Leadership development for junior doctors: What can we learn from “Darzi” Fellowships in clinical leadership?

An innovative programme of “Darzi” Fellowships in Clinical Leadership provides doctors in postgraduate training with a unique opportunity to engage in improving systems of health care and develop their capability as future clinical leaders. The purpose of this paper is to report an impact evaluation of the programme, highlighting transferable design principles.

Qualitative and quantitative data were used iteratively and included a review of literature, analysis of background documents and internal evaluation results, face‐to‐face and telephone interviews, observation of educational events, online questionnaires and representative case studies.

Impact was found at the level of the fellows' learning, their organisations and the wider health system. Identified influencing factors included: clarity of purpose and aims, mutuality of workplace and external learning, learning for transformational change, ambitious but “do‐able” projects, a committed and learning‐oriented sponsor, a supportive organisational culture, high‐quality mentoring, a network of supportive peers, diversity of participants, ongoing monitoring and adaptation, planning for sustainability and the tracking of impact over time.

The extent to which results are generalisable needs to be considered within the constraints of this programme evaluation.

The “Darzi” Fellowship programme is effective and impactful, spawning clinical leadership development throughout a wider system. Whole system engagement of trainee doctors in leadership will require more than a Fellowship programme alone, but it is a start.

The evaluation adds to what we know about leadership development generally and provides a rare study in the medical context generating helpful principles for the design of leadership development programmes, particularly in the clinical setting.