Chasing Failure

Thanks so much for having me on. This is the age-old question — I always get nervous you're going to ask it, and I probably should have prepared. But hi, I'm Mala. I trained as a doctor, qualified, and quite swiftly moved out of clinical medicine. I now work full-time at an early-stage health tech startup, alongside hosting the Royal Society of Medicine's Digital Health Podcast. I hold a few academic roles, and I sit on the editorial board of the International Journal of Digital Health. So, a few fun things — and I'm really excited to talk to you.

I think I can speak for quite a few med students when I say it's a long time, with a lot of structure — but a lot of time within that structure that you can fill with anything. Everyone goes off and finds their sports, their hobbies, their activities. I knew I really enjoyed technology. But when I started med school there wasn't much going on with healthcare and technology — it was seen as not as glamorous or exciting as it is now. So I started working in other tech companies. I worked in startups doing things like viral video management — internships over summers and any breaks I had. Not just because I wanted to learn, but because I needed to earn money, and I'd rather work in a startup than the local pub.

In year two I worked at Touch Surgery, doing surgical simulation validation and joining their sales team. The summer after, I did a short stint at Zesty and a short stint at DemDx, working on different projects. Then I went to Unilever, in their data analytics team — looking at how consumers were spending across all of Unilever's brands using their Google Analytics tools. The interesting bit was you could pair up what the different brands were doing and see, on a wider market, how all the shampoo buyers were buying.

Then I did three months at the European Space Agency, as part of my BSc project. I was doing global health, trying to relate how you take healthy people into unhealthy situations — mirroring what we do with refugees, where we take them into a high-stress situation, they're not eating or exercising as well. It's almost the same as what we do with astronauts: they're put into a different situation — what effect does that have on the human body? I was at the Harvard Digital Health Accelerator for a while too, and the Malawi eHealth research.

So alongside med school I was learning how to build content. That led to the Royal Society of Medicine's Digital Health Podcast. I did some work for The Guardian, wrote articles with the Microsoft Health blogging team, and blogged officially for Imperial for the whole six years. Slowly I learned the value of content production — what it can mean for building your own personal profile.

Persistence. Knowing what your story is, knowing what you want, and then just going and getting it. I'm telling you all the things I did do — but that's not talking through the hundreds of rejections I got. And this is really stark: resilience is taught a lot at med school. Every single time, they teach you what resilience is — but they don't give you many opportunities to fail. They shelter you from failure quite a lot, and I think in quite a damaging way. If you don't actively seek opportunities to fail, you won't build that resilience.

To get these internships — sure, you need a CV, you need a LinkedIn, all of those things. But the main thing is grit: when someone says no, either replying back with a follow-up of some sort, or having the patience to pick yourself up and try another email address. That should be more widely taught.

Yeah — be addicted to failure. That's honestly the one piece of advice I'd give. If you go out actively seeking to fail, failure stops being a disappointment and becomes a learning experience. Every single day we should be looking for ways to fail, so we can learn what we don't know, so we can grow. If you're not failing once a day, what are you doing? And then success becomes even more important, because it takes you outside your safety net — you start building success in areas you didn't even know were imaginable. It's crazy: six years ago I never thought I'd be at the European Space Agency. Now I look back and it feels really natural, part of my path — because I did coordinate it to try to get there.

Oh, there are so many. The obvious one is you don't get the email replies, and you feel like it's such a waste of time — but it's fine, keep going. But there was one time. For year four of medical school you apply for what project you want to do — I know you spent some time at Imperial too, so you know the gist. Back then you had to do a three-month stint somewhere, a 10-week research placement. I'd applied to go to Japan, part of the medical school programme. I got down to the final six, and three people go. By the time I was at interview, there was a one-in-two chance I'd get the place. I worked so hard — practice interviews, tailored my application, everything. I'd studied Japanese at school, so I was like, please. I went into the interview and thought it went really well.

And I didn't get it. I was really, really upset. It felt like I'd done weeks of work. Now I look back and think, oh, it's just a thing I didn't get. But at the time it's so important to you — it's almost crushing. You feel like your whole worth is riding on someone else telling you yes. And then you question your own worth: I thought I was good enough, so am I not? And it spirals. I got the email while I was on a hospital placement, on firms. I looked at my phone, read it, and I bawled. I couldn't stop crying — I was in the locker room, it was so awkward. It took me about half an hour to pull myself together. I think I had to Uber home. I couldn't talk to anyone; I didn't even want to tell anyone I hadn't got it, I was so embarrassed. And it's my friends, my partner, my parents — it's about surrounding yourself with people who help you get that resilience and help you stand up again.

That was when they said to me: that's just one opportunity, try going for another one. And that's when I got the European Space Agency. If I hadn't had that rejection, and if I hadn't kept going, I wouldn't have got my placement in Germany at the EAC. But I didn't know that at the time. It was such a bad place.

Thank you, that's really kind. I think you do personal branding really well too, so I'd ask you the same question. If you talk to anyone who accidentally created a brand, they'll tell you they'd rather have put it under their own name. You need to know the power of your own name right now — putting things under your own name, making sure people know who you are and what work you're doing. It's really important, and something we're just not taught at medical school.

At university in general: if you don't create your own worth, someone else will define it for you. I'll say it one more time because it's so important — if you don't create who you are, that sense of worth and what skill set you provide and at what price, then someone else will set your price. Someone else will tell you what bucket you fit into, and give you a job you maybe don't really want. And then you end up down a path you didn't want to be on. So it's really important that, almost weekly — whether through meditation, mindfulness, something — you stop and touch base with your values: am I on track? Am I doing things aligned with who I am?

Personal branding is so important because of that: if you know fundamentally who you are and who you want to be, it's really easy to build a brand around it. If you're confused about it, it's really difficult. So before you even start thinking about personal branding, you need to think about what type of things you enjoy, who you want to be known for. Then it's about taking as many opportunities as you can to create that brand. If it's content, like you do — blogging wherever you can, offering your skill set to startups and big companies, pitching articles. If it's something else — say you want to be the best UX designer — you need to build that portfolio, gun for opportunities where you can showcase it.

It's tricky, because I'm not a marketing expert — I just know what worked for me, and it took a lot of time to land somewhere. But the practical steps: you need to start somewhere. Stop worrying about the big picture and start thinking really strategically. Break it up like you would in a company — quarters of the year, then down to a monthly basis. What do you want to have achieved by the end of this month that you hadn't last month? Is it writing one blog post for one company? Great, go do that. If you want to be on a podcast, go pitch yourself. If you want to secure an internship or a three-week placement for your holiday — break it down into sizeable chunks. Once you've got that, you can start creating that portfolio of who you are. Then you can build your website, your Instagram, your Twitter, your TikTok — whatever channel you want. But you need something to go on there; you need that content to start you off.

It's a good question. I like to answer in reverse: I'll probably never know if it was the right decision. I just won't. It was the right decision at the time. And hindsight is the easiest thing to look back with.

Clinical medicine becomes a way of life. You take on that persona of being a doctor — that is who you are. Firms, the ward rounds, drawing the curtains, writing in the notes, the BMA — that's all part of who you are. So it wasn't a decision about whether I wanted to do this job or not, like other people facing different industries. It became a decision about whether I wanted to almost change who I am. Because it is that big a decision when you leave medicine. You've invested so much time into becoming a doctor — it's a new language, a new thing, and you're a new person to quit. It's like sunk cost. It's a lot to quit.

I had to take a step back and think of it like a job — and that was one of the hardest things to do, because again, you're not taught how. This is my job. And as a job: is it making me happy? Is it giving me the ability to do the things I want to do?

The way I always break it down: there are five pillars in life — friends, family, relationships, hobbies and extra-curriculars, and work. That fifth one, work, became all of them. I was cancelling on my family because I was working; I wasn't able to look after them properly when they got ill. My friends and I couldn't get together — we were working different shifts. And my non-medic friends? Really hard. Everyone I was friends with was pretty much a doctor. Long-distance relationships, date nights, planning holidays — really hard. And your hobbies become everything to do with work too. It's bizarre — you're excited to do a hobby, which is writing a paper. That's not a hobby, that's work. But they make you feel like it is. I realised I was working to work. I was going to work to carry on working when I got back, and I was letting it take over my life.

So I took a step back and said: if I want everything else in my life to look how I want it, this career isn't going to allow me that choice. That was really personal. But I knew what I wanted from the other pillars, and I knew the lifestyle I wanted. I take my hat off to everyone who does clinical medicine — I think it's fantastic. But for me, one, I just really wanted to do health tech; and two, at that point in my life I needed to be able to give more to my other pillars.

I guess you'd be the judge of that, not me. It really depends what role you want — that's all I can say. It's a job. If you want to be chief medical officer, then yeah, you should probably still be working as a doctor — to be a CMO in a startup you probably need to still be practising clinically.

I was able to get a job, and I think most people can, because once you've finished you've got one or two degrees. You can apply for a normal grad scheme, or a job at a startup, and most of the time you will get it. It will be hard — it took me a few months to find a permanent role I was really happy with, and I was doing lots of ad hoc work in between. It took about five or six months before I went full-time. So it takes time, but you can do it. It's that resilience again.

If you leave after reg, you'll have more clinical experience, but less of your twenties. So it depends. And I hate playing this card, but you need to put as much time into planning your personal life as your professional life. If you can have a five-year plan for your professional life, you need one for your personal life too. I knew personally that if I carried on, became a qualified GP or something, and then wanted to quit, I'd have to start again from scratch — because when you change careers, you start again from the bottom and scrape your way up. And I'd be in my thirties, and I didn't want that. That was just a personal choice.

I knew I wanted to do it, so I'd rather do it now — while I can give the time and energy, work stupid hours, literally give myself to a job. I'm in my twenties, I don't have kids, I don't have people relying on me. Because I'd mapped out my personal and professional life, I knew I needed to do it now, because I wanted to. Your twenties is the time for taking risks — well, you can take risks any time, but do it in your twenties, why not?

No. I wanted to help a bit more in the pandemic, but you can in health tech anyway, so that was fine. Honestly, there haven't been any cons. I have my weekends. I know when I can take annual leave. All these simple things. I understand money a lot better now — I understand my pension, all these things, because you're just learning about it. I have time in the evenings to have a bottle of wine, go out for after-work drinks. My lifestyle is better than it was as a junior doc.

It's different for everyone. I suppose the cons are that you're not in the NHS, which is fundamentally the greatest place in the world to work — it's fantastic, one of the best things that's ever come out of the UK. And I don't get a vaccine — is that a con? I'm making them up now. I don't really have many cons. Here's the thing: I came out of a rut when I left clinical medicine. I thought it was the thing I had to do — you have the dreams society has told you to have, and then you have your actual dreams. I thought that was my dream. I got to this pinnacle: I'm a qualified doctor, I'm working, I have great friends — and I was just deeply unhappy.

So I've now got to a place where I'm really, really happy with where I am. I have a job that I love. I have hobbies and the podcast. I'd love to see my family and friends more, but it's the pandemic. There are such healthy people around me, and I've cut the toxic people out. And I'm really proud of myself for getting here, because it's such a difficult choice to make for yourself. It feels really selfish to do it, to power through and say no, no, keep going down what you want to do, even if it's difficult. I'm proud of myself for doing it, and I hope other people who've made similar decisions are also proud of themselves for going and doing what makes them happy.

Yeah — most of the books I read are female empowerment and women in the workplace. I learned the greatest amount from Melinda Gates's book. She wrote fantastically about how, if you invest in women's health, in women's education, in women in general, you lift up the entire family and do wonders for a society. That taught me some of the basics I know about global and public health, and I really valued it.

The other is Lean In, and then I very quickly read Unfinished Business — the follow-on, which says there's more to be said here. Knowing that, as someone in the workplace — and it's the same in health tech — you might be somewhere that feels uncomfortable, maybe not the ideal work environment for you. For example, if you're a woman and it's hard to leave early because you need to pick up your kids, that's not your fault. It's the workplace's fault. Knowing how you can actually impact change — to make it more sustainable as a workplace not just for you but for others around you — I think that's really important.

I think there's something in the game of mentorship here. I don't know how to say this in a PC way, but one of the things I've realised is that people like to give you advice, unsolicited, a lot of the time. Knowing that you can stand your ground — especially in health tech — and say, no, I do understand this concept, is really important. Sometimes people confuse mentorship for unsolicited advice. They think they're mentoring you, helping you through problems, but actually it's patronising. So one of the challenges I've found is that — maybe it's because I'm a woman, maybe it's just the ecosystem, maybe it's because I'm from an ethnic minority background — sometimes advice is given in a patronising way.

Making sure the ecosystem is aware that we have diverse talent at the forefront of the space is really important. Because when you have people at the top who can speak like you and talk like you, it allows people to move upwards and not be stuck in middle management. I honestly think the biggest thing is we need more women in senior health tech leadership positions to be actively encouraging mentorship in the correct way. And we need lessons in what mentorship in health tech should actually look like.

Oh yeah, a hundred percent. It feels awkward to say, but when you watch television and don't see someone who looks like you playing the main roles, it's hard enough. But when you look in your workplace and can't relate to the people in leadership positions — you can't empathise with the way they work, you don't have the same thoughts or feelings as them — they can't mentor you in the right way. And if you can't get active mentorship because of it, not only is it not inspiring that you can reach those goals, you also don't get to learn the skills you need, personalised to you, to get to the top.

So having mentors who look like you is really important. Also having mentors who don't look like you, but who are willing to understand what they don't know and fill in those gaps. I've got the most fantastic set of mentors around me — but I wish every day that we had a more diverse workforce sitting at the top of health tech. Right now — we were chatting about this offline — you have people who've got to the top of health tech but don't really know how they got there. They had a bit of interest in technology and a bit of interest in healthcare and kind of ended up there. What I hope we'll see in the next few years is a much more structured career path: a lot more people going into the space, a lot more talent, and a lot more rigour on how we mentor people and how we think about diversity. I think it was starting to get there, but it's really important we encourage it from the start.