Transitioning to the next career

[valianteffort]

Does anyone have a good resources or possibly personal experiences on how they transitioned out of clinical medicine to jobs related to their medical degree? As in pharma, research, litigation, physician for a corporation (I know this one is still clinical) or something of the sort? I am about 5 years ago, get paid well, have good hours, however its just not cutting it anymore with the recurrent night shifts, patients that have become increasingly impatient, consultants clamoring for more from the ER, hospital admin breathing down the neck, etc.

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[painER]

The Physician Nonclinical Career Hunters FB group has some good info. There's also the Physician Nonclinical Careers podcast which is kind of boring but has some interviews with docs actually doing other jobs. It may be a good place to start. I think the first step is to try to identify what it really is that you don't like about your current situation and if the non-clinical career is actually going to solve that. As someone who switched to pharma and now is going back clinical, I can tell you the grass is not always greener. Feel free to PM if you have specific questions.

 

[cyanide12345678]

The Physician Nonclinical Career Hunters FB group has some good info. There's also the Physician Nonclinical Careers podcast which is kind of boring but has some interviews with docs actually doing other jobs. It may be a good place to start. I think the first step is to try to identify what it really is that you don't like about your current situation and if the non-clinical career is actually going to solve that. As someone who switched to pharma and now is going back clinical, I can tell you the grass is not always greener. Feel free to PM if you have specific questions.

What did you switch to in the pharma world?

Why didn’t you like it?

How big a pay cut did you take?

 

[gutonc]

What did you switch to in the pharma world?

Why didn’t you like it?

How big a pay cut did you take?

I can't answer that question specifically, but I have a number of friends and colleagues (in oncology, where the practice --> Pharma pipeline is relatively smooth and well established) that have made that transition. Of the 6 I can think of who have done it in the last 5 years, only one has stayed permanently non-clinical. The other 5 have either come fully back to clinical medicine, or are doing per diem clinical work and less than FT pharma work.

It's not just the matter of "missing" clinical medicine, it's that the pharma world might as well be an alternate universe compared to clinical medicine of any sort in the way that it functions. I've been tempted before, but my few real interactions with pharma (usually as a scientific advisory board member) have been truly disorienting experiences.

 

[Tiger26]

While I love the SDN EM forum, I think there's a strong sense that the grass is greener on the other side (whatever that side might be), whereas the reality is that it's likely just as brown.

Once I made peace with that, my fulfillment in EM went way up through accepting that it was just a job with the occasional meaningful save. A job amidst all the other jobs in life and medicine that has its annoyances and unsatisfying elements.

 

[deleted206819]

Except that this job is on an ever rotation of shifts, weekends, and holidays of which you will miss half because of what the specialty requires.

Let’s not talk about the circadian rhythm disruptions and how bad that is for your overall health.

I would trade it for a less salary but with my weekends, holidays, and nights belonging to me while being afforded a paid vacation, 401k matching, and other benefits.

 

[GatorCHOMPions]

While I love the SDN EM forum, I think there's a strong sense that the grass is greener on the other side (whatever that side might be), whereas the reality is that it's likely just as brown.

Once I made peace with that, my fulfillment in EM went way up through accepting that it was just a job with the occasional meaningful save. A job amidst all the other jobs in life and medicine that has its annoyances and unsatisfying elements.

Except that this job is on an ever rotation of shifts, weekends, and holidays of which you will miss half because of what the specialty requires.

Let’s not talk about the circadian rhythm disruptions and how bad that is for your overall health.

I would trade it for a less salary but with my weekends, holidays, and nights belonging to me while being afforded a paid vacation, 401k matching, and other benefits.

Both of these posts are true. Some can find the peace while others can’t. Some find an exit and are happier (myself included) while others are still searching, perhaps in perpetuity.

 

[cyanide12345678]

Both of these posts are true. Some can find the peace while others can’t. Some find an exit and are happier (myself included) while others are still searching, perhaps in perpetuity.

What was your exit?

 

[Apollyon]

What was your exit?

I think they're pain now.

 

[EthylMethylMan]

Both of these posts are true. Some can find the peace while others can’t. Some find an exit and are happier (myself included) while others are still searching, perhaps in perpetuity.

100% this. Some people definitely find a contentment or enjoyment in the EM grind. But for many, the benefits of the job are overshadowed by the downsides, and for them, multiple other fields in medicine are more satisfying. EM has unique negative aspects that many just can’t live with.

 

[GatorCHOMPions]

What was your exit?

Pain Med. I still do some EM but it’s becoming increasingly harder to justify.

Can’t say it’s all roses and unicorns but happiness, particularly sleep hygiene, is definitely improved.

 

[painER]

What did you switch to in the pharma world?

Why didn’t you like it?

How big a pay cut did you take?

I got a job in clinical development. While the schedule was better (no nights/weekends) and the work was just less stressful, it lacked the meaning that I derived from a clinical career. There's a lot of document review, useless meetings, writing, logistical minutiae. I'd have days where I didn't know what I even did all day, but I was busy. Its a corporate job in many respects. This works for a lot of people but not for me. While we love to complain about the ER, its a really pure type of medicine with the direct impact that's hard to find elsewhere.

Pharma also is more volatile. Layoffs are real (Pfizer currently cutting $3.5 billion for example) and while you will likely get another job somewhere else, it may involve moving, so there's that.

From a pay standpoint my base was 230k, with about 100k in LTI/STI (which you don't see the first year). So 30% paycut the first year, then by year 3 about a wash, after that more in pharma.

 

[RoyBasch]

It's not just the matter of "missing" clinical medicine, it's that the pharma world might as well be an alternate universe compared to clinical medicine of any sort in the way that it functions. I've been tempted before, but my few real interactions with pharma (usually as a scientific advisory board member) have been truly disorienting experiences.

Can you elaborate on this sentiment a little bit? How is it disorienting?

 

[painER]

I can't speak exactly to what was meant by disorienting, but I will say the first year in pharma is a super steep learning curve. It's like being an intern again. You learn an entirely new vocabulary with all the acronyms and learn how the industry actually works. For those who were at the top of their clinical game prior to joining pharma, it can be a challenging adjustment.

 

[gutonc]

Can you elaborate on this sentiment a little bit? How is it disorienting?

Unless you have experience in finance or some other large corporate enterprise with giant piles of money seemingly just lying around everywhere, it's a completely alien environment. And, as @painER points out, the expectations and the prestige game are so different from medicine that just being the smartest person in the room is no longer enough, plus, you're probably no longer the smartest person in the room in a way that matters anymore.

I also want to make it clear that I haven't actually worked for pharma yet, other than in an advisory/consulting role, but what I did experience made me reconsider whether it would be a good career option for me, and I'm pretty sure the answer is no.

 

[cyanide12345678]

Every other back up that I’ve looked at, i haven’t been impressed enough to follow through.

My primary exit plan still remains 3 more years of clinical work - have a 3-4M net worth, and then coast by with 6-8 monthly shifts until I’m emotionally fully ready to quit - which will likely be at 5M. But on paper we are FIRE at 3M based on our current expenses.

Just going to suck it up until then.

 

[fadeam]

I can't answer that question specifically, but I have a number of friends and colleagues (in oncology, where the practice --> Pharma pipeline is relatively smooth and well established) that have made that transition. Of the 6 I can think of who have done it in the last 5 years, only one has stayed permanently non-clinical. The other 5 have either come fully back to clinical medicine, or are doing per diem clinical work and less than FT pharma work.

It's not just the matter of "missing" clinical medicine, it's that the pharma world might as well be an alternate universe compared to clinical medicine of any sort in the way that it functions. I've been tempted before, but my few real interactions with pharma (usually as a scientific advisory board member) have been truly disorienting experiences.

What roles did these colleagues go into?

From what you're describing, I could imagine a scenario in which a researcher jumps to pharma because he/she wants to guide the strategy/pipeline for a big company, gets stuck with some bureaucracy at the trial-level, becomes frustrated, and finally leaves.

 

[fadeam]

I got a job in clinical development. While the schedule was better (no nights/weekends) and the work was just less stressful, it lacked the meaning that I derived from a clinical career. There's a lot of document review, useless meetings, writing, logistical minutiae. I'd have days where I didn't know what I even did all day, but I was busy. Its a corporate job in many respects. This works for a lot of people but not for me. While we love to complain about the ER, its a really pure type of medicine with the direct impact that's hard to find elsewhere.

How long were you in industry for? Did you consider moving to other functions?

 

[gutonc]

What roles did these colleagues go into?

From what you're describing, I could imagine a scenario in which a researcher jumps to pharma because he/she wants to guide the strategy/pipeline for a big company, gets stuck with some bureaucracy at the trial-level, becomes frustrated, and finally leaves.

Most of them start off as medical directors for a particular disease type or treatment type. They are typically responsible for moving things from pre-clinical and Phase 1 to their particular disease and are the names you see on the cover page of all industry sponsored trials as the sponsor's medical director.

The issue for those I've spoken with is that you spend a lot less time on the cool science stuff than they imagined and a lot more time in meetings with lawyers, marketers and regulators than they ever wanted to.

 

[painER]

How long were you in industry for? Did you consider moving to other functions?

I was in for about 2 years. Considered moving to other roles (safety, med affairs etc) but couldn't find anything I thought I would really enjoy and didn't involve moving/travel. There's a lot of great jobs out there in pharma, it just wasn't for me at that point in my life. Moving up the ladder in pharma often involves hopping around to multiple companies which for me would have meant multiple moves. I didn't want that for my family.

 

[Mbekweni]

I did clinical medicine to ER group admin and now moving into hospital admin next year. Still going to work 6-8 shift a month but minimal nights and weekends (none if I wanted). Will see if I like hospital admin that much but also likely easier to lateral from there into tech startup or other corporate role than straight from clinical medicine.

Also happen to have come across more roles through the admin connections and do some consulting work that sort of found me and is at least marginally fulfilling.

 

[HemorrhagicShock]

I did clinical medicine to ER group admin and now moving into hospital admin next year. Still going to work 6-8 shift a month but minimal nights and weekends (none if I wanted). Will see if I like hospital admin that much but also likely easier to lateral from there into tech startup or other corporate role than straight from clinical medicine.

Also happen to have come across more roles through the admin connections and do some consulting work that sort of found me and is at least marginally fulfilling.

Are you tired of clinical stuff? Is the vituity gig not doing it for you anymore? Why the transition?

 

[Mbekweni]

Are you tired of clinical stuff? Is the vituity gig not doing it for you anymore? Why the transition?

I still like Vituity and plan to stick with them certainly at the local clinical level. Their model of large scale national support while being essentially a huge multispecialty physician owned SDG that feels small scale at the local level is unusual and is really taking off with big growth ahead. plus really nice people who enjoy working with. I had the choice of trying to stick around and try to level up into regional or national admin with them but they have some really good people above me who aren’t going anywhere for 5+ years and the hospital route is available immediately. Very solid comp, no nights or weekends for admin, 5 weeks PTO…things you don’t get in clinical EM. I’m not done being a doctor so plan to continue that but in a really scaled down role. My ideal “semi retired” life would be 6-8 clinical ER shifts with almost no nights or weekends and I may have hit that combo (at the expense of more total hours and meetings so not really semi retired) . Clinical income+ admin also adds up to really good comp and it was an offer I couldn’t refuse. Plus I think the hospital/health system admin is a new challenge to tackle and try something new. I like big picture ideas, population health and this could be more macro level work than just the 1 on 1 patient stuff. I figure I can always go back to full time clinical medicine and local site leadership too.

 

[Groove]

While I love the SDN EM forum, I think there's a strong sense that the grass is greener on the other side (whatever that side might be), whereas the reality is that it's likely just as brown.

Once I made peace with that, my fulfillment in EM went way up through accepting that it was just a job with the occasional meaningful save. A job amidst all the other jobs in life and medicine that has its annoyances and unsatisfying elements.

Totally agree. I'm kind of the same way and I had a previous career in corporate America before medicine and definitely don't miss that existence. At the end of the day, although the circadian disruption can be brutal, there's just no other job I could conceivably do to come anywhere close to my current compensation and hours/mo. I've also come to accept it as a "job" and have found that I don't suffer from the disillusionment/burnout syndrome quite as much anymore. I've found greater enjoyment aiming for longevity and have since moved out of all the busy academic EDs and trauma centers to lower acuity community ED existence which is most definitely better for my blood pressure and stress levels. I'm actually in a pretty amazing ED right now and will hold this position as long as I can. Most of the younger docs in the city don't want to work here because it's not "exciting enough" but for someone like me it's exactly what I need right now to sustain my career and avoid the cath lab.

 

[Angry Birds]

Totally agree. I'm kind of the same way and I had a previous career in corporate America before medicine and definitely don't miss that existence. At the end of the day, although the circadian disruption can be brutal, there's just no other job I could conceivably do to come anywhere close to my current compensation and hours/mo. I've also come to accept it as a "job" and have found that I don't suffer from the disillusionment/burnout syndrome quite as much anymore. I've found greater enjoyment aiming for longevity and have since moved out of all the busy academic EDs and trauma centers to lower acuity community ED existence which is most definitely better for my blood pressure and stress levels. I'm actually in a pretty amazing ED right now and will hold this position as long as I can. Most of the younger docs in the city don't want to work here because it's not "exciting enough" but for someone like me it's exactly what I need right now to sustain my career and avoid the cath lab.

I am in the same boat. I took a non-clinical, non-medicine job, only to come back after a year. It's hard to compete with the hourly salary of ER and the flexibility. My burnout is much better now, especially since I have come to terms with the fact that I will do this into my 60s. I also found a nice, slow, boring ER.

 

[Groove]

I am in the same boat. I took a non-clinical, non-medicine job, only to come back after a year. It's hard to compete with the hourly salary of ER and the flexibility. My burnout is much better now, especially since I have come to terms with the fact that I will do this into my 60s. I also found a nice, slow, boring ER.

Yeah, it's actually perfect for me because mornings and overnights can be very slow at the beginning and end respectively and I use the time to do all my market research for the next day, lol. I put in an IT request that allows me to open all my financial websites without getting blocked by the web proxy. I think I told them I needed internet restrictions lifted because I was having a big problem accessing medical websites that I needed for patient care. 🙄

 

[fadeam]

I am in the same boat. I took a non-clinical, non-medicine job, only to come back after a year. It's hard to compete with the hourly salary of ER and the flexibility. My burnout is much better now, especially since I have come to terms with the fact that I will do this into my 60s. I also found a nice, slow, boring ER.

What did you do (if you don’t mind sharing)?

 

[CliveStaples]

Most physicians I've known that have made careers in research either do it through an academic appointment at a University Hospital (I.e. they get grants to subsidize their clinical time) or started doing the former and then leveraged their research to full time employment by a pharmaceutical company.

In general, academics isn't a bad way to prolong a career in Emergency Medicine. Many jobs are insulated from some (but not all) of the pains of community medicine. There are often opportunities in large departments to leverage your interests to buy your time away from clinical work if a full time clinical load doesn't feel sustainable, such as taking more educational appointments in an affiliated medical school, taking roles in department administration, finding a research niche, finding a niche in a sub-aspect of EM such as EMS, Ultrasound, etc. Not all of these pathways require fellowships (I am not fellowship training myself).

I know academics gets a bad rep around here as being disconnected from what "real" EM is like, but if this forum is going to encourage people to find alternative careers from community EM, I think suggesting that someone considers a career in academics is worth mentioning. I worked for a big CMG in the community before transitioning my career into academics and I work in a job that I can see doing into middle age.

 

[MechEDoc]

Does anyone have a good resources or possibly personal experiences on how they transitioned out of clinical medicine to jobs related to their medical degree?

I work at a low volume ER that pays well. While I am still doing clinical medicine, I retreat into a happy place in my mind while talking with people who are abusing the system. It makes the golden handcuffs more palatable.

I try to keep grounded on what matters in life and be a bit more like simple Rick.

 

[HemorrhagicShock]

I work at a low volume ER that pays well. While I am still doing clinical medicine, I retreat into a happy place in my mind while talking with people who are abusing the system. It makes the golden handcuffs more palatable.

I try to keep grounded on what matters in life and be a bit more like simple Rick.

How did you find a job like this?

 

[MechEDoc]

How did you find a job like this?

Pure luck. I was working with a large CMG and they decided to open a FSER in the same area. My contract was amended to include that facility. The pay is the same, but the patient volumes are much lower, so I switched. It's boring and the ER pretty represents everything wrong with american healthcare, but in terms of income/headache (mine), it's a good deal.

 

[xaelia]

Pure luck. I was working with a large CMG and they decided to open a FSER in the same area. My contract was amended to include that facility. The pay is the same, but the patient volumes are much lower, so I switched. It's boring and the ER pretty represents everything wrong with american healthcare, but in terms of income/headache (mine), it's a good deal.

Ah, posts like this ... almost make me want to go back and read my dewy-eyed medical school admissions essays.

Almost need a sticky thread in the "Pre-Med" forum with links to all the burnout posts from different specialties ....

 

[emergentmd]

Pure luck. I was working with a large CMG and they decided to open a FSER in the same area. My contract was amended to include that facility. The pay is the same, but the patient volumes are much lower, so I switched. It's boring and the ER pretty represents everything wrong with american healthcare, but in terms of income/headache (mine), it's a good deal.

Take it when you can because you could be on the other side tomorrow. Many hospital owned FSERs pay similar to the mothership with half the volume/acuity, so best to do some shifts there if you can.

 

[NYEMMED]

I switched to the dark side and became a CMO for a few hospitals.

I try to be seen as fair and not sell out.
I still do 1-2 clinical ED shifts each month (don’t need to, but try to)

Is it easier / better?
No, it’s a different form of stress and has less job security (you can be cut on a whim from the CEO etc…). I’d say I’m just stressed but don’t go home worried about my own patients or lawsuits

 

[emergentmd]

I switched to the dark side and became a CMO for a few hospitals.

I try to be seen as fair and not sell out.
I still do 1-2 clinical ED shifts each month (don’t need to, but try to)

Is it easier / better?
No, it’s a different form of stress and has less job security (you can be cut on a whim from the CEO etc…). I’d say I’m just stressed but don’t go home worried about my own patients or lawsuits

I have yet to see a CMO not change or ask to change.

 

[WhatJobDoIPick]

I work at a low volume ER that pays well. While I am still doing clinical medicine, I retreat into a happy place in my mind while talking with people who are abusing the system. It makes the golden handcuffs more palatable.

I try to keep grounded on what matters in life and be a bit more like simple Rick.

Wasn't Simple RIck a mind slave?

 

[Goro]

Does anyone have a good resources or possibly personal experiences on how they transitioned out of clinical medicine to jobs related to their medical degree? As in pharma, research, litigation, physician for a corporation (I know this one is still clinical) or something of the sort? I am about 5 years ago, get paid well, have good hours, however its just not cutting it anymore with the recurrent night shifts, patients that have become increasingly impatient, consultants clamoring for more from the ER, hospital admin breathing down the neck, etc.

How about teaching???

 

[AlmostAnMD]

Wasn't Simple RIck a mind slave?

Probably why he said golden handcuffs

If punishment doesn't feel so bad compartmentalize it until it's no longer punishment

Valid comparison imo