How to do a mid-career reinvention. With Will Mangar

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 other doctors create a successful and meaningful career. Today I’m having a conversation with Will Mangar and we’re talking about the mid career reinvention. Now many doctors assume that career decisions are a 1 off event, but the reality is that many of us make 1 decision after another.

Over time, our environments change, and we also change. Career management means paying attention to what’s going on in our careers and in ourselves and repeatedly adjusting to create the success and meaning that gives us career satisfaction. Welcome, Will. Tell me about yourself.

Will: Hi, Matt.

Nice to see you again. Um, so, yeah, I think we’re talking a few weeks ago, actually. And, um, So I’m I’m a GP. I’ve just had my, [00:01:00] I guess, eighteenth birthday as A GP principal or GP partner. So I’ve been a GP principal partner for 18 years this this month, Um, and sort of flirted with, uh, being a kind of single handed and being in a bigger practice.

From April, I’m back to single handed GP. Um, so that’s kind of where I’m gonna be. I also Do a couple of other bits and bobs work with doctors who are struggling and facing difficulty, Um, do a bit of work with them with the Hurley group. And I’m also very interested indeed in The kind of coaching angle, and it comes mostly to kind of men who struggle with, you know, purpose and meaning, but but also doctors as well who’s Struggling with career. Um, [00:02:00] so that that’s kind that’s kind of me.

General practice Takes up the overwhelming, uh, percentage and ratio of my time just just because of the the big old beast it is. Um, but I try and sort of include some of the other nourishing things in in in the career, um, just to keep things fresh, really.

Mat: So the topic for our conversation today is mid career reinvention. Mhmm. What is mid career reinvention?

I think it’s

Will: a really good question because I think it can mean Can mean anything to anyone, brilliant. Can mean something different to different people. It might be just Consolidation and, you know, that focusing on the career you have already, the specialty you have already, whether it’s general practice to sort of medicine, surgery. It’s really sort of maybe drilling [00:03:00] down into it and saying, actually, Maybe reinventing myself in the sense that I’m consolidating my career. I’m happy with my career.

I’m happy where I am. So that could mean that doesn’t necessarily mean a change or a transformation as an exit out of medicine or, You know, a specialty into something else. Um, but I think we spoke before, you know, I think we get to That stage in medicine usually sort of 15, 20 years into the career. And, um, I’ve been qualified 20, yeah, 23, 24 years now, and You get to that point where, actually, you need to kind of take stock and think, right, I’m maybe mid mid cycle, Midpoint through a career, how do I is it a time to kind of take stock review And sort of appraise my direction where I’m going because [00:04:00] it’s very easy to get into this kind of hypnotic State is hypnotic medium of just kind of, you know, wake up, eat, sleep, work, go to bed, you know, repeat. And I think that can just be shocking.

It can last years and years. And before you know it, you’re you’re in your forties and fifties, and maybe You’re in a career that is kind of no longer aligned with your core values, core beliefs as as as a clinician. I think what what it I think what it underpins is we sort of take a global view of things or macro view of As medics, as technicians, engineers within medicine, I think we need to recognize that, actually, We grow as much as the specialty. The, um, profession grows as well, And that’s a critical thing. And I think for me, um, the kind of will and anger of [00:05:00] 2005 or 2010 is very different To who I am now, I I don’t recognize myself professionally now to how I did maybe 10, 15 years ago.

A lot of my, um, aspirations, uh, beliefs, aims, motivations A wholeheartedly different to how they are now. So because of that, I think we have to Be very mindful and listen to that little voice in our mind about how we are morphing We’re evolving as as a human, let alone as a profession. And I think we have to take stock that, actually, we’re not a template medic. We’re not Who we are in 2000, you know, I chose to be a if you choose to be a doctor now, you know, that mindset, how does That changes your career goes on. And I think we need to recognize we have to be flexible [00:06:00] and malleable within our profession to say, right, I’m feeling that education is important for me.

I’m feeling that, actually, uh, looking after other doctors is important for me. And The critical thing is to respond to that and not to be afraid of the change. I think the problems probably come when we know that maybe we are outgrowing An environment that we’ve always worked in and, actually, we’re changing as humans. You know, our mind’s changing our expectations, our ethics, and we Stifle or repress that requirement or that urge for change, and I think that’s when the problem comes. And I think, As we said, Matt, you know, we hit our forties and fifties.

It’s quite a difficult thing to engineer, um, Change in our career. It’s like, uh, I use [00:07:00] the analogy. It’s like an oil tanker, you know, switching 1 80 in mid ocean. It takes miles to do that. You know?

It’s like a jet plane. If it wants to do a hundred and 80 degree Turn, it takes, you know, 20 miles maybe sometimes to do that if it’s going at 3 times the speed of sound. So we need to recognize that To make change takes a long time, and, also, it takes a huge amount of courage, particularly as we go through life. We start picking up, you know, You know, the sort of responsibilities of life, the mortgages, the kids, marriage, and all these things. And often, That is the primary reason we may remain ISQ and status quo.

We don’t change. We we stay in a career maybe we’re not aligned with because It’s more convenient not to change. Um, and I think people are often fearful of Making change within their [00:08:00] career because of the, perhaps, adverse outcome, which is, Obviously, most of the time, it’s a fallacy mindset because, actually, the real adverse outcome is remaining in a position whereby we’re not Aligned or we don’t have that kind of identity anymore with a career because that could be very to toxic, negative, And catastrophic to to the clinician. Um, so I think it’s it’s some it’s it’s the kind of mechanistics of A change that’s that’s quite difficult. I don’t know if that makes sense at all.

Mat: Yeah. Absolutely. And I’m I’m thinking of how How that plays out amongst the surgical consultants that I know or maybe along my career that that if If I think, you know, when you when you get your CCT as a consultant, then then you you’ve You you all of a sudden you’ve got all of that independent practice [00:09:00] and independent technical skills and team leadership and and you know you you probably spent, You know, certainly maybe 10 years building on that and, and refining what you do and perfecting what you do. Um, and, and Probably also creating a niche for yourself as to, you know, what what are you gonna do, what kind of surgery, you know, what kind of patients, etcetera. And you know that also happens Over time you know you you get sort of CCT in in the in the general aspect of specialty, but More often than not, you know, people then find a particular niche, um, in that area.

Um, and then, Then you kind of have done that and you perfected it and you refined it and then you kind of get to the stage where where it’s a job that that that you’re good at. Um, and and you you’ve you’ve created a career, um, and a practice that that that is absolutely amazing. Um, and then maybe, I don’t know whether whether you kind of whether you you get to what’s next moment. [00:10:00] I was thinking that when I got CCT, you kind of think here I am, I’ve got CCT now and then you realize, and, and you know, what, what, what next? Because you know that is 20 years ahead of you than of stuff that doesn’t change.

And of course that’s nonsense because things do change which is what we’re discussing today. So it’s an element of that. Or but but also that I like, you know, your concept that we change. And I remember in 1 of my appraisers, 1 of my appraisals, my appraiser said to me, um, in relation to my clinical practice, can I say, is it all a bit boring? And I kind of said, well, I mean it’s not it’s not boring.

No. Um, it, you know, not not at all. But, um, but maybe I’m not growing. Yeah. Sort of it’s not it’s not a stretch, you know.

I’ve I’ve I’ve grown I’ve grown into my This practice has grown and now grown alongside it. And and then, you know, you develop something and it it it it is it’s not It’s not a learning [00:11:00] edge anymore for me. It’s not a stretch for me anymore. Um, and then maybe then the sort of there there comes a question, you know, okay, what what what is my next stretch? Um, if it’s an element of of that.

But the other thing also, you know, you in your introduction, you talk about working with people in relation to to, um, maybe, you know, to to things like meaning and legacy. Again, you know, maybe you get to at certain age and and you think, well, you know, my ego doesn’t matter anymore. It doesn’t matter of how many papers I’m gonna publish or how prestigious people are going to see me. So, So, you know, those kinds of things don’t matter anymore, but, but perhaps, you know, I’m going to be dead in a few decades. What, what am I leaving behind?

Yeah. And will I be remembered? And Those kind of things become more important because probably when I was 20, I probably was much more interested. How many papers can I publish? How many letters with that.

Yeah. I I think that Yeah.

Will: No. Sorry sorry, mate. Yeah.

It’s really, really nuanced, actually. I [00:12:00] think with, um, There is a sea change in us. I think you’re right. I think we hit a certain age, and I I don’t I think everybody’s different. It’s a variable thing whereby There’s a switch that goes off existentially, psychologically, whatever you want to call it, whereby suddenly, Actually, we’re working for a different man, you know, you know, as a man in inverted commas, as in the human race, I guess.

We, As you say, we’re we’re on this kind of ego drive mid early career whereby, you know, we’re chasing the papers, we’re chasing the research, we’re chasing the kudos, Perhaps we’re chasing the materialistic aspects of, you know, a a job in medicine, money, Status, etcetera. And then it suddenly changes, and it’s very difficult actually to kind of pinpoint when there’s that Change when suddenly we [00:13:00] stop looking inwards, stop thinking about the the ego And the self and we we more we I guess it’s an actualization process whereby we suddenly start thinking There’s a greater good out there, and I I need to be of use. I need to be of service. I need to, like you said, Matt, leave some form of legacy, but I I guess it then transforms into, um, Um, how will I be remembered, and did I leave a mark in some way? And it doesn’t have to be As you say, it doesn’t have to be 500 papers on PubMed or anything like that.

I think, for me, Something clicked. I don’t I can’t pinpoint it over the last few years, whereby it was just the Patient who said, I don’t know. I ran into doctor Manger 3 or 4 years ago. He said something. He changed my way of thinking, [00:14:00] And maybe he reminded they might remind you of it a few years later.

And, actually, those are the kind of True kind of nurturing aspects and components of being a medic that are priceless And have no, uh, kind of dimension to them. And I think it’s that bigger picture Um, of use, like you say, the more kind of significance and are we significant as medics? Do we make a difference? Do we have alignment with what we do? Do we live in leave impact?

And I think those are the core components, and I think that’s Possibly what’s missing at the moment within the loss of medicine. Yeah. Um, and the the only follow-up thing I’d say to that is that I think we need to rethink how we do things. I don’t have a solution. You know?

I always say if you You’re gonna be critical of something, come with a [00:15:00] solution. Don’t just be critical of it, but I don’t have a solution. But we Create doctors far too young. I think, generally, in the Western world, we we we ask people to decide if they can be a doctor at 16, 17, 18 years old. Uh, we don’t have the mind hasn’t grown by then.

The brain hasn’t formulated and Crystallized indeed. I don’t think we crystallized as humans, particularly men, until we’re in our forties. We stop our brains probably Stop growing in our forties as men. I think a lot of men in their forties probably turn around and say, I wonder if I made the wrong career decision. And I think for the the girls are far more in touch with, you know, the kind of mind palace that is how we think as As medics, I think they do the more nuanced complex thinking if if I’m not being overtly sexist, but to to our male colleagues.[00:16:00]

But I think that is the problem, and it’s it’s a cascade of issues. You know, we choose doctors too young, And I think we ask doctors to basically make their bed when it comes to a specialty far too young in life. You Yeah. By the time you’re 23, 24, you’re a doctor. By the time you’re 25, 26, 27, you’ve decided on what you’re gonna do for the rest of your life.

And I I had no business, uh, you know, 25, 26, 27 years old, making those Very significant decisions about the rest of my life because my my brain wasn’t formed, and it’s only the last few years that I’m Coming to terms with that, you know, we do this dance, this mid career dance whereby we say, okay. Maybe I’ve Maybe I if I went back, I wouldn’t do it quite the way I’ve done it, but we’re left [00:17:00] Picking up the pieces of what we do. And don’t get me wrong. I’m not in any way unhappy with my career. I think the career is It can be almost like an arranged marriage.

It’s an unrealistic expectation from day 1 to suddenly fall in love with what you do. Um, but it’s a process, and it took me about 20 years to love general practice, to enjoy General practice. And at the age of 48, I’d only say it’s the last few years that, yeah, it’s been Peppered with various, you know, periods of overwhelm and, you know, subacute burnout and recovery, but Actually, understanding how to craft and sculpt a life in general practice has also allowed me To love it back, and that comes with maturity. Um, so I I [00:18:00] take some umbrage with The medics who sort of say, oh, yeah. If I had my time again, wouldn’t do it again.

I’d do something else. I believe, you know, for the right or wrong reason, being a doctor is a absolute privilege. Um, I still think within this country Most of the Western world, we are so highly respected. Despite what the tabloids and media do to us, We are treated with real respect and reverence by The general public. And despite the toxic media campaigns regarding, you know, how we’re treated and how we’re thought of, I don’t believe it because When you speak to patients and you really sort of get down into the nitty gritty, that respect is paramount.

And I I don’t see that Throughout other parts of society and civil service. [00:19:00] So I think we we really need to genuinely understand that We can’t be expected to make these decisions in the twenties, and, you know, the figures of people leaving medicine in their twenties now are horrendous. Um, and I think we need to try and sort of wrap people up a little bit at that age when they’re younger and say, look. Just Just be patient. Just bide your time because it it evolves.

You know? And I think Coming back to the reason we’re sitting together is we we need to we need to nurture doctors Through the decades, we need to provide them with some form of, um, road map Almost and specification of what to expect from change in motivation, change in mindset, and how you will start Reframing your career. I mean, as a generalist, I’m very lucky [00:20:00] because I’m, I guess, suspect a bit agile. I can move from here and do this, Try that. If I don’t like it, I could do that.

I’m relatively flexible. But, you know, for yourself and my colleagues in hospital, You’re you’re relatively, um, kind of crystallized in in what you do, and to make those changes is tougher. 1 of my I think the career itself is, um, I think we need to kind of frame it. I I when I did my ENT Um, specialism. I work with a GP who said that treat treat your career as a general practitioner or GP.

As a pregnancy, you go through 3 trimesters. So you can divide it up into 10 years, 12 years of each trimester. So your first trimester is hard. It’s really difficult because you’re getting used to being a specialist. You’re getting used [00:21:00] to Everything is novel, new, and frightening, and you can’t quite feel comfortable with anything.

It’s weird. And you you get into grips with your style, you know, your your voice as a doctor as it were, and that’s hard. And then you get into your second Trimester, which is, I guess, where I am now, where you have the potential to start enjoying things because you you know the job, You know the pitfalls. You know what to do, what not to do. You know what’s gonna land you up in a GMC hearing, and you know what’s gonna land you up with a good Um, relationship with a patient.

You know how to treat people well, and you start learning how to look after yourself. And You you have the experience. You’ve done your 10000 hours multiple times, so you enjoy it. And that’s the kind of, I guess, the garden party of the the career. And then your third [00:22:00] trimester is You feel okay.

I’m thinking I might retire in a few years, and I’m I’m sort of on my way out, I guess. So I think there’s lots of different ways of of framing it. I

Mat: hope you’re enjoying the show. Please click Scribe 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 1 person who you think might benefit from listening. Thank you. Now on with the show. There’s so much there for careers actually other than That, um, mid career reinvention and I really like, you know, your thoughts about early career decision making. And if I think when I was making those decisions, It was a different world than now.

Yeah. So, you know, you were a house officer and nobody knew what [00:23:00] they wanted to do. Yeah. And everybody went to the day and probably the best part to be here. And and or or went to Australia or traveled the world or worked on a cruise ship or whatever it was.

I mean, nobody knew what they wanted to do. Yeah. So certainly, none none of us thought, right, I’ve got to write these papers. I’ve got to do these audits because that has given my portfolio points. So And you know, and in my case, I did a and e and I thought I probably enjoy surgery.

So I did the basic surgical rotation which was 3 years and you know, and I rotated around 6 different specialties, you know, 1 of them being ENT. And I thought, okay, I think I like ENT. I’m going to be the senior SHO. And then I became the ENT senior go. And it was only at that stage and, you know, and and by that stage, I would have been probably what, 5 years after To graduate in something like that, at that stage, I said, yeah, ENT really is where I want to stay.

5 years. And then during that role, I then say, okay, what do I need to do in order to be competitive as a candidate. And of [00:24:00] course I did stuff as I went along, yeah, so you know, I did all the kind of generic stuff, but it was really at that SHO, senior SHO level where I thought, okay, I wanna do ENT. I’ve got to have a push in order to do that. So so probably for me much later than career decisions are made now.

And the flexibility, um, was there. And I always remember, um, that, you know, Back to mid career reinvention when I was when I was a registrar early on, I’m trying to think so to maybe, I don’t know, but I’ve been probably almost 20 years ago now. There was a there was an ITU consultant who Mhmm. They trained as a pediatric anesthetist. Yeah.

And it was initially by training And, you know, and had been an adult ITU consultant probably for 10 years. And then then what when I was there doing ENT, he was retraining to be a pediatric is kind of thought, why are you doing that? Like you’re an established ITU consultant. I, I didn’t get it. Probably I do get it now be be you know, because he’s [00:25:00] done that and he want to do something different.

And if I think the people that I that I have seen that have had Really, really great career. I think some people have stayed clinical throughout their career, but but their clinical role has changed in the sense that they’ve perhaps Gone from being from that that you know maybe there was somebody who was absolutely brilliant and and and a world authority um on clinical practice and and retired as a world authority, you know, in particular procedures. And I see those kind of peoples And those kind of people have been very successful because the whole world comes to watch them operate. Yeah. And you know and I’ve worked sort of with at least 1 person, um, of that ilk.

Um, and and, you know, they were a world authority. The whole world came to see them operate, and that was a really successful career that that just went from 1 clinical, Um 1, you know, 1 clinical achievement to another right up until retirement, sort of the boundaries of clinical [00:26:00] practice were pushed. And that was a really successful clinical career right to the end, but being a world authority, the whole world is we operate. Yeah. And and then the other sort of thing that I’ve also seen that has been very successful is when people have people have have changed from from being predominantly clinical focused to being predominantly development focused.

Yeah. You know, if I kind of think of another, um, consultant colleague and maybe where I am now is is is a shift from from from them being the main surgeon who delivers all of this sort of to being somebody who who is an established consultant, mentors and supports and brings other people along and also has an educational role, pastoral well-being role, career development role, whatever, which is kind of probably maybe a little bit of where I am now because I’ve been a consultant 12 years. I’ve got a new colleague, um, that started, you know, 6 months ago. I’ve got another new colleague that started in 6 months. And the thing is, well, they’re [00:27:00] both better than me.

Um, you know, they don’t realize that they are, but they they they are. They’re both better trained than me. They have better skills than I have because they Yeah. 12 years, Um, their, their fellowship and their career development is 12 years more recent than me. Doesn’t make me a bad surgeon, yeah, but you know, but but in terms of what they bring and what they know, they know stuff that that I don’t know, yeah.

Um, so you know They might not see it that way, but I see it that way. Yeah. And then the way that I see it is is, okay, you know, this person has has better skills. They’re a better surgeon than me. They’re more up today than me.

That doesn’t make me a bad surgeon, but but what I can do is I can help them propel their career further forward. I don’t need to be the main person that does the operation. You know, I can be there in a supportive role and help them grow their practice in a way that other people have done for me, um, 12 years ago. And, you know, and that that kind of worksheet well. I think what where I’ve seen problems is maybe people, [00:28:00] perhaps people whose careers have not changed or progressed yet.

So maybe if I think of some people that that kind of that that that got to a certain stage and they didn’t have national leadership roles or, you know, they didn’t move into more mentoring roles. They didn’t have younger ones, um, to bring on, um, or maybe sort of they perhaps they had the big ego that thought that they had to remain the primary surgeon. Absolutely. They they couldn’t support others. They had to hog, you know, all all the fancy stuff.

And then then kind of career stagnates and then for 20 years you do exactly the same thing. Um, and then with some of those kind of people Then I think I’ve seen them, you know, perhaps retire thinking, well, you know, for 20 years, I’ve just done exactly the same thing. Nothing’s changed. And the problem is they change as you’ve outlined. You know, they they change, but their work doesn’t change.

And and then it becomes a mismatch between who they are, um, and what the work is. And, again, it doesn’t make them bad doctors, bad surgeons, but when you’re talking about career [00:29:00] career satisfaction, I kind of certainly have have have 1 or I’ve I’ve observed when people’s careers haven’t changed and progressed, and, um, and that’s been problematic. Um, and I guess maybe it’s it’s also Just thinking about how people’s career progress, it’s it’s you’ve got the you’ve got people early in their careers who who who think that they’re gonna fall in love with something. Yeah. There’s this idea that that that that sometimes, you know, it comes up in my career coaching with people earlier in their careers That people think well I haven’t found something that I love and you’re spot on is, you know, you don’t find a career that you love, yeah, You create it, isn’t it?

You know, you you create, uh, either you fall in love with it, you know, or you craft and you create something that you like, that you love. So there isn’t there isn’t you don’t walk along and you know there’s a neatly packaged box with a bow on top that you say, oh my god, I love that. Yeah. It just doesn’t happen, does it? I don’t think it

Will: happens.

No. You’re right. I [00:30:00] think you you have to be You have to put that effort into customize and create a bespoke offering, which is a you You know, whether it’s a kind of portfolio career as a GP, but you have to create that, um, Nirvana state of of of being in a Happy medium and what whatever that is. Um, I think if that kind of doctor that needs help, Career help is lucky enough to kinda bump into you, Matt, you know, and speak to you coaching. That’s fantastic.

But I guess scratch my head. I’m I’m what I’d worry about It’s that the existing kind of resources, uh, the existing kind of structure within Certainly the the NHS and health care maybe isn’t geared up to ask those deep dive really kind of Fundamental questions, you know, because I think, you know, going [00:31:00] through the an the NHS appraisals appraisal system, I think a lot of doctors are still concerned. It’s a, um, you know, this is not a thing to kind of browbeat NHS appraisal, not at all. I I’ve been very lucky with my appraisers. I find it a fantastic, positive environment, but I think a lot of us still worry about, You know, whether it’s a policing, you know, sort of, uh, big stick type structure to, you know, be us with a big stick, really.

And I think I I nod certainly to the fact that it’s become more well-being and, uh, solution based over the last few years. But My worry is that as medics, we don’t, uh, volunteer the kind of deep deep stuff, which is Actually, I think I’m really unhappy with what I’m doing. I’m stagnating. I’m not enjoying it. I’m getting bored, Um, going into autopilot, um, [00:32:00] you know, which are the antecedents to major problems down the line, The burnout and and other things, I think we hold back on that because we worry about being criticized or being, I don’t know.

Sort of, um, highlighted if it were, um, that, you know, we’re a problem doctor or, you know, Which isn’t the case because of the NHS appraisal system and others’ systems should be there to kind of show us the The pathway in order to kind of start rooting around those things. Um, and I think for me, As you’ve highlighted, we we do see lots of us within medicine that maybe are not aware of Resources will know how to access the kind of more sort of nourishing A a recovery services that you get within health care, and they don’t grow on trees. And if you have a if you’re lucky enough to be part of a [00:33:00] PCN or hospital that accesses things like coaching such as yourself, Matt, then Those conversations are very pivotal and important. And I think the medics who sort of sit there and just ruminate and think, oh my god. I don’t wanna go back into prat The surgery today or I don’t wanna do this.

Um, I think there’s a lot of, um, guilt and Attach negative emotion to that. Oh, I shouldn’t be feeling like this. I’ve got a great job. What’s wrong with me? And I think you’ve hit the nail on the head.

We have to respond to how we change as medics. And even if it’s every year we change or every 5 years or 10 years, We have to listen to that voice and say, okay. I’m now hearing that I’m starting to feel like this. I’m I’m getting pulled into development, into education. Therefore, I need to respond to that.

And I really like what you said, which [00:34:00] is I’m not the best person in the room anymore. I’m actually maybe on tier 2 or t 3. Maybe there’s a better operator than I am, you know, in the room, but, actually, I bring something else. I bring the experience and the kind of The kind of father time, you know, and the sort of grandfather thing to which is that Commodity that you can’t measure which is gut instinct experience.

Mat: I take offense at grandfather.

Okay let me retract

Will: that.

Mat: Um, pick a different word, Will, please. Not that. I’m not going to be grandfathered.

Will: But No.

In in all seriousness, I think you can’t that that’s the problem we’re facing now, I think, within UK shores health care. We’re losing this Fantastic, uh, um, substance of experience, you know, particularly within general practice and [00:35:00] now probably within the hospital medicine. You You know, they’re saying, oh, you know, you can off you go at 55. You can take your pension. But, you know, cliche alert, but those are the years whereby We’re the most useful to people because you can put an arm around a 35 year old colleague and say, I know it says it in the book, but then do that.

I’d be like, yeah. But that’s the way we should be. Don’t do it because it will blow up in your face in 2 weeks. And, actually, You can’t explain why you’ve got a feeling about something, but you just have that feeling because you’ve seen things happen. Um, and I think That’s why it’s so critical to be to remain fresh, motivated, and enthusiastic within our career because we’re trying to get to that Really lovely period of that we’re entering in, which is the fifties, which is the time where we have that experience, and we can, You know, show the subtleties to the profession, to the specialty, to the career that [00:36:00] maybe aren’t in the books, not in the Literature, you’re not gonna see on YouTube, but it’s that valued experience.

And, Again, I think my worry is that we we’re losing that in medicine, and we don’t know what the future of medicine is, whether we Run on, you know, kind of more tech based AI and things, but, um, I think that that is the The endpoint for us, um, as as medics, that kind of wealth of wisdom that you you can’t Train people 4. You just have to just be there for several decades. I think that’s where we really become Useful to those to our patients and to those around us.

Mat: And wisdom is, um, the word that comes up for me. This is this is what sits by my Computer will, so it’s for people listening, it’s an OWL and and it’s it’s for me this is, um, and this is this [00:37:00] is this is something that I got to, you know, in my own coaching, which was about, you know, what what what’s my role?

What what am I doing? Where’s my career going? And, you know, what have I got that other people now don’t. And and what came up for me was was wisdom. Yeah.

I’m I’m no longer the best surgeon, you know, I’m no longer the best person. Technically, there are Nikita, there are people that are better than me. You know, at least 2 of them in my department, um, or want to come. But what I have is that wisdom that that’s come Yeah. That I’ve been around as a consultant, you know, 12, 13, 14 years longer, um, than, than they have.

Um, And I think that, you know, the key there is is that, um, is is is back to that road map. Mhmm. You know, what what’s the road map for careers? Because, you know, there there’s no road map. You know, there’s there’s no I didn’t go to medical school and sort of says, you know, you’re gonna you’re gonna join, you know, when When you’re gonna be in in your forties, you you’re gonna be sort of, you know, the best surgeon, um, in the world.

And then when you’re gonna go 50, [00:38:00] then you’re gonna have wisdom. You know, that There’s no and I didn’t have that mapped out for me when I was 20. You know, in my twenties, I was gonna be a trainee, sort of a thirties, whatever, and then I was gonna be this amazing consultant, And and then I was gonna have wisdom. You know? That that doesn’t exist.

And part of the issue is that that I mean, there’s a bit of an unknown path, which makes it difficult and everybody crafts different stuff for themselves. Yeah. Because it may be that you do continue to advance surgical practice. I’ve certainly seen people do that. Yeah.

As I say, you know, the people that from around the world, everybody comes to watch them operate and everybody comes on their course. Yeah. So so there is that, um, that happens. But then, you know, is it is it research? Is it education?

You know, is it leadership? Is it medical administration? Is it clinical governance? You know, sort of who who knows? There’s so many different things.

But, you know, 1 of the problems that that I think is that, um, Most of us most of us have no idea what these roles are and what and and that they exist. And 1 of the [00:39:00] things that I’m doing at my trust is is I’m determined to create a a map of medical leadership roles because there are Right. There are so many roles out there that that that most people have have never heard of. And, you know, at ICS, likewise, and at university, likewise, there’s a Stack of university leadership roles. There’s a stack of ICS leadership roles.

There’s a stack of hospital leadership roles. And and, like, when when you when you Start out, like, maybe, you know, as a 20, 30, 40, or even now as a 50 year old. I you have no idea who these roles are. And, you know, somebody says it’s I mean, somebody told me what What was the other thing? Somebody told me the medical gases committee.

Like I said, what’s the medical gases committee? And, you know, and there’s such a thing where, you know, somebody sits on that committee. But there’s all these roles and people people don’t see them and people don’t know about it. And and maybe, you know, what what, Yes. Each 1 of each 1 of us has to individually create and decide where our companies are going, but maybe what all of us as [00:40:00] a profession can do, we can We can we can give visibility sort of to to to all of these things that different people are doing.

Yeah. Because at the moment, a lot of that, It see it seems invisible.

Will: I think you’re right. And I I think we again, we just need that Superstructural signposting, uh, you know, I I I go back to my own when I was at school, and we had our a levels. And You did your a levels, and they gave you this great big folder with all the different careers you could do.

And it was like, pick a pick a life. Pick your life that you’re gonna have now at 18 years old or 17, 16, even earlier. So I think This, you know and I I’m I’m sure it happens in in other professions. You know? The the core more deep dive Appraisals and, um, review systems and stakes in the ground, lying in the sound, where are you now and where would you [00:41:00] like to go?

Um, I just worry that within our profession, certainly within general practice, we’re maybe rigid. Uh, we we very binary in our thinking, which is I continue or I retire. Certainly in my age group, you know, the fifties were like, I’m gonna keep going and then I’m gonna just suddenly just drop off the perch and retire. It doesn’t seem to be, actually, I’m going to evolve from you know, and I think we need to hold people’s hands to say, right. As you say, Matt, there’s a visibility problem here.

These are the things that we can think about, the leadership, the mentorship. You know, let’s take you out of 10 clinical sessions, which is making your eyes water, and let’s give you a little bit of mentorship to do. Um, did you know that existed? No. I didn’t.

Well, it does. You know? And most of the GPs that I work with I just literally head down getting on with it, um, and [00:42:00] I don’t think those conversations are being have. Um, so I think it has to be the future because we we have to retain people and, you know, there’s there’s 2 Kind of peaks in the distribution curve at the moment with medics. You know, we got this peak at 24, 25, 26 whereby, What are we losing?

30, 40 percent of doctors off the NHS are just vanishing from Registration, you know, they’re going whether they’re going to Australia, Canada, or New Zealand, or whether they’re just Going into the city or going into tech, which is just a tragedy. Um, I don’t know what we’re doing. Are we Trying to retain these people. Are we doing anything about it? How what’s our effort like?

Are we really going through the motions to stop people disappearing? We’re following them up. So that’s 1 of my worries. And the other worry is [00:43:00] how In how instrumental are we in the second age group of, say, the medics in meds in general practice Who had kinda get into their fifties and then hanging up their spurs as it were. Are we really sort of going the extra mile and saying, Don’t go.

You can still say if we I mean, this is what the retainer scheme was about. You know, can we sort of keep people involved? Can we give them other roles which keeps them fresh and interested? Um, I I just, Again, uh, I don’t wanna be negative, but how, you know, we we need to lose this apathy about loss Of good people, um, really good people within the community in hospital medicine. Uh, we really need to try harder to retain people, even those in their twenties leaving the profession and those at the kind of Other end of the spectrum who are just getting disillusioned.

Yeah. Um, because we’ll end [00:44:00] up with a huge brain drain within the profession if if we’re not careful. Anyway, they all said it. Sorry. I’m A lot of that

Mat: will you know, a lot of that is to do with the structures that we work in.

I also think that a lot of that is in in in your control and in my control as well because a lot of that type of thing is about how how we treat each other, How we support each other, what expectations we have, um, of each other, um, and certainly when it comes to To the early career doctors, you know, what what kind of role models are we? So if there are people 23, you know, if they’re like the people in the twenties that I talk to, They all sought to say every every GP consultant I see is is is unhappy, everybody moments and complains and nobody’s enjoying the work And I and sometimes it feels like maybe I’m the only person. I have a great job. Yeah. It sorts of, you know, sounds like you have a great job, will too.

Yeah. But I’m kinda thinking surely Surely you and I can’t be the only people that actually [00:45:00] enjoy our jobs and have a great job. But the message that people in the twenties get is that everybody’s unhappy and everybody’s miserable. Um, and and I just don’t think that’s the case. Yeah.

But people need to people need to People need to articulate the good bits that that that are that that that that those of us that are older need to role model the bits that we enjoy about our career. This this is

Will: why what you do in your your coaching, your podcast is absolutely critical at this time to Put this not spin. It’s not positive spin. It’s just a showcase for us as medics, and I think it’s Absolutely mandatory, required, valid, and totally supported by all of us because there’s not enough of this stuff going around. Um, you know, it’s all doom and gloom.

And, actually, what you’re doing is saying, right. Look. There is this you know, if you if you’re willing to look, It’s around. It’s [00:46:00] available. And you said you’re enjoying your career.

You know, I’m enjoying my career. I’m enjoying where I am, and it’s fantastic. But It like you said, it doesn’t come in a neatly wrapped box with a bow on it. It come you have to really work at it, and that’s the The element that is missing from medical education, which is you don’t only have to work hard as Doctors to see all your patients, do all your operations, and get out the door and go home and have dinner. You’ve got to work hard.

It’s like working hard at a marriage. It’s not about being there. It’s about working hard at being a good husband, good wife, And knowing what’s required, what are the elements of a good marriage. The same thing is how to be a good Career professional. It’s those are the things that we need to be helping people with.

You know, putting arms around people and saying, actually, It’s not about only [00:47:00] being a good doctor. It’s about being a good professional. And the professionalism within medicine It’s something that’s becoming grayer and grayer as we just losing that that kind of string, that thread. And, actually, to be a good professional, you have to self regulate and self monitor. We can’t leave it to other people, appraisal system, despite what I’ve said.

We have to learn to be able to look for the little signs in ourselves that means actually a change is due or you’re growing. Yeah. Not growing in a negative way, in a positive way, and you need to respond to that and to take action and activate a new sequence to build On on what you’re doing, um, and I think that, like you said, you know, they’ll see Matt And they’ll say, oh, well, Matt’s happy. He’s got a great career. That must have just happened by accident.

No. Actually, Matt has spent Hours and [00:48:00] hours and hours sculpting, crafting, and working away a career that is meaningful for him. And I still do. And you still and you’ve you’ve built this from the bottom up, and it’s like Lego bricks. It’s about that works.

That works. That pays me money, but this is nourishing. Um, and I think Those are the conversations we must be having with our colleagues, um, because it’s all about, oh, yeah. Get through this. Tick this box.

Do that. But it’s about, no. You you need to it’s like it’s like an ultra marathon. You need to just pay attention to your feeding, Your PACE strategy, all of these things. And that, you know, the PACE strategy in medicine, how we sort of pace ourselves through the job And how we sort of look for the long game, the marathon, not the sprint is so critical.

Yeah.

Mat: And that’s what [00:49:00] what’s missing from our education is is career management. Yeah. Not not career expression as a step wide thing, but but a career long career management. How how how do I manage myself?

How do I manage my environment, my in my career? And and that and that is a career long, um, endeavor for it to be successful. I’ll bring us to a close, Will, and maybe if I can ask you Thank you, Matt. To summarize what would be your top tips for doctors at work?

Will: Um, I just wonder if I’m gonna say the same thing I said last time, which is a little bit boring, but, um, I I think it’s Let’s listen to the little voice, you know, that that I always say that to people.

If there’s a little voice in the back of your head saying something, don’t Don’t ignore it because it’s your it’s all about consciousness. It’s about really the conversation that you need to have. The second part of that is Give yourself the bandwidth so that you can hear that little [00:50:00] voice because it’s too easy to spend your life On autopilot, doing things, drowning out life, joining out the voice with just noise of, You know, busyness and the illusion of busyness, but ring fenced times in your life where you have that Down that blue time, that unstructured time whereby you can have that free form thought process because that’s often when you have these pivotal Moments, uh, is epiphanies where you say, hey. I’m not an operator. I’m a developer.

I’m a Educationalist. You know? And, actually, you’ll go, wow. Where did that come from? But if we don’t give ourselves the opportunity or the time to have those thoughts, Uh, I think we we will never evolve or grow in the direction we really need to.

Mat: Wonderful. Thank you very much, Will. Thank you, Matt.[00:51:00]