Good, bad and ugly: Exploring the Machiavellian power dynamics of leadership in medical education

Medical education requires participation of various stakeholders and this contributes to power dynamics operating at multiple levels. Personality traits of an individual can affect the smooth execution of the educational programmes and eventually the professionalism of the environment. With the increased focus on leadership traits in medical education and collaboration in health care settings, I, through this commentary, would like to explore the Machiavellian power dynamics involved and how it can influence the harmony prevailing in an organization. The author has tried to review the several aspects of Machiavellianism in health care settings and describe day-to-day experiences at four levels; micro (individual), meso (departmental), macro (institutional) and mega (discipline). Introspecting on the unaddressed issues in a different light would help to gain a deeper understanding regarding work place ethics and professionalism. The reflection of day-to-day experiences in a different perspective would provide an insight regarding various issues to health professionals and help in developing ethical leadership abilities in them, which eventually promulgates professionalism. To my best knowledge, this is the first commentary to deal with the implications of Machiavellianism in different issues related to health care settings. With the increased emphasis on the leadership traits related to medical education, analysing organizational issues in various dimensions is of paramount importance.