Medical Leadership and Management

By Ryan Mccann
Friday, 19 December, 2014


Effective medical leadership is recognised as essential for improving the performance of health services and enhancing the well being of patients and the quality of outcomes. A growing body of literature has also argued that medical leadership plays an integral part in the success and effectiveness of organisational change in the health sector (Ham, 2003).
The Royal Australasian College of Medical Administrators (RACMA) is a speciality medical college providing professional qualifications in the field of medical management and leadership. The College members occupy a range of diverse and stimulating medical leadership and management positions in Australia and New Zealand, Hong Kong and in smaller numbers around the world. The College is a member of the World Federation of Medical Managers (WFMM).
RACMA Fellows have often completed a clinical specialty qualification before moving into executive management roles. Hence 60% of RACMA Fellows are also Fellows of other specialty colleges. A 2013 College workforce census of members showed 68.4% work in public sector health services, 15.2% in private sector health services with others working in a variety of settings.
All RACMA Fellows progress quickly to positions of seniority such as chief medical officers and advisers in jurisdictional and national health authorities, chief executives of hospitals, heads of medical schools and divisions of medical
services, chief health officers in national jurisdictions, consultants to governments and private sector health services. Fellows are also found in public policy and health program management, and hence have a strong influence on health systems performance (Gruner and Boyd, 2006).
Being an effective medical leader clearly requires a different set of skills from being a good clinician (Reinersten, 1998). The standout activities reported by the RACMA Fellows in 2013 were:


  • Engagement with external stakeholders working on quality improvement,

  • working on quality improvement,

  • clinical governance,

  • policy and regulation, and corporate governance.

  • The following table from the RACMA 2013 Workforce Census shows what RACMA Fellows reported as their management priorities in 2013 compared with 2012:


The College specialist Fellowship Training Program is a three to four year training program (adapted from CanMEDs developed in 2005 by the Royal College of Physicians and Surgeons of Canada) leading to the award of Fellowship (FRACMA). Accelerated pathway entry programs for senior doctors reduce the length of training significantly.


  • To be eligible to enter this program a doctor must show:
    Evidence of the award of a recognised medical degree from an Australian or New Zealand university or one that is comparable

  • Current medical registration in Australia or New Zealand. Whilst unconditional registration is highly desirable, those without full clinical and vocational registration will be examined on their merits, and

  • Approved clinical experience (direct patient care) of at least 3 years in an Australasian health system, or one that is comparable Applicants must have access to supervised medical management experience over the period of the College training program. This will be evidenced by a substantive position in health services management or appointment to a sponsored/government funded training program recognised by the College.


Training may be undertaken up to six years part time is accepted and may be extended in extenuating circumstances. Advanced Standing may be granted for senior applicants.
Structure and assessment framework of the fellowship training program:

  • Minimum of three years of supervised workplace experience in medical management

  • Formal academic studies at Masters degree level

  • RACMA national workshop and assessment program

  • Completion of a Management Practice Folio over three years

  • Participation in the preceptorship program with submission of reports

  • Research-based case in written and presentation forms

  • Successful completion of the Pre-fellowship oral examination The following areas are those in which examiners make assessments:

  • general management principles

  • current health policy initiatives

  • medico-legal issues in health services management


Lead and manage medical services to achieve excellence in health services
The College also offers the following programs aimed to develop leadership and management by doctors and clinicians:

  • Associate Fellowship Training: a 12 month training program leading to the award of Associate Fellowship (AFRACMA)

  • Management for Clinicians – a two day inter-professional development program for clinicians.

  • Practical Leadership Series – a new program of professional development for doctors moving into management

  • Open E-learning programs for clinicians – several streams of webinar based programs on leadership and management in health care


The College’s involvement in education, policy formulation and decision making enables it to help shape the future and thus represent the professional interests of its members. The College is a member of the Committee of Presidents of Medical Colleges (CPMC) which is the body that represents the interests of all medical specialists to Government.
Fellows and Associate Fellows of the College you join a unique network of other professional medical specialists who will always be there for you.
Continuing professional development is a major commitment by the College. Increasingly all Fellows, whatever their medical specialty are being required by their medical registration boards and other credentialing organizations, to
demonstrate participation in ongoing professional development.
At RACMA the Continuing Professional Development Program is the means through which Fellows participate in activities that are relevant to the maintenance of ongoing learning. The College supports Fellows by providing access to professional networks of learning groups, scientific meetings and conferences, official roles and responsibilities in College functions, and increasingly in special training programs and courses for medical managers. This participation is recognized and certificated by the College. This evidence is used by Fellows to substantiate their participation to credentialing and employing bodies.
Keeping in touch about issues and opportunities in health services and medical management
The College provides a variety of information services to keep Fellows up to date with current developments and trends in medical management. These include:

  • Specific information requests from Fellows co-ordinated and provided through the National Secretariat

  • The monthly e-bulletin - RACMANotes - delivered to the desktop with current College activities and topics of interest

  • A monthly e-bulletin – Board Update – also delivered to thedesktop and reporting on matters of interest from the College Board

  • A personal copy of the College’s journal, The Quarterly, that is produced in a relaxed, informative style and issued quarterly

  • A dynamic web site that enables members to develop a personal profile

  • Advice about careers and employment opportunities

  • Access to the online Collection offering access and information to helpful resources in medical management and planning. This is only available

  • to members through the web site • Participation in journal clubs and learning sets

  • Scientific meetings and information about conferences

  • financial management of health services

  • psycho-social issues in health services management

  • human resource management in health services

  • planning of health services, including epidemiological studies

  • recent advances in health care

  • analytical and presentation skills

  • personal attributes of leadership

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