There Is No Neutral

For a long time, I thought there were three types of leaders. Those who supported you. Those who opposed you. And those who were neutral.

I don't believe that anymore.

Imagine two surgical trainees. Both competent. Both ambitious. Both approaching the stage where they need greater responsibility. An operating opportunity appears.

One trainee has a consultant who says: "Give it to her. She's ready."

The other has a consultant who says nothing.

Nobody has attacked the second trainee. Nobody has written anything negative. Nobody has actively prevented them from operating. The leader has remained completely neutral.

But who gets the opportunity?

Now repeat that over six years. Cases. Research. Courses. Fellowships. Conference presentations. Introductions. References. Committee positions. Jobs. The difference becomes enormous.

When opportunities are scarce, a leader who isn't pushing for you may, in practical terms, be holding you back. Not deliberately. Not maliciously. They may even like you. But careers aren't built on whether people like you.

They are built on opportunities.

There is a form of leadership that isn't visible on any organisational chart.

Sponsorship.

Mentorship says: here's what I think you should do. Sponsorship says: I've told them they should consider you. Those are very different things. One gives advice. The other spends social capital.

The most powerful people in your career are often those willing to say your name in rooms you cannot enter. Harry would be good for that. Have you considered her? He's ready. Give them the opportunity. A twenty-second conversation can alter the course of someone's career — and the person whose name isn't mentioned may never know the conversation happened.

Surgical training makes this particularly important, because competence cannot develop without exposure. You cannot become excellent at surgery by reading about it. At some point someone has to give you the knife. Someone has to let you perform the approach, allow you to make the decision, stand beside you while you struggle. Eventually someone has to step back and say: you do it.

That is permission.

And permission is power.

As a Black trainee, I became increasingly aware of how important that power could be.

Not because every leader was biased against me. That would be far too simplistic. I had some extraordinary leaders and mentors throughout my career — people who opened doors, supported me quietly, gave me opportunities to demonstrate what I could do.

But I also learnt that waiting for every local leader to recognise your potential is a dangerous career strategy. Some will. Some won't. Some will genuinely be unsure. Some will have somebody else they are pushing. And occasionally you will encounter people who simply do not see in you what you see in yourself.

You can spend years trying to change their minds.

Or you can find another route.