Leadership Training in Undergraduate Medical Education: A Systematic Review





Medical education, Undergraduate, Leadership, Undergrad Medical Education


Background: This review seeks to characterize existing curricular interventions implemented to develop leadership skills in undergraduate medical students at LCME-accredited medical schools and elucidate best practices for leadership curriculum development.

Methods: PRISMA guidelines were used to guide the review. Comprehensive literature searches of five databases retrieved peer-reviewed journal articles with empirical data published in English. Two phases of screening were conducted to identify studies describing leadership development curricular interventions, followed by data extraction and synthesis.

Results: Comprehensive literature searching and hand searching identified 977 articles potentially eligible for inclusion, with a final set of 16 articles selected for the review. A majority of the leadership development programs targeted preclinical students, while others spanned the entire curriculum. "Mixed settings," including both classroom and clinical and community components were common. There was a wide range of cohort sizes spanning from over 100 students to fewer than 10. Using the competencies defined by Mangrulkar et al, we determined that all of the programs described leadership skills development, including conflict management and emotional intelligence. Out of the 16 selected studies, curricula that emphasized the development of skills were evidence-based medicine and practice, and 6 curricula targeted interprofessionalism.

Conclusions: Leadership development needs to be standardized in undergraduate medical education, ideally using a competency-based framework to develop these standards. Longitudinal programs that had a didactic and project-based component received consistently high quality and effectiveness scores, as did programs with smaller cohort sizes that received more consistent mentorship and monetary investment from institutions.


Schmidt JW, Linenberger SJ. Medicine: A Prescription for Medical Student Leadership Education. New Dir Stud Leadersh. 2020;2020(165):125-36. DOI: https://doi.org/10.1002/yd.20374

Army Leadership. In: U.S. Army Field Manual. 2016;6-22. U.S. Government Printing Office.

Hartzell JD, Yu CE, Cohee BM, Nelson MR, Wilson RL. Moving Beyond Accidental Leadership: A Graduate Medical Education Leadership Curriculum Needs Assessment. Mil Med. 2017;182(7). DOI: https://doi.org/10.7205/MILMED-D-16-00365

Standards, Publications, & Notification Forms: LCME. LCME RSS2. https://lcme.org/publications/. Accessed June 25, 2020.

About leadership development. AAMC. https://www.aamc.org/members/leadership/about/. Accessed June 25, 2020.

Core EPA Publications and Presentations. AAMC. https://www.aamc.org/what-we-do/mission-areas/medical-education/cbme/core-epas/publications. Published 2014. Accessed June 26, 2020.

Shaaban R, Rosenblum M, Bryson C: The seventh core competency: training residents to lead the health care team. Acad Internal Med Insight 2015;13(1): 4–5.

Standiford TC, Davuluri K, Trupiano N, Portney D, Gruppen L, Vinson AH. Physician leadership during the COVID-19 pandemic: an emphasis on the team, well-being and leadership reasoning. BMJ Leader. 2020;5(1):20-5. DOI: https://doi.org/10.1136/leader-2020-000344

Boland A, Dickinson R, Cherry MG. Doing a Systematic Review: A Student's Guide. 2nd ed. SAGE Publications Ltd; 2017.

Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta- analyses: The PRISMA statement. BMJ. 2009;339:b2535. DOI: https://doi.org/10.1136/bmj.b2535

Better systematic review management. Covidence. https://www.covidence.org/. Published December 13, 2020. Accessed January 7, 2021.

Mangrulkar RS, Tsai A, Cox SM, et al. A Proposed Shared Vision for Leadership Development for all Medical Students: A Call from a Coalition of Diverse Medical Schools. Teach Learn Med. 2020;32(5):561-8. DOI: https://doi.org/10.1080/10401334.2020.1754835

Kirkpatrick DL. Evaluation of training. In: Craig RL, ed. Training and Development Handbook: A Guide to Human Resource Development. 2nd ed. New York, NY: McGraw-Hill; 1976.

Hammick M, Dornan T, Steinert Y. Conducting a best evidence systematic review. Part 1: From idea to data coding. BEME guide no. 13. Med Teach. 2010;32:3–15. DOI: https://doi.org/10.3109/01421590903414245

Ginzburg S, Deutsch S, Bellissimo J, Elkowitz D, Stern J, Lucito R. Integration of leadership training into a problem/case-based learning program for first- and second-year medical students. Adv Med Educ Pract. 2018;9:221-6. DOI: https://doi.org/10.2147/AMEP.S155731

Ginzburg S, Schwartz J, Gerber R et al. Assessment of medical students’ leadership traits in a problem/case-based learning program. Med Educ Online. 2018;23(1):1542923. DOI: https://doi.org/10.1080/10872981.2018.1542923

Gottenborg E, Anstett T, Diaz M, Pierce R, Sweigart J, Glasheen J. Teaching Students to Transform. Am J Med Qual. 2021;36(4):277-80. DOI: https://doi.org/10.1177/1062860620961168

Sweigart J, Tad-y D, Pierce R, Wagner E, Glasheen J. The Health Innovations Scholars Program. Am J Med Qual. 2015;31(4):293-300. DOI: https://doi.org/10.1177/1062860615580592

Girotti J, Loy G, Michel J, Henderson V. The Urban Medicine Program. Acad Med. 2015;90(12):1658-66. DOI: https://doi.org/10.1097/ACM.0000000000000970

Vinci L, Oyler J, Arora V. The Quality and Safety Track. Am J Med Qual. 2013;29(4):277-83. DOI: https://doi.org/10.1177/1062860613498264

Hsiang E, Breithaupt A, Su P, Rogers A, Milbar N, Desai S. Medical student healthcare consulting groups: A novel way to train the next generation of physician-executives. Med Teach. 2017;40(2):207-10. DOI: https://doi.org/10.1080/0142159X.2017.1387647

Meador C, Parang B, Musser M, Haliyur R, Owens D, Dermody T. A workshop on leadership for senior MD–PhD students. Med Educ Online. 2016;21(1):31534. DOI: https://doi.org/10.3402/meo.v21.31534

Smithson S, Beck Dallaghan G, Crowner J et al. Peak Performance: A Communications-Based Leadership and Teamwork Simulation for Fourth-Year Medical Students. J Med Educ Curric Dev. 2020;7:238212052092999. DOI: https://doi.org/10.1177/2382120520929990

Barry E, Dong T, Durning S, Schreiber-Gregory D, Torre D, Grunberg N. Medical Student Leader Performance in an Applied Medical Field Practicum. Mil Med. 2019;184(11-12):653-60. DOI: https://doi.org/10.1093/milmed/usz121

Lawson L, Lake D, Lazorick S, Reeder T, Garris J, Baxley E. Developing Tomorrow’s Leaders. Acad Med. 2019;94(3):358-63. DOI: https://doi.org/10.1097/ACM.0000000000002509

Rotenstein L, Perez K, Wohler D et al. Preparing health professions students to lead change. Leadersh Health Serv. 2019;32(2):182-94. DOI: https://doi.org/10.1108/LHS-02-2018-0011

Agarwal A, Anderson J, Sarfaty S, Rimer E, Hirsch A. The Value of an Elective in Business and Leadership for Medical Students. J Med Pract Manage. 2015:276-80.

Cadieux D, Lingard L, Kwiatkowski D, Van Deven T, Bryant M, Tithecott G. Challenges in Translation: Lessons from Using Business Pedagogy to Teach Leadership in Undergraduate Medicine. Teach Learn Med. 2016;29(2):207-15. DOI: https://doi.org/10.1080/10401334.2016.1237361

Wagenschutz H, McKean E, Mangrulkar R, Zurales K, Santen S. A first‐year leadership programme for medical students. Clin Teach. 2019;16(6):623-9. DOI: https://doi.org/10.1111/tct.13005

Webb AM, Tsipis NE, Mcclellan TR, et al. A First Step Toward Understanding Best Practices in Leadership Training in Undergraduate Medical Education. Acad Med. 2014;89(11):1563-70. DOI: https://doi.org/10.1097/ACM.0000000000000502

Harris MR. The librarian's roles in the systematic review process: a case study. J Med Libr Assoc. 2005;93(1):81-7.

Coutinho A, Bhuyan N, Gits A et al. Student and Resident Involvement in Family Medicine for America’s Health: A Step Toward Leadership Development. Fam Med. 2022;51(2):166-72. DOI: https://doi.org/10.22454/FamMed.2019.857539


2023-03-01 — Updated on 2023-03-31

How to Cite

Evans, M. A., James, E. J., & Misa Mi. (2023). Leadership Training in Undergraduate Medical Education: A Systematic Review. International Journal of Medical Students, 11(1), 58–66. https://doi.org/10.5195/ijms.2023.1717