Case in Point: Black Pean
One of the things why I like Black Pean so much is how it teaches you that things are negotiable. According to the drama (we have to consider that this is fictional, Japanese medical community and does not apply to every culture), aside from getting licenses and degrees as a heart surgeon, the way to progress your career is through earning a position in the medical association and you do that by becoming a sponsor of research papers. But before you get there, you have to establish your own credibility first by writing them yourself, publishing findings and sharing them to the medical community. Write enough research papers until you become a sponsor. So to simplify, 1) write A LOT of research papers, and by the time you get older and credible enough, 2) you become a sponsor of research papers. And that sponsorship gives you the "impact factor" (it's like points, basically, to measure your progress) you need to 3) qualify for a position in the medical association. So aside from being a practicing surgeon, you earn a position in the association to be considered "ultra successful".
And here's why Tokai stands out. He thinks this system is bullshit. But how does he establish his credibility to say so if he doesn't write or sponsor papers? His ultimate ammo is a BAU (business as usual work) that only he can do - 100% surgery survival rate. No patient has died in his hands. Here's where it gets better - when surgeons run out of ways to save a patient during the operation (meaning, the patient is about to die due to blood loss and they can't find the hole to suture or something like that) Tokai's trusty nurse calls Tokai for help. Tokai comes in the room (during the operation) all dressed up in surgery clothes and coerces the assigned surgeon to pay him a million Yen to solve the problem and prevent the patient from dying. That's how much confidence he has. Of course, if you're the surgeon, you'll give in instead of letting the patient die, even if that meant living in debt. In short, Tokai saves the day, especially in that critical moment.
Bottomline, know your worth. You don't have to follow the status quo if you know you have a unique value-adding gift that only you can do. There's value in BAU.