I’m honored to share with you this excellent guest post by Dr. Morgan Leafe. Dr. Leafe is double board-certified in pediatrics and clinical informatics. After 14 years as a pediatrician, she transitioned into medical writing and informatics. This blog post offers concrete advice for dealing with the common emotions that come up when you’re considering leaving medicine. Please enjoy!
5 Tips for Handling the Emotional Side of Leaving Medicine
I very clearly remember where I was when I had what my idol, Oprah Winfrey, would call an “Aha!” moment while listening to Michelle Obama’s autobiography, Becoming. Mrs. Obama recalled the pleasing reaction she received from adults as a child when she would tell them that she wanted to be a pediatrician when she grew up. “Oh, a doctor! What a good choice.”
Oooohhh damn, I thought as I nearly drove my car off the road. How had I never before realized this exact same people-pleasing scenario that had played out hundreds of times in my life provided the positive feedback that kept me in a career I disliked, while at the same time fueling my guilt for wanting something different?
I had grown up believing that caring for sick children is one of the most noble career paths one can choose. What kind of horrible person was I to want to walk away from such important work? If everyone says medicine is a great career, who am I to think differently? Plus, all the time and money invested!
Have you ever tried to tell someone, especially someone outside of the medical field, that you don’t like your job? ESPECIALLY if you are a pediatrician, they look at you like you have 10 heads. As far as I can tell, this reaction is based on two things.
First, they loved their pediatrician growing up or their child’s current pediatrician and feel greatly uncomfortable with the idea that said pediatrician may not reciprocate these feelings. (For the record, I have loved every one of my patients over the years, and it’s part of the reason I stayed in clinical medicine longer than I should have.)
Second, many outside of medicine don’t really understand what our day-to-day life is like. They think of pediatrics as a fun gig where you play with kids all day instead of writing notes, running an office or team, dealing with bureaucracy, and worst of all for me, incessantly worrying about the patients you love so much.
There were so many things that kept me going longer than I should have. First and foremost were self-doubt and denial. I heard that little voice in the back of my head saying “maybe this isn’t the right path for me” and I aggressively stomped it into submission. Everything I had done since I was 5 years old was geared toward the goal of becoming a pediatrician. What would it mean to admit this was wrong?
I had been raised to believe that your job was not meant to be enjoyed. When my father would return home from work when we were children, my older sister would ask him “How was work today, Daddy?”. His response was always the same – “It’s work, Abigail. That’s why they have to pay people to do it.”
Like many physicians, I do NOT deal well with uncertainty (see above 5-year-old who laid out her career path and actually followed it). What would I do if I wasn’t a doctor? How would I make enough money with basically no other job skills? How does applying for jobs outside of the medical field even work?
After many years of rationalizing, contemplating, agonizing, and trying out different roles in the pediatric field, I finally came to the conclusion that facing uncertainty had to be better than continuing to experience the certainty that this was not the right career path for me.
Here are my five tips for others who are grappling with the mental and emotional aspects of transitioning out of clinical medicine:
- Come to terms with your decision before widely sharing it: It’s no secret that the culture in medicine is one of competing over who works the hardest, sleeps the least, achieves the most, and is the biggest martyr.
Sharing your feelings widely about wanting a career change with those both in and out of medicine before you have fully processed this decision yourself can often lead to doubt, shame, and guilt when others do not react in a supportive manner. A therapist is a great idea if you don’t already have one.
- Talk to everyone you can: Seeking out friends or even distantly connected colleagues who have made the leap can be incredibly helpful. I did a lot of this because my anxiety loves reassurance and everyone I reached out to was so kind and willing to talk.
Connecting with others who have made the transition out of clinical medicine can offer a number of benefits. First, it can help to validate your feelings about this huge life decision. Second, every conversation will help you learn about different career opportunities that you may not have known about. Third, sometimes networking with others leads directly to a job, either immediately or down the road.
- Hire a coach: No, Heather did not ask me to say this, I promise. There are some folks who make an organic transition out of clinical medicine. For example, they start doing utilization review work on the side as part of their clinical role. Then they realize this offers them exactly what they were looking for – better hours, better pay, or less stress- and so they parlay their new skillset into a full-time position.
But many who know they want to leave clinical medicine feel daunted by not knowing what career opportunities are available or which is right for them. This is exactly where a coach comes in handy. While you may think that you need to know what you want to do before hiring a coach so they can guide you down a specific path, this is not the case at all. A career coach who is experienced in working with physicians will guide you through this emotional journey from the beginning.
- Set aside dedicated time to work on your career transition: I talk to so many physicians who want to leave clinical medicine but can’t figure out how to find the time to get started. I totally get this – between the full-time job you already have, kids, pets, family obligations, etc., you are likely barely finding time to sleep, let alone pursue a career transition. However, many times this inability to find time serves as an excuse that helps you remain in a state of denial about approaching this seemingly overwhelming task.
Nonetheless, this piece is obviously essential to moving forward, and it pays to avoid letting it be the roadblock that keeps you trapped in a busy life that is not fulfilling. Whether you specifically hire a babysitter to watch the kids, skip a dinner with friends, miss a workout, or get up a little earlier each morning, make a plan and put it in your schedule. Also, consider that hiring a coach has the added benefit of providing accountability to keep you on track during your journey.
- Keep. The. Faith: There are a lot of ups and downs when applying for jobs outside of clinical medicine. It can be easy to lose confidence and start to doubt yourself. But don’t! You are a highly-skilled, hard-working, intelligent physician.
Here’s where your coach, therapist, or trusted inner circle comes in handy to boost your morale and help you put each step into perspective. This will also prevent you from making a fear-based choice (as Heather would say) and keep you on the path to a trust-based decision.
The journey out of medicine is often far more circuitous than the linear path into the field. But many have done it and are thriving in their new roles. Just remember that it’s an emotional journey as much as it is a practical one, be patient with yourself, and have confidence that the perseverance you have shown during your clinical career will carry you through this to a more satisfying future.
Guest post by Morgan Leafe, MD, MHA
A big Thank you to Dr. Leafe for writing this piece for the Doctor’s Crossing!
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This blog was such an aha moment for me. The positive feedback and guilt you mentioned is so relatable for me. It’s really tough to work through my turmoil but you have me hope that it can be done.
What a lovely comment Deepthi! I am happy that Morgan Leafe’s blog was helpful for you! It is challenging to deal with all the “emotional seaweed” we have to untangle to make some tough decisions but there is a way through. thank you for taking the time to read and comment. I am wishing you lots of clarity and good times to come.
Thanks for this. I am based in the UK, and I think the experiences, stresses, etc are similar across the pond. It would be great if you expanded to the UK someday.
The 5 tips were really helpful, and it was so brave of Dr Leafe to admit her unhappiness. I too have wanted to be a doctor from a young age, and only recently realised that an unhelpful degree of people-pleasing was underlying it.
Since leaving medicine, spending time in the wilderness, and then starting out in business and coaching I’ve had tough times financially, but that is improving, and the upsides of far outweigh the losses: Freedom! No registering body (Board/GMC), malpractice, abusive patients, burnout, insightless management, and morally injurious system.
Thanks to the Doctors Crossing team for this great site!
Hello Greg! Thanks for your lovely comment and words of appreciation for Morgan’s great blog and our website. I’m really happy to hear that you followed your heart and are experiencing the benefits of a life of your choosing. I understand how a big change like you made can be tough at first financially but it sounds like your commitment and persistence are paying off. It’s a shame that the system of providing health and healing to others extracts a big toll on the physical and emotional health of those providing the care. A very disturbing paradox – and as you describe, moral injurious. Here’s to your freedom and fulfillment. Rock on!
Dr Leafe’s article exactly mirrors my experience in walking down the pathway of career transition. Seeking guidance has brought all the benefits she outlines. Medicine (in my case, surgery) has some very seductive elements, which draw you in, motivate you over long years of training, hold you hostage to incredible standards of work intensity and duration, but also reward you like a drug with intense moments of fulfillment interspersed with intervals of suffering, only to punish you as you contemplate stepping off the treadmill of clinical practice. It has features more similar to a love affair than a job. Why should transition within the broad scope of a career punish us with the sense that we are betraying a sacred oath, abandoning our life’s purpose, etc? Why can’t we walk forward with excitement, anticipation, a sense of expanding our horizon rather than paying a steep price in regret, uncertainty, loneliness, disapproval of others? Since transition is increasingly common, necessary in some cases and complex enough without emotional overlay, learning this beforehand or at the front end of the process is helpful in order to avoid being sabotaged by oneself along the way.
Beautifully said Nathan! You really captured the agony and ecstasy of this profession. Very eloquent. It makes me wonder if you have a book in you? Thank you for sharing these words and thoughts with us. I hope you can walk forward with excitement and a sense of expansion. I truly believe that is how it is meant to be when we are honoring the gifts we have been given. It is not meant to make us feel bad or wrong. Walk on proudly!!
Very well said – this resonates with so many I’m sure as it resonates with me.
Difficult point is many of us are the sole ‘providers’ bread winners for our famliy and medicine has afforded us a certain lifestyle. Finding a way to pivot out of clinical medicine while still affording the same lifestyle is very difficult to achieve! That has been one of the sticking points that has kept me on the clinical treadmill.
I agree that Morgan’s piece was very well written and it has definitely resonated with a lot of physicians. Thank you so much for reading and commenting. I do know that switching to a nonclinical career raises financial concerns and each physician’s situation is different. A variety of factors can weigh in such as desired nonclinical sector, board certification, specialty, licensure, geography, time in practice, family obligations, etc. etc. Physicians from primary care are often surprised when they find out they may make more than their current salary, and sometimes specialists are disappointed to learn that they are not going to have the higher salary they were hoping for, at least starting out in a new role. But no matter what, if change is needed, it’s worth exploring options enough to find out what’s true for your unique situation, which I gather you have. You are doing a big service to your family to be the sole provider and continue to work in a way that is not your first choice. I give you a lot of credit and honor what you are doing. This is a big responsibility a lot of physicians bear and my hope is for it to be a win-win, where you get to do the work that brings you joy and satisfaction. You deserve it.
Thanks for this article. When I left clinical medicine I was very apprehensive as to how much I might miss it. I actually loved what I did, but after 23 years I was ready for something different. I have been repurposed for 4 1/2 years now and have not missed clinical medicine. The free time allowed me to write a blog article each week and publish 5 books and 2 courses. I love my new life. I will be adding this article to my Fawcett’s Favorites on Monday.
Thanks,
Dr. Cory S. Fawcett
Financial Success MD
Thank YOU so much for reading and commenting Dr. Cory Fawcett! I’m so glad you will be sharing Mogan Leafe’s great blog with your favorites. I feel that she really captured a lot of those conflicting emotions at the crossroads and gave some great advice. Congratulations on your own career pivot into helping others with their financial goals!
Great write-up. I made the transition in my fifties, from Orthopedic and Trauma surgery. I trained in the UK, and I remember when I was young and moved back to a more senior training post at a Hospital that I had worked for before, I met a plumber in the corridor of the hospital one morning, who recognized me. ‘Ah, Doc,’ he said. ‘Back for more punishment?’ That remark pierced my psyche like an arrow, and perhaps never stopped burrowing deeper and deeper, as I went forward with my career. But I never stopped the self-flagellation and punishing myself. The rewards were satisfying emotionally, as I became a Pediatric Orthopedic surgeon, although the demands physically were telling. Then I read an editorial in the Journal of Bone and Joint Surgery about retiring from Orthopedics. 80% of the respondents said they were very happy to have left Orthopedics behind them, and didn’t miss anything about it. Not even their patients. That was many years ago, but it had a large part to play in my own decision. The one take-away from that editorial was that one must not run out of money in later retirement, and should adopt work that would engages you. So, I took a deep breath, metaphorically speaking, and jumped. Its been quite enjoyable since. I have travelled all over the world, and have just finished writing my memoirs!
Great write up Tariq Khan! Thank you for sharing your own experience, it is poignant to read, as I am sure your memoir is as well. Good for you for finding your way to a new chapter in your life with freedom for travel and other pursuits. It sounds like you put in a lot of dedicated years as a surgeon. Thank you for reading and commnenting. All the best to you.