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Developing medical leadership in India: A mission impossible?
  1. Kamal Gulati1,
  2. Ian Kirkpatrick2
  1. 1All India Institute of Medical Sciences, New Delhi, India
  2. 2The York Management School, University of York, York, North Yorkshire, UK
  1. Correspondence to Dr Kamal Gulati, All India Institute of Medical Sciences, New Delhi 110029, India; kamalgulati.09{at}gmail.com

Abstract

Purpose Globally, there have been calls to enhance medical leadership in healthcare, although we know little about how this objective has been pursued in low-income middle-income contexts such as India. This paper highlights the opportunities to strengthen leadership in this context, while also considering the obstacles to this change and how they might be overcome.

Methods The paper draws on a review of available secondary sources including published journal articles in the academic and grey literature, reports published by the Indian government and transnational organisations. The search focused specifically on medical leadership, clinical leadership, management and governance in the Indian healthcare system.

Findings India is currently in the throes of the world’s biggest experiment in universal healthcare popularly known as ‘Modicare’. However, these reforms have been criticised with regard to the lack of solid healthcare management framework in the country. The current National Health Policy highlights the need for specialised ‘public health management cadre, human resource governance and leadership development’. Nevertheless, the available research highlights a gap in the research on this topic, specifically about the development of medical leadership competencies. Our findings highlight not only the opportunities to develop medical leadership but also the obstacles to this process. Inadequate training and education, spiralling workloads, low salaries in the public sector and a growing culture of kickbacks have all stifled attempts to engage more doctors in leadership roles.

Conclusions While the Indian government is now focusing more on the need to strengthen medical leadership, there are significant barriers to change. In future, building leadership capabilities will require deeper reforms in training, regulation and remuneration of doctors to generate sufficient incentives especially in the public sector.

  • medical leadership
  • competencies
  • management
  • health system
  • clinical leadership

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Footnotes

  • Contributors KG conducted the primary review of sources relating to medical leadership in India and initial drafting. IK assisted with the framing of the paper and final drafting.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data sharing not applicable as no datasets generated and/or analysed for this research paper. The paper draws on a review of available secondary sources including published journal articles in the academic and grey literature, reports published by the Indian government, research bodies and transnational organisations.

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