This is the first of a series of articles directed at medical doctors considering a career change. Topics look into (i) factors that influence your career path (lifestyle, commitment, responsibilities, pride, finances, age), (ii) what keeps doctors from making career changes, (iii) attitudes of family, friends and the public to the career-changing doctor, and (iv) what options doctor's have in non-medical areas.
As a medical practitioner you have some of the most highly 'transferable' skills sought after in business and commerce. Your medical degree connotes professionalism, team-work experience, problem-solving and analytical skills, hard-work, education, intelligence, wisdom and life-experience.
What motivates career change?
If you do a search for 'doctor AND career change' on Medline it will return to you numerous articles about factors influencing career specialisations that doctors choose within medicine; but you will find very few articles for doctors considering a change to career outside of medicine, and no articles discussing the process of making this difficult decision. In this article I attempt to summarise my own anecdotal findings from conversations with other doctors and my own experience. A motivation to change careers often develops over many years (if not decades) and may even start while at medical school. For many, a dissonance grows stronger over this time period from a general sense of unease to a strong desire to 'just quit' and 'take my chances'; balanced against this is the sense of responsibility and commitment we feel to our patient's and a hope that one's lot may improve with more advanced specialisation or professional status. This conflict many generate many problems affecting work and social life.
Factors influencing doctors to leave medicine
1. Personality-job role conflict
Sometimes there is a clash between key personality traits and the expectations/pressures of a doctor's role. Although, the practice of medicine is flexible and their are fields that require varying degrees of particular attributes, for some people there are no common medical specialties that satisfy them. Personality traits that may conflict with the doctor role include:
• narcism eg. "I'm too good to waste my time on these #%!@ people", "I'll only see y and z patients; you see the rest"
• high novelty-seeker e.g. "I'm so bored doing this all the time", "How can I spice this up?", "The first 2 months of a new job are fun, but then I need to move on"
• anti-social e.g."I really don't like being around people", "leave me alone"
• laissez-faire' - an attitude of bare-minimalism that places patients and yourself at excess risk e.g. "whatever", "yeah yeah", "it's not the best I could do, but it'll do".
• indecisiveness e.g. "I can't do it, it's too risky", "I can't decide - let's do a TRM MCT scan", "You decide"
2. Disappointment/failed expectations
Most pre-med students have over-valued conceptions about what it is to 'be a doctor'. Media, societal concepts, and the health profession itself create a very simple and biased schema of a doctor being 'a person who heals people'. The realities of medicine becomes more apparent further into medical training as one receives more clinical experience. There are several areas that doctors frequently feel disappointed by:
• cure-rate is very low for many diseases
• unreasonable expectations from patients to be cured
• unappreciated by patients
• excessive administration and 'red-tape' requirements in practice. Often these form the basis for a feeling of being dis-illusioned, incompetent, and/or ineffectual.
3. Initial 'wrong' career choice I love computers.
If I had done some formal computing studies at secondary school I most likely would have made a career from computing, however, when I arrived at University I had been groomed by family expectations to study a professional degree - so I did. I made a 'wrong' career choice. Now to be truthful, 'wrong' is not the correct word to use, as at the time it was right choice for me (medicine suited my need for assurance of job and income security, and boosted my low self-confidence); however, medicine is not the right career choice for me anymore. For some other doctors, they may discover strong interests in other fields such as music, writing, journalism, politics, I.T., research, or have hobbies that develop into businesses. In these circumstances, doctors may find that their non-medical interest exceeds their interest in medical practice. You don't have to dislike medical practice as a reason to leave it!
Thirty years ago once a person entered a profession it was expected that they would stay in that profession until they retired. Fortunately, the paradigm shift over the past decades has been for people to change jobs as they see fit and that a decision to change careers has become an acceptable option - at least in the commercial world. Leaving medical practice is probably one of the last areas that this concept is becoming acceptable, perhaps because of the special role that doctors have in society. We discuss this some more on the next page.
4. Existential crisis:
Maybe whatever job you are employed in you will always feel 'dissatisfied', because you are searching for fulfillment that is not obtainable by what job you do! People have varying degrees of need for existential meaning, most workers can find a sense of fulfillment from their jobs, doing the job they do well etc. However, some people frequently change career (or consider it) because they feel that the career they are doing is not 'meaningful' enough. For such people, they find they keep saying to themselves, "why am I here", "why am I alive", "I need to leave a mark on the world", "I want to be famous/ well-known/ important". For some people, the drive to 'find' existential meaning continues throughout their entire lifetime, with numerous job changes, travel, hobbies, religions, relationships, and/or careers. It is critical that you identify if this is you or not, because changing careers may not help. Maybe you need God, not a job change.
When work interferes with your family or personal relationships, there is often a motivation to cut-down on work or change jobs. In medicine, the competitive training environment can make part-time work/training untenable even though the effects of late hours, missed anniversaries, work stress can be disastrous on your personal life. For these reasons, some doctors look to self-employment, home business or career changes as an alternative, to allow them to accommodate family and lifestyle far more readily.
Unfortunately, the vagaries of medicine are that sometimes after years of education and training, events occur that do not allow a doctor to continue medical practice even though they want to. Sometimes a charge of medical negligence or bad decision-making ends a career. Sometimes, doctors move to new countries hoping to continue medical practice but are impeded by registration procedures. Sometimes, ill-health (blindness, injury, GBS, CFS, depression) means that the body or mind will not do the job you want to do.
As you can see, there are many different reason why doctor's may be motivated to change careers. In reality, most doctors will find that they are driven to change by several factors, although one may be more salient than others. Identifying what is driving your need to change careers is crucial. In the next section, we look at factors that motivate us to stay in the medical profession.