Competencies necessary for becoming a leader in the field of community medicine: a Japanese qualitative interview study

OBJECTIVES: To clarify competencies for inclusion in our curriculum that focuses on developing leaders in community medicine. DESIGN: Qualitative interview study. SETTING: All six regions of Japan, including urban and rural areas. PARTICIPANTS: Nineteen doctors (male: 18, female: 1) who play an important leadership role in their communities participated in semistructured interviews (mean age 48.3 years, range 34–59; mean years of clinical experience 23.1 years, range 9–31). METHOD: Semistructured interviews were held and transcripts were independently analysed and coded by the first two authors. The third and fourth authors discussed and agreed or disagreed with the results to give a consensus agreement. Doctors were recruited by maximum variation sampling until thematic saturation was achieved. RESULTS: Six themes emerged: (1)‘Medical ability’: includes psychological issues and difficult cases in addition to basic medical problems. High medical ability gives confidence to other medical professionals. (2)‘Long term perspective’: the ability to develop a long-term, comprehensive vision and to continuously work to achieve the vision. Cultivation of future generations of doctors is included. (3) ‘Team building’:the ability to drive forward programmes that include residents and local government workers, to elucidate a vision, to communicate and to accept other medical professionals. (4)‘Ability to negotiate’: the ability to negotiate with others to ensure that programmes and visions progress smoothly (5) ‘Management ability’: the ability to run a clinic, medical unit or medical association. (6) ‘Enjoying oneself’: doctors need to feel an attraction to community medicine, that it be fun and challenging for them. CONCLUSIONS: We found six competencies that are needed by leaders in the field of community medicine. The results of this study will contribute to designing a curriculum that develops such leaders.