Should I leave clinical medicine?

By the time people book in to see me they have often been puzzling and fretting over this question for months or even years.

This question is a biggie. It is one of the commonest reasons people come to me for coaching and I’m grateful for those who choose to include me (as a coach) in their decision making.

I’ve had a few clients who manage to resolve a way forward with a clear decision after just a single session. It’s very gratifying when that happens.

More commonly though it’s not possible to do justice to such an important decision in just one hour. After all, this question has usually been lurking for a while – and any easy solution would have already been found and implemented.

So usually for a sound decision I find it most often takes between 3-5 sessions and sometimes more.

What makes this a hard decision?

Medicine tends to be a sticky career. By which I mean, once in the system, medicine wants to hold on to you tightly.

Firstly there’s just the sheer number of years, energy and time it takes to get qualified and registered. Then so many more years in specialising. It’s very hard to think about letting go of something that was so hard to get in the first place.

Next, there’s the problem of it often being a one-way decision. Although it’s not impossible, it’s really, really hard to get back registration once you’ve let it go.

And as if the practical side isn’t hard enough, there’s some pretty big emotional hurdles as well. A huge sense of loss – loss of identity, income and status – and often guilt. Guilt for feeling like you’ve let down your patients, your colleagues and society as a whole. Guilt for ‘wasting all those years’.

Is it running away or moving towards?

One reason I encourage people to take time making this decision is it’s really important to figure out if you are, underneath it all, running away from medicine.

I’ve had so many doctors realise that, despite some very good rationales for leaving medicine, often it’s really about imposter syndrome, anxiety and loss of confidence at work that is driving the desire to leave.

As a short term strategy avoiding anxiety brings relief. But as a long term strategy, avoiding anxiety in the form of leaving medicine, has the potential really breed a deep seated sense of failure. That you couldn’t hack it, that you are weak, or that there is something wrong with you.

So I always encourage people to take some time considering the role anxiety is playing in the desire to leave medicine.

If someone has some grander plans they want to engage in, and continuing in medicine is going to get in the way, then it feels like a positive move to leave. But when there’s a hint of anxiety being the underlying reason I really encourage people to work on building their confidence…and then from that stance considering whether to leave or stay.

I can tell you that the vast majority of my clients rebuild confidence and discover a sense of meaning and purpose in medicine they had lost sight of, or never had in the first place. Most of my clients do end up choosing to stay in medicine as a proactive choice – and they tell me they are glad they made that decision.

How do I build confidence?

This is the key question everyone asks me in the end.

It’s always a tension filled moment because I can feel the deep yearning for an answer to relieve the anxiety. But I also know there is no magic answer. I can’t tell someone how to feel confident.

Well, more accurately, I can teach a bunch of theories, and provide support, challenge, and different ways to think in confidence building way. But confidence is something that grows in action. It takes time, introspection and commitment to change. It’s also incredibly individual and personal. Everyone has a different way in. I wish I had a cookie cutter approach but I don’t.

So should you leave clinical medicine?

Well nobody can make the final decision but you. But I encourage you to carefully consider whether issues such as anxiety underlie the desire to leave…and if so work on that. From there you can make a sound decision and walk confidently into the future.