Medicine as a discipline is constantly changing. Interprofessional collaboration is on the rise, requiring more complex teamwork and communication skills. There are still steep professional hierarchies and discrimination and harassment commonly occur. While most perpetrators are senior medical staff, doctors in training also experience these behaviours from other health workers, patients and their families. Unfortunately, learners are also exposed to other forms of occupational violence. The formal curriculum codifies professionalism into competency skills which can be taught and examined, but it is the hidden curriculum, shaped by experience, that instils professional attitudes and values. Many attempts have been made to reduce the risk of sexual harm, including training learners to recognise and respond to inappropriate behaviour, but none have ensured a psychologically safe workplace for all doctors. In this chapter, we explore the role of medical training in shaping the culture of medicine. Doctors in training are still developing their professional identities, and their experiences in training shape the way they work, and who they aspire to be as a professional. Without a vocabulary to discuss their discomforts and emotional needs, junior doctors are left isolated and vulnerable, hidden in a culture of silence.

This chapter explores the complexities of pushing for cultural change from a leadership position. After examining the barriers leaders may face in changing their workplace culture, we provide practical actions and key considerations to inform a strategy that improves workplace accountability and eradicates sexual misconduct. By outlining a framework for change and including examples of the framework in action, we look at how leaders can implement measures that are person-centred, collaborative, integrated and measurable. Our recommendations focus on the prevention of sexual harm as well as creating a culture where impacted people feel safe to report inappropriate behaviour because they trust their organisation to take swift, fair and decisive action.

Advocacy is a broad term, arising from the Latin word ‘advocare’ meaning ‘coming to the aid of someone’. Implied in this definition is the concept of lending one’s own power to the cause of another. The power to direct the goals of any advocacy effort should remain with the individual or group that will benefit from the advocacy campaign. Advocacy can be misdirected if the voices of the individuals for whom advocacy is sought do not speak, or are not sufficiently heard.

Many of the authors in this book have shared their experiences advocating for change. In this chapter, we will explore how advocacy can occur by examining where within the system advocacy efforts can be directed, the process of planning, implementing and evaluating advocacy, and how an individual can determine where to focus their efforts. We will also draw on examples from various authors, illustrating how and why they undertake their work, and the lessons they have learned through their advocacy journeys.

This chapter offers insight into some of the kinds of positions people can take in their emotional and personal journeys as advocates within medical training. It includes people in different positions in their advocacy journeys, offering their visions for the kinds of changes that need to happen to make a difference to sexual harassment in medicine. May Erlinger writes from her perspective as a medical student, describing the personal and emotional journey of becoming mobilised around sexual harassment in Australia. Becky Cox and Chelcie Jewitt are the co-founders of ‘Surviving in Scrubs’, an online campaign to tackle the problem of sexism, sexual harassment, and sexual assault in the healthcare workforce. They launched Surviving in Scrubs as doctors in training in the UK, giving a voice to women and non-binary survivors in healthcare to raise awareness of the problem, and to demonstrate the diversity of lived experience that needs to be addressed. Louise Stone and Fiona Moir are senior medical educators, who have had senior roles in medical student and GP training in Australia and New Zealand. They discuss the range of roles and challenges they have addressed in managing professionalism, wellbeing and professional identity formation in policy, teaching and leadership.

Leadership is a very fashionable term and firmly established in the lexicon of managers in both the private and public sectors and within domestic and international politics. As a concept, it is complex, multifaceted, dynamic and invariably influenced by the context and organisational culture in which it occurs.

The chapter begins with an overview of different ideas about leadership, examining ‘wicked’ and ‘tame’ problems, the distinction between leadership and management, psychiatrists as leaders and different leadership styles. We then delve into the emerging fields of compassionate and systemic leadership, emphasising relational trust, diversity and collaboration. We explore the role of contention, developing collaborative relationships, the centrality of developing relational trust and working with diversity. The chapter concludes with a discussion focused on the ubiquitous influence of conflict in organisations. Throughout, we will explore leadership through multiple lenses to unlock new possibilities for practice.

Friendship in the workplace is alternately approached as a resource to be leveraged or a liability to be managed. In leadership development, where practitioners carefully cultivate their subjectivities, appearing adequately self-aware and open-minded is valued highly. How do leadership development practitioners’ use of complaints in their workplace, in ways both formal and informal, serve as an affordance for friendship? Considering this example raises questions about what it means to make friendship useful at work and in other contexts, and it suggests that separating the “goods” of friendship from the “bads” is a misleading and problematic endeavor.

In this chapter, we get acquainted with the concepts of leadership, sustainability and governance, concepts we will need to develop our perspective on sustainability leadership. Leadership to move communities in a more sustainable direction will have to go through governance, through the process of collective decision-making that can place communities on a different development path. What amounts to good leadership will depend on the community and its stories about good governance and about leadership itself.

The chronicle of European social democracy is often told from the perspective of the party leader. If the party triumphs at the polls, it is surely because the leader is a visionary. If, on the other hand, the party loses elections, weak leaders are held responsible for that misfortune. Clearly, leadership matters but perhaps not in the top-down manner it used to. Drawing on the literature on political leadership and the Europeanisation of public policy, this chapter argues that the collaborative approach to statecraft deployed by the Portuguese Prime Minister António Costa in the period 2015–2019 paved the way for a period of political stability and electoral victory of the Socialist Party. Using the method of process-tracing to analyse official documents, parliamentary debates, and media reports, the chapter shows that collaborative statecraft enabled Costa to get four budgets approved, to complete a four-year mandate while leading a minority government, and to win the elections of 2019. The chapter also shows that the abandonment of collaborative statecraft in the period 2019–2023 resulted in greater political uncertainty and contributed to the socialists’ defeat at the 2024 elections.

This chapter examines the ideological origins and political impact of the American concept of the “free world.” From the late 1940s to the early 1960s, “free world leadership” served as the organizing principle of U.S. foreign policy. Although American officials imagined the “free world” as the self-evident expression of international liberalism, they defined it negatively as equivalent to the entire “non-communist world.” Cold War liberals’ persistent failure to fill the “free world” with positive content forced them to maintain a series of inflexible and ultimately counterproductive positions, including an intolerance of nonalignment, a commitment to global containment, and an axiomatic insistence on the enduring and existential nature of the Soviet threat. Although the “free world” mostly fell out of circulation after the 1960s, the logic of the concept has continued to underpin an American project of global “leadership” that derives its purpose and extent from the prior identification of a single extraordinary threat.

Some teachers and teacher educators take on quite significant leadership roles, such as serving as a new president of a teacher association in Thailand, but all teachers exhibit leadership in some way. It may be relatively small-scale, such as attempting to decolonize the curriculum in one program in Colombia or establishing a collaborative teacher research group in a school in Botswana. Diverse teacher leadership possibilities such as these are represented in the cases in this chapter.

Leadership on climate action is about demonstrating change in reality, not about having a senior position or being ‘in charge’. We are all involved in leadership. At work, at school, in retirement or in our leisure activities, we can demonstrate leadership by questioning default decisions and demonstrating our enthusiasm for alternatives compatible with zero emissions. Leadership could involve the four actions of Chapter 9, or speaking out among our work and community groups, or writing letters, or asking difficult questions at school. We can all show leadership, like that demonstrated by the two women who created the ‘flight-free’ movement in Sweden, and our leadership is urgently needed.

Action at scale on climate change is urgent. It is unavoidable that such action must for a period of some decades include restraint, because we do not have time to construct enough emissions-free substitutes for all today’s emitting activities. Leaders in politics and businesses cannot promote restraint without losing their jobs, so leadership must come from us, individually and collectively, making decisions to live differently. We can all act, at home and at work or in other teams. We can prioritise our most emitting activities, make changes where possible and, where it is for now beyond our reach, we can promote change through raising awareness of what matters and what help we need. These choices and actions are virtuous. Not ‘virtuous’ in the sense we parodied in the opening, of something admirable but prim and outdated, but a joyful, life-enhancing virtue that expresses the best of what we hope to be. The virtue of restraint in climate action is an act of leadership, an expression of faith and charity, and above all, an act of love.

The challenge of transitioning to a net-zero-carbon world requires engineers and scientists to blend their technical proficiency with soft skills such as trust-building, stakeholder influence, and effective leadership within multidisciplinary teams. This seamless integration of subject matter expertise and interpersonal skills — especially those focused on leadership — are essential for driving change. Unfortunately, these skills and knowledge are frequently left out of the foundational curriculum of science-based graduate programs across the United States. In order to accelerate the energy transition, we propose that our students receive instruction in developing skills required for effective implementation and leadership of change. This chapter will set up the framework for management and leadership training for STEM (science, technology, engineering, and mathematics) students or postdocs, whether in a two-hour workshop or a full semester course.