Surviving Teams You Didn’t Choose

There are few things more painful in medicine than a team that doesn’t work.

Not because someone’s clinically unsafe. Not because the rota is a disaster (though that doesn’t help). But because it feels wrong. Off. Misaligned.

You walk in. Nobody looks up. You don’t know who’s leading or who’s floundering. The atmosphere is a cocktail of tension, defensiveness, and resigned despair.

And you think: Is it me?

It might be. But also — it might not be. That’s the thing about teamworking. It’s less about whether you are good at it, and more about whether the system is set up for it to succeed. When psychological safety is absent — when you can’t speak up, make a mistake, or ask for help — even the best clinicians will shrink Hill et al..

The Buzzword No One Understands

“Teamworking” gets thrown around like it means something concrete. It ends up on GMC forms, in ARCP feedback, in shiny QI posters about handover templates and morning huddles.

But being good at “teamworking” is as vague as saying you’re good at food. Which food? Where? Do you mean growing it, cooking it, or not setting fire to yourself with a pan of oil?

Same deal with teams. Are we talking about:

• The surgical SHO team on trauma take?

• A GP partnership in crisis?

• A community geriatrics MDT with one phone line between seven people?

Each one demands a different skillset. Each one rewards — and punishes — different behaviours. So what does good teamwork even look like?

Let’s start with what you can control.

Are You the Right Person, in the Right Team, at the Right Time?

Sometimes the issue isn’t that you’re bad at teams. It’s that you’re in the wrong bloody one.

That happens. A lot.

• You get put into a team you didn’t pick.

• You get attached to a specialty that doesn’t match your skillset.

• Or worse — you chose it, and now you realise it’s eating you alive.

That mismatch isn’t just uncomfortable — it’s dangerous. Feeling out of place increases burnout risk and reduces empathy, especially in rigid or poorly led environments Zhou et al..

I once trained in Renal. Thought I could make it work. Liked the holistic bits. The conversations. The long-game stuff. What I didn’t like was the academic claustrophobia, the biochemical fetishism, the endless war over millimoles per litre. That stuff didn’t sing to me. It suffocated me.

And the team? Not bad people. Some incredible clinicians. But the dynamics? Rigid. High-pressure. Not built for anyone slightly off-template. My face didn’t fit — and after a while, I stopped trying to force it.

Survival Skills for Unchosen Teams

When you don’t pick the team — and that’s most of the time in early training — you need to ask two things:

• Can I adapt without losing myself entirely?

• How long do I have to hold my breath until I rotate out again?

Because look, sometimes you just have to make it to the end of the block. But if it’s somewhere you want to stay, or build a life — you need more than survival mode.

You need:

• A basic understanding of what the team values.

• An ability to read the room before you talk.

• A willingness to own your gaps early, before someone else points them out.

“That’s a blind spot for me — can I watch you do it once and then try it?”

That line is gold. Humble. Useful. Memorable. Use it.

These skills form the basis of psychological flexibility — and help you survive, if not thrive, in emotionally turbulent systems Grailey et al..

Masking vs Authenticity

Here’s the hard truth: you can’t bring 100% of yourself to every team.

Not at first.

If you’re loud, quirky, neurospicy, a bit left of centre — great. Me too. But you have to earn the right to be that person in a new setting. Otherwise, you’re just noise before people see the value underneath.

Start small. Build trust. Let people meet you in layers. It’s not faking it — it’s pacing it.

And when you’re ready — bring your whole self. It’s protective against burnout, and eventually, it creates space for others to do the same Remtulla et al..

Spotting a Fixed Mindset (and Getting Out Alive)

Some teams are stuck. Cemented. They’ve been in crisis mode so long they’ve forgotten what it’s like to breathe.

You’ll know the signs:

• Every new idea gets a “No, we tried that in 2016.”

• Every rota gap triggers a meltdown.

• Nobody says “How are you?” unless they mean “Can you cover the late?”

These teams aren’t evil. They’re exhausted. They don’t need a hero. They need oxygen. If you can’t give that without burning out yourself — leave.

In NHS-wide studies, trainees describe this dynamic often — stuck systems, unpredictable leadership, emotional fatigue. And it tracks strongly with rising rates of psychological distress Riley et al..

When Big Characters Rule the Room

Every specialty has one.

The Consultant who can’t be questioned.

The Nurse Manager who knows where every body is buried.

The Senior Partner who’s been there since the war and still signs every pathology form in fountain pen.

They’re not always villains. But they shape the weather. If they like you — you’re fine. If they don’t — buckle up.

Sometimes you have to play along. Sometimes you have to quietly work around them. Either way, know your audience. If they expect an X-ray before the referral, get the bloody X-ray. If they want the LFTs chased before clinic, chase them. It’s politics. It’s petty. But it’s real.

Leadership shapes team safety — not just through decisions, but through tone. Toxic leaders cost morale. Supportive ones buffer against trauma Peddie et al..

When You Find the Right Team — You’ll Know

There’s warmth.

There’s laughter.

There’s support when the wheels fall off.

You get your arse kicked when you need it, but you never feel alone. People look out for each other. Cover each other. Joke about the chaos without letting it infect their decency.

I’ve had that. I have that now. It makes everything easier.

If you’re lucky enough to find a team like that — hold on.

If you’re stuck somewhere that makes you feel small, scared, or silent — maybe it’s not you. Maybe your face will fit. Just somewhere else.

Stay positive

-DW