Seven Years of the Executive Masters in Medical Leadership at City, University of London
Matt Bungay in conversation with Professor Amanda Goodall
The Apprenticeships Hub at City, University of London
In 2021, I joined City, University of London to form an Apprenticeship Hub, with the purpose of creating a dedicated resource that could refine and oversee apprenticeship programmes across the university. The Apprenticeships Hub was created to build solid foundations for the MSc programs to utilise the Levy, widening participation for students to access otherwise very expensive courses. When I joined, my main remit was to ensure that City were compliant with ESFA funding rules and prepare for OFSTED, but little did we know that City would see OFSTED for a New Provider Monitoring Visit in June 2021!
That first successful inspection enabled change to take place at City and set the platform for me to be able to bring change to those courses that needed it. One of these programmes was our Senior Leader L7 apprenticeship, split into Executive Masters in Leadership and Executive Masters in Medical Leadership, both utilising the apprenticeship Levy.
The EMML Senior Leader Level 7 Apprenticeship
The Executive Masters in Medical Leadership was created in 2017 and we are now running our 7th cohort. Around 150 doctors have been through it – many of whom we are still in touch with.
The concept of a doctors-only course came from the research of City, University of London, Bayes Business School colleague, Professor Amanda Goodall. For 20 years she has been researching effective leadership and the characteristics of successful leaders. Her findings, that now span all types of industries and professions, show that we need core business experts going into leadership and management roles (available at www.amandagoodall.com).
In 2011 she published a paper in Social Science and Medicine showing that the best hospitals in the US were more likely to be run by doctors compared with general managers. The article garnered a lot of attention, and it drew Amanda further into the field of healthcare. Very few CEOs in UK hospitals are doctors (approx. 4%). This contrasts with practices in Europe, where physician leaders make up the majority of senior managers, such as in Germany (71%), France (63%), and Italy (50%).
Since 2011 there have been numerous studies demonstrating the importance of clinical leadership across all aspects of health. The growth of the Faculty of Medical Leadership and Management, with whom we are accredited, also began to shine a light on the importance of medical leadership. However, despite the substantial supply of management and leadership programmes for nurses - that have been running for well over thirty years - there were no equivalent courses for doctors. Leadership development should be available to all. But Amanda Goodall believes we need to recognise that different professional groups also have diverse developmental needs, and therefore, we need development programmes tailored to the requirements that each situation demands.
This was why in 2017 Amanda Goodall and Bayes Business School launched the Executive Masters in Medical Leadership (EMML), a two-year part-time MSc tailored to physicians’ specific requirements, a programme that at the time was unique. The EMML began as a self-funded MSc but as City, UoL created the apprenticeship levy route, NHS providers started to send their doctors to gain both the MSc and the Level 7 apprenticeship. In 2023 it was the largest cohort of Doctors (31), all through the apprenticeship Levy.
The EMML prepares doctors to become future expert leaders by helping them develop leadership qualities such as self-reflection, showing vulnerability, bravery, teamwork and emotional intelligence. It gives them skills in strategy, health analytics and AI, health innovation, marketing and machine learning. All benefits that are mapped and shared with the apprenticeship levy Level 7. Being doctor-only, we created a safe space for physicians across all specialisms to examine their own behaviour, demonstrate weakness, ask pertinent questions, open up, speak candidly, and critique, all within a private and protected environment. And importantly share their experiences and create a strong network.
Measuring Impact
Professor Amanda Goodall explains the impact of the EMML Senior Leader L7 Apprenticeship programme at City:
“After running the EMML for seven years, we know that doctors who complete Bayes’ Business School’s Executive Master’s in Medical Leadership (EMML) and Level 7 apprenticeship report a huge boost in confidence to tackle workplace politics, staff shortages and bring about positive change and innovation to patient pathways, helping to improve services to patients in the NHS and private healthcare settings. In addition, this new-found confidence, alongside the knowledge and behaviours that they apply directly to their workplace, leads to rapid promotion.
“Most leadership development programmes fail to measure actual outcomes. Our outcome findings come directly from recorded interviews from past and present students on the Executive Master's in Medical Leadership (EMML) over three years from 2021 to 2023. The Tripartite reviews are part of their Apprenticeship Levy reviews which take place every 12 weeks and are where the interview content comes from.”
Three key areas of impact have been uncovered. Amanda explains:
“First, doctors want high-quality tailored leadership development programmes; they want them taught by researchers and experts in partnership with the apprenticeship levy. They want the instructors to draw on contextually specific issues that relate directly to their work, and to learn methods that are optimal and supported by data. And they want to take on leadership roles to try to improve their health settings, mainly in the NHS but also in private healthcare.
Second, doctors’ motivation to learn and change their behaviours is evidenced in the data we have collected. Doctors’ line managers report huge changes in many areas of their behaviour, emotional intelligence and self awareness, team building, confidence and strategic thinking. Their new knowledge and behaviours help them tackle politics and promote diversity in the workplace. They are engaged in making big changes in their workplaces often also witnessed through their ‘Leadership Impact Project’, an important part of their EMML learning.
Finally, EMML doctors are interested in taking more responsibility and being promoted into management and leadership roles. And this is important. Indeed, they fly into leadership positions often quite early on in the MSc. These include: stepping up to group medical director, chief medical director, divisional director, clinical director and associate medical director positions in the NHS and non-executive directors within the NHS as well as resident doctors (RMOs) in the private sector being promoted to head of units and deputy leads of services.”
Roles and Responsibilities
Some of the initiatives and responsibilities, revealed in Amanda’s research, that were undertaken in students’ Leadership Impact Project include:
Project managing a new acute oncology unit creating a bridge between the ward and intensive care in order to monitor patients better
Designing a new digital platform in pathology to allow trainees and employees on maternity leave to stay up to date with learning and access digital slides working with the Royal College of Pathologists
Creating a system and pathway to prioritise emergency surgery at an NHS hospital
Initiating a project to help provide a high dependency unit alongside the paediatric intensive care unit nurse manager, and then writing a standard operational procedure (SOP) for the project
Moving the heart surgery unit from a place that only enabled low impact cases to one that now runs some of the most complex operations all within six months of migration and in spite of Covid.
Or starting to do research into stent surgery for a rare disease where there is no data.
Making a Difference in the Healthcare Sector
In a survey of doctors in Denmark, Amanda and colleagues asked: would doctors be willing to lead and, if so, what might motivate them to do so? The overwhelming majority of respondents (70%) said they were driven to go into leadership, a finding that surprised Danish medical bodies. Importantly, doctors said they would step forward if they could make a positive impact and explicitly ‘make a difference’.
We know that our MSc apprenticeship levy programme is really making a positive impact in healthcare. At a time when the NHS is virtually on its knees, this seems a hugely important contribution.
So, what next for Bayes Business School and the apprenticeship levy?
Amanda explains why Professional MSc’s funded through the apprenticeship levy are important for the UK economy:
“The idea propagated by many, that Level 5 to 7 apprentices are not necessary, is ludicrous. Leadership is lacking in the UK at all levels in both the public and the private sectors, but the effect of top leadership and line managers is the most substantial. We know that CEOs and senior leaders have a huge positive or negative effect on organisational performance. And we also know through years of research, that line managers have the largest impact on employee job satisfaction and retention. People really do leave bad bosses not bad jobs. ”
“The incredible influence of the EMML Senior Leader Level 7 on doctors’ effectiveness as leaders and managers is now well documented. We at Bayes are not stopping there. We are moving on to new programmes. We will launch in 2024 a Level 5 Coaching for Healthcare and a second Universal Coaching certificate. In 2025 we hope to launch the Executive Masters in Leadership for the Creative Industries Senior Leader Level 7 MSc. Future plans include an Executive Masters in Leadership for the Police and Security Services. Watch this space.”
City, University of London are launching further courses in 2024, Cyber Security amongst others are soon open for applications. Boasting a very high completion rate and rated as an OFSTED GOOD provider, City is the university for Business, Practice and the Professions.
About the authors
Matt Bungay is the Head of Apprenticeships at City, University of London, a leading UK University that prides itself on being the University of business, practice, and the professions. Matt boasts a distinguished career marked by transformative leadership and innovative business development. With a proven track record spanning over a decade, Matt has consistently demonstrated expertise in designing and implementing bespoke apprenticeship programs, earning recognition as an Ofsted Nominee with multiple successful outcomes.
In 2017, Matt founded Tate Apprenticeships, an initiative that seamlessly merged recruitment experience with apprenticeship expertise. Under his leadership, Tate Apprenticeships became a nationwide success, capturing the market with over 200 learners and earning the distinction of being the first in the recruitment sector with external clients.
Amanda Goodall PhD is Professor of Leadership at Bayes Business School (formerly Cass). Her main work analyses the relationship between leadership, management and organisational performance. It shows that leaders who have a deep understanding of the core business (‘expert leaders’) are associated with better organisational performance, higher employee job satisfaction and fewer quits. Being a good manager alone is not sufficient. Evidence supporting the ‘theory of expert leadership’ comes from a cross section of business, healthcare, universities, Formula 1, basketball, and among professionals. Amanda has also done research into gender differences in pay and negotiation, and she writes on diversity more broadly.
Amanda publishes in academic journals, practitioner publications (e.g. HBR) and in the media (e.g. Financial Times). In summer 2023 she released a business book on her research titled “Credible: The power of Expert Leaders”, with Basic Books and Public Affairs (Hachette). Amanda has been a research fellow at Cornell, IZA Institute of Labor Economics in Bonn, University of Zurich and Yale University. Based on her research, she created the Executive Masters in Medical Leadership a program tailored to the needs of physicians. Her work is available at www.amandagoodall.com.
