Although I’m not usually political by a long shot, the presidential transition in the US today has made me reflect on Barack Obama’s legacy and his mantra of: “Fired up, ready to go!”

I transplanted these words temporarily and thought back to where I currently stand as a junior doctor. When I left medical school I was naïve. I assume most of us were. We eventually realise when we begin to practice medicine, that the system that we work in is not always so conducive to effective working practice. I’m sure readers are avidly digesting the state of the NHS this winter. I also realised that as juniors we focus on safe and effective patient care, but our focus can be distracted by our worries of what those above us think.

A discussion in 2012 with more senior colleagues who I have known through-out my career reminded me that I still worry too much. They are now in the midst of stepping down and told me that as they approach retirement one of their regrets was worrying too much of what their bosses thought of them. But surely this is important? In the hierarchy of medicine, we need to progress and we need that golden recommendation. But as they continued in their reflections, they told me that this is not necessarily true. They advised that medicine is simply about finding the mentors that understand you and where you want to be. And that is ultimately the hard part. After all people fear what they don’t understand.

In 2012, I took that discussion as a mental note and left the UK, heading first to Asia and then the US. Why? Because I always wanted my work to involve travel. Will I return to the UK. Of course! But will I follow the prescribed training route? Unlikely. What I realised was that the prescribed training route, although described as one of optimum ways to gain competency, isn’t all it’s made out to be, with more time spent on service provision as opposed to anything else. It’s designed to make everyone the same, i.e. average. And I am sure we can all recall the usual frequent medic chat. It begins with the portfolio, and follows with questions on conferences and publications, with a comparison of who has done what, and where. None of this really matters. What matters is following what’s right for you and taking the path that makes you wake up with a love for what you do. People can spend a life time working in an environment that just doesn’t satisfy them. So after 2012, I followed the career path that suits me and I continue to do so.

Whatever your passion is, don’t follow the system if it’s not what you feel internally. Follow what suits you. And tell yourself even if you did follow the system you will still no doubt be questioned and critiqued. In reality our concerns about other people’s perceptions makes no difference. Tailor your training system by finding the right mentors and believe me by following your true passion you will love every day.

Neel Sharma graduated from the University of Manchester and is currently based at the Albert Einstein College of Medicine, Montefiore Medical Center, New York.

Competing interests: None declared.