Background Clinical leadership is key to quality improvement; however, there is limited research regarding doctors’ perceptions of clinical leadership.

Aim To investigate senior trainees’ perception of self as medical leader and explore what influenced their perception.

Methods A questionnaire with open and closed questions was distributed before and after a medical leadership module. Twelve trainees were then interviewed.

Results One hundred and fifty-six questionnaires were completed (95.7 % response rate). A significant number of senior trainees did not consider themselves to be a leader; however, there was a statistically significant shift in their self-perception during the programme. Themes identified during the interviews included a lack of understanding of the leadership concept, a lack of clarity of the medical leader’s role and vehicles for perspective transformation.

Conclusions To our knowledge, this is the first study to explore senior trainees’ perception of self as medical leader. Findings suggest, following a paradigm shift from clinician to clinical leader, senior trainees are a potential, valuable resource for quality improvement. To aid understanding of the leadership self-development process, a conceptual model is offered. The significance of the model is its focus on the individual’s leadership paradigm, as the starting point for self-exploration. This model could inform leadership development programmes.