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Succeeding as

 

'Trust one who has gone through it'
Virgil, The Aeneid – Roman epic poet (70 BC-19 BC)

One of the most popular sections in the Succeeding as a Hospital Doctor title is the colourful and diverse advice provided by leading lights who share the secrets of their success in medicine. 

Whatever your own definition of success is, we hope you will enjoy the secrets shared by those who have made it to the very top of medicine. Come and visit any time for a quick dose of inspiration and tried-and-tested guidance.

We also welcome your recommendations at feedback@fastfacts.com for new leaders to invite to contribute.

 

Professor Dame Carol BlackProfessor Dame Carol Black
DBE MD FRCP MACP FMedSci

Principal, Newnham College, Cambridge; Adviser on Health and Work to the Department of Health and Public Health England; Chairman, Nuffield Trust

May 2015

‘And the true success is labour’, wrote Robert Louis Stevenson, a better remark by far, I think, than his more often recalled preceding line ‘To travel hopefully is a better thing than to arrive’. 

There is no easy way to worthwhile achievement, to success. It needs belief, persistence and the care to do things well. To do things better calls for determination and endurance.

To change things means facing opposition with conviction, honesty, courage and stubbornness … with the willingness to be proved wrong

As Don Berwick, founder and former president of the Institute for Healthcare Improvement, reminded us, without change there is no improvement. But to bring about improvement, to change things, means carrying others with you. It means facing resistance and opposition with conviction, honesty, courage and stubbornness, yet with the willingness, however reluctant, to be proved wrong, or even to fail.

These private and public qualities, I suggest, measure Stevenson’s idea of success as labour. Without them, is there any real success?

Success for a doctor is favored by chance. Chance brings the insights offered by each clinical encounter; the fresh keen observations of able students and their disarming questions; the unexpected or unforeseen experimental result, or the discomforting challenge from non-clinicians with different perspectives, different responsibilities and other priorities.

Success neither can be, nor should be, a solitary experience

For the hospital doctor, success neither can be, nor should it be, a solitary experience. Ours is a corporate business, though I prefer the term ‘collegiate’, with its sense of a wide-reaching shared enterprise securely anchored by a professionalism for which sustenance and improvement are measures of success that really matter.

 

Professor Michael Baum, retired breast cancer surgeonProfessor Michael Baum
MB ChB FRCS ChM MD(hon) FRCR(hon)

Retired breast cancer surgeon,
Emeritus Professor of Surgery and Visiting Professor of Medical Humanities, University College London; cofounder of HealthWatch

November 2014

“Moderation is a fatal thing. Nothing succeeds like excess.”
Oscar Wilde

Echoing Oscar Wilde’s words, I have never been a moderate and have done everything to excess. I inherited a work ethic from my mother, which denied me the luxury of idleness, and a passion for reading from my father, so that my nose was always in a book. I learnt the spirit of enquiry from my older brothers, so I always questioned everything that others considered received wisdom.

Driven by this rich and toxic brew I worked and studied in excess, published in excess, and argued and debated in excess. I pushed myself to the point where I suffered burn out and acute depression.

Learning from that bleak experience, I tempered my zeal and made time for other passions such as painting, literature, creative writing, theatre and walking. Yet I never compromised my scientific integrity and continued to battle against quackery, standing up against the proponents of alternative medicine even at the cost of offending people of high rank in our society.

There are many strata to my identity by which I may be judged as a success. The fact that I have been married for nearly 50 years and have three successful and happily married children and nine delightful grandchildren, who gather as a clan on a regular basis, might be considered a token of my success as pater familias.

Never compromise on scientific integrity but never forget the humane role of the doctor

My family has been the bedrock upon which I’ve built what others may judge as a successful career as a clinical academic and surgeon. In the end, I achieved balance by combining my pursuit of evidence-based medicine with the teaching of medical humanities. That balance, I hope, is the lesson I might pass on to future generations.
 

Mr Henry MarshMr Henry Marsh
CBE MA MB BS FRCS

Senior Consultant Neurosurgeon,
St George’s Hospital, London; Professor of Neurosurgery, University of Washington, Seattle, Washington, USA
 
July 2014

I don’t think there is any great secret to being successful – it is a matter of luck and hard work, and I suspect most of us underestimate the importance of good luck in our lives. It helps, however, if you love your work, so that you work hard for the sake of the work itself rather than just because you want to be successful. I think doctors are at a great advantage over others in this respect. I remain deeply in love with neurosurgery, even though it can sometimes be very depressing.

We learn most from our mistakes, and it is important that we are honest with ourselves (if not with others) in recognizing when we have made a mistake. Honesty is the most important surgical virtue and complacency the greatest sin.

Other people are usually better at identifying our mistakes than we are, so having good colleagues with whom one can openly discuss problems is of immense importance.

It is also important to see what is happening in other medical departments, hospitals and countries and to appreciate that there are many different ways of solving problems, and better ways of doing things.

I genuinely have no idea as to whether I have been truly successful or not. I have always had a well-developed sense of failure, and when I look back on my life I see as much failure as success. The important thing is to carry on trying to do whatever one is doing as well as possible.

Mr Marsh is author of Do No Harm: Stories of Life, Death and Brain Surgery

 

Roger S Kirby

TUF cycling challenge,
South Africa 2013

Professor Roger S Kirby
MA MD FRCS(Urol) FEBU

Professor of Urology; Prostate Surgeon; Director, The Prostate Centre, London, UK

January 2014

Success in medicine is really all about developing and maintaining a good reputation with patients, colleagues, friends and family. That is not always easy to achieve, as we live in a society that tends to forget the thousands of things you have done well and damns you for a single mistake!

The first rule is to doggedly follow your dream: do not be lured off course by the ‘sirens’ of money, fame or power. Focus on strategic thinking, consistent hard work and achievable goals and avoid the pitfalls that lie in wait for the unwary.

Remember, you communicate with your body language as much as with the words you utter

Good communication skills, acquired by thoughtful application and practice, are a prerequisite for the successful doctor. Verbal communication that not only transmits empathy and understanding of your patients’ problems, but also displays a keen interest in your colleagues’ interests and careers, is paramount. Remember though that you communicate with your body language just as much as with the words you utter.

Clear, concise written communication in peer-reviewed journals enables you to build an impressive curriculum vitae; books, chapters and non-peer-reviewed publications are also an important part of your written output. However, always be prepared to stand behind every word that you write: remember, it can never be retracted!

Doggedly follow your dream: do not be lured off course by money, fame or power

Always be true to yourself and consistent, kind and straightforward with your patients and all those around you. Remember that your friends and family are your bedrock of support when times at work get hard, as they occasionally will.

Personally, I have loved every minute of my career in surgery, especially the challenges of learning how to use the da Vinci robot and setting up and running The Prostate Centre in central London as a centre of excellence outside the NHS. Equally, I have enjoyed growing and developing two charities that I have been closely involved with: Prostate Cancer UK and The Urology Foundation. 

Which brings me to the final rule: think with the end in mind. At your retirement you want to look back on your career with pride and a sense of genuine achievement. I can honestly say that I wouldn’t have changed my career in medicine for the world. That is what success is really all about.

Professor Kirby is author of Fast Facts: Benign Prostatic Hyperplasia, 7th edition and Fast Facts: Prostate Cancer, 8th edition, and editor of Succeeding as a Hospital Doctor, 3rd edition.

 

Professor Hugh Montgomery
MB BS BSc FRCP MD FRGS FRI FFICM 

Professor of Intensive Care Medicine, University College London; Director, UCL Institute for Human Health and Performance; Consultant Intensivist, Whittington Hospital; Greater London Authority ‘London Leader’ in sustainability

November 2013

In my medical career I recognize that the number of lives I may have saved is tiny when compared to the impact an economist or politician can make, but there has been success. One is to have met such extraordinary people (professors, patients, colleagues).

I increasingly devote time to matters of global health rather than just biology

Another is the learning – not just the facts, but about where one has gone wrong. It is for such reasons that I increasingly devote time to matters of global health rather than just biology.

I have also succeeded in having fun: being allowed to think for a living (as is the case for an academic) is a true joy, whilst working in a University such as UCL, that encourages (more than just tolerates) mavericks, is refreshing.

The best ideas often come from areas totally outside your own

So what have I learned about reaching goals? Work hard. The widely attributed quote, 'The harder I work, the luckier I get' is true. Don't be afraid to set a course – but equally, be prepared to go with the grain; sometimes cutting across it just gives you splinters! Take opportunites when they arise and, in general, set your default option to 'yes'

Don't silo: the best ideas often come from areas totally outside your own. Avoid negative people: their misery infects like plague. And try to think, 'Now, isn't that interesting,' at least once a day.

 

Dr Paul Lambden, medicolegal specialist

Dr Paul Lambden
BSc MB BS BDS
 FDSRCS MRCS DRCOG MHSM

 
GP and Medicolegal Specialist; Previously Chief Executive of East Hertfordshire NHS Trust and Specialist Advisor to the Government's
Parliamentary All-Party Health Select Committee
 
October 2013
Train, retrain and then train some more!

My suggestions for achieving success are:

  • Always take opportunities when they present
  • “Put your heart, mind and soul into even your smallest acts” – words borrowed from Swami Sivananda, the Indian spiritualist and physician
  • “Success does not consist of never making mistakes but in never making the same one a second time” – advice from George Bernard Shaw.

All simple but true.

Perhaps by the measure of most I would not be seen as an outstanding success, but I have had a happy family life, children of whom I am proud, a series of professional roles that I have enjoyed, sufficient income and great friends. Academically, I agree wholeheartedly with Samuel Goldwyn who said “the harder I work, the luckier I get”. Certainly, I made up for not being particularly bright by putting in many hours of laborious learning.

Doctors need considerable help to manage the distress and loss of confidence that comes with censure

I hope that I have achieved some small successes through my work as a doctor and as a dentist, as an NHS Trust Chief Executive, and now through the pastoral care I provide as part of my medicolegal support for doctors and other clinicians confronted by complaints and claims from patients. Clinicians invariably do their best to provide the care that their patients need, yet they are increasingly the subject of criticism. These days, complainants are egged on by the media, advertising by no-win no-fee lawyers and even the NHS, which encourages complaining.

Doctors need considerable help to answer often baseless allegations and to manage the distress and loss of confidence which comes with such censure. I consider it some measure of success to have been providing such support for many years.
 

Professor The Baroness Ilora Finlay Professor The Baroness Ilora Finlay of Llandaff
of Llandaff FRCP FRCGP

Professor of Palliative Medicine, Cardiff University; Independent Crossbench Member of The House of Lords; Vice-President, Marie Curie Cancer Care; Consultant, Velindre Cancer Centre, Whitchurch, Cardiff

From Succeeding as a Hospital Doctor, 3rd edn (2007)

There is a Japanese saying, ‘Success is fall down seven times, get up eight times’. My career path has not been straightforward, and indeed the specialty of palliative medicine did not exist when I first became involved full time in caring for the terminally ill. But if you are motivated in your work, believe in what you are doing and ensure that you approach the subject with an open mind and constantly learn, then you can develop as a doctor and contribute to the society around you.

There are no shortcuts or alternatives to hard work

Medicine is a constantly changing and expanding field, throwing up research questions faster than they can be answered. In our rapidly changing society those who are ill can feel vulnerable, frightened and undervalued as people. In providing care it is always worth thinking how you yourself would like to be cared for and remembering that attention to detail is crucial in ensuring that the patient as a person, as well as the patient’s disease, is treated appropriately.

And the day that you become hardened to the plight of patients is the day to retire.

 

Professor Sir Michael RawlinsProfessor Sir Michael Rawlins, Chair of NICE (1999-2013) 
BSc MD FRCP FFPM FMedSci

Chairman, National Institute for Health and Clinical Excellence (19992013)
 
From Succeeding as a Hospital Doctor, 3rd edn (2007)

I am not entirely sure what success is about; I am not at all sure that I have been a successful hospital doctor. Nevertheless, if professional success is about anything, it is about fulfilment. It is not about honours, titles and merit awards which are as much concerned with luck as anything else, but about deriving the greatest satisfaction from giving all patients (especially the nasty ones) the highest attainable standards of clinical care.

There are a number of essential ingredients to success, learned painfully over a long period of time, to which I aspire. 

  • Humility. Never be too proud to ask colleagues for help or advice.
  • Hard work. Nothing useful is achieved without effort. Success will not come from keeping ‘office hours’. Don’t get too upset if you are described as a ‘workaholic’.
  • Humanism. One day you, too, will be a patient, so treat all patients (even the unpleasant ones) as you would wish to be treated yourself.
  • Humour. Interject, at appropriate times, a little levity.
  • Honesty. When you make a mistake (as we all do), at least admit it – if only to yourself. But to really succeed, you must also be prepared to say you are sorry!
  • Honour. Respect and cherish those who work with and for you. Never abuse your position, or their trust, by bullying or humiliating them.
  • Hours. Make sure you spend some time away from work with your family and friends. And give yourself ‘thinking time’ as you mow the lawn, paint the kitchen, clean the car or drive to work. It is in those situations that you be at your most creative.

 

Professor Sir Peter Morris Professor Sir Peter Morris
AC FRS FMedSci FRCP FRCS

Nuffield Professor of Surgery, Emeritus, University of Oxford; Director, Centre for Evidence in Transplantation, Royal College of Surgeons; President, Royal College of Surgeons of England (2001–2004)

From Succeeding as a Hospital Doctor, 2nd edn (2002)

One should not equate success in medicine as the achievement of high positions in academic medicine or hospital medicine, as this so often is a matter  of pure chance and a question of being in the right place at the right time! Personally, I feel that success has been achieved if you are content with your lot and enjoy it for a good part of the time.

I have always considered myself fortunate to have been in an occupation which, in general, I have enjoyed most of the time. However, I have to say that working in the NHS has become increasingly frustrating over the past 10 years, and maintaining an air of content for a job well done has been increasingly difficult. Nevertheless, I remain an optimist that hospital medicine in the UK will become a more pleasurable experience once again.

"... you do need to like people!"

Furthermore, to be a successful doctor you do not need to be a rocket scientist, but you do need to like people! Sounds rather trite, I know, but entry to medical school does not take ability to engage in satisfactory personal interactions into account, and certainly inability to communicate with patients or indeed colleagues remains a significant problem in medicine, as emphasized in the Kennedy report on the Bristol affair.

A successful doctor will regard his patients as his equal and interact with them on that basis. If you practise medicine in this way, regardless of your special interest, it will remain one of the most rewarding jobs anyone could pursue, and furthermore you will make a lot of friends along the way.

 

Professor David G. Borenstein
MD FACR MACP

Clinical Professor of Medicine, The George Washington University Medical Center; Partner, Arthritis and Rheumatism Associates, Washington, DC; Past-President, American College of Rheumatology

March 2013

For this article, I would prefer to substitute satisfaction for the word success. Success may be more appropriately designated by others, while satisfaction is singularly defined by how you judge your own accomplishments.

During a medical career that has spanned over 35 years, I have taken the advice of physicians who were generous with their wisdom and support, and a number of rules have served me well.

Know your limitations

When I was a medical student I confided to my adviser that the amount of material to learn was overwhelming. I was going to fail. His advice was to recognize my limitations and to be willing to make the effort to learn. He said: “Before you are responsible for others, you will know exactly what you do and do not know.” I have always told my patients when I do not know the answer to their questions, and have constantly searched to fill the gaps in my knowledge. Medicine has never grown stale.

Learn from everyone

A gray-haired professor once offered me some very sage advice: “You can always learn something new from patients and your fellow physicians if you listen carefully.” Keep your ears open and your mind free to learn new things. Every new patient is an opportunity to gain greater insight into human beings and their illnesses. You can become a better doctor with each new interaction.

Later, on becoming an Assistant Professor, I took a class that developed my confidence in speaking with patients and other physicians. It made me a better educator to my patients and demonstrated my leadership skills.

Choose a topic and become an expert

When an orthopedic surgery professor asked me to see his patients with lumbar pain it was a major turning point in my career. I taught myself everything that was available on the topic of low back pain, and discovered a large absence of knowledge concerning this common health problem. I have spent my career trying to fill that knowledge gap for the medical community.

Be committed

Being involved with the American College of Rheumatology (ACR) has given me the opportunity to represent my profession around the world and ensure the future of my subspecialty. It has provided me with a sense of belonging. Over a 14-year period I have been a committee member, committee chair, member of the Board of Directors, and ultimately ACR President. By being committed, I have made countless relationships that have nurtured my growth as a physician and a person.

Never too old to try something new

Try to be open to new opportunities. You never know where they will lead. I recently started a radio program called “Speaking of Health with Dr. B” with the aim of educating the public about health issues, particularly musculoskeletal problems. I have enjoyed the opportunity to speak with a wide variety of interesting guests who have, once again, filled the gaps in my knowledge.

Life besides medicine

I have enjoyed my career but this has been balanced with life outside of medicine. I have had the support of my wife and three daughters, and they have always had my complete attention whenever needed. We have had many family vacations around the world, and I have also enjoyed the stress-relief associated with regular exercise, including playing squash. There are so many opportunities to grow as an individual, so make sure you make time for yourself.

When it is all said and done, I do not know whether I have been as successful as I might have been, but I have been satisfied with my career and would not have chosen any other path.

Professor Borenstein is author of Fast Facts: Low Back Pain, 2nd edition
 

Dr Clare GeradaDr Clare Gerada
MBE MOM FRCPsych FRCGP FRCP FICS

Visiting Chair, Kings College, London; Partner Hurley Group; Medical Director PHP; Chair of Council, Royal College of General Practitioners

January 2013

I hope my success in medicine is defined as giving a lifetime of service to my patients and the NHS, and still enjoying every day as if it were fresh.

“I knew all along I wanted to be a GP”

I am the daughter of a single-handed GP, who taught me very early on in life to work hard, not to expect anyone to notice and to give something back to one’s community. My father used to take me on home visits and I saw first hand the poverty of the then post-war slums of Peterborough and, through a child’s eyes, the effects of poor diet, overcrowding and poor sanitation.

After qualifying at UCH, I worked in A&E, then did a medical rotation and then psychiatry at the Maudsley, but I knew all along I wanted to be a GP, mainly because I loved every bit of it and wanted to do more. I was a generalist, wanting to care for patients across physical, social and psychiatric domains.

I also discovered I had a particular interest in treating substance misuse and was lucky to get a partnership in a local training practice where I felt I could make a huge contribution within this area. I later found out that they viewed me as a bit of a maverick, always on the go, and keen to implement challenging ideas. Since then, I have led the national development of policy on, and programmes for, primary care substance misuse, transforming the way care is provided to this difficult population of patients.

The practice also enabled me to combine research with clinical work, political roles with policy roles and generalism with a special interest in mental health – all within the framework of an NHS partnership. Later on, when I wanted to stand for Chair of Council, my partners were incredibly supportive and I owe them a debt of gratitude.

“The Kings Fund leadership course changed
the trajectory of my life”

Taking the Kings Fund leadership course in the mid-1990s changed the trajectory of my life and gave me the confidence to apply for the Chair of the Commissioning Group and a post at the Department of Health as a senior policy advisor. The course showed me, in a way that I hadn't seen before, that I had leadership ability and that I had ideas.

The next major milestone, in early 1999, was getting involved in the RCGP and realizing that far from a stuffy, distant organization, here was a bunch of people who were welcoming, intelligent, passionate about their profession and visionary.

“Women need to be heard and seen, and act in
their own way – not as surrogate men”

The RCGP is an exemplar where women are concerned, but only now, when I am essentially at the top of my career, have I realized how the world outside general practice is so male dominated, and how difficult it can be to inhabit this world. This state will only change when more women feel able to rise to the top. Women need to be heard and seen, and act in their own way – not as surrogate men.

The biggest challenge has been the workload – I have always done three jobs and have worked 16 hour days. Doing this and being a wife and mother has not been easy – it has been difficult missing key events in my children’s lives – and only possible because I have been able to afford good childcare and have minimum commuting. My husband has given me the support I needed to allow my career to grow. He has never moaned about not having food on the table!

“The most wonderful, rewarding and humbling job”

General practice has allowed every day to be different – and has allowed me to change my focus every few years, whilst maintaining a grounding in clinical practice. It is the most wonderful, rewarding and humbling job, and I am committed to protecting and promoting general practice, wherever and whenever.

 

TZ AzizProfessor TZ Aziz
BSC MBBS MD FRCS
FRCS(SN) DMedSci

Founder and Head, Oxford Functional Neurosurgery Unit, John Radcliffe Hospital, Oxford

From Succeeding as a Hospital Doctor, 3rd edn (2007)

Success in medicine is hard to define in the present environment as we struggle to meet ever-changing NHS targets. Nevertheless, here is my story.

I studied physiology as my first degree, initially to understand the nematode neuromuscular junction, but became deeply interested in the control of movement. I saw a film of a thalamotomy in which the surgeon passed an electrode into the motor thalamus of a parkinsonian patient with tremor. When the tip of the electrode was heated, the tremor stopped and normality was restored. That film transformed my life. I became obsessed with the idea that selective destruction of a deep brain target could restore function. I therefore decided to study medicine and make that surgery mine.

Upon qualifying in medicine and then training in neurosurgery I found that such surgery for Parkinson’s disease had become obsolete with the introduction of levodopa, a medication that alleviated tremor, rigidity and slowness. However, after a few years patients developed crippling side effects of drug therapy, such as terrible twisting and thrashing of the body. With no understanding of the neural mechanisms of the condition, few advances could be made. Then a primate model of the disease was discovered: giving a pethidine analogue (MPTP) to monkeys rendered them slow, tremulous and stiff, a condition that responded to levodopa. This model revealed that a target deep in the brain, the subthalamic nucleus, was overactive. It seemed possible that destroying this nucleus might improve parkinsonism.

I therefore went to Manchester to research the effects of such surgery in parkinsonian primates. The effects were dramatic, in that all the symptoms were reversed. Soon after publication, it was shown in France that high-frequency stimulation with implanted electrodes had the same effect. This avoided destruction of the nucleus and was more acceptable to clinicians. Today 40 000 people have had such surgery.

"Success ... needs belief in oneself and a
determination to push one’s work through."

Having completed my higher degree I decided that such surgery was my future, but it took fifteen interviews for a senior registrar post before I was appointed. Everywhere I mentioned my ambition I was told the days of such procedures were over, until I came to Oxford and was invited to start such a service. So I did, once appointed as consultant after completing the SR period.

Two years into being a full-time clinician, I felt it was time to return to research. I resigned from 50% of my job and applied for MRC funding to start primate work again. I was interested in the problem that 20% of parkinsonian patients did not respond to medical therapy and conventional surgery did not help them either. With funding from the MRC and with Professor John Stein in physiology, I set out to study the role of the pedunculopontine nucleus in movement. After 10 years of research we were able to show that low-frequency stimulation of the nucleus could reverse slowness of movement in the parkinsonian primate. This work was rapidly taken up clinically and I hope will help many more parkinsonian patients.

Neurosurgery has always fascinated me because of the wonderful opportunities it has given me to study the function of the brain. I am surrounded by a superb team of interested colleagues who share my enthusiasm as we continue studies into movement disorders and pain. I am also grateful to the patients who have taught me so much.

"... enjoy the specialty you have chosen
alongside the time to develop outside interests"

Success, I think, needs belief in oneself and a determination to push one’s work through. Now there have been many changes in medical training and the freedom to tailor a career pathway to suit personal interests has been lost; the MMC changes have introduced more rigidity, making it impossible for others to take the pathway that worked for me. If you are interested in pursuing a particular career, it is best to choose much earlier than I had to. Nevertheless, don’t rush to finish your training, and enjoy the specialty you have chosen alongside the time to develop outside interests.

 

Sir JA Muir GraySir JA Muir Gray
CBE MD FRCP

Chief Knowledge Officer, NHS; Director, The Oxford Centre for Healthcare Transformation; (previously) Programmes Director, National Screening Committee and Director, National Library for Health

From Succeeding as a Hospital Doctor, 3rd edn (2007)

I have found the following proverbs and epigrams particularly apt with regard to my own career, remembering the most useful definition of a ‘career’ is that it is the name given to all those crazy decisions one has made in the past 20 years.

  • Montgomery said, ‘There is only one rule in war – never invade Russia’. Always identify and avoid impossible tasks.
  • Having decided that you are going to have a crack at something, remember the motto of the Chindits – the boldest course is the safest.
  • Success in a project is often the result of chance, failure the result of bad planning and execution; failures are more important than successes for learning.
  • Never put your faith in organizations, only in people.
  • Fortunate is the doctor whose main source of stress is his patients; most doctors I know have more stress caused by colleagues.
  • It is easier to seek forgiveness than permission.

Sir Muir is author of Sod 70!

Sir David WeatherallSir David Weatherall FRS

Regius Professor of Medicine Emeritus, University of Oxford; Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Oxford; Chancellor, University of Keele

From Succeeding as a Hospital Doctor, 3rd edn (2007)

The several definitions of ‘success’ in the Concise Oxford Dictionary include ‘the attainment of wealth, fame, or position’. Medically, this might encompass strings of degrees, a Harley Street address, a university professorship, high office in the establishment, titles and, to crown it all, a lengthy obituary in The Times (ideally appearing in error before one’s demise).

But can these accolades be equated with genuine success? Or do they just happen to some individuals by dint of hard work, ability or driving ambition, and, above all, good luck? Certainly, they do not come to equally deserving people or necessarily bring with them the satisfaction of being your own man or woman. They do not provide a sense of being at ease with yourself, or the genuine fulfilment of having done at least one thing to the very best of your ability, or even just a little better.
 

“Take plenty of time to learn the
basic clinical and communication skills”

Is it ever possible to achieve these infinitely more worthwhile facets of success? Mentors are useful, if for nothing else than as living evidence of mistakes not to be made. Here are a few suggestions. First, do not plan your life or career in obsessive detail; those who do rarely achieve selffulfilment or happiness. Take plenty of time to learn the basic clinical and communication skills or, if you have the burning curiosity necessary to follow a research career, the essential tools of the trade.

Have a long look, both at home and abroad, at the many faces of our wonderful profession before deciding in which direction to proceed, and who to travel with. To achieve the satisfaction of doing at least one thing really well, focus on something really absorbing in a continuously self-critical way, but try to retain a broad view across medicine and the humanities. Ignore those who say there is only one pathway to career development; take some risks and be your own person from the beginning.

“Humility and an ability to listen sympathetically
to your patients are still the most important
attributes of a successful doctor”

Remember that, although medicine is a noble profession, there is no intrinsic difference between an effective doctor and an able high-court judge or thorough roadsweeper. That occupational hazard, pomposity, is a danger to patients and precludes any possibility of coming to terms with yourself, warts and all. Humility and an ability to listen sympathetically to your patients are still the most important attributes of a successful doctor.

Pace your life and learn to say ‘no’; a mind refreshed by something other than medicine or turgid administration is much more effective in the clinic or research laboratory. Later, treat young people with respect and understanding, however stupid and impossible they may seem; with increasing age, the pleasure that you will gain from their success will go some way to balancing your inevitable failures.

“Pace your life and learn to say no”

Finally, find a partner who is sympathetic to the many trials and few successes of what, if you follow this advice, will not always be an easy ride.

From Succeeding as a Hospital Doctor. Click here to purchase.

 

 

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