5 Things Holding You Back from Getting the Career You Love

[00:00:00] Rachel: Imagine you had a friend who was questioning whether they were in the right job and were thinking about trying something new or making some adjustments to how they work. What would you want them to do? Would you ask them to think about just how your colleagues would cope without you? Would you want them to consider all the sacrifices people had made just to get them where they are today? Or would you simply want the best for them?

[00:00:22] Rachel: So often when we’re thinking about our own careers, we take a much more judgmental approach and a far less supportive one than we take with a close friend. Both my guests and I have wrestled with these sorts of questions ourselves, so I’m really glad to have Dr. Sarah Goulding back on the podcast.

[00:00:38] Rachel: Sarah works with medics to help them find a place to thrive, and she’s identified five key things that can hold us back when we are thinking about whether we’re in the right job, if we need to leave completely or if we just need to make some adjustments.

[00:00:51] Rachel: Now, of course, the grass isn’t always greener on the other side, but if you are thinking about making a change, I’ve got some questions at the end of the episode that you can work through to help you design a path away from stress and burnout and towards something more fulfilling.

[00:01:08] 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.

[00:01:25] Sarah: I’m Dr. Sarah Golding. I’m a portfolio GP with a focus on doctor wellbeing and education. I am a training program director for the VTS. I’m an appraiser, a mentor, a locum GP, I’m head of development at the Joyful Doctor, and I’m a career coach for doctors.

[00:01:46] Rachel: So still got your seven jobs then Sarah.

[00:01:49] Sarah: I do, and I love it.

[00:01:50] Rachel: Brilliant. So it’s wonderful to have Sarah back on the podcast. You are our sort of resident career specialist, our career guru.

[00:01:57] Sarah: I like that. I’m gonna take that label and put it everywhere.

[00:02:00] Rachel: And we thought today we would talk about what stops us getting the career that we want. And we are not talking about like leaving medicine, going, doing something completely different. Although that might be an option for you. We’re talking about getting the career that you want within your current job, within your current role.

[00:02:16] Rachel: ‘Cause the one good thing about medicine and healthcare is that there’s, there’s lots of different options for you where you still are. And uh, we’ve got another podcast, it may be in released or it would be coming up with, uh, Dr. Joey Watkins with me and her discussing just why it’s really quite hard starting your own business, and what advice would we’d, we’d give to people because often it does look like the grass is greener on the other side. But you know what? No it’s not, because that’s a whole nother thing of like how do you get clients and work and all that sort of thing. And the other thing is, Sarah, I dunno if you’ve found this, but you take yourself with you to anything you do. I have found,

[00:02:47] Sarah: Yeah, that’s disappointing, isn’t it? You don’t suddenly become a brand new, shiny version that you think you’re gonna be.

[00:02:53] Rachel: yeah. Yeah. It’s a bit of a shame. So like all the old stuff just comes back to bite you because most of it’s due to the way that you are acting and thinking and behaving and, and all that. Anyway, I’m sure we’ll get onto that as we talk today.

[00:03:05] Rachel: So we are talking about the common themes that you’ve seen, Sarah, particularly in the clients you’ve done one-to-one coaching with one-to-one career coaching with lots of doctors, lots of people in healthcare. And you’ve said to me, Laura, Rachel, there are these really common things that just stop people being able to make changes that they need to. So we’re gonna go through those things. So should we just, should we just kick off and go straight into it?

[00:03:26] Sarah: Yeah, so my number one is other people. Because we often, when we start thinking about stuff, we’ll talk about it out loud with our friends, with our colleagues, maybe with a trusted supervisor or mentor at work. And those people are really influential to us. And that’s okay that they are, but fundamentally, other people are selfish.

[00:03:50] Sarah: And I don’t mean that everybody is malignant and has bad intentions towards you, but they will have their own experiences, they will have their own values, and it can feel uncomfortable for other people to hear you not loving something that they’re doing. So it can really actually shake people a bit like when people who stop drinking find that other people really find it difficult if they are continuing to drink and feel okay with it.

[00:04:16] Sarah: So people ultimately have their own agenda. And also it may be that people are thinking, oh goodness, if they go, that’s gonna make my life much harder. Or if they go, it’s gonna be really difficult to recruit. Or What does it mean for me? But people can’t help that. And there still might be really lovely people, but it’s really helping you not take on their opinions too strongly.

[00:04:45] Sarah: So for example, when I was leaving my partnership and there were all these different feelings about it, my mom said to me, will you now become a specialist in something else, like go back to hospital? And in my head I took that to mean, oh, she thinks I should do that and I’m not doing, it’s my opportunity to.

[00:05:07] Sarah: So it’s. It’s being clear on what those reasons are and helping you to see what you really need to think within that, because nobody knows your path and what you need more than you do.

[00:05:18] Rachel: I’ve experienced that myself. Definitely, definitely. When I’ve said different things I’m going to, I’m gonna do, and I, I think there’s another couple of things to add in there, Sarah, because. I think sometimes just like with the, yeah, giving up, drinking a, it confronts people with where they’re at. Uh, I’ve experienced that. I’ve been doing an alcohol experiment the last, last 30 days, and honestly the first time I went out, I got all this abuse. It was ridiculous from people. I’m like, I’m not lecturing you. I don’t even say anything. But you are, you’re finding this difficult that I’m in a bar and not drinking, and you are, you don’t have to justify it. It’s quite interesting. I’d never experienced that before.

[00:05:52] Rachel: But I think there’s also some envy sometimes that, that you are thinking about doing something different and the other person might be stuck in something that they may be persisted at for years and years and years and they, they might not be loving themselves. And when they see someone else changing, that might be triggering some cognitive dissonance for them, because they might have kept themselves stuck by thinking, I have to, I’ve got no choice. It would be a very bad career option to, to go that direction rather than this direction, and then they say, you doing it Well, they’ve got to maintain their own decisions, they’ve got to make themselves feel better about the decisions that they’ve made for themselves, which may well be a hundred percent right, but they’re not for you. But then that will come out as, as disapproval or, oh, you’re making a, a, a very bad decision, or, or even a bit of anger. Well, you know, why should you do that?

[00:06:36] Rachel: And I was just writing down as you’re saying that I remember listening to Brene Brown and um, well first of all, anger’s a secondary emotion. And what’s underneath that might be resentment. But resentment belongs to the family of emotions that aren’t the angry family of emotions, they’re the envious family of emotions. So there might be that envy that you are actually doing something, they might feel really trapped. They might not be able to change, all those sorts of different things.

[00:07:00] Rachel: So there’s gonna be a lot of stuff underneath other people’s reactions and triggers that you have no idea about, that you might just think, oh, it’s my decision they’re upset with, it’s probably not your decision. It’s probably something, something very, very different. I, I bet you’ve experienced that yourself.

[00:07:18] Sarah: I absolutely have, um, certainly when I’ve done appraisals and again around the time I, I had left my partnership and had various. Unprompted un asked for opinions profited by people. And I, there was one chap who’s a lovely chap, and he’s one of these people that was working into his seventies, he worked at the weekends, he would give patients his phone number. So he was one of these probably dying breed of GPs. And I cannot remember the exact phrase, but it, it was something along the lines of, well, isn’t that a shame that you are doing that? Because we need more of people like you. Or, you know, if you are going, what does that mean?

[00:08:02] Sarah: And, and I, Yeah. I did feel angry ’cause I was like, who is he to tell me what he thinks? But, because actually it made me feel shame and guilt and the shoulds that were following me around about what I should be doing, I found very difficult to confront. But actually I didn’t want to work in a way that he was working. The way he worked sounded awful to me and sounded like you couldn’t fit the rest of your life around it or your family, or the things that really mattered to me.

[00:08:30] Sarah: But it was trying to remember to see myself as other than him, and I can respect and admire him and appreciate he, he probably had lovely intentions towards what he was saying to me, but actually the way it landed felt incredibly uncomfortable to me, and the fact that I still remember it seven years later, I think is telling.

[00:08:52] Rachel: And it’s interesting, isn’t it, that guilt and shame thing. ‘Cause I bet when you do your coaching around people that want to, you know, diversify their work, do different things inside or outside medicine, there’s a lot of guilt and shame that goes with it. You know, that I’ve trained all these years for this and what does it say about me?

[00:09:08] Rachel: And so you’ve managed to get that person to change their mindset and they tell themselves stories which are more true, like, it’s okay to change and let’s work in our zone of genius and do something different. And you’ve done all that work internally, then somebody else says exactly what you’ve been thinking and you’re like, hang on a sec. I thought that was just a story in my head. Oh my god, it’s a story in your head as well. And that just brings all the shame and the guilt around what we decided back again. But it does not make it true.

[00:09:34] Sarah: It doesn’t, and I find what can be really helpful with people is really going back to why did you start medicine? Because that version of you when you were a teenager, often looking at what was your role in the family? What are those scripts that you have taken from childhood? Who did you need to be or felt you should be within the family role? Are you the peacekeeper? Are you the somebody that doesn’t rock the boat because actually there are other big personalities in the family, so your role is look, just go along with everything and that’s, that’s your value? I’ve certainly had that conversation with a client in the last couple of weeks.

[00:10:16] Sarah: Or are you somebody that needs to achieve stuff because actually your parents didn’t get where they wanted to, that, um, Carl Jung phrase about the greatest tragedy of child is living the unlived life of their parents, I think is incredibly powerful.

[00:10:33] Sarah: So unknowingly we will have taken those scripts with us as well in terms of where we are at now, and I think it can be really powerful to unpick that and go, are you still believing that? Is that something you are still weaving through your life and your decision making and holding, holding you back from taking a step in a different direction?

[00:10:52] Rachel: I think whenever you ask anyone else’s opinion, you’ve got to sort of run two questions through your head. The first is, well, what does this decision of mine mean for them? And the closer they are to you, like if it’s your parents like, well, actually it means that they can’t go round. Saying, my daughter is a, well, my case for my parents, my daughter’s not a GP anymore. You know, what is she? Well, she’s a trainer, podcaster, whatever, might not in their eyes be quite as nice. Now I I, I know my parents don’t, don’t bother about that sort of stuff, but you know, some people do.

[00:11:22] Rachel: And then the, yeah, the other thing is if it’s a close colleague, like what does it mean for them? Quite literally there’s gonna be more work for them to do. If you are maybe going to go and do a TPD job or a trainer job, actually, which means that you’re not seeing so many patients. So it’s al always gonna affect them.

[00:11:36] Rachel: The other question you’ve got is what is their experience of the world? I know that when I was working at the university, I was given a lot of advice about what I should do in order to stay and progress up the career ladder in faculty at the medical school in Cambridge. Um, I enjoyed my time there, I really loved it. But for them, you know, after the career pinnacle was, was getting to like associate dean, dean level even, you know, and that wasn’t where I was headed. So in, it wasn’t their experience of. Of what a, a career looked like.

[00:12:08] Rachel: So always run through what’s their experience. And also we do make the mistake sometimes of having mentors in a certain area and these mentors are so amazing and they’re so wise and they’re so helpful to us in that area. And then we think, well, then they can advise me in the rest of my life. And if they don’t quite get where you’re going or something different you want to do, they’ve advised you brilliantly on your, in the case of my medical education job and your medical education career, but you are not in that space anymore, you want to do something slightly different, they give you their opinion, which is just their opinion, but you put the same weight on it as you would the weight of weight of other things. And I think that can be really quite a trap, particularly if you really, really respect that person. And you, you know, we know we want our mentors to think that we’re doing well and, and all that sort of stuff. So that can be tricky. Have you experienced that with, with clients or with yourself?

[00:13:00] Sarah: I absolutely have, and I think there’s, in terms of the career, the, this perception that it has to be a ladder that to you, you know, if you’re in hospital, you must want to be a consultant, if you’re an academic, being a professor in general practice, my perception was that being a partner was the top. And as soon as I got there and I sent my dad a photo of my name outside the building, he said, oh, well you know, Sarah, just remember your children are only small for a while, so don’t, don’t let that take up, you know? And I was like, insert expletive here. My life, I can’t win. There was me looking for the, oh wow, that’s amazing. Well done you, and he popped my balloon and he was also right, because it wasn’t long till I was feeling I was crying ’cause I wasn’t seeing my kids go to bed at night.

[00:13:54] Sarah: I think the flip of this, ‘ cause it’s, it’s coming across quite negative, but it, it is a really important point and people always have examples of this. Is that, what would somebody who had your best interests at heart advise you? And recognizing that we are often not that person for ourselves because of everything we carry with us and all these past people, the, the culture we are in, the society we’re in, the jobs we’re in. What would it look like to put your best interests at heart and that is including you as a whole person outside of work, because we’re focusing on the, the inside of work bit. And I think we really need to remember there’s a whole world outside there and you are a being that isn’t just a worker bee.

[00:14:42] Rachel: So that is something that really derails a lot of people, and particularly when it’s your nearest and dearest, actually. I’m really lucky that my other half’s always been really supportive. But you know, if the family’s relying on your income, the family’s relying on, you know, all of this stuff, it, it can be quite tricky. So the, the very people you want support for from, are the very, are the very people that also probably have a hidden agenda, not hidden agenda, but actually have an agenda. They need you to just keep functioning in the role that you’re in ’cause it suits them pretty well thank you very much.

[00:15:12] Sarah: And a lot of those worries are completely valid because, you know, you’ve gotta have a mortgage payment, you know the hierarchy of needs. I need to be able to buy food for my family. I need to have fuel for the car. And that is one of the things I often work on. And I, uh, in terms of what do you actually need in order to make a change?

[00:15:34] Sarah: And for me, I needed to work out, okay, what is my bare minimum earning? What would be really lovely and what’s okay? And I sat in a coffee shop for hours doing a big, um, thought process of what were the elements that I needed if I was gonna leave my partnership, almost presenting a business case to my husband so that I then felt that he could give me permission to leave, which I know isn’t the way it should be.

[00:16:00] Rachel: That’s interesting. And so this is our number two, isn’t it? It’s, it’s money, the big, the big M. And I think most of us don’t really know. And I, I was listening to her podcast, um, it was a financial advisor actually talking about retirement. She said, people always come to see you going, can I afford to retire? She goes, well, I don’t know. What do you need and what have you got? And she said, most people dunno either of those two things. And so you did exactly the right thing of actually working out what you needed.

[00:16:28] Rachel: And I do remember when I was, when I was working, um, at the university, there was a, a full-time consultant and, uh, she was getting really frustrated. She said to me, Rachel said, I’m getting so pissed off. I pay for a nanny for my childcare. I’m paying for a dog walker to walk my dog. I’m paying for a laundry service and a chef. She said, I’d just rather do that myself. I feel like I’m outsourcing my life and then doing the bit that I hate. So I thought, wow, that is interesting. That is really interesting. And I, I’m all for outsourcing the stuff that you don’t wanna do, but I’m not for outsourcing the stuff that you really want to do because you feel you ought to be doing your job and your work.

[00:17:07] Sarah: I, I am the granddaughter of a very prudent accountant and so that thread runs through me. My grandfather was, um, the only child of a working mother in Streatham and that was very unusual at the time. So he was very prudent. I think there is a huge gap around among healthcare professionals around money, both in terms of being educated and empowered.

[00:17:32] Sarah: Sometimes that’s because it’s just really bloody incomprehensible in terms of pensions. Um, but it’s also because it’s not part of how we are taught. And I know that on the GP training scheme, we try to give trainees a bit of an understanding as to funding and if you’re gonna work as a locum, what do you need to do? But I don’t think we are very financially literate as a group of people. And I think knowledge is power. And first of all, we need to understand what is money to us? And that sounds very meta and it is.

[00:18:05] Sarah: I know that when I was a partner, when our drawings, IE my pay packet were going down month on month, I got furious because to me that was my value. And in my head I was like, well, if I’m being paid the same as a salaried, but I’m absolutely slogging my guts out, I can’t be worth much. And I’d be looking very enviously and bitterly at my hospital consultant husband going he can earn more in an afternoon than I can all week, and I’m making myself ill to do it. So I had lots of stories around what money meant about my worth and my value. And I think that’s incredibly common as medics, and I think it’s, it’s something worth unpicking. What am I taking my pay packet to mean?

[00:18:57] Sarah: I think moving beyond that, there’s capitalism and the wider society that is telling us to hold certain beliefs. Success is having this kind of house, having this kind of holiday. You know, when I grew up in the eighties, people didn’t re, unless you were uber rich, people didn’t really go on holidays that much. You know, if you went to Brittany and you drove and you went on a P&O ferry overnight with all of the chainsmokers, know, that was your holiday and that was brilliant. Whereas now our, our expectations are we go on this number of holidays, we look at everybody else having their holidays, and we look at what they wear, what, we are buying stuff at a rate that is exponentially increasing.

[00:19:42] Sarah: So what it’s, it can be very hard to separate yourself from that. So that’s another one where there are people that have an agenda and they do influence what we feel and what we think in the same way as drug reps do, which is why we are encouraged not to, to have as much contact with them.

[00:19:59] Sarah: So it’s the what does money mean about me? What does society tell me I should own and therefore earn to own? How long should I be working for? And therefore, how long do I have, how much do I need to earn to have a retirement that I feel that I should have? And then what do your family think about you? These, again, these external views of others. You are a doctor, therefore you must be loaded. Um, I, I’ve certainly seen those thoughts, um, from other people. And it, it’s not a good look, is it when you go, oh, well actually no, it’s not as much as you think and poor me, dot, dot, dot, nobody wants to hear that from a doctor.

[00:20:40] Sarah: I think it’s very multifaceted and also that concept of the scarcity mindset around money, that there’s never enough to go around, um, so I better keep squirreling away and earning more and putting more in savings or putting it in a house or putting it in stocks and shares, because actually I have this tremendous fear that I’m not going to have enough.

[00:21:04] Rachel: gosh. There’s, there’s so much in that, Sarah. We did see a whole podcast on money, and in fact, we have done a podcast on money a, a while ago with, uh, Dr. Tommy Perkins from Medics Money. And if this is an interesting topic for you, we’ll put the link in the show notes. I, it drives people to go listen to that. And Medics Money are totally brilliant. Big shout out to them, big plug for them. They have loads and loads of financial advisors who can help you out. And, and Ed and Tommy themselves give really, really good advice.

[00:21:29] Rachel: For example, saving. If you just don’t spend that money, that’s better than earning it. Because if you just don’t spend 20 quid on, I don’t know that that takeaway, then what you’ve actually done is saved yourself 40 quid, or you know, 30 quid between 30, 40 quid if you’re on the high tax brackets or whatever. Whereas it would, it would, it would cost a lot more to earn that money from that. So I haven’t explained that very well, but you save 20 quid, that’s worth more than earning 20 quid is, is essentially what it is. And most of us could budget better. We just have no idea of what we got. We don’t dunno what our budget is and that’s very releasing.

[00:22:08] Rachel: I remember when me and my other half did a budget quite a long time ago, but just even knowing that it was okay to spend X amount on a haircut made me feel less guilty for doing that ’cause we’d budgeted it. Um, we actually need a lot less than we, than we’ve got. And I would say it’s worth having a, a better life day to day than flogging yourself for those occasional big holidays or expensive cars.

[00:22:32] Rachel: The other thing is as medics, we just don’t invest in ourselves. So since I’ve started doing the podcast, I’ve spent a lot of money on online courses and learning how to do stuff. I’ve probably spent at least 10,000 pounds in how do I do a podcast? How do I get it out to people? How do I create an online course? How do I learn about this, that, and the other? These things are expensive.

[00:22:53] Rachel: As medics we’re used to either having a, our mediocre courses slightly funded by our, by our organization, and we don’t put any money into doing that ourselves. And so the thought that we’ve got to retrain or, or do something at ourselves, we just think, oh, far too expensive, I can’t possibly do it yet. At a flash, we’ll buy a new car or, or go on this holiday. But you know what? I found that all the learning that I do and the courses I’ve invested in to upskill myself, not just have been worth it in terms of then career, but they’ve just been really enjoyable as well.

[00:23:23] Sarah: Yeah, I, I think that’s absolutely true, Rachel. And we often hear these stories from people who’ve been on this snazzy holiday and gone, oh yeah, but the kids still behaved like little grot bags and had a tummy bug on this day, and it wasn’t what I wanted it to be. And I think in terms of trying to think more broadly in terms of what it means for your life and the impact it has is fast forward to a future version of you. You know, what would, what would you in five or 10 years time say really matters about where you spent your time and money and energy right now?

[00:24:02] Sarah: And again, coming back to the knowledge is power thing, as medics, we love knowing new stuff, but we can have a real resistance to doing it about stuff outside medicine that doesn’t give us a certificate that says, well done you, you are clever or you are capable. Whereas actually around money and finances in general, knowledge is power. And there’s a lot of really good stuff around that you can look at in terms of helping you think differently about it and fundamentally change your experience of life because your relationship with money changes.

[00:24:37] Rachel: And I would say it’s really worth getting a good financial advisor, a good accountant, and they will help you work out what you need and what you’ve got. And also, you know, the great thing about medicine is you can still continue doing bits of the day job while you look at what else you want to do, either within medicine or or outside of medicine. And really think about all those hours you’re working unpaid anyway, to be on the various committees and this and that and the other. It, it, it, one thing you can do is actually work out what your average pay is per hour on what you’re currently doing. And then you’ll probably find that the thing you are aiming towards is probably pretty similar or even, or even better. And when you are working your ze of genius and you’re, and, and you’re just enjoying yourself more, you’ll, you’ll be more successful and that will have an impact on your income. Anyway.

[00:25:21] Sarah: Yes. I often find people go, well if I earn enough in this bit, I can do even more of the bit that I really love. And it’s that portfolio and just really being choiceful around where you spend that time and energy.

[00:25:35] Rachel: but we do this in every area of life, don’t we? You know, to just enable ourselves. And I, I like the idea behind thinking of it as a whole package. So there’s a bit unpaid for, but there’s a bit that I do as well. But that’s, that’s the whole package. It’s not that one’s worth more ’cause it’s paid more. It’s just, that’s enabling me to do this other thing as well.

[00:25:52] Rachel: Let’s move on to number three. Now, this was very interesting to me, Sarah. You said that when you coach doctors, you ask all of them to consider whether they might be neurodivergent.

[00:26:01] Sarah: I do now. That has been a big change in the last year. I think like you, I had a, a late diagnosis of ADHD and I recognize that there are, there’s one in five of us statistically, who in one way or another will be neurodivergent. And there are a broad range of what that means. Fundamentally, usually by the time you’ve got to being a doctor, it means that you have some capabilities, you have a lot of capacity, we have a lot of skills. And then they may get to a point where you feel like you don’t fit in, you are struggling mentally either because there are elements of the job that you just are physically and mentally finding it hard to do, or because actually it’s making you unwell, or it’s just not satisfying to you. And you feel different to the people around you because actually, you are different to, to some of the people around you. And people who are neurotypical will move through the world in a different way.

[00:27:04] Sarah: For example, if you have rejection sensitive dysphoria, you will really struggle with receiving feedback or perceived rejection and have very strong emotional reactions to things that other people might not. Um, you might not realize that’s what you have. I’ve realized recently I have, it’s another three letter acronym, PDA, persistent demand avoidance. If somebody tells me to do something, I’m bloody well not gonna do it. Even if I really want to do it. It’s very stubborn and bratty, and that can be a real blocker.

[00:27:39] Sarah: So these feelings that there are things that I find really hard to do that other people just seem to find easy. Why is that? And often when you’ve got to the point of going I’m really uncomfortable in my career. And that’s usually when they’re coming to see me. There’s a, there’s some stress point. I’m not happy. Part of the unpicking that I now ask everybody, look, this has been true for me. Is it at all possible that that could be going on for you? Because they might know, yes, that is, or they might go, I don’t know. But people have said, or I’ve always wondered if I might be autistic or I might have ADHD or dyslexia, dyspraxia. And I’ve certainly seen it in trainees as well, who have flown through the rest of their training, get to a certain type of exam and just fall apart and then have this huge shame spiral.

[00:28:31] Sarah: So it’s just woven through life. And I think given how many of us there are, it’s worth asking that question. And if it’s a, maybe looking into it. That the knowledge is power thing. What, okay, if I am, what, what does that mean? And it’s getting the information about where my, where my brain will be happy. You know, asking that question, what does your brain love? What do you do? And you get really fired up and excited about?

[00:29:00] Sarah: You know, Rachel and I met today and we hadn’t really planned what we are gonna talk about, but we love coming up with new ideas. And I had a just all these thoughts and important things that came outta my head, ’cause actually I love working that way. And other people would feel incredibly stressed and anxious and horrified by that. Um, but it’s working in a way that really feels comfortable and natural to you. And yeah, like your zone of genius, it’s understanding yourself better.

[00:29:27] Rachel: I think that’s so important. Yeah. And I do have podcasts, guests, and they’re like, I need all the questions in advance, otherwise I can’t possibly do a podcast. I’m like, that’s not really the way I work. It needs to be much more like a conversation, otherwise, it’s really boring.

[00:29:40] Rachel: However, I, I think asking that question, where is my brain happy and I love that. And yeah, I just do want to mention that I know some people do have slight antibodies ’cause there is maybe an overdiagnosis bandwagon, but maybe not. Maybe it’s just actually we’re all recognizing that we are all different. And rather than trying to, and I think the very first podcast we did, Sarah, was all about how to stop trying to fit a square peg into a round hole. And if you’re a square peg, let’s just understand your squareness and your peginess and what makes you tick.

[00:30:15] Rachel: Because for me with ADHD, and I know if you like, people probably roll their eyes and I do worry about people rolling their eyes going, here we go. Another person says they’ve got ADHD, but honestly, it’s made a huge difference understanding myself and going, what does suit me best?

[00:30:28] Rachel: And it’s not an excuse, it’s not an excuse for stuff, but it can be a reason for things. So I know now what strategies I need to put in to stop myself getting burnt out to work best for other people to get the best out of me. And it really, really, really, really, really helps. And other people don’t like diagnosis. They don’t like labels. I can imagine my husband rolling his eyes there at the PDA aspect of that. He’d be like, yeah, you’re just bloody minded, aren’t you? I’m like, well, you know, but if you get a model around it, if you just understand, okay, so this is then how I can make it better.

[00:31:01] Rachel: There was, uh, you know, in our business, my, um, my colleague, Sarah, there was a email I had to send with some summary of stuff and it just, it, it felt like a really painful task to do ’cause I had to go and look for things and get really into the detail. And she loves that sort of thing. I said, Sarah, can you just help me? She did. She did it. She summarized it. I was able to look at it and go, that is so good. She’s like, I really like doing that Rachel. I’m like, really? Do you? But she’s brilliant at that and I’m brilliant at other stuff. And just recognizing that is part of the battle.

[00:31:31] Rachel: And if you do recognize that your brain works in certain ways, you’re happy doing certain stuff and that the current role you’re in, you’re doing more of the stuff that doesn’t work for you and less of the stuff that does, why on earth wouldn’t you change it for yourself? You’re gonna be so much happier. Life will just feel more easy and more joyful. So there’s no shame in this. It’s just about self-awareness and, and understanding.

[00:31:55] Sarah: I think I shared that I was feeling really grumpy and fed up over the summer with one of my roles. And I was c chunking away to my colleagues and thinking, do I really wanna stay in this role? And, and I said to my colleagues, look, oh we need more help, we don’t have enough admin support. I was feeling like a victim in the drama triangle. And they said, oh, actually we, that doesn’t bother us. We actually really enjoy that bit. And I went, oh. It’s me, it’s a me thing, And I am not a good fit with this role because I’m not doing it well and I’m hating it, um, and so it’s taking up far too much of my brain. And so I asked to move and I created myself a role that did matter to me and that I am good at and that I feel really passionate about. So yeah, I absolutely believe in that.

[00:32:45] Sarah: And I think, yeah, you don’t have to have a label. It’s more understanding how your operating system works. It’s then entirely up to you what you do with it. Obviously if you do go down diagnosis route and you want to, then there’s a whole tre of support that’s available and there’s access to work, you can have some coaching around it, you can get gadgets and various strategies to help you. Um, but fundamentally it’s working out what’s going on for you right now and why are you struggling in certain areas?

[00:33:17] Sarah: And if it just doesn’t make sense, I cannot work out why I’m so disproportionately angry about doing a bit of the job that involves spreadsheets. I’m a clever person, but I’m absolutely bloody awful at spreadsheets and I hate them, and they give me an absolute fear. They give me a deep-seated gut fear because I just know that I have a panic and I get, get things wrong. So it’s Yeah. Giving you the tools to go Yeah, what shape am I and can I move towards a place where I can, I can use my wonderful, wonderfully shaped form.

[00:33:54] Rachel: Yeah. I love the idea of operating system, like what operating system is my brain running on because i’ll, I’ll soon. Definitely suit different jobs to, you know, this one I’m sure if, if anyone can email in and tell us some different operating systems that we could use as a metaphor, that would be really helpful.

[00:34:08] Rachel: Um, you mentioned about when you are doing the wrong thing or the ring that the thing that doesn’t suit you, it, you know, you start chuntering, you start swear whatever. I do as well, but eventually it just wears you down. And I think that can be a real cause of burnout actually, that we don’t talk about a lot.

[00:34:24] Rachel: I think if you are neurodivergent and you are in a role which is constantly working against your operating system, you can feel very burned and then it’s very difficult to make a decision about your work. And I think this applies to anybody who is in burnout for whatever reason. Um, and I know when I’ve had coachees who have come for career coaching and things, it’s very hard for them to make any decisions when they are in that place of absolute exhaustion. And actually what often happens is they come, they, they weep their way through the first session. They then realize they need to be off sick, they take a few months off, and then they’re in a much better position to move forward. Is that your experience too?

[00:35:04] Sarah: It utterly is at the moment, Rachel, and actually I, it’s another thing that I’m starting to ask before I even talk to people, because unfortunately, I think the medical environment that we’re in at the moment and societal influences are that more people are burnt out than ever is my perception. And you often do you not know how burnt out you are. So I see people and they’re like, no, no, no, I’m, I’m okay. I’m a bit unhappy, but I’m, I’m okay. And by the time you get to sort of session two or three, they go, oh, actually I’m really crispy, burnt out, and I need a break.

[00:35:40] Sarah: And, and, but people don’t want to believe it. They don’t. It’s that whole mental health stigma aspect. And yes, there’s definitely evidence if you’re neurodivergent you are more likely to have burnout and anxiety and depression. Um, that, that’s, there are plentiful evidence around that. Um, partly because you are working in a system that isn’t set up for you.

[00:36:03] Sarah: So in terms of burnout, yes, if you are burnt out to any degree at all, and by the time you realize it or acknowledge it or even want to consider it, you’re probably much worse than you thought you were. Your brain just doesn’t work properly because you are, you are not using that prefrontal cortex that lets you think clearly make decisions, have compassion for yourself or others, um, your short term memory, you’re, you’re functioning from your primitive lizard brain that is all in amygdala hijack. You’re in fight, flight, freeze fawn. So it’s really difficult to diagnose yourself.

[00:36:40] Sarah: So this is where talking to somebody else is really crucial. And I might be that first person or it might be that other people have have brought it up. But I certainly mention it at appraisal, and I do think certainly. That’s becoming more overt as a thing that we’re meant to talk about, you know, GMC duties of a doctor. There’s a whole section on wellbeing now and your responsibilities to look after yourself, so it’s a little bit more sanctioned, and I think that’s a post pandemic positive.

[00:37:11] Sarah: But you can’t avoid the fact that burnout will stop you from making changes and moving away from what’s burning you. And it’s, it’s a really difficult one. It’s, it’s one of these cycles that can be very difficult to break on your own.

[00:37:25] Rachel: because I think what does happen in burnout, you start to blame yourself. Why can’t I cope? I’m not good enough. And like you said, your amygdala is triggered and your decision making goes. I’ve also seen not just you find it difficult to move away, you also become very black and white in your thinking. We, we know that, um, when you are stressed, got high cortisol, and then it’s very hard to make any positive decisions. Sometimes you just make very black and white decisions, right, that’s it. I’m leaving completely or I’m completely moving away from that. I’m just completely leaving that, rather than moving towards something that, that’s more positive.

[00:38:00] Rachel: And I think making decisions from a place of burnout is quite, is quite dangerous because I think you do end up throwing the baby out with a bath water and not being able to sit. Um, so many metaphors here. You can’t see the word for the trees, So it’s very hard to decide what, which bit the job is, the bit that actually doesn’t suit you and which bit does suit you, it’s just too much of it, which, so you’ve got burnt out. So you need to get into a place where you are rested, where you can, you can think clearly.

[00:38:26] Rachel: And just a big plug for doing this before you get to the place of burnouts. Because if you wait until you are really so far down the line that your brain is not working properly and you are, you, you’ve burnt out your hypothalamic pituitary cortex, it’s gonna take a lot longer, it’s gonna be a lot harder.

[00:38:43] Rachel: Um, and one thing we’ve realized, Sarah, is there is just nothing between someone identifying that they’re stressed and going off sick with burnout. So if you think about the stress curve, you know, you start to slip the pressure performance curve as the pressure increase, as you start to slip down the curve. And the amount of people that contacted us and said I went to my GP, or I went to occupational health, and they said they could, I, ’cause I said I was feeling stressed, I was feeling overwhelmed, they said they could sign me off. That’s all they could do right now. And they couldn’t actually do anything till I was off sick with burnout. Once I was off sick with burnout, then they’ve got things that could help me. They’ve got therapists and stuff like that, but I don’t wanna go off sick because I’m not at that point yet. What do I do? What do I do in between? And that is where I think our Shapes Toolkit comes in. It’s the stuff that will just help you get back up the curve before you get to that point of, of burnouts.

[00:39:31] Rachel: Um, one of the things we’re, we’ve got is our Beat Stress and Thrive online course, which people can do that just takes you through prioritizing, managing your time, managing your workload, working what’s in your control, what’s outside of your control, getting out the drama triangle, being able to design a working life that you’re gonna love. So we take you through all this stuff. You can do it online. Interestingly, we are also gonna be putting on some dates where people can come and do it live with us for a day. So we’re site some Beat Stress and Thrive Live days. So in person, in person is back, which I’m really pleased about. And we are gonna do these beat Stress and Thrive days so you can come do the course with us, get through the whole course in a day, and you’ll also get the access to the online course.

[00:40:08] Rachel: And also we are gonna run days with different. Flavors. So we’re gonna do one for people that have found they’ve got burnout on repeat. So we’re gonna look at the course and think, really, how do we avoid burnout on repeat?

[00:40:19] Rachel: And, and this is why this is, this conversation has reminded me, I’m really keen to run a beat Stress and thrive live day for people with ADHD for doctors with ADHD because I think they were strategies I’ve learned, they’re all in the beat, stress and thrive course, but also they’re ones that particularly apply and we can really dig down into those strategies.

[00:40:35] Rachel: So we’ll have those links in the show notes if you wanna book on, please come. There’ll be very limited number of places. If people like them, we’ll, uh, we’ll put on some more. So that’s just a, a quick plug for that. But really, if you recognize you are starting to go down the line of burnout, please, please, please just do something about it, get some help, get some coaching, do something. Really pay attention to your wellbeing, ’cause it’s much harder to treat once you are, once you’re down there.

[00:40:58] Sarah: There are also some organizations, some departments that are toxic and don’t have the capacity to change. And sometimes you, sometimes there are will be, and I want to hold a space for and compassion for people that feel actually there aren’t things that can change it, I just need to leave and go. Um, and we are trying to say, look if you can, but there are some places where even if you change stuff, it’s not a place that you can be happy and thrive. And, and I want to acknowledge that and kind of bring it out because we know that there are departments where the organizational culture is toxic or where the culture is one of bullying and scapegoating, so it’s important to acknowledge that there will be some of those as well. And if that is the case, there are lots of areas of support in terms of whistle blowing, freedom to speak up leaders that you can contact.

[00:41:59] Rachel: I hundred percent agree. I remember one of my appraisals, um, I said to my appraiser, oh, I just think I’m in, in the wrong job. And they, it to me said, no, you’re not. You’re in the wrong practice. And I hadn’t even thought. The penny dropped. Literally, it was like a weight lifted off my shoulder and bizarrely the next day I was in my office at work, someone came in, the GP came in, this was at the university, I said You don’t have any jobs going at your practice, do you? And they said, yeah, we do, closing dates tonight. Send us your cv. And I got another job the next day. And you know what? It was the best thing ever.

[00:42:31] Rachel: So I think there’ll be a lot of people who are listening to this that are soldiering on in departments or practices that are toxic and they’ve tried to change things. But let’s face it, if, if it’s coming from the top down and there are some really toxic leaders out there, you have very little control over that. And there is no shame in saying, this doesn’t work for me. This pot, this pan I’m in is not working and going to a different pan. Believe me, there’s no shame in that. In fact, that is the wise thing to do.

[00:42:57] Rachel: So Sarah and I giving you permission guys, if you are in a really toxic place. You have tried stuff and it’s not worked, you, you need to give yourself permission to go somewhere else. Um, because if you are just absorbing it, absorbing it, absorbing it, then, then you are allowing it to happen, aren’t you? You’re just allowing things to carry on how they are.

[00:43:16] Sarah: And one thing I would add is that a question I get asked a lot is, oh, well, how will it look on my CV? And this was a worry that people have always had, and I think this is from our parents’ generation. There used to be this perception that you have to have a completely full line of, I’ve always been working and I need to justify all of my moves.

[00:43:39] Sarah: I don’t think we’re in that generation anymore. And certainly our children’s generation looking at, am I even gonna consider going to university? The things that we took as a definite are no longer the case. And I think certainly from when I’ve been on recruitment panels, when I’ve looked at CVs, when I’ve talked to people, what you really want to know is, okay, what’s this person like? Are they a good egg? Are they nice to work with? What have they done? And also, if you have moved, why? And it’s completely valid to say, I moved because actually it wasn’t the right fit for me. The organizational culture didn’t chime with my values. Often places will have a reputation, if that’s the case, I’m giving an example. There’ll be lots of other ways of work. You’re going, actually, I felt there might be somewhere that could play to my strengths better. And so sometimes I work within that. How do we. How do we look at what experiences you do have and reframe it? Because I don’t think it’s a blocker now having a gap on your CV or having moved. I would see that as a real positive because people have identified I know better. I know where I’m gonna be happiest.

[00:44:46] Sarah: Because if I’m working with a colleague, I want to be happy. I want them to be at their best. I don’t want them to be there feeling miserable, performing less well. We’ve all seen people peri-retirement who’ve mentally clocked out. I don’t wanna be like that, and I don’t want my colleagues to be like that. We want someone who’s happy and healthy and passionate. So yes, it’s okay to move and it’s okay to have CV gaps.

[00:45:10] Rachel: I mean, it’s weird. Why in medicine do we think we should be in the same place for 30 years? It’s bizarre ’cause it, it can’t be good. You know, you, you see people that train somewhere. They got the, um, they were in medical school, then they got their house jobs and they went to registrar, then they got consult, they’ve never been anywhere else. But if you’ve gone to different hospitals or different practice, you know how things are done in different places, you can cross pollinate. So helpful.

[00:45:32] Rachel: My behalf is not a medic. He moved jobs every three to five years. Um, ’cause that’s the way he got promoted and, and worked in different, different places. So, you know what, I, I would, you know, if I was looking at someone’s CV and they’d worked for somewhere for 20 years and then said, oh yeah, I moved because really the culture was banned. I’m thinking, well, well how 20 years? And then you, you know, why didn’t you move earlier? That’s just bonkers, isn’t it?

[00:45:53] Rachel: So, yeah, I think that’s a really good point. As long as you can say why and what happened. Or even, yeah, I took six months out to go traveling or to do a course or do something different. Or even if you are unwell, say it, right?

[00:46:04] Sarah: Yeah, it’s also a jumping off point to go okay. If I wasn’t here. What would my new choices and options be? You know, I’ve realized there are loads of people that go, oh, well I’ve, I’ve actually always had a real interest in minor surgery, but they told me there would be a list that I could do, but actually there’s no space for that. So I’m gonna move where I can do that because I really want to do that. Or where there’s space for me to learn a new skill. ’cause I really love learning new things and I’d like to be a trainer, or I’d like to become a specialist in X, Y, Z. So it opens up those opportunities again.

[00:46:38] Rachel: And um, I’m just gonna flag up for some listeners. I know that the job situation is getting harder out there at the moment, um, for GPs and for hospital doctors. So I just want to acknowledge that to people. But I still think, or, and I still think you need to choose somewhere that suits you and don’t rush into the first job just ’cause it’s, it’s there. You would be better taking your time doing locum positions and finding the right fit rather than sort of burning out in a job that you really don’t like because of a worry about scarcity of, of, of jobs and, and things like that.

[00:47:11] Rachel: Finally, Sarah, you told me earlier that one of the blockers is that people just don’t know what they don’t know. What do you mean by that?

[00:47:19] Sarah: What I mean is people feel that they have to know. What they’re gonna move to if they do move or what they can change. So they have this feeling of discomfort, distress, lack of satisfaction going I don’t like what I’m doing now. Or There are elements to what I’m doing that I don’t like, but they don’t know what could also be true.

[00:47:41] Sarah: Now that could be, if you’re changing jobs entirely, what are all the possibilities? And look, nobody knows what all the possibilities are. I often get people going, oh look, you are a GP and you’ve been around the block a fair bit. You are gonna know lots of stuff that you could tell me all the possibilities if I leave this. And I absolutely couldn’t. I could give you a fair list, but I would never come up with everything that you could do. So it’s the, you know, not wanting to let go of a branch before you identified which branch you’re gonna swing to next.

[00:48:13] Sarah: And I, I think getting comfortable with it. You might not know what that is, but what are the ways of starting to know or finding out what are the possibilities? And I know you and I have lots of examples of this ’cause we’re quite nosy people. We Love speaking to different people. And I’m often going, oh, I wonder if I could do that. I went to a talk by a sleep disorder specialist, and at the end I said, oh, do you ever have GPs working in your service because it sounds like that. would be really interesting. He said, no, we don’t, but I think we should. And I was like, oh, maybe I should do that. And I went, Sarah, you’ve already got seven jobs, pipe down.

[00:48:51] Sarah: But it’s, it’s starting to open your eyes up to where possibilities can be and things that sound interesting and could be something that you might enjoy doing. And that’s starting to cast the net.

[00:49:06] Rachel: When I think back to sort of my career change and everything that I’ve done in my career as a portfolio GP, as a specialist medicaid education, then as an executive coach, trainer, podcaster, and now what I mainly do is podcasting, keynote talks, online courses, um, uh, with a bit of training. There’s no way I could have predicted what I was moving into. And I think if I had and, and stuck to it, I would not be where I am now.

[00:49:33] Rachel: And I’m really pleased that I didn’t, I didn’t know. It’s been really hard work. It’s been really tough. And I think if I knew then what I knew now, not sure whether I’d have done it or not. But it’s the journey and part of the pleasure is finding out along the way and trying out stuff. So it’s really, really hard to know where you’re gonna end up. And also it’s gonna hard be hard to know what you enjoy doing it until you’ve tried doing it as well.

[00:49:56] Rachel: So you need to know, sort of know vaguely what you like and what you enjoy. And that’s why coaching does help with your strengths and, and just being able to take some time out to work it out, but, but yeah, embrace the uncertainty, embrace the unknown, and go get curious and find out. I think getting curious for me is, is, is really important.

[00:50:15] Rachel: And sometimes you just need to try roles out. Like the role you were trying out with your, with your TPD hat on that you really hated and you’d just given to somebody else. Right. I bet you didn’t think when you took that on. I’m gonna absolutely hate this. You probably thought, oh, that would be interesting.

[00:50:28] Sarah: Absolutely. And there were bits about it that I was completely passionate about and I went, this is a great fit for me because actually I really care about this aspect. But the performance of the role was very different to what the role was aiming to do, and I hated the performance of the role. So yeah, I couldn’t know. And there are so many different things that I’ve tried along the way. And just acknowledging it’s really uncomfortable for medics. We are so used to a clear path and we get really comfortable in it, and there’s a real, um, lack of anxiety because it’s a known thing. Even if you don’t really want to get there, i’d rather do the known thing than the unknown thing, because actually it’s, it can, it’s terrifying. What does that look like? What will I have to do? I, there are skills that I don’t even know that I’m going to need.

[00:51:22] Sarah: And that can feel so weird for us because we’ve been working in a system that has these sort of ploughed pathways that we just follow and it has, doesn’t involve much brain or risk or heart, ’cause you go, oh, well here are all the pathways. I’ll just choose one of them. And plump for the one that seems the least worst sometimes. Um, I’ll rule out this, this, this, and this, and what I’m left with. Okay, that’s my choice.

[00:51:48] Sarah: But actually, it’s incredibly powerful going, look at all the choices you have and what might I choose to move towards in this, in this journey of moving away from an area where I’m not happy? But that’s quite confronting for some of us to sit in. You know, gestalt going back to 70s psychology calls it the Fertile Void.

[00:52:12] Sarah: And we, I often talk with my coaching clients, you know, the literal zone, what is that tidal zone between one space and another. And really sitting in that discomfort and trying not to move away from it too quickly, because you know, that whole nature abhors a vacuum, okay, right, I’m not doing this anymore, what can I fill it with? Quick, quick, quick, ’cause it doesn’t feel good. But actually that’s where you allow yourself to go, okay, well what if this, and, and develop a little bit of a template for yourself, for what, what a potential yes or a maybe might be, a sort of enthusiastic, maybe rather than a hell Yeah. In some cases. And sometimes you’ve just gotta give it a go and give yourself permission to go this might not be the answer. In the same way as I’ve tried something before and it wasn’t the end zone for me, I might buy an outfit and think it’s gonna look amazing. Actually, I never wear it ’cause I don’t have the opportunities. That’s okay. Um, and just trying to hold it a bit more lightly and we’re not used to that as medics.

[00:53:17] Rachel: Sarah, there’s been so much in that. Thank you. In fact, I’ve been writing down some questions that we can ask ourselves to go through these things. So, um, number one, the thing about other people’s agendas, asking well, what would somebody advise you who had your true best interest at heart? What would they advise you? Um, in terms of the money thing, it’s what do I actually need and what have I actually got? Uh, in terms of the neurodiversity, neurodivergence thing, it’s like, where is my brain most happy? Number four, firstly, just ask yourself, am I burned out? How far down that curve am I and how can I get up to the top of the curve back to, you know, feeling myself before I make any rash decisions? Um, and then finally that question, um, what can I say in enthusiastic maybe to, and how can I stay in that? I love that title zone, the space between one thing and another,.

[00:54:08] Rachel: And I’m just reflecting in my life and everything I do, there’s always a title zone somewhere. I’ve never completely got to where I think I’m gonna get to ’cause we’re always just trying stuff out. And maybe that’s easier when you do your own thing in a bit more of a creative industry than, than yeah. Like career path on medicine. But I have found that every role I’ve taken on has led to another role. And it’s, even if that role didn’t work particularly well, it’s been a good stepping stone to somewhere else. So you just never know what’s coming up until you’ve tried, do you?

[00:54:38] Sarah: I think that’s a great summary. I think stepping aside from those questions, the overarching thing is helping you look at where you’re at from a, a different viewpoint, stepping back and going, what’s really the case and what could be the case, if I allowed myself to really try to thrive?

[00:54:59] Rachel: I think that’s a good place to leave it then, isn’t it, Sarah? If people wanted to get hold of you, how can they do that?

[00:55:05] Sarah: they can find me at my website, which is drsarahgoulding.com. Goulding with a U, and I’m on Instagram and LinkedIn as the same, but I’ve got to be honest, I don’t use them loads.

[00:55:18] Rachel: Great. And if anyone wants to know more about our Beat Stress and Thrive course, we’ll put the links in the show notes. Um, we also have a Leapfrog career retreat day for people in their mid to late careers who really want to just pause and think things through.

[00:55:33] Rachel: But if you think you may have any degree of burnout, then do start with Beat Stress and Thrive. Start with, you know, getting yourself sorted so you can make a decision from a place of wisdom, from a place of that deep knowing and, and being relaxed rather than just needing to abandon ship and get out of there at any cost. So, Sarah, we’ll have you back at some point if that’s okay.

[00:55:54] Sarah: Definitely.

[00:55:55] Rachel: Brilliant. Thank you. Speak soon.

[00:55:57] Rachel: Thanks for listening. Don’t forget, you can get extra bonus episodes and audio courses along with unlimited access to our library of videos and CPD workbooks by joining FrogXtra and FrogXtra Gold, our memberships to help busy professionals like you beat burnout and work happier. Find out more at youarenotafrog.com/members.