Physicians and career questions

Testing out career alternatives

One great strength of clinical education during medical school is allowing students to experience some proxy of what life might be like as, say, a general surgeon or pediatrician. The older we get, the higher the stakes in making a career transition, but the harder it is to acquire those proxy experiences which teach us so much. The paradox is we are much more in need of “testing out” roles as older adults than when we were students. “Adults are much more likely to act themselves into a new way of thinking than to think their way into a new way of acting.” said Pascale and colleagues in their book “Surfing the edge of chaos”. Check also out our career quiz if you want to learn what career paths will suit you best

The goal

The goal in this testing phase is to learn two inter-woven things about yourself:
[1] How will it feel to give up or reduce your time spent in direct patient care? and, [2] What alternative career options seem most appealing to you?

[1] How will it feel to give up or reduce your time spent in direct patient care?

It’s easy to underestimate the rewards from patient care after a rough week at the bedside. I’ve seen too many doctors speed past this phase and end up feeling quite disillusioned. That’s why I’m a big believer in keeping a simple diary (or even just jotting down key words as triggers for your memory) of the most joyful and most frustrating parts of your work life. Practical constraints make it very difficult to test out the realities of life out of practice – vacations teach little and may provide a misleading sense, sabbaticals are impractical for almost all but academics (and even fewer of these over time). Cutting back to 60 or 80% for a minimum of 3-6 months is obviously imperfect but may be the best that you can do. In scaling back, be sure you don’t just drop the least appealing parts or patients. I want you to know how you feel when you no longer see some of your favorite patients, or work with some of your most pleasant colleagues and support staff. Scaling back from clinical work is to free up time to take on and test alternative tasks to patient care, discussed in [2] below. Reducing your clinical time over the summer months to work on your golf game qualifies only if you are aiming to try your hand at the Senior PGA tour.

[2] What alternative career options seem most appealing to you?

Earlier essays should have generated some ideas. I can think of examples, but you’ll have your own list. Here are a few for starters:

A. Committee work at your medical center but at a staff and not a committee member level. This could be credentials, risk management, recruitment, formulary, education, quality assurance, IT, or others. Thus, a substantial time commitment, being involved in behind the scenes policy and procedural development, and requiring active leadership, education (likely self-education), and overall engagement i.e. not just showing up for meetings. Exposure here should allow you feel how you might enjoy and contribute to work at your medical center in any of these areas, or what might life be like as a CMO.

B. Engage in clinical trials with a substantial time commitment, ideally no less than 20%. How would you feel working in the pharmaceutical or medical device industries? What will be your tolerance for corporate life, the regulatory environment, the job insecurity, the travel on short notice, the reality that individuals in sales and marketing may have as much of a say in what compounds get pulled or pushed as you do? Engagement from within your existing job is not the same thing obviously as working for Medtronic or Pfizer, but recall what you’re after here is testing and tasting.

C. Engage in consulting. I have something different in mind than fitting in a few extra hours a week doing medico-legal work during the long winter nights. Have you some marketable skill that you can hone, and sell?
How about practice management, financial management for physician practices, educational programs to promote to pharma, medicolegal work as a full time consultant, development of basic teaching courses in biological fields to local community colleges, work for the medical insurance industry? A little imagination opens up a score of options. Can you
– discipline yourself to sit down at your office desk at home at 8 a.m. each day?
– learn how to run a small business by taking courses at some local college organized by the local branch of the SBA?
– deal with the inevitable rejections, even after you thought you’d made a sale?

Recall successful testing requires you to know how much you’ll miss clinical practice and how you’ll use your professional effort otherwise. You may do best to try out a number of different options, test and retest, always redefining your mental model of who the new professional you will be, accept that there are no absolute right answers, and you must allow yourself to ultimately succeed by a process of trial and error.