“What do you wish you had done differently?” 

It’s such a great question, and a challenge that I was asked at one memorable Next Generation GP evening. It really set me thinking.

Outside medicine the answers are relatively simple. The one that really bugs me is that I wish I had fitted a loft ladder in the house where we lived for 36 years, but which I put off for year after year because it didn’t seem worth the hassle. At least once a week I had to use a wobbly step ladder which chipped bits off the ceiling, scratched the landing wallpaper, and involved hazardous balancing to retrieve whatever I needed from the attic. I’ve just calculated that I must have gone up into the loft well over 1500 times, but “it didn’t seem worth it”. Trivial annoying inefficiencies build up. Sort them out now.

But as for my career, I’m not sure I have any regrets. This isn’t because I didn’t make any mistakes. Of course I did. (And we don’t have anywhere near enough time here for me to list the clinical mistakes!) I’m looking at decisions that I made, career options that I followed, or opportunities that I failed to pursue. And I don’t have regrets because I’ve always felt that if you change anything in the past, you change everything – and who knows what the unintended consequences might have been. Solve one problem and you probably create a hundred more.

You’ve probably seen the film “Sliding Doors”, a Gwyneth Paltrow movie which alternates between two story lines, showing the two paths that the central character’s life might take depending on whether or not she catches a train. It’s a great premise for a film, and I’m sure that you – like me – can look back at such moments in your life – the extraordinary random nature of how you met, or equally might not have met, your partner, for instance. But I’ve also always believed the premise was flawed for one particular reason. We don’t have just one “sliding doors” moment in our lives – we have an infinite number. The things that did or didn’t happen are indeed infinite in their possibilities.

There were definitely moments in my life when a clear bifurcation in options meant that my career took one direction, not another. I recall going for an interview for a very senior regional role in postgraduate medical education, realising half-way through the interview that I was both bored and irritated with the educational jargon that the interview panel was spouting, and so when we got to the inevitable “Have you any questions for us?” at the end of the interview, I said “No – but I do have a suggestion. If you’ve got any sense you won’t appoint me. You’ll appoint…” and I named one of the other candidates.

They took my advice.

I’m actually delighted that moment of interview madness turned out the way it did, even though my career up to that point had seemed to be on a logical trajectory. But if I had shifted onto that all-consuming educational pathway, I don’t think my subsequent career would have turned out to be half as interesting as it did. Though one young doctor who interviewed me at a conference pointed out that my secret of success was that “every time something goes wrong, you redefine it as a success”. I think he was probably right.

So – regrets. Yes, more than a few. But an equal number of lessons learnt, and a recognition that it is absolutely pointless agonising about the things you can’t go back and change.

And the lesson, if a blog has to have a lesson, must be that there’s absolutely no point in losing sleep over the things you can’t change, and that applies to everything that’s already happened. And that old tale that says “when one door closes, another one opens” is absolutely true.

Though I still wish I had installed that loft ladder.



A podcast about big ideas in health and care. We talk with experts from The King’s Fund and beyond about the NHS, social care, and all things health policy and leadership.

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Will Owen (GP trainee and Next Gen GP leader) reflects on developing a ‘portfolio career’ as a trainee.

I recently had the slightly surreal pleasure of being asked to share a few thoughts on setting up a ‘portfolio career’ for a short article in the BMJ. To be honest I’d never really made time to think about it before but it was a useful exercise! Here are a few things I’ve learnt so far….

For the last 2 years I’ve split my week between GP training, work as a paediatric specialty doctor, helping lead Next Gen GP, and spending a day each week with my 2 year-old daughter. Creating a varied ‘portfolio career’ was one of the reasons general practice appealed to me so much, and I’ve not been disappointed… I’ve unexpectedly found that I have more energy through my working week and a greater appreciation for my clinical time with colleagues and patients. It also, inevitably, comes with added complexity; at times developing a portfolio career has felt like spinning lots of plates – and I’ve certainly dropped a few.

  • Consider what different roles or opportunities will give you – not necessarily in terms of career progression but in what they add to your life, wellbeing or energy levels.
  • Be clear on the challenges – aside from the added complexity of ‘life admin’ (keeping track of finances, annual and study leave etc) I’ve also experienced more self-doubt as ‘a jack of all trades, master of none’. This is compounded the longer-time taken to gain clinical competencies and the difficulty some others have in understanding non-linear training paths. If developing a particular clinical interest then relevant qualifications or accreditation may help in benchmarking your experience.
  • Find allies – when you have several different roles then issues in one can impact the time and energy that you have for the others. Try to find supportive seniors, colleagues or friends who know a bit about your work blend, listening and helping when things feel difficult.
  • Build up a portfolio gradually and try to be flexible – sometimes things all fall into place at once but try to be realistic and not over-promise how much time and energy you can give each part of your week. Keep this under review and if you find the balance isn’t working for you then discuss it and change it.
  • Protect time for yourself and your personal relationships – this is usually the first thing to go when we get busy, and I’ve found that every role occasionally demands more time & energy than I’ve allocated for it! Having multiple roles comes with increasing reasons to sacrifice the time for ourselves or our relationships so it’s even more important to be aware of this.
  • Don’t be afraid to break mould – training programmes can feel very rigid but flexibility is almost always possible and can bring so many benefits, sometimes you just need to find the right person to ask.

In my experience however hard I try to manage my diary the lines between roles will blur and priorities will change week by week. I’ve had to call parents of paediatric clinic patients in the coffee break of my GP clinic, responded to urgent Next Gen emails between in between paediatric clinic patients, and been late joining conference calls booked over my lunch break because an urgent home visit cropped up. Initially I felt guilty that my attention was often split but I’ve realised that it really does all even out over time, and provided my attention is undivided when I have a patient in front of me the flexibility can be really satisfying when you get to the end of a busy day having met several very different goals.

It has been a real (ongoing) learning experience to develop a blended ‘portfolio career’ in training, and there have been several difficult periods along the way, but I still feel that the variety I have in my work has taught me skills I wouldn’t otherwise have learnt and helps keep me fresh and enthusiastic.



Leaders, in my opinion, have always been easy to spot- even as a child. They shot their hands up in lessons, they were the ones out on the dancefloor first, the team captains, the debate queens…They were loud, confident and always popular. As a child, I was happy, and still am happiest, surrounded by like-minded people, dissecting the world and trying to find our place in it. I read incessantly, have lots of friends, and have always over-filled my days with too much stuff. I’m enthusiastic, passionate, and curious. Fabulous qualities- if I was interviewing for a place as a ‘BFF’. But not worthy of leadership status, surely?

Emma Grenell

 I didn’t fit my pre-conceived mould of a leader. I couldn’t see myself in those roles, so I never went for them. So, what the heck was I doing on a leadership programme? If you, like me, have been left feeling like leadership is a sky rocket dream, BUT still have this unwavering little voice inside of you willing better things into the world, then please read on.What does it mean to be a leader? Who are the great leaders of the world? What do they look like? Is that me? These were the questions I was hoping to answer by joining Next Gen GP. Listening to all shapes and sizes of leaders at Next Gen GP helped me to challenge my own assumptions on what it means to be a leader. One particular session struck a chord with me- the session delivered by Hannah Miller, based on the Clifton StrengthsFinder tool. Developed after 40 years of research, this is a much more in-depth personality quiz that the ones you used to find in the back of Seventeen magazine. Clifton StrengthsFinder provides an assessment to identify your top 5 strengths among 34 common talents.

When I completed my questionnaire, I thought “yeah, yeah… I’ve taken one of these personality tests before, every doctor I know is going to have these top 5 qualities”. How wrong was I? Check these figures out; There’s 1 in 340,000 chance that somebody else has the same top 5 strengths as you. And there’s 1 in 33 million chance that someone has the same top 5 strengths as you in the same order! The theory is not to pigeon hole you into a personality type, but rather to encourage you to own your strengths and recognise them as your special power.

To give you a taster, here are my top 5 strengths and paraphrased definitions of what they mean to me. 

1. Input: I love information; books, podcasts, documentaries. I enjoy sharing this info with friends and colleagues who come to me for advice. 

2. Connectedness: I believe that we are tied together somehow. I can help people see the bigger picture. 

3. Restorative: Give me a problem and I’ll help you fix it. Friends often come to me for advice and my bookshelf is full of self-improvement books. 

4. Individualisation: I appreciate the uniqueness of people and how they fit together. 

5. Empathy: If you’re happy…I’m happy, if you’re sad…pass me the Kleenex.

We’re in this together. All interesting stuff, but the real work only begins here. Enamoured by the whole experience, I rushed home after the session and signed up to an even more in-depth analysis. It may sound dramatic to declare that this session was life-changing, but that’s exactly how I felt. It completely opened my mind to what my drivers were in life.

I’m now working hard on developing and being proud of my strengths, whilst being aware of my weaknesses. 

So, if you’re reading this and still thinking: ‘I’m not sure I’m cut out for this whole leadership malarkey’…. please look in the mirror, and realise that you are completely and utterly unique. No one has thoughts, perceptions, or experiences like you. Your passions and your story are yours, and yours alone. Your story is your strength. And you can use that to make a difference- which is, after all, what leadership is really about.

 In the words of Dr. Clifton himself “What will happen when we think about what is right with people, rather than fixating on what is wrong with them?”.

 If you don’t believe me, have a look at the Strengthsfinder tool, and dip your toe into Next Gen GP! You’ll never know what it might change for you. I never expected that it would change me like it has.