Why do doctors struggle with success?

I've been thinking about this a lot recently. Partly because I've been creating a series on YouTube about the World Cup, money and success.

I work in football, my brother owns a football agency, and we hear the same stories again and again.

A player spends their entire life chasing the big contract.

They train, sacrifice, push through rejection. Then finally... Success arrives, but often, within a few years, it's all gone.

How does someone lose everything after working so hard to get there?

The simple answer is they couldn't handle the success, but if we go a level deeper, I think it’s more than that

I don’t think anybody taught them what to do with it…

Yea sure they were taught to put their head down, struggle, be the first on the training pitch and last off it.

But nobody says: and when you get there, this is what you do next…

I don't think doctors are any different.

We know how to work hard. We know how to sacrifice.

We know how to pass exams, earn qualifications and keep moving towards the next milestone.

But nobody teaches us what to do once we get there…

Think about your own career, getting into medical school, then passing finals, getting your first training post or receiving your Completion of Training Certificate

Each milestone probably felt huge at the time, but the feeling rarely lasted.

At best, there was a graduation ceremony, a celebration dinner or a post on social media.

Then almost immediately... it’s the next exam or job application. The next mountain.

I think that success makes us uncomfortable.

I think we know exactly what to do with struggle and striving harder. We can all study longer or prepare better.

Success is brings something different.

It’s a change of state.

For a brief moment, there is no next exam to pass, no applications.

And I think many of us find that unfamiliar, so we don’t stay there for long.

We return to what we know, which is goal seeking, striving, and working towards something.

I think part of it is the era our parents grew up in.

If your parents were born before the 90s, they were born into what I think of as the professional era.

Information wasn't readily available. You went to the library.

You wrote your dissertation from books. There was no online bank of papers, no question banks, no past papers in one place.

Having knowledge made you extremely valuable.

So the professional, the doctor, the lawyer, the engineer, the pharmacist was success.

And society agreed..

Work hard, climb the linear ladder. It's laid out in front of you. Most importantly it’s safe.

However, nobody discussed what happens when you reach the top of the ladder.

Because in that era, reaching the top was the point.

But we're not in that era anymore.

And I think that's part of why so many doctors reach CCT and it’s an anti climax.

Psychologists have a term that partly explains this: hedonic adaptation.

The thing you once desperately wanted eventually becomes normal.

Our circumstances change, but remarkably quickly, we adapt.

Success changes our circumstances faster than it changes us.

And perhaps that’s why the finish line so often becomes another starting line.

There's something else going on too.

Doctors conflate hard with valuable.

If a specialty is difficult to get into, we assume it must be more worth pursuing. More noble or more prestigious.

And this belief comes from the same place.

In the professional era, the hardest paths to enter were often seen as the most valuable. Scarcity was part of the point.

I think times have changed, but the belief hasn’t.

I think times have changed, but the belief hasn't.

I saw this with a doctor who joined my Summer Sprint last year.

She was in her first year of GP training, convinced she wanted to transfer into surgery. The way she spoke about it, you'd have bet money on her applying. As we worked together over those weeks and interrogated it properly, she realised something that surprised her.

She had grown up believing that all of her fulfilment had to come from her career. That for her life to mean something, her job had to be the hardest, most impressive version of itself.

Then she noticed what was actually true.

She had friends. Relationships. Things outside medicine that gave her purpose and she was content in her training.

Her life didn't have to fully be medicine.

When she defined her own North Star, (instead of the one handed to her by the culture around her) it looked completely different.

She ended up staying in GP training, she had finally defined success on her own terms.

The happiest people I've come across, in medicine and outside it, all have this in common.

They decided for themselves what success means and they decided what they would do when it arrived.

I don't think doctors have a problem with achieving success at all.

I think we have a problem knowing what to do with it once it arrives, holding on to it and using it to our advantage.

Somewhere along the way, the means became the end.

Working hard stopped being the route to something.

It became the thing itself.

Hedonic adaptation exists, but here’s what I think we can do to get around this.

Before the next mountain appears, ask what has this achievement/success made possible.

Before it becomes normal.

In my own career;

Every success I've had has taught me something, often something I didn't expect.

CCT gave me credibility. It proved I could work independently, that I was capable, that I'd completed something difficult, but it also taught me something harder to admit at the time:

This wasn't it. This wasn't all I wanted to do.

My time at the BMJ did the same. It showed me what I genuinely enjoy, and just as importantly, what I don't.

We talk a lot about learning from our mistakes or failures

I think success teaches us lessons too. We just never stop to listen.

Your success gives you the same clues as to what you're good at.

What you enjoy.

What you no longer want and the kind of life you're actually trying to build.

Because to me, a successful person isn't the one in the hardest specialty or with the most letters after their name.

A successful person is someone who is in control of their choices.

Someone who is content with what they have, not trapped, not asleep, but intentional.

Someone with options.

Because if you have options, then you're making a choice.

And the purpose of working hard cannot simply be to earn the right to work harder.

At some point, success should buy you something.

Otherwise...

What exactly was all the sacrifice for?

If tomorrow you achieved everything you've been working towards...

Would you know what to do with it?

Or would you immediately find another mountain to climb?

Speak soon,

Dr Niks

P.S. If you’ve reached a point in your career where you’re quietly asking “what now?”, that’s exactly why I created The Summer Sprint

Over 12 weeks, we’ll look at what everything you’ve already achieved has made possible, the skills you’ve built, the value you may be overlooking, and the opportunities available beyond the path directly in front of you.

You’ve worked hard to get here. The question now is what you do with it.

[Apply here]

🎥 Watch: The Success Trap