Crafting Tomorrow’s Medical Leaders: Insights from Medical Students and Interns in Saudi Arabia

Figures & data

Table 1 Socio-Demographic Characteristics of Medical Students and Interns (n=519)

Study Data	N (%)
Gender
Male	266 (51.3%)
Female	253 (48.7%)
Nationality
Saudi	482 (92.9%)
Non-Saudi	37 (07.1%)
Academic year level
5^th year	163 (31.4%)
6^th year	166 (32.0%)
Medical intern	190 (36.6%)
GPA
≤1.99	02 (0.40%)
2–2.49	11 (02.1%)
2.5–2.99	61 (11.8%)
3.00–3.49	82 (15.8%)
3.5–3.99	105 (20.2%)
4–4.49	147 (28.3%)
4.5–5.0	111 (21.4%)
Current first of choice of medical specialty
Medical Specialties	167 (32.2%)
Surgical Specialties	260 (50.1%)
Others	92 (17.7%)

Figure 1 Distribution of responses among medical colleges in Saudi Arabia.

Figure 2 Perceptions regarding where leadership training should take place in a medical career.

Figure 3 Perceived barriers to the implementation of leadership in clinical training.

Figure 4 Perceived meaning of medical leadership.

Figure 5 Mean ratings for the self-perception of the leadership skills.

Table 2 Current Leadership Education/Training and the Definition of Medical Leadership (n=519)

Statement	N (%)
Rate the management and leadership education that you have received during medical school
Very Poor	23 (04.4%)
Poor	130 (25.0%)
Satisfactory	185 (35.6%)
Good	112 (21.6%)
Very good	69 (13.3%)
Leadership skills are taught across multiple courses/blocks/rotations in your medical school
Strongly Disagree	21 (04.0%)
Somewhat Disagree	110 (21.2%)
Neutral	166 (32.0%)
Somewhat Agree	146 (28.1%)
Strongly Agree	76 (14.6%)
Your current clinical training prioritizes leadership training
Strongly Disagree	32 (06.2%)
Somewhat Disagree	100 (19.3%)
Neutral	141 (27.2%)
Somewhat Agree	176 (33.9%)
Strongly Agree	70 (13.5%)
What is your understanding of leadership as a core competency in a physician?^†
Leadership encompasses important skills such as decision-making, communication, empathy, etc., which are all required in a physician	343 (66.1%)
Leadership in a physician relates to the ability to lead and supervise daily activities of patient care as well as educate junior doctors	222 (42.8%)
Leadership skills do not need to be intentionally taught in medical school as the curriculum adequately prepares the students	163 (31.4%)
Leadership development is beneficial for only those who wish to pursue leadership roles in their medical career	96 (18.5%)
Others	01 (0.20%)

Note: ^†Variable with multiple response answers.

Table 3 Assessment of the Perception, Attitude and Interest Toward Medical Leadership (n=519)

Statement	Mean ± SD
Perception toward medical leadership
1. Leadership is a core role that is required to succeed in the medical profession	2.77 ± 1.19
2. Being a physician and being a leader go hand in hand	2.74 ± 1.24
3. Students are well-informed about what a managerial position in medicine entails	2.27 ± 1.38
4. Students possessing stronger leadership skills would improve their skills as a physician	2.61 ± 1.29
Total perception score	10.4 ± 4.32
Level of Perception	N (%)
Poor	111 (21.4%)
Moderate	209 (40.3%)
Good	199 (38.3%)
Attitude toward medical leadership
1. I feel there is room for leadership training in the career of medicine	2.50 ± 1.35
2. I think students can easily engage in leadership training in the field of medicine	2.51 ± 1.10
3. I think that students should have leadership responsibilities during their clinical training	2.68 ± 1.20
4. I feel that the responsibilities given to students during clinical training prepare them to be better leaders	2.65 ± 1.24
Total attitude score	10.3 ± 4.16
Level of attitude	N (%)
Negative	93 (17.9%)
Neutral	244 (47.0%)
Positive	182 (35.1%)
Interest toward medical leadership
1. I would like to have had more management/leadership training during medical school	2.66 ± 1.14
2. I would seek additional leadership/management training in my postgraduate studies	2.44 ± 1.27
3. I am interested in taking on leadership/managerial responsibilities during my career	2.53 ± 1.22
4. I think clinician’s managerial/leadership opportunities should be highlighted and promoted to medical students	2.74 ± 1.11
Total interest score	10.4 ± 4.04
Level of interest	N (%)
Low	103 (19.8%)
Average	265 (51.1%)
High	151 (29.1%)

Table 4 Differences in the Score of Perception in Relation to the Socio-Demographic Characteristics of the Medical Students/Interns and General Awareness About Medical Leadership (n=519)

Factor	Perception Score (16) Mean ± SD	Z/H-test	P-value§
Gender
Male	10.8 ± 3.98	1.823	0.068
Female	9.96 ± 4.62
Nationality
Saudi	10.3 ± 4.39	1.390	0.165
Non-Saudi	11.6 ± 3.14
Academic year level
5^th year	11.1 ± 3.46
6^th year	10.8 ± 4.29	10.404	0.006**,‡
Medical intern	9.42 ± 4.82
GPA
<3.00	7.22 ± 5.23
3.00–3.49	11.2 ± 3.83
3.5–3.99	11.3 ± 3.68	34.034	<0.001**,‡
4–4.49	10.8 ± 3.29
4.5–5.0	10.5 ± 4.84
Current first of choice of medical specialty
Medical Specialties	11.8 ± 3.37
Surgical Specialties	9.84 ± 4.49	25.828	<0.001**,‡
Others	9.38 ± 4.75
Knowledge about leadership training takes place in a medical career^†
PBLs	12.0 ± 2.97	7.081	<0.001**
Case-based discussions	10.9 ± 4.32	1.968	0.049**
Lectures	12.2 ± 3.59	6.760	<0.001**
Internship	10.9 ± 4.08	1.865	0.062
Residency	11.3 ± 3.33	3.208	0.001**
Research endeavors	11.4 ± 3.69	2.468	0.014**
Club organizations	10.2 ± 3.94	1.186	0.236
Barriers to facing the implementation of leadership in clinical training^†
Inadequate training	12.2 ± 3.32	8.771	<0.001**
Inadequate budget	8.98 ± 5.24	3.044	0.002**
Lack of time	11.3 ± 3.50	3.595	<0.001**
Lack of interest	11.0 ± 3.39	1.958	0.025**
Not seen as important	9.62 ± 4.21	3.215	0.001**

Notes: ^†Variable with multiple response answers. ^§P-value has been calculated using Mann Whitney Z-test. ^‡P-value has been calculated using Kruskal Wallis H-test. **Significant at p<0.05 level.

Table 5 Differences in the Score of Attitude in Relation to the Socio-Demographic Characteristics of the Medical Students/Interns and General Awareness About Medical Leadership (n=519)

Factor	Attitude Score (16) Mean ± SD	Z/H-Test	P-value§
Gender
Male	10.6 ± 3.75	1.171	0.242
Female	9.96 ± 4.62
Nationality
Saudi	10.2 ± 4.19	3.802	<0.001**
Non-Saudi	12.7 ± 2.73
Academic year level
5^th year	11.1 ± 3.09
6^th year	10.7 ± 4.46	10.509	0.005**,^‡
Medical intern	9.38 ± 4.52
GPA
<3.00	6.88 ± 5.27
3.00–3.49	11.2 ± 2.96
3.5–3.99	11.0 ± 3.79	37.138	<0.001** ‡
4–4.49	10.8 ± 2.84
4.5–5.0	10.7 ± 4.79
Current first of choice of medical specialty
Medical Specialties	11.8 ± 2.84
Surgical Specialties	9.85 ± 4.19	28.950	<0.001** ‡
Other Specialties	9.09 ± 4.75
Knowledge about leadership training takes place in a medical career^†
PBLs	11.9 ± 2.68	7.771	<0.001**
Case-based discussions	10.9 ± 4.27	2.471	0.013**
Lectures	11.8 ± 3.66	6.386	<0.001**
Internship	10.9 ± 3.77	2.594	0.009**
Residency	11.3 ± 2.88	3.294	0.001**
Research endeavors	11.7 ± 2.88	3.310	0.001**
Club organizations	10.4 ± 4.19	0.508	0.612
Barriers to facing the implementation of leadership in clinical training^†
Inadequate training	11.9 ± 2.91	7.929	<0.001**
Inadequate budget	8.46 ± 5.22	4.260	<0.001**
Lack of time	11.5 ± 3.12	4.902	<0.001**
Lack of interest	11.2 ± 2.74	2.635	0.008**
Not seen as important	10.1 ± 3.91	1.449	0.147

Notes: ^†Variable with multiple response answers. ^§P-value has been calculated using Mann Whitney Z-test. ^‡P-value has been calculated using Kruskal Wallis H-test. **Significant at p<0.05 level.

Table 6 Differences in the Score of Interest in Relation to the Socio-Demographic Characteristics of the Medical Students/Interns and General Awareness About Medical Leadership (n=519)

Factor	Interest Score (16) Mean ± SD	Z/H-Test	P-value§
Gender
Male	10.3 ± 3.70	1.210	0.226
Female	10.5 ± 4.37
Nationality
Saudi	10.2 ± 4.04	3.456	0.001**
Non-Saudi	12.5 ± 3.41
Academic year level
5^th year	11.8 ± 3.15
6^th year	10.5 ± 4.57	37.101	<0.001** ‡
Medical intern	9.11 ± 3.83
GPA
<3.00	7.49 ± 5.17
3.00–3.49	10.5 ± 3.34
3.5–3.99	10.5 ± 4.19	33.500	<0.001** ‡
4–4.49	11.0 ± 2.60
4.5–5.0	11.3 ± 4.26
Current first of choice of medical specialty
General medicine specialty	11.6 ± 3.09
General surgical specialty	10.3 ± 3.71	32.199	<0.001** ‡
Others	8.37 ± 5.40
Knowledge about leadership training takes place in a medical career^†
PBLs	11.9 ± 2.96	7.990	<0.001**
Case-based discussions	11.6 ± 3.74	4.116	<0.001**
Lectures	11.2 ± 4.04	3.279	0.001**
Internship	10.9 ± 3.94	1.864	0.062
Residency	11.2 ± 2.89	3.419	0.001**
Research endeavors	12.1 ± 3.27	5.334	<0.001**
Club organizations	10.3 ± 3.78	1.294	0.196
Barriers to facing the implementation of leadership in clinical training^†
Inadequate training	12.2 ± 3.14	9.232	<0.001**
Inadequate budget	9.03 ± 4.87	3.209	0.001**
Lack of time	11.2 ± 3.57	3.987	<0.001**
Lack of interest	10.8 ± 2.99	1.026	0.305
Not seen as important	10.5 ± 4.03	0.029	0.977

Notes: ^†Variable with multiple response answers. ^§P-value has been calculated using Mann Whitney Z-test. ^‡P-value has been calculated using Kruskal Wallis H-test. **Significant at p<0.05 level.