Communication & Correspondence

This section may well have a feel of an old person ranting but this is an amalgamation of experience and observation. Personally, I still can’t call those who are were my senior but now my peers by their first name without feeling uncomfortable, but different specialties have different habits.

A slow but steady change that has been occurring the NHS and in many other organisations is a shift towards flattening the hierarchy. The biggest advantage of this is the empowerment of those who may otherwise be reluctant to speak up due to perception of their ‘position’, and ultimately means that issues can be raised sooner and managed earlier. For patients this can improve their overall safety and satisfaction, whilst stamping out bad behaviours such as bullying and harassment.

This openness cannot be interpreted as an opportunity to be casual. It is still absolutely vital that as you engage with colleagues you remain appropriate. How you interact and behave will create a perception of you that can help or hinder you. Politeness and courtesy cost nothing, and is the best way to be until you’ve scoped out any given individuals preferences.

Flattening the hierarchy also cannot be taken as an opportunity to assume total equality in a given situation. Ultimately, the hierarchy exists with accountability. The more senior the individual in the situation the more responsibility and accountability rests on their shoulders. In the operating theatre, everyone has a role. During the anaesthetic and transfer of the patient – the Anaesthetist is the most second most important person in the room; during the surgery, the operating surgeon is the second most important person in the room; and during closure the scrub nurse is the second most important person in this room. The most important person is the patient.

This isn’t to say that input from other colleagues isn’t welcome or is ignored out of hand, but at certain points you need to be leader, but you always need to be a team player.

Face to Face Communication

  • If it is a meeting, be punctual – we all acknowledge that there will be instances when you are late but in those cases letting your colleague(s) know what the situation is important
  • Dress appropriately – this can be a point of contention, but please consider that every organisation has a uniform policy, and these are more focused on ensuring appropriate attire for your job and to fulfill requirements of other hospital policies (such as infection prevention). Be aware that there are very few people who will call you out on it for fear of a complaint, but it won’t stop them from raising an eyebrow and changing their perception of you.
    • Dress for the job you want, not the job you have – as a junior colleague you should be developing behaviours for the next stage of training.
  • Use titles – If you’ve never met someone before, then use their title – it’s not about servitude but a demonstration of professional respect that will then be returned. If, after that, you are invited to address someone differently then that is fine.
  • Respect your seniors – once again, this is not about servitude but more about the fact that your senior is the one who will be on the hook for anything that goes wrong. Take a moment and absorb that. If the senior invites you to call them by their first name then it is different.
  • Be kind to everyone – It doesn’t matter what you think of yourself, that view will never be shared if you are horrid to others. Everyone should be afforded respect and kindness, especially junior colleagues who will look up to you and learn from you. So if you behave badly then this will passed on to the next generation.

Email Communication and Correspondence

I received a fantastic email from someone once. It was one line, no introduction, just a demand. I replied quite bluntly and received a very feisty response. However, when this individual realised that I was a consultant the email grovelling started. This was even worse! This individual was rude in an email but then said that had they known that I was a consultant they wouldn’t have been so rude! This shows a lack of insight, lack of common sense and heaps of arrogance, because no-one should ever receive a rude email. So here are my tips for sending emails:

  • Greet the recipient
    • If you have a relationship with them then go with first names, if not, use titles – you can not really go wrong….
  • Introduce yourself (if needed)
    • if they don’t know you it will help them start working out what your needs will be
  • Acknowledge/Thank them
    • Acknowledge them e.g. I appreciate you may be busy but…..
    • If you are replying then thank them e.g. Thank you for your email….
  • Ask the question
    • Make your purpose clear and be specific
    • Keep it short and sweet
  • Finish off with a polite thank you and a closing with your name
  • Have an email signature
    • That clearly identifies who you are, where you work, etc..

As an example, read the below emails and decide which one you’d prefer to see in your inbox from someone you don’t know

Email 1



Dear Usman, I need access to the weblink for teaching tomorrow, Andy


Email 2


Subject: WebLink request for Teaching Session

Dear Mr Ahmed

I’m a 4th year medical student at —- University

Apologies for the bother, but may I please have the link for the teaching session tomorrow on lower limb injuries.

Many thanks


Andrew Smith

4th Year Medical Student

University of ———

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