Ricardo Gaminha Pacheco, MD | MBA

Hi, I'm Ricardo.

About 1 year ago I made the decision to look for a ‘better way’. A way that would allow me to not only earn a good income, but pursue my passions and free some time up for me to spend with my family, live a meaningful life and do the things I enjoyed doing.

Much like you, my journey started when Medicine came into my life.

As far as I can remember, during my childhood I was excited and stimulated by the idea of exploring the unknown. Unconsciously, I think I made the decision at that early age, to one way or another, follow a professional path in an area that would allow me to constantly explore new frontiers. This area turned out to be the noble field of Medicine.

To follow this path and go into what was, at that time, my unknown, I decided to embark on an adventure to leave my coastal home town of Lisbon in Portugal to live abroad and study Medicine for 6 years in Central Europe in Czech Republic. In the process, I ended up having to give up being close to family and friends, however, convinced that this was the beginning of my journey to explore new horizons and achieve the desired impact, I gave my heart and soul to that pursuit.

As probably happened to you, after 5-6 years of many sleepless nights, a series of exams, a lot of hard work and a lot of fun in between, once I graduated and officially became a Medical Doctor, I was extremely proud of what I had achieved and was feeling excited about what the future would hold for me. As with any recent Medical graduate, my first priority was to put into practice what I had been technically trained to do, gain clinical experience, enter a residency program and, of course, get my first paycheck.

As you can imagine, this was exactly what happened!

I rushed to get all the paper work out of the way, Certifications & Accreditations in place, Registration in the respective Medical Council and got myself straight into practicing medicine, initially as a service provider to multiple Public & Private Healthcare Institutions and later on, into the General Residency Program that included a series of rotations across different core Medical specialities, both in the Hospital and Community setting.

Soon enough, while feeling I was adding value and making a difference to my patients, I found myself so immersed in the range of medical activities I was responsible for, that were basically consuming all my time. From Hospital ward rounds to ER night shifts, medical appointments/consultations to minimally-invasive procedures, preparing clinical presentations for the weekly meetings to medical writing for scientific publications and congress posters on my spare time to enhance my curriculum (as this activity was not included in the weekly working schedule of physicians) and many others. On top of feeling overworked and underpayed, once I understood that, on top of everything, there was no clear development plan and a medical career path to grow into: one that would allow me to grow, learn new things and impact patient's lives from a broader perspective, my level of commitment and drive, unconciously started winding down.

With the end of the Residency Program approaching, the overwhelming decision of having to choose the Medical or Surgical speciality I would be practicing for the rest of my life until I retired, was now looming around and progressively daunting me. After all, this was a key decision that would completely influence and shape my future and one I really didn't feel ready to take just because the system in place, said that was the "normal" path to follow and, as it was put back then, "just choose one".

I'm sure, one way or another, you can relate to this in your own journey!

I certainly had been exposed to different specialities along my journey, however, as you know, the experience as a student is one thing and as a practicing physician, knowing the ins and outs of each speciality, is another. I felt I wasn't ready to choose a speciality without fully understanding what I was passionate about in the first place and what was driving me to choose one vs another. I needed to get to know myself better, understand the drivers behind my decision and explore different alternatives and possibilities before "burrying my head in the sand". Choosing a speciality residency that you will be immersed in for the upcoming 3-5 years is not an easy process, let alone choosing the one and only that you are going to be practicing for the rest of your life.

You get the picture, right? You remember the thought process and weighing in all the pros and cons of each choice, correct?

Which speciality were you going to choose and were you going to have access to it? Why did you want that speciality and what were the reasons you told yourself of why you chose it? Where would you be located and would you need to move to pursue it? What was the lifestyle and the work-life balance associated with that choice? Would it provide you an income you could live comfortably of? How would you evolve and what were the career prospects? Would you be limited to the Public Healthcare System or would you have the possibility of Private Practice?

Many of us end up choosing a specialy according to our own perceptions and bias of what society perceives to be the most successfull medical specialities, the ones that would allow you to make more money or simply because your family always wanted you to be a specific type of Surgeon, an Anesthesiologist, a Dermatologist or whatever speciality it is. I have to admit that the idea of doing the same thing, over and over, throughout the years and live my life exchanging my time for a 60 to 80 hour per week job and an undervalued paycheck were daunting. I wanted to be in control. I wanted to be able to design & decide the meaninguful life I wanted to live, on my own terms. I wanted to make a difference for patients & impact their lives for the better at scale.

So, all this said, fast forward to that decisive moment, what do you think I ended up ultimately doing? Yes, you have guessed it right. I succumbed to the multiple pressures, followed the traditional pre-determined path that the system in place dictates for Medical Doctors and decided to get my self into a specialty residency that was available to choose from and which I was not passionate about. I was, however, committed to give it a try and learn from it, while striving to find the path to my true calling.

While my level of frustration on the system in place, that I was apart of, progressively building and accumulating within me, I started questioning myself. Is this what I signed myself up for? Will this be all I will be doing for the rest of my life? Will this be the life I will be living? Where is the balance, the equilibrium? How can I have a meaningful impact on my patients lives and make a difference beyond the 1-to-1 basis? What can I do to improve the system, current state of care, healthcare outcomes and modern medicine in the process?

Remember, I came into Medicine in the first place, to explore the unexplored and I believed I could contribute at a much higher level to advance patient care and the future of Medicine.

With that vision set in my mind, I soon understood that if I wanted to reach that level of impact, I would need to find ways to"elevate", upskill and grow beyond my acquired medical & scientifc knowledge, clinical experience and technical delivery of patient care at an indiviual level. I realized that, if I wanted to change the system for the better and earn a seat at the table where decisions are made, I needed to "arm" myself with a new set of skills and capabilities that would allow me to be an advocate of change and influence the sytem from within. Once again, I needed to set myself on the path to the unknown and follow what my instinct was telling me and ignore what all my colleagues were telling me not to do.

While maintaing myself in the clinic. I was constanly in the look-out for ways to turn this vision into reality and the first opportunity I spotted was to get progressively involved in Clinical Research activities sponsored by Pharmaceutical Companies. This was an area of Medicine and Science that was forward-looking that had, in its essence, the objective to bring Innovative Medicines to improve patient lives and displace outdated standard of care treatments. Just like that, I had just discovered a whole new world, one that would open new horizons and allow me to explore new frontiers and impact people's lives on a broader scale.

Following many proactive contacts (a few replied but the majority didn't), I found myself collaborating, on a freelance basis, with a few Pharmaceutical Companies that had invested on researching and developing new medicines and were now ready to launch and make their Medicines available to patients in specific European Markets. Fast-forward, after being involved in a series of projects with a few companies and while still in the clinic, I received an invitation from a Global Pharmaceutical Company to join their Medical Department on a full-time basis to work on Neurodegenerative Diseases like Multiple Sclerosis, Alzheimer's & Parkinson's. I had understood by then, that I had a keen interest in diseases that were Public Health concerns and a major burden to society. I now found myself at a major crossroad and one that I needed to decide which way to turn,.each leading me to a complete different path and journey.

I'm sure you can recall episodes where you have silenced your inner voice, your own instinct and what your heart is telling you!

Against all opinions from my peers, and after hearing things like "you're throwing your medical career away" or "you're going to the dark-side of the force" and many others, I decided exchange the safe and sound for the uncertainty. I had previously silenced my mind and just knew that, even against all odds, this was the right step for me. I cancellled my lifetime contract with the National Health Service, got myself out of the residency program I was in, and decided to join Novartis, while reaching an agreement with the company that I would have 1 day and a half per week to maintain my clinical activity. I envisoned it as a once in a lifetime opportunity for me to learn with the best and fuel my search to explore new avenues, reach impact at scale for patients and contribute to the future of Medicine. The road less travelled, the unbeaten path, brings many challenges but with it many opportunities.

You cannot discover new oceans unless you have the courage to lose sight of the shore. Albert Einstein once said: "The one who follows the crowd will usually go no further than the crowd. The one who walks alone is likely to find him/her self in places no one has ever been before." With this, I am not suggesting here that this is the path you should follow. Every single one of us is unique! So, pay attention to your inner voice - listen instead of silencing it, trust your instinct, envision your future-self, go for it and start taking action. There is nothing more important than living a meaningful life following your passion. The more value you can add the more fulfilling it will be!