Thoughts and advice on immediate post-residency non-clinical careers

[Seekingadvice9990]

Hello,
I am an intern at an EM program in the US who is unfortunately already feeling very burned out and realizing that I probably made a mistake going into medicine in the first place. Over the course of the last 10 months this is to the point where I have decided that I no longer want to practice medicine as my long-term career. I am now trying to think about the implications of whether to continue with residency versus stop practicing all together. I know intern year is always the hardest for any specialty but let’s assume for now that I simply will not be practicing medicine after I graduate.

I am hoping the large community of the forum might be able to shed light on their experiences regarding anyone in a similar position (i.e. finished residency and then found a non-clinical career without even really being an attending). I have done research on non-clinical careers for physicians and am open to the idea of working in the biotech/device/hospital EMR and IT sector/public health/medical financial advising or research/various allied professions to “medicine” and “life sciences” etc. (Pretty much any occupation where having an MD might be considered an advantage to a recruiter). These all seem like careers that are more suited to burned-out attending level physicians who no longer want to practice but I would be seeking such jobs with basically no attending experience (maybe 6 mo-1yr of urgent care or part time ED work if I can only get interviews for clinical work during my last year of residency). I’ve also thought about returning to school to get a degree like MBA or MPH but I’m not sure about that right now.

My questions are about the following: How realistic is it for residents to graduate from residency and then turn right around and look for these kinds of jobs? Have you heard or know of people doing this?
Are employers really looking for attending experience to come do these kinds of jobs? Even those that would otherwise be considered "entry level"? because as of right now I am planning on not even working on an attending if I can avoid it.
If I am really looking for a job that requires no patient interaction, am I still building “useful” skills by being a resident for the next few years until I graduate? Or is this just poorly-utilized time since I will have to start from the bottom in a different but related field?

People say there will be so much extra opportunity if you graduate residency, but theoretically I would be starting this job search with almost no attending experience, and not having any job experience outside of the clinical realm. I could see myself doing part-time urgent care work or working at a low-volume ED part time if I am unsuccessful in obtaining a non-clinical job offer during my last year of residency in order to make supplemental income as I eventually transition to a completely non-clinical career. However I don’t think I will ever be up for the challenge of working as a full time attending.

Thank you in advance for any advice, websites or resources, personal stories, et cetera.

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[RustedFox]

Dude.

Breathe in. Breathe out.

Get thru intern year, then re-evaluate.

I was 11/10 burned out and depressed during intern year.

It's April. It's almost over. I promise you, it will get better.

 

[AlvinKamara]

Dude.

Breathe in. Breathe out.

Get thru intern year, then re-evaluate.

I was 11/10 burned out and depressed during intern year.

It's April. It's almost over. I promise you, it will get better.

Doesnt it get worse in second year? *nervous laughter*

 

[RainbowOtterz]

Doesnt it get worse in second year? *nervous laughter*

Yes and no. I was an em2 as a pgy3 and felt a lot of burn out as an em1 since I already did a surgery intern year. As an em2 there was a lot of stress and pressure to carry the department (or try to). I spent the first six months until Feb or so being brunt out. I went on cards and then a productive but relaxing elective month. Now is honestly the happiest I've been in a few years, work is going smoother and easier. I feel at peace.

Intern year Sucks for different reasons than junior year. Once I got over the junior slump my quality of life is so much better.

 

[gamerEMdoc]

Hello,
I am an intern at an EM program in the US who is unfortunately already feeling very burned out and realizing that I probably made a mistake going into medicine in the first place. Over the course of the last 10 months this is to the point where I have decided that I no longer want to practice medicine as my long-term career. I am now trying to think about the implications of whether to continue with residency versus stop practicing all together. I know intern year is always the hardest for any specialty but let’s assume for now that I simply will not be practicing medicine after I graduate.

I am hoping the large community of the forum might be able to shed light on their experiences regarding anyone in a similar position (i.e. finished residency and then found a non-clinical career without even really being an attending). I have done research on non-clinical careers for physicians and am open to the idea of working in the biotech/device/hospital EMR and IT sector/public health/medical financial advising or research/various allied professions to “medicine” and “life sciences” etc. (Pretty much any occupation where having an MD might be considered an advantage to a recruiter). These all seem like careers that are more suited to burned-out attending level physicians who no longer want to practice but I would be seeking such jobs with basically no attending experience (maybe 6 mo-1yr of urgent care or part time ED work if I can only get interviews for clinical work during my last year of residency). I’ve also thought about returning to school to get a degree like MBA or MPH but I’m not sure about that right now.

My questions are about the following: How realistic is it for residents to graduate from residency and then turn right around and look for these kinds of jobs? Have you heard or know of people doing this?
Are employers really looking for attending experience to come do these kinds of jobs? Even those that would otherwise be considered "entry level"? because as of right now I am planning on not even working on an attending if I can avoid it.
If I am really looking for a job that requires no patient interaction, am I still building “useful” skills by being a resident for the next few years until I graduate? Or is this just poorly-utilized time since I will have to start from the bottom in a different but related field?

People say there will be so much extra opportunity if you graduate residency, but theoretically I would be starting this job search with almost no attending experience, and not having any job experience outside of the clinical realm. I could see myself doing part-time urgent care work or working at a low-volume ED part time if I am unsuccessful in obtaining a non-clinical job offer during my last year of residency in order to make supplemental income as I eventually transition to a completely non-clinical career. However I don’t think I will ever be up for the challenge of working as a full time attending.

Thank you in advance for any advice, websites or resources, personal stories, et cetera.

Physicians generally get paid to provide patient care. That's going to be the bulk of your income. There are more stressful (EM) and less stressful (Paliative care) ways to do that, but in the end, physicians generally make money providing patient care. Yes, there are jobs such as those you mentioned above where you may get lucky and make some money, but I highly doubt any such company is going to hire a residency grad who is so burned out they don't want to practice medicine straight out of residency to a lucrative salary. That just doesn't seem logical. Why would you even need to complete residency if this were the case? You already have your MD. If you don't want to practice medicine, and just want to get paid a salary because you have an MD, you already have that. What does completing residency do for you?

My concern isn't that you are burned out on EM and don't think you can do it. My concern is that you say you don't want to practice any form of medicine. I'm not sure that's feasible coming straight out of residency with loans. I really think you need to relook at your goals here.

One of three things are true:
1. You are totally overwhelmed as a PGY1 and it will just get better with time
2. You are a bad fit for EM, and this isn't going to get better and switching to something less burnout prone will improve your outlook immensely
3. You truly do hate medicine, nothing will make this better, and you can't ever work a clinical job doing anything

Which one is actually more likely? How often does option 3 actually happen? There are less stressful areas of medicine. There are less stressful EDs where you can sleep 90% of your shift and see 3 patients in 12 hours. You can do a palliative care fellowship after residency and have a lot less stress. Or you can switch to something completely different, you aren't locked into completing an EM residency. You have options, I assure you. You absolutely have options to live a much less stressful career with almost no burnout if you want it while practicing medicine. The trade off is you won't make nearly as much money as you could have, but that's ok, you are already willing to make that trade-off anyways by taking a non-clinical job.

 

[RustedFox]

Doesnt it get worse in second year? *nervous laughter*

I didn't think so, but hey; YMMV.

I was 200% burned out and ready to quit and go be a farmer or truck driver or something else.
Now, I really do have my "dream job". Sure, I could ask for a higher hourly (because TeamHealth skims far too much off of the top), but I my gig is the best around these parts.

 

[Seekingadvice9990]

Physicians generally get paid to provide patient care. That's going to be the bulk of your income. There are more stressful (EM) and less stressful (Paliative care) ways to do that, but in the end, physicians generally make money providing patient care. Yes, there are jobs such as those you mentioned above where you may get lucky and make some money, but I highly doubt any such company is going to hire a residency grad who is so burned out they don't want to practice medicine straight out of residency to a lucrative salary. That just doesn't seem logical. Why would you even need to complete residency if this were the case? You already have your MD. If you don't want to practice medicine, and just want to get paid a salary because you have an MD, you already have that. What does completing residency do for you?

My concern isn't that you are burned out on EM and don't think you can do it. My concern is that you say you don't want to practice any form of medicine. I'm not sure that's feasible coming straight out of residency with loans. I really think you need to relook at your goals here.

One of three things are true:
1. You are totally overwhelmed as a PGY1 and it will just get better with time
2. You are a bad fit for EM, and this isn't going to get better and switching to something less burnout prone will improve your outlook immensely
3. You truly do hate medicine, nothing will make this better, and you can't ever work a clinical job doing anything

Which one is actually more likely? How often does option 3 actually happen? There are less stressful areas of medicine. There are less stressful EDs where you can sleep 90% of your shift and see 3 patients in 12 hours. You can do a palliative care fellowship after residency and have a lot less stress. Or you can switch to something completely different, you aren't locked into completing an EM residency. You have options, I assure you. You absolutely have options to live a much less stressful career with almost no burnout if you want it while practicing medicine. The trade off is you won't make nearly as much money as you could have, but that's ok, you are already willing to make that trade-off anyways by taking a non-clinical job.

At this time trying to be as objective as I can, I think the issue(s) are between me and medicine in general and that "3" is probably where I am headed at this point...even if that is after a brief, if necessary, stint doing clinical work like I mentioned in the opening post. (I am still trying to work with mentors/program leadership and other people to figure out reasons for my dissatisfaction and potential coping mechanisms, etc. However would rather not go into that on a public forum).

I recognize that decrease in salary and potentially even worse working schedule compared to some attending positions might be a trade off. I understand that completing a residency and then looking for a non-clinical job do not align goals-wise, as gamerEMdoc mentioned. However since that is where I may be headed at this point, I am still interested in hearing anyone's experience about my original questions regarding non clinical careers and experiences after graduating residency.

Thank you for responses thus far

 

[Groove]

Hello,
I am an intern at an EM program in the US who is unfortunately already feeling very burned out and realizing that I probably made a mistake going into medicine in the first place. Over the course of the last 10 months this is to the point where I have decided that I no longer want to practice medicine as my long-term career. I am now trying to think about the implications of whether to continue with residency versus stop practicing all together. I know intern year is always the hardest for any specialty but let’s assume for now that I simply will not be practicing medicine after I graduate.

I am hoping the large community of the forum might be able to shed light on their experiences regarding anyone in a similar position (i.e. finished residency and then found a non-clinical career without even really being an attending). I have done research on non-clinical careers for physicians and am open to the idea of working in the biotech/device/hospital EMR and IT sector/public health/medical financial advising or research/various allied professions to “medicine” and “life sciences” etc. (Pretty much any occupation where having an MD might be considered an advantage to a recruiter). These all seem like careers that are more suited to burned-out attending level physicians who no longer want to practice but I would be seeking such jobs with basically no attending experience (maybe 6 mo-1yr of urgent care or part time ED work if I can only get interviews for clinical work during my last year of residency). I’ve also thought about returning to school to get a degree like MBA or MPH but I’m not sure about that right now.

My questions are about the following: How realistic is it for residents to graduate from residency and then turn right around and look for these kinds of jobs? Have you heard or know of people doing this?
Are employers really looking for attending experience to come do these kinds of jobs? Even those that would otherwise be considered "entry level"? because as of right now I am planning on not even working on an attending if I can avoid it.
If I am really looking for a job that requires no patient interaction, am I still building “useful” skills by being a resident for the next few years until I graduate? Or is this just poorly-utilized time since I will have to start from the bottom in a different but related field?

People say there will be so much extra opportunity if you graduate residency, but theoretically I would be starting this job search with almost no attending experience, and not having any job experience outside of the clinical realm. I could see myself doing part-time urgent care work or working at a low-volume ED part time if I am unsuccessful in obtaining a non-clinical job offer during my last year of residency in order to make supplemental income as I eventually transition to a completely non-clinical career. However I don’t think I will ever be up for the challenge of working as a full time attending.

Thank you in advance for any advice, websites or resources, personal stories, et cetera.

You're an intern. Suck it up. Life gets better.

Don't quit. I guarantee you'll regret it.

 

[gamerEMdoc]

At this time trying to be as objective as I can, I think the issue(s) are between me and medicine in general and that "3" is probably where I am headed at this point...even if that is after a brief, if necessary, stint doing clinical work like I mentioned in the opening post. (I am still trying to work with mentors/program leadership and other people to figure out reasons for my dissatisfaction and potential coping mechanisms, etc. However would rather not go into that on a public forum).

I recognize that decrease in salary and potentially even worse working schedule compared to some attending positions might be a trade off. I understand that completing a residency and then looking for a non-clinical job do not align goals-wise, as gamerEMdoc mentioned. However since that is where I may be headed at this point, I am still interested in hearing anyone's experience about my original questions regarding non clinical careers and experiences after graduating residency.

Thank you for responses thus far

I guess what I'm getting at is, why would you take a job for lets say 100k to not work clinically if you could get paid 150 or 200k to see almost no patients and sleep all night and only work 15 days a month? Because those jobs actually exist. You can make more money, with less actual work, in a very low stress environment. You won't make 400K doing it, but I'd imagine you'll make more than you will being a consultant for some tech company.

Don't get me wrong, if you hate clinical medicine that bad to where seeing 3-5 patients in a 12 hour period is too much, then I guess my second point is, why are you even finishing residency? You have the MD. If you aren't ever going to do clinical work, what is a residency doing for your career if you aren't going to do anything related to the field of that residency?

I'm definitely intrigued by this situation, and what jobs you may be able to land. I wish you all the best. I truly hope you don't give up, and all of this is better when you look back on it.

 

[Seekingadvice9990]

I guess what I'm getting at is, why would you take a job for lets say 100k to not work clinically if you could get paid 150 or 200k to see almost no patients and sleep all night and only work 15 days a month? Because those jobs actually exist. You can make more money, with less actual work, in a very low stress environment. You won't make 400K doing it, but I'd imagine you'll make more than you will being a consultant for some tech company.

Don't get me wrong, if you hate clinical medicine that bad to where seeing 3-5 patients in a 12 hour period is too much, then I guess my second point is, why are you even finishing residency? You have the MD. If you aren't ever going to do clinical work, what is a residency doing for your career if you aren't going to do anything related to the field of that residency?

I'm definitely intrigued by this situation, and what jobs you may be able to land. I wish you all the best. I truly hope you don't give up, and all of this is better when you look back on it.

To your first point, I hear you and appreciate the responses. But as of right now I am just in a position mentally, physically, where I would rather do the former of the options (with any drawbacks) than the latter. Sure that may change in the future but I need to prepare for the possibility that it does not change, so I am trying to obtain as much knowledge about alternatives as possible.

Similarly, with regards to your second point: again, I guess this is basically why I am posting here. So far no one has attempted to answer those questions about if residency right into a non-clinical career (but a career still related to medicine and life sciences in some form or another like those that I mentioned in my first post) can or has been done, and whether it is feasible. Maybe this is because this is truly a unique situation or simply because those people haven't posted yet or don't exist on the site. Hopefully more people will post their experiences!

 

[dadaddadaBATMAN]

I guess what I'm getting at is, why would you take a job for lets say 100k to not work clinically if you could get paid 150 or 200k to see almost no patients and sleep all night and only work 15 days a month? Because those jobs actually exist. You can make more money, with less actual work, in a very low stress environment. You won't make 400K doing it, but I'd imagine you'll make more than you will being a consultant for some tech company.

Don't get me wrong, if you hate clinical medicine that bad to where seeing 3-5 patients in a 12 hour period is too much, then I guess my second point is, why are you even finishing residency? You have the MD. If you aren't ever going to do clinical work, what is a residency doing for your career if you aren't going to do anything related to the field of that residency?

I'm definitely intrigued by this situation, and what jobs you may be able to land. I wish you all the best. I truly hope you don't give up, and all of this is better when you look back on it.

1.) Completing a residency means you have an alternative salary available that’s 200-300k or more. It makes you less desperate, and it functions as a competing offer for whoever wants to hire you. It also gives you a temporizing measure if you need work in between

2.) the magical words of “board certified” can be added behind you

3.) you don’t have to explain why you quit something that almost no one outside clinical medicine understands

4.) you are competing on a more even field with the other people who are trying to find an out from clinical medicine who are mostly attendings

I agree with you that there’s probably no significant difference in how you would actually function as an insurance utilization reviewer or epic physician consultant, but that doesn’t mean there isn’t a perceived difference.

The almost uniform advice from old threads on this topic is to complete residency if possible. I'm no expert, but I think there is a reason for this. You are the only attending I have ever seen advocate for anything else.

 

[southerndoc]

You will have far better chances of securing a non-clinical position after residency training than before. I highly recommend that you finish. If you drop out, you will need to get a second degree (MBA, JD, etc.) and will likely be looking at a <$100k entry level position. There are a variety of positions available for physicians that aren't clinical: EMR design and implementation, market analysis for healthcare consulting firms, drug/device analysis for investments companies or hedge funds, venture capital funds, government oversight work (i.e., Medicare), foreign medical intelligence and analyst for CIA, FBI agent (yes there are a few physicians out there), etc.

Join the Drop Out Club (www.docjobs.com) and you'll see what is available. A variety of non-clinical jobs pop up all the time.

I do consulting work for a very large hedge fund looking at medical devices and drugs and making sales forecasts, whether I think FDA will approve new drugs/devices, remove from market, etc. I spend <20 hours week working remotely, 2-5 hours/month away (not counting airfare), and I make as much as I do clinically (working a lot more hours clinically).

 

[gamerEMdoc]

1.) Completing a residency means you have an alternative salary available that’s 200-300k or more. It makes you less desperate, and it functions as a competing offer for whoever wants to hire you. It also gives you a temporizing measure if you need work in between

2.) the magical words of “board certified” can be added behind you

3.) you don’t have to explain why you quit something that almost no one outside clinical medicine understands

4.) you are competing on a more even field with the other people who are trying to find an out from clinical medicine who are mostly attendings

I agree with you that there’s probably no significant difference in how you would actually function as an insurance utilization reviewer or epic physician consultant, but that doesn’t mean there isn’t a perceived difference.

The almost uniform advice from old threads on this topic is to complete residency if possible. I'm no expert, but I think there is a reason for this. You are the only attending I have ever seen advocate for anything else.

Oh yeah I should clarify, I wasn't advocating for it. I'd never advocate for someone to drop out of residency and try and find a non-clinical job, I think that's a terribly risky thing to do because there's no backup. I was more trying to understand the psyche of the original posters thought process on this whole thing if anything. I wanted to know why they wanted to finish residency (ie did they have a glimmer of hope of working clinically). I hope they didn't take that as me advocating to drop out of residency.

 

[TheComebacKid]

I will echo some of the sentiments that others have already stated... Namely, intern year is horrible and it is also a horrible time to make life decisions that will have huge implications for yourself going forward.

As I'm finishing up my third year in a four year program, only now, for the first time, do I feel like I chose the right specialty. I got annihilated my intern year.

It is very, very, very uncommon for someone to go through 4 years of premed, 4 years of medical school, take a series of board exams, incur catastrophic amounts of debt, only to realize that they didn't want to do this in the first place. Does it happen? Sure, but it is exceedingly rare. The system is built to weed out people like that, and chances are you made it through because part of you likes this, but you are just too jaded right now to be able to reflect properly on things.

Intern year is essentially a vacuum and you really have no frame of reference to help you make important life decisions. Intern year is not in any shape or form a reflection of what your career will be like.

I know you are likely going through a tough period of time, and I don't take what you are going through lightly. That being said, I do think that most interns lack maturity (I know I sure as hell did), and you think you know what you really want, but in reality, you don't. You need to accrue enough experience before you throw in the towel and make a decision that this is not for you. That experience should be residency. You can decide to pursue non-clinical stuff after.

My advice is to complete residency, push through the rest of this year, prioritize your mental health and well being. If you absolutely loathe EM, find away to switch into a different specialty and complete that residency. But don't close all your doors by throwing in the towel at this stage of the game. Once you walk away, unfortunately, you can't really go back.

Good luck to you

 

[88222]

I do consulting work for a very large hedge fund looking at medical devices and drugs and making sales forecasts, whether I think FDA will approve new drugs/devices, remove from market, etc. I spend <20 hours week working remotely, 2-5 hours/month away (not counting airfare), and I make as much as I do clinically (working a lot more hours clinically).

This sounds super interesting! How did you get involved with this? Do you have a background in finance or pharma/devices? Any experience prior to doing consulting work as a physician? I would love to dabble in this kind of work. Also, thanks for the link!

 

[citymd1234]

To the OP, I did exactly what you are talking about and happy to chat about how to switch careers in a meaningful way that will over the course of a career end up providing an earning potential 1-2 magnitudes more than as an ED doc. Have a bunch of MD buddies that took similar routes and we're all very happy. Some of us practice minimally, some don't. You can make your life what you want.

PM me to discuss.

 

[betamale]

Hang in there bud. I did 6 yrs of GME and I can honestly say that it gets better.

You can do medical director jobs for plasma centers or research at med school....pure admin from what I heard. They pay about $125/hr. You can have 3-5 of those

 

[enalli]

To the OP, I did exactly what you are talking about and happy to chat about how to switch careers in a meaningful way that will over the course of a career end up providing an earning potential 1-2 magnitudes more than as an ED doc. Have a bunch of MD buddies that took similar routes and we're all very happy. Some of us practice minimally, some don't. You can make your life what you want.

PM me to discuss.

I'm sure many people are curious about this. Any details you can share with the wider forum?

 

[enalli]

At this time trying to be as objective as I can, I think the issue(s) are between me and medicine in general and that "3" is probably where I am headed at this point...even if that is after a brief, if necessary, stint doing clinical work like I mentioned in the opening post. (I am still trying to work with mentors/program leadership and other people to figure out reasons for my dissatisfaction and potential coping mechanisms, etc. However would rather not go into that on a public forum).

You don't have to go into specifics of your life, but you will get more helpful responses if you can try to pinpoint what you hate about your current situation.

 

[citymd1234]

I'm sure many people are curious about this. Any details you can share with the wider forum?

Sure. Broadly speaking these options tend to be in the finance realm. Ranging from investment banking to private/public market investing. They don't lend themselves to mid-career switches as much as they do to early career switches. The jobs also tend to be very rigorous so if you're burned out in the ED, chances are this isn't what you're looking for. I would even venture to say the grind is much much harder in these jobs than in the ED. Some weeks are such a grind that I imagine the oasis that is clinical medicine. Even with that, I wouldn't change my situation.