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The medical director (MD) is a key member of the senior management team within a Trust and is expected to contribute at a strategic and policy level as well as being the main management conduit to the medical workforce. While little formal training for MDs was available in the past, more latterly there has been considerable emphasis on training in leadership and management. However, the question as to whether the skills gained during medical directorship are subsequently utilised after MDs have stood down from their post has not been addressed. We undertook a small study to determine the impact of this on individuals and their organisations. The major finding was that the considerable skill and expertise gained by those who had undertaken the MD role, albeit in this instance self-taught, were not utilised by the organisation or the wider NHS once the incumbent had stepped down. The role of the MD is pivotal in bridging the clinician-manager divide and further research of the issues raised would be of value. [ABSTRACT FROM AUTHOR]