What does leadership in surgery entail?

Background: Leadership is not formally taught at any level in surgical training; there are no mandatory leadership courses or qualifications for trainees or specialists, and leadership performance is rarely evaluated within surgical appraisal or assessment programmes. Methods: Literature obtained from a MEDLINE search was reviewed to determine the characteristics of surgical leaders; outline an analytical framework through which these characteristics can be developed both in surgeons and surgical departments; and reflect on future challenges and recommendations for the central role of leadership in the field of surgery. Results: Leadership in surgery entails professionalism, technical competence, motivation, innovation, teamwork, communication skills, decision-making, business acumen, emotional competence, resilience and effective teaching. Leadership skills can be developed through experience, observation, and education using a framework including mentoring, coaching, networking, stretch assignments, action learning and feedback. Conclusion: Modern surgery will need leaders with superior leadership skills that are well defined. It is vital that leadership programmes to develop leadership skills are put into practice in medical education curriculum and postgraduate surgical training. This will ensure maintenance and improvement in the quality of patient care.