Changing Careers: Is the Grass Truly Greener on the Other Side?

Stephen Rosen and Celia Paul,
Celia Paul Associates, New York City

How to decide if you have a brighter future outside of medicine.

In a survey of 1,300 physicians done fairly recently,(1), 63 percent said they wouldn't recommend medicine as a career to their children, explaining that society does not value the immense amount of hard work and intelligence it takes. Because of this feeling of under appreciation, many physicians are thinking about leaving medicine. If you are one of them, we have some advice for you.

In our work as scientific career counselors, we're approached by hundreds of physicians each year who say they want to leave medicine. In some cases, their instincts are right on; a career change is the only way to recover the values and use the skills they prize. However, less than half actually leave. The rest are able to find ways to get fulfillment from their current work. In this article (reprinted by permission from the Review of Ophthalmology, November 1998), we'll provide three universal exercises you can perform to help you zero in on what's missing in your career, and give you some ideas on how you can either put it in, or, if necessary, find it elsewhere. Both the exercises found below at the end of the print version of this article, and the career transition process itself, apply to any educated professional in any specialty.

If you are considering changing careers, either partially or completely, there are several factors to take into account. In the following exercises, you'll have the chance to explore your attitudes toward work and your talents. Have a pencil ready, so you can score yourself and gauge your career inclinations.

Take stock of your skills

One key to evaluating your career involves finding out how much what you do influences who you are. You can get a general answer to this question with the following exercise. List the six personal and professional accomplishments that are most important to you. On the table marked Exercise 1 (click here for a print version!) found at the end of this article (in its print version: Rev. Ophth. Nov. 1998), imagine a grid made up of six verticals columns and the listed skill set as rows. At the top of each column, place one or two word descriptions of your favorite accomplishments. Then, cross-index these accomplishments with each of the listed skills you used in them, placing an X at the intersection. After you've done this, we'll discuss the results.( The skills commonly used in ophthalmology appear at the top of the list, marked with an O.) How many of your marks fell within the ophthalmology skill sets? By comparing the skill sets you felt most satisfied using to those most often used in ophthalmology, you can get a rough idea of how much you enjoy your day-to-day work, as well as how much you've internalized it and made it part of you.

However, if many of your activities weren't ophthalmically related, that doesn't necessarily mean you should jump ship. Remember, fewer than half of the professionals who come to us for guidance actually end up switching careers. You may be able to markedly increase your career satisfaction by simply working your favored skill sets into your current situation.

Examples abound of individuals who have found fulfillment by changing their current careers a little. A dentist client of ours enjoyed the sales and financial challenges involved with real estate. As a result, he studied real estate at night school and eventually bought a residential property. He rents it out, and is happy to exercise skills which were lying dormant. Some physicians with whom we've worked are very good at manipulating medical data. They've been able to parlay this skill into small medical software cottage industries. Similarly, many surgeons have been able to supplement their income and derive intellectual stimulation by inventing or perfecting medical instruments.

However, some individuals realize that in order to attain the fulfillment they seek, a career change may be in order. One ophthalmologist whom we counseled found that he was reading fewer peer-reviewed journals and more financial magazines. On his days off, he would pore over analyses of the stock market. He had taken a course in portfolio analysis, and though his was small, he managed it well. His interest in finance eventually became his full-time vocation.

Find your values

The other aspect of your personality we'll explore are your values, which are those tangible and intangible things that make it possible for you to get up in the morning and face your job, such as autonomy, power, or security. Exercise 2 (click here for a print version!) will help you identify the values that are important to you. Rate the importance of each item on the list using a number from one to five. Five means the item is one of your "highly valued," four is "usually valued," three is "sometimes," two is "seldom," and one is "never." Do this now.

Now that you've filled in your responses, total them. If the total is greater than 100, go back and change them so it's 100 or less. This process is most helpful if you think carefully about where you want to make the compromises rather than just lowering each score by a set amount. Put your new scores next to the old scores. We'll discuss what certain results may mean when you're done.

After looking at your scores, you should be able to get a general sense of which values are important to you, and compare them to the values that are often found in ophthalmology, such as predictability, a fast pace and supervision.

In some cases, your career may have had certain values when you started, but has since lost them, or your values may have changed while the career's hasn't. For instance, a few physicians find that they simply no longer enjoy interacting with patients. For a person such as this, who no longer finds fulfillment in his current position, it's often not enough to simply know what values he doesn't like in his job. Rather, he should try to isolate the values he does like. This enables him to focus his energies into a career search with a good chance of succeeding. Maybe he still loves the intellectual challenge of medicine, and would rather work in research, or perhaps he finds business more interesting, and would do better in an administrative role.

This exercise can also be helpful from the standpoint of turning a negative situation into a positive one, as well. Even though you feel disgruntled about some aspects of practice, maybe you'll find that you actually have many values in common with ophthalmology, after all. Remember that every occupation has its tradeoffs. For example, even though members of the business and financial world don't have to deal with Medicare, they do have many other frustrations which often relate to having to accept decisions from above that seem unreasonable. At your practice, you're probably the boss, and everyone looks up to you.

Your career health

The last exercise is a general one. It lets you see how closely your behavior and personality match up with those of individuals who have proven themselves successful at controlling their careers. For each of the statements in Exercise 3 (click here for a print version!), rate how frequently it applies to you, giving it a two for "always," a one for "sometimes," and a zero for "never." As usual, we'll discuss what the results mean after the exercise.

These questions are excerpted from a larger "career well-being inventory" found in our book Career Renewal, that describes the people who are successful at making their work lives fulfilling. They are very good at bringing together both their skills and values in their current situations or entirely new ones. Your score should give you a rough idea of how your behaviors and attitudes compare to individuals who play the career game very well.

After tallying the scores for each statement, if you find that your total is below 20, it may mean there are some areas on which you can work to increase your chances of finding fulfillment in skills and/or values. For example, we worked with a cardiologist who displayed several of these healthy behaviors. He was good at building relationships with his colleagues, was practiced at turning random events into opportunities, and was optimistic. After working a short time in a practice, he realized that he simply didn't like touching patients. However, he still loved medicine, especially the administrative side. So, rather than be defeated by his apparently huge stumbling block, he saw an opportunity. Since he had such a good relationship with his colleagues, he convinced them to do more of the hands-on work and let him handle the business side of the practice.

Another physician found that she was enjoying public speaking more and the practice of medicine less. Our advice was to find speaking opportunities at meetings and local community seminars. By creating an outlet for this skill, she actually enjoys practice more.

In almost every case in which a professional is successful at managing his or her career, optimism and energy are the keys. These allow you to either spot new opportunities in other careers, or to see "how good you have it," by picking out the values your current job offers that another may lack.

Individuals derive so much satisfaction from their work, it can be hard if they're work lives begin to feel devoid of that. However, if you can keep your energy level as high as possible, and always remain optimistic about your career, you may find that the greener pastures you seek may be right under your feet.

Celia Paul and Stephen Rosen are principal partners at Celia Paul Associates in New York, and authors of Career Renewal (Academic Press, New York). They specialize in medical and scientific careers.

1. Stamps PL, Cruz NT. Issues in Physician Satisfaction, Health Administration Press, 1994.

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