“B

urned out cardiac surgeon seeks opportunities or empathy,” one message reads. “I feel stuck,” another confides. A third says simply, “I don’t want to be a doctor anymore!”

The posts come in from across the globe, each generating its own thread of commiseration and advice. “I just wanted to reach out and let you know I feel your pain,” a doctor-turned-MBA replies to one surgeon. “Your story is so similar to mine,” a respondent marvels to a fellow trainee. “Before you quit, think about what motivated you in the first place, and what changed,” cautions an emergency physician to an early-career doctor.

This networking site, and others like it, is where doctors come to discuss the verboten: leaving the medical profession. There are posts from medical school students questioning their career path, and from trainees unable to find a full-time job. And predominantly there are posts by physicians who, after years in the field, are desperate, at the end of their rope, looking for a way out.

Some of them are suffering from what doctors know simply by the shorthand of burnout — loss of enthusiasm for work, feelings of cynicism, and a low sense of personal accomplishment. Burnout is on the rise among doctors: One study found that over half of all US physicians are experiencing it, for reasons such as long work hours and an increasing burden of bureaucratic tasks. With no nationally available, peer-reviewed data on physician turnover, it’s not clear precisely how many doctors leave because of burnout.

But more than most, doctors may find a career change daunting. There’s the time invested — four years of medical school and as many as nine more years of specialty training — and perhaps a lucrative salary that’s hard to leave behind. Doctors’ specialized skills may seem less obviously transferrable to another field. And the perceived virtuousness of a career in medicine may make some feel guilty to consider leaving.

So they come to Drop Out Club to air their worries, seek solace from those who’ve made the leap — and just feel less alone. The site’s forum is where they ask for and offer advice; there’s also a job board where employers post positions, and members can converse privately in individual messaging. Among its 37,000 members, about half are doctors, said Heather Clisby, a company spokesperson.

Two recently established Facebook groups aim to meet a similar need. Since their founding last year, Physician Nonclinical Career Hunters and PMG Physicians and Non-Clinical Careers have amassed nearly 3,000 members combined. (The latter group is visible only to those who are invited by current members.)

“The frustration with medicine is fueling our growth,” said Dr. Laura Fijolek McKain, the founder of Physician Nonclinical Career Hunters. “Doctors are frustrated with how much time they’re spending on paperwork and other activities that have little to do with patient care.”

And on the web they can find what is often hard to come by in daily life: a ready-made community of people grappling with the same questions.

Dr. Maryam Shapland
On average, one new physician per week emails Shapland for advice after finding her contact information through Drop Out Club.

Finding solidarity online

Dr. Maryam Shapland initially loved her job as an emergency physician. It was busy, exciting, and important. But after a few years, the work felt less exciting and more stressful. She reduced her work hours, but still felt worn out all the time. Then, seven years into her practice, one of her patients sued her.

Devastated, she decided to start searching for a new career.

At first, she felt guilty for wanting to leave. “People thought I made good money, helped people, and had a nice life,” she said. “All the checkboxes were marked off, so what did I have to complain about?”

Then she found Drop Out Club. She quickly became a “lurker” on the member forum, reading messages posted by others. “Reading all these stories of people trying to leave made me realize I wasn’t crazy for being unhappy in this career I had worked so hard for,” she said.

Shapland hired a career coach, started actively using LinkedIn, and in 2015 was hired as a medical director at a life insurance company. “Leaving medicine felt like giving up a big part of my identity,” she said. “But I’m proud of what I do now. Most importantly, I’m happy and thriving.”

And now that’s a message she’s hoping to transmit to others in her shoes. In retrospect, Shapland said, Drop Out Club suffered from too many mentees and not enough mentors. Once she made it to the other side, she decided to regularly provide career advice — and her email address — on the forum. Since her first post in 2015, she said she gets approximately one new person a week emailing her to seek advice on leaving medicine.

Dr. Maryam Shapland
Shapland displays a picture of herself in the Philippines on a medical mission trip in December 2013, back when she worked as an emergency physician.

Grappling with leaving

One of those was Dr. Ashwini Zenooz, a radiologist who had practiced for over 10 years. Surrounded by colleagues who seemingly loved their jobs, Zenooz felt that she couldn’t discuss wanting to leave medicine with them. Finding Drop Out Club “was a way to extend my network to people closer to my needs,” she said. Browsing the forum, Zenooz saw Shapland’s email address and sent her a note — which became an extended email conversation, and, eventually, an hourlong phone call one afternoon. Zenooz ultimately took a job in health policy.

Many of the inquiries Shapland receives are related to financial concerns. Medical education can leave doctors with up to a half million dollars of debt, making many feel tied to a high-paying job. Others struggle with the “golden handcuffs” of medicine, unable to leave lifestyles supported by comfortable incomes.

Fear of the unknown can also be daunting, especially to those who have spent their entire careers in medicine. “Leaving behind the familiar and going into the unknown was scary at first. I had been doing this job for decades, and there was a certain comfort level with that,” says Dr. Joshua Schechtel, a hospitalist who left clinical practice this year.

Dr. K.K., an oncologist who requested anonymity in case she returns to clinical practice in the future, found Drop Out Club while trying to make sense of the various nonclinical career options. She posted questions and read stories of members’ career paths out of medicine. “I saw proof that a lot of people who left medicine found other jobs and were happy,” she said. “It made me realize that I, too, could find a way out.” She recently left clinical practice and now works as a consultant for health insurance companies. “Leaving my patients and their families was very hard,” she said — but “my new role allows for a much healthier work-life balance.”

Still, not everyone finds meaningful support through online communities.

Some simply want more hands-on support than a peer-to-peer site can provide. Dr. Mary Schultheis, a colorectal surgeon, joined Drop Out Club after 10 years in private practice. “The hardest part of leaving was accepting that it didn’t mean I was a failure,” she said. “Drop Out Club couldn’t help me come to terms with this, but working with a career coach did.” She left clinical practice this year and now balances part-time consulting and health insurance industry roles.

Others find there aren’t enough people to provide advice. “There were a lot of people who piled on to commiserate, but it was hard to find actionable advice on Drop Out Club,” said a dermatologist in California. She reverted to networking the “old-fashioned way, meeting people locally and building a Rolodex,” which ultimately led to her current mix of part-time consulting and part-time medicine.

Shapland agrees that the site — and the medical field more generally — needs doctors who have left clinical practice to speak up and share their unconventional career paths. They need to make themselves available to help as she did, she said. “Just being a living, breathing example of someone who made it to the other side and will answer a couple questions can help someone take that leap of faith.” She’s proof of it.

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  • Over 50% of US physicians are employed, most by hospitals. When you are mandated a quota of patients to see, MRIs to order, procedures to order and ordered to discharge patients quicker and sicker, you have given up the principles you were dedicated to that attracted you to medicine in the first place. As a family doctor, 55 years a physician and 47 years in the same town let me attest that choosing private practice, and staying in one place can open you up to the greatest rewards one human being could ever receive from another. To deliver a child, then care for that child for 40 years, guiding her development, sharing in joys and sorrows and even delivering HER children creates a relationship that is beyond delight. And going to the office each day to visit with a bunch of old friends is priceless!

  • “And the perceived virtuousness of a career in medicine may make some feel guilty to consider leaving.”

    Certainly this is true for some to some extent, but I think a much stronger and somewhat related point is: The vocational calling to help people in a fundamental way has been sadly overwhelmed by administrative, bureaucratic, regulatory, and malpractice roadblocks.

    • You are correct in your opinion, “The vocational calling to help people…has been sadly overwhelmed by administrative, beaurocratic…roadblocks.”

      Yet, who do you suppose is best equipped to fight that battle? Who but the physician was responsible to see that these areas did not grow out of hand?

  • As a patient with many physicians in my large family, what I’m hearing from them as frustrations in their professional lives are the increased regulations and manipulation of how they provide their care, most especially by the insurance companies which rule the world (and all this time we thought it was the banks!). They can’t order tests they feel are necessary, they can’t do 2 things in one office visit, they simply can’t do what they trained for so many years to do, and what they do best: care for and improve the lives of others.

    Additionally, they say, and I hear this from my own physicians as well, the paperwork, digital or otherwise, is crushing. Record-keeping is important, but it’s out of control ridiculous. They can’t practice their caring art, they’re now just doing a job. A revolution is in order.

  • I am in Australia but here we see a lot of people becoming doctors for the perceived status and income, rather than a true calling.

    Interestingly I am an engineer and University for an engineer is 4-6 years and really you do not work in a really autonomous role for at least another 5-7 years as a “graduate” and “junior” engineer where you get taught all the useful stuff you need to know to work in industry that your degree never taught you. Despite often having to work away from home and also being burdened by administrative tasks that are often not technical very few engineers leave the field (or wish to) once established. I would say the main reason for this is that most people who become engineers do it because they want to be an engineer, any status or income benefits are a side issue.

    I guess the lesson is that you should choose a career based on something that genuinely interests you and then maybe you will enjoy it more.

  • Nice article… We already have indications of many stressors in rural and lower concentration settings that have already been facing the loss of support, loss of control, and loss of meaning for longer periods with more to come.

    Only half of doctors are found in 2621 lowest physician concentration counties with 40% of the population and 43 – 47% of the most complex patient types. These are places where mental health and basic specialties are in lowest concentrations leaving the remaining workforce on their own. Cuts in food stamps, Medicaid, disability, housing support, and energy assistance will hit hard in two ways – declining local resources as well as more moving from higher concentration counties as they must find lower cost available housing. This is why these counties have been growing fastest in numbers, elderly, complexity, and demand.

    But they do not support more team members (MD DO NP PA, others) to deliver the care as the populations have the worst paying, least supportive, most obnoxious plans – marginalizing the patient and the provider.

    More of the nation should prepare for this situation as higher proportions of Americans are added to these counties and in other locations. The 79 highest concentration counties will continue to do well, but not most Americans behind by design.

    Loss of control, loss of meaning, loss of support will continue to impact the patients and the physicians.

    Review the Dark Side of Doctoring or The Dark Side Killing Doctors for more resources

  • Burnout high in my profession also: ICU/CCU registered nurse. Simply put I went too many funerals after 20 years and cried too many tears. My Emergency Medicine physician husband was my best supporter. When he retired after 30 + years he was fed up with bean counters at healthcare industry telling him how to practice medicine. He was double boarded in Internal Medicine and Emergency Medicine and had to retake his EM boards again every ten years. And to improve their profits and for no other reason insurance company drones could change how he practiced medicine. No we don’t have the best medicine in the world, we have the most regulated and manipulated for profit medicine. As a potential patient I regret good people leaving medicine, but I don’t blame them.

  • I am curious about learning more about the doctors who make the career change. How many in % volunteer their clinical skills in the US or abroad

  • I have worked as a pediatrician for 11 years until I left the practice last year. Too much computer work and patient load and not enough time to foster the relationships that made the work rewarding in the first place!
    I’m teaching now, though still looking for something that mixes my knowledge and experience with medicine and a good quality of life!

    • After nearly 20 years of increasingly soul crushing regulations and the corresponding mountain of aggravating non-patient care chores day after day (charting for billing purposes being the biggest) I left third party reimbursement family practice and opened up my own Direct Primary Care practice with between 550-600 patients. This was my salvation. Do not know what I would have done otherwise. If you’re in Primary Care and don’t want to quit if you can find another option you should check out DPC.

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