By David Spellberg M.D.

For many reasons, physicians occasionally decide to leave clinical practice and pursue other careers. Often new opportunities arise, such as in the rapidly developing health information technology industry and telemedicine development. Other decisions may be more personal, such as burnout, boredom, unhappiness, or as in my case, disability.

This type of transition is not always quick and easy. If preparation is possible, it is wise to wind down clinical work while developing a new career over months, or even years. For success, a lateral transfer may work the best. This means taking the skills you already possess and moving “laterally” into another career that utilizes some or all of the same skills, just applied differently.

Luckily, many of the skills possessed by doctors are easily transferred. As highly educated professionals we have a positive work ethic and interact well with people. We have the ability to be effective in difficult and stressful situations, and have good organizational skills. We have been trained as doctors to critically evaluate evidence – in whatever form it comes – and make decisions, sometimes rapidly, based on that evaluation. In addition, communication skills are extremely important in the practice of medicine. After a decision has been made, we are usually comfortable taking responsibility for it. All of these leadership skills, which are integral to the practice of medicine, are also highly desirable in the world outside of medicine.

If you are considering a significant transition to a different career – or changing your role within the same or a similar career – where do you start? Asking yourself: Why are you interested in making this change? What is the goal? Will changing careers actually achieve the goal? Are there other alternatives? Creating a list of reasons both for and against the proposed change will be a good starting point. Rarely is an opportunity presented directly to you, but in that case ask the prospective employer detailed questions about a wide variety of scenarios. What will your day-to-day responsibilities and experience entail? What will be expected of you? Don’t be afraid to ask questions! It takes time, effort, and commitment to create the best possible new situation. Under any circumstances, it is important to be prepared, proactive, and patient, yet ready for any opportunity that presents itself. If possible, it is also recommended that you create a contingency plan – no one takes a position that they think will not work out, but it is good to be prepared just in case.

Unfortunately, as in my case, a motor vehicle accident dramatically and unexpectantly changed my life and forced me to change careers. Not having the luxury to prepare, I was forced to determine my future pathway very quickly and without preparation. I do not recommend this, as not every career is as “rosy” as it appears. Take time to research the industry, and spend time working, even volunteering in a position in that field. The best way to learn about a new career is to spend a few days shadowing someone who is actually performing the daily tasks and experiencing that new life for you.

Anyone considering a major change is advised to seek a knowledgeable consultant or coach to help with clarity, sorting out and understanding the marketplace of opportunities, and to provide objectivity. This can also help prevent you from simply jumping to the first position you are offered, without taking the long term view. A consultant can also help you quickly eliminate any possibilities that might not be right for you. They should also be able to help in narrowing down the available options, and provide a network of contacts to help in the journey. In consulting and coaching, the client’s interests should always come first.

Potentially free advice is worth exactly what it costs, and even though it may be given in a well-meaning manner, be cautious. Just because your Uncle Joe made a fortune in the stock market does not mean you should follow his advice word-for-word. Gather information from a wide variety of sources and come to your own conclusions. Do not underestimate the need for financial preparation, especially if the career change may require going back to school. In my case, I began working as a consultant at a Merger & Acquisition Advisory firm, but quickly realized that I was lacking a strong financial foundation, which is very common in physicians due to the strong science background required to go to medical school. I decided to go back to school to obtain a MBA degree, but this took 2 years and a substantial commitment.

I can’t underestimate the need to know exactly why the career change is being considered. If it is boredom or burnout, then it is truly necessary to experience the new career on a trial basis, or the risk of remorse is extremely high. If it is an attempt to find happiness, and if the right position for your happiness is one that requires a pay cut, can you afford the reduction in your income in the near future?

Be realistic, and recognize that more often than not you will make less money. Of course, there are exceptions. Some physicians have become successful stockbrokers or venture capitalists. Top management positions also pay well. Some doctors decide in midlife to pursue other dreams and passions, long put aside, such as playing music in a band or sailing around the world in their own sailboat. However, consider talking over your aspirations with a financial planner to see if you can afford to realize your new goals.

In addition to the financial considerations, changing careers can have a big impact on your personal and family life. New careers often involve heavy travel schedules. However, some involve working from home, allowing a more flexible schedule for family life, other activities, and hobbies. New careers sometimes offer an opportunity to relocate and create new life adventures, but make sure the entire family is on board.

Not everyone who wants to leave clinical practice is ready to give it up forever. Also, a career change does not need to be permanent. Many physicians, who decide they no longer want to work in hospitals or private practice, maintain their licenses and medical education requirements either as a backup or as part of a plan to return to clinical work, at some point in the future. Doctors can keep up with licensure and continuing medical education, but it may not make financial or logistical sense. In my case, I was no longer able to perform surgical procedures so it made no sense to pay thousands of dollars for a license. Here are tips to plan ahead, in case you decide to return to the practice of medicine:

 Research the rules for physician reentry in your state, or any other state you might move to. Would you be willing to expend the effort necessary to reinstate your license if it lapsed? The American Medical Association (AMA) maintains a list of such requirements.
 Alternatively, do you want to keep your license active by completing the required Continuing Medical Education (CME)? Are there requirements as to having an office location even if you are not actively practicing? Are you required to carry malpractice insurance as a requirement for licensure even if not actively practicing?
 Consider the cost of the additional CME and licensing fees to maintain your board certification. Make sure you understand what it would take to get your board certification reinstated if it lapses.
 Consider volunteering or working with another physician to add experiential learning to your CME.
 Maintain connections with professional societies in order to keep informed of CME opportunities and maintain your professional network in case you need it again.
 Find another physician who has left practice and later returned, and ask about his experiences.

In general, any major change in life is likely to cause a combination of fear and excitement. You will face the unknown, which can be scary, but it can also be tremendously exciting to take on new challenges and have new experiences. At first, everything might seem ambiguous and confusing. You might not have sufficient knowledge about your new employer or the people you work with. You might be faced with the need to learn new skills, the extent of which will depend on how different your new career is from your previous one – or how different it is from what you have been trained to do. Hopefully, you will be energized by the change you have created and your passion for new tasks will be ignited. You may be able to apply what you have learned from previous careers to similar situations that arise within your new career. Changing fields may be one of the most invigorating things you can do, but preparation if possible is extremely important. A new work environment can be inspiring and interesting, giving you a new lease on life.

David Spellberg, M.D. is a career physician, surgeon and entrepreneur with professional experience in M&A Advisory, Corporate Development and Healthcare and Medical Technology. He is in the process of completing a M.B.A. Degree from Columbia Business School in New York City.

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