I am nearing the completion of my current residency. I had my doubts about the field overall, but ultimately decided to stick it out and finish. Needless to say, I am still concerned with the employment prospects which have been mediocre to poor even in unsaturated areas. I am not interested in a fellowship as they do not appear to confer any advantages. My choices have been narrowed to stay put, pursue MBA, or retrain in a new field with better prospects. Staying put is tempting but I think long term this might be problematic. The MBA has opportunity costs and would likely lead to more debt unless I found an employer willing to pay for it (not great odds on that). My goal is to use the MBA as leverage and eventually become a leader in the department. I have some ideas but it may take years to develop the credibility and trust to advance into such a role. I think an MBA is pretty versatile as it allows you to pursue other avenues outside of hospital admin like venture capital and consulting but again these things take time to build as well. The final option is to retrain in a field with better employment prospects and geographic flexibility seems like an attractive option. The draw back is the opportunity costs of more training. I feel like if I go down one path there really is no going back. Any advice?