Moving away from clinical medicine

Moving away from clinical medicine

Wednesday 16 October 2019


Considering a change from clinical medicine? Doctors comprise half of the 37,000 members of Drop Out Club (docjobs. com), a US-based jobs site dedicated to innovative non-clinical health careers. Former Australian GP and career coach Dr Jocelyn Lowinger’s Facebook support group for doctors interested in non-clinical careers had over 1,000 members.


Dr Lowinger observed that burn-out and imposter syndrome commonly prompted career soul-searching but after recognition and support, many decided to continue with a satisfying clinical career.


For those who do make the change to a non-clinical career, it is usually a satisfying choice.


I interviewed Dr David Oldham, Director of Medical Education at WACHS and Dr Greg Sweetman, Director of Medical Education at Fiona Stanley Hospital – two doctors who are intimately involved with medical careers – about their own journeys.


The decision to cease General Practice was a big one for Dr David Oldham.


“As much as I loved working at Fremantle Hospital and in General Practice, I felt a lack of stimulation and was looking for a fresh challenge,” he said, adding that to his surprise, he hasn’t missed clinical practice as much as he thought he would.


Dr Sweetman said changes in health services brought about “an opportunity to reappraise where he was going and whether he’d withstand the rigour of emergency medicine work and on-call into his 60s.


Some doctors feel trapped by clinical medicine, which can then turn into a wellbeing concern.


“I think medical practitioners should pace themselves for a career of 30-40 years and look at options that augment and prolong their clinical longevity,” Dr Sweetman said.


“For each practitioner, that will be different but too many remain mono-dimensional in terms of only clinical work, which means a clinician has limited options in their future,” he added.


Stigma and self-identity are common themes in forums for doctors considering a non-clinical career.


“Clinicians view with suspicion any doctor who is not predominantly engaged in clinical work,” Dr Sweetman said.


“I found the transition to not seeing patients a challenge as it was a significant part of my identity. A colleague, however, provided the most useful personal perspective: ‘you have done your tour of duty’, which was a nice way of acknowledging previous contributions and at the same time respectful of a new role.”


Dr Oldham had a different experience.


“Moving from a clinical to non-clinical role was difficult in two respects – no longer seeing patients with whom I had developed a long-term professional relationship, and concern about losing touch with the coalface.


“Whilst I can’t do much about the former, in my non-clinical role I liaise closely with those at the coalface and ensure they are properly consulted. For me, the loss in identity of being a practising clinician is more than made up for in the knowledge that as a good educator and manager, I can have a much greater positive impact on patient care (albeit indirectly),” Dr Oldham explained.


Neither Dr Sweetman nor Dr Oldham had planned a late career transition into a non-clinical role but had taken their opportunities in diversifying their work mix over time. Both doctors advised pursuing your interests – stack your odds for serendipity.


“Doctors are usually intelligent, hardworking, conscientious and well organised – that would make them good employees in many non-clinical environments,” Dr Oldham said.


“Where I have seen doctors struggle is when placed in a management role such as being Head of a Department. Here they require a different set of skills such as tolerance of uncertainty, and good interpersonal, planning, organizational and negotiation skills. Management requires having a big picture and long-term view.


“The health system is complex and getting more so over time – it is important to teach all doctors (including junior doctors) managerial and leadership skills.


 “Try and remain adaptable in your career, accept that fate will take you in different directions, buckle up and make the most of the unexpected,” Dr Sweetman advised.


“Be comfortable with your own achievements.”


Dr Oldham concurred: “Many of the stressed doctors I have talked to have placed unrealistic or unnecessary expectations on themselves.


“Having said that, I also know doctors who have worked 60 hours a week for 30 years in clinical practice and loved it.


“Everyone is different and at the end of the day, doctors have to work out what works best for them.”


Read Robert Frost’s poem The Road Not Taken in full and contrary to popular perception you’ll note that both roads are equally satisfying.


Doctors Health Advisory Service WA, phone 9321 3098 for confidential advice.


Australasian Doctors Health Network

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