Exploring Alternative Careers in Medicine

An edited version of previous material on this website in preparation for a new section titled ‘Answers to Physicians’ Career Questions’.

Having the Self-Confidence to Begin

What’s often construed as confidence today is more the sophomoric behavior of some braggart than the real thing. We see examples in our own profession, our political leaders, and some captains of industry. It’s a false confidence as easily punctured as a balloon and as useless thereafter. Quiet unassuming confidence is the real deal. It allows one come up short, err, or experience doubt. It allows one say; “I’ve got to think through this.”

We doctors may shrug off success and accomplishment as if we are just meeting our own and others’ expectations, while simultaneously being overly bruised by vicissitude. It’s tough for us to fail, it’s very tough for us to admit mistakes, we struggle to admit doubt. Would the humility to admit to career doubts end up strengthening our self-confidence (perhaps a paradox to some) rather than undermining it? Humility about our limitations may make us more mentally flexible, more willing to listen well, to be seen by individuals helping us as more receptive.

Doubt is not a synonym for indecision, rather a manifestation of an active questioning mind, and a tolerance for ambiguity that is a mark of maturity.

Principal Elements Influencing Career Choices

Each of us has our own motivations for the career paths we’ve chosen, whether conscious or not. There are 10 primary drivers of our choices, listed in alphabetical order below. These are dynamic elements, showing significant evolution with time even in those individuals who remain within the same career track. Physicians will benefit from considering how each element may have influenced prior career choices, and which dominate current career decisions.

Autonomy: The degree to which you want your professional life is dependent on the reactions, behaviors, and reliability of others.
Creativity: Encompasses both job description and work product.
Endogenous Growth: The degree to which internal development drivers motivate career choice.
External Recognition: The degree to which the opinions of others matter.
Interpersonal contact: The value of work relationships.
Opportunity to Mentor: Interest in advancing the well being and careers of others.
Security: Confidence in the stability of your work circumstances.
Taste for Power: The degree to which being in charge matters.
Technical Competency: Your drive for specific expertise.
Variety: Your need for novelty and change over time.

I ask physicians to rank order the elements at different stages of their professional lives, e.g. at completion of graduate medical training, and every 5-10 years thereafter, the interval duration depending on the length of their career. We should be particularly attentive to respecting the top 2-3 current elements, and any element that is consistently ranked in the top 5.

Unique Abilities

Many physicians considering other career options perish on the rocks of thinking that their only skill is a professional metier like replacing hips or reading brain scans. Having completed rigorous and lengthy training to acquire such expertise, we overvalue those clinical and procedural skills, and undervalue more personal attributes which may have broader application to the world at large.

Unique abilities are particular capacities that set us apart from almost all others. Typically they are carried out with an ease and grace that is especially striking to the outside observer. They come so naturally to us that we may consider them unremarkable.

Recognizing our unique abilities will give us valuable insights into what facet of our professional lives we should be emphasizing as we explore alternative career options. Technical or procedural skills rarely qualify as unique abilities.

I use myself as an example. My skill in EEG interpretation is not useful outside of clinical neurology, but my talent as a teacher and communicator in making this difficult field understandable and fun is. With excellent speaking and writing skills, I make the obtuse straight and the arcane mundane. Such is my unique talent, my paramount transferable skill.

Identifying Unique Abilities

On your own or with the help of others, it is about understanding what lies at the root of those moments, however fleeting, where you feel deeply satisfied with who you are and what you are doing.

Proceed as follows:
1. Identify 10-15 individuals who know you well and whom you view as well disposed to you. Ideally, they will be from a variety of contexts, about 1/3rd professional, 1/3rd family, and 1/3rd friends. The latter third could be drawn from groups like your golf or book club, volunteer organizations, your church or synagogue.
2. Ask these individuals to identify 2 or 3 special human qualities that you possess where you really shine, and to share them with you. A sample note is provided below.
3. Make a list of these qualities.