Clare Chapman's encouragement for more senior managers to be recruited from the medical ranks echoes our conclusions that this would accelerate the breaking down of perceived barriers between managers and medics, write Ian Gilmore and Martin Else

This will need a cultural shift, to which the royal colleges are ideally placed to contribute. Recently the development of the medical leadership competency framework, adopted by the Academy of Medical Royal Colleges, has established a formal development structure for leadership training for doctors.

In addition, this college has already run a successful programme jointly with the NHS Institute for Innovation and Improvement, bringing young consultants and managers together in a practical programme of training built around a service improvement scheme applied locally.

We will be launching a masters in medical leadership, delivered in collaboration with universities, and will continue to support further initiatives in this area, which are vital to ensure that a high-quality cadre of doctors actively pursues top management posts.

Professor Ian Gilmore, president, and Martin Else, chief executive, Royal College of Physicians