Career Development: Logical Next Steps and Dealing with Change

Medical Post
Helping Hand Column, 2011 #4

So, we have now decided that we want to change some aspect of our career in medicine. We must have a clear understanding about our selves, and why we want this change.

What is the logical next step?  Whatever we do, it must make sense, and be understandable in light of where we are and where we want to go. There are some practical strategies we can use as we move forward.  If we have decided to focus on a new aspect of medicine, we can start to go to conferences in that area of interest. There are specialized journals, publications and books we can read. We can take a course on this topic. There is plenty to browse through on the internet, and once can even create their own related website.  We can join an association, start networking, get a mentor. A great way to show others that you are interested and capable is to volunteer in a related capacity; by taking on extra responsibility, you can demonstrate your dedication and willingness and let them see you as a potential resource.

For big changes, a good rule is the 80%-20% Overlap.  Whenever possible, try not to make a complete change all at once.  The next step should overlap this one by 80%; 20% should be new, different, exciting, fun.  This gives you time to adjust and confirm that this is what you want.  Set a realistic timeline; it usually takes 2 to 3 years for a major transition.

Dealing with change, even if it is a change that we chose and want, is not easy. Changing or closing a clinical practice is truly difficult and draining, and we always underestimate the associated emotional and physical toll.  There is a lot of work to do, charts to complete, summaries to write, transfers to facilitate.  There is a sense of loss, by our patients, our colleagues, and our self. Part of dealing with a loss is allowing for the stages of grieving – denial, anger and protest, bargaining, sadness, acceptance and integration.  This is physically and emotionally exhausting, even when we expect it.  While dealing with the denial, anger, and protest is not easy, many of us are surprised to realize it is also not easy to receive the kindness and gratitude that is expressed at this time.  It can be overwhelming, making us feel guilty, and even making us question if we are making the right decision. Ultimately, it helps to remind yourself regularly why you chose this and what good lies ahead.

“I am not a doctor anymore”. If the decision we make involves giving up clinical medical practice entirely, many of us initially find it tough to consider no longer being a doctor.  This has been a huge part of our identity.  There is an associated status, prestige, and sense of recognition with this occupation, which we now feel at risk of losing. There can be an awareness of ageing, of having to face our mortality. This can seem challenging and even scary.  However, the reality is that we will always be a doctor.  We will always have the training and education, and will be utilizing them in a new manner to maintain our skills, expertise, knowledge and attitude.

It is up to us to actively shape our career paths.  In doing so in a positive, proactive manner, we can continue to set future goals and continue to mature personally and professionally, and enjoy satisfying careers.

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 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.