How to Take a Good Long Look at Your Career

[00:00:00] Rachel: As life shifts and changes, the things we want and the things we want from our career change too. The goals we had on the things we had some energy full when we were younger aren’t necessarily the same now. So take a moment to think about your career. Is it giving you what you want or is it asking too much? Are you playing to your strengths or simply doing, what’s been expected of you for years?

[00:00:23] Rachel: This week, I’m talking to Dr. Lois Brand. She regularly runs group workshops for healthcare professionals to help them craft the next stage of their career. We talk about navigating changes in our work, how to ask for the seemingly impossible, and what conditions in mid-life can learn from their younger colleagues.

[00:00:40] Rachel: And if after listening to this podcast, you wants to come on a career retreat day with You Are Not a Frog, just drop us a line at hello@youarenotafrog.com.

[00:00:48] Rachel: 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

[00:01:06] Lois: My name is Lois Brand and I am an emergency physician by background. I spent, a couple of decades working as an emergency medicine consultant, uh, mainly in Oxford, and I’ve been working in medical education for the last, oh goodness knows how long, but I’m, I’m Associate Director of clinical Studies at Oxford University Medical School.

[00:01:27] Rachel: It’s wonderful to have you on the podcast, Lois, thank you so much for coming. We are talking today about how to have a sustainable career. We met at the FMLM conference earlier this year where I was recording a breakfast session. It was a live podcast recording about just this: is it possible to have a sustainable career? And, and Lois came along and you gave us your sort of two pennies’ worth, which was really, really helpful. So we’ve got you on the podcast because I know that this is a, a particular area of interest for you. What, what got you thinking about this in the first place, Lois?

[00:01:56] Lois: So I’ve always been interested in medical careers and I’ve got a, a Masters in medical career management, which is a little bit niche. So I’ve always been interested and nosy in other people’s careers. And then a couple of you, well, about three or four years ago, my own career, my clinical career in emergency medicine, which I was doing part-time, I became more and more uncomfortable with feeling, actually, this is really difficult to sustain. It’s a very broad, very technical, very immediate specialty. And I was thinking how am I going to continue with this, only working part-time?

[00:02:31] Lois: And I came to the conclusion that actually I would either have to do more in order to stay sharp enough or to stop altogether, because I’d actually tried to narrow my focus, in, in the emergency department, which had worked for a couple of years. Um, but unfortunately that, the geography of the department changed at a massive expansion, and it wasn’t possible for me to do that more focused role. Um, so I felt stuck between doing more in order to make it sustainable, or needing to stop.

[00:03:02] Lois: And I felt very sad about that, um, and disappointed. But as I thought about it, I realized that actually there were people all around me who were experiencing a similar thing. And despite conversations with, um, my trust, there weren’t really, uh, options to allow me to stay and, and develop my career. So I started to explore what might make a difference.

[00:03:25] Rachel: So what did you start with?

[00:03:26] Lois: Um, I started on a walk with my sister. We are walking the, uh, southwest coastal path very slowly at the moment. And, uh, so every, every few months we meet up on some chunk of it and walk along the coast. And it was on one of those walks that I just started talking about what I’d like to do, really what I would’ve liked for myself, which was a place to think, a structure to think in. Um, and so I started to think about a day to take consultants or senior GPs away to a place which was beautiful and spacious and to encourage really positive thinking about what they can do to make their careers sustainable, what they want for the next chapter of their lives and careers.

[00:04:13] Lois: Um, and as a trained coach as well, I was thinking there were quite a few really simple coaching techniques which we could use with people co-coaching each other, just peer coaching in pairs. So I started to put this together. Um, and it started to take shape. And the deanery, the, the Thames Valley Deanery, um, when I made this proposal to them, they said, well, let’s give it a try with our educators and let’s pilot it. And so nearly two years ago now, I ran the first one in a barn in Oxfordshire. And um, yeah, since then I’ve done another 14.

[00:04:49] Rachel: Obviously very much in demand. How did all this thinking that you were doing in these days that you were running make a difference to your own career?

[00:04:57] Lois: Yes, I think what started with a conversation with my, uh, medical director after I decided to step away from my clinical post, what started as, I think there’s something that needs to be done in this space. I think there’s something creative that can be done, I think there’s something that this trust can do to make a difference in this, in this area, then became real. Um, and it’s, and it, and I could see the difference it was starting to make to people.

[00:05:27] Lois: My original concern was that I would just encourage people towards the exit, uh, that, that people would stop and think and then they’d think, oh, good grief, this is, this is awful. My set of circumstances is terrible. What am I doing? I need to get out. But actually that didn’t happen. And when I started to get the longer term feedback, three to six months post the pit stop day, what I was hearing back from people was that they were able to make small changes. Most of them weren’t that dramatic, but they were small changes. They’d been able to have conversations that they’d been putting off or they’d had before, without, um, without getting the result that they needed. To make small changes, which would make their next chapter more fulfilling, more joyful, and most importantly, sustainable.

[00:06:13] Lois: And what I was worried about didn’t happen that there wasn’t a mass rush for the exit. And in fact, so far of the people who’ve responded to the long-term feedback questionnaire, uh, only one has actually left her clinical career and she’s gone off to do, uh, she’s opened an amazing jewelry business actually.

[00:06:32] Rachel: When we think about career development, often we are thinking about, well, I’ve gotta just have a change. I’ve gotta change absolutely everything. I’ve gotta do something completely different. But the reality is often it is just small tweaks in what you do on the day to day, or just doing a bit less of one thing, a bit more of another thing make, makes a lot of difference.

[00:06:51] Rachel: So when you did your initial sort of going down to focus more, how did that help you? And then what helped you actually make the transition to, to then move outta that and try something else?

[00:07:02] Lois: It was pre Covid that I recognized. So I, I I, I think everybody that we’re all on a sort of spectrum of, of how seat of the pants we are and emergency physicians are often quite seat of the pants type of people, I think. And for the, for that, it, it wasn’t a great fit for me because I’m not a good seat of the pants person, but I am somebody who likes a lot of variety and change and action and speed. I like that. Um, so increasingly I was feeling uncomfortable with all the things that I needed to be able to do in Oxford, which is a major trauma center.

[00:07:36] Lois: So I thought, well, what does the department really need that would fit with what I can offer? And I realized that actually, um, care of the elderly within the department was an area of need. Um, and my background is as an MRCP medical background rather than a a, a surgical background. Um, I’m old enough to have been pre, um, membership for the, uh, Royal College of Emergency Medicine, so I’ve got a a, a foundation in general medicine. And so I thought actually, I wonder whether that would be something which would work for the department and also narrow my focus and allow me to come to work without feeling sick when I drove past the helicopter landing pad where the major trauma people were brought in.

[00:08:22] Lois: So that took quite a lot of work actually to establish that, um, and work out how that role was going to be within the department and work that out within the rostering and timetabling. But it did work and it worked really well, and I felt reinvigorated in my work, I felt valued. And that’s so important, isn’t it? When when we’re at work to feel valued and feel that you are doing a good job, it’s so important. Um, and that did work really well. And I really enjoyed actually the new interfaces that I was having with, with the, the care of the elderly teams and the, um, I was working in a more multidisciplinary way with the occupational therapists and physios.

[00:09:04] Lois: And then came two things, covid and also a physical change in our department, which meant that our department was, uh, grew enormously, um, in size and we needed to have the two consultants who were on the same time. One of them needed to be running the department as had always been the case, but the other one had to be in recess all the time because it was geographically quite separate from, from the main hub of the department.

[00:09:33] Lois: And so the luxury of saying the second consultant can, you know, do a bit of this or a bit of that, or if it’s lower, she’s going to look after all the people who are elderly in the department, we lost that luxury. So I then had to move back into a much more general role of either running, running the shift or being in recess and, and dealing with all that stuff. And then there was covid too. So I did that role. Again, um, as I had been doing for many years before that, um, and it was then that I started to think, actually, I’m not sure this is sustainable for me. What does the next bit look like? And if I didn’t change, I could see the natural history of this was that I would become less skilled, uh, more uncomfortable and less I invested far more time.

[00:10:18] Rachel: What you are talking about I think is something that a lot of. Older doctors go through and they older people in general. I’ve just written a written, I wish I’d written it. I’ve just read a really good book by Arthur C. Brooks, um, I can’t remember what it’s called. It will come to me, but it’s about sort of the second half of life and how you create a, a, a sustainable career and how you really thrive in the second part of your life.

[00:10:41] Rachel: And he talks about the fact that your sort of knowledge and skills increase when you are younger and they sort of hit a peak, I don’t know, late twenties, early thirties. You know, you are really skills, you’re really bright, you’re really on it. You really, you know, you can solve problems really, really quickly, but that, that declines quite a lot in your, after your sort of thirties through your forties.

[00:11:03] Rachel: And by the time you know, you’re fifties 60, you have much less immediate, immediate sort of intelligence to solve those problems. Your brain works a bit slower and certainly for women around the age of, you know, anytime from 40 or hit by the perimenopause and menopause. And as a consequence, even if we are perfectly well skilled, we sometimes then feel de-skilled.

[00:11:24] Rachel: And of course you’ve got the new people coming in with all the new techniques and they just out med schooled or they’ve been on the latest training courses, and we compare themselves to them and go, oh my goodness, I’m just, I’m just not worth it anymore. I’m, I’m just rubbish. But actually what happens is that your experience grows, obviously through life. Your wisdom grows. And so you are much more likely to spot patterns in things to recognize stuff that’s gone before, to be able to step back and give some sort of wise judgment, to use your intuition. And that is a skill that is, you know, not really talked about very much. That he, Arthur C. Brooks talks about it a lot in his book, and I found that so profoundly reassuring.

[00:12:03] Rachel: But often we just expect ourselves to be doing exactly the same as we were doing. And in medicine it’s quite weird, isn’t it? ‘Cause you could, I don’t know, I qualified as a GP. I think I was about 26, 27. I’ll be doing exactly the same thing for the rest of my career, you know, in terms of seeing patients. But most other careers, you, you progress up and then you’re doing different things at the end of your career that you’re doing at the beginning. But as emergency physician, you are still seeing patients the same way you would’ve done when you were, when you were 30. That’s not reflected in the structure of what, of what happens to us in our medical careers.

[00:12:33] Rachel: And we don’t value the wisdom, the experience that that, that we get. And that makes us feel really inadequate, really worried. We really nervous, worried that we’re gonna drop balls. And, you know, some of that anxiety I think is fair enough, anxiety, fair enough. If I don’t know the latest guidance and I’m not so skilled up on that particular procedure, or there’s something wrong, I can see why things get worrying. But also we compare ourselves to our younger colleagues who can also stay awake longer without sleep and also perhaps don’t have the family situations at home to deal with. And all of that now is, does that, is that ringing true at all to you, Louis?

[00:13:08] Lois: Oh, totally. Absolutely. And I, I totally agree around the, the tacit knowledge and wisdom that you gain as, as you have seen more and more and more have made all the mistakes and, and you, you just don’t really realize that a bit like your, your frog analogy of the, of the water getting, you don’t notice because it’s just happening so gradually over time and it’s not so visible, I think to yourself.

[00:13:34] Lois: I think other people can see that and know that they trust your judgment as somebody who’s been around for a long time. But what I, and I think others tend to notice more is exactly what you said about these people who are coming through, who’ve been trained in the latest techniques through their registrar years. And you just think, oh gosh, that’s another thing I can’t do. Oh, that’s another thing that I, embarrassingly don’t know how to do.

[00:13:58] Lois: And there was, there was a time a few years ago where fascia iliaca blocks, using anatomical landmark techniques came in and we had a great teaching session organized in the department on that. And I, I, I thought, great, okay, I’m happy I know what to do. And then predictably, it was a long time before I actually got some hands on time to, to do it with a patient. And increasingly I just thought, oh, actually I’m not so sure I’m, I’m ready anymore.

[00:14:26] Lois: And I thought, right, come on, Lois, you’ve, you’ve got to do something about this. So I thought, the next time I see somebody about to do it, I’m going to go and watch them. So I saw a middle grade doctor about a setting up and I said, do you mind if I watch you? ‘Cause it’s been ages since my training and I just want to refresh my mind.

[00:14:42] Lois: And he looked at me like he didn’t believe me and that I was actually, you know, assessing him or something. And I said, no, honestly, I really, I’d really appreciate that. And then behind me came, um, a more senior consultant who I have massive respect for. He was a real giant in the department. And he just whispered in my ear, Lois, do you mind if I watch that too?

[00:15:03] Lois: And I thought, it’s not just me. It is very, very difficult to keep up with all the skills and all the new bits of equipment that come in. And it’s something that we don’t talk about enough. I think it’s almost like a guilty secret and it becomes a real discomfort. But we need to get that out in the open. We need to talk about it. We need to normalize that.

[00:15:26] Rachel: And it’s just striking me that, I mean, clinical skills, new guidance and stuff, actually, they’re quite easy to learn. You’d have watched it, you’d have done a few, and then if you’re doing it every day, you’d have just become a total expert in it. What’s not easy to learn is how to deal with a difficult colleague, is how to deal with yourself and be aware of your own emotions around things. How to deal with complaints and failure, which we hopefully get a bit better at as we get older. The, it’s the interpersonal stuff, it’s the leadership stuff, it’s the, it’s the wise old owl stuff that really one can only get through going through it yourself.

[00:16:01] Rachel: And that, that’s one of the things that really pisses me off about resilience is the best way to build resilience. Go through rubbish, go through crap, go through stuff, that’ll build your resilience. Like, like no training ever will. And so it’s like, oh, you know the best way to learn how to have a difficult conversation with someone, give difficult feedback, yeah, do training, but go and do it. Go and have one. You’ll learn what it feels like. You’ll learn what works, you’ll learn what doesn’t.

[00:16:24] Rachel: Coaching, you can’t learn coaching, but by learning about it, you’ve got to go and do it, haven’t you? And this is experience that builds up over the years, But we are not recognizing the value of it. We are not recognizing the value of it in ourselves. And sometimes we’re not recognizing the value of it in our colleagues.

[00:16:39] Rachel: And in my mind, when we, when we pivot our career or we’re crafting our career, we should really be thinking out what have, what am I really experienced in? What can I help people with? What have I been through myself that I can now share and help help others with? I think one of the reasons why I’m doing this work as a career change is because I’ve had ADHD all my life, I didn’t realize it. And that’s why I’m so obsessed with like self-awareness and self-help because I really struggled in a way that I don’t think other people did as much.

[00:17:07] Rachel: And so I was reading this stuff and I was thinking, well, that helped me. Therefore can I share it with, with other people? So in a way it’s, it’s like making a message out of your mess, as it were. And that’s exactly what you’ve got done with this this day, right? That you were like, there’s something I really need ’cause I’m really struggling here. What would I want right now?

[00:17:26] Rachel: So that, this thing about, about wisdom, about experience, but about maybe feeling that our skills are a bit, a bit lower, that’s obviously a theme that you’ve noticed coming through in all the people that you’ve helped, have there been any surprises for you in, in why people are attending these days or, or really needing help with stuff?

[00:17:44] Lois: Almost, well, not almost everybody, but a huge number of people who come on the course are really clearly articulating how much they love their career, actually, how much they love the clinical medicine side of things.

[00:17:58] Lois: And alongside that is often a clearly expressed sense of grief and loss about not being able to see a way through to make this sustainable. And it becomes so, that the loss to the system becomes so tangible because you can see these people in the room with people nodding heads and, and really acknowledging, yes, I feel that too, of, I wish there was a way, and I’m not sure there is a way. What can we do?

[00:18:26] Lois: And we do an exercise at the beginning of the day, which encourages people to think in a different way by using metaphor. And often that can become quite emotional actually, as people open up and articulate, maybe identify actually the way that they’re feeling and, and feel, actually, I feel sad. I feel this sense of loss. So that has really surprised me, but it’s driven me more to think this is something that needs to be addressed.

[00:18:54] Lois: There’s such a lot to lose for the system, for our patients, for the organization, but also on an individual level as well. There’s so much to lose here if we can’t find creative ways to, to make our careers more sustainable as doctors.

[00:19:09] Rachel: What ways have you found that people have done that?

[00:19:13] Lois: What quite frequently comes up is people saying, well, I want to talk about my job plan. I want to perhaps think about in another year or so coming off the on-call rotor. Or I want to work fewer hours and cut down my PAs. And then they often say, but I’ve asked before, and it didn’t go down very well. And phrases like cherry picking come up. Um, and they feel worried about dumping on their younger colleagues and, and these sorts of things.

[00:19:43] Lois: So we talk o openly about that. And the good thing about, uh, getting older, um, when we’re thinking about cherry picking is that everybody is going to be in that situation at some point. Not everybody’s going to get pregnant and have babies. Not everyone’s going to, um, have a, a, a chronic health condition, but everybody is going to get older. And I think that people are beginning to think more about, okay, well I might have to do a little bit more of the out of hours during my younger years, but then if I can look ahead and see actually as my career develops, I’m going to be doing a little bit less of this, a little bit more of that, then I think it’s actually quite positive. So, so, encouraging people to have these discussions to, to make small changes in their job plans.

[00:20:31] Lois: Another thing that people are doing, which again, is very, it’s not anything new, is actually planning a sabbatical and taking that time away to really reflect and think about what they want for their next chapter, or just taking a break and, and allowing a different pace. Focusing on their relationships, focusing on their wellbeing.

[00:20:53] Lois: Now, most trusts, of course, offer that, but I, from my experience, quite, quite a few trusts don’t trumpet it. And it, you have to delve quite, quite a long way into, into the, uh, trust intranet to find out how you might actually go about that.

[00:21:09] Lois: Some people have increased the amount of non-paid volunteering work that they’re doing. Recognizing that actually now my children have flown the nest, i, I don’t actually need all of this disposable income. And actually what I want to do is, is, is work a little bit less for the trust, but actually I’m going to be re-energized by, by going to work in a, a low resource situation for, you know, a few months each year.

[00:21:35] Lois: So lots of things that, that people have done, but I’ve just been so reassured by the fact that almost everybody has talked about small ways to change, to stay, um, and, and that they’re now enjoying or they see more sustainability.

[00:21:52] Rachel: I think the sabbatical thing, that’s a no brainer, isn’t it? Because the amount of people that, well, like you said, it was very difficult to really think straight when you are just caught up in the throes of busy, busy clinical workload, you’re basically just in survival mode. And the idea that you might have a, even an hour to think, like if you’ve got an hour, you wanna go and do some exercise or just sleep or go get your haircut, or something like that, not just sort of sit and think what do I really want?

[00:22:16] Rachel: And I have never, ever heard of anyone who did a sabbatical or took some prolonged unpaid leave that didn’t get a bit of perspective about their job and what they really want once their brains are settled down and once your nervous system settle down. And I think it takes a while for your nervous system to settle down so you can think well. I think it’s always quite dangerous when people are in a state of burnout and they make career decisions, because at that point you just wanna get like, that’s it. Just wanna lose it all. And you, that is when you are very, very much in danger of throwing the baby out with the bath water.

[00:22:51] Rachel: Because there will be bits of your job that actually you are really suited to and you can do. Um, but if you’re in a position where you are just so exhausted because you’ve been running from your cortisol, from your chimp has been running, running the show for the last six months, whatever, then it’s impossible.

[00:23:06] Rachel: And what you said about, you know, disposable income, plan a sabbatical. Even if you, even if there’s no provision in your contract, you can save up, can’t you, for six months, put a little bit of money aside every month and just say to your trust I really need to go now .You can only ask. They might not pay you. But if you said like, I’ll do it unpaid or whatever, you might, you might get what you’re asking for.

[00:23:28] Rachel: I was coaching someone once and um. She was wanting to go down on some sessions and she was really worried about asking about stuff, you know, well, they, they won’t let me. I just know they won’t let me. I said, well, if they don’t let you, what’s the option? She said, well, I’ll probably leave and go somewhere else. I’m like, well, why don’t you at least give them the chance to, to give them what, what you want? Because otherwise you’re gonna leave anyway. And that summer saw her, she was like, jumping around. She said, they gave it to me. I asked for the outrageous, and they just gave it to me. Because the, the other option was me leaving. And so that worked. Really? That worked really well. Have you found that people have gone and asked for stuff and surprisingly, they, they’ve got it?

[00:24:02] Lois: Yes. So this, in the long-term feedback, that’s a common theme that people say, I went and had that discussion. Um, and quite often I can hear, so we, we uh, uh, for quite a few sections of the, the workshop, we’ll pair people up to go and have, um, coaching discussions and we use really simple coaching frameworks. And at the end of these, I can sometimes hear people going, right, okay, so I’m going to, I’m going to email you on Wednesday and make sure you’ve had that discussion.

[00:24:32] Lois: So I know that there’s, that, that people are, are making really determined, um, decisions to get going on this. And I’m finding that actually people, I think what makes a difference that when they go back and have that discussion is that it’s been, their situation has been normalized in the balm, that they understand it’s not me. I’m, I’m not deficient. This is just a normal part of development through my career. It’s just that the system isn’t properly set up for that yet.

[00:25:01] Lois: So I think it makes them, it, it allows them to go into it rather than on the back foot. And I’m so sorry to be asking, and I’m probably, I can understand why this might not work very well, going in with a, Okay. I’m a valuable resource and my trust will, will want to flex in some way if the other option is that they might lose me and not going in as a threat, but recognizing their value and recognizing that what they’re asking for is very reasonable.

[00:25:25] Rachel: And I think there’s another mindset shift that’s needed for these conversations that people are go into as well. It’s actually knowing why you’re asking for it, and getting really, really clear on your why. Because if you know that the why you’re asking for this is for the good, obviously the good of you, but long term it’s for the good of the department and the patients as well, because they might lose you or you think you’ll burn out if you carry on working like that, then you’ve got, you can then tolerate the pushback that you, that you might get a little bit better and the, the grumbling and, and the whinging and the, you know, I’ve been talking a lot about saying no and, and dealing with pushback.

[00:25:59] Rachel: And I think people get very discouraged when they go and have maybe their initial job planning conversation about around this. And they might get an initial negative reaction from, from the person because, well, I imagine if you had a full-time consultant and you were struggling to cover your department anyway, and they came and said, actually, I need to do this otherwise, you know, I’m not sure I can last very long. Of course your first reaction’s gonna be, oh, well I’m not sure we can do that. I mean, that’s just like human nature. It doesn’t mean that that person was wrong to ask. It’s just you thinking shit, what’s gonna happen to my department if that happens? But on reflection, you’ll probably think, okay, actually they’ve got a point, maybe we can do it.

[00:26:36] Rachel: There’s a book by an FBI negotiator, actually, it’s really good. It’s called, never Split the Difference, but he was saying, you actually literally get out all their objections before they can say it. So you might go and say, I know this is gonna sound really difficult. And you’re probably gonna be thinking, gosh, they’re just trying to cherry pick. This department is short start enough without them going off. And you’re probably gonna think, oh, for goodness sake, why should I do this? However, I am just gonna ask because this is why I need it.

[00:26:59] Rachel: So you’ve already said their objections. And often what then happens is in FBI negotiations, I’m not sure if this will happen in job planning, but the person will then go, oh no, don’t, don’t worry. I don’t think you’re cherry picking. I don’t think this. And they’ll try and then reassure you. It’s a really weird psychological thing, but we don’t wanna be accused of stuff like cherrypicking, like stuff of not pulling our weight, like stuff dumping on colleagues. We’re so scared of that.

[00:27:22] Rachel: But everything I’ve learned about career development is that cherry picking is 100% the way that you can develop a sustainable, brilliant career. Because cherry picking to me is choosing to work in your zone of genius rather than do the stuff that you are not particularly good at and you probably don’t like doing..

[00:27:40] Lois: This is something that comes up when we, um, right at the beginning of the pit stock. We’ll. Contract together for how we’re going to make the best use of the space. And one of the things that I’ll contract for is not, if I see that we’re getting suck, sucked into sinkhole as I call them, things that will be a really rich ground for a good old whinge fest about how terrible, so the, the predictable ones are things like parking and anything to do with the non-availability of, of PA support, all that sort of stuff. Pensions is another sinkhole. And another sinkhole is about whinging, about the generation below us.

[00:28:17] Lois: And actually I’ll say, okay, I’m going to, I don’t think our time is best served if we start plunging down one of these sinkhole. ‘Cause we could stay there all day and actually enjoy it in the moment. ’cause there’s something delicious about having a whinge. So I’ll say I will pull us out, however, let’s just think for a moment about what we might learn from the generation below us. Because the generation below us have got a very different mindset about their careers.

[00:28:40] Lois: Now, when we’re, a lot of us are sort of pre modernizing medical careers and then the early part of modernizing medical careers where we lost a lot of agency, we became quite passive, apart from choosing a specialty. And then we’re just in a sausage factory going through. And actually what, what we’re seeing now as a behavior of the, the younger generation coming through is that they are pushing back against the very highly structured, pretty rigid career framework. And they’re saying, no, we’ll loop out. We are looping out. So the vast majority of foundation doctors now will loop out and take an F3, even an F4, sometimes an F5 year before saying, okay, I’ll come back.

[00:29:23] Lois: So I think that they’ve got a much more healthy, in some ways relationship with their career. I think that they’re more tuned in too, as, as we see outside the NHS, much more people taking control of their careers and saying, I’m going to go to this organization and get this experience and then I’m going to come away. So the average amount of time that a new graduate outside of medicine will spend in an, in an organization is 18 months. Whereas it used to be that you would, you would, get a contract with somebody and you’d probably stay there and go up through the organization.

[00:29:58] Lois: So people are a lot more mobile, um, and feeling, I think a lot more sense of autonomy in choosing how they’re going to engage with their career. And it’s very easy for people of my generation to then think, oh, that’s so annoying. You know, we are, we are left carrying all the responsibility, doing all the work. And actually what we need to do is turn that over. I just think, what can we learn from them? How can we become a little bit more autonomous? And recognizing that sometimes we can find ourselves and I’m, I’m, you know, I, I absolutely would put myself in this category where I was a few years ago in a state of learned helplessness, And we need to take back some control.

[00:30:39] Rachel: a hundred percent agree. There are things we can’t do anything about, parking being one. Then it’s like, okay, if parking’s really, really getting you go, if it’s something you can’t get over, then your choice is to leave and go and work somewhere else, or maybe hire a parking space just outside the hospital from someone’s drive, i, I don’t know. There’s got to be solutions to it.

[00:30:58] Rachel: But this, these think holes in these learn helplessness. Absolutely. That’s what I find really stops people changing and that’s when you sort of know people don’t really wanna change. ’cause sometimes people are really, I won’t say ha, they’re not happy being stuck in the victim, but it feels more comfortable, doesn’t it then, than taking that leap and, and asking for the outrageous or doing some extra training to do something different or whatever.

[00:31:20] Rachel: What, what have you found helps people with that mindset shift from sort of victim to, okay, I can actually do something about this?

[00:31:28] Lois: That’s a really great question. And I’m not sure that you, you can try and help people to see that that’s what they’re doing, but that can be quite difficult actually. I think a lot of people who choose to come on the workshop are more proactive perhaps, anyway, and prepared to, to think creatively.

[00:31:46] Lois: The drama triangle, of course, has got a, you are referring there to the drama triangle, I think, with the sort of being in victim mode and the, the NHS or your, your, um, divisional department being, being the persecutor, and perhaps hoping that somebody’s going to come and rescue you. And of course they don’t.

[00:32:01] Lois: Um, but there’s a, there’s a positive version of the drama triangle, which I’m sure you are familiar with, where the persecutor turns into the challenger, I think, don’t they?

[00:32:09] Rachel: Well, we teach this as part five Shape Toolkit, and we have the, the persecuted turns into a challenger or a catalyst, someone who, you know, makes things happen. The rescuer, yeah, turns into a cage. The victim turns into an activator. They can actually solve their own problems, get stuff done, they hold the resources that they need. They, they might need some support getting a crew around them. They might need some coaching to think things through, but they’ve got all the resources. And, and let’s face it, the people you are working with, Lois, they’re intelligent people. They know what to do, they’re probably supporting other people in exactly the same way, you know, to solve their own problems and stuff like that.

[00:32:41] Rachel: But It’s so easy to get into victim, particularly when it it comes to career. And um, there’s another model called the ladder of accountability, which I love, which helps you get outta victim. And the very first step is just acknowledging reality. And it sounds like to me, the people that come on your, your day, they might not have got very much further apart from acknowledging reality. And then I think the next step is acknowledging my own part in that and then recognizing what you want to, what you want to change. And then you, you can go up to like all the way up to like creating the change you want and all that.

[00:33:14] Rachel: But just the acknowledging stuff is, is, is better, you are, you are at a higher level in terms of consciousness than being below the, I I always think of it as a line, you know, you’re, you’re conscious and w or your unconscious. And I always talk about the book called The 15 Commitments of the Conscious Leader, which is just the most brilliant leadership book.

[00:33:32] Rachel: When you’re below the line, you are in victim, everything’s happening to you, you’re a bit unaware of your thoughts and emotions, whatever. And most of us are below the line that comes to career feeling like a victim. And the only thing you need to do to get above the line, the first set is to acknowledge reality.

[00:33:49] Lois: Yes. We talk about that a huge amount and one of the, uh, tools we use, um, and I give people that almost a script to use this with their, with their paired person for this coaching exercise is the really well known Grow model. Um, which is most people listening I’m sure will be familiar with it. Um, but I encourage people to absolutely focus on the r. Because that’s exactly where you need to really delve down, slow down, deep dive into what’s the reality.

[00:34:18] Lois: So r is for reality. So you’ve got G, goal, R, reality, O, options, and W, will and way forward. And it’s the R of reality. What’s really going on here? And if you can spend time in that bringing, as you say, stuff up into consciousness about what’s actually going on here, that’s where you are going to be able to generate options, um, and, and take action.

[00:34:41] Lois: I think you have, have referenced a book that I read recently in the last, just a couple of times actually during the podcast. Um, you talked about the Zone of Genius. And I, I’m wondering whether you were talking about Gay Hendricks

[00:34:54] Rachel: Yes, the Big Leap. Well, there, there’s a couple of people that talk about Z of genius, but he, he is, he is one of them. And yeah, that’s an interesting book, isn’t it? What have you taken from that book?

[00:35:03] Lois: What I’ve taken from that book is that I recognize patterns in myself of what he calls upper limiting yourself. And that certainly we know as humans that to change is often very anxiety provoking. And it’s interesting to notice those patterns in how you may be limiting yourself and keeping yourself safe. And you talked earlier around people staying in something even though they’re unhappy. Um, and I think a lot of that happens because we are, we’re anxious about change and what that might mean. What happens if I change and ask for something different in my job plan and then I still struggle? Or what happens if I step away from this particular role and then I really miss it? Oh, I better stay safe and better stay in it. So recognizing, and again, acknowledging it’s about acknowledging the reality.

[00:35:53] Lois: But what the natural history of people that that stay and avoid change is that at some point you will reach a crisis point, and that’s where you get into that binary decision, I can’t stay, so I’m going to have to go and this is what we’re trying to avoid.

[00:36:08] Rachel: Yeah, because I think most of us avoid change when we go what if.? What if I miss it? What if, what if? But we don’t say what. If not, what if I don’t miss it? Or what if I don’t change? Because, as you said, we fear the change. But what we should be fearing is staying the same. That’s often much, much riskier than the change, but it’s more comfortable, you can be much more passive, you can stay in victim. You don’t actually have to do anything. Career change takes quite a lot of effort. It’s a hundred percent worth it. But that’s why I think people really, really need support along the way. And traditionally we’ve had no career support in, in medicine, have we?

[00:36:46] Lois: no. There’s very, very little, even, even at the junior stages, there’s, there’s very little, um, in terms of career support, I think where, where we have made improvements is thinking about that transition from higher specialist training into consultant or the transition from, a GP trainee into substantive GP.

[00:37:06] Lois: But, uh, beyond that for, for people who’ve chosen to step off the training pathway and take a role as a, a locally employed doctor, there’s very, very little and very little acknowledgement that the, the landscape’s changing all around you. If you’ve been in post even 10 years, doing the same role, you are not doing the same job as you were doing before. Stuff’s been changing around you, and there’s little acknowledgement of how you manage that.

[00:37:32] Rachel: And I think career development, career crafting is something that we really need to take the initiative on ourselves, ’cause like no one else is gonna come to you and go, right, how do we develop your career? They just really, they wanna keep you there. They wanna keep you happy, but often don’t realize actually developing your career so you can work in your, your zoner genius, that which you love and you’re good at is the best way of keeping you anyway. But often we don’t have the skills.

[00:37:56] Rachel: And I, I think sometimes in the NHS there can be sort of these sort of coaching, mentoring schemes set up, which are great, but often the people who are mentors might not have coaching training or they certainly don’t have career change coaching training or, or support. And so if you are someone that is wanting to do a career shift, ‘ cause I, I hate saying career change ’cause it’s, I think that scares people. ’cause a lot of people don’t go in wanting to leave, do they? Like you said, they just want something to change something so that they can survive and, and actually thrive.

[00:38:31] Rachel: So it’s really important to look, look for someone to talk to that actually has a bit of experience in this and c can ask you the right questions or doesn’t have an ter motive of trying to keep you.

[00:38:41] Rachel: If you could give some advice to your earlier self, say your 30-year-old self to craft your career right from the get go, what would it be?

[00:38:50] Lois: I think I would, um, tell myself that it’s vitally important to build in time to actually be proactive about planning my career. I think I expected the system to provide that framework for me and continue to provide that framework for me. And what I’ve learned over time is that there’s a real need for proactivity here because the system hasn’t caught up with what we really need now with our longer careers and with the fact that the pace of change, both in terms of technology but also knowledge, clinical knowledge, is so rapid now that we have to take a different approach to our careers. And because the system hasn’t caught up with that yet. There’s a real need for individuals to be proactive here. So I would encourage myself to be making regular, sort of stops. Zooming out, thinking, what do I need? What do I need for the next stage?

[00:39:45] Lois: I would also be encouraging myself that this is normal, that this doesn’t mark me out as somebody who is in need of special attention or can’t cope in the system. This is about keeping fresh, making sure that where my strengths lie is, is what I’m actually using in my work.

[00:40:04] Lois: So I would say focus on strengths. Um, I think that’s really, really important. And as you get older, you certainly have a better self knowledge, don’t you, of, of, of where your strengths lie, and of what you really enjoy, in a workplace.

[00:40:20] Lois: And I would also say to myself, get good earlier. I didn’t, didn’t do this for many years. Get good at spotting your limiting beliefs because I have been so limited by that, that’s internal narrative. And it’s only trying to keep me safe, but getting good at spotting limiting beliefs, I think is, is really vital too.

[00:40:39] Rachel: Yeah, that sounds really important. I think strengths is really important. I didn’t realize how important till recently when I’ve actually done a strength survey and looked back and gone, ah, I’m now doing stuff that is really in my, in my top five strengths whereas I wasn’t before. And when I was feeling really disillusioned, I kept thinking, what’s wrong with me? Why am I not enjoying this bit of the job? But everyone else seemed to, and then I’m like, okay. Oh gosh, my top strength, even before I started podcasting. Was like sharing ideas and collecting ideas. I’m like, oh, now I’m doing something that actually places my strength. I’m so much happier. You can do a free strength survey by, I think you, if you Google VIA Survey of character strength, that’s Martin Seligman’s, um, strength survey. That’s, that’s totally free. You can also do strength surveys with, um, there’s Gallup, there’s lots of different ones. And having a coaching debrief on that is really, really helpful. If anybody wants that, get in touch with us ’cause we’ve got somebody, um, in, Wild Monday that, that can do that.

[00:41:36] Rachel: Lois, what three top tips have you got? Of everything that we talked about today, what would your three, we always ask our guess this, what would your three top tips be?

[00:41:44] Lois: Okay, number one, then I would say take time and space to think. That’s extraordinarily difficult for busy doctors who like to be doing all the time. Can be really difficult to access that time and space. Just both from clearing a space in your diary, but also because it can be uncomfortable to stop and think and take stock. So we’ll find all sorts of reasons why we can’t do it. So really creating some space to think about what’s going on, what’s your current reality, and then thinking forward for the next chapter of your life and career.

[00:42:18] Lois: The second thing, um, I would say is think about the people that you’re surrounding yourself with. Because at a time when you are thinking about potentially making some changes or reflecting, uh, you want to be with people who are wanting to take positive action, who are wanting to, think positively and creatively. Uh, you want to stay away from whinging and a, a culture of learned helplessness. That has such an impact on, on the way we think, the people that we’re surrounding ourselves with. So think about the people who are surrounding you both at work and home, and maybe import one or two people into your network to try and catalyze things a little bit.

[00:43:00] Lois: And then the third thing I would say is, and I haven’t mentioned this book, which I, I can’t believe say because it’s one of my absolute favorite books, and really was, was so important when I started to think about this, was reading this book called The Hundred Year Life, uh, by Gratton and Scott, who are a psychologist and an economist, and they, they wrote this book really around how we need to change our approach from the standard three chunk life of chunk of education, chunk of work, chunk of retirement, to a multi-stage life. Because we can’t expect that our education will, will see us through the multiple decades that we’re now going to have in our long lives. and that we can’t retire when we thought we could retire because, uh, the system can’t financially manage that. And there’s so much richness in that book.

[00:43:54] Lois: Um, and they’ve also written another one on a similar sort of theme called The New Long Life, which was also fantastic.

[00:44:00] Lois: But what I would encourage people to think about from that book is they talk about something called your intangible assets. We tend to think of assets in terms of finances, um, and, you know, property and that sort of thing. But they talk about your intangible assets and they divide them into three types. The first one is your productive assets. So that would be things like your skills and your knowledge, um, that you use and need to do your job. The second group of intangible assets are vitality assets, and those are your wellbeing, your health, both physical and mental, but also your social connections, your friendships, um, the depth of those and your connections with your family. And then the third set of intangible assets, which we don’t tend to talk about very much, are the transformational assets. And these are absolutely key to a multi-stage career.

[00:44:51] Lois: Transformational assets are things like your knowledge and understanding of yourself, things like the VIA Strengths Survey would be understanding your strengths through that would be a, a real good investment in a transformational asset. So looking in and understanding yourself, but also looking out and thinking, so what could I do? What other things might be available even in the trust that I’m working in, um, that might really play to my, my strengths and skills?

[00:45:17] Lois: So I would encourage people as part of their reflection process to think really carefully about their intangible asset balance, because most of these are nontransferable. You can’t sell it and buy something else. Your productive assets, your vitality assets, and your transformational assets, and the system again, isn’t set up to help you do this. You have to do this as an individual.

[00:45:40] Rachel: I love that I’m gonna get that book. For a long time I’ve just been thinking, you Know what the, the key to a happy life: self-awareness. Know yourself, understand how you think, know what you like, know what you need, know how you interact with other people, then. Bob’s your uncle. Brilliant.

[00:45:56] Rachel: I love your top tips. Mine would be number one, ask for the outrageous. Like if you don’t ask, you’re not gonna get, and so many people just don’t ask.

[00:46:04] Rachel: Number two would be cherry pick. Totally cherry pick. That I think is the key. You could talk about working in his own genius and maybe if you describe to the person who’s accused you of cherry picking, say, well, I don’t really see it like that. I see it as working where I can give my highest contribution.

[00:46:18] Rachel: And my third one is exactly like yours, Lois. Get people around you that support you, that know you, that get it, that can be your cheerleaders. Now, I’ve talked about this on the podcast before. I think I did a, a quick tip called Beware Your Kindest Colleagues. These probably shouldn’t be your close colleagues at work because they’ve got a vested interest in having you staying and doing exactly the same, because they probably won’t like change either and any change you make probably will impact on them. So they can’t really be neutral. What you want is people outside, you know, your work that, that don’t necessarily gain anything from you doing it or not doing it. They can be neutral but they know you and they love you.

[00:46:56] Rachel: Um, and also get community, other people in the same boat so that you can not have a winge fest but so that you can actually learn from each other and support each other.

[00:47:05] Rachel: That’s really helpful, Lois. Everything you’ve been talking about is ring so many bells for me. If people want to get hold of you, how could they get hold of you, find you?

[00:47:13] Lois: I have, um, an nHS Net email address. So lois.brand@nhs.net. And I’ve got a website, which is not very exciting, but, um, that’s another way to get hold of me. Lois Brand Coaching.

[00:47:26] Rachel: We’ll put the links in the show notes and, um, yeah, Lois, I’m just thinking of all, all, all sorts of things. If, if, if listeners would be interested, you know, in, in coming on a, You Are Not a Frog pit stop day, maybe we could, you know, think about doing one of those. If we get enough people who reply maybe to one of our emails, just email hello at you or not a frog, let us know if we get enough people, we’ll make it happen.

[00:47:46] Lois: Fantastic. We just need 12 people. Um, and, uh, yeah, we can make it happen.

[00:47:51] Rachel: 12 people. If we get 12 people replying saying yes, I’d love to come on that. Hello, at you are not a frog. Tell us where you are so we know where we can sort of hold it in the country. And if you know a nice venue nearby, let us know as well. Um, so that would be wonderful. So get in touch.

[00:48:06] Rachel: The other thing we will do for you is put a, um, a free download for you all about some key questions that you can ask yourself. Some key self-coaching questions you can ask yourself to get really clear about the issues. So often we would, Lois and I were talking about actually often facing reality is, is the first thing, but we don’t know how to do that. So we’ll put a download of that in the show notes for you. So Lois, thank you so much for being here, being such a useful, useful conversation. Will will you come back?

[00:48:33] Lois: That’d be great, Rachel. I’ve had great fun. Thanks.

[00:48:35] 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@unnotterfrog.com. I love to hear from you. And finally, if you are enjoying the podcast, please rate it and leave a review wherever you are listening. It really helps. Bye for now.