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Experimenting With Your Career

This post is about taking a few years off from clinical medicine in order to experiment with your career. This requires only a slight bit of planning and you will always have the safety of falling back on your clinical career.

Landing a traditional medical career right out of residency isn’t hard.It comes with the added benefit of allowing the young attending to earn a very high and steady income.

The most problematic factor is often the student loans. That’s why I encourage physicians to pay that off as soon as possible so that you have more options. It’s not too late and you can still draft a plan to pay off your student loan debt in under 5 years.

Once you pay off your debt, you can replicate damn near any employer’s retirement benefits and health insurance plans. Getting your own retirement plan and your own health insurance will allow you even greater control over the quality of these services.

 

Leaving Your Medical Career

Before leaving clinical medicine the most important step is to notify your medical boards so that they know there is a change in your practice status. This will include your practice location and your medical license.

The next step is to talk to your current employer about the possibility of a leave of absence. A leave of absence allows you to walk away from your job and return to the exact same position once you return.

A leave of absence is usually only 1 year-long but you can extend it if your medical group considers you a valuable employee.

 

Experimenting with Your Career

Imagine you have a few hundred thousand dollars saved in a retirement account and that your student loans are either paid off or you have very little left on them. At this point, if you are relatively young, say, under age 50, you can start experimenting with your career and pursue something non-clinical for a while – either for the purposes of curing burnout or to simply try something different.

The options are endless. Many of you still love medicine so you can remain employed in healthcare while doing non-clinical work or get out of medicine completely and pursue a past passion.

Getting out of medicine completely isn’t as hard as you think. Female medical professionals know this intimately, many take time off for maternal responsibilities and they return to work unscathed.

Savings/Retirement

If you can get by on relatively little, say, less than $5k/month, you should be able to experiment with different careers and see if it’s the right fit for you.

If you are willing to work full-time, there are very few careers which will earn you less than $5k/month these days. After all, that’s the median household income in 2018.

The money which you have already saved and invested in your retirement account will continue to grow. That’s one of the main reasons I encourage young physicians to build a small nest egg early. Even if you stop contributing to it, it will continue growing on its own.

$300,000 can become $1M if you give it enough time in the market – assuming you are invested in safe investments.

Putting Medicine on Hold

When you take time off of medicine, you might run into some issues with medical boards so it would be good to be proactive about this. Fortunately, the medical boards, for the most part, want you to succeed and be happy so they are incentivized to allow you some freedom.

Here are some realistic ways to put medicine on hold without jeopardizing your future potential of returning to clinical medicine:

  1. The first option would be to do some clinical volunteer work somewhere. Any medical school or residency program will be happy to have you be a volunteer faculty member. I’ve done that for 2 different medical schools, OHSU and UCSD, while I worked full-time and they were delightful to work with.
  2. The second option is to contact your medical board and ask them what the reentry process is. Most medical boards are quite organized when it comes to this. There is often a test that you take which satisfied your re-entry criteria into clinical medicine. Again, have this conversation with your medical board before you take time off.
  3. Finally, the last option might be to do a little bit of telemedicine work on the side. It’s still considered clinical work and will satisfy the requirement to have continuous patient care experience.

 

Budgeting for Experimentation

At first glance, you’ll probably think that an alternative career outside of medicine won’t earn you enough money. But most careers offer livable wages otherwise they wouldn’t be pursued.

A friend of mine tells me that she’d love to make pottery for a living which isn’t the most lucrative of careers traditionally, but there is no reason that she can’t find a way to earn a decent income doing it.

Income Potential

She can teach pottery at the community college part-time and she can sell some of her work to friends or on Etsy

I wrote a post about how full-time waiters and waitresses in Portland can earn $100k fairly easily. And my buddy, whose family owns multiple fast food franchises, told me that their managers can earn as much $200k a year.

Finally, my good friend J. earns $40,000-50,000/year working at a coffee shop as a barista. Most of it is tips which he usually forgets to include on his taxes.

Budgeting

Once you leave full-time medicine, I’m convinced that many of you will have a much lower overhead. It’s expensive being a clinician. And we spend a ton of money trying to treat the stress of working in medicine.

Downsizing for a few years doesn’t have to be drastic, though that’s my preferred method of downsizing. You can rent out your primary residence for a couple of years and make a temporary move to a cheaper location.

Paying for your license renewals and CME’s and journal subscriptions are expensive. If you become a volunteer faculty somewhere then you can get free access to the journals and you can put your medical license into a volunteer status which is often much cheaper.

The rest of your expenses should be housing, food, and transportation.

Cash Reserve

The first few months, maybe the first 6, will be the toughest when it comes to earning an income outside of medicine. It would be good to have some cash reserves to get you through.

More likely, once you do something long enough, you’ll figure out ways to earn an income with it.

 

Returning to Medicine

If you time it right, you can return to medicine in your 50’s. The advantage there is that you are able to set even more money aside into your retirement because of catch up contributions.

Since income in medicine constantly goes up, you’ll likely earn a higher income as well. Maybe by that time you’ll also have enough saved up in retirement that you won’t need to work full-time.

And, many of us who have tried dabbling in alternative careers outside of medicine will be able to continue doing that gig on the side indefinitely. This allows extra income on the side while doing something we hopefully enjoy.

Experimenting with your Specialty

Once you return to medicine, you can continue your career experimenting. Try a different position in your specialty. If you’re inpatient, try outpatient, or vice versa, if that’s feasible.

Try switching from a large medical group to a small one. Or consider starting your own private practice.

 

Possible Career Options

It seems that I’ve been having the same conversation with my friend N. for the past 3 years, trying to figure out which career options to pursue. Sometimes the answer is clear and other times the only thing you’re certain about is that you definitely need to try something different but you have no idea what.

Go back to your childhood; what did you love doing as a child or young adult? If it’s something as simple as playing video games, are there video games which are catering to children and teaching them about health or lifestyle? Your clinical background might make you a good fit for a job at such a company.

Maybe you used to love working with your hands. Being a contractor or creating things is still a lucrative profession and worth pursuing.

For many medical professionals fitness comes easy. There is always a need for someone who can inspire and teach others to exercise.

I love writing – I can sit down for hours and write and spend just as much time researching a topic. For such individuals, copywriting or editing might be a great experimental career to try out. I can earn $100 a day on a website like Blogmutt.

Medical professionals love serving people, which is probably why many of my friends consider having a B&B or a cafe or restaurant. I have no idea what it costs to start one but I’m sure that working in a restaurant for a few months would provide you with quite a bit of insight.

Resources

Websites like Indeed or LinkedIn are great places to start.

You can do a job search for non-clinical roles for physicians on Indeed. You may not get the right fit but you’ll identify the companies which have such roles available. That should help you understand what options are available.

LinkedIn is potent for networking and it’s a website which I’m still trying to master. You can do a search for physicians which will bring up many MD profiles. Click on those doctors and see what roles they have in order to help you become familiar with the possibilities of non-clinical roles.

Many chief medical officers are also non-clinical physicians. That’s another good search term to use in order to find such positions or roles.

 

You might also want to read this post which is about giving up your MD and doing something completely different in healthcare such as nursing or physical therapy.

4 replies on “Experimenting With Your Career”

UptoDate is handy for both reference and CME credits, but a bit expensive if not practicing. Medscape is a decent alternative, and free. I think it’s getting harder to take a break because of the specialty boards going to “maintenance of certification” and insurance companies playing along (colluding?) with it. There are only a few states that forbid insurance companies from requiring board certification. There are plenty of physicians who have lifetime certification only because they were born early enough to get it (age discrimination?) if there were good evidence that MOC improves outcomes then it would be legit to require it for all physicians regardless of age. My friend is an NP and gleefully told me all boarded NP’s are certified for life. If I could do over that’s probably the route I would take; then there’s the option to work as an RN or an NP or both, not to mention admin and consulting jobs.

I’m not sure you’d need CME’s if you’re not practicing – I didn’t come across that during my research. As for board certification, I would recommend switching to NBPAS – the ABMS’s mission isn’t aligned with that of physicians. Should you decide to stick with ABMS, even if you take time off, you can always return, make up the MOC’s you missed and then sit for the recertification exam.
I would check with your malpractice, employer, and insurance groups, many might insist on your having an ABMS board certification. I have found employers who could care less and those who are quite obsessed with ABMS.

I don’t think CME is required if the license isn’t active, but it would be easier to reactivate if the CME’s are current. At least, that was what a friend told me who came back to clinical practice after several years away. Agree with you about NBPAS and did that already.

That’s good to know. I have a friend now who is taking a couple of years off, I’ll ask her how she’s handling CME’s. And I’ll second that UpToDate has been a really nice way to earn those CME’s.

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