Easier.

“It doesn’t get any easier you know”.

Words ruefully said from a consultant on the precipice of retirement, to a registrar on the precipice of their career. I didn’t understand at the time. Surely it got better. Anything was better than being a registrar to me at the time, post exams, exhausted from night shifts, babies, endless demands. But now that I’m deep into my first year of consultancy I’m beginning to understand. In medicine, someone always wants a piece of you. Or, they don’t want you at all and will tell you so. The demands are endless, the rejections searing. And he was right. (Although it’s still better than being a registrar, I can promise you that).

You go through medicine with this deep and unconscious desire to be wanted. You will do anything to be wanted. Join committees, do research papers, work long hours. You want to be wanted by your consultants, your patients, your colleagues. And the system reinforces this by making you reapply for the same damn job, year after year. And then you finish, and the worst thing happens. You’re unwanted. You disappear from being the centre of everything. Everyone still employed by the hospital keeps on with their day, and you fall into that black hole of just another registrar passing through. Unconsciously, or maybe even consciously, you put up with so much as a trainee, because somewhere in your mind, you hold that coveted position of the ‘boss job’ so dear. And everyone knows of a golden child registrar who sails straight through into that coveted role and everyone builds it up, tells you to invest your self esteem in it. But it’s a mirage. It’s so incredibly rare. Most people don’t have that experience. And people will try to tell you this, over and over, but you wont listen. That won’t be me, a small whisper inside of you says, I’m special.

In this game, none of us are special. The hospital system is not your family and it is not your home. What has happened is that you’ve overinvested in it and you’re in for a big letdown. And the best, and the worst part is, is that this needs to happen. You need to know. You need to really really know just how unimportant to this system that you are. Because once you do that, you get your life back. Once you really know, you wake up one day and realise that you don’t have to feel guilty for doing nothing. You don’t need to treat having a hobby like it’s a special treat. Or time with your kids. Or making time for your kids. You don’t have to die, over and over on the sacrificial altar of medicine anymore. You get to have a life. Those rare, golden children, rarely realise that until it’s much too late, or never. The whole system, being run by politicians, relies on good will to run. And it pushes us all into thinking we are never enough, never good enough, never enough to be wanted. We are all incredible and dedicated people. When you are finally released from this place, out into the community, everyone needs you. Everyone wants you. Everyone thinks you’re amazing. And the difference between the two places becomes ever more stark. Suddenly medicine becomes less about administration and patient flow, and becomes about the patient and their family. Suddenly you find yourself focused on their needs, and their story, and all the rest melts away.

If I could give my past self a piece of advice from the future, it would be this. Don’t hold out for a public hospital boss job. Look past that. Hold out for the sort of life you want to live and the free time you want to have. Ask yourself how you can make your newfound freedom work for you. The BEST thing I did, was join a private practice that lets me work as much or as little as I want. And in having that freedom I began to rediscover who I was outside of that system, and what I liked doing. The money you earn enables you to live the life you want, and more importantly to enjoy it. Private land is barely even whispered about in the public system – partly because those working privately don’t want others to know how good they’ve got it, and partly because those who’ve never worked private are terrified by the concept of it. And so, while I might be restarting back in the public system shortly, this time away from it has given me the gift of disinvesting my self esteem from it.

Wherever you are in your training, no it does not get easier because life just doesn’t. But it DOES get more rewarding. And you do get more control of your life when you finish, and I’m glad I did.