The Toxic Culture of Medical Leadership: A Case Study in Power and Accountability
What happens when the very institutions meant to uphold health and safety become breeding grounds for toxicity? This is the question at the heart of the recent suspension of Dr. Sharmila Chandran, the president-elect of the Royal Australasian College of Physicians (RACP). Personally, I think this story is far more than a bureaucratic scandal—it’s a stark reminder of how power dynamics and personal conflicts can erode trust in even the most respected organizations.
The Spark of a Royal Mess
The RACP, a cornerstone of medical specialization in Australia and New Zealand, has been thrust into the spotlight for all the wrong reasons. The suspension of Dr. Chandran by the Australian Charities and Not-for-profits Commission (ACNC) over alleged health and safety breaches is just the tip of the iceberg. What makes this particularly fascinating is the context: months of infighting, police involvement, and a boardroom culture described as “toxic” by its own members.
One thing that immediately stands out is the role of SafeWork NSW, which accused Chandran of exposing RACP staff to “immediate and serious risks” to their psychological health. In my opinion, this isn’t just about a failure to follow directives—it’s a symptom of a deeper issue. When leaders prioritize personal vendettas over the well-being of their teams, it’s not just the organization that suffers; it’s the very people they’re meant to serve.
A Leadership Limbo
The timing of this suspension couldn’t be worse. With Chandran’s ascension to the presidency on hold and the outgoing president, Dr. Jennifer Martin, ousted early, the RACP is in leadership limbo. From my perspective, this chaos raises a deeper question: How did a college with over 32,000 physicians across 33 specialties find itself in such disarray?
What many people don’t realize is that this isn’t just about individual personalities clashing. It’s about systemic failures in governance and accountability. The ACNC’s intervention, while necessary, highlights the broader issue of how charitable and professional bodies often operate with limited oversight until things spiral out of control.
The Culture of Conflict
The RACP’s troubles didn’t start overnight. Last August, the board passed a vote of no confidence in Chandran, accusing her of fostering a “toxic culture.” Chandran, in turn, filed an anti-bullying order against Martin and the RACP, which she later dropped, calling the Fair Work Commission “not very fair.” If you take a step back and think about it, this back-and-forth isn’t just petty squabbling—it’s a reflection of a system that allows personal grievances to overshadow professional responsibilities.
A detail that I find especially interesting is the prohibition notice issued by SafeWork NSW, which barred board members from communicating with RACP staff. This isn’t just about protecting employees; it’s about restoring trust in an institution that has lost its way. What this really suggests is that the RACP’s problems aren’t just about leadership—they’re about culture.
The Broader Implications
This scandal isn’t just an Australian story; it’s a global cautionary tale. Medical colleges are meant to be bastions of professionalism and ethics. When they become battlegrounds for personal power struggles, it undermines public confidence in the entire medical profession.
In my opinion, the RACP’s crisis is a wake-up call for all professional bodies. It’s a reminder that leadership isn’t just about titles—it’s about accountability, empathy, and the courage to put the greater good above personal interests. What this really suggests is that we need stronger mechanisms to hold leaders accountable, not just when they break the rules, but when they fail to uphold the values they’re meant to embody.
The Path Forward
The appointment of Adjunct Prof Susan Pascoe as interim board chair is a step in the right direction. Her experience as the inaugural charities commissioner gives her the credibility to steer the RACP out of this mess. But, personally, I think this is just the beginning. The ACNC’s warning that it could extend Chandran’s suspension or take further action against the RACP underscores the gravity of the situation.
If you take a step back and think about it, the RACP’s future hinges on its ability to rebuild trust—not just with its staff and members, but with the public. This scandal has exposed the fragility of institutions that we often take for granted. It’s a reminder that even the most respected organizations are only as strong as the people who lead them.
Final Thoughts
As I reflect on this saga, one thing is clear: the RACP’s crisis isn’t just about one leader or one decision—it’s about a culture that allowed toxicity to thrive. What this really suggests is that we need to rethink how we select, train, and hold accountable the leaders of our most important institutions.
In my opinion, the RACP’s story is a call to action. It’s a reminder that leadership isn’t just about power—it’s about responsibility. And when leaders fail, it’s not just their careers that are at stake; it’s the trust of the people they serve. This scandal may be a royal mess, but it’s also an opportunity—to rebuild, to reform, and to restore faith in the institutions that shape our lives.
