Management skills are essential in fulfilling the consultant role in the modern NHS. Higher specialist training provides the opportunity for trainees to accrue essential management training and experience. Conventional, didactic approaches to teaching management skills are challenged in this paper by describing a more direct and experiential approach. The broad range of learning opportunities available in this model vary from gaining factual knowledge to reflective learning, and support the consolidation of the trainee's management skills and approach to leadership. Trainees' reports after the placement have been encouraging. Implementation of this 'hands-on' approach is recommended to all higher specialist training schemes as a way of stimulating and developing doctors' management interests.