Thinking about leaving clinical medicine, but worried about downsides? If you’re wondering if you’ll regret leaving clinical medicine, listen to this episode, and hear some concerns and questions from a listener like you.

In this episode of The Career Rx we’ll discuss:

  • Questions you should ask yourself about nonclinical medicine
  • Worries and fears physicians have around nonclinical career changes
  • Myths that hold doctors back from pursuing nonclinical careers 

Today we take a deep dive into a listener’s question about the experiences and expectations of possible regret when going from clinical to nonclinical. Listen along, and ask yourself these questions to help you decide whether leaving clinical medicine for a nonclinical physician career is right for you.

Special announcement: My course, Industry Insider, is now accredited for up to 12 CME credits. Learn how to land an exciting and impactful role as a physician in the world of pharma, biotech, or medical devices, AND how to do that even if you think you’re not qualified, don’t have any connections, or concerned about a pay cut… I’ve got you covered!

In this Episode:

[2:40] Normalizing fears that come with transitioning to nonclinical
[6:30] Will you be bored? Will you find balance?
[9:35] How final is this decision, or is there a way back?
[14:20] What about job security?
[16:20] Once a physician, always a physician

Links and Resources:

#88 – What Physicians Do in Pharma: Drug Discovery and Development

#89 – Physician Jobs in Pharma: Medical Affairs

#90 – Physician Jobs in Pharma: Clinical Research and CROs

#91 – Physician Jobs in Pharma: Drug Safety and Pharmacovigilance

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TRANSCRIPT: Episode 103 – What If I Regret Leaving Medicine? Discussing the Downsides of Nonclinical Jobs for Doctors

Hey there, I’m Marjorie Stiegler and you’re listening to The Career Rx podcast, where we tackle the important things they don’t teach you in medical school. Like how to treat your career, like the business, it really is, with strategies to accelerate the kind of success that you want, because you deserve a career you love, and a career that loves you back. Are you ready? Let’s get into it.

Hey there. Today we’re going to tackle a question that’s actually quite common that I think I’ve never really addressed before on this show. It comes from a listener, I will read it to you here in a minute and in her own words, but it’s really about what are the downsides to leaving medicine for a non clinical career? I think it’s such an important consideration. And so let me read to you the note that I got. And I think it asks really many questions, I’ll try to address as many of them as I can.

So my listener writes, “Hey, Marjorie, my name is Aisha. I just started my journey to non clinical pharma and I’m very closely following your amazing podcast.” Thank you. Thanks, Ayesha. “I do have one major fear, though, or maybe many. I’m a pediatric gastroenterologist, and I’ve been practicing for 13 years but I feel like I am stagnating. I’m very excited to learn something new, and I’m really excited to grow.

But what worries me is, will I miss seeing my patients? Will I miss the thrill of solving a complicated case or a hard procedure? Will I eventually get bored with pharma? What if I don’t like it? And I’m well known in my specialty today, will I have to rebuild my brand again, if I go back to clinical practice? What if I forget how to do procedures that I haven’t done in a while. And I’ve never had to think about being laid off as a physician, which provides pretty good job security. But now it makes me think, will I be laid off? If the company doesn’t do well? This is the first time I’ve thought about job security. And finally, will I lose my credibility as a physician, since I would not be a practicing physician? So these are my questions. Thank you so much.”

Well, thank you so much. These are amazing questions. These are really, really good questions, and they’re very common questions. And so I will try to address them as best I can. It is really important, you know, to say, first and foremost, that, obviously, everybody’s experience as a clinician is a little bit different.

So you know, only you know, what you have been experiencing in your practice, and what really sort of lights you up and what gives you energy, and only you know, what kinds of things will light you up potentially in an industry job? And, or what you won’t like so I’m going to try to. I obviously can’t answer the question of, you know, will you like it? Or, or will you miss things, but I can try to put into context how to think about that.

Before I answer these specific questions, I want all my listeners to remember you can also get in touch with me this way, you can send me an email or you can send me a voice memo to And I love to get your questions, they do inspire many of my episodes. And sometimes I get so many of the same ones that I don’t have an opportunity to call out a listener by name. And sometimes I do like today.

Okay, so thinking about this message. First of all, I want to really commend you for calling out your being excited to learn something new. And to grow, that is a really, really important thing, because it’s essential that you have something that you’re looking forward to in your new career. Many, many people do sometimes feel stagnant, or they feel a little bit bored, or sometimes they feel burned out or, or they have many, many feelings about their current work.

But it’s very important to think about what are you looking forward to in the new career, rather than what are you trying to get away from, because very often, you know, there will be things in any career, in any job, in any role, in any company that you don’t love. There’s always going to be that so there’s always going to be the potential for stress, there’s always going to be the potential for boredom, there’s always going to be the potential for burnout.

So it’s really important to have a good reason for wanting to go towards a new career rather than just you know, sort of an idea that if I just get out of clinical medicine, I will leave all of those troubles behind because that’s not really the case.

Now, too, will I miss seeing patients and miss the thrill of a complicated case or hard procedure? You know, many physicians that are in industry now, myself included, really look back on the clinical time with a lot of fondness. So you know, I loved trauma, I love being in the, or in the emergency bay really taking care of really high stakes cases, and making it really big, you know, life saving impact on a patient.

So, I very much found that meaningful, I found it enjoyable. It was a little bit thrilling. I wouldn’t say today that I miss it. And I think many physicians feel the same way. They liked it at the time, right, but didn’t really miss it today. It’s not like a hole in the heart, you know, you look back and you say, hey, I really loved doing that. It’s usually not missing.

However, having said that, many pharma companies and many medical device companies are more than happy for their physicians to maintain a small amount of clinical practice. Usually, this is on the order of a half a day to a day a week. And that they know has a variety of benefits for the company, but also for you, of course, but for the company so that their physicians can continue to stay up to date, on their board certification and on their licensure.

And it adds some, you know, scientific credence to be able to say, you know, the physicians who are working here, also still clinically active. Now, don’t get me wrong, most companies do not require that, but they usually will support it if it’s something that you want to do. So those are some considerations. I don’t know if you’ll miss it. Many people don’t actively miss it. But if you do think you’ll miss it, you probably can still do it.

All right. What about your questions Will I eventually get bored with pharma? And what if I don’t like it? These are really good questions, it shows that you’re having insight, and you’re being really thoughtful about your career progression.

I don’t know if you would get bored because there’s a lot of movement, you know, industry careers are very, very dynamic, there’s always something new and different to do, because there’s always new medicines in development. So you will literally not be doing the same thing year upon year, even if you kept the exact same job.

But more than likely, you’ll move through a ladder or a lattice of career progression, or people tend to change their roles every couple of years, either within the same company or in another company, that’s just sort of the cadence within industry, it is great way to advance and get promoted and have different experiences and learn new skills and be in different environments.

So I think it’s very unlikely that you would be bored. But again, I don’t know what lights you up. And only you know that. So if you haven’t had a chance, please do take a listen to my series of episodes about the different kinds of jobs within Pharma. Because the one or more might suit you better, right research and development versus pharmacovigilance versus medical affairs and so on. These are quite different types of jobs. And one might be, you know, more exciting to you than another.

Now, what if you don’t like it? Well, the easy answer to what if you don’t like it is you can always go back to what you’re doing today. I know that many physicians feel like they’re sort of standing on the edge of a cliff, and that if they jump or when they jump, it’s a permanent decision and the language that people use, it seems very definitive, right?

Like, what if I leave clinical medicine, right, quit clinical medicine. And it really does sound very permanent. But it’s not, I don’t know, many physicians who have come to industry and decided to go back to clinical medicine. But the small number that I’m aware of have not had a problem doing so. So they decided the industry wasn’t for them. And they went right back to clinical practice and it was not a problem. So if you don’t like it, the answer is you go do something else, either something new and different, or the same thing that you’re doing today. It’s not permanent.

But this is a great segue into your question about being well known right now. And will you have to build your brand again, if you do go back. So again, I don’t know your practice environment and whether or not you have your own patients or if you’re in academics and patients are essentially just referred to you.

I think if you’re well known within your community, you’ll still be well known in a couple of years. So if you took a year or two pause to explore a different career and you ended up going back, which is probably the timeline that it would happen,I don’t think you will have lost anything, people will still know you.

It would be pretty unlikely for somebody to come and work in industry for you know, a decade or you know, a very long period of time and then want to go back in that case, I suppose you probably would need to build your brand again, because it’s likely that you know, the patients won’t know you anymore. The leaders in your institution may not know you, and certainly many of your colleagues may not know you.

But again, I’ll say I think it’s really pretty uncommon for someone to move on from clinical medicine into a non clinical role for a long number of years and then decide to go back to clinical medicine. Generally, what I have observed, and what most of my colleagues say is that physicians can recognize really pretty quickly within, you know, a year 18 months or so, whether or not they have made the right decision, right, whether they feel like they enjoy the work, it’s meaningful to them, and whether they miss what they were doing before. So it’s usually not a prolonged period of time.

But even if it is, to your question of what if I forget how to do procedures that I haven’t done in a while? I think that’s a legitimate question. I don’t know for every specialty, but many, especially procedural specialties do have formal reentry programs for people who have taken a break from their clinical practice, for whatever reason, and want to spend, it could be months to perhaps two years, I don’t really know all the details, but to spend a period of time in a semi supervised educational type of setting similar to residency or fellowship, so that they can get up to date on what is sort of the current standard of care, and what is the most current way that technologies and that ways of doing procedures.

I wouldn’t again, I wouldn’t worry about, you know, because certainly technology and medicine and knowledge is advancing at a very rapid clip. So if you step away from clinical practice for a while, it’s pretty likely that when you come back, even if you haven’t forgotten what you were doing before, maybe the best thing to do is something different. So there will be a learning curve and there are mechanisms for this.

There’s either formal programs like that, or you know, you can just go back potentially to work in a practice where there’s an opportunity to learn from your colleagues, and where you have the sort of support of a larger department, whereby you can have that learning experience sort of on the job as you reenter it.

Because we’re all lifelong learners, it’s always the case, even when you were an early attending, surely there are things that you taught yourself, or that were new that came on the scene post training for you. So I would not worry about that. There’s definitely a way to address that. One thing in the back of my mind, though, especially for procedural physicians, is that your licensure, or your board certification may have a requirement for a number of clinical hours.

And if you don’t have any in a certain period of time, then you may not be eligible for your renewal. So it’s pretty important to check with the requirements before you make your plans. If because if you’re not sure, and you want to be able to keep your license and your board certification, and none of that to lapse, if you do need contact hours with patients, probably pretty important to arrange for some kind of part time or locums or volunteer work that is enough to keep you fresh in that way.

Okay, moving on, because you did have so many great questions. What about if you are laid off? This is really, really a very common physician question. And I think it’s a little bit of a misconception. Many doctors feel like they have tremendous job security, especially in academics, as a practicing physician, it just feels like there is absolute job security.

And I think people are well aware that in the corporate world, that’s not the case, because companies have all kinds of changes. They have internal changes, there’s mergers, there’s acquisitions, there’s de mergers, and certainly in in medicine, and in drug development, there are lots of medicines that are progressing through the r&d pipeline, and don’t end up being suitable candidates and so are either are not approved, or they don’t even make it so far as to try to get them approved.

And when that happens, there’s a lot of changes internally. So people do feel like there’s a whole lot of insecurity in industry, but I don’t think that’s really the right way of looking at it. I don’t think it’s an insecure place to be, it is just a very dynamic place.

So if there are changes within your company or within the medicine that you’re working on, or any other reason why, you know, there’s changes in your role and it’s, you know, becomes no longer needed. There are absolutely mechanisms for you to be doing something else so companies are very good at understanding where they will move their talent when things like that happens and so that’s not that’s not something really that I lose a lot of sleep over.

Also, most companies have really pretty robust programs in place for separation, including severance, so that you can have a little bit of that buffer as you look for a new job if that’s necessary.

I also would sort of challenge and push back a little bit on the idea that you have total job security within academics or private practice as a practicing physician. I do know that a lot of people feel that way. But I think, you know, COVID has shown a lot of our practices that there can be dramatic shifts in the amount of patients that we take care of, and where those patients are concentrated and what kind of care they need.

And at the end of the day, that is what pays the bills, right? Even if it’s paid to your department or at your hospital, the way in which your salary is generated, obviously depends upon delivering health care, and that can really change not only can the desire or the need for that health care, evaluation or service change, but so can the reimbursement for it.

And so while you may always be busy, I don’t know if your job security in the sense of financial security is really as much in your control as it feels like that might not be the case, I think that’s a little bit of an illusion that a lot of people hold.

I know so many physicians and nurses and other health care professionals to have really expressed that over the last several years in particular, they feel like they are being worked harder and harder and harder, no longer and longer hours, higher level stress work for either the same pay or little bit less pay, which is the I mean, you have a job right. But there’s something about that that I think is worth considering.

And of course, there are people who have been laid off or people who have just found their practice conditions to be unacceptable and have left. So I don’t know. But that’s my two or three cents about job security.

Finally, to your question about will I lose credibility as a physician if I’m not a practicing physician? You know, I don’t think so. I don’t know exactly what you mean by that. But you know, we have people who are retired physicians, and we still view them as physicians, it doesn’t really matter when they chose to retire, right? Those people are still physicians.

And certainly someone who is still working in health care is absolutely a physician. And when you think about the contribution that you’re making, not only to the healthcare system in general, but to the many, many, many patients, sometimes millions of patients who will be relying on and having health benefits from developments in new medicines, I would say that’s absolutely Is that is that not absolutely being a physician that’s really meeting a health need, that a patient has, and also meeting the needs that your colleagues have in terms of how they can best treat their patients.

To me, there’s nothing about that that feels far away from medicine, it’s just a different way. I think of making a difference with your same education and your same professional stature.

There will be people who don’t understand your decision.

Certainly there are people who are confused when physicians leave clinical medicine for industry roles, whether it’s in pharma, or medical device, or industry or consulting, or insurance, or I mean, there’s any any number of places where physicians go when they have pivoted away from clinical medicine. And a lot of times our colleagues are confused by it. A lot of times they’re very interested in following in your footsteps.

So I wouldn’t lose any sleep over whether or not everyone understands or agrees with your decision. So thank you again, for the really, really thoughtful and detailed communication with all of these wonderful questions. I hope that my answers to you are helpful to you.

And I also hope that they’re really helpful to my other listeners, I do think they resonate with a lot of people. These sound really familiar things I hear again and again and again. So I’ve tried to put them all here together in an episode that feels, you know, meaty enough to listen to and I hope that this has helped you to think about your current career and your potential future career. Best of luck.

Before you go, please leave me a review on Apple Podcasts, share and subscribe to this podcast. Your support makes all the difference and it truly helps this information reach someone who may really need it. Until next time, thanks for listening.

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