Leaving medicine

Authors: Justine Davies 

Publication date:  20 May 2009


Sometimes, a career decision made at 18 is just the wrong one. Justine Davies, one doctor who has left the profession, looks at your options

The decision to leave a career as a doctor is not an easy one to take. Aside from the obvious worry of leaving behind a regular income, there are huge psychological barriers to overcome when considering leaving the profession. Most doctors will not have taken lightly the decision to study medicine at university; it is a degree with essentially only one result—practising medicine and being a doctor.

The medical degree is hard work but when the degree is completed a job comes along without most junior doctors really having to think about it. There is no job application form that has medical school leavers taxing their brains considering which skills they have that match the ones that the job requires. Graduates are doctors; if we have passed the exams we therefore have the correct skill set for the job.

Medicine is all encompassing

The stress and fatigue that accompanies long hours and irregular shifts lead many doctors to spend their social time with other doctors because they understand the demands of the job. Medicine, therefore, so easily becomes our entire lives, and we find that after a couple of years of practice it has both embraced and devoured us. I was made sharply aware of medicine as an omnipotent force in my life when telling an older colleague that I had left the profession. “No you haven’t,” she said, “once a doctor, always a doctor; you may leave it, but it will never leave you.”

Despite bad coverage in the media, medicine is a respectable profession. Parents are proud of their medical offspring, and people in the community are always happy to know that a doctor has moved in next door. No one would say that doctors crave this respect, but most of us would be happy to admit that it is a perk of the job. When considering leaving medicine the thought of losing this respect is not pleasant.

Thoughts of disloyalty also intrude into the consciousness of doctors thinking of leaving. Not only are those who are proud of us betrayed, but doctors tend to think of themselves as indispensable and worry that patients and colleagues will not cope without us. I considered leaving for two years before finally taking the plunge; the thing that kept me at my job was my professor. I liked and respected him and to me leaving my job was a betrayal of all he had invested in my career.

For these reasons alone leaving medicine is difficult, but once the decision has been taken the next barrier that we come across is one with “But what do I do?” written on it.

Medicine is a vocation, and many of us feel that we are trained for nothing else. In addition, job application forms that are based on skills may come as a shock after the standard medical application form. My first non-medical application form had me lamenting for at least two months that I was “trained for nothing else.” Although recognising what transferable skills we have may not be easy, doctors do possess a huge number of them.

Transferable skills

No one can argue that we don’t have a positive work ethic. We are also able to work effectively in difficult and stressful situations, and the pressures of the job mean that we have to develop good organisational skills. We have to be able to critically appraise evidence (in whatever form it comes) and make decisions, sometimes rapidly, based on this appraisal. After decisions have been made we have to be comfortable taking responsibility for them. In addition, communication and leadership skills are key in the practice of medicine.

All these skills, although integral to being a doctor, are also highly desirable in the world outside medicine.

I left medicine during my time as a university lecturer with NHS duties in internal medicine and cardiovascular disease; I had been practising for 10 years. Not knowing what to do, but realising that I had to keep myself busy, I took two years to study for a zoology degree. This gave me time to think and helped me to realise that my passion is in educating others about science. To me, there is nothing better than explaining a complex scientific idea in such a way that other people understand and are enthusiastic about it.

After graduating in zoology I worked with the BBC on a couple of medical science documentaries and am now working as a freelance science writer. The transferable skills that I use most often in my new career are critical appraisal of evidence and communication skills, but all the other skills listed above have come in handy, especially when working with the BBC.

Other suitable careers

Media

Jed Mercurio, the writer and creator of the television series Cardiac Arrest and Bodies, was in his third year after graduation when he left medicine. He “took a six month sabbatical from the rotation to concentrate on scriptwriting commitments for the second series of Cardiac Arrest.” When the BBC commissioned a third series, he resigned from medicine to pursue full time writing. Jed’s consultants were very supportive. “They made it clear I could rejoin the rotation in the future if my career change didn’t work out. So I always felt it was never an irreversible decision—that fallback position made it easy for me to take the leap.”

For Jed, leaving medicine was not prompted by dislike of the job but by seizing a passing opportunity; he “didn’t so much leave medicine as go into writing.” The long hours involved in working on a television series were made easier as he was used to the long hours in medical work. On transferable skills, Jed says: “I was accustomed to working in a hierarchy where people are sensitive to the way you relate to colleagues.” As an aside he also says that being used to “learning through humiliation” helped in his new career path.

Legal profession

After graduation Mark Rogers embarked on surgical training, but while working towards an MD he became increasingly interested in medical law. At the same time he started to be concerned about the effects that a consultant led service and the European Working Time Directive would have on his personal life. In addition Mark worried that “superspecialisation would make medical practice less interesting.” Although he recognises that these measures are necessary, they were not compatible with the life that he wanted to lead.

Mark did a law conversion course to obtain a diploma in law at City University, followed by a diploma of legal practice at the College of Law in London. He then did the standard two years as the legal equivalent of a junior doctor before fully qualifying as a solicitor in 2006. He now works at Capsticks lawyers where he deals in particular with medical regulatory work. As well as the key transferable skills listed above, the in depth understanding of medical practice is a huge bonus to his colleagues and clients in this field of work.

Transition to law is a well trodden path towards a respectable profession; this eases the pain of leaving medicine and Mark says may have softened the blow with his family. He states that work as a solicitor, although harder in some ways than medicine, does allow him to have more control over his working hours. He does acknowledge, however, that it is difficult to start a new career from scratch. “The world outside medicine is commercial, which means that you stand or fall on your merits.” This may come as a shock to many of us who are used to being on a career escalator, where although competition exists, most medical graduates are guaranteed to end up with a good career.

Business

A proportion of doctors leaving the profession find themselves working in business. These are often healthcare related businesses, but the ability to think quickly, appraise evidence, take responsibility, and communicate personably are skills applicable to any business. Jamie Brammer is the co-founder of Avaleo, a Danish company that designs software to enable home care to be delivered more effectively. Jamie started making the transition into the information technology industry during his senior house officer jobs (the equivalent of today’s specialist trainee 2/3 years). He felt that business was more suited to his personality than medicine as it gave him more leeway “to take risks and be rewarded for risk taking”. Although he was never disillusioned with medicine, Jamie feels he is more able to flourish in a business environment. Jamie cites people skills, problem solving, and stress management as transferable skills that have helped him greatly in business.

Doctor for life

None of the people that I have talked to said leaving medicine was easy, and most made the transition to the outside world gradually. Colleagues were often surprisingly supportive; Mark found colleagues “fell into three broad camps; there were those who thought that leaving was disgraceful, but also those who thought it was a good idea and asked for advice, and others who thought that while leaving was a good idea it was not for them.”

From a personal point of view, when I was bright eyed and bushy tailed about the prospect of entering the non-medical world a colleague telling me that “medicine would never leave me” seemed like a damning blow. Now, a few years down the line, I realise how correct her words were. Those of us who leave may no longer practise, but all the years of study and work as doctors mean that medicine has permeated our being—we are still doctors, just ones who now do other things.

Competing interests: None declared.

Justine Davies freelance journalist Craigend of Aldbar, West Drums, Angus, Scotland

 j.i.davies@dundee.ac.uk

Cite this as BMJ Careers ; doi: