What are some post-fellowship career options for psychiatrists who want to escape from academia and put together a work-life balance that allows one to focus on family? This question has been eating away at me for months now, and I hope someone can share a bit of wisdom with me. Apologies for the long post that follows; I have, shall we say, a lot of feelings about this. I am currently a CL fellow at a rigorous academic medical center in a major city in the Northeast. I completed a very academic residency in that same city. Most of our fellowship graduates continue on in academia but more and more I am feeling that this path is not for me. The reasons are many: a desire for work/life balance, planning to start a family, and wanting to escape the “publish or perish” world that has surrounded me for the past 4.5 yrs. These feelings are making it difficult to begin applying for jobs as all I have had exposure to is academia and the overwhelming majority of faculty in my programs are lifelong academics. Additionally, the culture of my program is very much the traditional “ivory tower” mentality, with a pervasive belief you are a sellout, or somewhat “less than,” should you choose to leave academia. This makes it hard for me to even begin conversations with senior leaders in my program about other options. As a result of all this, I know next to nothing about the world outside of university-affiliated medical centers, and I don’t know where to begin looking for jobs, or even what kinds of jobs exist that might make me happy. This lack of knowledge is making the job hunting process incredibly stressful and anxiety-provoking. The thought of a lifelong career in academia makes me feel anxious, exhausted, helpless, and trapped… but I literally do not know what to look for or who to talk to about alternative career paths. My dream job might include the option for flexible/reduced hours (32 hour weeks, 4 days a week, perhaps even half-time), being able to help underserved patient populations, and working in collaborative teams consulting in the inpatient, outpatient, or mixed setting. Does this job actually exist anywhere, or am I fantasizing?? Can anyone help me see beyond the walls of the ivory tower and understand what life, and career, can look like on the outside?? Thank you for reading through this wall of text, and for any wisdom you can share!