As my original 2016 post, '15 tips on what to do if you want to quit medicine', has been getting a spike in views, I've decided to update it - check out my latest advice on what to do when you've had it with medicine.

With everything that’s been going on lately with Covid-19 – the insane rotas, the failure to protect staff, the appalling lack of leadership and the battlefield the NHS has turned into, I’m not surprised that we’re now seeing doctors seriously considering a change of career.

As much as the political rhetoric tells us we’re ‘all in it together’ and that camaraderie in the health service is back, it feels like too little too late. So many brilliant, hard-working doctors out there are feeling lost, exhausted, and just plain fed up.

When I first considered quitting medicine, I found the whole idea deeply distressing, and I felt really alone. I didn’t know where to start, what to do, or even how to find out more information. It also felt like such a taboo to even talk about my feelings – socially isolating, you might say… (Too soon?)

Anyway, in honour of my old colleagues, and anyone else out there who has doubts, I’ve updated my guide for what you should do if you’ve had it with medicine.

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1. Find some head space

As much as our beloved eportfolios bang on and on about the importance of ‘reflection’, working as a doctor rarely gives you the chance to actually reflect on your life. I got my chance to do this completely by chance – in October 2015, I was called up for jury service, and as all those who have done it before will know, you spend a lot of time waiting around. The hours I spent sitting in a tiny room outside the court with a bunch of strangers forced me to think, and in the end, the inefficiency of the justice system served me well, because five days later, I wrote my resignation letter.

Whether it’s getting away from normal life for a while (admittedly tricky right now), or talking to someone who’ll respond to your concerns objectively and not critically, spend some time exploring your doubts and feelings.

2. Know that you don’t have to leave medicine outright

I’ve had doubts about medicine since my first year of medical school, but one of the reasons I held back from doing anything about it was that I genuinely didn’t realise that you could be more than a doctor.

It seems like such an obvious thing to me now that I’ve done it, but the medical schools rarely tell students how they can diversify their careers. As a medical student, you’re led to believe you’re on a non-stop train to consultancy. You start to believe medicine is all you’re trained to do, all you know how to do, indeed all you can do.

But it’s not true. I’ve discovered that you can get off the train. You might change trains and go via a different route. You might ditch the train for a while and drive a car to the next station, where you get back on again. I’ve met people who have had several career breaks over the course of their lives, doing both medical and non-medical things. For these people, their experiences have enriched their lives and have actually helped them when they have returned to their medical careers. Don’t believe the old-school naysayers who will tell you that career breaks will damage your chance of making it in your chosen field; if you do something interesting that will help you grow as a person, it can only be beneficial.

You may not even have to take a career break in order to pursue new interests. I for one firmly believe that things like sabbaticals, 'F3' years and part time practice should be the norm in the medicine, not the exception. It is such a demanding and all-consuming job that we should be championing those who recognise that prioritising their mental health and their emotional wellbeing by balancing their lives with other things, be it side-hustles, non-clinical roles, their own businesses or hobbies.

Here are just a few examples of incredible doctors, some still practising, some not, who have diversified their careers:

UK-trained or based

Evgenia Galinskaya, Production Associate, Coulter Partners (Life Sciences)

Gyles Morrison, Clinical User Experience Designer

Lafina Diamandis, Founder of Eurekdoc, amongst many other things

Stephanie Eltz and Suman Saha, Founders of Doctify

Kishan Rees, Founder of WatMed Media

Sara Kayat, GP and Television Doctor

Abeyna Bubbers-Jones, Founder of Medic Footprints

Shafi Ahmed, Surgeon and Digital Health/Innovation expert

Patrice Baptiste, Founder of DreamSmartTutors

Fiona Dogan, GP Trainee and Medico-Legal Manager

Janak Gunatilleke, Digital Health expert

Edward Lynch, CEO of Lyfe

Saif Abed, Cybersecurity expert and Founding Partner of AbedGraham

Shirani Rajapaksa, Independent Strategy, Comms and Helath consultant

Overseas

Errin Weisman, Host of podcast Doctor Me First

Maria Phalime, Award-winning author and TEDx Speaker

Melissa Theunissen, Clinical UX professional.

Joseph Liu, TEDx Speaker and Personal Branding Consultant

3. Remember who you were

While on jury service, I went out for a drink with one of my dearest friends, who happens to be an old teacher of mine. She taught me French at high school and we stayed in touch after I left. Whenever I see her, I feel a strong connection to my high school self: the girl who was a brilliant linguist, but didn’t appreciate or realise it at the time; the girl who loved poetry and prose better than covalent bonds and the Krebs cycle; the girl for whom English, French and German held such a fascination, that studying them hardly felt like real work.

My wise friend listened to me so understandingly, and told me of her own search for happiness in life, and suddenly the right thing to do became blindingly obvious to me: I didn’t just like languages – I was madly and irrevocably in love, to the point that life without some linguistic aspect would always feel incomplete.

So who were you before medicine eroded the passions you once had, and drove out the hobbies, interests, talents and little personality quirks that once gave life that spark? The coronavirus pandemic may be closing doors at the moment and making things like career changes more tricky, but it may also be an opportunity to reflect on who you really are.

4. Ask yourself: is it medicine or is it the NHS?

This notion came from an unexpected corner: my dad. Although he expressed doubt as to the wisdom my leaving the profession, he made a very pertinent point: debate is important when you’re making big decisions, and while the medicine referendum was going on in my head, my dad represented the ‘stay’ campaign.

Working for NHS England can make it very difficult to like medicine at times, and it can be really hard to know if it’s medicine itself that is making you unhappy, or whether it’s just the system. Would it change things for you (if we’re ever allowed to travel again…) if you were working in a different country? Could a different speciality, part-time work, or a year or two abroad give you that sense of perspective? What about the private sector? It’s a taboo subject I know, but you’d be surprised to know that even junior doctors can find roads into it. The co-founders of Doctify, Drs Stephanie Eltz (mentioned above) and Suman Saha, set up their independent health tech platform partly because they felt stagnated in the NHS, and setting up a business has been their way of getting that spark back.

It’s a really hard question to answer, but I guess, if you don’t ask it, you never look into it.

5. Do your homework… in the right way

If you’re like me, you’ve probably spent hours googling thing like ‘alternative careers for doctors’, and seen unhelpful lists of other careers that are vaguely related to medicine. But I stopped when a friend of mine, Dr Evgenia Galinskaya (also mentioned above), who used to be a Dermatology reg, told me not to do this. (Her exact words were: “stop googling alternative careers for doctors!”) In fact, she’s just updated her excellent blog post about this very issue, so check it out.

Those lists are bullshit written by people who have only a vague idea of what the job market actually looks like. You are not limited to those lists. When was the last time you sat down and thought about what you wanted to do? Years of medical school and postgrad training give you a plethora of skills, but it can make medics forget that they have other facets to their personalities.

You might also – and there is no shame in this, because I was like this too – have certain prejudices and ideas about certain professions. I had a massively negative and distrustful view, for example, of the media and also of the pharma industry. It’s a doctor thing – we can get locked into a pretty narrow view of the professional world. Cut to five years later, I’ve worked in the media industry and advised the pharma industry, and loved both and at no point did I have to compromise any of my personal values. Also true of both those roles is the fact that I could never have even conceived of either of them at the time I left medicine – I didn’t know they exsited, and I certainly had no idea I’d enjoy them.

Remember that it’s an incredibly diverse world out there with a tremendous amount of variation between companies, and there are good bits and bad bits of every industry, just like there are good people who work in the health service, and people who are morally bankrupt, corrupt and self-serving.

So give yourself the chance to rediscover your natural skills, weaknesses and goals, and be open-minded. It might not come straight away, because you aren’t used to asking yourself what do I actually want. But it’ll come in time. Finding your sense of purpose and direction is a journey – start it now.

6. Evaluate your own health

The GMC estimates that 10-20% of doctors suffer from depression at some stage, but more recent studies suggest that the real figure is much, much higher than this. I suspect that, after this pandemic is thorugh with us, the percentage will be even higher.

Of course, not every doctor who questions their career will be experiencing either mental or physical health issues, but I think the risk of this happening is greater, because changing career just isn’t something we do. As I said before, it’s classically been a bit of a taboo – you work so hard and invest so much personally; leaving could naturally make you feel that a lot of time and effort has been wasted. Then there are the wishes of your family or colleagues, and their investment in your career, plus the horrible, awful guilt many doctors feel about leaving. When all of this was added together, for me, it made the misery so intense that I honestly began to wish I could go to sleep and not wake up again.

Please don’t feel alone if you find yourself struggling. You know what the signs and symptoms are; if you were your own patient, would you be worried? Don’t suffer in silence: contact the Professional Support Unit in your Deanery or NHS Practitioner Health. Or reach out to support wellbeing groups on social media like Tea and Empathy. Or get yourself a licensed counsellor or therapist – again not something doctors do, for some reason.

Physical health is also an important consideration. How is being a doctor affecting your body? Do you have a condition or disability that, if given more attention, could allow you to continue practising? Doctors are really good at feeling guilty and ‘weak’ compared to their colleagues, and therefore not asking for what they need. But knowing your own body is not weakness, and you’re allowed to be a human being.

7. Get yourself a person

Even if it isn’t health support that you need, people who are having a career crisis generally could use a little help. Having someone who specialises in careers guiding you, such as a coach or a mentor, was a critical part of my successful transition out of medicine.

When I was considering leaving, I contacted the Professional Support Unit in the London Deanery. They gave me four free career coaching sessions (that was five years ago – I’m not sure what they provide now). I was linked up with a coach who wasn’t a doctor, but a writer by profession. She did all sorts of things with me, like personality tests, a CV overhaul, a skills analysis, non-medical interview practice and lots more. As she worked with me, it became a bit clearer to me why medicine wasn’t the right career for me.

My mentor was (and, in fact, still is) Dr Gyles Morrison (mentioned above). He left medicine about a year before I did, and was therefore able to relate to me in a very specific way, as he knew exactly what I was going through – he understood on a level that even my most supportive non-medic friends never could. His support and advice became a lifeline to me as I felt my way through a strange, new, non-medical world.

That was an informal mentorship, but there are also a lot of professional career coaches, life coaches and mentors out there, like me, who specialise in helping other doctors. We all have different backgrounds and niches, so have a look around and find someone whose style and story reonates with you.

Here are just a few of my fellow doctor coaches: Sarah Goulding, Rachel Morris, Adam Harrison, Sally Graddon, Amrita Sen Mukherjee, Caroline Walker

Formal or informal, having a person to specifically discuss these issues with you can bring you empathy and new perspectives, as well as helping you to set goals and holding you accountable to them. Remember, engaging a coach doesn’t mean that you’re definitely going to end up quitting medicine – it just means that you’re exploring your options.

If you’re interested in mentorship with the Disillusioned Medic, click here.

8. Explore opportunities to take time out

For you doctors with a specialty training number, it could possible for you to take an Out of Programme experience (OOP). This can be related to training, research, or something completely non-medical altogether. They can be hard to get, but they are definitely worth exploring. I’ve met many OOPers, Dr Azra Chang being one of them. Like her, many have stepped out of medicine into something completely different, like management consultancy or health policy. I don’t think a single one of them regrets doing it, for the experience has allowed them to learn something totally new. Some don’t return to medicine, but some do, and from my experience, those who do feel empowered to come back on their own terms.

9. Network your socks off

Doctors – especially junior doctors – are not used to the concept of networking. Generally, you know where to find the people you need (even if they’re not always available!) and as jobs in the early years are dished out using some strange algorithm that puts the SJT on a par with six years of med school, you don’t really need to get out there and meet people in order to find work.

However – and I cannot emphasise this enough – this is not how it works outside medicine. Meeting people and knowing people can mean everything. I’m not talking about nepotism; it’s more about being in a position to take opportunities. How can anyone become your mentor, your new boss or even business partner if they don’t know you exist?

I’ll give you an example: my mentor Gyles walked past a health tech start up’s PR stunt one day, and stopped to ask them questions about what they were doing. The Head of PR ended up introducing him to the founders of the company and they paid him for some UX consultations. Some months later, I met Gyles by networking at the Medic Footprints Alternative Careers and Wellbeing event and he became my mentor. Gyles then asked me to assist the same company in another PR stunt they were doing, and I just went along out of curiosity and to be helpful. In the process of doing this, I got to know their Head of PR and I guess he saw something in me, because the company then called me in for an interview and hey presto, I become their new Head of Content and Marketing.

When I left that job, I met the CEO of my next company at a GIANT Health event. I heard him speak, loved his perspective on the way companies hire, and went to talk to him about it afterwards. He gave me a job on his marketing team, but because the company was a management consultancy, I learned about the consultancy world and then I became a consultant myself.

Now I know that right now, it’s impossible to go to networking events, personal development events and careers fairs (thanks, Covid-19…), but there are still ways you can be curious and keep your eyes and ears open. We’re currently seeing a surge of people work remotely and attending events online, so get researching. Looks also at social media – there are alternative careers groups for doctors on Facebook, there are videos of ex-doctors talking on YouTube, and then there is THE major professional platform… LinkedIn.

10. Get on LinkedIn

This ties in with networking, and is a must for medics who want to explore new professional territory. Make yourself a profile, put some effort in and make it look good. Write a decent bio about yourself and put up a good, professional-looking photo of yourself. You can go further by putting up blog posts as well.

Another benefit of networking is finding that peer support. When I first started discovering the alternative careers sphere, meeting other people who thought differently was just the most inspiring and comforting experience.

I know LinkedIn can seem a bit befuddling if you’ve never dealt with it before, as doctors don’t tend to use it, but if you’re serious about exploring the non-clinical world, take some time to learn about it or even get your coach to take you through it. Because I guarantee that when you meet people in a professional capacity and they want to know more about you, the first thing they’ll do is Google you, and unless you have your own website, the first thing to come up in search results will be your LinkedIn profile.

11. Think about when you’ll be in a good position to leave

It’s not a nice subject, but I used up a lot of the money I had saved working as a doctor while I was unemployed. It didn’t feel great – especially when I was considering unemployment benefits – but I felt it was a necessary investment in myself. I was extremely lucky to have the support of my fiancé as well.

Dr Roger Tackley made headlines when he left his post as a Consultant Anaesthetist to open up his own hair salon. A career change is always a financial burden, but for him, setting up a new business at the same time made it even more challenging. However, he told me that he was so glad he took the plunge, and his advice to anyone who has a passion to do something alongside a medical career is to give it your best shot. He said it’s a good idea to experiment and sample it before swapping careers, and to make sure that you are secure enough to survive if it doesn’t work out.

12. Remember that the door is always open

Dr Lafina Diamandis (mentioned above) is a testament to how varied a doctor’s career can be. She took several career breaks to try different things, including setting up her Boutique Property Services in Spain, and founding Eurekadoc, the only UK publishing house dedicated to printing ‘niche’ career guides for doctors. In December 2015, it was she who organised the ‘Medicine: Stay or Go?’ conference. Lafina went in and out of medical practice, and is now returning again to complete her Paediatrics training. So if someone tells you that once you leave, you can never come back, ignore it; it’s simply not true.

And even if you do completely cut ties and tell the GMC to well and truly fuck off, a global pandemic might end up pulling you right back in (case and point: yours truly).

13. Free yourself from guilt

When I spoke to Dr Sabine Fonderson, CEO of HelloDoc, about switching careers, getting rid of the guilt thing was her number one tip.

I too was racked with this terrible feeling, but Gyles put it this way for me: if you did a degree in history, would you feel guilty about not becoming an historian? Probably not. Yet doctors continue to feel this sense of shame and guilt when they consider leaving medicine. I felt like I was letting everyone down and I felt that I owed the NHS all the money spent on my training.

Do remember, though, that the government subsidises every single degree in this country – medical students might get a bit more, but the difference is not as big as people believe. Also think of all your fees, exam costs, the free overtime you do, the quality improvement projects, the audits, the teaching and everything else you do completely out of your own pocket and your own time. You’ll probably find that the NHS owes you more than you owe it! Also your value is not just monetary – you are more than just a pay check. The fact that you’re a doctor makes you extremely valuable to other sectors – health policy, for example, like Dr Harpreet Sood. People who harangue you for wasting taxpayers’ money are ignorant of these things and therefore not worth listening to.

Ultimately, you have to do what is right for you. If you are miserable, you and everyone around you will suffer, including your patients.

14. Turn down the volume of negative influences

It can be hard to avoid negativity. When someone close to you expresses a strong aversion to the idea of a career change, it can make it very difficult to make the call. I also had a bad experience with my educational supervisor, who simply told me I was wasting my life.

Having said that, I did notice, particularly in the wake of the junior doctor contract fiasco, that more and more senior doctors are willing to talk about the realities of working in medicine than they were before. I was surprised at how, as well as those consultants who have urged me to go back, there were a considerable number who were open to discussion about other careers and who helped me – by providing references, for example.

At the end of the day, people will always have an opinion about what you should do with your life, but I now try to take advice only as it empowers me.

15. Learn to talk about yourself

Often I find that doctors who are leaving medicine are not very good at talking about themselves. Any professional confidence they had within medicine suddenly evaporates, and they don’t know how to communicate their skills and value to non-medics. They also often suffer from an aversion to boasting that is so severe that they’ll often downplay their talents.

This makes sense in the strictly hierarchical medical world – if you talk yourself up, chances are you’ll get put straight back in your place by your seniors, or worse, you’ll be asked to do something outside of your competency. Also, you don’t really need to say very much to another doctor to communicate your level of expertise. For example, if you were to say that you were a Paeds ST3, another doctor would have a fairly good idea of your professional aptitude just within those two words.

Not so in the non-clinical world. People won’t hire you or partner with you unless you’re able to explain why they should, so start prepping that elevator pitch. Your coach or mentor can help you with this.

16. Create a non-medical CV

Medical CVs are only understood by people within the medical field. They often are extremely long, due to the level of detail you need to go into about the competencies you gained in every post.

Non-medical CVs need to be short (two pages max), snappy and to the point. There will almost certainly be a number of superfluous details you need to get rid of, and until you reach a certain level of experience in a non-medical field, you will almost certainly need to tailor your CV to every position you apply for.

Also, don’t assume that your medical degree will open every door for you. People will often tell you that a medical degree is a ticket to anywhere, but this is a misconception.

It is true that, as a doctor, you will have a range of transferable skills. You will likely be very adaptable, fast to learn, flexible and extremely diligent. But people won’t necessarily understand that, or have the ability to see how you’ll fit into their team.

Remember, most people have no idea what doctors actually do, and they often have weird assumptions about the kind of people we are and the kind of capabilities we have.

I’m not saying this to dishearten you – remember, you ARE much more than just a doctor, and you DO have a number of transferable skills, whether you know it yet or not. I just want to prepare you for the probability that you will meet resistance, and therefore have to ‘sell yourself’ in a very particular way. It is undoubtedly true that medicine has opened up many, many doors for me, and I wouldn’t be where I am today without my MBChB. It just didn’t necessarily happen in the way that I expected.

Again, ask your coach or mentor for help.

17. Stop thinking so big

Now this might seem counterintuitive – what could possibly be bigger than leaving medicine?! You NEED to decide EXACTLY what you’re doing with your life now, right? You NEED to have a new pathway to success mapped out with precision, to know IMMEDIATELY what your new purpose is, what your career progression is gonna look like, what your salary’s going to be, what you’ll be doing in two years, five years, ten years. How are you going to do GOOD in the world, make a name for yourself, make a difference, make up for the fact that you left the most NOBLE profession of all?? Oh God, it’s overwhelming! Maybe you’ll just crawl into a box and think about it later…

I understand. This was me, once. I felt like I needed to have all the answers, and it didn’t help that people around me were asking me what the hell I was doing with my life. But if you think too big, you’re only going to feel more stuck. This is a gradual process, so take it one step at a time. You’re probably not going to land your perfect dream job tomorrow. But you can go to that art class, you can read that book, you can attend that webinar. The small steps will lead to big ones – just be patient.

18. Explore

This ties in a bit with my last point. Doctors are really bad at exploring. For many of us, having been on a conveyor belt ever since we were in our late teens, we never actually had the time to experiment. It’s almost like you got married when you were 15 and never had the chance to date. You never kissed any frogs, never had a fleeting romance, never figured out what you like and don’t like, never spent a year with that guy you knew deep down was a mistake, but hey, it was a mistake you needed to make.

I think it really boils down to fear. Medicine always gave me a goal to work towards, no matter what stage I was at. To suddenly be without that very specific goal made me feel like I was wandering around aimlessly. I had jobs that I didn’t like but had to stick out for a while, jobs that didn’t really seem to be going anywhere, and periods of not really knowing what to do. These things acutely stressed me because I felt like a massive failure all the time.

But I realise now, they were all an important part of me learning about what I liked and what I wanted to do. Let yourself explore.

This is one of the reasons why it’s easier to leave medicine when you’re younger. Quite frankly, leaving medicine now would be much harder for me than it was five years ago when I wasn’t a mother and we didn’t have a mortgage. But being further down the line doesn’t mean that you can’t leave. It might just have to be a slightly longer and more convoluted route, and you might have to be more creative about how you do it.

19. Don’t presume you have to do a Masters

Because medicine requires us to have formal training for everything and demands proof of it before we even set foot on the wards, doctors often make the incorrect assumption that, if you want to go into new field, you’re going to have to retrain. And most frequently in my practice, my mentees talk about doing a Masters degree.

However, in the non-medical world, academics are not the be and end all of everything. There are plenty of fields where your experience, your personality and your talent (as well as knowing the right people) are the primary drivers of your success, and I would argue, are more important than your qualifications. This is a bizarre concept for a lot of newly escaped doctors, and it can feel quite uncomfortable at first.

Now I’m not saying that you should never undertake another formal qualification – I’m just saying that timing is important here. Often, doctors put themselves under huge pressure, as I said above, to ‘decide’ what their new life will be, and this drives them to looking at expensive degrees they have no idea whether they’ll actually enjoy or find useful. It’s basically like medicine all over again.

So pull it back a bit – start by building your skillset on a smaller scale. It doesn’t matter if you don’t know what you want to do yet, or even if you’re not sure you’ll leave medicine yet. Just start looking at things that interest you. If you think you might want to set up a business one day, read some business books. If you think you might be interested in health tech, maybe do a coding course and see if you’re into it. There are so many resources out there, including free webinars, courses and educational platforms. Use those research skills and start researching what you’re into!

Once you have an idea of that, you can step it up – find a more in-depth paid course, get a ticket for an event in that area, geek out about it a bit more, and talk to people who are in it. Perhaps you’ll even get a job in your new field of interest so you can explore it a bit more.

And one day (not always), there might come a point where you realise that, to take this further, it might be useful to do that degree. You might realise you’re really interested in management consultancy for example, and to work for the Big Four, you’re going to need an MBA. At that point, you’ll be ready to take the plunge and spend that £10k. Or you might find a completely different route into your chosen field without doing a degree – there is almost always more than one way of getting where you want to go.

Example: I’m a strategic marketing and communications consultant. My clients are small to medium sized enterprises and they pay me a pretty decent day rate. And I don’t have any sort of marketing degree.

20. Get ready for a massive personal learning curve

Before I left medicine, I didn’t realise how ‘doctor-y’ I was. It was in part because I’d been institutionalised by the NHS, and infantalised by a management culture that still speaks to you like you’re a toddler even if you’re in you’re a highly trained specialist in your thirties. But it was also partly because I’d never actually experienced the outside world myself. I had ideas and presumptions about it that turned out not to be true, in both good and bad ways. Certain prejudices and suspicions turned out to be unfounded, whilst in other areas, I realised I was desperately naïve.

And the spiritual growth! Blimey, I was not expecting that. I mean, I realised that leaving medicine would impact my emotional and mental health, but I really had no idea how it would change my entire outlook on life itself! It’s perhaps a rather hippy-dippy thing to say, but my soul has changed. And changed for the better. It’s really why I started doing my Real Reflective Practice livestreams – I have learned to think in a different way, and it’s been a deeply healing skill to learn.

It will take you a long time – months, maybe even years, to rewire the neural pathways that are keeping you stuck right now. And to be quite honest, it might sometimes be really painful. But if you embrace the process, it’s worth it. Bloody hell, it’s worth it.

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I hope this article has been helpful to you. Just remember, you’re not alone. In medicine, always being in the same environment can make it difficult to see the bigger picture, but take it from me – there are other options out there, and there’s no harm in looking!

Dr Anjalee Perera is a former NHS doctor turned Marketing and Communications Consultant and Career Coach for doctors. She is also the founder of Disillusioned Medic and the host of Real Reflective Practice. Get in touch here.