Could career pivoting be for you?

It may not be obvious to some why this topic is on a psychiatry website i.e. ‘what has psychiatry to do with career and pivoting?’

I’ve been picking up consistently that many doctors – mainly younger ones below 40 – are feeling trapped, demoralised and unable to progress in their careers. Many are burnt out and fed up. Some younger doctors under 25 are unable to get into training due to fierce competition e.g. 800 applicants for say 5 places. They are stuck and do not know what to do. Many have toyed with the idea of leaving medicine but are trapped by financial circumstances e.g. their livelihood is from their wages in medical practice. The challenge of career pivoting is to find a way out that is not sudden, is financially achievable within the individualised time frame of the doctor.

What is career pivoting?

Think of your career like a long road trip. You’ve got a direction, you’ve been making decent progress, but lately, the journey has turned sour. The scenery isn’t what you hoped, storm clouds gather overhead, and the road ahead looks treacherous. You try to push on, but it is only getting worse. Floods are gathering ahead. Every mile feels like a battle, and your spirit is starting to break. This is not what you bargained for.

Career pivoting is like taking a bold exit ramp. It is saying, “Okay, this isn’t working. If I persist, I’ll end up lost, or worse. It is time to figure out where I really want to go. Can I spend my time and effort elsewhere more profitably?” Sometimes that means venturing onto a smaller road, maybe even making a careful U-turn. It might be time-consuming and feel a bit disorienting, but it is necessary to avoid disaster. Other times, it means charting a course into entirely new territory – embarking on a whole new adventure with unfamiliar landscapes and the thrill of discovery. A career pivot can be scary, sure, but also incredibly exciting. Because it isn’t just about changing jobs, it is about taking charge of your future and building a work life that genuinely makes you happy.

Career pivoting may be impossible for some doctors. It is seniority-dependent and constrained by a number of socio-economic and psychosocial factors, that I couldn’t list here (unless you need 500 more words).

It is about how you do that. This article is not a checklist, prescription or guide on how to do it. I am no life coach for doctors. The ideas here have been worked on for several weeks. It isn’t one size fits all – and it is not meant to work for any one person or everybody. It works if you make it work. But you need a scenario that that may resonate.

Case scenario

Dr M closed her eyes, feeling the sting of tears she desperately held back. Another 14-hour shift in the overpacked A&E (Emergency Department) was finally over, but the relentless thrum of exhaustion still pounded in her skull. It wasn’t the long hours alone that shredded her nerves, though those would test a saint. It was the constant feeling of not being enough.

Too many patients, never enough beds. Every bleep of the heart monitor echoed with the knowledge that someone was waiting, someone in pain who felt their turn never came. Patients overflowed into corridors, and the sharp words of frustration weren’t always aimed at staff – they cut Dr M just as deep. It was triage in its cruelest form – not deciding who would live or die, but who would suffer a little longer to keep things just barely afloat.

Back home, a half-eaten dinner waited, cold and forgotten. Her flat was always dark, always silent, save for the echo of ambulance sirens wailing past on the street. Sleep would be a cruel game of half-waking nightmares – flashbacks of rushed assessments, missed details, of that one time, just yesterday…that one time where the blur became too much, where a decision was too slow. What if someone paid the ultimate price because of her exhaustion? That fear nestled on her chest like a stone.

And the worst part? She wasn’t alone. Dr M saw the same slump in shoulders, the same haunted look in the eyes of even the toughest senior doctors. It was a system-wide drowning. There had been the initial outpouring of gratitude during the worst of the pandemic, the clapping on doorsteps. But as the adrenaline faded, the same problems remained, magnified and heavier. There wasn’t time to fix things…because there wasn’t even time to breathe.

Dr M had chosen medicine for the moments of healing, the knowledge that her efforts were life-changing. Lately, those felt further and further apart. Every news article detailing healthcare worker strikes only solidified the growing dread inside her. She loved her job, but more than that, she loved herself. How could that survive such relentless assault? Change had to come, even if she wasn’t sure what it looked like. One thing was certain: this, this endless war zone existence, this just wasn’t sustainable.

The road ahead

Dr M’s experience isn’t isolated. Behind the exhaustion and the heartbreaking ethical compromises, there’s a system buckling. From bitter pay disputes to the overwhelming competition for training places, today’s medical landscape is littered with seemingly insurmountable obstacles that go beyond bedside pressures.

The pay restoration battleground: For years, doctors in the UK have been engaged in a bitter fight with the government over pay restoration. Doctors argue that their wages have significantly eroded in real terms over the past decade. It is estimated that over £1 billion has been spent on legal disputes and negotiations surrounding this issue, with no resolution in sight. This demoralizing stalemate highlights the government’s perceived failure to value the critical contributions of front-line healthcare providers.

Competition at the gate: While there’s no shortage of individuals aspiring to careers in medicine, securing training positions has become fiercely competitive. Intense application processes, coupled with a limited number of training spots, often leave highly qualified aspiring doctors out in the cold, contributing to frustration and disillusionment.

Financial strain: Medical school comes with a hefty price tag. Many young doctors graduate with enormous student loans, forcing them into high-pressure situations where financial obligations might outweigh their personal well-being and career exploration options.

Medical complexity & bureaucratic demands: The practice of medicine is continuously evolving. Doctors battle ever-increasing clinical complexity alongside extensive bureaucratic tasks. There’s constant pressure to uphold the highest standards of care while grappling with understaffing and limited resources—it is an exhausting imbalance.

Defensive practice & fear: An increasing fear of litigation and a heightened concern over errors (often rooted in systemic failures) contributes to a culture of ‘defensive practice.’ This practice often focuses on minimising legal risk rather than on what might be clinically ideal, ultimately compromising care and adding further frustration for doctors.

Multiple nationwide systemic failures deepen the sense of disillusionment for UK doctors, forcing them into impossible situations and never-ending dilemmas. The risk is in becoming frozen or ‘comfortably numb’.

Options for pivoting

This has to be looked at from several angles. Explore the tabs below.

Strategy and determination is everything

No pain no gain. Doctors know that from their days in medical school. Address the following in the tabs. No one is coming to do this for ‘you’. But no one should embark on career pivoting if they are uncertain. It is not thing to try. It requires more determination than that.

Stackable Skill Categories

• Data Science & Analytics:
  • Why these matter: Medical decision-making is inherently data-driven. This translates to many fields beyond traditional healthcare. Biotech, health insurance, etc., all crave this analytical capability.
  • Resources:
    • Coursera: Offers many “Introduction to Data Science” type courses, from reputable universities, often without hefty time commitments.
    • DataCamp: Focused platform for coding/data skills (R, Python). Short, targeted lessons perfect for squeezing in knowledge between shifts.
    • Kaggle: Real-world datasets for practice; some include medical themes doctors can instantly relate to.
• Project Management:
  • Why these matter: Medicine already requires organisation and prioritisation under duress. This competence is prised in numerous sectors.
  • Resources:
    • edX: Several ‘Intro to Project Management’ micro-courses or certification options from major institutions.
    • Udemy: Wide variety of shorter, budget-friendly courses if a doctor doesn’t want to commit to a certificate program initially.
    • Google Project Management Certificate: This is highly reputable, fast-paced, doable alongside work in theory.
• Business Fundamentals:
  • Why these matter: Understanding business helps if aiming for consulting, biotech, etc. Doctors do not need an MBA, but basics matter.
  • Resources:
    • Wharton Online (UPenn): Short Wharton business courses on platforms like Coursera. That brand recognition matters on a resume.
    • Khan Academy: Surprisingly decent coverage of finance, accounting, even entrepreneurship for total beginners.
    • Podcasts: Some excellent ones (“How I Built This”) give insight into the mindset without demanding huge time investment.

Caveats and closure

Career pivoting is not for everybody. It requires careful assessment, planning and professional advice from the likes of the BMA.

Stackable and related ideas do not create instant results. Skills take time to build. This is about creating a viable exit ramp over months, not magically making an ideal job appear next week.

Learning style fit: Some resources will be too dry for exhausted doctors.