Skills Pay the Bills.Identity Builds the Income.

Last week, a doctor told me she was "good at teaching."

I asked, "What kind of teaching?"

"You know... just teaching. Explaining things. Making stuff simple."

"Okay. And who are you when you teach?"

Silence.

"What do you mean?"

"I mean, are you the person who breaks down complex cases into patterns? The person who makes exams feel less scary? The person who turns confused medical students into confident clinicians? Who are you?"

She paused. Then: "I've never thought about it like that."

Most doctors haven't.

And that's the problem.

Skills pay the bills. But identity builds the income.

Let me explain what I mean, and why this will change things for you.

Prefer to watch instead?
🎥 In this video, I break down the exact skill shifts doctors need to build income and freedom without quitting medicine.

The £10K vs. £6K Question

I personally have a friend (a photographer) JB who charges £10,000 for 12 hours of direct contact work..

A Consultant Trauma Surgeon makes £6,000 for a month full of night shifts.

Same 24 hours in the day, Less work. Definitely saves fewer lives.

So why does JB (the photographer) make more?

Because the surgeon is paid for a skill. JB is paid for an identity, helping photographers build passive income by training teams to shoot for them.

Stick with me,

Skill = "I can do this thing."

Teaching. Writing. Communicating. Operating. Mentoring.

It's transactional. You trade time for money. £100/hour. £500/day. Linear income.

Identity = "I am the person who solves this problem in this way."

“I help medics with comms skills build freelance income through medical copywriting.”

“I am the person who helps public health doctors build digital products that teach preventative care at scale.”

"I help junior doctors get consultant jobs by fixing their CVs and interview technique."

See the difference?

The skill is what you do. The identity is who you are when you do it.

The thing is, thousands of doctors have the same skills.

But only one of them is you.

That's why identity builds income.

You might feel a niggle reading this.
A flicker of guilt.
Like, “£10K? That’s a rip-off. I’m a doctor I don’t need that much. Just £500 extra would change things.”

I’ve felt it too.

But after working with 100s of medics and being one myself here’s what I know:

That feeling is normal.
But it’s also holding you back.

Because when you undervalue your work,
You stay stuck in roles that undervalue you.

This isn’t about chasing money for the sake of it.
It’s about building freedom so you can practise medicine on your terms.

Picture your career like a pyramid

At the top: The stuff you actually want. Income. Freedom. Impact. Time with your kids. Not feeling like your soul is being crushed by rota coordinators.

In the middle: Execution. Offers. Marketing. Courses. Job offers..

All the "business stuff" that makes you want to run back to the wards.

At the bottom: Your foundation, Your monetisable identity. The thing you're already doing that people trust you for.

Now here's where most people go wrong.

They skip the foundation and jump straight to the middle.

They start building course, spending hours on a website, launching Instagram accounts and creating offers. Trying to "build a personal brand."

And it all feels... wobbly. Like you're making it up as you go.

Because you are.

It's like building a house starting with the roof and hoping bricks slide under it later.

(Spoiler: they don't.)

The people who actually build something that lasts? They start at the bottom.

They figure out their identity first. Then everything else gets easier.

Why Doctors Are Terrible at This (And It's Not Your Fault)

Look, if you're struggling to identify your "monetisable skill," this is normal

I see three reasons doctors get stuck here:

1. Skill Invisibility

The valuable things we do every day, mentoring juniors, simplifying complex information to patients, managing absolute chaos, arent really registered as skills.

They’re just expected parts of the job.

There’s no certificate for "Makes panicked F1s feel calm" or "Can explain renal physiology in under 3 minutes."

So you forget about them, but what I have learnt from working with hundreds of Doctors is that..

The things that come easily to you are often the most valuable to someone else.

2. Role Rigidity

In medicine, you role defines you

I’ve painfully watched neurology regs struggle with LPs and eventually took matters into my own hands to teach them as the anaesthetic reg, even though its not “my job”

Job titles have their place, but they can be limiting.

Do Audit points, portfolio entries and ePortfolio tick-boxes make you a better person or Doctor? I don’t think so. If anything they obscure your transferable skills?

So you spend your time trying to fit into the mark scheme definition of a "doctor" that you forget you're also:

• A communicator

• A teacher

• A problem-solver

• A leader

• A strategist

But those don't get you ARCP points. So you ignore them.

3. The Idea Flood

You've got 5 or 10 ideas bouncing around your head.

"Maybe I could coach. Or consult. Or teach. Or write. Or start a podcast. Or…"

This will save you time, forget about all of them and just pick one..when you think about all of your ideas you end up moving forward with very little.

(Ask me how I know. I'll tell you about my failed startup sometime.)

That's where clarity gets killed.

What Oprah, Elon, and Branson Know (That You Don't)

Here's what I've noticed about people who've built successful careers:

They rely on one core skill.

This isn’t to say they don’t have other skills, but they focus on one.

Take Oprah for example: Emotional intelligence + interviewing. That's it. Everything else the show, the network, the book club, came later.

But it all started with: "I can make people feel seen and heard" a basic skill of a GP

Or Elon Musk: Systems thinking + engineering. Tesla, SpaceX, Neuralink, they're all just different applications of the same core skill. Richard Branson: Brand + storytelling. He knows how to make boring industries feel exciting, he literally used his personality to build billion pound companies.

They mastered one thing. Then built outward.

You can do the same.

The only difference? You haven’t picked your skill… yet

(And no, "being a doctor" is not a skill. It's a job title. Keep reading.)

Your Core Skill Compass

Alright. Let's stop talking about billionaires and make this about you.

Grab a pen. Or open your notes app.

Here are three questions, that will help you get started.

Answer them honestly:

Question 1: What do people ask you for help with when you're off work?

Not in your job description or in your portfolio.

What do colleagues, friends ask you about?

• “Can you help me organise this?”

• “Can I talk something through with you?”

Write down two things.

Question 2: When you're relaxed, what do you talk about or research without thinking "this needs to make me money"?

What do you geek out about? What does your youtube search look like?

The thing you'll happily talk about at a dinner party (or in the doctors' mess at 2am).

Write down one thing.

Question 3: Which of those things could someone else pay you to fix?

What are people actively stuck on? What would they pay to solve faster?

Getting a job? Passing an exam? Building confidence? Managing their time?

Write down one thing.

Now look at your three answers.

The intersection of those? That's your core monetisable skill.

It's:

• Something you're already doing

• Something you actually enjoy

• Something someone else will pay to fix

That's your foundation.

Everything you build your offers, your content, your portfolio career starts here.

(This took me three years to figure out, by the way. You're welcome.)

Once you’ve got your answers, reply to this email.
I’ll send you a short video outlining what I think your Core Skill is and where I’d start if I were you.

So if you've been stuck in vague ideas like “I’m good at teaching”...

This is your moment to flip the switch.

From doing things you're good at...
To becoming known for solving one specific problem.

That’s the shift from stuck → in demand.

Now here’s how to move forward fast:.

If you've made it this far, you're already ahead of most doctors.

Most never get past "I should do something" to "Here's the one thing I'm going to do."

But you're here. You're thinking about this.

So here's what to do next:

Step 1: Take the 2-minute quiz and get instant clarity on your monetisable skill.👉 [TAKE THE FREE SKILL QUIZ HERE]

Step 2: Write down your 3 answers to the Core Skill Compass.
(Scroll up if you missed the questions.)

Step 3: Send me the answers to your 3 Questions:

I’ll send you a short video outlining what I think your Core Skill is and where I’d start if I were you.

If you’re too busy, for now? Just figure out your one skill.

Everything else the offers, the income, the freedom builds from there.

You don't need ten skills to build a portfolio career.

You just need one to start with.

And you already have it.

Dr Niks

P.S. Already taken the quiz? Forward this to a doctor friend who needs to read it.