Successfully Managing Your Career in Medicine

Medical Post
Helping Hand Column, 2011 #1

We have all taken a distinct path to becoming a physician. Some of us knew from the very start that this is what we wanted to be when we grew up.  Others knew once they started high school.  Still others among us had no idea what we wanted to do even when we were at university. Regardless of when we decided, we were all mostly so excited to be in medical school, and even more excited to graduate, that we gave little thought to what it was going to be like to practice medicine every day. In fact, the average physician finishes medical school in their mid-late 20’s, and retires in their mid-late 60’s.  That gives us about 40 working years to fill…and hopefully, enjoy.  It used to be that doctors finished their training, and expected to practice medicine for the rest of their lives, and then retire.  Such a career trajectory is uncommon these days.  Luckily, there is a lot of choice to allow us to successfully manage our career in medicine.

One of my mentors in medical school shared with me his Seven-Year Rule, his belief that we can only do, and enjoy what we are doing, for about 7 years at a time.  He encouraged me to regularly reassess what I was doing every 7 years or so, and modify it so I could continue to appreciate and feel a sense of reward through my work.  Inherent in this was a huge lesson – that a career is not something that just happens to me, that the key to career satisfaction is to proactively shape my own career path.

There are three well-described stages of any career.  The first stage is when we have the most energy and drive, feel full of excitement and enthusiasm, and feel ready to set bold goals and work to achieve them.  Possibilities seem endless during this time.  When we hit the second stage, reality sets in.  We start to realize that we may not be able to do it all.  It becomes harder to remain focused on the original goals and we may start to feel tired or discouraged.  In the third stage of our career, we redefine our goals and priorities and reconcile our decisions.  We set new accessible goals, see challenges ahead that we can meet, and work towards that, with success.  These stages occur within a medical career too.  Being aware of this allows us to monitor and react effectively when we reach a new stage.

I just attended my 25th medical school reunion last fall.  It was great to reflect over the years, and see the range of what we were all doing.  Some of my classmates continued to practice clinical medicine primarily, but others had added educational, administrative, or research duties.  We were all abuzz about a colleague who left medicine after 15 years of practice to become a makeup artist on Broadway.  We spoke of loving our work, of finding it meaningful, of feeling overwhelmed and burnt out, of being too busy and out of balance, of realizing that medicine was not the right fit for us, of having the opportunity of doing something else now that the kids were grown up, or of just wanting to do something else now. Despite a variety of reasons, all of us were ready for some change.  Fortunately, such change can easily occur within medicine, allowing us to make the required adjustments so we can feel more fulfilled. 

It is crucial to realize that stages of career development are normal, natural, necessary, and will occur. Over the next few columns, I will take a closer look at this process.  We will explore it from a temporal point of view – before, during and after the change. In the next column, we will look at the process before we even take any steps, understanding what are the reasons to make a change, and anticipating potential barriers to this.  Next, we will discuss how to consider and choose options that may work for us.  In the final instalment, we will identify practical steps towards our new direction, and address how we can best deal with the change.

Being a physician is both a calling and a career. Career development is lifelong and occurs throughout the major stages of our life.  Managing our career in medicine is an important skill to develop and cultivate, and is a process that we each must actively lead for ongoing career satisfaction.

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.