This one’s for anyone who’s trying to break into medical device sales and wondering what that first year really feels like plus what happens if you move countries to keep doing the job. Rachel Littleton did exactly that. Here’s her path, straight from her chat with Jacob.

Who’s Rachel Littleton?

• Started her career in recruiting after college.
  
  
• Took an outside sales job selling wine to build real sales experience.
  
  
• Broke into medical device sales in Denver as an associate sales rep.
  
  
• Got promoted to territory manager in under six months (that’s fast—many people say it can be 12–24 months).
  
  
• After ~2.5 years in Denver, she moved to London to keep selling for the same company.
  
  

The First Year: Fast Promotions & Real Feelings

Rachel’s early days were intense. New products, new accounts, new responsibilities—drinking from the fire hose. She leaned a lot on a supportive counterpart and took it day by day. There were good days and there were “cry on the way home” days. Totally normal.

Her reminder to herself (and to you): in the first 6–12 months, you won’t know everything. You’re not supposed to. Give yourself some grace.

How the UK Move Happened

Rachel wanted a change of scene but loved her company. She told her manager (who was supportive). A maternity leave role in London popped up—timing didn’t work. The recruiter said, “If you’re serious, we’ll keep you in mind for a full-time role.”
A month later, a full-time London position opened. She interviewed, the company applied for her visa, and three months later she moved.

Takeaway: “Not right now” can turn into “go time” pretty quick.

Life Abroad: Fun & Lonely at the Same Time

Yes, a new city, new coffee shops, new rides on the tram. But also: lonely days, missing family dinners, and rebuilding a life from scratch. She doesn’t regret it—it’s worth it—but it’s not all highlight reels.

What helped:

• Supportive manager and teammate who cared about her as a person.
  
  
• Talking things out instead of spiraling alone.
  
  
• Keeping track of personal wins to fight the negative voice in your head.
  
  

US vs UK: What’s Different in the Job

• Healthcare system
  
  
  • US: driven by private insurance.
    
    
  • UK: NHS (publicly funded). Budgets, rules, and multiple approval layers affect what devices get used and when. Some clinics have long waitlists (even up to two years), so calendars are slammed.
    
    
• Titles & etiquette
  
  
  • In the UK, surgeons are often called Consultants and addressed as Mr./Ms./Mrs. (not always “Doctor”). Easy slip-up, easy fix.
    
    
• Access & education style
  
  
  • US: easier to schedule 1:1 lunch meetings with a doc and small team.
    
    
  • UK: harder to catch people at lunch; more common to do evening medical education sessions with multiple consultants. You’ll present to a room more often, so presentation skills matter.
    
    
• Pay timing (her experience)
  
  
  • Monthly salary and quarterly commission in the UK at her company (vs. biweekly and monthly in many US setups). Just different rhythms to adjust to.
    
    
• Who you see
  
  
  • Mix of registrars (junior doctors) and long-time consultants. Some will try a new product; others will stick with what they know. That’s normal.
    
    

What Actually Moved the Needle

Rachel didn’t just chase the surgeon. She built real relationships with the secretaries, front desk, MAs, PAs, and the whole support team. Those folks often influence the doctor and remember your product at the right moment. When the whole clinic knows you, your territory starts working even when you’re not in the room.

Advice to Break In (Rachel’s Way)

1. Network with intention.
   When she applied for an associate role, Rachel messaged the whole local team on LinkedIn: who she was, that she applied, and who to talk to.
   Her future manager told her she would’ve passed on the resume without that message.
   
   
2. Get outside sales on the resume.
   Her wine role wasn’t forever, it was a bridge to build the right skills.
   
   
3. Stay organized.
   Track applications, people, and follow-ups like a pipeline.
   
   
4. Expect the overwhelm.
   First 6–12 months = learning. Ask questions, shadow, and keep going.
   
   

Why Rachel Littleton Loves the Work

She likes helping patients and one of her products lets some people avoid another surgery. When a patient calls to say, “This device helped me,” it keeps her going. The meaning matters.

Final thoughts

The first months are hard and that’s okay. You’re learning.
If you want in: reach out on LinkedIn, be specific, be respectful, and follow up.
If you’re in: build the whole clinic, not just the surgeon, and keep the patient at the center.

Think about Rachel Littleton’s move, too: a “no for now” turned into a yes a month later. Stay ready, keep talking to people, and give yourself the space to grow.

Want More Details?

For the full story and more insights, watch the full episode on YouTube or listen on Spotify and Apple Podcasts. Don't miss out on valuable lessons and experiences!

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All the best,

Jacob McLaughlin