When I had my break from medicine almost 2 years ago, I had no idea what I could do as a career if I chose not to return to clinical practice. I knew that I didn’t want something prescriptive that required yet more training, but had no idea what.

I saw the amazing Giles P Croft talk at the Diversify conference in London that April. His talk, “The 10 Principles of Career Change” helped me start to see the world and my career completely differently. 

I have been keen for a long time to share some of his insights, and he very kindly agreed for me to interview him. When we spoke, here’s what he had to say….

Giles, you started out your medical career as a surgeon. What were the factors that led you to leave clinical medicine and to decide to take an “alternative path”?

It wasn’t any one thing in particular. It’s always convenient to think of these situations as one day you wake up and decide not to be a doctor any more and do something else. In reality, it’s far messier.

There were a lot of things going on at the time. The European Working Time Directive had just come in and I’d gone from the “bad old days” of working all hours—but working with a tight-knit team, knowing all my patients—to working shift patterns, where I was less likely to be operating under the same consultant. It felt like my training took a real hit.

I was working in a big teaching hospital and was quite disillusioned with the job I was doing. It was an incredibly competitive environment. I’d been encouraged to take a very particular job, which I had been promised would lead to a registrar number, something that I am sure that many other doctors will be familiar with. At the end of the job it became apparent that this wasn’t the case and I was looking at 3 years of research on top of that. So I felt a bit let down and, frankly, the overall environment was just not inspiring. There were a lot of disgruntled doctors about and when I looked at my seniors, they were all miserable and not the role models that I wanted to aspire to be like.

On the plus side, I’d always had a keen interest in health informatics after being given what in those days was called a Personal Digital Assistant (PDA) by one of my consultants, as part of a trial of paperless care for the juniors. It changed the way I saw the practice of medicine, and I wanted to make a difference in this field. I initially started trying to find out whether I could combine this interest of mine with orthopaedics and was constantly looking for research opportunities. Then out of the blue, a full time health informatics position came up at the RCP (Royal College of Physicians), so I just went for it and that was the beginning of it all.

When you started your new adventure, did you experience any negative responses to leaving the profession?

During the transition process I didn’t tell many people. I had some non-medic friends who knew about my plans but I didn’t tell my family what I was up to at first, and I certainly didn’t tell any of my colleagues; not until I knew I was already out of there. Morale was so low at work that people weren’t all that shocked when they found out. It was more a case of people not believing life would go on after leaving medicine – they were fascinated by the idea of what I might do instead.

Occasionally I get asked if I regret all the training I went through. I don’t, not for one moment. It’s all part of who I am and what I’ve become. I’d do it all again.

It sounds like you didn’t really plan the transition. What advice would you give others planning to leave?

I can see it might come across like none of it was planned, but I’m a strong believer of having something to work towards.

It is very easy to focus on all the things that you don’t want. I’ve been guilty of that myself in the past. Constantly battling against all the unwanted stuff I’ve found myself in the middle of. But you need something to work towards – something that gets your juices flowing. It doesn’t have to be meticulously mapped out, just something that you enjoy doing, and that you’re switched on to. Some direction you want to go in. Thinking about it. Talking about it. Doing it, a little bit at a time, so that you are gradually doing more of what you do want and less of what you don’t want. Slowly the scales tip and something will come out of the blue for you.

A lot of people don’t know what they want to do. Would you have any tips as to how they discover that? I certainly struggled with this.

You’ve heard me speak. I talk about the “career onion” as opposed to the career ladder, which is this idea of focussing a little less on finding some specific job to do and a little more on finding out who you want to be; how you want to live your life. Having an idea about the values that you want to express, and working towards finding a way to do that, in whatever guise. Looking a bit inwards about what makes you tick – that reason for getting out of bed every day.

I knew, deep down, that what I really wanted was to write, ideally about cycling, but I wasn’t ready for that at the start as it was too big a transition for me. I got there in the end, but I needed the stepping-stone of health informatics – which was something I knew I wouldn’t have a problem throwing myself into 100%. The different working conditions gave me the space I needed to pursue my bigger dream… so I suppose my advice is to ensure that when you’re making career decisions you never close any doors on what it is you really want.

And for those who don’t know what they want?

Someone once came up to me after I’d been speaking and said:

I feel like this empty husk. Medicine has sucked the life force out of me. How could I possibly know what I want to do?

This is common, unfortunately. But I believe that who we are, and what we really like doing, is still there, it just needs to be re-discovered.

There is a period of reflection – of reading, listening and talking to different people; of really getting your mind into the idea of focusing on thinking about different things. Shaking yourself out of the rut that you’re in. “Switching your radar on”, as I call it. Think back to your childhood. What did you enjoy then? What would others say that you’re good at now? What’s important to you? What can’t you leave this earth, having left undone? What would you regret, if you didn’t do?

Equally, I think it’s important to stop thinking how can you make a career out of this. That’s often counter-productive, because it’s grounded in that “what am I going to do?” sort of thinking. Accept that you don’t know where it is going to end, or how it will turn out. Just commit to something different happening. You just need to discover how to get those creative juices flowing again. Happiness comes from fulfilment, mostly on a day to day basis. I’m sure I’ve not achieved half the things I want to, but I’m so much happier than I used to be, simply because I’ve acknowledged the gap between where I am and where I want to be, and I consistently take steps to bridge that gap.

When you start going through this process, you might get just the tiniest of ideas at first. This will grow, then you start talking to people and having more ideas and doing more research and talking to more people and it becomes a virtuous “Cycle of different” where you get on a roll and see changes start to happen.

I can really relate to that.

The problem with medicine is that you start off being creative and then it all gets squashed as you learn to excel in absorbing facts. It felt like we all started medical school diverse and came out uniform.

Yes, and for good reason. It’s like the military really. They’ve got to get you thinking in a certain way. And getting back to the normal way of thinking is pretty hard.

In “The Artists Way”, Julia Cameron encourages committing to a period of writing every morning. It doesn’t matter what it is. It doesn’t have to be anything at all. It just has to be writing, even if it’s utter rubbish. It’s a good exercise to get into, to kick start that whole process of connecting with your inner self if you like, of starting to shake things loose and becoming a little less automated.

It is about switching you radar on. Your brain has been wired in a particular way for medicine and you need to re-wire it. You’re not going to do that if you are just sitting around thinking about medicine and how terrible it is. You’ve got to do different stuff.

I like that – re-wiring of the brain. It’s a good analogy.

For me that links to Stephen Covey’s bestseller “7 Habits of Highly Effective People”. You recommended that book when I saw you speak. I found it amazing and it felt very relevant.

The fundamental aspect of that book—and something I try to use as my guide, in all I do—is to be willing to see things differently.

To give yourself the space and chance to see things differently and to accept that what you know and the way that you think things are, aren’t the way it is! Rather, they’re a result of all the different conditioning and life experiences that you’ve had.

What I love is when Covey talks about the difference between management and leadership. Management is doing things right and leadership is doing the right thing. He gives this analogy of the managers cutting through the forest with all their plans to increase productivity and then the leader climbing up to the highest branch and shouting down “Wrong forest!” I just love that.

I talk about productivity at the BMJ careers fair and I think that we all have a duty to ourselves to be our own manager and our own leader. We want to be productive but we do need to take a step back and think “Hang On. Am I doing the right thing here? Am I in the right forest? Is my ladder leaning against the right wall?”

You make a commitment to medicine at 14-15 years old when you take your GCSEs. One day you wake up maybe 20-25 years later and you’ve never ever questioned that decision.

This whole thing of career change is more difficult for doctors and those in rigid conveyor belt type careers. You have to commit so early and you have to be so committed to it that you have to shut yourself off to other things. It’s in your best interests to put the blinkers on, get your head down and aim for that tiny pinpoint of light in the distance. That’s why it’s so difficult to leave.

I think we convince ourselves as doctors that the career decisions we’re making are career decisions but they’re not. It is all fine-tuning within a very narrow band of a particular career. 

In your talk you talk about everything being transferable. What in your opinion are our transferable skills and assets as doctors?

Generally, I think that just being a doctor—particularly if you have done an A & E job and come out the other side—you can manage anything. Being out in the real world is a piece of cake after that.

Talking specifics, I like to think of there being hard and soft transferable skills. The hard ones are things you could write down, like communication and negotiation skills. Those alone will take any doctor a long way in any alternative career.

In my talk, I mention sales. It’s not something medics really talk about, but when we refer a patient to someone, we “sell” the patient’s story to that other clinician. We’re packaging everything up, giving them all the information they need to know, in a format they’re likely to accept. Those “sales” skills apply equally out in the real world, if you decide to forge your own career doing something else. You’re simply packaging up all your skills and your own work, in a format people are likely to accept. It’s how I got started as a freelance cycling journalist.

But what I think is more important than those hard transferable skills, is the soft ones. Taking forward all your experiences and the person you’ve become as a result of those. “Being yourself” sounds cheesy, but it’s so the most important transferable skill you have!

There are many transferrable skills but many of them may not be our strengths?

Yes! Another thing is that we often feel obliged to do things that we are good at, even when we don’t enjoy them. My advice is don’t do them. And if you are rubbish at something, but enjoy it, then do it till you are good at it. You’ll learn new skills. There are skills that I have now that I wouldn’t ever have dreamed of. You pick up what you need as you go along. You are guided by what it is that you want, so that you are doing more of what you like and less of what you don’t.

You have now moved to do a lot of public speaking on career change. What tips would you have for those forging new paths whose roles may require more of this?

Firstly, I’d say I fell into public speaking because I was just doing what I wanted. Every time I read or listened to a book, I was taking notes. I was acting in a way that was congruent with sharing that knowledge and my own insights someday with people. I really wanted to do that! And when the way to do that showed up, I was open to it and leapt at it.

In practical, presenting terms I’d say avoid putting too much information on slides – people have come to hear what you have to say, rather than what they can read up on the screen themselves. Again, it’s about being yourself when conveying information, not just dispersing data.

So being open and acting congruent with what you want to do are important, rather than goal setting?

We’re back to planning stuff, and I don’t want to give the impression that I think the best way forward is to cast yourself adrift, with only your hopes and dreams to guide you… I think you can, and probably should, have goals. It is really important to know what it is you want but it doesn’t need to be so specific that you limit yourself. You certainly don’t need to know all the steps you’re going to have to take to get there. That’s the difference.

For medicine you have to have everything lined up before you can take the next step. And I don’t think that career change works like that. Generally, I think that you’re taking steps the entire time and then eventually you get to a point, look back and realise how you got from A to B. Whereas in medicine you go “Right, to get from A to B, I need to do this first, get it signed off, and then I need to do this.” That way of thinking is all about having permission to move forward. The real world doesn’t work like that. You don’t need permission. Just do it!

In your talk, you said that it is OK to change your mind. How do you recognise when you need to change direction?

Maybe when whatever you’re doing loses its shine?

Look, this stuff is personal, and I don’t expect everyone to feel the same about it as I do, but for me it’s always been about being able to commit to something properly. I’m not averse to a bit of adversity, but if you’re miserable and you can’t see yourself making a good go of it within a few years, then surely it’s time to change? Back then, when I was making the big decision, I just imagined the person I’d be if I stuck with surgery, and it wasn’t what I wanted. I had other things that were more important to me.

Personally, I don’t respond well to seeing the path stretch out before me for the next 20 years. Some people like that, but I just want people to understand that if they think the same way that I do about these things, then that’s ok. You don’t have to be that person who goes through from junior to senior and professor. That’s just one model and there are other models.

Looking back, I think my philosophy has always been about trying to do more of what I want, and less of what I don’t. Nothing revolutionary, just plugging away at that. I’ve a young daughter now and I want to spend time with her. I still do the health informatics now but in a different way. I feel strongly about the career change stuff and squeeze that in between my other work, sharing the childcare with my wife and writing my book.

If there is something that you love to do, commit to doing it as often as you can. That is where happiness lies as far as I am concerned 

And finally, what would you recommend that those considering a career change or a more portfolio career should read or listen to? 

It would be remiss of me not to plug myself, so I can be found on twitter: @gilespcroft. To be first to hear about the forthcoming book release, about the 10 Principles of Career Change, you can sign up to my mailing list. If you want to hear me speak, I’m usually at October’s BMJ Careers conference in London, and also look out for http://medicalsuccess.net, which are brilliant one day events put on specifically for doctors who want to branch out into alternative careers. I speak there, too.


  • The $100 start-up by Chris Guillebeau. It dispels the myth that you need to have a huge amount of capital before going off to do something new. (Any of his books are good!)
  • The 7 Habits of Highly Effective People by Stephen Covey
  • Feel the fearAnd Do It Anyway by Susan Jeffers
  • What should I do with my life? by Po Bronson


  • Side Hustle School by Chris Guillebeau. Each 10 minute episode is a case history of someone who’s doing something on the side of their regular job, for income. These are the sort of stories that get people thinking. They show you that things are possible.
  • The Tim Ferris Show – seek out particular guests that appeal. He wrote The 4 hour Work Week, all about doing your own thing.
  • Free Agents – a podcast about taking the leap towards being an independent worker

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