[00:00:00] Mat: Welcome to Doctors at Work. This podcast is about doctors’ careers. My name is Mat Daniel. I’m an ENT consultant, a medical educator, and a coach working with doctors to help them create successful and meaningful careers. Today, I’m having a discussion with Gilly Friedman. Gilly is also a coach, and she has worked a lot with doctors in the field of career coaching.
As doctors, we make career decisions all the time and some of these will be challenging. In this episode, Gilly shares her experiences of having career discussion with doctors. She tells me that as doctors we are used to having a very clear career roadmap, but doing something different requires agency and courage.
And I love her top tips. Number one, value yourself. Number two, be kind to yourself. And number three, be aware that there are always more opportunities that seem immediately apparent. I hope it’s useful.
[00:01:02] Gilly: Welcome, Gilly. Tell me a little bit about yourself.
I’m a career coach and a coach, and I help a huge number of people, but I specialize in working with doctors, which I particularly love. I have a contract with Health Education England, NHS, so I’m helping trainees, anything up to consultant and GP. I also have my own private practice where I see doctors who are qualified as well as trainees who come to me through word of mouth.
I also do a lot of training and facilitation of workshops. And I’d like to say I got into working with doctors partly because I come from a medical family. So, my father was a doctor. Both my grandfathers were doctors. My brother is a doctor and my other brother, my father was heard to say if he doesn’t do medicine, what can he do?
So, he became a barrister specializing in medical negligence. And I followed the family tradition.
[00:02:08] Mat: Everybody’s involved in medicine in some sort of another.
[00:02:11] Gilly: Yes. And my husband’s parents are both doctors.
[00:02:15] Mat: So, I invited you to talk today specifically in relation to doctor’s careers and I know that for some people it can be difficult to make career decisions.
So why is it difficult for us to make career decisions?
[00:02:29] Gilly: I think that one, one aspect I’ve noticed about the doctors I work with is that because they’re in quite a necessarily hierarchical system, I think they sometimes lose agency. So, when they come to see me, they don’t seem to feel they’ve got the autonomy that they would need, perhaps, to make changes.
They’re also quite often, I’ve noticed, self-critical. They can talk themselves out of thinking that they might try something different develop a portfolio, career. I think there’s a lot of fear that lies behind that. And… I think also if they’re contemplating leaving medicine, there’s a huge amount of psychological and I would say investment in terms of time and energy in medicine that can really prevent that from happening.
What I would say is that the doctors I see, their identity is so much tied up with medicine that they are aware they’re giving up a huge amount if they need it. And there are also a huge amount of expectations around them, proud parents, peers who seem to be doing very well. So, there’s a lot of, I would say, psychological blocks around for doctors in thinking about making career decisions.
[00:03:58] Mat: I wonder if I can pick up some of those one by one, let’s start with the idea of agency and autonomy. Can you tell me a little bit more about that?
[00:04:08] Gilly: Doctors I think sometimes come to me feeling that they’ve met one milestone, then another milestone, and it’s all prepared and set out for them in a way.
And so, the idea of Certainly jumping out of the structure of medicine can feel very frightening and they’re really not used to having that autonomy and agency and really mapping out a career for themselves. But even within medicine, there are so many options and so many ways they could develop a portfolio career.
But they. Sometimes I’ve noticed are so self-critical, they don’t think they can do it. They see other people who they appear to be much better than they are. And there’s also this sort of perfectionist tend, tendency that I have noticed. Which means that if, they’re not absolutely up for the, for another role, or they see themselves as performing.
Brilliantly, then, they taught themselves out of it. And that’s what I class as either or thinking. Either I’m perfect and I can do it, Or I can’t do it at all.
[00:05:20] Mat: And it, it’s interesting ’cause you are, you work a lot with doctors, but you’re not a doctor. And that gives you an outside perspective, which is really rich because those of us that are very much within that’s all that we see.
We see those conveyor belt, career pathways and the tick box career progression and we assume that all of that’s normal. But it’s really interesting that, a lot of us are highflyers, high achievers and yet we find ourselves. Thinking that, okay, we find ourselves incapable of making career decisions for whatever reason and feeling that there’s a set path that we need to go along.
And of course, for a lot of people, that path may be suitable, but for some people it might not be suitable.
[00:06:02] Gilly: Yes, that’s very true. And I’ve also noticed, there’s a particularly useful exercise I use called the career timeline, where I get people to look at, where they’ve. really had enjoyment in their work and where they feel that they have made good decisions.
And because of the sort of self-critical tendencies, I’ve noticed Certainly some doctors blame themselves, why did I go into medicine? I fell into it. I should have thought more about what I really wanted to do. And then there’s sometimes this notion of feeling trapped. I’m in there now.
Okay, I just need to finish medical school, and then I go on to the next milestone, and then I think it’ll get better, so I’ll stick at it. And I’ve had doctors come to me who’ve actually qualified, and they say, I’m in the wrong specialty, and they blame themselves. There’s a lot of blame and regret that can go on.
[00:06:59] Mat: And how do you help people deal with that blame and regret?
[00:07:04] Gilly: I very much work in a positive psychology frame. And first of all, I use a great deal of empathy in helping a doctor see that age 16 or 17, it’s incredibly difficult to make a decision. Often The school is proud to send their students into medicine.
They may have had a doctor in the family who’s been very encouraging it’s not easy. And the other important thing, I think, to say is that there’s no such thing as a right or wrong career and, we always learn from experiences. They will have developed a huge number of transferable skills and developed.
their strengths. So, nothing is wasted on. Also, I think it’s very easy to get trapped into a system where there’s one milestone and another than another. A huge amount of, showing my understanding and acknowledgement but also that nothing is wasted, that, they’ve gained very valuable experience.
[00:08:07] Mat: So, it strikes me that for a lot of people, it might be, it’ll be quite difficult for people to admit to themselves to say actually, you know what, I don’t think this is the right thing for me, because that’s quite a big step, I think.
[00:08:21] Gilly: It is a big step. And Some, what I did also want to say is that values are incredibly important here.
And in looking at their career timeline, we often look at their family of origin and look at what things like achievement and success. Mean to their parents and how that might have impacted them and try and separate out for them what really matters to them and what really is important.
Which, there may be obviously some influence still in terms of parental values, but often, their values are different and it’s so important to help them look at what really matters and what really interests them and what’s important to them where they get meaning.
[00:09:03] Mat: And what, tell me, what are values?
[00:09:06] Gilly: Obviously it’s what, what really matters to somebody, what is important to somebody. It’s how they want to show up in the world, actually. It’s how they want to be. It’s how they want to be seen. And identifying those top values can help and be a really useful steer in anything that a doctor or anyone for that matter should choose in the future.
So, it’s incredibly important to inform. Decision making, it’s not the only thing, of course, there are what interests you, where your passions lie, what your skills and strengths are, what you want to be using when you’re at your best, but values are incredibly important, and also the sense of purpose.
[00:09:48] Mat: And for somebody listening who says, I’ve no idea what my values are. So how can people figure out what their values are?
[00:09:55] Gilly: I have a number of exercises that I use and helping doctors to really think about what their core values are, but what are their core values in, in practice as well.
So, helping doctors to. think about how important those values are, I’ll give them a list to rate those values, and then to think about how well they might be being met in their role currently, when they might have been met previously in Korea and how they could be better met. And that doesn’t mean making radical changes.
It could be that they could be making adjustments, changes in the way they work. I’m thinking about, medicine moving forward in the future, how they could better play to those values.
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So, it’s about knowing these are the things that matter to me.
And in the past, when did my career meet those things, what’s happening at the moment and how I can adjust my career to better do the stuff that actually matters to me.
[00:11:22] Gilly: Absolutely. And as I said, values are not the only thing that informs decision making, but they are. They are key because we know that if people are playing to their values, they feel much happier, they’re much more productive, and they feel much more fulfilled.
So, it can be a very much a steer. But there’s another lovely exercise that I use with doctors that you might be familiar with Matt, which is called job satisfiers, and I call that job and life satisfiers. So that is that, based on their values, but also their skills and strengths and also their passions and their interests what do they want?
For the future in any role or opportunity. So, what are those satisfiers. And we look at the deal breakers as well. So, if there’s any future opportunity they might be thinking about, or they could imagine. What would make them turn that down? So, what really matters? And also, if there was any role they were going for that they felt really excited about because of something, what would that something be?
So, we step outside a bit and have a look at what are some deal breakers. Then the other thing, important thing to say is that, sometimes people feel they, they have a job satisfied. For example, to do something really important in my life and to deal with some complexity and look at some sort of intellectual side.
However, at the moment, a doctor might have a young family and be very clear that their priority is to Spend time with their family. So, they may be flagging up in the future. I want to do an MD or a PhD, but I’m clear that I can’t do that now. So, I think this short term, medium-term, long-term career decision making is really important and helping doctors to, to flag that up.
not to forget it, maybe to start thinking about taking your small steps to get them into the position of being able to do a PhD or an MD or develop some area in their portfolio.
[00:13:28] Mat: You talked earlier about this idea that there’s no such thing as a right decision and a wrong decision, or there’s no such thing as a right career or a wrong career.
If there isn’t a right career and a wrong career what is there?
[00:13:42] Gilly: So, I think, and that of course can feed into this this sort of black and white thinking. Either it’s a perfect career or it’s a terrible career. And I think, I like the notion of better. What could perhaps fit me better at the moment?
What could I do to, develop so that I got closer to what might be.
And there’s another important exercise or way of working that doctors find incredibly helpful, which is coming to see me and saying I’m a paediatrician at the moment but I’m not sure if I want to continue. And I get doctors to scale. their current role, and that’s very powerful. If ten is completely and absolutely I adore it, I know you don’t, one is I absolutely hate it, where would you put yourself on that scale?
And that could be so helpful in terms of helping doctors to really crystallise their thinking, to notice what they really do like about them. The job, if they put it, say, as a four it’s not a one, it’s a four. What are those things that, really do motivate, that they really do enjoy?
And then to look on the other side. Where would you hope to be? Oh, I’d hope to be an eight. Okay, so what are all those things that are missing? And what can come out of that, which I think doctors can find really helpful, is noticing the intrinsics and the extrinsics. So, the intrinsics being, the things I’m actually doing.
So actually, I really do love working with patients and I really do delivering difficult messages to parents. However, I find the hours terrible, the weekends and evenings terrible, I don’t get enough training in this hospital. So sometimes, separating out those intrinsics and extrinsics can help doctors see that actually it’s the environment that’s not working.
But the intrinsics are there in place, and then the conversation is around how they could get more of the extrinsics met. Now, not always, but sometimes that can come up so that doctors can feel actually, I probably do enjoy this more than I realized.
[00:15:53] Mat: So, I’d say from my experience, I think a lot of people do enjoy the clinical job, but most of us struggle with the environment and it’s probably the same across the NHS.
But I’m interested because you work with people outside of the NHS because we all know, NHS is this and that. Is it any better outside the NHS?
[00:16:14] Gilly: That’s an interesting question. It depends how you define better. I do have doctors coming to me saying, I’m fed up with the work life balance.
I know I guess a good salary in terms of the general population, but I don’t really feel that the outcome in terms of the financial record. Financial benefits meet my input and then they’ll say things like I have friends who are in investment banking and they’re making a fortune and they’re doing far less hours.
It really does depend what is better and how you define it. What I do if people and very often they do actually they want to look outside medicine to start with, so they know that I work with a range of people. And to do a brainstorm where we, encourage lateral thinking, so encouraging them to come with lots of different ideas.
I come with lots of ideas, I do research, and together we, enlarge a brainstorm of ideas. That’s very powerful. And often it is because doctors, I’ve said to you there a bit in this, sometimes in this either or thinking, either I do this or I stay in medicine, and I can’t do anything else because I’ve always been in medicine.
And just symbolically being aware of all the possibilities and ideas out there that, that could fit, and my coming with ideas which sometimes coincide with what they’ve collected is also very powerful. And. In itself, I think it just widens the horizons, makes them feel that there really are possibilities.
And often, ironically, they come back to Benson because some of those ideas are medical. But in a sort of freer way, because they feel I’m not trapped, there are other ideas. And actually, what I’m doing isn’t so bad, but let’s look at how we could extend it or make it more interesting or use more of my creativity.
[00:18:14] Mat: So actually, so I’m liking this idea that going on a journey of exploring what there is outside of medicine, and then you might come back to medicine realizing that actually what you’ve got isn’t all that bad and you can make some tweaks and it would be even better, but it’s not that binary, I either leave or I stay, it’s, I can do a bit of both at the same time in, whether it’s as a portfolio career or.
Or something that you can do in 10 years’ time. Maybe it’s not for you today because you’ve got responsibilities, financial obligations, in 10 years’ time it might be something that you can do.
[00:18:48] Gilly: Exactly that. And also, that, nothing is forever. If they do leave medicine, there are ways of getting back.
Obviously, it’s a little bit more challenging if they’re further on down the line in terms of their training. But. Nothing is forever. And I think it’s that sort of notion of freedom, really, so they don’t feel so trapped, that can be incredibly liberating, actually. If they, if it is that they genuinely want to start investigating a couple or, so ideas outside medicine that’s a whole different ballgame because, doctors will say to me I don’t know, I don’t know what else there is outside medicine, but I don’t know how to look.
I don’t know how to find out. And so that is quite challenging.
[00:19:32] Mat: So, for somebody listening who says actually, I’m ready to look for opportunities outside of medicine, how do they get started?
[00:19:40] Gilly: So, I do spend time talking to them, working with them, collaborating with them as to what are the best ways of trying to get some information around, a particular career such as management consultancy, which is a role that doctors do sometimes move into.
So, we will spend time talking about the best ways, which absolutely, without doubt, networking is a key way of getting information. So, I very much insist that people get a LinkedIn profile. It doesn’t matter how sketchy that is to start with. And I help them with a LinkedIn profile. It’s a brilliant way of networking, connecting with other doctors talking to doctors who may have left medicine and moved into.
management consultancy. I always ask them if in their circle of contacts, they know anyone who is a management consultant, and often they know somebody who knows somebody. I spend a bit of time working with doctors to help them structure a networking interview, so they come up with really good questions, they do research on the person they’re talking to they manage the time, and they always send an email to thank them.
So networking is absolutely key. We talk about Google Online Research, a professional body such as Management Consultancy. There is a professional body there looking at YouTubes, a day in the life of. We talk about maybe doing a bit of shadowing and voluntary work in a Management Consultancy a bit further down the line if it seems to be really interesting.
We might look at a couple of Specialist Recruitment Consultancies. It’s just to get some information. So, we talk about the best ways of doing research, as well as attending online webinars, maybe going to seminars. Very much getting out there and thinking, am I that sort of person? Could I actually see myself doing what these people are doing?
And with them, I help doctors set an action plan for doing some really good research. And then, they come back, we discuss those, and we see where we’ve got. But I have to say that very often, doctors do return to thinking about actually, this isn’t too bad what I’m doing at the moment, but let, how can I plan to have more creativity in my medical career, or how can I get more intellectual stimulation, and maybe that’s doing less than full time, but then looking at roles, to complement their medical careers.
[00:22:04] Mat: So, I love those pieces of advice of getting out there and exploring what there is. And that takes us back to this idea of agency and conveyor belts. We are all on a conveyor belt and we don’t think that we can step off. But what you are saying is that if you are wanting to explore careers outside some outside of medicine, you need to step off the conveyor belt and put yourself out there and talk to people and network.
And go and find out, that there is a world out there that isn’t medicine. And then, you can do whatever you want once you have those facts.
[00:22:32] Gilly: That’s so true. And because, as I mentioned to you at the beginning, I work in a very sort of positive psychology frame. I am genuinely encouraging of people because, as I said, doctors can downplay their strengths.
They can be very self-critical and not show self-compassion. So, I’m very conscious all the way through of noticing with them. the strengths they do have, the transferable skills they’ve got, just what they have achieved. And usually, there’s an incredible number of achievements which doctors often don’t notice.
So really important to encourage that genuine positive identification of skills and strengths and achievements. I also often get doctors who want to get that clarity about themselves first to get some feedback, gentle feedback from other people. So, I will invite them to get some feedback from others whose opinion they respect around when they’ve seen them at their best.
And that’s often very powerful to bring the outside world in because we start to identify themes. People, so they make they may notice that in many examples in their lives they’ve been very proactive. They’ve shown a great deal of creativity or, they’ve always shown compassion, whatever it is those themes are very powerful.
And they can ask friends, family, whoever they like. The other thing I would say if doctors do really want to explore the outside world with some seriousness, is to remind them that changing careers doesn’t happen overnight. It really is a journey, it’s a voyage, which I’m very happy and keen to collaborate with them on, but it won’t happen overnight, and it’s not a structured journey.
And these contemporary competencies of a bit of risk taking, curiosity being creative, being persistent. I do, educate doctors in that respect because they’ve been so used to one target, then the next. Whereas, in the outside world, outside medicine, it’s not like that.
So, it’s being patient, it’s being persistent it’s… identifying perhaps a mentor after a process with me, someone who can, keep the momentum going with them coming back to me for follow up sessions, but it won’t happen overnight. So, I think that’s something I really want to bring home to doctors I’m working with.
[00:25:06] Mat: And in terms of the timeline, in your experience, how somebody comes to you and says, I want to make changes to my career, how long would you say does it take for people to implement those changes just roughly?
[00:25:19] Gilly: You really asked me how long is a piece of string, but in terms of a process that I implement it’s usually four sessions, sometimes six, depending on whether we need to work very practically in the last two sessions on producing a CD that’s not medical and a LinkedIn that’s that they feel happy with.
But I do encourage at least one week, if not two or three weeks between each session, because there’s quite a lot of work to be done, thinking to be done, reflection, getting feedback experimenting at the latter end, if it is that they want to look at roles outside medicine. And it can, if they are seriously thinking of changing career, could be up to six months.
I always say that making a radical change in your career involves almost doing a job every day in terms of keeping going, keeping all your irons in the fire. Keeping that con networking going Doing your online research getting out there, maybe going to conferences, etc. So, it, it can be up to six months.
But, if they keep going with it and, a couple of follow up sessions with me, but also, I think identifying a mentor or peer who can keep them going is important because otherwise you’re a bit, left to your own left your own devices, you’re on your own with it.
But as I said, I think more doctors come back to medicine, but having gone through this process, I think they feel reinforced in their decision making. They’re reminded of their purpose and their motivation but they’re also looking at making adjustments and changes and developing often a portfolio.
[00:26:58] Mat: I’m going to come back to portfolio career in a second. But before we go there, if I just think of the timeline, because I’m guessing that people will probably be thinking before they even approach or before they start thinking about career change or before they approach a career coach or before they start taking action, there’s going to be probably a much longer period before that when people will realize that whatever’s going on for them at the moment.
Something isn’t quite right so it’s, it’s good to hear that perhaps there’s that six-month period of making a decision, but there’ll be a period of dissatisfaction before, and there’ll be a period of actually transitioning afterwards. So, from recognizing that something is not quite right to being settled in a new role is going to take even longer than six months that you talked about.
[00:27:44] Gilly: It could well do. And it’s, it is important for me to, to make them aware of that upfront.
[00:27:51] Mat: Before we go on to portfolio career you’ve said transferable skills. So, in, in general what kind of transferable skills do doctors have, would you say?
[00:27:59] Gilly: So many and so many that they’re not aware of.
The typical ones, working under pressure time management, delivering difficult messages problem solving, obviously diagnosing working with complexity, juggling lots of different priorities at the same time Educating, many who go on to train juniors or become educational supervisors, the teaching, the training side the management, leadership side, having to step in to run a department or deputize or manage a team, being a team player, there are so many and, that often Doctors don’t notice them.
They just get on with the work. So, I think, stepping back and really looking at those transferable skills and strengths, but seeing them in context as well. So, we do look at examples of when those have been demonstrated. So, they, they have some reality. They’re not just plucked from the air.
[00:29:01] Mat: So, the problem is that all the time we’re doing the job, and we don’t notice that these are the skills that we have and it takes a period of stepping out of that, stepping back, going outside and reflecting on what’s actually happening to notice. What skills we actually have or what skills we’re using.
[00:29:17] Gilly: Yeah, absolutely. Yes. And yep. So, the sort of the clinical side, but also the administrative side. So many other skills and strengths that I think it’s really helpful for doctors to have played back to them by me. When they’re talking about that, the examples and their previous experience and current experience too.
[00:29:39] Mat: Okay. So, you’ve mentioned portfolio career. So, what is a portfolio career?
[00:29:43] Gilly: Well, a portfolio career, to my mind, is when you’re not just doing one role or you’re not just doing one job. A portfolio career could be less than full time as a clinician and doing something completely different outside medicine.
I had somebody I saw the other day who was a clinician for two days a week as a GP. And then three days a week, she was a medical writer, still part of medicine. A journalist with the BMJ. So that would be an example of a portfolio career. And she was unhappy with the balance. So that’s why she came to me.
But it could be doing something completely different. I had somebody who another who was a, just trying to remember now. Yes, she was a radiologist and she had gone less than full time. And she spent the other couple of days volunteering at a shelter for dogs.
She loved animals and she, yeah, so she, she decided she was going to bring that into her life. So, it could be something completely different.
[00:30:55] Mat: What are the benefits of a portfolio career?
[00:30:58] Gilly: I think it’s horses for courses to continue the animal theme. But, for many doctors who come to see me, variety is important.
And we talk about, is that variety just in terms of the role, or is it variety of location, or is it variety in seeing different people? But, for some doctors, they feel sometimes that they have more potential that is being realised in medicine. Creativity comes up quite a lot. Having the opportunity to realise a bit more of their potential, and having a life outside medicine, so maybe having a better work life balance, can give a bit more balance and perspective in their lives.
[00:31:44] Mat: Okay. It strikes me as interesting that people feel that they have more potential and it’s interesting that, that can be met outside of medicine as well as within medicine, can’t it? If somebody feels they’ve got more to give than they have. You can change careers completely.
Does something completely different, whether that’s writing or management consulting, or whether that’s working in animal shelters or whether you adapt that potential in, maybe the medical writing, isn’t it?
[00:32:09] Gilly: Yeah. Definitely. Yeah. So, the, I think, one message I would like to leave doctors with is that there are far more opportunities and options than they often can think of when they come to see me.
So, there can be a sense of feeling trapped or limited. Okay.
[00:32:27] Mat: And maybe I’ll bring us around to the final question there. So, what would be your top tips for doctors at work?
[00:32:34] Gilly: I think one tip would be value yourself, show yourself. Self-compassion. I think the medical arena is tough. I don’t think that there’s an awful lot of positive feedback going round because there isn’t often the time or the energy from consultants, say, to be giving positive feedback to their juniors.
So, one, one key tip would be, try and step back. Value yourself. You’re doing the best you can in quite difficult circumstances sometimes. And be your best friend to yourself rather than your worst enemy. I think sometimes doctors, they’re a worst enemy. You couldn’t find someone more critical than they are about themselves.
So that would be one key tip. Be kind to yourself. You’re doing the best you can in sometimes very difficult circumstances. And a second one would be to Remember or realize that there are always more opportunities and options than they might think of. And that’s both within medicine, but outside medicine as well, because they have fantastic transferable skills and strengths.
More than they, they could ever realize.
[00:33:48] Mat: Okay. Wonderful. Thank you very much, Gilly.
[00:33:51] Gilly: Pleasure. It’s been lovely talking to you, Mat.