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Doctors at Work Podcast.

Episode #81

How to define career success. With Jason Cottle

Mat Daniel

23/04/2024

Career success means different things to different people. However, as doctors we compare ourselves to each other, and when applying for jobs we are compared against other candidates. In this episode Jason, who is a PGY3 doctor, tells me about his experiences of defining career success. We talk about how comparison with others can be good, but it can also be problematic. His advice is to focus on learning, people, and the “why”, as much as on external indicators of success.

Jason is a postgraduate year 3 doctor currently working as a medical education HMO in Melbourne. You can connect with him on LinkedIn, or on twitter @drjasoncottle.

You can also watch at www.youtube.com/@dr-coach/videos.
Production: Shot by Polachek

Podcast Transcript

Mat: [00:00:00] Welcome to Doctors at Work. My name is Mat Daniel and this podcast is about doctors careers. It’s part of my mission to help others create successful and meaningful careers. And today I’m having a discussion with Jason Cottle, who is a postgraduate year 3 doctor, and actually we’re talking about how you might define career success.

As doctors, career success means different things to different people. But the reality is that all the time we are comparing ourselves to each other, and when we apply for jobs, we are ranked and compared against other candidates. So that comparison happens all the time. Now, that might be a useful thing, because it can help us grow and develop and be aspirational, but comparing ourselves to others can also be problematic, particularly if that leads to insecurity and resentment.

Um, Jason tells me that it’s important to focus on learning, on people, and on the why. As much as on external indicators of success, of course, you do have to progress your career. You do have to do the audits and pass exams. So all of that’s important. But if [00:01:00] that’s the only thing that you focus on, that just leads to burnout.

So there needs to be a balance, a focus on what matters, on meaning. And the why as much as a focus on those external indicators of career success.

So welcome, Jason. Tell me a little bit about yourself.

Jason: Hi, I’m Jason Cottle. I’m a junior doctor. I’m post foundation years currently in an F3 or postgraduate year three. I’m working as a medical education resident in Australia, um, my interests currently lie in medical education, LGBTQ health and general medicine, but my future career is completely undecided.

Okay,

Mat: and I invited you to talk today about how one defines career success. And I’d be interested in hearing maybe about the decisions that you’ve made and what you’ve thought about. And then maybe also we can spend some time talking about what are you thinking about at the moment, because there’ll be lots [00:02:00] and lots of people in exactly the same position as you are.

And they probably all think that they’re unique and they probably all think that they’re the only person that’s having these thoughts. So it’d be really useful sort of to try and um, yeah. To try and look at some of the things that you’ve thought about. Yeah. So, I mean, how do we define career success in the medical profession?

Jason: Oh, it’s an excellent question. I spent a lot of time actually thinking, um, the answer to this question. I think success in itself is quite an ambiguous, um, term. Everyone’s got their own individual, um, idea of what a successful person might be. Um, when it comes to career success, I think it’s very easy to, um, look at your colleagues, look at your peers and think success in medicine is having a number of publications or having another, uh, another degree.

Or experience can be seen as success. However, I feel like if you were to guarantee or get a lineup of 10 people in a room and ask [00:03:00] what measures of success that they take into account or that they hold, um, you might get 10 completely different answers. Um, which is what drew me to this, uh, sort of topic in particular.

Um, I also found myself a little bit bogged down about the idea of comparing myself to other people, particularly in London, um, where it can be a lot of, a little bit more competitive to, um, get certain jobs currently, um, particularly in the state of our, um, application system at the moment for junior doctors.

Mat: I’m interested in this idea that, that we look to others. to define success because you kind of said, you know, that we look around, we see what’s everybody else doing? What does everybody else have? Um, and then that, that is how we’re making decisions as to what we should be doing or what, what success is.

And I’m wondering, you know, what, what’s the implication of the fact that we’re looking to others?

Jason: I [00:04:00] think it probably comes from a place of looking for a role model, whether or not it’s conscious or something subconsciously. Um, all of us have an idea of, um, who we want to emulate, um, whether that’s as doctors, as people, and quite often they might overlap, um, particularly in our profession.

I do wonder if that does lead us sort of a little bit more, um, prone to our biases from how we grew up or, um, the education that we’ve had, because you might find that your role models are those that have had similar life experiences to you. And that can sometimes I imagine clash with an idea of a successful person who might have, um, you know, been working as a, say an A& E consultant for several years, and you look up to their experience, um, as a consultant, um, as well as having some sort of intrinsic, um, relation to them as a role model.[00:05:00]

Mat: So how, how do our backgrounds and our past experiences, how, how does that influence how we view career success?

Jason: Sure. I mean, I can’t speak for anyone else. I can only speak for myself. Um, but I, uh, for example, went to quite a underperforming secondary school, um, where, you know, getting the right grades, it does change your whole life.

It can change the opportunity that you’re exposed to. Um, so I think there’s a tendency for. People, particularly those that are high achievers or that go into medicine law, um, to associate their physical accomplishments, their grades, um, things that they’ve been validated on externally with, um, success as an idea.

And I think that’s part of the thing which can be quite unhealthy. So,

Mat: so, so instead of. maybe instead of us valuing ourselves for who we are, for who we intrinsically are, [00:06:00] for what kind of human being we are, we, we derive value and we derive success by our external achievement, how, how other people view us, what kind of secrets we have, what, what, how other people massage our egos, et cetera, et cetera.

Yeah. So I can see that as being unhealthy. If, if we kind of talking about, you said that, that, you know, we compare or you compared yourself to others. And I think we all do that as humans, don’t we? You know, we, we, we compare, we compare ourselves to each other. And I’m, and I’m interested how, how has that helped you and how has that hindered your career decision making?

Jason: So with regards to helping career decisions, um, You can actually learn a lot from the people that you see as successful. Um, you can choose what things that they do that might be helpful for you. So it might be getting involved in an audit or writing research. [00:07:00] You might have a peer or a senior that has done this and, um, you value whatever behavior, whatever experience that they have.

Um, and I find that most people are really willing to help if you do show interest, um, where it comes to hindrance. Um, I think it’s down to the individual. I don’t think everyone’s going to be hindered in the same way. Um, but yeah, If you’re working in an environment where you are prone to moral injury, like the NHS, um, you might find that, um, you don’t have the resilience, um, to be continuously exposed to people you perceive as successful, um, and have the capacity to engage and learn from these people, but instead be perhaps intimidated or, um, perhaps even a bit resentful towards, um, what you perceive other people’s successes are.

Mat: So, so there’s, there’s something there about how, [00:08:00] you know, if you and I view somebody that’s successful and then there can be a problem at our end because we put ourselves into a position where we end up being resentful and envious. Of the other person and then that becomes that becomes something that demotivates, you know, the other thing I’m wondering is the people that that the people that project success.

I’m wondering, I’m wondering how accurate that is all the time and I’m sure there are people that are that are successful and humble. I’m wondering how many people there are in our profession that that are very good that at portraying a carefully crafted image of success. Which, which may not be quite as accurate as all that.

So what,

Jason: what would you say? It’s fascinating actually, isn’t it? I think that can be tied back to how you’re brought up. And I think there’s this idea of Um, code switching, um, which I’ve come across, which is namely, um, in [00:09:00] relation to people from different backgrounds that are exposed to professional backgrounds or things that they wouldn’t have access to normally.

Um, and feeling like they have to change their persona or change how they behave in those groups. And I think there must be an element of that from, um, you know, people that have come from non professional backgrounds or families that don’t have lines and generations of doctors upon doctors, um, that may feel like they need to put on this persona.

Um, I don’t know. Do you think there’s any other, um, sort of reasons why people put on this persona of success or?

Mat: Maybe the reason why I asked the question is that, that But I talk quite to quite a lot of surgical trainees, okay, and inevitably they come and say, everybody’s so much better than me. And, you know, and okay, so that the first person said that to me, and the second person said, everybody’s so much better than me.

And I kind of say, okay, well, I’ve [00:10:00] got two of you that are really crappy and everybody else is so much better. By the time I get to the hundredth trainee, and they sort of say, do you know what, everybody’s so much better than me. And I kind of say, do you know what, I’ve got another 99 people that I’ve spoken to that everybody else is better than them.

So, so, um, so, so I have to say, you know, from my. From my experience, and you know, this is experience, not a randomized controlled trial, there’s an awful lot of people out there who think that everybody else is better than them. Okay. Um, so, so, you know, and, and actually, yeah, I, I think that’s a fact. Yeah. I think it’s a fact that there’s an awful lot of people who think that everybody else is better than them.

So I suppose the question is, where does that come from? I hope you’re enjoying the show. Please click subscribe so you’ll be notified when new episodes become available. This podcast is part of my mission to help doctors create successful and meaningful careers. You can be part of that mission too by forwarding this show to [00:11:00] one person who you think might benefit from listening.

Thank you. Now on with the show.

You know that that might come from from that, that, that, you know, that, that those people, those trainees that they’re humble. Um, and, and, you know, they don’t have big egos and they’re focused on learning and they want to make a difference. So it might come from them. So if you think there’s a hierarchy or, you know, this person’s brilliant and I’m not, so, you know, that hierarchy might come from the bottom, as in, I don’t think that I’m very good.

therefore I put the person in, it’s, it’s in a position of authority and power and expertise, and you know, that might be good or it might be bad, as you said, because it might be good because that might motivate you, but it might be bad because you might become resentful. Um, I suspect that a lot of it happens from the top as well, as, as in, as in that people go in and, and people portray, um, an image of [00:12:00] competence, you know, an image of perfection, and then that’s.

that pushes everybody else into imperfection. Yeah. So if I go into the workplace and I say I’m perfect, I’m brilliant, I’m the world’s most amazing surgeon, then what happens is I push everybody else into a position of imperfection. Okay. And then I’ve done that. Yeah. Sort of, but, and, um, but so especially in the next question is then, you know, why would somebody go into the world workplace projecting an image of perfection?

Well, you know, maybe you really are perfect. Um, maybe it’s, maybe it’s then, you know, it’s my insecurities that mean that I go into workplace projecting that perhaps as you say, you know, I feel insecure because, you know, maybe the person hasn’t had the professional background or the person feels inadequate or they themselves have a low self esteem.

And then you kind of you overcompensate by trying to project this overconfidence. And then we’ve got the people that come and sort of say, everybody else is so much better than me. But in reality. Those people in the workplace probably think, Oh, everybody’s so much [00:13:00] better. Therefore I need to compensate.

And therefore I pretend that I’m brilliant whilst all the time worrying that I’m not very good. And, you know, the world is full of people who all think they’re not very good. But they all project an image of perfection because that’s a compensatory action for the fact that they don’t think that they’re very good.

I don’t know.

Jason: Yeah, I know. I mean, there’s a lot to unpack there, isn’t there? I think, I would like to think no one is projecting an idea of, or a version of themselves that’s perfect with an intention to make others feel um, perfect. You know, perhaps that they aren’t and I, I know that not many of the people I’ve worked with, if any, come from that point of view, but it is interesting.

I think we all like to try to be our best selves at work and try to be the most competent that we can be within our limits and I think that’s reasonable to aspire to. The thing that I found interesting was the, [00:14:00] um, the number of your trainees that say to you that, you know, they feel like everyone else is better than them and it made me think of how we currently rank and how we currently apply for jobs.

I mean, medical students are ranked on a decile of the, you know, the top 10 percent and the bottom 10 percent and although we’re all competent to do the job. Um, it doesn’t surprise me at all that, you know, some people might come away from, um, medical school, which is obviously the first step in our career for a lot of us.

Um, it doesn’t surprise me that they may come away with an idea that they aren’t as good as the, you know, other, however many percents that they’ve studied with. Um, so it’s, yeah, it’s a combination of both. quite complicated factors, isn’t it?

Mat: How does that, you know, the people are getting ranked or, you know, you, you do your MSRA and, you know, you get ranked on that and [00:15:00] medical students, et cetera.

So how, how, how does that affect people’s careers decision making do you think?

Jason: I do. I would worry that if someone didn’t get a particular rank at medical school or in an exam that they wouldn’t feel adequate enough to, um, perform the job. And at the moment, I feel like we have a lot of very competent, um, doctors out there that aren’t able to, for whatever reason, for, um, you know, social reasons, for family or health reasons, um, aren’t able to do the check boxes that we’re expected to, um, to do in order to get to the first loop of an application for a job.

Um, so it doesn’t surprise me at all that, um, I imagine quite a few number of people, um, are put off, um, from applying to specialty jobs. It’s, [00:16:00] it’s

Mat: an interesting, there’s been an interesting change if I think for when I was, you know, at your stage, then largely you got, you got a job because, you got a job because of who you knew.

And because you were good at the job. And the advantage of that system is you got the job because you were good at your job. Yeah, people knew that you were good, you know people already worked with you. They knew you and you know you got the job because they knew you because you’ve done the job and you were good at the job so in many ways the kind of you know, like the external assessments, you know, like MSRA, for example, you know, or how many audits, whether you’ve done four audits versus three audits, like that kind of stuff didn’t really matter because fundamentally people worked with you and people knew what you were like.

Yeah. But the downside was that, of course, That meant that, by and large, you got a job where you already were. Sort of because, you know, like, if I think if I did my, my training in the Midlands, you know, people in the [00:17:00] Midlands knew me. And, you know, and of course, you know, I was likely to get a job in the Midlands because people knew me and I did a good job.

You know, could I get a job in, in Scotland or, or London or Manchester, you know, probably not like, cause people there didn’t know me, you know, it would just, it would be an anonymous person on a CV and I probably wouldn’t get a job there. In fact, most people wouldn’t even be applying outside of the region.

So the advantage that you’ve got now is, is, um, it, it, it allows much greater mobility. Okay. Um, although weirdly that might be a problem because I think a lot of trainees now sort of complain about the fact that they’ve been moved all around, whereas, you know, Like when I was at your stage, I probably wouldn’t have much of a choice because, you know, because I’d get a job where people knew me, so I would struggle to move because, you know, chances are I’d get a job where people knew me.

Um, but, you know, the kind of the current system is probably, in many ways, it’s fairer because everybody has an equal chance, but it’s fairer. People are [00:18:00] judged on, on ranking and MSRA and how many audits you’ve done, rather than people being judged on how good you are at your job, which is what used to happen.

Jason: Can I ask, when you were, you know, applying for the same hospital, for example, did you, do you remember feeling limited at the time that you couldn’t, or you felt you couldn’t apply to other places around the country, or was that not something that was, um, big on your mind? Would

Mat: I, you know, it’s just people by and large didn’t, people did it, but your, your overwhelming success, success was likely to be where people knew you, or, or, you know, what, what you would do is, you know, you sort of speak to a consultant and say, you know, I want to get a job in Leeds, you know, do you know anybody in Leeds?

And they’d phone up and I kind of say, you know, you know, I worked with Matt. He’s really good. We don’t have a job for him here. Or, you know, he wants to work with, to Lee, he wants to move to Leeds for whatever reason. So there was, there was You know, that kind of happened. Yeah. Um, and you know, I [00:19:00] mean, there were problems with that.

Yeah. Particularly, you know, if you face didn’t fit, yeah. You know, if, if you were different, it, it perpetuated a lot of that, you know, sort of the stereotype, you know, the stuff that works against minority groups. Yeah. Because, you know, cause if you face fit and, you know, if you were like the consultant, then, then you moved on.

So, you know, that, that, that was the problem with that system. Um, but to me, it feels like it was much more, um, You got rewarded much more for your clinical competence, whereas at the moment it doesn’t, it doesn’t, to me, I don’t know, you know, you correct me if I’m wrong, but to me it doesn’t feel like, like whether you’re a good colleague or what you, what your clinical competence is like.

It doesn’t, it doesn’t feel like that features, you know, your academic ability features heavily. Yeah. Um, but doesn’t feel like those interpersonal skills, that clinical competence doesn’t feel like that features particularly.

Jason: There’s definitely a feeling I think amongst a couple of my colleagues where, um, some, you know, colleague [00:20:00] that, you know, we may not work with looks fantastic on paper, um, has all of the qualifications, all of these fantastic things that they’ve done.

I’m not trying to discredit that at all. Um, but perhaps when it comes to the, uh, realities of working with that person or, um, their confidence as a person clinically. Um, sometimes that’s incongruent with their success on paper.

Mat: Absolutely. Um, so I’m interested in, you know, if you kind of go to career success, so, you know, we talked about there’s our backgrounds that influence and, you know, we’re constantly comparing, um, ourselves, but tell me a bit more about kind of, you know, your thinking about how you’re defining career success.

Jason: So yeah, career success. specifically is, I think it’s easier to define because it narrows down your objective of what you [00:21:00] think is successful. I think the number one thing that’s important to me when it comes to career is being able to enjoy that career, um, but also balance that, um, with other interests.

Around that. So when I say career, um, specifically I would be talking about clinical things, but perhaps that might be someone with a portfolio career. Um, that might be someone working part-time, two different jobs. One is a doctor, one is something else. Um, but as long as you’re getting enjoyment out of that and feel like you’re learning, um, I would argue that is a successful career.

And how,

Mat: how did you, how did you get to that stage? Because, you know, we started talking about everybody’s got these audits, these publications, you know, how, how did you, how did you move from that external stuff as to comparing yourself and what everybody else has to outlining something that what you said now, which actually [00:22:00] is really very personal and not comparing yourself with any other people.

Jason: I think there were two main things that happened. One was when I graduated, I didn’t, I felt fantastic, but there was a sense of a, like an arrival fallacy, of perhaps it not initially being everything that, you know, you meant it or that you needed it to be at the time. Um, so that was, that was one thing.

And then the other thing was, um, from clinical experience, you are privileged to meet people that may, Be at the end of their life, or approaching the end of their life, or people that are unwell. And if you were to ask some of these people what they would feel their most successful thing in life is, or the thing they’re most proud of, Um, that commonly doesn’t, doesn’t happen.

mix or mesh well at all with these preconceived ideas of success of, you know, being financially better off or fame [00:23:00] or, um, you know, this excellent employment opportunity that’s come up. Um, quite often they reflect on things like, you know, having family that they’re able to confide in or, um, memories. Um, these things that are very tangible to that person, but aren’t easily, um, transferred on paper or media format.

Mat: Okay. That sounds very important. Maybe if I bring us to a close and perhaps if I just, just invite you maybe to summarize what we talked about, or, you know, what would be your top tips for doctors when they’re thinking, okay, what is career success for me? What, what top tips would

Jason: you give? So, um, yeah, we talked about definition of success, um, and how that can be quite different to different people.

And the idea that success is quite often ambiguous and, um, our [00:24:00] ideas of success might be related to how we grew up or our experiences at work, um, and the role models that we might come across, um, throughout our life. Um, in terms of top tier, top tips, I think my main one would be try to not rely on successful outcomes.

alone, um, these sort of, you know, grades or these publications or these awards that you might get, but perhaps, um, the things that you’ve learned in doing so, and the people that you’ve met that have helped you, you get there. Um, but also more importantly, understanding why you’re doing what you’re doing.

These things, um, if you can rely on my, um, your why, I would hope that you’d able to, you’d be able to build mental resilience, um, by not relying on the validation of things that you’ve accomplished

Mat: instead. Wonderful. Thank you very much, Jason.

Jason: Thank you so [00:25:00] much.

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