadership, I suppose, in the wider form, how am I going to manifest as a leader? And I think that was a different journey when I really stood in the shoes of leadership, as opposed to technical roles that were leadership roles, if that makes sense.

Jonathan
Yeah. So, you started accidentally, as you put it, and then you became a bit more intentional about it at some point?

Dal
Yeah

Jonathan
Was that really when you took on the role of Associate Medical Director that you started to think, well, I need to be more clear what sort of leader I want to be?

Dal
Yeah, because I used to spend time thinking about how I wanted to be a doctor. All of us interpret the role as doctors differently, and it's beautiful that we have different shapes and size of doctors, right? So, people manifest themselves as doctors differently, but I used to have this assumption that leadership had one mould, and I wasn't a good fit. I wasn't the leader, so I was taken on these roles to support patients, to support clinicians, but it wasn't taken on a role as a leader, and that is what I convinced myself. That's why I called it accidental.

But as the AMD role, I really did have to start thinking about who am I as a leader, just as I used to think about who am I as a doctor. And so, I think it is conscious, it is intentional, but there's also a mindset shift where I had to overcome my own demons in my head that said, ‘You're not a fit, you're not a leader, you're not what the prototype is.’ So I needed to make adjustments and readjust the thinking, the mental post in my own head to say, well, what would it take for you to step in the shoe of a leader and embrace leadership as a person?

And so that was a personal journey, as well as certainly a developmental journey and learning new skills and capabilities to be a leader. But there's also a mental journey of, are you really standing in the shoes of being a leader or not? And I think that transition is quite important.

Jonathan
So, do you have any tips or reflections on how you did that bit of addressing those demons or whatever's in our head that makes us think, oh, we can't do that?

Dal
I almost spent my time thinking about when I felt that I was doing a good job as a leader, just similar to when I used to think I did a good job as a doctor. It was more about my values, it was more about my behaviours. It was less about what I know and what skills I have, but it's more about your humanness. Who are you bringing to the table, who you bring into the conversation? So, I spend a lot of time reflecting on who am I and is that, who I wanted to be in that meeting? Is that who I wanted to be when I was in relationship with one of the managers? Who am I trying to be when I'm trying to address a change in the organization?

So, it was really about, as you say, being conscious and intentional about who is showing up.

Jonathan
Yeah, you mentioned authentic a little bit back. I think the way you're describing your approach, there is a bit about authentic leadership. Can you tell us a bit more about what that's all about?

Dal
I guess I started my journey in this leadership space trying to mirror who I thought was good leaders. I want to be more like that person, I want to so I was trying to mirror people, and I really almost took my attention externally rather than internally. But then I gradually took myself to a space of, I need to give myself permission to be myself, and I was actually my best when I was myself.

For me, authenticity is that self-awareness of what my values, what my principles, what's ethical, what's moral? To me, you know, what's my compass?

I think the other thing about authenticity for me was actually embracing vulnerability. I think from day one of being a junior doctor, I learned to have this armour of self-protection. I needed to protect myself from all these micro traumas that are surrounding us as doctors, you know, especially as paediatricians. We see death, we see disability, we disappoint families where they've got this beautiful image of what their child's going to be, and then suddenly you say, no, that's not the reality

So, we are surrounding ourselves with these micro traumas all the time, and we almost see it as norm, but to be able to accept that I was starting to develop this armour, I was encouraged to be strong. You know, be a rock. Don't be vulnerable. The patients are allowed to be vulnerable, you're not allowed to be vulnerable. As a doctor, you've got to be their rock. You've got to be their strength. The armour was what sort of enabled me to be a doctor. Initially, I allowed the armour to be the way to make myself stronger. I wasn't becoming resilient, but I was being stronger because I could then face that environment I'm in, which is not a normal environment, that's not how we should be living our lives.

But, leadership isn't about that, I think leadership, you almost realize that there isn't a guidebook, there aren't evidence based, there aren't things that I'm going to guide you. This all relational, is about making judgments. It's about learning, it's going from a space of knowing to learning. I can't be a leader saying that I know everything. I've been a leader because I'm willing to learn and be open to experiences and trying to understand.

So, I really had to let go of that armour and embrace vulnerability, and also not to shame myself or blame others. When that vulnerability became painful, it's painful to be vulnerable. You suddenly realize you're human, and it hurts when you make a bad decision, or it hurts when you do something wrong, and it also hurts when the environment around you is in pain. I think the vulnerability is something I learnt that is a strength and guides me, supports me, allows me to be authentic as a leader.

And so, I parked that armour even in my medicine, now I don't wear that armour anymore. I'm allowed to be myself and I'm allowed to not be emotional, but I'm allowed to bring in empathy, I'm allowed to bring in compassion, I'm allowed to bring in patient centered care. You know, what do you want as a patient? So, I think there's something about my stance changed when I embraced leadership truly, both in my medical career, but also in my leadership career.

And I think letting go of that armour was a really big part of that.

Jonathan
Just to help us think practically, if I'm trying to move into that space of almost embracing my vulnerability, or at least being willing to have it there as part of who I am, not just hidden, but sharing it sometimes. How could I do that? Or do you have any examples in your experience of leadership where you've done that in a particular way?

Dal
Every day, a good example would be COVID. It was chaotic, it was ambiguous, we had absolutely no idea what's going to happen. You know, we all were feeling things were out of control. We had absolutely no idea, that lack of control really does disorientate you. One of the ways to respond to that and the world to respond to that was blame, blame, blame. Blame like, you know, blame the Prime Minister, blame the college, blame somebody. You know, let's blame because actually, it's painful.

So rather than blaming and shaming, it's like, okay, I feel vulnerable right now, and I'm going to name it and say who else is feeling vulnerable, it's okay to feel vulnerable. It's okay not to be okay. And I think that was a phrase I used quite a lot during COVID, it's okay not to be okay. And that was not saying I'm bad for not being okay, it's not shaming. It's actually saying I'm a human being, and this doesn't feel right, it's okay.

And so normalising is a big part of that vulnerability. So, I think that's a good example of the strength of vulnerability, the strength of being human.

Jonathan
And thinking, you just mentioned COVID and the complexity of it all. Something we talked about earlier was leadership in complexity. I think that's something you've incorporated into your own leadership. Can you tell us a bit more about how you see leadership in complexity, why that might be relevant to us?

Dal
I'm afraid I'm a bit obsessive about this. I think the world is becoming more complex. It's certainly more volatile in the NHS, and it's certainly more ambiguous, it's the space of unknown unknowns. So how does one step forward when there's no path to follow? And that's really tough, it's not a linear system anymore. I think in complexity, what happens is our brain is hardwired to say, I want certainty, I want control, I want the space of autonomy. I need to know that I can expect a certain pattern to emerge or certain things to happen, I like certainty, we're hardwired for that. If that doesn't happen, we activate our limbic centre, that's just unconsciously happens all the time.

So, if the world is becoming more complex and uncertainty is rising, we are probably acting from a space of limbic actions, behaviours, stances, as opposed to our prefrontal cortex, which is actually our high executive function. So, our prefrontal cortex has been inhibited while our limbic has been activated.

So, if that's what complexity does to us, unless we are thinking about that and conscious of that, this has all happening unconsciously, and we are leading from a space of reactivity. We're leading from a space of ‘I feel unsafe’. What we have to think about is, if we can't change the world outside, we're going to have to change our responses to the world outside. And I think that's what leading in complexity is about.

You have to change your responses, you've got to change your stance, you've got to change your thinking, and you've got to learn new practices, you've got to learn new skills. You've got to think of new ways of navigating this complexity. It's not about managing it, you can't manage complexity because one action in one part of the complex system will set up a whole set of reactions that will unfold, and you don't even know they're happening. So, complexity is all these interconnections that are just unfolding all the time, and you can't possibly know what's happening. You've got to want to know what's happening, but you absolutely can't predict anything. You've almost got to in the space of complexity, navigate your own internal messiness, which is interacting with the external messiness, and you've got to be different.

And I think the research now tells us in complexity, we need to develop more vertically as human beings, rather than horizontally. And what I mean by that is, horizontal development is more knowledge, more skills. More knowledge, more skills. Vertical development, and this is something that's been researched now for the last 20 years or so, as adults, we have the ability to develop vertically, which means our thinking becomes more complex. We are more expansive, we're wiser, as opposed to knowledgeable, we're wiser.

And so with that wisdom, the evidence says that it's the wisdom, it's the vertical piece, that allows us to be more effective in complexity. So how are we going to enable us all to be more vertically developed? That's the question, and that's probably what's required in this space of complexity. It's not about knowledge and skills, those are important, but it's about that vertical piece, let's become wiser.

Jonathan
Great, so, thinking about that, then I think everyone would acknowledge we're in a more complex world, not just politically, but within the health system. So, I'm sure we can all agree that we need a different way of being leaders. So, the metaphor is the horizontal is adding apps to your phone. We go on a course, we learn a new skill. Instead of the horizontal, we want the vertical, which is like almost an upgrade to your operating system.

Dal
Exactly.

Jonathan
So then practically, what might we do to think more vertically or have that increased complexity? What things can I do if I'm trying to take that forward?

Dal
I think there’s a couple of things we can do. Firstly, we need to throw ourselves in a variety of experiences. This is those experiences that give us the opportunity to learn about our mental processes and how we're interacting with the world.

So, it's not so much about our knowledge, but it's about how am I seeing the world? What process am I using to navigate this world or this context? What are my assumptions, my bias, my blind spots, you know? So, it's almost a deep dive into your mental processes, which is going to help you build your wisdom become more expansive.

Jonathan
But embracing new experience or different experiences?

Dal
To reflect on them right. So, the experience itself won't help you learn. You've got to then extract the learning from that experience, which is the reflection, which is the deep dive, it's about understanding. So, I think the first thing is throw yourself in different experiences.

Jonathan
Particularly meaning workplace?

Dal
Anywhere. I think for me, certainly, my journey in vertical has been about, certainly throwing myself in different experiences in the workplace. But also, I intentionally threw myself into space for coaching that gave me a very different perspective, a different stance, a different way of looking at the world. It's about, how can we expand our exposure of things? Because that exposure may expand our perspective, and it's the expansion of perspective and understanding makes you see the world differently.

Jonathan
Yeah.

Dal
It's almost like you've got a camera, if you widen the zoom of the camera, the lens, you'll see more of the world. If you've got a very narrow focus, that's all you'll see. And then if you're only seeing a very narrow picture, you're only going to make sense of that narrow picture, whereas if you've got a broader picture, you'll interpret the world very differently.

And so, one of the things we encourage is expose yourself to many experiences and learn to give yourself space and stand on the balcony rather than being on the dance floor. You've got to zoom out and see what is happening in the world at large. What are the different perspectives here? What are the different players here? I've got one perspective. I know my perspective, but do I know other people's perspectives? Do I know what others are seeing? I know I know what I'm seeing, there’s a bigger picture here.

Jonathan
How do you do that bit about standing on the balcony?

Dal
I think the thing is, you intentionally go out and speak to people in the system and get their perspective. You've got to be in the space of not I know, it’s the space that I want to learn. So, I'm going to go and speak to you, Jonathan and find out about the college. I'm going to go and speak to the CEO and see what's the CEO's perspective on paediatrics. I'm going to speak to somebody in NHSE. You know, it's about broadening your perspective. It's about getting a greater insight of what's at play here.

Because the reality is, if we spend our time on just what we know, that's a very small part of the picture, we've got one piece of jigsaw. We need to see the whole picture, right? So, we need to extract as many jigsaw pieces as we can, because then we'll get a complete picture. And once you've got a more of a complete picture, we may be able to make better decisions to navigate that system. Sometimes we make decisions, you know, it's like medicine. You see one blood test, and you can act on the blood test, or you can zoom out and say, well, I've got the blood test, but I also need to see what's happening as a family. I need to understand what's happening with their mental health. You know, you're seeing the child in its holistic approach, your decision may be different than just the blood test.

So, you've got to expand your perspective. I think the other thing, you can be on programmes and courses that are vertically orientated. So, it's courses that are really trying to push you down that vertical route rather than the horizontal route. A lot of the course and programmes we have access to are about knowledge.

Jonathan
If somebody's interested to find some course or something that will help them on the vertical route as you call it, any suggestions?

Dal
I think a couple of good things. That there's the Cynefin framework, which talks about complexity and how one can better characterize a system that you're working in and seeing how best to act and behave in that system, so that can be a very good one.

Jonathan
Just spell Cynefin? It’s not the obvious way is it?

Dal
C, Y, N, E, F, I, N, it's a Welsh word. There's some videos on Cynefin, it's a very good one. And then there's many vertical development groups. So, you've got the Harthill group, you've got stages that if you look up vertical development, there's many, many articles now on vertical development, and they'll describe the different stages of vertical development adults have. They can range from five stages up to 16 stages, depending on which model you use.

Jonathan
Great, thank you. We're coming towards the end, and I'd love to be talking a lot more. But are there any particular things in your leadership journey you'd like to highlight in this last part that we haven't yet covered?

Dal
Sometimes we focus a lot on leadership, about the doing, you know, and the decision making. I think that another big part of leadership is seeing the potential when people and processes and having the courage to fulfil that potential. So, it's not so much about how do I activate change, but how do I help the system and the process and the people I'm working with to really fulfil their potential. So, I think leadership is about looking into the future and saying, do we have the workforce? Do we have the people for the future? So, it's not just about now, it's about being future orientated. And I think that's what took me to the coaching space. I was in all these leadership roles, but I felt like I was not focusing on people and their development and their potential, and that's probably why I went down the coaching route. So, I think a big part of leadership is to really park your own agenda and say it's not about me, if anything. Sometimes, as leaders, our egos can get out of control and we start loving ourselves, be careful not to start loving yourself. That's a big shadow of leadership, I think we need to start thinking about, how can I get the best for a community using the people and processes that are there. How can I develop those people and processes? And I think sometimes, especially when their resources are poor, times poor as it is at the moment, development goes out the window. And we can't let development go out the window, that's a big part of leadership.

Jonathan
Coaching has obviously been quite significant for you, you've learned from doing it. Is there any particular key message that comes out of that for you?

Dal
Yeah, I think as I started to embrace coaching, it's now almost an equal in my career. I'd say I'm a half coach, half doctor. I think the beauty of coaching for me is, you have to learn to stand back and see what's unfolding in front of you. You can't sit there diagnosing or trying to lead the conversation. The conversation's about that other person, not about you. And it's so interesting how many times we go into a conversation not listening to understand, but we're listening to decide how we're going to respond. We're not really actively listening. So, coaching for me really taught me how to truly listen and hold that other person as the area of interest, as opposed to where my brain was going and what my brain was thinking and my brain was trying to correct things for them, or make decisions for them, or I know how I can help this person, that's not my job as a coach. So, I think there's some really vital skills about listening that happens also. I think there's something about freeing yourself from judgment. We're all judgmental. I mean, let's face it, no one's judgment free, but it does make you sit there and think, what am I judging this person for or about? And trying to free yourself from that, you know, just really seeing the human in front of you, rather than the labels that they or others might be putting on that person. So, I think there's something about seeing the human in front of you.

And then lastly, it's learning. Learning, learning, learning. So coaching, I think, is about clarity and growth. We sometimes jump in too early without that clarity. And so another thing coaching has taught me is to change the pace at which I operate. I've learned to get a lot slower. I used to run around like a headless chicken, being as active as possible, doing 200 things at once, and thought it was great if I was exhausted by the end of day, that meant I did a good day's job. I don't believe that anymore. I think it's about being thoughtful, being considerate, and sometimes allowing yourself to slow right down and just take stock, and I don't think we do that. We don't gift ourselves that time just to take stock. And if we did, we'd refresh ourselves, we'd re-energise ourselves, and we would see the world more clearly. And I think that's another part of coaching, I think that's really been helpful for me.

Jonathan
I think you’re absolutely right. That's quite a difficult thing in our busy world, isn't it?

Dal
Yeah.

Jonathan
But very valuable when we do.

Dal
I used to, especially during COVID, and we all started to work more from home, I'd have meetings program in from 7am to 7pm non-stop.

Jonathan
Yeah.

Dal
That wasn't the way to lead, it really wasn't. So, I would intentionally then start ending meetings 10 minutes earlier, or start a meeting 10 past the hour rather than the hour, and just go for a five-minute walk or just stretch my legs or something, just to reframe and refresh. I'm not asking people to do big changes, but there's little things that we can do to re-energise ourselves, to recharge ourselves, just to get ourselves back into the right headspace. Otherwise, we are just constantly on this overdrive. It's almost like over stimulation, an overstimulated brain. We see it in other people, we know when people are over stimulated, they don't make the best decisions.

Jonathan
So, something about the need to look after ourselves and our own well-being.

Dal
Taking a five-minute walk out the ward is okay, because if there's an emergency, you will be notified, you know. So, I think it's permission to do those smaller things. I'm not saying go off for two hours and come back, but no one's going to say you can't have five minutes. It's being wiser about your time, smarter about your time. You don't have to just be automated all the time, you don't have to be passive about this all the time. I think you have to learn to take a step back and think about your energy, think about your resources. You know, we get on a plane and we say, put the oxygen mask on yourself before someone else right? We say that all the time, but how often do we care for ourselves before we care for others?

Jonathan
I think we feel that we're not allowed to sometimes, but we're caring for others first.

Dal
Yeah, and the word selfish comes up quite a lot when I say that, I can't possibly be selfish. Well, would it be selfish? Would it be safe to make sure that you're safe first before you then treat somebody else? I don't know, there's a balance in all of this, isn't there. I think to not pay attention to yourself at all is probably quite selfish, because then that patient doesn't get the best version of you. So, I think there are decisions that we sometimes have to make. And the reality is, it's hard times, isn't it? We're all exhausted, the work is demanding, the resources are poor. It's this real sense of overwhelm at the moment, and in that overwhelm, we need to learn to lead ourselves as well as lead others. And we forget the leading ourselves, don't we? There's a responsibility for that, and that is part of that authenticity, isn't it? Can I really say that I made the right choice by not taking that five-minute break today?

Jonathan
On that note, I think we're going to have to draw to a close. It's been fantastic talk, and I'd love to have a few hours to go through more about all of these things, but we thought a bit about authentic leadership, leadership and complexity, these concepts so important for us, thanks so much for sharing.

Dal
You're welcome.

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Narrator
Thank you for listening to this Leading the way episode from the Royal College of Paediatrics and Child Health. The thoughts and opinions expressed in this podcast relate solely to the speakers and not necessarily to their employer, organisation, RCPCH or any other groups or individuals. You can find the transcript to this episode and more from the Leading the way podcast on our website, RCPCH Learning – go to learning.rcpch.ac.uk.

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(Music starts)

Jonathan Darling

Hello and welcome to this RCPCH series of podcasts on leadership. I'm Jonathan Darling. I'm Vice President for Education and Professional Development at the Royal College of Paediatrics and Child health, and this podcast comes from our belief that leadership is for everyone and it's about making a difference around us in our clinical and wider work. Today, it's my pleasure to introduce Joshua Hodgson, who's an ST6 trainee at Evelina Children's Hospital, and I'm hoping this will give us an opportunity to think about how leadership fits in with training, and to talk about some of those issues and maybe some resources that can help us. Josh, a warm welcome to the podcast.

Josh Hodgson

Thanks so much for having me, Jonathan.

Jonathan Darling

So maybe to start off, Joshua, if you'd tell us a bit about your journey so far, where you're at in training, and maybe a few things you've done along the way, just to kind of give us a feel for where you're at.

Josh Hodgson

Certainly, yeah. So, as you've said, I'm a specialty trainee in year six in London, currently the Evelina London Children's Hospital and undertaking paediatric intensive care medicine subspecialty training. So that's the clinical context. We're here today to talk about leadership. So, how has my leadership journey unfolded? I think, as is the case for many people, it's been somewhat serendipitous, and I've been lucky to have opportunities come along the way. And those things have ultimately led to some roles which I'm undertaking at the moment, including as the ePortfolio and curriculum representative for trainees across the country with the Royal College of peds and also with the faculty of medical leadership and management, FMLM on their trainee steering group as their communications lead. And I'm sure we might come on to explore how I came to get those roles and the opportunities that they've opened for me and others.

Jonathan

Great. Well, you mentioned about this sort of idea of serendipity and things coming your way. Tell us then what might have been one of those that led you towards thinking about leadership?

Josh

Yeah, well, I think there have probably been countless ones over the years, as is the nature of all of our lives, and probably many of them have passed me by without even realizing, but there's one that's definitely stuck with me as being a very obvious, fortunate opportunity. And that was when I was in ST1, ST2, pretty junior in training, and was approached by one of my consultants at the time with an opportunity to join a pilot leadership program run by one of the big hospitals in London. They were recruiting trainees of different experiences, at different grades to pilot this program. And I happened to be there, one of the trainees that this consultant approached, we had a bit of a pre-existing relationship and thought that I would be suitable to give this a go and see what the pilot can learn from us and what we can learn from it. So, we had a conversation around that, and we agreed that it would be a good idea to jump at the opportunity, and that was a significant leadership course and a qualification, despite it being a pilot, that then enabled me to put that on my CV, have lots of other conversations when I was applying for progressive leadership roles, and I think I really struggled to see how I would have followed the pathway that I have done without that window, having presented serendipitously through that one particular consultant at that time.

Jonathan

So that opportunity came along and you grabbed it. Did you have any second thoughts? Or was it an easy decision?

Josh

It was relatively easy because I think I was grateful to have been in the position to be approached by the consultant. It could have been anyone, I didn't see myself as being any more qualified to be approached and to receive that offer than anyone else. So, I think recognizing that was helpful. And yeah, therefore I felt it would be crazy to turn down this opportunity, but I equally did feel a bit nervous and a bit intimidated. I'd be trying this pilot I knew as one of the most junior trainees amongst lots of other senior trainees ready to become consultants. So, it was a little bit intimidating at the same time, but I knew it was a great opportunity, and so had a conversation with the consultant, learnt a bit more about it, and thought, yeah, let's give it a go.

Jonathan

Great. So, some of our listeners might be wondering, well, is this pilot or the course still around, because they might want to join it, but I believe it's not still continuing. Is that right?

Josh

No, it's not, like many other great up and running projects, the pandemic finished it off, from what I understand, which is a great shame, and hopefully they can re-establish it or something similar going forwards. But indeed, there are various other similar opportunities to develop leadership experience and learning that can be implemented in practice, progressively senior roles. So, there are alternatives, and I'm very happy to talk about those, and how trainees can think about getting involved.

Jonathan

Well, maybe we'll come and cover those towards the end. Coming back to your course, what would you say you took from it? You talked about it leading on to other opportunities, and it made you think about being involved in leadership in a way that perhaps you wouldn't have done otherwise. But was there anything particularly you actually took from doing that course that you'd like to share?

Josh

So, what did I take from this course personally? Well, I think again, there are two key things there for me. The first is the very practical consequence of being able to build a CV that was a bit more leadership slanted, and that inevitably opened up some doors and opportunities to take roles further. The second is the skills that I learned during the course, which were transferable, and all of these are non-technical, human skills that are not surprising things. But I think if I had to choose a single one as standing out, that would be communication.

Communication, I think, is the most important thing in so many aspects of our life, professional and indeed personal lives also just as true for leadership, I think, and I really began to appreciate how important it is in different contexts, in emails that you might be writing to your team or in the context of meetings, and so was able to communicate a bit more consciously and in a different style of leadership and management, and been able to take that forwards and expand on it further in all the roles and other experiences that I've gained since.

Jonathan

Brilliant, so you had that amazing experience it sounds like, where you were able to combine theory about leadership, some practice, reflection, mentorship, all coming together, and then some things you took away and you've mentioned communication as a particular one. And just stepping back a bit, and I wonder, as we think about where leadership fits with training, what's the reason somebody might consider doing it? You know, getting involved in leadership roles during training when you've already got quite a lot to do and you might think, well, I'll just delay that till a bit later on. Can you give us some thoughts on why do it during your training?

Josh

I think that's such an important comment, because training is busy. We'll all know there's plenty to do just to get through each year, tick the curriculum boxes, get through ARCP as well as perform well, if not better, doing our normal day to day job. So, what's the benefit of doing these things, which we might consider to be extra? Well, I think there are two things to say there. The first is that arguably, some of these things are not extra, and leadership and management features in the college curriculum from ST1 through to ST8. And so developing some sort of these skills is a necessary part of our training. And I think that's completely appropriate. The it is possible to tick those curriculum boxes without doing too much in our own time, which, again, I think is the correct thing. That's how training should be. But, if you wanted to take things a bit further, as I and many others have done, then there are opportunities to do so. Why would someone want to do that? Why would someone want to go to dive even further into leadership as a trainee in particular?

Well, I think it's in order to gain skills that you can then carry forwards. I mentioned communication being one, you might focus on other soft skills, team working, and many more. And I think these are helpful for all aspects of our work. So, you learn a lot of transferable skills actually. I think the other thing to say is that leadership is how we drive change, and I know for me, when I was a trainee, even from the very beginning, I was so frustrated by silly things I was seeing going on around me. Maybe it was a particular process, getting on the computer, having to change my password every five minutes, or some frustration at work that we all experience countless times a day. And I felt disempowered by not being able to change those things and thought it would be so nice if I could just make everyone's working life easier and ultimately, hope to look after our children and our families in the best way. So how do we do that?

Well, it's through leadership. And management is how we drive change. And so from a fairly early period, I wanted to do what I could in order to do that, in order to make our care and our working lives better. And I think the final reason that someone might want to start building a bit more of a career around leadership and management from a fairly early stage is in order to be able to progress that later on in their career as well. I always think about as trainees, we can sort of direct our career in a few different directions.

There's obviously the clinical side of things which should come first and foremost in training. But then there might be other secondary interests we develop. Lots of people choose to do something around education which is brilliant. Others may choose to do research, and I think another third arm is leadership and management. And often, as I see consultants and think about their lives more, they tend to have a secondary focus alongside their clinical work in in one of those three areas, principally. And so personally, I envisage having more of an interest and more of a role in in leadership and management for the same reasons of being able to drive change. I think that's a very different way of working to our clinical work, which is interesting. And so being able to build a bit more of a career that's aligned with those goals from a fairly early stage, I think, is a sensible thing.

Jonathan

Thank you. You've done roles within RCPCH, in the trainees committee and so on. Just briefly mention those roles, but I think it'd be helpful if you could say a bit more about the experience of volunteering with the Royal College of Paediatrics and Child health, and what it's meant for you, what others might take from doing that.

Josh

Absolutely, So I've been working with the trainees committee for the Royal College of Paediatrics and Child health for around five years now, that was with two roles. The first was as the regional representative for my area geographically, and the second was as the e-Portfolio and curriculum representative. So, they've been enormously valuable experience, and I'd really encourage any listeners, trainees, to think about applying for those, and trainers to encourage their trainees to do so If you find them all on the College website. They've been great opportunities to see the inner workings of the college, which, at a fundamental level, has just been interesting and they've been really valuable experiential opportunities to develop my skills.

I've had a real privilege through those roles in terms of meeting plenty of people within and beyond the college who are interesting and have lots of input to the wider delivery of child health within the NHS. I've been able to undertake some project work, including a nationwide survey of neonatal resuscitation training and from a personal point of view, that's been helpful in CV building, to have a publication out of it, for example, and much more importantly, it was hopefully beneficial for our training and our patients ultimately. And being able to do a big piece of work like that at a national level was something I definitely would not have been able to do if it weren't for having a role on a national committee such as for the college. So, I think, in summary, it's an opportunity to meet interesting people, understand the wider healthcare system and to make a change at a big level.

Jonathan

Thank you. The other thing you've been involved with is FMLM. I always find it difficult to say that one, but stands for faculty of medical leadership and management. Tell us a bit about what that does from your perspective and how you're involved.

Josh

Thanks Jonathan, yeah, spot on. FMLM, bit of a tongue twister. Yeah, exactly. So I've worked with their trainee steering group for a couple of years now as their communications lead. And I think the really, the benefits have been very similar, and it's another national committee. This is obviously now for a body that is specifically leadership and management focused, and also is multi-specialty, so that's provided a very different spin on the sphere of leadership and management for me, as well as having the direct experience that was very comparable having a role on a national committee. It's also enabled me to interact with people and organizations who are specifically focused on healthcare, leadership and management. So again, it’d been very interesting to see that organization develop and grow and have some insight and contribution to the inner workings.

Learnt a huge amount about soft skills, we've had some additional training through that, which has been great. And again, an opportunity to drive big change at a high level that's in the meta position of being related to leadership and management. And if I had to choose one example of an amazing piece of work that trainees should be aware of that's done by the FMLM Trainee steering group, it would be their leadership commitment. So, everyone can go and have a look at that, I'd really recommend it, and that's a document that any local trust can subscribe to, commit to delivering a certain standard of leadership training and experiences for all of their resident doctors they have. So that could be a powerful piece of paper to see A) what we as resident doctors should expect from our employers with regards to our leadership management training and B) for employers to aspire to and then commit to delivering.

Jonathan

Thank you. Now that leads us on, I think, to resources we touched on those earlier. So FMLM, I think you're a member, aren't you? That's right. Take it to another level by becoming a member and then there's a fellowship and so on. But what other resources are you aware of? The people who are thinking, I'd like to develop my leadership abilities and skills, and I'm not sure where to turn. Tell us a bit more what you've found could be useful.

Josh

Yeah, really important. Listeners might be thinking, oh, this is all well and good. Josh got lucky and had an opportunity come on. But what can I do if this is something that I want to develop? There are things you can do.

The first and most important thing, I think, is knowing where to look, in case you don't remember everything that Jonathan and I talked about today, which I think would be very forgivable. I would really recommend the Royal College of Paediatrics and Child Health Leadership hub. That's a web page that has a collection of resources, they're really worth taking a look at. The FMLM also have a similar set of resources available on their website as a landing page, and indeed, the two websites link to one another, and that will summarize two things that we've talked about earlier. A) getting the theoretical foundation, and B), getting the experience.

So, what are some, some examples of those things that you'll find on those web pages, but you can also search for separately. Well, an example of a learning course that is readily accessible to everyone to establish the theory is through the NHS Leadership Academy. They have various resources actually, but one that I would really recommend is the Edward Jenner program. That's one I've done myself. It's fairly straightforward, doesn't take too much time, it's free as a modular digital learning program that encourages a bit of foundational learning and some reflection about your own experiences as well. So that's the Edward Jenner program through the NHS Leadership Academy, well worth taking a look at.

And then, what about experiences? At some point you have to get a bit stuck in and really that's how we learn soft human skills, which are the foundation of leadership and management. And I think you can think at every level, you can think about local departmental level. It might be that you choose to take on a role as a trust representative or as a rota coordinator or coordinating their teaching program within your department, for example. You may look beyond the department; you may look to the region and your school of Paediatrics for example, they'll have a committee that you could get involved with, have a look at their website, and indeed, beyond to national committees and national roles. I've spoken a bit about the couple with which I'm involved.

Another thing to be aware of is there are these things called Leadership fellowships out there. So various organizations offer these, they're often one-year programs that could be taken out of program, for example. And examples include the Darzi fellowship, the Royal College of Paediatrics again, have a Leadership Fellow, and also the FMLM have their own as well. There'll be various other organizations too, you could do it in other contexts, like global health, for example.

We've spoken a bit about getting the theory, getting the experience. And I think the third piece of the puzzle is getting this all documented and recorded so that you can evidence it if you're applying for other roles. And also, it's just an opportunity to reflect, so you can document this experience in any way that you wish. What I'd recommend, though, is some form of leadership passport. And again, the FMLM is a great place to look for that. They have a template document called their leadership passport, which just encourages you to document the learning that you're taking, both theoretical and experiential, and do a bit of reflection. And you can use that to really build a strong portfolio, if that's what you want to.

Jonathan

Is that an ePortfolio type document or something you download and keep in your own files?

Josh

Yeah, it's in PDF format on their web page, from what I understand at the moment.

Jonathan

Sounds very useful. As we come to towards the end, I'm thinking about, how do we combine leadership and our clinical roles and the rest of life. How do you make it all fit together?

Josh

Yeah, I think particularly as a trainee or a resident doctor, that can be a challenge, because we don't have much time outside of our clinical service delivery in order to work on these things. That maybe some consultants have dedicated professional activity time to a leadership role, but we don't as junior doctors unless we're doing one of these leadership fellowships that we've just talked about. So, balancing all of that, life's complicated enough, isn't it? It's difficult, and I think there's no ubiquitous solution. Everyone's going to have a slightly different way of working these things in.

I think being opportunistic is important, and understanding that actually, our day-to-day work involves a huge amount of leadership and management, and we don't necessarily need to do much more. It's more about how we think and reflect on the things that we are doing. And we can certainly use some of the time that we have. We should, in accordance with the trainee charter, be entitled to some time to develop our own curriculum, and a part of that is leadership and management. So in time that we should all have incorporated in our rotors to be off clinical duty, to develop ourselves, that would be a very good opportunity to look at undertaking some of these courses that we've spoken about, or even a local leadership role, and spend some time doing the associated work with that, for example.

And again, some of the project work we’ll undertake anyway, if people are undertaking quality improvement work, for example, this is a form of leadership and management absolutely, especially if you're overseeing such a project. So, a lot of the stuff we'll already be doing will be very relevant 100%. It may be that people want to go above and beyond and still use some of their own time to develop these things in this portfolio further because it's an interest or they're particularly dedicated. And I think that's also fine if people want to do that, it's just like any other aspect of work that we have to be conscious. We have to balance it against our other enjoyments and things in life and make sure that we're not getting too focused on work and detracting from other things.

Jonathan

Thank you, and you're not so far off your the end of training, two or three years I think?

Josh

That's right.

Jonathan

Are you aware of any good resources or things that can help in terms of stepping up to being a consultant in due course?

Josh

Yeah, well, the Royal College of Paediatrics offer a transition to consultant course, which is which is really helpful. I've heard positive feedback from that, from peers who are a bit ahead of me and have been through that process. And the other thing I'm anticipating is just spending increasing amounts of time talking to consultants and people who have gone through the process recently, and really learning from them about what the challenges are, what the great aspects are as well, and understanding what we can do to help ourselves with that transition.

Jonathan

Thank you. I think we're bit out of time. Josh, it's been great talking, and we've covered lots of useful resources and things that can help people who are either in training or involved with trainees, or for any of us in our leadership journey, there's lots in that that I think we can take away and use usefully. So, thanks very much for the chance to talk. We're coming towards the end, but as we do that, would you like to give us a final thought about leadership?

Josh

Yeah, well, thanks so much for having me today, John, it's been great to talk about this stuff. So, I'll just end on a on a message to the resident doctors out there, I think. That is to say that you can, you can do this stuff, leadership and management. You're doing it already, even if you don't know it. And if you want to take it further, then you absolutely can. How do you do that? Get yourself on the Royal College of Paediatrics leadership hub. Have a look at what's on there, undertake some basic foundational training. The NHS Leadership Academy is a great place to look for that. Think about taking on some roles locally, regionally, even nationally, if you want to, and spend some time reflecting and getting it all documented. I think you'll have a lot of fun. I think you'll develop as a doctor and even, dare I say it, as a person, you'll meet a lot of interesting people, and first and foremost, the reason we all go to work every day, this is all about making lives better for our patients and their families.

Jonathan

That's a great message to finish on. Thanks, Josh.

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RCPCH

Thank you for listening to this Leading the way episode from the Royal College of Paediatrics and Child Health. The thoughts and opinions expressed in this podcast relate solely to the speakers and not necessarily to their employer, organisation, RCPCH or any other groups or individuals. You can find the transcript to this episode and more from the Leading the way podcast on our website, RCPCH Learning – go to https://learning.dot.ac.uk.  

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(Music starts)

Jonathan Darling
Hello I'm Jonathan Darling, Vice President for Education and Professional Development at RCPCH. Welcome to Leading the Way, our podcast series on leadership. And this podcast comes out of our belief that better leadership skills are good for all of us, not just a few and that we can learn from people's stories and experiences and how we approach leadership can positively change the environment around us and make a difference for our patients, our colleagues and the systems we work in. So, we hope that as you join us on this and future podcasts, we'll learn together about better leadership. I’m really excited to introduce today’s guest, Emma Dyer. Emma is an ST7 Paediatric Emergency Medicine trainee at the Royal London hospital, and she's the outgoing Chair of the Trainees Committee at RCPCH. So, it's a real pleasure to welcome you, Emma, thanks for joining us today. First thing I'd like to ask is about how you came to be the chair of the Trainee committee?

Emma Dyer
Yeah, absolutely, and thanks so much for having me. So, years ago, through a colleague, I ended up piloting and testing the ePortfolio when it was in its early stages, and it was quite interesting. And then a bit after that, the role of the ePortfolio and curriculum rep became vacant on the Trainees Committee. So, I applied for that, thinking that it might be quite interesting and try to help make some improvements and improve things around that area. And I ended up getting the role, and I did that role for almost three years on the committee, and then towards the end of my time in that role, the chair position became vacant, and it wasn't ever something I'd really thought about doing. Always sort of thought that those kind of leadership positions were maybe for other people.
But then a few people on the committee, or who worked with the committee, approached me and asked if I'd be interested in applying, and they said they thought maybe would fit the role. So, I gave it some thought and decided to go for it, and applied, and was lucky enough to be elected. So yeah, it required a bit of prompting from other people, but I'm really glad that they did and that I did put myself forward for it.

Jonathan
I'm interested in the bit of where you said those roles are for other people. That's what you kind of initially thought when you heard about that, just tell me more about that.

Emma
Yeah, I think I'd always sort of thought that leaders, or people that were in positions of leadership, were people who were kind of maybe a bit louder, maybe quite charismatic, maybe kind of very sociable. I didn't really see myself as that kind of a person. I'm a bit more of an introvert, maybe a bit quieter, so I kind of didn't necessarily see myself as a natural leader. But I think especially through that role, I've kind of learned that there all different types of leaders, and actually that you can find your own leadership style. My leadership style is not always the loudest, but I think that I do well in terms of, you know, being collaborative and bringing other people along with me, and being able to make my points in a, maybe not always a very loud way, but a way that people will respect and listen to because of the other skills I have. So, I think I've learned that you don't always have to be that kind of stereotypical, very charismatic and loud person to be a leader, that there are lots of different types of leaders, and you can find your own way of doing it, and that can be just as successful.

Jonathan
Fantastic. You mentioned that you first did that role of, was it ePortfolio rep?

Emma
Hmmm.

Jonathan
So that is on the Trainees Committee?

Emma
Yeah, that’s part of it.

Jonathan
You were part of that committee for a few years?

Emma
Yeah, I think almost 3 years in the end before I did the chair role, yeah.

Jonathan
And do you think that was it important or helpful in preparing for the chair role or would it be easy to step into it without having done that?

Emma
I think it was definitely helpful. Just in terms of, kind of those relationships, getting to know people within not only the committee, but within the college team, the wider kind of volunteer roles, and knowing kind of how those processes worked, how things at the college worked, meant that when I did step into the chair role, there was still lots to learn, but I at least had a kind of basic grounding in how those things worked, and who the people I was going to be working with were. Because I think in a role like that, it's all about relationships. It's all about being able to work well with the people around you to get stuff happening.

Jonathan
Hmm. And going back to that first role, the ePortfolio role, just say a bit more about why that appealed to you or what drew you in to doing that?

Emma
I think I mean, any trainees who are listening will probably sympathize, especially when the ePortfolio that we currently use first was brought in, because I've been a trainee for a while, it wasn't always great, and I think we were very keen to spend a lot of time complaining about how terrible it was. And I thought, well, actually, maybe this is a chance to try and make things better and actually do something about the complaining, rather than just complain. So, I think that was the thing that drew me to it, that maybe it was a chance to, you know, make a bit of a difference and try and improve things to the trainees in a small way.

Jonathan
Yeah, because I think it’s interesting where leadership you can think of it as trying to make things better for our patients, for our colleagues, for the system. That was your first step in a way, and then that led on to being chair of trainees committee. Just looking back on your time as chair of trainees committee, how has that been? Is it overall positive or has it been difficult, or what are your reflections on it?

Emma
Definitely positive, I love doing the role. I mean, it's been challenging at times. It's a really busy role, and there's a lot of juggling to try and fit everything in, especially around work. And whilst doing the role, I had a baby. So another thing to juggle it around, but it's been a really, really great role, very fulfilling, very interesting. Loads of amazing opportunities that I would never have got the chance otherwise, you know, to be in a room with really interesting people, very passionate about what they do, and also with people who have power to actually make changes happen. And I get to be at that table kind of trying to put the trainee voice across, or make the case for paediatrics, or whatever it may be. So, yeah, it was great.
And I got to work with a bunch of amazing people as well. I mean, the other trainees that are on the committee, you know, there's such a brilliant bunch of really committed, passionate, inspiring people. I mean, it was a joy to be able to chair that
committee, and then also the team within the college. I mean, I got to know so many of the college staff, who again, are just so great to work with, really, genuinely care about the lives of trainees and trying to make things better, really care about children and young people and their experiences. And to getting to kind of work with those groups of people was, yeah, amazing.

Jonathan
And can you just give a bit of insight into things you've been particularly involved in doing over the period of your term?

Emma
Wow, yeah, it's hard to like when you look back on it, remember everything, but there's been a lot of stuff that's been going on. I mean, obviously, when I first became chair, we were just transitioning over to Progress Plus. So, there was kind of all the work around that, making sure that the transition was as smooth as possible. And then when there were bumps in the road, trying to work to, you know, iron those out the best way that we could.
We've done lots of work around the Training Charter, which is kind of owned by the Trainees Committee. So, we've made updates for that, and then within that, we've looked recently more specifically around issues of with SPA time. We know that lots of things are not getting access to it, so we've developed resources and things to try and improve that. Through that, we've also run a national training charter survey to see how that's being adhered to throughout the country and where improvements need to be made and we’ve now got a working group looking at taking that forward.
We've done lots of different work. There was one of our amazing reps in our committee Gemma, was really passionate about writing some guidance around pregnancy loss and fertility issues for people in training but actually applicable to anyone really in the health service. And with her leading that, we set up a small group, we wrote this guidance, and then we were able to get it approved as an official college policy. But actually also we took it to the Academy of Royal Medical Colleges, and they also now published it through their website, so hopefully that document can be accessed by any specialty now not just paediatrics.
So, it's another piece of work that, like, I'm super proud of and amazing to come out of paediatric trainees, this one trainee in particular who was leading the way on it. So there's been loads of stuff, like, really, varied things that we've been able to do. And at the moment, we're doing a lot of work with the college and other work streams within the college looking at the exam and assessments strategy, how we're going to develop that going forward. So, loads of that going on, and I'm sure I could go on with much more, but that would take the rest of the podcast.

Jonathan
It’s great to get that sense of some of the things that you’ve been able to accomplish. And just to give me a sense of the Trainees Committee, how many people are on it?

Emma
That’s a great question, and I should probably know the exact number. I think we number around 30 something now, because we have all our regional reps. So, every region across the four nations has a representative, some regions more than one, depending on the size. So, then we have all the regional reps. And then we have the kind of more subject specific reps. So, we've got some less than full time reps, we've got, like, recruitment rep, exams rep, ePortfolio rep, EDI rep, digital rep. I'm going to miss people off, but then we've got the chair and the vice chair as well. So, there's lots of different people within our also got an academic rep as well. So, it's quite a big committee, but I think it's important we have that representation from across the whole training body.

Jonathan
And does that bring challenges in terms of how you represent the voice of so many people? And obviously you represent your trainees, but that’s quite a big group in your committee to bring together. Do you find that’s difficult?

Emma
Yeah, it can be a challenge. I think I'm always really keen in the meetings that we have to make sure that everybody kind of gets a chance to speak, that wants to speak, so we are making sure we hear everyone's voice. I think, especially being across the four nations, that things can be experienced quite differently in different areas. So, making sure that we bring all of that in, I mean we're all on different contracts. So, you know, obviously the people who are in Wales and Scotland and Ireland have a different contract to those in England. So, you know, trying to make sure that we remember that and represent everybody it's really important.
But I think one of the things that has made it easier, in a way, is that the college, and I didn't know this before I started working in the Trainee Committee, but at our college, the trainee voices really embedded at every level of College life. So, in my role as chair, I was part of the executive committee of the College, as well as the College Council, the education and training exec and in every committee within the college, there's usually a trainee rep or at least space for a trainee rep. So, that voice is not just the Trainees Committee, that voice is embedded throughout the college all the way up to the most senior like committee within the college. So, there's always a trainee voice in the room, which I think is so important, and that's been really amazing to see and be part of.

Jonathan
Yeah, it certainly struck me in my role how well the trainee voice is represented. And just on what you said about trying to make sure everyone's voice is heard, how practically do you do that?

Emma
I don’t think I’ve got it perfect by any stretch. I dunno, I’m always aware in meetings. I remember when I first joined in my role, that I would hardly ever put my hand up and say stuff in a meeting because it always seemed a bit intimidating. So, I'm always aware that there might be people that feel that way, and I think a lot of our meetings are remote. So, there's different ways people can get involved. And actually, some people maybe feel more comfortable using like, the chat function rather than speaking up. So, to make sure there's kind of different ways people can feedback and that we kind of look at all of that I think can be helpful.
I found when we have in person meetings, sometimes breaking people up into smaller groups so that people can have, like, a more informal discussion, and then feeding back in means that people that maybe aren't so happy speaking up in a big group, might feel comfortable to speak up in a smaller group, and that gives more voices a chance to be heard as well. And we also have WhatsApp groups and stuff where we can bring up issues and feed stuff back in between meetings. I don't know if that's the perfect way of doing things, but that's the way that we try to make it work. But yeah, it's something I'm conscious of because I know that sometimes that used to be me, that was the one that was unsure of speaking up in a group so I'm always trying to be aware of that.

Jonathan
I’m sure the first step is to be conscious of it and then you think of ways to address it as you have.

Emma
I hope so.

Jonathan
Going back to what you said about it’s a busy role, and then you said you’ve had a baby as well. I’m just reflecting on how people might think it’s busy enough doing your paediatric training job, never mind taking on a College role, never mind having a baby. How do you actually combine all these things, how’s that worked out.

Emma
You’ve just got to do it. I mean, obviously yeah, I did the role through maternity leave, which actually in the beginning was like quite good in a way. I think this is my first baby so it was a big shift to go from, you know, working and being really focused on your career and your road to just running your life to suddenly having no work and this tiny human look after. And actually having a college role and that little bit of
structure and that little bit of keeping in touch with the medical world, I think for me, was quite a good thing, and maybe helped keep me a little bit sane in this first few months of maternity leave.
It might not be right for everyone, but for me, I think that was actually quite good. It was a juggle and I'm not going to lie, towards the end of the role, I was sometimes trying to do meetings with an almost two-year-old, who was trying to burn the house down, and was quite a different challenge than when you’ve got a newborn baby that you know, that will generally just be happy to be held or sleep or whatever.
It was a juggle, and I think especially when I went back to work, then juggling college stuff, with my family life, with my rota, and it was difficult, but at the same time, I think taught me a lot of important skills. So, I learned to be a bit better, although my husband would probably disagree, but I think I learned to be a bit better at putting boundaries and managing expectations a bit more about when I might be able to be available or when I might be able to get something done by, being a bit more careful around that I think.
And also, I think in a way, having a baby and making sure I needed to give him and my family time, and that when I was doing work or college stuff, I was kind of more focused on it and more present, because I knew that I've got a limited time now to do this bit of my life, because then I need to go and be with my son or whatever it is. So, I think in a way, it kind of made me more present and more focused when I was doing that. There's definitely a juggle but then I think again, it's really important that to see women in leadership roles, but also women with families, and also men with families who are still very present fathers at home, to show people that it's possible to do that. It doesn't have to be one or the other.
It does require a lot of organization and juggling, and there are some things that I just I'm not able to make because I don’t have childcare that day, and that's just how it is. But I think it's important that we can show people that we can do that. And actually, being at the college has been great for that, because, as you might imagine, quite child friendly. And so, my son, poor thing, has been brought up out of the college and has come to many meetings and been to conference where they've got an amazing creche that he had a great time at.
You know, I've been made very welcome in meetings where I've been breastfeeding or they've provided a room that if we needed to go and have a bit quiet time, he could go to. There's even a widening participation Fund, which will help fund costs of additional childcare if you need it to make meetings. So, it's a much easier place, I think, to do that than maybe other places, and I think that's been really lovely to see. And I know other trainee reps with children have taken advantage as well.

Jonathan
It’s good to mention those things. Is there anything else along those lines to mention that helps when trying to juggle family life and college commitments, work commitments?

Emma
Being organised is helpful. I mean you have to plan everything in advance, having a supportive family also helps. I’ve got a very supportive husband and wider family I’m really lucky with that. But yeah, I think you can do it, It's hard. And I'm not saying it’s without sacrifice and it may not be for everybody but I think it is possible. And I know for me, like I've got a little boy, and I want him to grow up knowing and seeing that women can do important things and be in positions of leadership, and it doesn't have to be men or people who don't have children or whatever. I think it's important to kind of model that as well.

Jonathan
Going back to your earlier comment when you said you wouldn’t think you would do that role, it was not for you. As you look back now, you obviously have done it really well and it’s been very positive for you too. What would you say to somebody else who’s looking at a role and thinking I couldn’t do that, how do you make the step?

Emma
I think the more you do these kind of roles, meet people who do these kind of roles, the more you realize that actually everybody who does leadership roles, to some extent, has a bit of imposter syndrome. I think most people I've spoken to in leadership roles have a little bit of that to some extent, and maybe some more than others. But I did a really interesting exercise when I came back to work after maternity leave through the support program, I got some free coaching. And one of the things, the exercises they made me do was to reflect on sometimes that I could identify where I felt that I thrived in a work environment. So, I did that, and I came up with a couple. And then I look back at them, they all had, like a similar theme, that they were all times when I had to do something, or I did something that felt quite out of my comfort zone, that maybe I was a bit anxious about or a bit nervous about doing. But then had all been times that actually I felt, in the end, that I thrived at.
I think that gave me a bit of confidence to kind of embrace opportunities that initially made me feel a bit nervous or I thought were a bit daunting, because I knew from doing this exercise, actually often the times when I found that I actually thrived, and I think sometimes pushing yourself a little bit out of that comfort zone can provide you with opportunities and experiences that you just didn't think maybe you could have, or that worked for you, and I think that's given me a bit of confidence to maybe try and embrace that a bit more going forward.

Jonathan
So can you tell us a bit more about that support programme that you mentioned?

Emma
Yeah, absolutely. So it's a program, I think, available nationally to trainees from all specialties, offering resources, but also there's some funding as well available for trainees that are coming back into clinical practice from a time away, and that often could be some statutory leave, like maternity leave or shared parental leave or paternity leave, but also applies to people who may have, you know, had some time out to do a PhD or something like that. So, anyone that's returning to practice, and you can apply for funding to help with courses or to help your department kind of provide some locums to give you more support on your first shifts back. And there's also resources that you can access as well. So, if anyone's interested, you can just Google support program and it's spelled s, u, double P, O, and then capital R, T, T, and you'll be able to get all the information online.

Jonathan
Fantastic. Thank you. Could you give us an example of one of those things when you were reflecting that you thrived at but it was outside of your comfort zone?

Emma
I think it was often things like one of them was presenting at conference, doing like an oral presentation at a conference, which public speaking was always something that I found quite difficult and didn't come naturally to me. So that kind of thing always kind of made me feel quite anxious, and do I really want to do this? But actually, when I did it, I was like, oh, okay, like that actually went quite well, and I got some nice feedback, and maybe this is something I can do. So, things like that, I think, were the things I identified where, yeah, initially was quite unsure about it, and actually turned out to be something quite positive.

Jonathan
As you kind of reflect on your trainee committee role, what would you say you learned about leadership that you’d share with others to reflect on?

Emma
I think I've learned that leadership is often not about you. For me anyway, I think it's often about the people around you, and actually what you can get out of them. And I think being able to use your leadership position to give other people kind of opportunities and support them and provide them with the kind of connections that you might have because of your position to be able to go off and do the thing that they are passionate about or really good at, I think that's been really nice. That's been a really kind of positive thing about having a position of leadership and that's been nice.
I think I've definitely learned that you don't have to do leadership in the style of someone else. You can find your way of doing it. You don't have to be the loudest
person in the room to be a good leader so that's been quite good. And I think the other thing that I've maybe taken away is that I've got this friend who has this lovely saying, and I think it translates something like bloom, where you grow. And I think when you're looking at trying to fix that, or like you look at the NHS or the world and all the issues that there are, it can feel really overwhelming and you kind of feel like, well, I can't do anything about that, but I think if you can just focus on improving little things in your sphere of influence, and kind of leave your little patch better than you found it, whatever and wherever that may be, I think that's a nice goal to have.
And I think by taking up leadership positions, it allows you to do that, and it might just be small changes in small ways, that if you can make even a little bit of positive difference, then that is something. And I think that's how I try to look at it. I don't think, you know, I'm going to change the world, or fix the NHS or training or anything like that, but if you can just make some small improvements, and if everybody did that, then I think that's not a bad goal to have.

Jonathan
And I think that is leadership. Well, that’s a great place to be drawing to a close is there anything you'd particularly like to mention as we finish, some key takeaways?

Emma
I think the only other thing I would add is that, if you're looking at something and thinking, oh, that's probably something for someone else, maybe have a go, maybe apply and see what happens and if that thing is, you know, at the college, I would definitely encourage people to get involved. I’ve had a great experience being involved with the college and you know, I think other people would do too. So, if that's something you're interested in, or you think might be a nice fit, or even think you might not be, have a think about it. And then, yeah, don't be afraid to kind of put yourself out there. You never know what might happen.

Jonathan
Fantastic. Well Emma, thanks very much for the chance to chat today. I think you’ve said, there's lots of really great lessons that have come out of that.

Emma
Thanks so much for having me.

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Voiceover
Thank you for listening to this Leading the way episode from the Royal College of Paediatrics and Child Health. The thoughts and opinions expressed in this podcast relate solely to the speakers and not necessarily to their employer, organisation, RCPCH or any other groups or individuals. You can find the transcript to this episode
and more from the Leading the way podcast on our website, RCPCH Learning – go to learning dot RCPCH dot ac dot uk.

(Music fades out)

(Music starts)

Jonathan Darling

Hello, I'm Jonathan Darling, and I'm Vice President for Education and Professional Development at the Royal College of paediatrics and Child Health. Welcome to this leadership podcast series. The podcast comes out of our belief that better leadership skills good for all of us, not just a few, and our approach to leadership for each of us is vital to professional effectiveness. It positively changes the zone of influence we have around us. So, do you want to be a more effective leader? Then join us on this and future podcasts as we learn together about effective leadership. I'm really excited to introduce today's guest, Simon Broughton. Simon is a general paediatrician at King's College Hospital, and he's held multiple senior roles in education and training that he's going to tell us about during our talk, and he's currently our officer for recruitment at RCPCH. So, a warm welcome, Simon.

Simon Broughton

Many thanks, Jonathan. It's a great honour to be invited and to help to start this podcast.

Jonathan

Great. So, we're going to move on to our first question. And I'd like, if you would, Simon, talk us through your career journey briefly, to give us an idea of the kind of things you've done along the way.

Simon

Thank you. I think it's important, because we are defined by our journeys, and everybody's got a particular journey that's important to them. So, my medical training journey, I guess, started in Southampton medical school, and I went through from 1989 to 1994 and qualified. After finishing medical school, I did my house jobs. It was just one year at those times, and then did my training. Then from then on in London, where my wife to be lived, and finished my three years of SHO jobs, and did my registrar jobs. And I guess this is the first kind of particular, first real sort of serendipity moment I'd like to highlight. So, I was going off to Australia for a year to do a year in Sydney, doing retrieval medicine, flying around New South Wales, picking up sick children from all the hospitals throughout New South Wales and bringing them back to both neonates and paediatric patients. And my very final shift at King's College Hospital, where I've been doing general paediatrics, I'd stayed on for a bit longer after handover to socialize with my colleagues and say goodbye to them and a very esteemed professor, Anne Greenoff, run the ward. And normally, by this point, I would have left the ward, but I was still there at that particular time and she spoke to me and said, thank you for all of the care that I delivered to the neonatal graduates on the ward, and she asked how that she could help my career going forward, which is a massive honour to be asked that by somebody so influential. I hadn't really thought about research. Of course, I'd thought about it, and I'd utilized it during my training, but I hadn't really seen myself doing research. But then suddenly the penny dropped, and I thought, well, when I get back from Australia, it'd be really nice to actually have something to come back to, which is organized and the idea of doing research and the project that was proposed just sounded great to me so, I said yes. And you know, having those opportunities that come to you through life, they come to everybody, I think the first thing you have to realize is it is an opportunity, and then decide if you're going to take advantage of that opportunity, and then actively say yes or no. And I'm delighted that I said yes, and then moved on into really enjoy my year in Australia, and then to come back and to do a PhD with, Anne Greenoff which was, which was great. I'm very, very proud of what I achieved.

Jonathan

What was the subject of your PhD?

Simon

So, it was looking at the long-term respiratory morbidity in prematurely born babies following RSV infection and follow them up to the age of two. So, we looked at lung function before neonatal unit discharge, again at the year, and then looked at all of the different viruses they collected that they had by collecting nasal secretions from them when they were at home. So, I had to go to lots of homes, which was interesting. And then I developed a real time multiplex PCR, which was very trendy at the time, and was one of the first thing, first kind of real time multiplex PCRs for nine respiratory viruses, of course, now that's been superseded by other technologies and yeah, follow these families up. So, it was great. And that opened my eyes to research. I then went back into training. I thought that I wanted to be an intensive care consultant, having done my year of retrievals in Australia and done some intensive care when I got home. But then I kind of realized, actually I really like children to talk to me, and I enjoyed the outpatient setting, and I enjoyed actively collaborating with families and with children, which you obviously do on intensive care as well, but I wanted to do that in a more in a less stressful environment, so I moved into general paediatrics and finished my training.

Jonathan

So, you had been thinking of being an intensivist, and then at some point, you decided to go general, yeah.

Simon

That's correct, yeah.

Jonathan

And you mentioned your moments of serendipity when Anne spoke to you, but you implied there were other ones. Is that right?

Simon

There's been lots. So, when I became a consultant, one of the key things I wanted to achieve was to improve the experience of trainees going through the clinical work at King's College Hospital where I was working. I got appointed there in 2007, I then got into what would be ST1 recruitment, and I met another very influential person, so Hilary Cass, who, was the lead of the London School of Paediatrics at the time. And she called me after being involved in some interviews, and said, Simon, I think you're pretty good at this interview thing and recruitment. It's obviously something you care passionately about. Would you like to be a training program director and to help out with that? So again, another massive opportunity to which I straight away said yes, and again, was extremely proud to be invited by her to take this role up. And that really led me to many more of my education and training roles and opportunities sort of completed throughout my career.

Jonathan

Just briefly mention them. We can't cover them all in this short podcast, but just run through a few of them.

Simon

Yeah, so after college tutor, then I was training program director and lead for recruitment for London for about six, seven years. I initially got appointed on a clinical academic split of 73PAs, but I kind of realized that being an academic is quite challenging to you know, you really have to keep that time precious and maintain that time, and I found that quite hard, and I was more suited to education and training and clinical work. So, Anne was very gracious, and then helped me to move those PAs more into education and training, and I took on a course director and a master's in paediatrics for King's College London for seven years, which was brilliant. And I collaborated with colleagues from King's College Hospital, from what is now Evelina London Children's Hospital and St George's, and it was a really fantastic experience of developing what effectively was a South London masters.

Jonathan

Was that something people would do during their paediatric training, so alongside clinical role, or would they step off and do that full time for a bit?

Simon

Yes, it was part time and over two years. So, it was done during training, was able to be done during study leave for the trainees and it was a mixture. The first year, it was all UK based, trainees, nurses, pharmacists, so it was very multidisciplinary, multi professional. But as it progressed, it started to attract more overseas students and then I handed that on to a fellow consultant, who carried on moving forward with that MSC.

Jonathan

Can I just return to this idea of serendipitous moments? Because you've mentioned two of them. There's several more, it seems, that have happened for you, but for people thinking about you know where they might go in their careers. I think the key thing is, doing the good job in the first place, because I imagine that's partly why those came your way. It wasn't just totally random. Is that fair to say? And the other thing is recognizing them. Can you give us a bit more reflection on how we make the most of those kind moments?

Simon

Yeah, well, I think these things come around when it's identified that you're really care passionately about that particular opportunity that may be coming up. And so definitely, I always say to trainees and to medical students, you know, you do whatever it is to get you out of bed with a smile on your face, and if you're going into work with a smile on your face, you're having a positive influence on everybody else who's around you, and effectively, that is part of leadership by demonstrating that you're enjoying being where you are and you're truly present. I think it is important to show that you're really committed to that particular role, and then opportunities do come around.

Jonathan

I like that, do what gets you out of bed with a smile, and if you're not, then try to find your way towards that, and then looking out for those moments and making most of them. And then moving on you, at some point, became clinical director at King's College.

Simon

Yeah.

Jonathan

Would you tell us a bit about how that came about and what drew you or motivated to do that role?

Simon

Yeah, it was as I progressed through my education and training roles, I'd worked collaboratively with colleagues from many other hospitals. I had developed a really good set of relationships with many clinical leaders across South London and across London. And initially the role came up as being deputy clinical director, because it was such a big role. So I took that on for a couple of years, and then progress to being the Clinical Director. It's, it was a massive honour to be clinical director at King's College Hospital in charge of over 100 consultants, you know, 750 staff, and I was the Clinical Director through the COVID pandemic, which was obviously a massive challenge.

Jonathan

Just say a little bit about King's College, because people may not know, it's not just a children's hospital. No, it's an adult and children's, is that right?

Simon

Yeah, that's correct. So it's, it's a big adult and Children's Hospital in in London. It's one of the four trauma centres in London, and it's probably the busiest, or second busiest of the trauma centres. In terms of Paediatrics, so, we have over 100 consultants. It obviously has the world-famous liver service that it runs. It's got big intensive care, big neonatal unit, respiratory, oncology, gastroenterology, endocrinology, and a really big general paediatric department as well.

Jonathan

And your clinical director role was for the children's side of the hospital. Is that right?

Simon

So just for the children.

Jonathan

And say a bit more about how, how you came to do the role you obviously keen to you've done the Deputy Director. But what made you step up for the director role?

Simon

Yeah, I thought that I'd develop the sort of competencies and capabilities that would make me a good clinical director. I think if I was going to define what they are, it's, I think you firstly, do need to have that clinical respect from your colleagues. People need to see that you're good at doing your day job, I think that's important. You need to be held in kind of high, at least reasonably high, regard by most of your colleagues. It's not possible to be liked by everybody, and if you try to be like everybody, you're probably not going to be getting out of bed with a smile on your face, but you need to be held in reasonably high regard by most of your colleagues and you need to want to do it to make things better for your colleagues. So, they were probably my main motivations. I would say, when you are in any managerial role throughout the NHS, effectively, you're always in the middle, and so you have pressure from above, so from the trust, from the medical director or from the chief exec, and then you have pressure from below, your colleagues, and you'll try, you only to try to work out where that balance is. For me, my balance was always closer to my colleagues than to the trust, which potentially could make me unpopular with some of my more senior colleagues, but I thought it was really important to have really good relationships with my colleagues and try to do the best for them, but also then to develop the best possible clinical environment that we could for children at King's College Hospital, and developing systems and developing infrastructure in the NHS throughout the last 7, 8, years has been challenging. But yeah, I think if you're motivated by those things, wanting to make things better, and being able to go to bed at night, even if there are lots of issues going on, because there will inevitably be issues and worries going on. But you do need to be able to turn off and go to sleep at night. Then I would suggest the role for anybody. It's incredibly rewarding and a really good step to whatever it is that you're going to do next in your career.

Jonathan

And if you were speaking to somebody sort of taking on such a role, or speaking back to yourself when you started, what do you think key things that would help somebody do that role really well?

Simon

Yeah, I think when, when we come into medicine. None of us, I don't think, start off wanting to be a leader, but we, the people that do get involved in any project because they want to change something, because they want to make something better, because they want to develop something, because they want to improve care. That is the right motivation to want to get involved in any managerial position. And if you're involved in a committee and that they're your motivations, then already you're demonstrating leadership capabilities and competencies, and you're inspiring other people around you by your enthusiasm and your motivation. Moving on up to the people, when they get to taking on more senior trust position roles, then I would say to, I've given advice to at least two Clinical Directors since I stepped down. Firstly, have a strong set up at home to go home to where you obviously feel as good a work life balance as you possibly can and to really enjoy your home environment, whatever it is. Secondly…

Jonathan

So, that's like a life outside work? Making sure that is there and important.

Simon

Yeah, is so important and you can't do these roles without having that. I'd say secondly, you need to really know yourself, and you need to know when you're most effective. So, I'm a really, really good morning person, and I'm not very good nighttime person. So, I can wake up at five o'clock in the morning, and inevitably, you're going to be receiving, you know, hundreds, 200 emails per day. You can't do them all as they're coming in real time. It's not possible. But I used to find if I got up early, that I could clear the backlog and then be ready for the day. I would walk into work. I'm very lucky that I lived, just lived just two, three miles away from the hospital, and that was a great time for me to be able to kind of clear my head, and also have telephone calls with people before I arrived, and usually in a good mood when you're walking. So, I found that really helpful and then,

Jonathan

The walking into work bits?

Simon

Yeah, just that time to reflect on what the day is going to bring you, and then you arrive prepared. I think people that have long obviously, most people don't have the luxury of being able to walk into work. I do take it as a particular luxury, but, but arriving ready to work is a is a great thing, and I'd actually achieve quite a lot walking in and then knowing when you're going to turn off, and being clear with everybody that after this particular time you're not checking anything else so that you can have your own time.

Jonathan

Yeah.

Simon

And if the person is motivated to want to make things better and has that kind of safety element built in around helping them to look after themselves, I'd highly recommend any managerial, senior, managerial type position in in all aspects of healthcare.

Jonathan

Thank you. And you've mentioned, as you've gone along, management there and also leadership. I'm just interested to know what the difference between those? But I wonder, is management more about systems and processes and leadership about people, or is it, how do you see them linking together?

Simon

Yeah, the classic saying isn't it is leadership is doing the right thing and management is doing the thing right.

Jonathan

Okay.

Simon

And which, I think there is some truth to that. I think some leaders are good managers, and some are not, and some managers are good leaders and some are not. So I think you need to surround yourself with people who are good at the things that you're not so good at. So in terms of someone who was able to read through 50 page documents that wasn't my happy place, I could do it and, you know, and then would be able to reflect on it and to deliver an opinion on that particular piece of work. But I'd also like if somebody else did it as well, and often I find the managers were better doing that particular analysis. So I'd say that is probably the key thing is surround yourself with people who are better at doing the things that you don't particularly like doing.

Jonathan

In terms of your leadership style, where would you say, how do you think you do it? What styles are there and what's your main approach?

Simon

If you go on any leadership course, you'll be taught lots of different styles of leadership. I would say probably the most important thing is to learn from other leaders that you've seen as you've been going through your career, and who may or may not be role models, but they're people that have inspired you. They've demonstrated their ability to lead and how they how they make things better. So, in terms of my style, I think I'm very collaborative. I take great pleasure in developing teams and making the team really effective, one of the first things I start doing when I take on a leadership role within the first year or two. Most leadership roles for me last 5,6,7, years. At the end of year two, I’m already thinking about succession planning and thinking who's going to take this over from me, and who's going to do a better job than I'm currently doing, and if I managed to successfully hand that over to the next person and they do a better job than I did, I take that as an enormous success. I'm collaborative, focus on the team, and I guess I'm more transactional.

Jonathan

Say what you mean by transactional.

Simon

So transactional is working together and being very aware of other people's needs and helping them to be able to do their job, and understanding that you both have to give and take a little bit. You know, the transformational leaders are more able to kind of stand up and give big speeches, very good at the big blue sky thinking, but less good at the detail and so And there's absolutely a role for both types of leaders and for all other style of leadership. But you know, for me, I'll say collaborative and transactional.

Jonathan

And when you mentioned about really bringing on the team so you go into a new role, you find you got team around you, or you're building that up. Just say a bit about how do you do it in practice? What do you do to make a team work, build up?

Simon

Yeah, so I've developed quite a few teams throughout my career, and I think it goes back to finding people who are good at the things that you're not so good at. So, I inevitably needed a detail person when I was doing the team. But then you try to involve as many stakeholders as you possibly can with your team. The issue I've had is sometimes you make teams too big, and they become unwieldy, and if they become too if they're too small, then it's too much work for anybody to be able to get through it. So, there is a sort of fine line about the size of a team, and it obviously depends on the size of the project. Try to make it as multi professional, multi-disciplinary as possible as you can try to involve the most important stakeholders in paediatrics, which are children and families, to get their opinions and then, when you've got your team, important things that they really enjoy themselves, hopefully, and that they have a clear vision about what it is that they want to help to achieve. Sometimes teams are set up for a short period of time, like a start- finish group, and other teams are set up for much longer. But you do need to have an idea about what you're going to have to do, what success looks like when you get there, and then, and then, how to measure that you're actually getting there. Yeah, so I've enjoyed developing multi-disciplinary, multi-professional teams to for most of the projects I've been involved with.

Jonathan

So you're talking there about team that is the right size, the right skill set, the vision that shared, that you kind of build up together, that collaborative approach. And I think another key thing is about how you bring people on, as you've talked about and thinking succession planning, but also in their different roles. How do you best empower people to be the best that they can be in their roles?

Simon

So if I was to take sort of new consultants, for instance, so, the first bit of advice I would give to new Consultants is, firstly, really kind of learn how to be a consultant, and it takes at least three years, and probably up to five years before you feel able to really do your clinical job really well. And then during that time, if you're meeting regularly with these people, which you hope that they've got mentors to help and support them, during that journey, you begin to identify what it is that gets them out of bed with a smile on their face and I think it's about then enabling them to move forward and do more of that as their career moves on and. And then I think you have a happy workforce who hopefully are doing stuff that they enjoy. So I think that would be my main advice to colleagues, whether they're trainees or consultants, is, you know, really focus on the stuff that you enjoy.

Jonathan

Fantastic. Can we just move on to your role as Officer for recruitment? Because that's a big role you've held now for quite a few years. Can you just give us some insights into how that came your way or want to apply for it, and what you've learned from doing that role?

Simon

Yeah, so as I said, I've been London's lead for a group of quite a long time, and so I thought it was the natural transition to think about taking on more of a national role. So the role was advertised, and actually I was encouraged to apply again, possibly another serendipitous moment, by another giant, the late Simon Newell, who called me up, and he was kind and ebullient, and he said he thought that I should apply for the role. And I, of course, immediately thought that it was good idea, much like the other serendipitous moments. And I applied. Actually, I didn't get it. I lost to another great person, who was David Evans, who went on to be brilliant in that role, and then obviously an excellent vice president of the college as well. When David moved on to the Vice President role, I reapplied, and I got it at that point. So in total, which is unusual for a college role, I've done this for coming up to 10 years. Normally they're five years. The college was kind and kind of reinvented the role and went from assistant officer to officer after five years. So I've had the real great opportunity of working with the recruitment team for all that time, and we've worked through many challenges. Obviously, COVID being the main challenge, where, literally within hours, we were having to change processes that we were going to run for recruitment and went from face to face to being on, you know, Teams or other platforms overnight, and that was a massive challenge, but I've taken great pride in our ability as a team, and that team has really developed over the last 10 years. So, you know, we've gotten from having just over 500 people applying ST1 for about 450 jobs, and now we're having about 1500 people applying for the same number of jobs. So, I think it has been successful. It's not just down to that team. There's other components there as well. So, there's the Choose Paediatrics campaign, which is incredibly enthusiastic and full of energy, and hopefully we're inspiring the medical students and the foundation trainees of the future to come into paediatrics and then really working with trainees and consultants throughout their careers to highlight what they're particularly enjoying and what they see as there being their kind of main opportunities going forward. Another role that I do with the college is look at the kind of lifelong careers aspect. I help with that as well, and that's a great honour, because you start to think about what you do at the end of your career, when you get to you know, your mid to late 50s or your early 60s, and how we transition into a role that maximizes the effectiveness for those fantastic members of the workforce with the most experience, but at the same time, doesn't exhaust them. Yeah, so it's been an absolute honour to be involved for the 10 years, and I probably say out of all the roles that I've undertaken, it’s probably the one that's given me the most personal satisfaction.

Jonathan

I think there's been quite a lot of changes you've alluded to, and I guess part of leadership is helping teams and health systems through change. Do you have any insights into how in leadership, we can help through change better?

Simon

I think firstly, you need to understand the problem, whatever the problem is at that particular time. So with the recruitment team in particular, we obviously sit in with part of the Royal College normal processes, and have good support from Vice Presidents and presidents, and I've had the opportunity to work with the last three or four presidents very closely, which has been great. But then also we're part of national bodies, so the Academy of Medical Royal colleges, the National recruitment office, etc. So a lot of our rules and laws come from those particular bodies, and we have to kind of respond to those and integrate them into paediatrics and make them suitable for paediatrics. But one of the things that, for instance, we've said no to, so there was a push for all PD, for all specialties to use the MSRA assessment.

Jonathan

Could you say what the MSRA stands for?

Simon

So this is the medical specialty recruitment assessment, this is something which basically is an MCQ, but also like a situational judgment type test, and it's been shown to be incredibly effective for identifying certain groups of clinicians going forward, and saves on a lot of time of doing interviews and shortlisting, etc. But it's not, certainly not set up for paediatrics, and it was extremely unpopular with our trainees and with the consultants as well to be used as a mode of determining who should come into paediatrics. We did use it for one year during COVID, but we only counted it towards 20% of the total score. Thankfully, we've managed to convince the powers above that this was not suitable for paediatrics, and we're stuck to shortlisting and interviews, which I think we all agree is a better way of identifying the paediatrics the great paediatricians of the future.

Jonathan

So part of change is understanding the systems and having good links to all the people we work with and partly being able to say no. You know, as you come to collaborative view as to what is good or bad for our specialty.

Simon

And if you do say no, you need to have a very clear why.

Jonathan

Yeah, that's great. Well, we're coming towards the end, but I'm just interested as to whether you can recommend any author or course, or any resource that might help people in a leadership journey that has helped you?

Simon

I think the best course is life and is going along and taking those opportunities that come up, those serendipitous opportunities, and also creating your own opportunities, and really looking at the leaders who are around you. We use the word leader, but anybody leading a ward round, anybody who leading a multi-disciplinary team meeting, they are the leader in that room, and they will be exhibiting, you know, behaviours that you can identify to and think about emulating as you go forward in the future. In terms of authors, I pretty much love everything that Atul Gawande has written, and I think he's a truly inspirational sort of human being and doctor. So, I found his books very helpful.

Jonathan

If you were picking one of his books to direct people to, which would you go for?

Simon

Gosh, I'm probably going to not answer that, if that's okay, because I found them all to be to be equally effective. No, I've really, I've enjoyed them all.

Jonathan

Fantastic. And as we close, is there any one point you'd like to highlight about leadership, you think we should sort of take home message?

Simon

Yeah, I think leadership is for everyone, and I think it's really important that as you're going through your journey, if you really want to change something, if really want to make something better, if you want to improve patient care, if you want to improve the experience for your patients, your children you're caring for, then do get involved and bring that enthusiasm to the table. Take opportunities, if you want to, as they're coming up to you through your life, you know, say yes to things that are going to get you out of bed with a smile on your face. Yeah, learn from others, and then be very giving with what you have experienced and what your learning has been, and hopefully then you become the person that inspires the next generation.

Jonathan

Well, Simon, that's been really amazing to talk through some of your experiences. Thanks for sharing with us. Thanks everyone who's been listening for joining us on this RCPCH leadership podcast. I hope you'll join us again for future episodes.

Simon

Thank you very much.

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Kirsten Olson

Thank you for listening to this Leading the way episode from the Royal College of Paediatrics and Child Health. The thoughts and opinions expressed in this podcast relate solely to the speakers and not necessarily to their employer, organisation, RCPCH or any other groups or individuals. You can find the transcript to this episode and more from the Leading the way podcast on our website, RCPCH Learning – go to learning dot RCPCH dot ac dot uk.

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