Are you feeling challenged and stretched in a healthy way at work? Are your unique skills being used to their fullest? If not, what might be holding you back from taking a leap into a career that can offer greater fulfilment and happiness?

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Is your current role really making the most of your skills?

And what would it be like to have a job, but you were really, really challenged and stretched, where you could learn new things, but you really knew that you were in the right place?

This week.

Under lighted to bring Dr.

Sarah Goulding back onto the podcast to talk about how to make a career change from the right frame of mind.

Now taking the leap to something different can bring about a lot of really uncomfortable questions, such as, why can't I just stick with a roller what's wrong with the job I'm already in?

Well, why can't I be happy with the job that I've already got?

But when these questions come from a place of guilt or shame, they can really stop us from exploring new territory.

So if you're feeling on the edge of burnout, Now might not be the time to explore a completely new future.

But if you've got the sense that your passions or interests might lie elsewhere, either within medicine or outside of medicine, then this conversation will give you some practical tips to help you drop the shoulds and make a choice that's right for you.

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

I'm Dr.

Sarah Goulding, I'm a career coach for doctors and portfolio GP.

Lovely to have you back on the podcast, Sarah.

It's like your fourth time?

I think this is number four.

So we talked about imposter syndrome before.

We've talked about, I think the first one was about being in a shape sorter when you feel that the, the shape of you doesn't quite fit the right hole for your work, and that you are always slightly stuck out on a limb and not really fitting in.

And then last time we talked about lots of shoulds and why we stay in roles that don't suit us, mainly because of guilt and identity.

And a lot of your message is around what suits you and is it right, and I think one of the big problems that a lot of our listeners have, and I know I've had as well, is that there are so many expectations of what you should be enjoying, having trained for God knows how many years to get where you are, and then you suddenly find you're in this role that you don't actually like.

And then you feel the judgment from other people, but you're not enjoying it.

But I think the biggest judge is, is probably oneself.

You know, about why can't you cope, why aren't you enjoying it?

It took me a long time to realize I was in the wrong role.

Um, and one day I just found this, uh, stack of BMJs next to the bed, which were completely unopened.

You know, we, we've all got them, haven't we, in the corner.

And I thought, what is wrong with me?

Why can't I read?

Why can't I read?

Why can't I keep up the date?

And then I looked at the other side of the bed where there was like a whole stack of self-help books up to the ceiling.

I'd read them all.

And I was like, ah, not I don't read and I'm not interested, but at this point in my life, I'm more interested in that than this bit over here.

And that, that was quite a revelation to me because I'd, I'd just been criticizing myself for it.

Do you find that there are lots of people like me, or am I the exception rather than the rule?

Yeah, I mean it, I think some of us have particularly strong self critics and they might be there when you're happy, when you're sad, But if you are fundamentally feeling unfulfilled, unwell, or unchallenged, or you've been happy and you've just got to a point where you go this isn't enough for me anymore, or I don't have enough autonomy, actually I've got more skills, I'm not using it.

It it, you have to feel that little bit of discomfort in order to look inwards and outwards and start looking to make changes, otherwise you wouldn't do it, right?

So it, it's something I see a lot and everybody has their own little story as to what's going on for them.

And sometimes it can take really quite a lot of searching to work out what really is going on for them, what, why are they feeling so yucky or ashamed or unhappy or tired?

It is interesting, isn't it, that the first place we go to is shame, is I'm not enjoying this role, therefore I must not be good enough.

Which is crazy because I don't read a book and go, I'm not enjoying this book.

I mustn't be good enough, or I don't like this television program, therefore I'm obviously not good enough.

But when it comes to what we do, I, maybe have so much identity pegged in what we're achieving and the, and the status and the, and the role that when it doesn't fit, rather than going, oh, well that's good information, we just beat ourselves up and stay for a lot longer than we possibly should.

I will come back to my certainly controversial feelings around how medical education changes us as someone that's done sort of sort of higher level medical education qualifications, one of the things that we're exposed to at a very early stage is outcomes based medical education.

You are trained in a way that you get the outcome that means that you progress.

And we do that over and over again, and we get very good at getting the outcome that means we progress.

And also even part of our appraisal.

I'm an appraiser, I'm a medical educator.

Our appraisal and our medical education encourages us to look at our failings and our lacks, and therefore it tunes us into framing issues as an us problem, and if only you could go and do more learning, get more skills, then you'd be all right.

So I do think there are messages that we are given along the way.

I don't think it's intentional, it's just evolved that way.

But I think we've got really good at going, oh, I'm so rubbish at x, y, z.

Please, Mr.

and Mrs.

Appraiser tell me what I need to do in my PDP for next year.

Whereas actually when I try to say to people, okay, but what are you really proud of?

Or what are you going to do for your wellbeing?

People look really uncomfortable.

It's not something we are used to or comfortable with doing, and I would love to see that as a change.

But I do think it's, it's not just the type of people, it's also what we're exposed to and the skills we use to get us there, make us put a microscope on our failings or our I'm not there yets, and we're historically terrible at taking compliments as well.

It doesn't, it doesn't settle in as well.

So I think it's really important that we really take the time to examine what's going on.

Don't go straight to the self-blame of I'm obviously not good enough, I just need to learn more X, y, and z, and then I'll be enjoying it more.

And I think we're gonna talk about how we do that.

I think there is one trap that we can fall into, and I want to go right at the start of this episode and say how do we avoid not throwing the baby out with the bath water and wanting to make a load of change just because we are probably stressed or burnt out?

The first step of this journey is working out what's going on for you right now.

Are you ill?

If you are ill, then you need to get help because an ill brain can't make good decisions and doesn't have insight, can't weigh up the pros and cons.

It wouldn't be able to assess whether things that seem a little bit daunting actually might be exactly what you need to do, or whether actually you can make changes with where you are, which will make you feel considerably better once you've got better and you're on that road.

So it's a key point to discriminate.

And I think when I've tried to coach people who feel like they're better, but actually it becomes obvious they're not, it's not worth it.

They need to pause.

They need to let their brains recuperate so that they're then in a place where they can be compassionate to themselves and make good decisions based on, based on wellness, not based on, I just have to get away, well, from where I'm at right now.

Sarah, when people come to you and want some help with this, does everyone just want to completely quit and get a different role?

Or are there some different categories of people within that?

There are broadly three categories I think.

Yes, there are people who just want a wholesale change and either that's leaving medicine or leaving the specialty they're in.

I wouldn't say that's the majority actually.

There are also the people who are just not satisfied or happy with their current work, but looking at the changes they can make, it can make a significant difference to their experience of working there, and actually they can start thriving and remain there.

Then there's the people who actually, they're okay with the day job that's, it's not really a major concern or a discomfort for them, but they just don't feel it's enough for them.

And I think particularly when you've been in.

In your career for a while, you, you have a bit of mastery.

They want more challenge, they want more interest, and they love learning.

And this can be as part of developing a portfolio career within medicine, or it can be doing something completely unrelated to medicine.

What were your previous interests?

What did you enjoy doing before?

Where can you get more creativity into it?

And that's a really interesting area to work on as well, and help people really think in a very macro way, you know, a very bird's eye view, what's going on and what are the options here?

So that you can really think quite openly about the possibilities.

How would you help someone work out which category they were in and, and which way they should be heading?

They need to spend some time really thinking about what's, what's going on right now.

What, what is the discomfort and whose opinion matters here?

I think we've talked previously that it's quite common, particularly when you've just finished training to be very influenced by either your family, your friends, or influential mentors, people that do your, uh, your references if you're applying for jobs.

But actually what's going on for you and what matters, and letting yourself.

Really examine your own thoughts and feelings on that.

So I want people to really think about, if you're thinking about the change cycle, where are you at on that?

Are you just beginning to weigh up, like, something feels like it needs to change?

And if so, what's going on to make you feel that way?

Where are you at now?

And then once you've worked that out, what, what do you feel needs to change if you do feel there needs to be a change?

And then moving on from that, that's when you start thinking about, well, what would good enough feel or look like?

And you could talk for hours just on that one topic because where do we get our sense of what is good enough?

And then it's the, what are the first steps?

How do, how do I even start this?

Because often we've been in our little paths, in our jobs, in our specialties.

We've become super expert at what we're doing, but we don't really know much about other options, and that might include different skills as well.

I think that's the main problem that people have.

People are like, I have no idea what option I've got.

I have no idea what I want to do, what I want to be, and there's nothing advertised anyway.

So I'm gonna ask you how you find out in a minute, but I do want to go back to that second question that you asked, which was, what do you feel about it?

I think most people would just go, what's going on now?

Where do I wanna be?

Or, what does good enough look like?

And where do I wanna be?

So what does the feelings bit give you in this journey?

It gives you, is the dissatisfaction here?

What about you isn't being fulfilled or expressed in a way that it's filling you up or, or depleting you?

For example, is it that you are somebody that really enjoys influencing and making change and having autonomy, and currently actually you're just seeing, you're just doing the clinical work you, you're not having a chance to be a bit creative with solutions or, or would change what your working week or day might look like, or care for your patients?

Is it that the interactions you are having with people, there's something about your relationships in the workplace that are causing you discomfort.

And is that something to do with you?

Is it that your style of communicating, and again, this is a whole other podcast in itself, you know that we can talk about personality types, we can talk about assertiveness, negotiation, boundaries.

What is it?

Where's the gap?

It's either a gap in satisfaction or a gap in something about you that you would like to express, I think ultimately.

I think that's helpful because as doctors we are, it's often told to squash our feelings down that what I feel doesn't matter, and then you learn to ignore your feelings.

But they are such a good barometer that something is wrong.

They're not a good barometer of, your thoughts are correct and you're absolutely right or whatever, but they're a good barometer of the things that are going in your head, which means something is wrong.

So I love that thing about using your feelings to tell you where the gap is, to tell you there's a gap here.

There's a gap here that you might not have thought of.

'Cause your brain can, you can explain everything, can't you?

You can explain stuff away and say, oh well it's just 'cause I'm tired, or it's just 'cause of this, or whatever.

But when you're just feeling like that, so I think.

I'm very interested that you put that question in, ' cause otherwise I think you'd lose a lot of information there.

Also, I think it's very common that people don't know really what they think until they start really talking about it and being listened to.

Because we have such patterns of thinking and I, when you are in the workplace, there's also that habits of communicating.

You know, do we all just get together and when we get together, rather than going, oh, this is something interesting, I saw you all have a major whinge.

And that's really common, isn't it?

Particularly the black humor, the, the kind of like competitive tiredness you get in early parenthood.

Where it, what is your actual thought and trying to separate that out and also giving validity to it because I think we can very easily edit our thoughts and feelings and say it's not valid.

So allowing them to see that their feelings and therefore thoughts are valid.

Some of those thoughts might be unhelpful thoughts like the, I'm not good enough, I'm struggling because dot, dot, dot.

In which case, it's getting them all out and really inspecting them and going, okay, that's an unhelpful one, I'll chuck that in the bin.

Or actually, where's that coming from?

Why don't you feel like you're good enough here?

And do you get people to write these down or do you just talk about them?

It depends on the person, because everybody processes things in different ways.

Some people work really well with things like just free flow journaling.

I'm very auditory, so I think best when I'm talking out loud with other people and I'll notice what I notice.

So it's trying to personalize different exercises for different people.

But I think a lot of the power is reflecting back to people what you are noticing that they're saying, and saying this is what I'm hearing, what does that mean to you?

I was just thinking of when I did some career counseling.

The thing that made the biggest difference to me was just picking out some cards that had pictures on about what was the problem now, or how did it feel to be doing what I'm doing now and how did I want to feel in the future?

And the difference between the two cards, I can still remember what the cards are.

And I think I've talked about that on the, uh, podcast we did recently about using your right brain in leadership with, um, Yda Bouvier.

And I'm just wondering about getting creative.

When you're looking at these things, and we were talking earlier about drawing stuff and actually, you know, doing a little map or whatever, and you were recommending a TED talk about drawing stuff.

Yeah, there's a fantastic one, by Patti Dobrowolski.

It's called Drawing Your Dreams into Reality, and it's often used.

In the corporate world in terms of inspiring as a leader, but it helps you put in pictorial form and you don't have to be good at drawing.

I'm terrible at it.

It doesn't have to look beautiful.

But drawing where you are now on one side of a big piece of paper and then on the other side of the paper, where would you like to get to?

Um, and allowing your brain to be creative and notice what you notice and what do you notice about where you are now or what do you notice about if you are just being completely open and free, where do you want to get to?

And really creative, either drawing or writing exercises can be fantastic.

I know you talk about the ideal week as an exercise.

Well, some people do the ideal day, but I really like the ideal week, and this is this exercise where you write down and you just free flow write, any format you prefer.

You could dictate it if you prefer speaking out loud.

If I waved a magic wand and it was the perfect week for you, what would it look and sound like?

And for me, I also want people to go, what's going on outside of work?

Because I think we neglect that aspect.

And just write it, leave it, and then come back to it.

And what do you notice?

What are the things that stand out about where you would like change to happen and therefore, what's really going on at the moment?

We use that ideal week planner.

We call it the Thrive Weekly Planner.

It's got some questions, very similar to the ones you've just said in it, and as well as writing them down, you actually plot it on a, on a calendar, you'd actually see it.

It, it worked really brilliantly for someone I was doing some coaching with because he put down everything, you know, he'd come to me saying, I just wanna be a bit happy, I wanna get a day off.

He put down everything that was he did in his week, and we just looked at it.

I went, well, tell me what you notice.

He said, I think I'm working 13 sessions a week.

He'd never actually plotted it out before, and it was so obvious what the problem was.

So.

I think getting stuff down, like putting it in a chart, looking at stuff, can it, it, well, it activates your right brain.

You can start problem solving and then comparing it to what ideally you'd like to have or you'd like to feel or you'd like to be or how you'd like to live is really, really helpful.

We'll put the link to that in the show notes.

It's totally free, so, please do download it and have a look at it.

What's interesting to me about that, about the sort of draw your dream life or whatever it is, and the Thrive Week Planner, that it, it's about how you want to live.

It's not so much about what you are actually going to be doing every day.

I mean, it's a sort of vaguely what you're gonna be doing, but it's, it's much more about how you want to feel week on week.

And doing it's, you're probably not gonna write, I want to be director of this, or in charge of this in your day.

It'll be things like connecting with colleagues, seeing patients, or you know, doing some creative stuff or leading a team.

We are much less bothered when we look at how we want to feel and how we want to live in the status stuff and in the job title identity than if we were to say, right, what ideally would I like to be and not think about actually, how do I wanna live and feel.

I think we find it very difficult to actually think in that way, but it's about living.

It's not about the titles and prestige and status and when we, when we chase that, it just sort of go completely the wrong direction sometimes.

It's trying to get your ego out of the way.

And I, we can often have that, what do I feel about myself?

What do others feel about me?

But if you, if that's the thing you are mainly focusing on, you're not actually going to get the beautiful juicy bits of life where you actually focus on the bits that you really find funny or joyful, or silly or challenging, really meaty bits of work that you really enjoy, because we are too focused on what other people or what we think about ourselves.

So trying to focus on the bits that really matter and why that really matters.

You know, that old adage about when people are on their deathbed saying, I never wish I'd worked more.

I, I would like people to create a work portfolio or set a way of working for them where they're not doing that dreaded, claustrophobic countdown to retirement that a lot of people do, that they feel, yes, I could.

Retire then.

But actually I don't feel that I have to, because I'm enjoying it.

I'm well, I can make decisions based on other reasons.

Then the question becomes, Sarah, how?

How do you get there?

How'd you get to, there's one thing saying, okay, ideally this is how I would like to live and think and feel, and blah.

How to actually get there because we've not ever had any career development, whether it's, you know, leaving totally, or staying and career crafting, we don't know how to do it.

We don't, and a lot of us don't feel that we have the ability to do it.

And something that I see a lot is barriers that we put up ourselves related to this inability to see all the skills that we have and we're these incredibly competent people.

So an area that I think can be really interesting to spend time on is what are your transferable skills?

Let's really get into the detail here, because it's very freeing.

And the way I phrase it, to get people past their, either their shame or their ego around it is to go, what are the neutral facts of what you do or what you have done?

And this might go all the way back to med school or school.

What are the things you have done?

And put it down as a job descriptor.

So if you've been as the foundation doctor, you had a role doing the rotor, multi stakes negotiation, weighing up complex needs of a team and communicating clearly.

Put it in business speak.

Start getting your ears and eyes into, how would I put this on a CV?

Write it all down.

What are you currently doing now?

If you are a gp?

I'm having to weigh up the needs of the different stakeholders in a cash limited system and negotiate.

Actually what we are doing is far more complex than we realize and just keep going and add to it and ask other people, what is it that I do if I had to write down my job list?

And also outside work?

You know, I've had somebody who ran a really interesting initiative in the community.

I was like, this is perfect.

Because then it also, it's getting you to think about roles you could do in other jobs, roles that you might enjoy or not enjoy, but also starting to think about interview.

You know, you're going to be asked about, can you give an example of when?

And it's just starting to help you disengage from the, what am I now?

And look at the what have I done and how amazing I actually am.

And then step aside and go, what are the bits that actually I really thrived at, I'd like to do more of?

And I can start focusing my search a little bit.

Yeah.

I love that.

I love the way you put all that I, I've written down.

Weigh up needs of different stakeholders in a cash limited system.

That is literally being a GP, isn't it?

Deescalation, conflict management, you know, management of resources, allocation.

Yeah, all that, all that sort of stuff.

But that's a really nice way of thinking it.

The other problem people have, they say they might have identified their transferable skills, but they'll say, but there's nothing advertised that, you know, I, I've been looking for a job, but I have no idea even well where I would go or what's been advertised, or even if I wanna stay in my own job, how do I find something different to do?

That's a really big question and particularly an issue at the moment while the job market is a little bit peculiar compared to how it has been, particularly for GP locums, I would say this is where people have to start thinking really creatively and get comfortable with the fact that this is gonna feel weird and you're gonna be in a funny limbo for a bit, but start getting nosy.

Start looking around.

Are there things that other people do that you're a little bit interested in or jealous about?

Is there a broad topic?

Okay, where do those people work?

How do you find out how to speak to those people and start networking.

And by networking I don't mean go to networking meetings, although they do exist outside of, in, in the muggle world of non medicine, there are lots of networking meetings.

You can sit on places like LinkedIn.

You can search around in social media.

So it's, it's starting somewhere and then following that thread.

And I certainly found that when I was going.

I want to advertise as a coach.

How do I do that?

Where do they all sit?

How do people find out about me?

And it's, it's doing a lot of following a thread that might not lead anywhere, and that's okay.

People love being asked about stuff that you're interested in.

I think I might be vaguely interested in x, y, z, can I take you for a coffee and pick your brains or go up to somebody, drop a message to somebody and they might not have the answer that you want, but they might have a friend who who does, or they might know a resource.

So get bold.

'Cause people aren't going to be offended.

I've certainly done this countless times.

I'm always interested in new jobs.

I went to a conference recently and there was a woman talking about sexology.

I don't know if I would want to do that, but I thought it was really interesting.

So I connected with her on LinkedIn, I went, how do you do that?

So it's, it's just starting to ask that question and then you can start ruling things in or out.

And the ruling in or out is where you need to have a template for what feels, what feels like a yes or a no, or a maybe to you.

I think we're so worried about doing that networking, because in our minds, networking is like going out and selling yourself, and that is, that is scary if you have to do that.

But, um, the way I did it was exactly what you said.

I've just identified loads of people they thought did interesting jobs and bought 'em a coffee, picked their brains about that, what their job was like.

And every single time I'd say, well, who should I talk to next?

And they'd give me another really good contact and I'd just go and talk to.

And most of them, actually something, something came out of them at some point.

You know, even someone I'd talked to, I thought, well, I actually don't wanna do anything like you do.

But they came back to me a few years later and said, well, can you come and do some training in this organization?

And you know, it, it's really interesting and people do like talking about themselves and, and what they do.

So it's, what you're doing is fact finding.

You are not going there to say, can you give me a job?

You're going there to say, can I find out a bit about what you do?

What do you like about it?

What do you not like about it?

And how can I find out more?

Or is there anybody else that you think I should talk to?

It's really, really powerful.

It is just great in general.

It's just interesting, isn't it?

There's so many very interesting people out there.

There are.

And I think we can get in our own, own way because we feel, who am I to contact them?

And that's where the getting the ego out of the way needs to happen, because actually that whole, you don't know what you don't know right now.

And only by following various paths, some of which aren't gonna get you anywhere, but you know, what's the worst that's happened?

You found out something new about an area that you thought was interesting.

Brilliant.

That's we're really good at and we love finding out new things.

And also not just through people.

There is so much available online or on social media now.

Where are the places where people do the things that you think are interesting?

It might be a social media platform.

It might be a literal place that you can go to and meet those people.

But there's gonna be a lot of work involved, but it's gonna be interesting.

I think people often rule themselves out by not being.

happy to put themselves out and try something they might be bad at as well.

Um, and you know, I think we're so used to being so competent as doctors and we're, by the time we do career change often we are really, really skilled in what we're doing.

And then we go and start doing something else and we're not very good at it.

I mean, between you and me, the first few episodes of this podcast were dreadful.

And I'm hoping I've got a long way to go, but I'm hoping they gradually got a bit better as I have practiced and now onto 220 something episode, yeah, they're gonna be better now than they were before, but I never would've expected me to be brilliant at that start off with.

But it was really frustrating and I also had to do quite a few online courses to learn how to do various bits and pieces.

So I think though sometimes we just expect ourselves to be good at whatever we've turned our hands to next, and that's not always the case.

And you do have to invest a bit.

I think sometimes we don't like invest, investing in stuff, but I have colleagues who aren't doctors, you know, in the coaching and training industry, they will, they spent thousands, thousands on personal development, on courses, on learning to do x, y, and z.

That's just normal for them.

But we are like, ooh, I dunno, 150 quid?

Not sure.

I think that's true, but I also think we can really lean on if there's, there must be a perfect qualification for me to do and then I'll be comfortable, and then I'll be good at it.

And, uh, I think I.

That's a very comfortable way for us to go about it.

There must be a course that I can do that would teach me how to do x, y z, and then I'll be great at it, or my discomfort will go.

And some of that is this, I, you know, this, this concept of imposter syndrome and that actually sometimes you just need to do it.

Because also in the doing of it, you find out whether you like it or not.

There are lots of jobs that you might like, but unless you do it and find that what that experience is, you won't know whether you, you like it or not.

I did loads of public speaking in lockdown because my other portfolio came to a screeching halt.

And I could do it, but I found that actually I got really stressed about it when I could see the date coming up.

So now I don't do very much of it and that's okay.

It's working out what's a know as well.

Just because you follow a path, you're not obliged to go all the way down.

It

Yeah, I would definitely second that.

And being happy to try something and saying that's not working, and to get your head around the fact that that is not a failure.

That means you've tried it and you didn't like it, and that is totally, totally fine.

We still beat ourselves that, oh, I'm not good enough.

I should have just stuck with it.

You know, I haven't got any stickability.

Like, rubbish,

Yeah.

And that each time you do it, you're learning something new about yourself and probably gaining new skills.

So I fundamentally agree with that.

And we are not the same people as we were 10 years ago.

So anything that we are doing now Is going to be an evolution of who we are and what our skills are, and we are learning new things.

But it's not realistic to expect to just slot into a perfect answer that's going to be right for you forever.

And so that ability to go, I'm gonna try this, it might not be the answer, which feels really uncomfortable because it's what we did right at the beginning of coming out of training.

Is there anything else that people can be a bit naive or underprepared with when they're doing a career change or, or changing bits and pieces in their role?

I think people need to understand their brains, and this is coming back to the hot topic around neurodiversity.

I tried to create a career based on what I thought was best for me, and actually it turns out I have ADHD and it makes sense that the things that I didn't like doing weren't where my brain were happiest.

So if you have some information about your brain or how you work best, really pay attention to that.

And if you think you might be neurodivergent, please do look into it because it can be so instructive and informative about the types of places you will thrive, the type of jobs where you are gonna be at your best.

Uh, because that's such valuable information.

And I think we are only just at the beginning of starting to understand that.

I think the other things are around how do you feel around your skills related to negotiations?

The biggest shock for me when I started being a GP locum was having to negotiate, because everything was a one size fits all.

You do the job, here's the money, here's the hour, off you go.

And that often is true when you're in hospitals.

However, lots of roles involve negotiations, and that's a very complex area, and that's to do with is it important to me?

Why is it important to me versus somebody else's needs?

And bearing in mind that other people might not have your best interest at heart.

If I'm a GP partner, I might want to make sure that you are seeing the most possible amount of patients rather than having you take on a new specialty, that's my prerogative.

And that's okay.

And in the hospital I might have different preferences for working.

So what does negotiation look like and how do you prepare for that?

Because that is a skill and a strength you can definitely build.

And some people call it assertiveness.

I, I think it's all part and parcel of the same thing.

How do you have conversations where your needs are being put forward and you're trying to get them met in an adult way.

That is something I really struggle with.

I've noticed that particularly recently is, I have real difficulty articulating what I actually want or what I actually need in a clear way, and I end up fudging it sometimes.

And as Brene Brown says, clarity is kindness.

But I think I've been so used to, you know, as a doctor, you never get to say what you want.

You just, particularly as a junior doctor, you know, you just were at everybody else's beck and call and their needs, you know, have to do everything.

To make sure the patient was, was okay quite rightly, but then you just had to do everything for everybody else.

And if the cleaners decided it wasn't their job to do that, you pretty much had to go and do it.

And so you are, you're very not really used to saying, this is what I want and this is what I need, and I'm sorry if it's not exactly what you want on need either, but that's it.

And so I often feel very guilty in, in stating what I need, particularly if I think it infringes on what other people want or need, which half the time it doesn't, they just want some clarity.

So that is something I have noticed.

We aren't really trained in, in how to do that.

We, we get trained in assertiveness around maybe communication with patients, but not around difficult stuff, role descriptions, money, uh, all that, all that sort of thing.

And that is absolutely crucial, really, particularly if you're gonna do something that's not being sort of directly employed by someone, but you're having to negotiate with, with people or you're freelance, you know, like you are with your coaching.

No, and I can feel your discomfort and I made so many errors and when you get it wrong, you feel you have to make peace with the fact that people might not react in the way that you want them to.

You know, this slightly childlike need to be liked that, well, lots of us have, making peace with the fact that it's not gonna suit everybody what you want, and that there's gonna be some displeasure or frank discussions going, well, that doesn't work for us, or Why do you want that?

Or.

That's not okay from our point of view.

Or having to really be tenacious.

I've come across a lot of people who've tried to negotiate, particularly in the hospital system, actually, I would like to reduce my session like this.

It can take years to even have the meeting with the people that need to.

So you have to really be tenacious and spoken to a lot of, for example, salary GPs who go, oh, well I did say this and I sent an email three months ago, but they never responded.

And how do you then have the kind of the gumption and the balls to really go, actually no, this is important to me and therefore it is important that we have that conversation, and getting okay with conversations that might feel uncomfortable.

And I know with the fantastic podcast you've had with Jane Daker about the pay gap, this is something women historically aren't great at in terms of asking for money.

And particularly, that's why looking at things like neutral facts and negotiation and having those uncom, what uncomfortable conversations are so key to develop that skill, because historically, we've not been expected to ask for more, and how do we do that in a way that we feel comfortable with, but also serves us and maintain relationships.?

So when we are thinking about doing a change, we fixate on what's a change gonna be and how do I get there?

And then we don't think about all this other stuff.

It's like, how do I manage myself in negotiations and, and upskilling myself and not being perfect at the first thing I do?

And, and all that.

And fact that, that stuff is almost more important than where you end up.

Because I guess one thing I can guarantee is that you will never, ever end up exactly where you think you're going to.

It'll be somewhere else entirely, but, but the journey will be really, really fun and you will end up doing something that you really enjoy.

And whether that is completely out of, of medicine or your current note or still in it, but doing some slightly different, different things.

And just a little sort of, uh, side note, we are definitely not trying to get people outta medicine.

We are really not.

But what we want is a, a workforce that really engaged and really enjoying their job and, and happy.

And if.

Doing something else is gonna help that then, then that's what we want.

'cause nobody wants a load of bent at doctors who just aren't doing what they want or aren't doing what they like.

You, you're never gonna get a, a good health surface like that, are you?

It's really about focusing back on what you do have the ability to do, and I think it can be easy to look at all the things that we don't have or that we can't change.

But actually we've got a tremendous amount of power and skill and strength.

And using all of those.

Can really change your experience of your working life.

So absolutely.

I'm not saying everybody has to leave medicine or drop sessions or take up new things.

You can, and if that's something you want to, then great, that's fine.

But you Are so much more skilled and capable then you perhaps might think And spending time really looking into that is, is so empowering.

And getting comfortable with, there's going to be some discomfort along the way.

There will be a period of limbo where you're not sure.

And sticking with it despite that takes a bit of grit and determination because there will be something better and some real specifics to add to it.

It's not just looking at the what ifs.

And staying stuck, it's, it's a comfortable place to be sometimes, 'cause you're not putting yourself out there, you know, staying stuck and miserable.

Yeah, I mean, It's familiar.

So I think that's why a lot of people don't make the move, 'cause actually the, the discomfort of going through that, uh, not knowing in the slightly dissatisfaction and the uncertainty, sometimes it's worse than being stuck in the first place, but I, I've never known anybody who has made a change and really, really regretted it.

I think our brain is really good at offering up the worst case scenario, isn't it?

So the thoughts about the what, what might be the bad stuff that happens?

If I regret my decision, I've definitely taken on jobs that I went into, this is awful.

It's much more awful than I thought it was going to be.

It's not a good fit for me.

And so I left.

And then I came away from it going.

Okay.

This is not the worst thing that could have happened to me.

The worst thing that could have happened is if I stayed in it and I didn't actually look after myself or my interests or my needs.

Or you absolutely loved it, then they sacked you.

Yeah,

Yeah, that's pretty bad as well.

Much better to leave when you're not enjoying it.

And I dunno why I went there.

Um, probably because my brain is now going, oh, I need a break.

So thinking about what's good for our brain.

Sarah, can you summarize your three top tips about, you know, if you're thinking about doing a change, whether it be career or just some job crafting and stuff, what would you suggest people do?

So number one is why are you even thinking about it?

What, what's going on for you right now?

If, if I fast forwarded you?

In two years time, what would you look back and go, this is what's going on for me right now?

Number two is what would be good enough if I have to make a change, what would good enough look like?

And just start having those broader thoughts in a really general way, trying to avoid specifics.

And number three is.

In order to get to that, what do I need to start doing now?

I love that.

and I think my, my tip to add in there would just be, get comfortable with being uncomfortable, ' cause it is going to be uncomfortable, but it will be better.

It will be better out the other side.

So thank you so much Sarah.

We'll put the link that you mentioned in the show notes.

People will also be able to download our Thrive Week Planner pack so you can do that exercise yourself.

If people wanted to get a hold of you, how can they find you?

They can.

Find me at drsarahgoulding.com and I have the @DrSarahGoulding on Instagram as well.

Brilliant.

Thank you so much for being with us today, and we'll speak to you soon.

My absolute pleasure.

Thanks for listening.

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