Got a goal? Here’s how to actually achieve it.

Peter Thiel is known as a contrarian.

Never heard of him? He’s the founder of PayPal, an active Silicon Valley Investor, and the author of Zero to One, which is a heavy hitter in the world of startup strategy and culture.

So in this case, what’s the controversy? He started a scholarship to encourage young people to skip (or drop out) of college.

You read that right. Thiel believes that for young people with vision, going to college is a waste of time. It’s checking the box for the sake of checking the box. There’s a better way to achieve your goals, he argues. Get started now.

You’re in charge

As physicians and experts who have devoted 20+ years of our lives to education, following a well defined path and “checking the box” to get to the next level, his perspective can seem outrageous.

But Peter’s main point is that it’s totally possible to have the career you desire. You just can’t wait for anybody to hand it to you.

Don’t believe this could work in the medical field? Look, of course you’ll never go into surgery without the appropriate training. Just like in business, you won’t become a CEO without management experience. But you can’t wait for someone to hand you those opportunities. You’ve got to go out and get them yourself.

The business and medical worlds alike are filled with hopefuls: talented people, patiently biding their time, waiting to be the most experienced person in the room, waiting for the stars to align just so… before finally achieving their dream career.

But you’re smarter than that — if you want to be.

Young and Hungry

Let me share a story about a colleague we’ll call Arya who is an up-and-coming rockstar in medicine.

Arya recently finished residency and she is interested in leadership.

Before she even finished residency, she got actively involved in leadership. She sought out opportunities to participate on committees; she worked with state medical advocacy groups; she’s worked with me on technology startups.

Arya understands that the previous model of working for years, checking the boxes and hoping for an opportunity doesn’t work anymore. Because of that, she’s been able to carve her own path, which has catapulted her to achieve her goals years ahead of schedule.

A Simple Formula

After a few decades of experience running medical practices, starting my own company, and comparing worldviews with people like Arya, I’ve crystallized my motto for success into three short words: Don’t wait. Plan.

What do I mean by that?

I mean to find success, you don’t have to wait for anyone to promote you. You don’t have to wait to finish your degree. You don’t have to wait, period. But you do have to take ownership, and you do have to plan. Here’s how:

1. Define where you want to be

When I finished residency, I knew I wanted to be a Medical Director and part owner of the company I worked with. I had well-defined goals, and I certainly didn’t want to spend ten years following the traditional path to get there. That’s step one.

2. Identify your hook

Your hook is your way in. Where can you add value? What do the people around you need, and how can you help?

For example, Arya knew her team needed additional technology leadership.

She understood that implementing new EMRs, understanding reporting and analytics, and improving the physician workflow were holes in the current practice.

So she set herself up to be the solution to those problems.

My hook was my business background. I offered to sell a new contract on behalf of the practice. Up-front, I negotiated my terms: I would continue to help sell if they let me manage the business. If I pulled it off, it would be a win-win for both me and the company. I had an “in,” and I ran with it.

3. Put your master plan into action

By now you know where you want to go, and you’ve figured out an angle to get there. The final step is the hardest one: following through. This is the most important step, and it’s the one that weeds out the hopefuls from the successfuls.

Remember, Arya wasn’t a software engineer. She wasn’t better suited than anyone else on her team to tackle her practice’s technical issues. But she didn’t let that stop her from stepping up. She had concrete goals she was determined to achieve, and found a path to get there. By doing so, she fast-tracked herself into a leadership position. Success.

In my case, you probably guessed by now that we landed the contract. Shortly after, a colleague and I became co-medical directors. I was only six months out of residency — I hadn’t even passed my boards yet — and I was managing a large ER and medical team. Success.

Don’t Wait

I’m so passionate about this concept because it’s the same approach I used to get where I am today: an active, happy physician, investor, and advisor who gets to sit down to dinner almost every night with my amazing wife and two awesome little girls. My life is incredible. Because I was willing to buck convention to get here.

What I really want you to remember is this: Goals are great, but you have to have a system in place to achieve them.

I’m not for a single second saying this process is easy. It requires self-awareness and consistent, concerted effort. No one’s going to hold your hand.

The good news? You absolutely have the power to build a career and life that you love. And once you know how, no one can stop you.


Sylvan Waller is an emergency medicine physician and entrepreneur passionate about helping other physicians lead careers they love. See more at sylvanwallermd.com or connect on Twitter at Sylvan M. Waller, MD.