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Purpose – The purpose of this paper is to present the findings of a short research project, conducted in 2010 as part of a larger EU funded action investigating the participation and impact of doctors in management. The authors sought to compare the ways in which hospital doctors in the UK and Poland – countries with distinct histories – participate in management; whether they are converging and whether the type of participation found results from changes in the governance and management of these systems. Design/methodology/approach – First, a review of existing evidence and an analysis of policy documents and healthcare statistics were conducted. Identifying a lack of empirical data in the Polish context, and a potentially changing situation in the UK, the authors proceeded to collect some exploratory data in Poland, via interviews with expert informants, and to draw on data collected alongside this study in the UK from qualified doctors participating in research on management and leadership development. Findings – Hospital doctors currently hold similar types of management role in both systems, but there are signs that change is underway. In Poland, different types of medical manager and role are now emerging, whereas in the UK younger doctors appear to be expecting greater management responsibility in the future, and are starting to take up the management training now on offer. Research limitations/implications – The potential implications of these changes for the profession and policymakers in both Poland and the UK are discussed, with opportunities for further research highlighted. Originality/value – The paper provides a comparison of how medical engagement within two systems with different histories is occurring, and also of the changes underway. It provides some much needed initial insight via interviews with expert informants within the polish system, which has been under-researched in relation to the involvement of medicine in management. [ABSTRACT FROM AUTHOR]