Two years ago I attended a weekend residential course on team-building and leadership at an outdoor development centre in Devon.

This formed part of a new management training scheme then being piloted. It was unique in that the participants consisted of specialist registrars, NHS management and finance trainees.

I was not looking forward to it at all. Three days of endless jargon and unbelievable role- playing scenarios seemed inevitable - time I felt difficult to justify in terms of expense or practical value.

After a brief introduction, we were set to work. The format was to undertake various challenges while working in small teams. These included activities such as building makeshift bridges, mountain rescue drills, and crossing assault courses.

Feedback sessions were used to evaluate individual and team performances, supported by short seminars on team roles, group dynamics and leadership styles.

The central message was simple: the team can accomplish far more than the sum of its individual members, or it can achieve only a fraction of its potential.

Determinedly sceptical, I expected to gain little from this course. But by the end of the weekend I had begun to wonder why a subject fundamental to the way we work has been so inconspicuous in medical training.

The mix of doctors and other NHS professionals was a definite advantage. Increasing exposure and interaction between them gave an opportunity to break down barriers, while making the small-team activities more informative.

The concept of team-working is particularly relevant now. Difficulties in recruitment, staffing shortages and the new working-time directive will have an inevitable impact on continuity of care. The introduction of clinical governance demands better team performance.

So far the medical profession has given team-building and leadership little attention. In many other large organisations these skills receive far more emphasis.

Presumably they believe that by teaching such subjects, they can improve efficiency and performance.

Perhaps they are right.

Dr JM Smart Specialist registrar in radiology Southampton