Anuj Sean Chathley is a UK-based GP with an extended role in medical and surgical dermatology.
A confession. A question. A quiet revolution.
I was forged in the fires of Indian medical training—where steel met sweat and sleep was a currency we rarely traded. We were not taught medicine; we absorbed it. We lived it. We competed not for praise, but for endurance. For the longest call. The bloodiest shift. The boldest procedure.
A hundred hours a week? A badge of honour.
In those halls, medicine was not a career. It was a covenant.
And then I came here.
To a land of systems. Syllabi. Safety. Where the stethoscope is worn—but rarely burdened. Where doctors-in-training speak of balance. Protected learning time. Portfolio reflections. Where clinical contact is rationed and resilience is pre-packaged.
And I ask myself: What happened to us?
Did we trade something essential for something comfortable?
Did the scalpel get blunted in bubble wrap?
Now, as a GP trainer, I watch with both hope and heartbreak.
I see bright minds. Kind hearts. Gentle intentions.
But I also see detachment. Distance.
Doctors who have memorised the map but never walked the terrain.
They seek general practice for the “work-life balance.”
But medicine was never meant to balance—it was meant to burn.
Not recklessly. Not endlessly. But with purpose.
We are not candlelight—we are flame.
And so, I do not condemn them.
They are not weak—they are changed.
Forged not in fire, but in policy.
But I remember a time. A different oath.
Not to survive medicine, but to become it.
Not to count the hours, but to make them count.
Am I alone?
Or are there others who feel the same chill—the quiet loss of something noble, something raw?
I do not call for martyrdom.
I do not miss exhaustion.
But I miss immersion.
I miss meaning written in long nights and short breaths.
And if you too feel this—this fracture between then and now—
Then let us not lament.
Let us shape.
“What man is a man who does not make the world better?”
If we do not like what we see, let us rise—not run.
Let us teach our trainees not only how to rest, but how to rise.
Not only how to document, but how to decide.
Not only how to cope, but how to care—truly, completely, relentlessly.
Let them learn balance, yes.
But also boldness.
Let them taste the blood and thunder of real practice, and still choose to stay.
The clock ticks differently now.
But time, like medicine, is what we make of it.
Featured photo taken by Andrew Papanikitas, 2023
Brutally & compassionately honest.
Totally agree with the polemic, as the current training does not prepare the doctors for the real world and they have no reserve in their capacity they will struggle to withstand pressure in form of increased demand or increased complexities.
What we learnt in those gruelling long days was crucial to build reserves which help even now when facing a busy on call day.
Our Alma mater did well in training us for the any type of environment. Something for RCGP to consider for the current GP VTS programme.
[…] Deputy Editor’s note – see also: https://bjgplife.com/the-clock-ticks-differently-now/ […]
Brilliantly conveyed the feelings of all the trainers of our age.
The balance is tipped too much the other way. I wonder what do the new generation of trainers think about this ?
Clearly a very caring doctor and very much in tune with the systematic dismantling of General Practice that has been occurring over the Last 10-15yrs.
The mind set of medical students-young doctors( not just GP registrars) of ”clocking in and clocking out” has made it much easier for the government to hasten the decline.
In order to change the mindset it is time the educators–at medical school/trainers in genreral practice –encourage and highlight the importance of learning form clinical exposure to patients. Not what is currently occurring–eg -if doing 40hr per week in GP less than 20hr is spent dealing directly with patients.