On qualifying as a GP, I followed a traditional route from trainee to salaried and locum doctor, to partner, trainer, and appraiser. A path that many doctors of my generation have taken.
Underneath, I suspected that the anxiety which appeared in my 30’s, as the invincibility of my 20’s faded, would limit my time in clinical practice. I planned to retire early around 55 years. Over the last few years as pressures for doctors have mounted and my circumstances at home and work changed, this retirement age got lower and lower. It somehow made me feel less trapped.
Having had to stop, I have had to re-consider what is important in my life and re-visit my values, goals and aspirations. As a result, like many others, I am carving out a kind of portfolio career.
Or perhaps, to be more current, a “slasher” career. Not to be confused with horror movies, this term describes “the ‘slash’ in the job title of someone who is a X/Y/Z – or journalist/web editor/PR, for example” or the shedding of 9-5 working and one career for life.
The way we look at careers has changed. Very few follow a true linear career ladder or stick to one job or profession for life. As medics, we are unusual in this. Although more and more doctors are diversifying as reflected by the rise of organisations and coaches supporting medics who want to pursue this path.
In her controversial book Lean In, Sheryl Sandberg, COO of Facebook, talks of careers as “jungle gyms” which allow “great views for many people, not just for those on the top” as compared to a career ladder where “most people are stuck staring at the butt of the person above”. Medicine is typical of this as we wait for people to retire or move on to further progress our own careers.
I like Sandberg’s analogy. I picture a more exciting creative path. One where you follow your interests and passions. One that is flexible, where you can swing or jump from one thing to another as the desire or need arises and, very importantly, where there is opportunity to take rest in the shade when needed.
Steve Jobs, former CEO of Apple, talks about a similar concept in his address to Stanford in 2005. Again, a shift away from the linear path that is all too familiar to us as health professionals. He lists three essential elements for happiness and success in work: connectivity, love and living each day as your last.
To illustrate connectivity, which you can only appreciate in retrospect, he describes how dropping out of college allowed him to pursue subjects that really interested him, one of which was a calligraphy course that had no purpose at the time. Something on looking back which contributed to Apple’s success.
Watching this was transformational to me. The concept that people could possibly be wanting to do their job if it was their last day bewildered me completely. I knew absolutely that I would not be doing my job if it was my last day, last month, last year or last few years. So, it was clear to me that I needed to make a change!
As medics, all too often much of our “success” and self-esteem is tied up in our identity as a doctor. We tend to say “ I am a doctor” rather than “I work as a doctor”. Being a doctor, as well as being a great privilege, gives us kudos. It makes us credible. We are (on the whole!) respected.
Our own drive and perfectionism mixed with the perceived expectations of others, particularly our peers, and the expectations we often place on ourselves can lead us along an automatic track which we then have difficulty in jumping off.
Many of us will know colleagues who have burnt out, suffered anxiety, depression, other mental illness, or in the worse case, taken their own lives.
Most of us will also be aware that mental ill-health in doctors is a global phenomenon and that we experience more mental ill-health than other professional groups. (I will be exploring some of the factors that make us vulnerable in a future blog.)
So, perhaps it is time for us all to stop and re-define what success means for us as individuals and then work out the steps we can make towards it.
For me, success at work is now to have fun and to feel that what I do has meaning, is impactful, and connects with others. Similar to re-wording yourself as a new way to think about what you want for the year ahead, there are no SMART goals here, so the perfectionist in me can’t fail!