The 1990 World Cup gave English football its strangest cultural artefact — a rap, performed by the squad, with a line about football that somehow became a philosophy for anyone who has ever felt a door close in their face. John Barnes wasn't talking about surgery. He was talking about beating a defender. But some lessons travel a long way from where they started.

The idea was simple. If someone tries to stop you, you don't stand there arguing with them. You find another route.

Football has always understood this instinctively, in a way medicine has been slower to learn. The best players don't wait for permission to become who they are. They move. Some leave academies as teenagers. Some fight their way up through non-league obscurity. Some take a sideways route nobody predicted. Different eras, different stories, always the same underlying principle — that potential isn't always unlocked by working harder where you are. Sometimes it's unlocked by changing where you are.

We don't punish footballers for this. We call it ambition. A player moves clubs to find a manager who rates him, and nobody accuses him of disloyalty — we admire the nerve of it. Medicine has never quite made peace with the same idea. Staying is treated as the noble default. Leaving is treated as a small defection, as though loyalty to an institution should outweigh loyalty to your own development.

I learned the difference the hard way, at ST3.

I applied within my own deanery. It felt like the obvious choice. I had trained there as a medical student, then as a Core Surgical Trainee. I knew the hospitals. I knew the consultants, and they knew me. I prepared for that interview more carefully than I had prepared for almost anything — read everything, rehearsed the stations, refined the portfolio until it said exactly what I wanted it to say. And quietly, without ever saying it aloud, I assumed something. If there was any unconscious bias in that room, surely, this once, it would work in my favour. I belonged there. Didn't I?

The interview came and went. Then the scores arrived.

Six. Out of fifty.

I read it twice, certain there had been some mistake. Not thirty-six. Not twenty-six. Six. The number itself wasn't the hardest part to sit with. It was the unanimity of it — every examiner, every station, arriving independently at the same verdict: that I was almost without merit. I wasn't claiming to be exceptional. But I knew, with some certainty, that I wasn't a six-out-of-fifty candidate. The score told me something, and whether it was an entirely accurate account of my performance that day became almost beside the point. What it told me, unmistakably, was that my future wasn't going to be built there.

I've thought often about the compassion that was missing from that afternoon. The panel already knew, before they wrote anything down, that there would be no number for me that made a difference. That decision had effectively been taken. And yet there seemed to be no attempt to deliver it with any humanity. Perhaps they believed the score reflected my performance honestly. Perhaps they didn't. I'll never know which. What I do know is how it felt to receive it.

That afternoon changed the course of my life. Not because of the rejection itself — rejection, on its own, changes nothing. It was my response to it that mattered.

That was the day I decided to leave.