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Ahmed I - Trainee doctors are unlikely to come into direct contact with senior managers, although they may have some interaction with junior managers. As a trainee, the author have noticed an apparent lack of understanding, trust, and confidence in doctors by managers, and vice versa. Following recent discussions with managers at both junior and senior levels, the author realise that this distrust stems from a clear lack of communication between the two. There is little appreciation and value of each other’s work, role, and responsibilities in the provision of health care. The author believe that with the departure of the highly sceptical senior consultant workforce and with increased involvement of medical staff in management - which is likely as a result of the incorporation of management competencies in the training curriculum - the existing mistrust and lack of understanding between hospital managers and clinical staff will slowly disappear.