Doctor in scrubs sitting in a hospital, reflecting on life design and career choices

Nobody Trapped You: The Truth About Life Design for Doctors

Nobody trapped you. You just never got round to life design.

That’s the uncomfortable truth, and it’s worth sitting with for a moment. There was no single bad decision. Nobody sat you down and handed you a life you didn’t want. Instead, you built it yourself — one sensible, reasonable, completely unexamined decision at a time.

What’s more, you probably built it for good reasons. If you’re a few years from becoming a consultant, or a few years into a consultant or GP post, you’ve spent most of a decade doing exactly what the career asked of you. The next rotation, exam, or portfolio sign-off. And it worked, because here you are.

But here’s the question almost nobody asks at the finish line: did you design the life that comes next, or did it just happen?

Training chooses your life for you.

For ten years or more, medicine tells you what to do next. Consequently, you never really have to choose. The deanery picks the hospital, the rota picks your weekends, and the curriculum picks what you do with your evenings.

That isn’t a criticism. In fact, it’s exactly what gets people through. Blinkers work. They keep you moving through years of nights, exams and portfolio deadlines, when looking up would only slow you down.

The problem with all of this comes at the end. Once you qualify, no one tells you what to do next. Most of us do the same thing. We take a job that’s there, in the place you can get it, on the terms that come with it, and then we backfill our life.

You buy the house near the hospital, then the schools follow; your spending increases to meet the salary. Eventually, the whole shape of your week and life is set by a job you accepted because it was the obvious next step.

I call this the backfilled life — the opposite of life design. The career gets decided first, and everything else fills in the gaps.

Some people thrive in it. Others slowly feel trapped.

To be clear, there’s nothing wrong with a life where the career comes first. For some doctors, medicine genuinely is the purpose. The work fills them up, and they’d choose it again tomorrow. If that’s you, and you chose it, brilliant.

However, for many of us it wasn’t a choice. It was a default, with no life design behind it. And defaults have a habit of revealing themselves years later, usually as a vague sense of being trapped — by the rota, by the commitments, by a week that no longer looks anything like the one you’d have picked.

That’s the real cost of the blinkers. They were the right tool for getting here. Yet they’re the wrong tool once you’ve arrived, because the question has changed. It’s no longer “what’s the next step?” It’s “what do I actually want my life to look like?” Sometimes you have to put your head above the parapet and have a proper look around. That’s where life design starts.

I changed careers twice and kept the same design.

I know this pattern well, because I lived it twice before I noticed it.

First, the Royal Navy. Good salary, good job. But I spent a lot of time away, and there was no real possibility of being there for my family.

Then an opportunity came up to become a financial adviser in London. I took it because I thought it would eventually let me build a business. On paper, it was a completely different direction. In practice, I was away from home three or four nights a week, every single week.

That was the hardest part. I changed careers, but I didn’t change my approach to life design. When the opportunity was there both times, the job came first, and my family got fitted in around whatever was left. The second move, changing careers, even felt like a choice but was built on the same default as the first.

Only when I came back from London did I see it clearly. So this time, I chose the other way round: life design first, job second.

Life design runs in the opposite direction.

Life design flips the order. Rather than choosing the job and backfilling a life around it, you decide what you want your life to look like first. Then you check that picture against what you actually value. Only after that do you shape the career, and the money, to serve it.

For me, that meant coming back to medicine in a job where I roster myself. I still enjoy emergency medicine. On top of that, self-rostering means I have a lot of control over my week. There’s extra work available if I need it, although these days I’d rather spend that time building digital assets on the side. And the consultant posts I’m working towards are still self-roster, so the next step keeps what I designed rather than trading it away.

Money plays a different role once you design this way. It stops being the goal and becomes a tool. I used to say my top values were family, education and finance. But the longer I’ve worked, the more I’ve realised the only reason I wanted the finance was so I could spend more time with my family. It was never a value. It was a route to one.

The difference here matters. If you mistake a means for an end, you can end up building a life that optimises for the wrong thing. With doctors, that usually means more and more work.

Your life design plan for this week

calendar on wall — Photo by photoGraph on Pexels.com

Life design doesn’t need a sabbatical or a life coach. It needs about an hour, spread across the week, and the honesty to look at what you write down.

1. Write your ideal ordinary week. Not a dream holiday — a normal Monday to Sunday. Which days do you work? Which evenings are yours? Who do you spend time with, and what would you stop doing? Mine includes clinical shifts I choose, time to build my businesses, and family time that nothing else is allowed to eat into. Give it 20 minutes, and be specific.

2. Name your top three values, and rank them. Be honest — no one is watching. Then test each one: is it really a value, or is it a route to one? My “finance” turned out to be a route to “family”. Yours might be a salary, a title or a sense of security that’s quietly standing in for something else.

3. Mark last week’s big hours as designed or defaulted. Go through your diary for last week. For every block of time, ask: did I choose this, or did the career choose it for me? My Navy years and my London years would both have failed this test miserably. The point isn’t to feel guilty. It’s to see the pattern.

Then close the gap

4. Find the biggest gap between your ideal week and your real one. Then write down the single decision that created it. It might not be where you expect. My own gap runs the other way to most people’s: I’d like more time to build, not less work. Right now, I can only give building one or two days a week before it starts to encroach on family time.

5. Make one design choice this month that closes the gap, even slightly. Have a conversation around a job plan. A boundary around one evening. Saying no to one default you’d otherwise accept on autopilot. My choice is the cap itself. Building stays at one or two days so it never takes from my family. It’s slower than I’d like. Even so, it has brought in a growing amount of passive income, without costing me the thing it’s meant to protect.