Career Development: Assessment and Exploration

Medical Post
Helping Hand Column, 2011 #2

Medicine has been a rich and rewarding career.  Yet, lately, you have started to feel restless, recognizing that work seems to be less stimulating and challenging that it used to be.  This is not uncommon; the majority of us will experience this at some point in our career. To recapture the initial sense of excitement about coming to work each morning, there will be some important decisions to make ahead.  We are well trained to make decisions for our patients when they present with a medical problem; the same process of analysis applies here.  We need to analyze the situation so we can understand it; identify and explore options; choose an option and create a plan of action; and then implement it and evaluate the outcome.

First, let`s understand why we want a change. There are many reasons why we desire a change in our current work situation.  These include:

• Burnout – we may be feeling overloaded and realizing that our workload and responsibilities are not sustainable.
• Work place issues – we are not happy in the work environment, or with the people we work. 
• Frustration with health care system – it is increasingly more difficult to practice medicine with decreased resources, increased workloads, more regulations and limitations, and rising malpractice rates.
• Wrong original choice – some of us chose medicine because it was the right thing to do, what our parents hoped we would do, or what our school guidance teachers recommended for us.  We may have selected a specialty that does not suit us well.  It may not be the best fit for us.
• Seven-year itch – many of us start to feel bored with what we are doing after several years and need a change.
• New Interests – our interests have expanded and changed, and we would like our work to reflect this.
• Need for more stimulation.  The job is good enough, but is not exciting or challenging any more. It feels like the same old thing each day.
• Financial freedom – we have paid our debts, kids are through university, and we now have gained financial freedom to not work the way we used to do.  Alternatively, we want a different job that may offer us greater financial freedom that our current practice.
• Life changes – marriage, marital separation, having children, empty nest syndrome, dealing with aging parents all may cause us to reassess our work.
• Health problems – we may have a health problem that limits our energy and our capacity to work in the way we did previously.

Once we identify some of the reasons to consider a change, we start to see why the change seems impossible.  There are many barriers to such a change for many of us.

• Guilt – we have a huge sense of responsibility to our patients, staff, and family.  How can we do this to them?
• Shame – there is a sense of shame, that we will be perceived as being unable to cope, that we “couldn’t cut it” in medicine.
• Fear of failure – What if we don’t succeed after the change?  Too many people seem to be depending on us, and we can’t let them down.
• Finances – we can’t afford to stop practicing medicine.  There are few other things we can do that offer the same pay per hour so consistently, and so we often stay because the money is good.
• Uncertainty – We may not know what the options are, or where to go for advice.

Over the years, I have come up with the Three-Step Rule for career change: Modify, Change within medicine, Change outside of medicine.  There are times when we know what exactly we want to do and go for it.  However, more often, there is no perfect or quick solution, and it helps to take it one step at a time. In many situations, things improve with modifying the current practice – reassessing the work hours, changing the location of the practice or joining a new group, changing the scope of practice, or balancing work with a non-medical activity. If this is insufficient, then you can consider defining a new focus within medicine. Such career diversification can include medical education, leadership, administration, or research roles. Finally, we could explore roles outside medicine where our medical skills and knowledge would be welcomed, such as with the government, a medical organization, insurance company, pharmaceutical company, computers and technology, consulting, writing, speaking; or even new roles not connected to medicine at all.

The process starts with a review and reflection of your current situation.  Identify what you now like and dislike about work, your values, your future goals, elements that you would like to have at work, your skills and strengths and weaknesses, your interests and fears, what you are deeply passionate about, and at what you can be the best.  You can start this on your own.  There are some career counselling books that can guide this process.  Some colleagues find it helpful to work with a career counsellor, advisor, or coach.

We can now start to develop a career focus and explore career options. We look around and see what our colleagues may be doing, and find out what potential positions exist.  We can turn to resources such as books, websites, and job search groups.   Like building a custom home, we look at what possibilities have all of what we need it to have, most of what we want it to have, and some of the fun parts too.  It helps to be specific, take your time, and give it a lot of thought.  As we picture the ideal first month on the job, we have a good idea of what we may want to go.  In the next column, we will look at how to get there.

Mamta Gautam is an Ottawa psychiatrist who specializes in treating physician patients. If you have a question you would like addressed in this column, please contact Dr. Gautam at mgautam@rogers.com. Please include “Helping Hand” in the subject line. All inquiries will be confidential. Your questions will not be replied to, but may be selected to be answered in this column, which is intended to be educational, not therapeutic.