There are many great schools in England, where I grew up, but the one where I did the first part of my secondary education wasn't one of them. Most of the students there did not go on to university, and fights and verbal abuse were common. Now that I am a physician, people ask me how I made it out of there, and sometimes they even seem to feel sorry for me, but I am proud of my past. Attending this school taught me unique and valuable skills. I learned the importance of standing up for myself and for what I believe in. I also learned how to interact with people with challenging behaviors and defuse emotionally charged situations through a diplomatic approach. Above all, my experience at this school prepared me to question things and push back against practices I disagree with, in my personal and professional lives.

ILLUSTRATION: ROBERT NEUBECKER

“Throughout my career, I have tried to avoid doing things halfheartedly.”

As I pursue a career combining clinical practice, research, and teaching, I have noticed a number of cultural norms that trouble me. For instance, in the medical community, it is all too common to see students neglected or humiliated during their training. I am also uneasy with some of the trends and practices in the research community. Recently, for example, I received an email—and it wasn't the first one—offering an “easy” opportunity to build up my research CV. The selling point was that, without much work, I would gain a publication that would help me tick a box on future job applications.

Such messages reflect a worrisome status quo in our research environment. They typify the publish-or-perish paradigm and shed light on a questionable approach to career advancement: Through fear of not progressing, researchers sometimes pursue activities not for the opportunity to explore, learn, and grow, but just so they may add more items to their CVs.

Throughout my career, I have tried to avoid doing things halfheartedly. A couple of years ago, I declined an invitation to take part in a large and well-funded research project that probably would have looked great on my CV. It was just so remote from any of my areas of interest that—even though it offered a chance to gain research experience and develop transferable skills, both of which are certainly important—I would have struggled to justify my involvement. I remain grateful for the opportunity, but I don't regret my decision. I am glad it went to somebody who wanted it more than I did, and meanwhile I have been able to learn from other research projects in medical education that lie closer to my heart.

Some would argue that, by taking this approach, I exclude myself from opportunities and appear to be lazy or detached. I do recognize that there is a pragmatic rationale behind ticking boxes, and I am aware of the risks of not following suit. I would like to do a research doctorate, and I know that I may struggle to compete with others in academia who have played the game better than I have. My counterargument is that it is a simple matter of quality versus quantity. It is true that, by choosing my ventures carefully, I may have been involved in fewer projects. But I like to think that the work I have done, I have done right, and this takes a lot of effort, passion, and commitment.

My career strategy is to look for interesting niches where a few high-quality pieces of work will be held in higher regard than dozens of lesser quality. Colleagues and supervisors have told me that my standout quality is the passion I have for the work I do. My hope is that, when applying for a job, grant, or whatever else may come along, I will have enough on paper to make it to a stage where I can present myself in person, display that passion, and speak for the value of the approach I have taken. In the long run, I hope that the current academic paradigm will shift so that we can look beyond the tick boxes: Perhaps this will improve scholarship and help develop a more creative research community.