After graduating in medicine next year, I've decided not to become a doctor

As I write this, I’m supposed to be at a ‘Medical Careers Workshop’ put on for final year medical students to decide their future career in the NHS. After five years of full-time study in an infamously intense course, turning away from a career in clinical medicine and towards a life in enterprise was more of a realisation than a decision, and it’s something that more and more of my colleagues are considering. After endless junior doctors’ strikes, rock bottom morale and low pay, it’s something that more and more of my colleagues are considering.

There are many things I love about medicine - it’s a fascinating field to work in that lets you connect with people and improve lives. The NHS is also an institution whose ideals we should be incredibly proud of.

However, there are also significant and, probably inevitable, drawbacks to working in the NHS, none of which should be particularly surprising given that it is easily of the largest, most bureaucratic and politically driven public sector monopolies in the world. This has predictable effects on your salary and working hours, which to be honest I’d be happy to accept – as an early-stage entrepreneur I’m already working far more hours for less pay than I would as a junior doctor. For me and many others, the deal breaker is that the NHS doesn’t treat its employees as individuals, and it certainly isn’t open to their ideas.

“Innovation” is something that the NHS has a huge incentive to talk about, but insurmountable barriers to actually achieving. If I were to work in the NHS, I’d be offering them my skills not just as a newly qualified doctor, but also as a serial entrepreneur and technologist. I don’t expect or want to be paid any more for it, but it does sadden me that my employers wouldn’t care enough to learn about and develop these interests shown by myself and many, many of my colleagues.

At the same time, the NHS will gladly sink billions into external consultants and contractors looking to make a quick buck by getting onto the gravy train that is the “NHS Preferred Suppliers List”. Innovation, to the NHS, is spending inordinate amounts of money on new schemes that sound good, but there’s no incentive for these schemes to actually do good.

For me, just keeping my head down and do the best job I can, while turning a blind eye to all the systematic failures and inefficiencies that we know occur on a daily basis just isn’t a realistic option. The NHS reacts to reforming voices within its ranks in much the same way one’s immune system reacts to an invading virus – a threat to the status quo that must be silenced before it has chance to infect others.

So ultimately our only option, as people who really want to make a difference, is to take the skills we’ve acquired through five years of medical school and work on projects that improve healthcare from the outside. As entrepreneurs, we’re able to work on such projects on our own terms.

Why am I turning my back on the NHS? The simple answer is that I’m not - I believe in the founding ideals of the NHS and genuinely want to help it overcome the significant problems it faces. But after everything that’s happened in the last two years, I now know I’m better positioned to do that by working with, rather than for a National Health Service that desperately needs to change.

James Gupta is the founder of Synap