27th February, 2024

Life’s Too Short NOT to Love What You Do

With Dr Sarah Goulding

Photo of Dr Sarah Goulding

Listen to this episode

On this episode

There are times working in medicine or other high-stress jobs, when you feel trapped and unhappy. And maybe you’ve told yourself you have no other option but to stay put. These “shoulds” can come from societal expectations or the idea that you’ve put so much into your job already that it would be silly – or even irresponsible – to quit now.

These myths and pressures keep us feeling stuck, and prevent us from exploring alternative possibilities within or outside of our current field.

This week, Rachel is joined by Dr Sarah Goulding, who breaks open those myths, and shows how we can uncover new possibilities. It all starts by recognising we’re not defined solely by our roles, and embracing the idea that it’s okay to change and to pursue work that aligns with our strengths and passions.

Sarah also has a set of self-coaching questions that can help us discover what we’re going to do with our “one wild and precious life”.

Show links

About the guests

Dr Sarah Goulding photo

Reasons to listen

  • To discover how to find a way of working that doesn’t harm your well-being and allows you to be passionate and energetic in and out of work
  • To explore the myths and societal pressures that keep us feeling trapped in our current careers and learn how to break free from them
  • To gain valuable insights into the importance of reflecting on your skills and experiences to uncover new career possibilities within or outside of medicine

Episode highlights


The job-for-life fallacy


Toxic expectations of gratitude


Availability bias and the sunk cost fallacy


Reinventing yourself


When’s the right time to make a change?


Satisfaction outside of work


Your one wild and precious life


2,000 weeks left


Taking imperfect action


Career crafting


Self-coaching questions


Crafting your joyful career path


The “I will be happy when…” myth


Sarah’s top tips

Episode transcript

[00:00:00] Rachel: Tell me, what is it you plen to do with your one wild and precious life. These last few words of the Mary Oliver poem, The Summer’s Day are what inspired me to start my organization Wild Monday. Off to years working in medicine and seeing the frustration and stress it was causing me and my colleagues, I changed how I work and I’ve now made it my mission to help people understand, like I say, all the time that getting out or burning out, aren’t your only options.

[00:00:28] This week I’m inviting Dr. Sarah Goulding back on the podcast to talk about how we can craft our ideal career, one that’s challenging, but not draining. And if you all listening to this thinking, that’s all well and good, but we can’t all do what you’ve done, I totally get it. But this episode will give you some questions that you can ask yourself about your career, so that even if you’re not in a position to leave and start something completely new, you can find more of the pieces that might be missing for you. So grab a pen and paper and get ready to cross the career you’ll love.

[00:01:01] If you’re in a high stress, high stakes, still blank medicine, and you’re feeling stressed or overwhelmed, burning out or getting out are not your only options. I’m Dr. Rachel Morris, and welcome to You Are Not a Frog.

[00:01:17] Sarah: Hi, I am Dr. Sarah Goulding. I’m a portfolio GP and career coach, passionate about helping you find a place where you can thrive.

[00:01:25] Rachel: Brilliant. It’s so good to have you back on the podcast, sarah. You’ve been how many times?

[00:01:30] Sarah: I think this will be number three, but we’ve definitely have a number four planned as well.

[00:01:34] Rachel: Yeah, we do. And I remember a very memorable one talking about when you’d been feeling like, you know, you were the wrong shape to go through the shape sorter of medicine and how quite a lot of the people you work with feel like that as well. And so, you know, we often, whenever we meet up, have these conversations about careers. And you are a career coach as well as being a GP and I know that a lot of people that I’ve been talking to recently are feeling really, really stuck and really, really trapped in a job that they hate.

[00:02:04] Now, the last thing that this podcast is about, by the way, is getting people to leave medicine or leave some of these high stress jobs. But I’m very passionate about the fact that that is not your only option if you are feeling burnout and if you are feeling miserable, although it can be an option. So what You Are Not a Frog is about is about helping people think about the, the fact that they have other options. It’s not just about do I burn out or do I leave completely and do something else? It’s about actually what can I do within the job I’m already in? Or is there something else that I could do, which might suit me better? But it’s not sort of escaping the boiling water as a, as opposed to actually working out what’s gonna suit me much better. Because boiling water for, for one person is someone else’s dream. And, and then, and then vice versa.

[00:02:48] And we think, we often beat ourselves up about the fact that what’s wrong with me, I’m not coping and I know that in. Some of the careers and the jobs that I’ve done, I thought I was just rubbish ’cause I didn’t like it. Only to find it wasn’t that I was rubbish, it just, it didn’t play to any of my strengths.

[00:03:02] So that was a very long introduction, but that’s sort of where, where we are coming from. And I know that you’ve thought a lot about this and how there are some myths about careers and career development that we tell ourselves, particularly as doctors. Is that right?

[00:03:17] Sarah: Absolutely. And you know, I’ve got seven jobs now and I’ve been through lots of others along the way. Um, and I think I’m an outlier in that respect, and I think the number one is a slightly Victorian concept that you’ve picked your path, you have to stick with it. This concept, it’s a job for life. I’ve chosen a specialty. I have to stay in it. What will people think of me? That availability and confirmation bias that all you can see around you is people that have done it and stayed in it.

[00:03:52] And so this concept that I could do something other than where I’m at now, either alongside or instead of. I think can be a really challenging, stressful, sometimes shame inducing concept to people. Because they cannot imagine that it’s a positive decision to make. And so being able to place yourself in this, I’m sure I’ve mentioned this before, though, you cannot be what you do not see, the the things that other people are doing. You can move outta this path.

[00:04:25] Rachel: That’s really interesting what you’re saying. The thing about shame and when we leave or move out, there’s a shame associated with that for doctors. I, I certainly found that myself. When I left clinical medicine a couple of years ago to focus full-time on this, someone actually said to me, a member of my family said, oh, Rachel, what do we call you now? Do we call you Mrs. Morris instead of Dr. Morris? And like there you were shaming me out loud and saying what had been in my head, which is why it devastated me so much.

[00:04:56] Sarah: But isn’t that interesting? Because other people might say, that’s not a shameful question. Is it shameful to be Mrs. Morris and not Dr. Morris? That’s, that’s you translating it and making, taking that to mean that that’s something bad. We are so interwoven as to this identity of what I am. And, and I really think that comes down.

[00:05:18] You know, we are niching so much more in medicine, aren’t we? You’re not just a radiologist, you’re an interventional neuroradiologist. And that is you, you are that person. And I remember when I decided to leave my partnership, and again, I still have to work through those thoughts. ’cause I don’t want to do what other people want to do. What’s wrong with me? What’s, how am I less than? And my children were like, brilliant. Now you can be a marine biologist like you always wanted do. They couldn’t care less.

[00:05:47] So it was me and what I felt about what that meant and that. Difference between. Shame and guilt and that what does it mean? What do other think of others think of me, but so much more, it’s what do I think of myself and what the implication is about that. And I think it’s so important to step aside from I’m making a decision related to where I’m at now, because actually I’m not happy or I’m not fulfilled, or I’m not stretched or, or I have loads of skills and I’m not using my preferred ones.

[00:06:23] And it can feel very confronting to make a change and move. And looking at why that feels so difficult, what, what’s really going on in your brain that’s making it feel so uncomfortable to you and having that language for when you talk to other people as well.

[00:06:42] I remember thinking when I was leaving my job trying to, I didn’t even have the language for it. I couldn’t explain why I was leaving at the time. And now five years down the line, I go, like you say, it actually wasn’t a good fit for me. There are lots and lots of reasons, and actually over time it’s become clearer to me. But while I was doing it, it wasn’t that obvious. I just knew that I wasn’t happy and I felt suffocated and I felt I needed to leave. It’s very, very complex and, and a lot of those messages come from your childhood, your upbringing, but also the external society that you see as well.

[00:07:19] Rachel: It is interesting ’cause I was just thinking to myself it, it’s something about the professions that we are in that we think there’s a deficiency with us or blame ourselves when we want to leave. Whereas if you were, if you were doing a marketing job somewhere and you decided to go into sales or you decided to go into operations or something you wouldn’t be going, oh, I’ve, I’m so, I’m so bad. Why am I, why can’t I cope with doing this marketing thing? And you, you’re just like, yeah, I’m, I’m going to do that, ’cause I realize that that’s a bit the job I enjoy more. But why can’t we see it as that? Why do we beat ourselves up about it

[00:07:53] Sarah: I honestly use the word grooming about some of it. I think there’s a real.

[00:07:58] Rachel: Oh my word. That’s very emotive, isn’t it?

[00:08:01] Sarah: it’s deliberately a provocative word because I just think the, the atmosphere that we breathe is that we need to be grateful for doing what we’re doing. We owe it to the system to stay in it and give back because aren’t we lucky we’ve had all of this investment spent on us, and then we get all the stuff from the, the hierarchy telling us, oh, well it’s much better than whenever. And, and you kind of almost have this generational obligation placed on your shoulders before you even qualify, I think.

[00:08:32] So we have this sense of obligation and this is the correct thing to do. And how we are mentored or not mentored, but just told what to do by our seniors, who are the ones that hold the key to the next stage of training and future jobs That that real power balance, we are very influenced by who, who we meet along the way and what their experiences have been.

[00:08:57] Rachel: Yeah. Wow. Just that you just saying that word grooming. I was like, oh my gosh. That’s it. From a young age, you know, you’ve gotta go to medical school. Wow. Aren’t you clever? Okay. You’re in medical school. You are one of the top people ’cause you’re at medical school and then, oh, you, you finished medical school, you’re working. It’s really tough. You’re having a horrible time, but you should be grateful, right? ’cause everyone wants to go to medical school and then it, it carries on. Wow. That’s Wow. I’m like reeling from that word,

[00:09:21] Sarah: It’s deliberately provocative because I really passionately believe it. I think, you know, I’m in my forties and you look back to what you had to do, even as a medical student and the sacrifices you make, and I didn’t. I didn’t come out with any debt, you know, I might have had one student loan that I used for going around Thailand. I was very, very lucky. Students now have a very different set of decisions to make, and I think they need to be a lot more clear-eyed about what they’re getting into along the way in terms of the expectations for you as a person and the requirements from you, from the system.

[00:09:57] Rachel: I think it’s really interesting what you said about confirmation bias that, you know, every decision you make seems to be confirmed by the people you’re working with because you’re in that system. And the other bias, which is availability bias was you only think the options you’ve got are the ones that you can see.

[00:10:12] So even within medicine, you can’t see all the other careers that exist within even medicine, let alone the ones that exist outside of medicine, ’cause often you are, you are stuck in a, a very small niche. And because all our lives we have never had to look for careers or jobs. You just have to vaguely know what training scheme you’re gonna go for and what specialty, we, we haven’t been taught those skills that we need, either to find out about ourselves or to find out about what jobs are out there. And also, I don’t know about you, but in my experience, the jobs that I want to do don’t seem to be advertised anywhere either.

[00:10:50] Sarah: That’s right and and I think that also comes along to one of those, one of the other big myths, which is that I’ve got this far, I better keep going, you know? And that is the sunk cost fallacy. I’ve put so much time and effort into this, everybody around me knows that’s what I’m aiming for. I’ve spent a lot of money to get to this point, I’ve sacrificed a lot. I’ve missed friends’, weddings, I’ve, whatever. I’ve gotta make that count. And that can lead to people continuing far longer than they really planned to or really want to because they don’t feel that they can come up to air. I have to keep going.

[00:11:30] And so it doesn’t occur to them to even start to look because you and I know there’s absolutely tons of stuff out there when you really look around and make contacts from people who aren’t necessarily doing the traditional path. But you have to be able to lift your eyes up from the sort of tunnel vision, the blinkers, whatever analogy or metaphor you want to use, and get curious to consider that there might be other options, but that can be really hard to do while you are still trying to walk the walk and get your portfolio signed off, try and get your ESR, try and, um, make sure that you’ve got the publications so that you’re not falling behind your colleagues. There’s, there’s a. There’s a terrific sense of, I’ve got to keep going because otherwise I’m a failure in where I’m at, and it doesn’t let you then think, but what could I also be, or what, what else could be true of where I’m at now?

[00:12:23] Rachel: I mean, to think about sunk cost bias, I just need to say the words HS2, right? Because you know that cost, I mean, I’m gonna get the figures all wrong, billions to get to where they are now. And they knew that to finish it would cost an extra like twice as much as they’ve already spent. But because they spent so much, it’s like, well, we should carry on. But if someone said to you. Sarah, would you like to spend 20 billion pounds on this project that’s, that’s not really gonna work, you’d go, no, of course not. But if we, if you’d already spent 10 billion pounds, you think, well, maybe I should, right? But your decision making goes completely wonky. And yeah, you do put so much time and effort in.

[00:13:00] But I think sometimes we don’t realize about the skills that we’ve picked up on the way and the experiences that we’ve had, which means that everything counts. Even if you are no longer working in exactly the same role, doing exactly the same job, all that experience you’ve had, you’re not gonna lose it just ’cause you go and do something else. It’s still with you. It’s, it’s still there.

[00:13:21] For example, I, I can do what I do today if I didn’t have that experience and that knowledge and that, that understanding of, of what it was like or where I came from, and I’m really grateful for those years I spent.

[00:13:34] Sarah: Yes, and I think. It’s helping people really understand what, what are your skills, what are your transferable skills, but also what are the things that you’ve really learned when things got tough? Because that’s often the really formative bits. And that you are so much more than a piece of paper or an, a certificate or a, or an exam that you passed, or a role that you have got. Because actually the interesting thing about you might be a time where things really went wrong, and actually as a result of that, you had a really important realization and you developed a new skill or an insight. And I think people can feel really wary of being open about that aspect of themselves.

[00:14:23] Although in training, you often have to go, these are the things that I could do better and I’m gonna reflect on it, and then I’ll do it better. I think there’s still a lot of fear of going, oh, I didn’t handle that well at all, and the shame that comes with that, because often the system makes you feel ashamed, and how you can have the learning that feels healthy and sort of post-traumatic growth actually from, from a really difficult situation.

[00:14:47] I think you and I can both think of things where we’ve really massively cocked up, either interpersonally or decisions at work, and that sticks with you. And rather than being something that I beat myself up with, I go, okay, that’s gonna be something I can share as massive compassion with someone else, or I’m never gonna do that again. And how to take that on as a positive piece rather than something to really flag yourself with is a skill and a muscle to develop that I think many of us don’t naturally have.

[00:15:21] Rachel: Yeah, I think these emotional intelligence skills, these sort of softer skills, which is what other people would say, although they’re anything but soft, aren’t they? They’re the things that actually really count in success in a lot, in a lot of careers, but because you can’t sort of label them so much as then hard to think, well, I’ve got this skill that I could take over to this place, or whatever.

[00:15:41] I just go back to that thing where you said Jobs for life, you know, and that we do feel we’ve got a job for life. It, it’s very antiquated and I don’t know many other professions where you are in that job for life. Maybe you sit up maybe teaching accountancy law, but the amount of accountants I’ve met that are now doing other things, because actually accountancy is a very good springboard for other stuff.

[00:16:01] And, and most people, I think the average, you move careers. Probably every five years. Most people change careers every five years, if not less, when you are a bit younger. So this reinventing stuff, doing something different every five years, well I think that’s quite healthy, but that’s ’cause I get really, really bored. But I think for even people that might be a, say GP partner and they’ve got another 20 years left and they don’t wanna leave their partnership, well, there’s a lot you can do within the job that you’re still in to sort of reinvent what your role is every five years rather than just carrying on doing the same old thing, right?

[00:16:34] Sarah: Absolutely. And I think when I started coaching, I thought I was gonna be seeing lots of people who wanted to leave their jobs and how was I gonna support them in that? And actually, that has not been the majority of the case. It’s the what? How can you look? What is it that’s really bothering you about where you’re at? Is it something about where you get your satisfaction from? Your energy? Is it that you’re not actually doing the bits of the job that you really enjoy? Is it that you are not no longer doing learning? Because we love learning new things. Are you not interacting with people as much?

[00:17:07] So it’s, it’s helping you kind of take that power back, isn’t it? And looking at what you have control over. And like you say, I’ve spoken to people who thought, oh, I’m definitely gonna leave this job. And actually by the time that you look at it and they’ve had a look at what it is that’s bothering, they go, actually, I could really be content here. I just need to work on those areas that feel like the pinch points for me, or I need to make some brave decisions within that role and see what I can influence.

[00:17:36] Rachel: I think you’ve hit the nail on the head there. It’s, it’s the brave decisions and the influence that people really struggle with. I think we, and I talk about this all the time in the podcast, we have this issue where we try and take too much control over the things we, we can’t influence, and that causes us a lot of stress within our jobs. And then we don’t take enough control over things that we, we could influence like those, how can we change our hours? How can we reduce recessions or the work, or even give up that role.

[00:18:05] I think it’s really hard to give up a role when you’ve become senior. And I, I think of colleagues that I really, and, and friends actually, I really respect who, you know, got all the way up to the hallowed position of, you know, medical director or you become PCN director or a clinical director and they do it for you and they go, you know what, I really don’t enjoy this. I’m gonna just step backwards or sideways or whatever you call it. I’m just going to carry on doing this job here as a consultant, which I love, and then I will do some teaching or I will do some coaching or I’ll do something completely different. But I don’t need to be at the top of the ladder in order to be fulfilled. But lots of us only find that out once we’ve been at the top of the ladder for a bit and gone, oh, this is awful. And then we feel we’ve gotta stay because how does it look if we, if we climb back down, right?

[00:18:51] Sarah: Yeah, and that very much speaks to that. We feel we have to climb the ladder and once we’ve ticked that box, we sometimes look around and go oh shit, I don’t actually like the job that I’ve fought tooth and nail to get to a great personal cost. What can I do now?

[00:19:10] And it’s difficult ’cause sometimes you can’t know until you’re actually in the job how much, you know, my mum became a teacher and was very experienced and then became head and was like I’m really passionate about this school and what I’m doing, but now I’m doing the bits that I never trained for, I don’t actually have loads of skills on that, and I’m taken away from the teaching, which is the bit that I’m really passionate about, and I’m a bit kept apart from my colleagues who are really good friends. And I think that’s true for lots of us when we get senior positions in one way or another, and it’s how you take a view on, on what better would look like.

[00:19:48] I think when you look at, for example, in positive psychology, where does satisfaction or happiness come from? And the evidence was that giving beyond yourself to others was the greatest form. In medicine we kind of do that all day long. The other bits are, you know, material goods, gains. Mostly we have that. The bit that I think we forget about is the flow. And as medics, we’re often people that really love learning. We are really passionate about new things. And when we get that mastery of our subject, and there are some jobs where you can never feel like that ,GP being one of them, where actually the learning goes or the how do I practice a skill where, where can I get into that lovely sense of flow, where I’m excited and all, what’s that? And time’s gone by. And sometimes reminding people that you can still do that, either within a job or outside of a job because I think we are very much focusing on the job bit here. How you turn up to work and what your energy and satisfaction and Happiness levels are like when you arrive in work, I think is really key.

[00:20:55] And one of the areas I’m really a bit boringly evangelistic about is, okay, we can really focus on what’s important to you in work, but are you also focusing on what’s important to you outside of work? Because if you’ve become a vessel of a person that is purely about your work and you’re not getting as much satisfaction or interest or feedback from that, then what does that mean about the rest of your life?

[00:21:20] So how can you also start living a juicy, fruitful, interesting life that on your deathbed, you’d look back and go, okay, yeah, that I’m, I’m, I feel content with what I’ve lived here.

[00:21:34] Rachel: And it is such a cliche, isn’t it, that no one ever looks back and thought, I wish I’d spent more time in the office. But we do need to remind ourselves of that, that you, you are gonna be looking back on your career and going, why? Why did I spend so much time doing that thing that I really hated when I could have done something else? Either, you know, within your work, you know, if you hate teaching, don’t do that. Say, can I do all the QI for this department, or whatever. You know, there are so many different things and sometimes you just have to ask. I don’t think we ask enough.

[00:22:04] Sarah: One of the key reasons I made my big career was because one of my dear friends who was a partner, died in my practice, and she was not that much older than I am now. And I kept asking myself, if I ended up in that same situation where I had a life limiting diagnosis, would I be happy with how I was living my life? And I had to keep coming back to Not in that job, no.

[00:22:33] And I’ve just been to, unfortunately, another funeral of a wonderful woman younger than me who was a GP and had had to live with a, a, a potentially life limiting disorder, but she didn’t know. And again, it, it just reminded me and it made me just think again, it is a gift having those reminders. That mortality we don’t have forever. If I was gonna find out that I was gonna die soon, what would that mean? And I think it can be a really stark mirror to hold up to yourself.

[00:23:07] Rachel: Really is. We, we don’t consider that. And the quote that I love, and in fact we loved it so much, we know in the organization after it’s the quote from Mary Oliver Summer’s Day, tell me what is it you plan to do with your one wild and precious life? And we think we have to wait to have this wild and precious life till we’re traveling around Thailand or you know, retired or able to take all the time off in the world. But actually, no. It’s what are you gonna do with your one wild and precious life on a Monday morning in the job that you inhabit, the life that you inhabit right now and the job that you are doing for 30, 40, 50, 60, 70 hours a week Because life is too short not to enjoy the thing that you spend most of your time doing apart from sleeping, and that is generally working.

[00:23:52] Sarah: And what does that mean that you have left when you come home? Who are you when you’re not at work? And does that need to change? And how does what you’re doing at work influence how you are out of work?

[00:24:06] Rachel: Someone said, it was a book by the School of Life. What is your current work doing to you as a person, to your mind, your character, and your relationships? Thought? Gosh, imagine if we stop breakly to go, what is my current work doing to me as a person? What’s it doing to my mind, my character, my relationships? Because so many people I know that are, are stuck in a, a dreadful job or a dreadful role are doing it out of a sense of commitment that they think they ought to, to serve their patients or their customers or whatever, but they’re not considering what’s it doing to my mind or what’s it consider doing to my relationships. And it’s really obvious that being, they’re being a complete grumpy bastard to everybody else. Excuse my French, but they’re staying out this sense of duty to their patients, but they’re not serving anybody. And they’re miserable to live with. I thought, oh my goodness. We, we just do not see the link between what our work is doing to us and then how we are with other people, and how we are with other people is pretty much what there is in this world, right?

[00:25:07] Sarah: Yeah, and we also often defer this sense of Happiness. This I will be, everything will be okay when I pass my exams, I get a posting where I don’t have to move every five minutes, I am a partner, I’m a consultant, I’m married plus 2.4 kids. And then we go, oh, everything’s a bit rubbish. Everything will be all right when I retire. And, you know, not to be morbid, you might not get to retirement, or you might get to retirement an absolute shell and not know who you are and not have good quality relationships because you haven’t been investing in that or your life outside. It’s, you know, time to live now.

[00:25:52] And that is such a morbid way of looking at it, but it’s also true no matter what your spiritual beliefs are, you are irreplaceable as an individual. The system will keep going whether or not you are there, but you as a person are irreplaceable. So what does that mean? What does that mean? What do you need to do?

[00:26:14] Rachel: Whenever I’m doing training on, um, productivity and saying no and stuff, we always just use quotes from that wonderful book, 4,000 Weeks by Oliver Burkeman, but even the title of that book, 4,000 Weeks, you know, I say, oh, did you know that?’Beause 4,000 weeks is pretty much what you’ve got on this planet, give or take. And everyone goes, Ugh. And I don’t know about you, sir. I’m, I’m way past my 2000 weeks already, so, you know, less than 2000 weeks left, right?

[00:26:38] Sarah: So what do you need to do about it? And, and I think that can shake people out at this sense of sort of. I think people can feel impotent or they’re just really tired or they’re scared. And I think sometimes you do need to be really dramatic to kind of, you know, we can, we can do these coaching exercises where you do the magic wand thing and go, okay, if I waved a magic wand and made a big change for you, what, what would you want that to look like? How would it feel?

[00:27:06] There, there are exercises you can do, but sometimes really being confronted with something massive can actually help you imagine, oh, okay. Yeah. Oh, actually I really hate this aspect of my job. Or actually, I always wanted to have a job that involved this. Why am I not doing it?

[00:27:22] Rachel: Yeah. Life is too short to do something outta sense of duty. It really is. And out of sense of should or ought. I do think though, that people continue quite a lot of the time because they’ve got massive fear and anxiety. You know, what will happen if I change? I don’t know how to change. What if I can’t get a job? I’m the main breadwinner. What if it all goes wrong? What if I, what if I can’t? So have you got any other suggestions and hints that gonna help?

[00:27:46] Sarah: one of the things that can be hard and. It’s easy for us to say these things. You and I have done it. It doesn’t mean that it, it goes smoothly for everyone. And there are certainly some jobs that I tried that were absolutely awful. And taking that sense of whatever you do doesn’t have to be perfect. That next move doesn’t have to be the move,

[00:28:09] Rachel: So not perfect, not permanent, right?

[00:28:10] Sarah: Yeah. It is very rare that a decision you make is either irreversible or that the thing that you choose, you then stuck with forever. And keeping that lightness of concept takes a lot of pressure over, over the what next. That you can just take that first step and go, now, let’s see. And if it’s not for you, fine. You’ve learned something else and that’s gonna help you move on to the, okay, let’s try something else. And hopefully this time it’s a better fit, or I’ve tried that, I didn’t like it, or I’ve tried it, it didn’t earn me enough, or it really didn’t bring out the best side of me.

[00:28:49] Rachel: I think in medicine and, and professions like that, we are very lucky in that there aren’t enough doctors. So even if you go off and then think, oh, we’re gonna come back, great, yeah, you’ll get a job, you can go locum, you can do sessional stuff, you can go work somewhere else. So that we have a lot of options actually, which perhaps other, other career changes don’t have. At least you can know that you are gonna be able to keep the lights on. At the end of the day, you can go and always do some covering shifts. Do this, do that, and, and you can, you can keep the lights on, which is, which is great actually. There always is a plan B if you need it.

[00:29:22] Sarah: There is, and I speak to a lot of people who are really terrified of doing something like locuming because all they’ve ever known is a steady career through training that has a very clear pathway. And actually I find that when people do do some locuming, it’s incredibly empowering because it’s quite a scary concept. There are lots of skills that you need to recruit to do it, and actually going a bit more into what is it about locuming that really scares you? What, what is it that you’re worried that you can’t do? Because I’ve locum all over the place. I’ve helped run renal units around the country because nobody else wanted those night shifts in a hospital I’ve never been in. I’ve done GP locums in inner city London where there were bulletproof glass. I can’t say that I loved some of these jobs, but afterwards I felt like I could do anything because I had done those things that scared me and actually what I needed to do were fairly basic skills. I needed to say I don’t know really where things are. Can you help me? I needed to use my communication skills. They just wanted me to do the bums on seats, doctor type jobs. I could do those. The actual fundamentals of doing those jobs are doable. And often it’s just the systems that people are scared about.

[00:30:40] And so I’m really glad you mentioned that bit because people are really, really scared of locuming. And often it’s the best thing that you can ever do because it helps you know that actually I can go to different places and cope fine. And also it’s a really good way to sort of try before you buy, and have a little dip your toe in, work out negotiation skills, how much are you gonna pay me? What am I gonna do? What am I definitely not gonna do? And make some mistakes in negotiating badly. And yeah, actually I think that’s, that can be a very formative exercise personally.

[00:31:16] Rachel: So what sort of things do you advise people when, if somebody was to come to you for some career crafting or career development conversations, what would you be getting people to think about?

[00:31:26] Sarah: So first of all, I, I want to know what’s really going on for them right now. What is at the heart of their discomfort? Because change it often is either a push or a pull. And I think at the moment it, it’s a push. People feel I need to get away from where I’m at, and I want to know why is that. Are you not well? Do you need some time off? Are you doing too many hours? Are you not doing actually the roles that you really enjoy, or is it something around you are not getting your cup filled up with energy because you are looking for fulfillment in the wrong places? So something around what’s going on? Where are we at? Or are you staying put because of other people’s expectations of you?

[00:32:14] Then I want to take a really macro view, a real helicopter view of what is really important to you right now, both in and out of work. And if we then look at those things, what needs to happen and what are your options and choices in terms of stuff that changes at work, stuff that changes in you, or changes related to a different job?

[00:32:44] Rachel: Great. So some really useful stuff around where you might start. Now, I know that you’ve, uh, done a bit of preparation for this episode and you’ve actually got some self-coaching questions that people can ask themselves. So I, you, you shared some of them with me earlier. I think they’re absolutely brilliant.

[00:33:01] So, you are gonna go through them. Now, can I recommend that, um, if you are at a point where you can just pause this podcast and go get yourself a paper and pen, go and do that now. ’cause Sarah’s gonna ask some questions and then you can, um, she’ll ask them fairly slowly so you can write stuff down, but because it’s a bit boring listening to complete white space as you’re driving along. We’ll, we’ll go through, there won’t be too much of a pause, but if you are on a point where you can pause them and then write stuff down, do.

[00:33:26] Sarah: Okay. So my first question is, I am at my best when. And you can decide what best means to you. I am joyful and exhilarated by my work when. I enjoy what kind of interactions with people? When is my energy filled up and depleted? Who am I making choices for? How do I need to view myself and what does that mean for my career and home life? The classic, if I was on my deathbed, what would really matter to me?

[00:34:13] So I think we’ve are focusing on trying to help people look at fundamentally what’s important to them, but also related to their energy levels and their values and what they have control over and can change. For example, are you investing a lot of emotion in being liked? I remember that was really important to me as a GP. I wanted, I, I needed to be needed and I liked to be liked, and I was spending loads of energy in all my patient interactions in trying to get that. And then found myself very crushed when I wasn’t getting lots and lots of positive feedback and interactions, ’cause actually that wasn’t what was most important to patients. They just wanted me to sort their problems. So I needed to look at where else can I get that feedback from and satisfaction and energy, just as an example.

[00:35:06] Rachel: Interesting you give that example. I remember working with a GP who was incredibly direct and quite brisk and blunt. I was quite scared of her, but actually I grew to really love her and all the patients loved her, but she wasn’t worried about being liked or not. She was really honest and had really clear boundaries, so yeah. So should have done this exercise. I can imagine, yeah, she’s like, how do I need to view myself well as, as honest telling it like it is and what does that mean for my career and home life that I draw boundaries and I’m not gonna take any shit? And, and she didn’t. And she was great. She was great. So yeah.

[00:35:42] Sarah: And that’s a conversation I, one of my roles as a medical educator is, is having that chat with trainees who make that difficult transition into having to function independently. And that real discomfort where they’re having to be a gatekeeper or patients have unrealistic expectations. And particularly at the moment where there’s a lot of holding patients and coping with the fact that they can’t get the service that they need. And how you look after yourself within that setup, and be a lovely, empathic doctor, but also not crucify yourself on the fact that you can’t provide that service. And I think now more than ever, and again, I see this in appraisals, it’s how do you maintain your resources in that situation?

[00:36:30] Rachel: Out of all those questions, Sarah, which ones do people struggle with the most, do you think?

[00:36:35] Sarah: I think they’re very clear on, on some of them, but I think the one about who am I making these choices for, I think it takes quite a while to get to the bottom of how they are viewing themselves and where, what has, what has influenced that. Was it that you were praised at school because you did well in exams and therefore that’s how you started to get your self-esteem? Was it a very influential mentor who said, oh, you’d be an excellent X, Y, Z?

[00:37:08] I think people really internalize external opinions and it takes a really long time to get to the bottom of, why do you think that? Is that really what you feel? And, and to help them see that just because they’re having those thoughts doesn’t mean that they’re necessarily real. Your brain can come up with this script that it tells you, you are only good if, or, oh, look at what other people are doing, and you can go, hang on a minute, this comes down to the whole mindfulness, doesn’t it? That’s not a very kind thought. That is not a very helpful thought. I’m not sure I even believe that thought.

[00:37:42] And yet we carry these things around with us as if they’re true and give them so much weight and allowing ourselves to take that and put that, put it somewhere else, or chuck it in the bin and see it for what it is, I think can be a really challenging, actually,

[00:37:58] Rachel: One of these questions that I think I would have trouble answering is the one about I’m enjoyful and exhilarated by my work when. I’ve found that in coaching people, people often when they’re very stressed and very overwhelmed for a very long time, have forgotten what they really enjoy. They’ve forgotten which bits they do enjoy about their job which bits they don’t, ’cause everything seems like a chore. So even the bits that they used to enjoy, they’re not enjoying anymore. And it’s really quite difficult to then realize what, what you do enjoy and what the bits that that fill you up. You just realize that, oh, I’ve got to the end of a really long day and I’m completely depleted. It must have been all of it, but actually it was probably some of it. So how do you get people, how do you help people work out what it is that they enjoy at work?

[00:38:42] Sarah: I think it’s trying to help them come back to, and it can you think of a time when, and trying to get them to be really specific. Can you think of a time where you went home or you bumped into a friend in the corridor and went, Ooh, this just happened. Or, I just had the loveliest interaction with X, Y, Z, and it just gave you that little pulse of joy, you know, these glimmers of joy that they talk about.

[00:39:08] Actually one of the benefits of teaching can be, it really reminds you of what you’re doing well and the complexity of what you are doing. And people often say to me, actually, I did feel like being a trainer or having to do supervision. It’s annoying because it takes up my space. But you are showing your mastery at that time and it helps you understand where it comes. So have you taught anybody recently and what did you notice? What did you notice that was positive about you or positive about your job when you were in that teaching environment?

[00:39:43] Rachel: And I love that. ‘Cause that’s, that’s really concrete, isn’t it? Part of my brain though, is saying, okay, well, I can imagine, I can think back to some, you know, patients that were wonderfu and the interactions were lovely and I’m thinking, but that was really random and I couldn’t control what came through the door and I couldn’t control what sorts of patients I saw and the bits that were nice and bits that weren’t, it felt completely random. So how do you take control of that and job craft even in those situations when it does seem to be completely random?

[00:40:09] Sarah: I think some of it is that acknowledging that you can’t control those bits. And I do think this is a challenge, is how do we hold onto the memory of those moments? You know, we, we often focus you, you finish your day and you think about the things that annoy you. And this is coming back to some of those techniques around gratitudes or what went well today and how do you refocus your brain on the things that weren’t awful and exhausting and annoying. Because the language you use to yourself and there can be this group think in a department.

[00:40:45] I remember I used to find it incredibly depleting going to coffee breaks at my partnership sometimes, and we’d all just sit there having a whinge about what was annoying and, and yet if I could come home and go, what were the best bits of it? It takes a bit of energy, but writing those things down or recording it somewhere, or telling somebody. My daughter has learned this trick with my husband who’s a hospital consultant, and if she just goes, how’s your day? He’ll go, oh, well this bit was annoying. And she knows that he really loves food. So she’ll say, what did you have for lunch? And he’ll Ooh, I had this really nice panini and he lights up and she’s only 13. She’s a genius and he knows she’s doing it, but there are ways of doing that, focusing on, and it could be your food, but what are the bits of your job that give you those little glimmers of enjoyment or interest?

[00:41:36] It might be that you saw a case that was really juicy that you thought, oh, that’s fascinating. I’m seeing all of the day-to-day stuff. But actually I do still also get these bits that are really getting my brain going and making me think and challenging me, and I really enjoy that.

[00:41:52] Rachel: You are making me think as well of. Of actually getting yourself in the right position where more of those things might happen. So I remember listening to someone that said, you know, some people say that they’re just unlucky and some people are just lucky. But it’s interesting how the lucky people tend to just be in a position where they’re getting more of the luck. They’re sort of being able to maneuver themselves or they’re put themselves where they might get those interactions or that, and I’m just thinking, you know, if, if, if the, the, the patients that you’ve really enjoyed, uh, for example the, you know, interactions with the families and really talking to the s whatever, then actually you may volunteer to do more of the nursing home stuff as long as you’ve got the time for it, ’cause you know, a lot of people are like, oh, the nursing home’s just something we have to do as this extra team, actually, you could really get into that and really get to know people if. If you know that some of those interactions have been wonderful or you know, you can be the one that volunteers to do the, the palliative care stuff within the practice, or you could upskill yourself and that sort of thing. Or if you know that you really like getting through the on-call list and seeing the emergencies and the interesting stuff like that and the times where you’ve really enjoyed yourself at work, we’ve got to solve the problems and get, you know, then put yourself more into that position where you’re more likely to have those sorts of interactions.

[00:43:02] So there’s something about, yes, you don’t know what’s coming through the door, but you can maneuver yourself or suggest stuff where you are more likely to have those, those sorts of interactions as, as well I, I guess.

[00:43:15] Sarah: I think so, and I certainly see that with people that I work with. And also looking at what really are your strengths? Because we often just do the job and not really think about, okay, if somebody was describing me, what would they say I was good at? They might go, okay, Sarah’s not great at filling in reports or doing admin, or blah, blah, blah. Oh, but Sarah’s really good at having those difficult conversations, or she’ll, she’ll really take a thing and see it through to the end, or she’s really passionate. She’s got so much energy. I really like that about her. And you don’t see yourself that way. And even when we do these dreaded multi-source feedbacks that we, we, we sometimes get that.

[00:43:59] I always say to appraisees, please keep that feedback and look at the free text in it. You know, laminate it, put it in your drawer, put it somewhere that you can look at it on your bad day. ‘Cause we, we believe the bad press much more than we believe the positive. And again, trying to tune your brain to really take that on board, how do people view me? What, what am I, what’s different about me?

[00:44:22] Rachel: And then knowing what’s different about me, how can I put myself in that position and craft my role so that I’m doing more of that stuff that I love, less of the stuff that I don’t love. And if I genuinely in a role where I’m not doing any of that stuff that I love, then that is probably the time where you start to think, right, I’m probably in the wrong role here and I need to then start to look. And then we haven’t even scratched the surface of how you even go about career change, networking, all that sort of stuff. And I think we’ll cover that on another podcast. But I think it’s really right to start at this place where there’s no point making a change unless you know what is important to you, what you enjoy, and what your strengths are. Otherwise, you’ll just jump from one position and role that you hate into another one that you hate as well. ’cause you haven’t done the work of really working out what lights your fire, what’s important to you, and what do you, what do you need out of life? And you are right, you are, you are jumping from a, you’re in a push situation. I’ve just got to avoid that there.

[00:45:18] But, you know, we take ourselves with us into any, any job or, or, or any role. And I think anything can turn into a complete nightmare if you’re doing the wrong thing, be it within medicine or away from medicine, and so doing the work before you do anything dramatic is really important.

[00:45:36] Sarah: Yeah, and that’s another classic myth is that when I get the perfect job, my life will be perfect. And you know, we are taking all of our insecurities, our previous histories into it, our whatever is going on in our home life. And actually, that’s part of why you have to look at this helicopter view as well.

[00:45:57] I’ve certainly worked with people and they’ve told, oh, if only I was in this, that, and the other. And when they get down to it, they went, oh, actually, I’ve really got serious marital issues. Or actually, I fundamentally have incredibly low self-esteem. And those big, big, massive, chunky issues, sometimes it’s easier to look at what am I seeing day to day and blame it on that. Well, I’m not very fit, or I’m in chronic pain, or there are some huge issues that we can take from place to place and it will still cause issues for us. And some of us just have to live alongside these things. Not everything is gonna be malleable, but looking at what is really, really going on here and doing that deep and sometimes really uncomfortable work means you’re gonna put yourself in a position where you are most likely to thrive going forwards, hopefully.

[00:46:50] Rachel: Also that’s been so helpful. And we have got another podcast recording planned, haven’t we? So watch this space. Everybody we’ll be talking about. We’ll take this conversation a little bit further. Um, what would your three top tips for someone who is thinking, oh, I just don’t know whether to get out or stay or career change, I’m a bit stuck. What would they be?

[00:47:10] Sarah: So number one is focus on where you get your satisfaction. Where do you really enjoy things? Number two, this very controversial concept. Your thoughts may not be the truth, so if you’re unhappy or frustrated, spend some time usually with someone else to help you unpick what is really going on here, and what do you need to do about it? And number three is don’t be afraid to break some rules because they’re there to be broken.

[00:47:42] Rachel: What rules have you broken, Sarah?

[00:47:44] Sarah: Um, you have to stay in a job for life. You have to give your life purely to the NHS and nothing else. You have to only do one thing and it has to be salaried. You have to do fewer than three jobs. Current count is at seven. You have to stick at the first job that you have a go at.

[00:48:03] Rachel: Love, love all of those. Yeah, gosh, if I need someone who told us that when we, when we qualify, that you are allowed to change. You’re allowed to swap, you’re allowed to go, no, that’s not working for me. I’m gonna change. But we go, oh no, I’m not, it’s not working for me. I must be dreadful at it, therefore I’m gonna hang my head and just do this move That makes me feel really bad. ‘Cause No, absolutely. You’re allowed to change and that’s fine.

[00:48:28] Sarah: Actually, it’s interesting on that, there’s been a GMC study about workforce and it showed that if you have an F three year, if you take a year off in between your foundation and going to training, they are more likely to retain people. And that’s how it always used to be. And there are so many things that you could do in that time that could help you set up a, a very different career potentially than if you just keep on going.

[00:48:53] Rachel: Yes, I would add to those top tips. Don’t be afraid to take some time off and explore stuff and just take some time off and go traveling. You know, the career will always be there. There will always be more career options. It’s one of those things with the, the 4,000 weeks, you know, we’ve gotta get used to Jomo joy of missing out. Ditch the fear of missing out. ’cause yeah, you are gonna miss out. You’re totally gonna miss out on most of life, ’cause you’re finite, you’re human. You don’t have much time on this planet to do everything that’s available. But you really need to pick the things that you are going to do, and that means you’re, it’s fine to miss out on some other stuff, but I don’t think we focus enough on that. Actually what is it that I am gonna do with my one wild and precious life?

[00:49:36] So Sarah, thank you for being here. And I was just thinking those self-coaching questions, we will put them in the CPD worksheet for this week. So if you want to go through those, um, and write ’em down on a Word document or just have them sort of printed off, then sign up in the link in the show notes for this CPD worksheet so that you can get hold of that, and go through that in your own time. And Sarah, if people want to get a hold of you, how can they contact you?

[00:50:02] Sarah: A few places. It’s www drsarahgoulding.com, and I’m @DrSarahGoulding, Goulding with a U in it, like Ellie Goulding, the Pop star, at Instagram. I, I’m on Twitter and LinkedIn, but not quite as much. So those places are the best.

[00:50:17] Rachel: Great. So do contact Sarah if you’d like some more sort of one-to-one support and help. So thank you so much Sarah, and please come on the podcast, another time and very, very soon.

[00:50:27] Sarah: I will. Thank you, Rachel.

[00:50:29] Rachel: Thanks for listening. Don’t forget, we provide a self coaching CPD workbook for every episode. You can sign up for it via the link in the show notes. And if this episode was helpful, then please share it with a friend. Get in touch with any comments or suggestions at hello@youarenotafrog.com. I love to hear from you. And finally, if you’re enjoying the podcast, please rate it and leave a review wherever you’re listening. It really helps. Bye for now.