Have you thought about pursuing a non-clinical career or switching out of medicine completely?

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kcmd

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I'm an MD that switched early on in the game from clinical medicine to pursuing a non-clinical career in health insurance and more recently in entrepreneurship.

As a little bit of background, I was pretty certain by my third year of medical school that clinical medicine was not for me, but had little knowledge/opportunities/support to be able to explore fields outside of medicine.

I loved the preclinical years - physiology, anatomy, pathology (perhaps not biochem so much..:) ) - and was extremely excited to be on the medicine journey.

Then the clinical years hit - and almost immediately I did not resonate with the clinical application of the textbook information. I enjoyed being with patients, but did not get excited by clinical signs, was bored in surgery and thought the quality of life for the residents and consultants/attendees was poor (skipping meals/bathroom breaks, working 12+ days regularly, black bags under their eyes...). Managing stroke patients, palpating enlarged livers, assisting with appendectomies or working my way through overbooked outpatient clinics was not my idea of something I could realistically do for the next 40 years without dying of boredom.

So lo and behold, I graduated med schoool with honours, but the unhappiness, tiredness and frustration mounted quickly. Eight-minute consultations with patients just to adjust their prescriptions had me feeling less-than-fulfilled to say the least (glorified pharmacist comes to mind), and it was frowned upon to spend any longer with patients in clinic or on ward rounds - the team, whether medicine or surgery, just had too many demands to get through each day.

I'm not even going to start with the on-call part - 30-hour shifts, beeper going off non-stop etc. etc. On my first call, I got four hours of accumulated sleep, and was told the next day that that was an 'excellent' call and I should consider myself lucky... again, the quality of life, health implications and just expecting better for my future certainly came to the forefront. Was I doomed to spend the rest of my life like an overworked, non-passionate, zombie-like doctor who thinks four hours of sleep is excellent? I shuddered at the thought.

When looking outside of medicine, any of the 'support' and 'information' available was if you couldn't 'hack' it in medical school or residency (roll eyes), then you could pursue a master in international health, public health, medical management etc. Again, after doing a bit of research, these degrees didn't offer a passionate career that I was hoping medicine would have satisfied.

What surprised me the most was not the paucity of information available on the world wide web for physicians looking to pursue a non-clinical career or quit medicine (there is a bit more information now how many years later), but instead what shocked me was the resistance from other physicians. I couldn't believe the amount of other MD's who made the following statements:

-"You're crazy for leaving medicine, look at all you have invested (time, $$ etc.)!" - My response: Just because you're digging a hole and realize it's in the wrong place does not mean that you need to keep digging! Stop, climb out, and start again. We are not a tree, we can move.

-"You're going to waste over half a decade of training and knowledge, right down the tube!" My response: Just because I am trained as a physician does not mean that my accumulated experience, skills and knowledge will be wasted. These can be applied to a multitude of clinical and non-clinical settings. Think of quality control and management (all those medical notes you write!), time management (getting through a 50-patient day clinic, hypokalemic patient on the ward and consults throughout a regular working day), prioritization, ability to handle (literal) life-and-death situtations with time constraint, incredible skill of absorbing volumes of dense, complex information in a short period of time for practical application... these are all skills that we have as physicians that very few people outside of the clinical arena in the corporate or start-up world have. Talk about an A-grade applicant!

-"You'll never make it. Medicine is the only thing we know." My response: Dude, we've overcome insurmountable odds to make it through pre-med and medical school. We've pulled all-nighters, taken (and passed!) some of the most difficult exams in the world and dealt in life-or-death situtations in the workplace each and everyday. Relax, switching career is not like climbing Mt. Everest during an avalanche - it's just switching career.

I resigned from my clinical position, and my consultant/attending at the time, an incredible rheumatologist and all around gentleman, understood and encouraged me taking time off to "travel and do what I need to do". Then he closed off saying: "You're a great clinician, so I would be happy to be your reference when you return to medicine." I was more than grateful for the understanding and support. As I walked out of the hospital for the last day, it then struck me - he actually expected this to be a 'short break' and then I'll be back in the clinical field. It never occured to him that I would be walking away from clinical medicine permanently!

To make a long story short, I successfully nagivated a place in public health insurance for a few years and quite enjoyed it - developing policies and procedures that impacted thousands of patients at a time was exciting. However, alas and alack, bureaucracy (and politics) is the antithesis of progress and implementation and eventually became very weary.

Now I've recently started my own business, and really enjoying the journey - the ups, downs and wins, big and small, that growing a business from the ground up provides. Again, totally different from clinical medicine and health insurance, but exciting all the same.

What about you?

Have you ever thought that clinical medicine isn't what it has cracked up to be?

Have you wondered if you were meant for a different path in life?

Have you ever wanted to find your true purpose and passion, but you're married to medicine?

Have you thought about a non-clinical career or a total switch in careers - from doctor to chef, fashionista, business owner, finance, author..?

Would love to hear your thoughts and musings! You're definitely not alone! :)

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I've been thinking about a non-clinical career for a while - entrepreneurship, informatics, maybe management consulting, or some mix of all three. I'm coming up on halfway through residency. I've convinced myself to take the safer path and secure my future and my family's future financially before taking any risks on the business side - the irony,now, is that in order to pursue any other path besides clinical medicine I'll have to forego a significant amount of income.

What's clearer to me now with some time in the hospital under my belt is that the passion some people feel in clinical medicine is not one I share. To me, it's just a job - I never felt the calling some people describe, and I still don't.

Of course I realize it's silly to complain about this situation. But I think it's going to be hard to be hungry as a good entrepreneur should when there's a sweet juicy ham at the table you just walked away from. Part of me is afraid I'm just going to take the easy safe road and practice clinically, or even worse, put a half-effort towards both paths.

I can tolerate clinical medicine but I don't think it will help me develop the way I hope to as I get on in years - I'd always hoped to become a better communicator, a a better decision maker, a better manager, a better leader. I have to some degree, but it seems residency - a mostly fixed journey with firm expectations - is not a great place to develop these skills. I don't pretend that the business world is anything it's not - I'm sure I'll find cutthroat competition, insane hours, and constant travel. I'm hopeful I'll have the grit to sacrifice to try to become the person I want to be. For the upcoming year I'm going to focus on networking -picking people's brains who work in consulting, informatics, and health startups to try to figure out what my next step will be - the first part of residency didn't give me much time to think, let alone network. But I'm ready to start laying groundwork for whatever comes next.
 
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That was a great read, and thanks for sharing. I would have replied sooner, too, but coincidentally, I've been working on avoiding what you're talking about since you posted.

Have you ever thought that clinical medicine isn't what it has cracked up to be?
I have. It used to seem like the best job out there to me, until I read about physician's lifestyles and the stress-level of different specialties. For some context, I attached the results of two recent physician surveys on their satisfaction and hours worked by specialty; compared to other careers, such as the ones that are possible with an MD in healthcare, pharmaceuticals, business, etc., physicians have the lowest relative satisfaction. Every job is stressful, and physicians have it pretty good all things considered, not the least of which being job security and income, but personally, its the repetitive nature of the job that I don't like. Physicians on the specialty forums complain about this, too, ergo feeling like technicians that perform one specific skill repeatedly.

Have you wondered if you were meant for a different path in life?
Sure. All of the paths lead back to drug development and business, for me; living in the Bay Area exposed me startups, google, etc., which most likely explains things.

Have you ever wanted to find your true purpose and passion, but you're married to medicine?
I did, but considered your question before declining my last allopathic interview a year ago. I'm preemptively doing an MSc in the above areas to give me a way to do more as an MD so that I'm not "married to medicine." I'd still like to practice, of course, but also pursue my other interests.

Have you thought about a non-clinical career or a total switch in careers - from doctor to chef, fashionista, business owner, finance, author..?
Clinical/transational research and business are the most appealing to me. Other pathways I could take via my degree include becoming a clinical assistant professor, pursuing an MD/PhD (and if I discover something marketable starting a spinout), etc., or doing some or all of these things and then entering the business side of a pharmaceutical company.
 

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