You’ve been on the ladder so long you’ve stopped asking whether it’s leaning against the right wall. Medicine, law, teaching, accountancy – these professions hand you a career plan the moment you choose your profession. Foundation years, specialty training, partnership, consultancy – the rungs are set on the career ladder, and most people just keep climbing, because stopping feels more dangerous than carrying on. Until one day they look up and realise the view from the top isn’t what they expected, or that the top of this ladder is just the bottom of another one.
This episode is not about leaving medicine or your chosen profession. It’s about something more immediately possible. Rachel introduces the AB-Z method – a concept she first heard about from James Clear, that replaces the paralysing demand to have everything mapped out with something far more workable. You need to know where you are (A), have a felt sense of where you’re headed (Z), and identify just one next step (B). That’s it. Not the whole alphabet. Just three points on a line you’re already standing on.
Here’s where Rachel pushes the framework a bit further. Z, she argues, isn’t a job title or a specialty or a grade. It’s a way of being – how you want to feel in your work, and who you want to be with the people you love. The friend who shows up fully present, the parent who can actually switch off and the colleague who isn’t running a background list of unfinished tasks through every conversation. And for those approaching burnout, she makes a distinction that matters: getting free from burnout is a step, not the final destination. Growth, meaning, and significance still need to be built on top of it.
Rachel draws on her own career, portfolio GP, medical educator, assistant director of studies, team coach, podcaster – not as a success story but as evidence of how this concept works. None of it was planned, and not all of it was successful but all of it was informative. The two piles she noticed next to her desk, one was unopened medical journals and the second was devoured personal development books – didn’t tell her to leave medicine. They told her something about how her brain works, and what she really loved. And that self-knowledge, accumulated through trying things alongside her clinical work, is what eventually made the next step obvious.
