November 15, 2019

Career Transition Posse – Update from Dr. Gabriel

Back in April, I introduced Dr. Gabriel, one of the intrepid members of the Career Transition Posse. In case you’re new to the blog, several physicians are sharing their transitions in real time, using pseudonyms. You can read Dr. Gabriel’s first post by clicking here.  Four months later, Dr. Gabriel has found a new position. Please read below for my recent interview with him.

Q: In your initial post in April, you were looking into non-clinical careers but still considering staying in clinical practice. Where are you right now in the career process?

Dr. Gabriel: Ultimately, I decided to return to clinical practice. I actually chose an opportunity that is different from my previous positions. I am joining a small single-specialty practice after leaving a large multi-specialty practice (and I was previously in academics). I was specific about what I wanted, and I have, for the most part, been able to get a position that I felt was a better fit for me. The group has a focus on maintaining a reasonable lifestyle and quality of life. I have seen very few other opportunities where this is prioritized.

Q: What are some of the non-clinical careers you looked into?

Dr. Gabriel: I considered a number of different areas, including utilization management (U/M) and the FDA. I did interviews for U/M and even flew to Baltimore to formally interview with the FDA. Ultimately, I did not feel these were going to be a good fit for me. I felt I performed quite well at my interview with the FDA, but when they told me this was the kind of position usually taken by physicians closer to retirement, I wondered if they thought I would miss practicing.

The FDA never communicated with me afterward, so I think it is safe to assume they went with another candidate anyway. I looked into some medical device opportunities; however, the opportunities were mostly just part-time consulting positions.

Q: What made you decide not to pursue these non-clinical options?

Dr. Gabriel: I should be honest and admit that salary was a big part of the decision. I have never been someone who cared all that much about being “wealthy,” but I have three young children and am the sole income generator in the house. I also felt a job working from home (U/M) would be very difficult for me while my kids are still young.

Q: Did you explore a number of different clinical practice settings?

Dr. Gabriel: I did! I interviewed at a lot of practices of all types: academic, multi-specialty/single specialty, small/large. I also considered starting my own integrative-style medicine practice. But the risk of doing it on my own wasn’t something I wanted to pursue, and joining an already established integrative practice left me with too many constraints on how I would want to care for patients.

My final decision on a clinical practice came down mainly to location and lifestyle as the deciding factors.

Q: How did you end up choosing this new position?

Dr. Gabriel: I wanted to be close to family and to join a practice that cared about quality of life, not necessarily about making the most money. This group believes in having balance, and generally no one works a full 5-day week. They also insist on taking vacation. One of the physicians in the group went to a 5-day week and saw a negative change in his quality of life and relationships with his family. He went back to a 4-day work week and everything improved.

Q: What has helped you to believe this is the right decision?

Dr. Gabriel: The group I joined was endorsed by one of my closest friends. When I interviewed, they were all very open and friendly. The practice is in a different state and will require a move for the whole family, but we are excited about the new location and being closer to some other family.

Q: What uncertainty remains for you at this point?

Dr. Gabriel: The issue is the future of medicine. The group is looking to merge with other groups to form a larger group, and I have asked to be a part of this. While the group is completely willing to allow this, the lawyers are making things difficult. Unfortunately, everyone is trying to squeeze the last bit of money out of medicine as it changes, and I think most of us younger people are losing out.

Q: What has been the hardest part of these past few months for you?

Dr. Gabriel: The uncertainty. Will I find a job? Will it be right for me? Will I just go back to hating clinical practice again in a few months or a year?

Q: What has been the best part for you since having left your job?

Dr. Gabriel: Without a doubt the time spent with family. I feel like I barely knew my daughter before I left the job. Now we are like a real family.

Q: Anything in particular you’ve learned about yourself during the career search?

Dr. Gabriel: I think it would have been better if I had waited longer to leave my job. In hindsight, I’m not sure it helped clear my mind but rather just made me feel pressure to “figure things out” sooner. I may be wrong, maybe it was the best for my mental health. It’s hard to say for sure.

Q: Anything you would do differently up to this point in the search process if you could do it differently?

Dr. Gabriel: I would have approached locums very differently. I engaged with a locums company as a “backup” plan. I was clear from the beginning that I was working toward a permanent position. I was trying to learn more about the process, and before I knew it, they were turning down opportunities that I liked for their own reasons and signing me up for opportunities I wasn’t sure about before I could even think about them. Then, when I found a permanent position, they were understandably not very happy and, in my opinion, acted rather unprofessionally toward me. I learned a lot about how locums can go, and if I ever have to consider it again, I’ll be smarter about my approach.

Q: What advice do you have for others going through this process?

Dr. Gabriel: Be honest with yourself about what you want and figure out how you can get there. I’d also say to try and move through the process in a way that doesn’t make you feel pressured to make decisions before you are ready.

Q: Anything else you would like to share?

Dr. Gabriel: I’d like to say that the uncertainty went away, but it never does. I definitely feel like I am in a much better place than I was 6 months ago. Admittedly, I am not very good about being consistent with it, but I recommend considering some form of meditation. I think it can help through the stress of the process.

A big “Thank you” to Dr. Gabriel for sharing his transition thus far on the blog. I will check in with him after he settles into his new practice. I’d like to add that it is rather common for physicians seeking career change to stay clinical, especially at first, and try out different practice arrangements and styles. Finding a practice setting with more time off can be helpful in reversing burnout as well as freeing up time to build a platform towards a non-clinical transition. Some physicians find that they end up enjoying practice enough that they no longer seek to transition, or they do a “blendini,” with both clinical and nonclinical work.

There is no one right way to do a transition, just the way that works for you. 



  1. I appreciate Dr. G’s honesty and openness. Great insights into the process of career transitions for physicians. I look forward to reading more interviews like this.

    • Thank you Lisa for reading and commenting. I too, am very grateful to Dr. Gabriel for sharing his journey with us. Not everyone is willing to do this and I can’t thank him enough, and the other Transition Posse members. Speaking of which….. the next post in one month will be an interview with Dr. GiGi, our other posse member! Stay tuned!

  2. Dr. N. Betic says:

    Great post. It really resonated some feelings i have been having. I am a FM doc ..feel torn. Wow i didnt even know that “4-day week” EXISTED. I have been saearching futily for 8+ years a more relaxed schedule for my sanity’s sake and also for my family life’s sake. People act like FT is God’s decree. Recruiters try to make me feel guilty for wanting a LIFE. Locums is bottom of the barrel. I like clinical pracctice… but not a ton. Im thinking about doing alternatives med but cant afford another loan. I wish they taught us some of “this” in training instead of acting like we aremoh so lucky to be part of a noble profession and we should be happy to sacrifice anything and everything to reach some sort of money-related medical Nirvana.

    • Thank you Dr. Betic for your comments! You are so right that having a better schedule and respect of YOUR time, can make a huge difference. I am sorry that you have not been able to find what you are looking for, but don’t give up – you deserve it and it IS possible. Since you mentioned alternative medicine, I am sharing a link for you to a job site for physicians looking for integrative/functional medicine positions. Some do not even require previous experience and are willing to train. If you are open to working for someone else, instead of the start-up costs of your own business, the investment could be instead some integrative and/or functional medicine training, and maybe not even that! All the best to you and please feel free to keep us posted. Heather

  3. Beth Cardwell MD says:

    Dr. Gabriel, you are clearly a guy with, as my dad used to say, “A good head on your shoulders!” Congratulations to you and may you and your family find fulfillment as you assume your new position and your new home.

  4. Dr. Steven Cohen says:

    Dr. Gabriel, I think the solution you have chosen is often the best option. It’s difficult to walk away entirely from medicine, as most of us have invested a huge part of ourselves in the profession. If one can find a setting within medicine where there is a work/life balance that is comfortable, then staying in the profession is possible.

    I was determined to transition out of medicine in my early 40’s, and even got an MBA in anticipation of the move. When I started to look for non-clinical jobs, I realized that I would likely take a significant hit to my income (I’m a Radiologist and the sole income for a family of four). Fortunately for me, teleradiology was growing, and offered a way to step out of traditional practice while still maintaining a typical income for the specialty. I opted to try teleradiology, and have stayed with it for the last decade. There are professional sacrifices involved – I’ll never be a “partner”, just a worker bee, and I’ll never have the prestige or professional accolades that leadership in a traditional practice can bring. Frankly, some consider teleradiology to be the “bottom of the barrel” (completely untrue, but there is that perception in some circles). I have come to realize that I don’t value the professional perks nearly as much as I value having time off (I work second shift hours, seven on seven off) to pursue things that I enjoy (in my case, I am a competitive golfer). This balance has made it possible for me to stay in medicine, and not feel like life is passing me by.

    I think that by emphasizing work-life balance in your most recent job choice, you’ll be much happier.

    • Thank you kindly, Dr. Cohen, for your most thoughtful and supportive response to Dr. Gabriel’s update. Your perspective is well taken and has much validity.

      I don’t have statistics on this, but from my coaching experience, a higher number of physicians end up finding ways to be satisfied in medicine than actually leave for a non-clinical career. This is not to say there are not a significant number of doctors who are happy working non-clinically, there are, however, there are ways to still practice and enjoy being a physician and have it work for you. You are an excellent example of this possibility. I am glad that you found the right balance for yourself according to your priorities and have time for competitive golfing too!

  5. Dr N. Betic says:

    Ive been searching in the Intergrative Med path. Im having a hard time finding reasonable training opp’s (under a month is reasonable IMO) that are also acceptable for actual PRACTICE in my state (Fl). I reached out to thw bord of health of acupuncture in FL and have no reaponse. I def cannot get a 4yr degree in oriental medicine now, which is what thw Bd of Health makes it seem like is needed to practice Acupuncx. Something doesnt fit but I cant figure out what/why. Im sure not all the docs practicing acupuncx went back to school for 4 yrs. As a physician I already have a great grasp on anat/phys/neuro/etc.which HAS to account for something… any help is humbly appreciated.

    • Jane Zendarski says:

      I took the Helms acupuncture course for 10, 000 dollars and got licensed as a Doctor of osteopathy acupuncturist in Pennsylvania. The course is 3 long weekends with a lot of videos and quiz taking in between over 6 months.

  6. Thank you for the information Dr, Zendarski.

    Have you been using acupuncture in your practice? If so, I am curious what kind of results you have seen.


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