The 3-5 Year Career Pivot: How Doctors Can Take Control of Their Future

The First Years After Residency: A Journey of Discovery

When you embark on your first attending job after completing residency, you are embarking on much more than just a new employment opportunity—it's the beginning of an important 3-5 year journey. During this time, you will be navigating the complex landscape of shaping and defining the kind of professional life that aligns with your aspirations, values, and long-term goals.

Residency doesn't truly prepare you for the profound journey of being a doctor. The medical education system sets out to achieve two goals, but only one is intentional. Yes, it equips you with the foundational skills needed to treat patients in your specialty. But what about preparing you for the real-life challenges and stresses of a 30-year career as a doctor? That's where it falls short.

Instead, you're molded into an exceptional resident: following orders, ensuring no one doubts your capabilities, and pushing yourself relentlessly to cross that finish line. It's almost as if this system is perfectly crafted to lead us straight into burnout—and that's exactly what happens! Once you're practicing on your own, you'll find that your job description strays far from your ideal vision; it's tailored instead to fuel the revenue model of your employer. And just like during residency, you keep grinding away because that is what you were conditioned to do.

Many young doctors find themselves in this pivotal phase where there is some financial and professional rewards but you still feel like you are grinding through an uphill battle. You naively assume it magically get better soon because the “great life of a doctor” has been experienced by so many. It must just around the corner, but it remains elusive!

This is the exact pivot point for my predecessor in my new locums assignment. This period is marked by critical exploration and decision-making as newer physicians all types of healthcare clinicians assess their work environments, weigh personal satisfaction against professional demands, and evaluate how well their current roles fit into their vision for the future.

Interestingly, statistics reveal that more than 50% of these young doctors choose to leave their initial positions within five years. This high turnover rate underscores the importance of this transitionary period as many medical professionals seek roles that better suit their evolving priorities or offer greater opportunities for growth and fulfillment. Whether due to factors like workload expectations, growing family demands, geographic preferences, or career advancement prospects, this decision-making process is essential for ensuring long-term satisfaction and success in one's medical career.

I have seen this happen over and over, particularly in rural America. It’s a reality that often stems from the tension between career expectations, lifestyle demands, and the stark realities of practicing medicine in challenging environments.

A Case Study: The Doctor I Replaced

During my most recent locums assignment, I stepped in for a family physician who had been serving in a rural FM-OB role for five years. Her story is one I deeply respect and fully understand. In some regards I admire the pivot she made only 5 years in, when it took me over 15 years to figure out that it was time “stop drinking the Kool-Aid”of corporate employment and make a change. Read More: My Journey To Empowering Physicians Through SimpliMD

She took this rural position in exchange for a four-year loan repayment commitment. Her father had practiced family medicine for over 30 years in a nearby town, and she wanted to follow in his footsteps while focusing on surgical obstetrics and women’s health. When she started, the community had an OB-GYN and four FM-OB doctors. The system was sustainable. But over the past few years, things changed dramatically:

• The OB-GYN left, along with two FM-OB doctors.

• She had two children under three while continuing to work full-time.

• Her call burden skyrocketed as OB options for patients dwindled.

• She was essentially on call 24/7, with minimal shared coverage.

• As a W-2 hospital employee, she was paid fair market value (FMV) with performance bonuses but felt the constraints of corporate employment.

• The inefficient EHR, staffing turnover, and constant administrative changes left her frustrated and disengaged.

• She picked up a side hustle as the director of a regional women’s clinic that she got connected to during her residency.

After nearly five years, she reached her breaking point. With two young children and a freelancer husband at home, she decided to pivot.

The Pivot: Rebuilding a Career Around Life Priorities

She chose to move to a suburban area in the Upper Midwest, where she will:

• Stop doing surgical obstetrics but continue low-risk FM-OB in a 15-doctor call group.

• Work as a 0.8 FTE instead of 1.0 to create margin for family life.

• Maintain some job stacking opportunities in women’s health.

• Possibly continue her remote medical directorship for the women’s health clinic.

With her medical school debt eliminated, she is now crafting a professional life that aligns with her lifestyle goals. The rural community she leaves behind will miss her deeply, but her decision is a familiar one: fulfill loan obligations, then move on to a more sustainable career and life.

The Winners in This Transition

The true victors in this ever-evolving landscape are undoubtedly the doctors who seize the precious years immediately following their residency to meticulously carve out their ideal practice and define a strong, authentic professional identity. These early career choices hold immense potential, and with the healthcare job market currently expansive and accommodating, there is a remarkable latitude for making career shifts that resonate with both evolving personal aspirations and professional ambitions.

This period represents a pivotal moment in one's medical career, one that can determine whether a young doctor thrives or succumbs to the pervasive burnout epidemic that looms over the medical profession. It is crucial to embrace this opportunity to intentionally nurture your well-being with vigor and without an ounce of guilt.

During residency, guilt might have been an omnipresent shadow—a forceful driver compelling you to strive relentlessly under intense pressures. However, now as an independent physician stepping into your own practice, it is imperative that your guiding purpose emanates from within you—from the core of your values and vision—rather than being dictated by external demands or expectations which may not align with what truly matters to you.

This inward journey towards self-discovery and satisfaction in your work isn't merely about survival; it’s about thriving in a field where fulfillment should be as paramount as service. Let this intrinsic motivation fuel your decisions, enabling you to cultivate a career path steeped in passion rather than obligation.

Allow yourself the grace to step away from outdated notions of duty-driven sacrifice when they no longer serve you. By doing so, you'll not only protect yourself from burnout but also set an inspiring precedent for others who too seek harmony between their professional duties and personal happiness.

The Losers In This Transition

The true victims of this relentless cycle are the communities of Rural America, who find themselves caught in a seemingly never-ending struggle against the tide of physician turnover. In these tight-knit communities, doctors are not just healthcare providers; they are integral parts of the social fabric, and their departure leaves a palpable void.

Practicing medicine in such areas demands an extraordinary level of dedication and resilience. It's akin to living life in a "glass house," where every move is observed and privacy is a luxury seldom afforded. The challenges faced by doctors in rural settings go beyond professional duties. They step into roles that often blend personal and professional lives indistinguishably, where their actions both inside and outside the clinic come under constant scrutiny by the community they serve.

This lack of anonymity can be stifling, driving many young physicians to weigh their options carefully. Given these conditions, it's no wonder that when young doctors have choices before them, they often gravitate toward suburban or urban environments. These areas promise not only more advanced facilities but also offer vibrant cultural experiences and robust professional networks. In cities or suburbs, there is an abundance of personal support systems that help foster both career growth and a balanced life—elements that are crucial yet scarce in rural practice settings.

As a result, despite the vital need for healthcare professionals in Rural America, many opt for settings where their work-life balance can thrive amidst greater anonymity and support.

Practical Steps for Young Doctors in Their First 3-5 Years

If you’re in this critical post-residency phase, here’s how to take control:

1. Recognize that your first job is not your forever job. It’s a learning phase, meant to enhance your professional development and your self-identity. It’s does not have to be a permanent destination.

2. Evaluate your true career goals. What do you love? What do you hate? What are your non-negotiables professionally?

3. Pay off debt strategically. Programs like loan forgiveness can be great, but make sure they align with your long-term plans.

4. Consider job stacking. Side hustles like telehealth, consulting, or directorships can give you flexibility and security along with diverse income channels.

5. Build financial independence. Create savings, reduce debt, and explore micro-corporations to increase and preserve your professional autonomy.

6. Learn about self-employment. Many doctors realize they want more control over their professional lives and pivot toward independent practice. SimpliMD can help.

You Have More Options Than Ever

Thankfully, today’s physician job market is not just a binary choice between traditional employment and private practice. The rise of telehealth, direct care, fractional employment, and micro-corporations gives you multiple avenues to build the career you want. Need some inspiration on what is possible as an independent doctor, read my blog post on 10 self-employment options for doctors.

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