Why should medical students learn about management? Timothy Rittman explains the importance of thinking and learning beyond clinical skills

Medical school is a place for learning but should not be the only place medical students pick up the training they need to be doctors. We take in clinical skills and information at an often alarming rate, but the job of a junior doctor is made up of more than clinical work. Articles in the BMJ have highlighted consultants' lack of skills outside the realm of the clinic; it has even been said that seeing patients is “the easy bit.”^{1 2} The same is likely to be true of doctors at all levels.

For most people, training in management skills means sitting in a seminar room being talked at from a flipchart. Although this is the start, training also includes applying what is learnt to everyday life. The range of skills is almost endless—for example, time management, communication, presenting, teaching, effective learning, working in a team, and leadership—to name just a few topics.

Imagine a junior doctor looking after 20 patients, following up the results of blood tests, x rays, meeting relatives, liaising with nursing staff; time management is key to surviving an average day. Further on in a medical career, long term plans for finance, waiting lists, and multidisciplinary teamwork, all require a professional strategic planning approach.

Even during their medical school careers, many students take on extracurricular activities and projects that are not covered at medical school. This has made many medical student groups around the world look hard at what the needs of their members are and how best to meet them with a training programme.

You can, of course, be involved in the many non-medical student groups—for example, sports teams, theatre groups, music groups, and community action initiatives. The need for these groups to provide training for their members is clear both for their own survival and that of the future doctors who take part in their activities.

Consider, as an example, a session on strategic planning at the first executive board meeting of the year for the officials of the International Federation of Medical Students' Associations. Already halfway through the session, the group of medical students, each with different roles from different countries has already learnt something new. By the end of the session they will have learnt something more. By the end of the week they will have thought about how to use strategic planning in their work. By the end of the year they will have put a strategic planning process into practice to increase the efficiency and effectiveness of their own and the association's work. More than this, they have already started to take on board the ideas and approaches they will need in the future. As already highlighted, strategic planning is an important part of long term planning in medicine. But the opportunity to learn and apply such skills is not available in medical schools.

Strategic planning is one example of training in the association and the same is true of medical student groups around the world (table). For both scientifically based organisations and health promotion organisations, training forms an integral part of their meetings.

So why do organisations value training to such a degree? Training helps members to achieve their full potential. Students are enthusiastic and often motivated. Students bring different backgrounds, experiences, skills, and knowledge to their work. But, on their own, these characteristics may not be enough. Providing extra training in, for example, team building, helps a group to become more proficient and more professional in the way it works. On both an individual and an organisational level, building skills helps people to succeed.

The wider medical community benefits from the training these medical students receive. If the job of a doctor is made up of more than just clinical work, current students will find themselves overwhelmed because of today's focus on examination skills and knowledge consumption in most courses at medical school. Not that these are a bad thing—the value of clinical skills should not be underestimated—but additional life skills of self organisation, time management, and effective communication can only help to manage life as a doctor.

Not only this, but having skills above and beyond the medical curriculum offers opportunities that would otherwise be unavailable. Robert Zielony (known to many as Dr Bob) has trained many medical students and others in peer education skills, particularly in the area of HIV and AIDS and sexually transmitted diseases. He describes seeing the people who go through his programmes increase in motivation and sense of purpose. He sees that, after having applied their skills in school and sex education sessions at youth club, future doctors are better at dealing with people, have a greater understanding of vulnerable people, and are more ready to accept the limits of their own knowledge. This was made possible by the training these students received.

Skills such as using and evaluating a variety of teaching techniques or managing your own time and that of others are best learnt outside the walls of the hospital. These two examples are taken from the UK General Medical Council's second edition of Tomorrow's Doctors, which sets out the skills and knowledge students should leave medical school with.³ The document places a huge learning task in front of the prospective doctor, including clinical skills and knowledge, basic science, teaching skills, and organisational capability. Ever more creative initiatives from medical schools aim to meet the targets set by this document, but is it really possible to be taught all this in a hospital?

Training beyond the curriculum should be a priority for every medical student and every group of medical students. Tomorrow's Doctors states that “students must accept responsibility for their own learning.” Receiving and using training outside the hospital will no doubt make for a better medical profession—not only doctors who know how to treat patients, but also how to deal with the non-clinical workload that comes as part of the job.