My family all worked in the factories and warehouses around Leicestershire and had never sent anyone to university, so when I started my history degree at Bristol it was important for me to hold on to my place. I realised in my second year that I wanted to go into medicine, but there was no-one to go along to and say: 'I've made a mistake.' I had to get a degree, even if it wasn't the one I wanted.
After history I studied social studies and then, fearing I couldn't get into medical school, decided to wander round the world, working with VSO in the Gilbert and Ellis Islands.
When I finally got into medicine, aged 25, I knew it was absolutely the right decision. I wanted to be a hospital consultant, and chose to specialise in rheumatology, as it wasn't very popular. I developed a research interest in a disease called Scleroderma, going on to build the national unit for the disease, which is still the best in Europe. That was very fulfilling.
In 2002 I was elected president of the Royal College of Physicians. I'd never had any formal management training but have never been afraid to seek the advice of good managers. I always said there shouldn't be any job I'm asking people to do that I'm not prepared to do myself - if that meant painting the walls, I painted the walls. I never imagined I'd get to this position. I'm now the Government's director for health and work, and chair of both the Academy of Medical Royal Colleges and the Nuffield Trust.
The odd thing is that I now really appreciate history. At university it was all constitutions and laws and it lost its excitement. Now I'm always reading biographies. Medicine struck me as being all about people too, and that turned out to be true.
- Dame Carol Black is national director for health and work.