No… not me. “I’m leaving medicine” is a phrase I’ve recently heard two of my physician friends say.

Wait a second! It’s not Medicine Mondays! It’s Finance Fridays! You’re off-topic! You caught me… this is kind of a Medicine Mondays posted disguised as a Finance Fridays post. However, please hear me out. 

So, recently some hot topics on Twitter are Physician Burnout and Medical School Attrition. I plan to blog about these topics in the next few weeks, although they require a little more research on my part before I dedicate a post to them.

Unfortunately, I need to work with some vendors about doing some work on my house as well as study for an upcoming test. Most likely, these next few weeks will consist of some auto-posted content until November 7th. Don’t worry though, the auto-posted content, while consisting of mostly old content, will still be helpful I think.

I was thinking of making “roadmaps” of the recent Medicine Mondays, Whatever Wednesdays, and Finance Fridays posts. This will highlight some of my more popular posts, in similar fashion to my prior Favorites Series: Monday, Wednesday, Friday.

For this reason, I will need to delay my Physician Burnout and Medical School Attrition posts until at least mid-November.

“I’m leaving medicine.”

A few of my friends have told me this, one directly and one indirectly. Both of them are radiologists, like me. However, that is where our similarities end in terms of the jobs we took and our outlook on future. Whereas I am very happy with my job and can see myself doing it for a long time, these two are not very happy at all.

Their reasons for doing so aren’t explicitly clear to me, but I think the two major factors are physician burnout and desire to pursue other interests. As such, they have both decided to leave medicine.

Let’s examine their situations:

“Dude, I’m done. I’m leaving medicine.”

It doesn’t get more direct than that I think. Surprisingly, this is the guy who was the most gung-ho about radiology when we were fellows. He honestly enjoyed radiology and being a doctor and was an all-around good guy. This all changed after a few months into his first job. The rose-colored tint on his glasses fell off I guess. I think more than anything though, he wanted to do other things and radiology/medicine was just taking over his life. I think he realized that the other interests he had outside of medicine were eaten away because he was working so much.

He’s only been at his job for 2 years.

People think, oh yea, Physician Burnout, that’s like 10-15 years in right? I disagree. Burnout can happen at anytime, 10-15 years is probably just when most people are finally able to leave. So well, what’s his plan, how is he going to leave medicine? Well, I think he realized that he can’t do radiology/medicine as a full-time job forever, at least not in its current state. Since starting his job, he’s been saving a lot of his money and using most of his salary to just pay down his loans. He rents a reasonable apartment and drives a reasonable car. If a part-time job or more flexible job became available, I think he would consider it. Remember, he still has student loans he needs to pay down too.

Can’t he just work less?

It’s not that easy. It’s easy to talk about going part-time, but how many jobs will actually let you do that. More than that, as a part-time employee, your job is inherently less stable than any full-time person. This is a risk many physicians can not take, with student loans hanging over their heads and other bills to contend with. This especially holds true for radiologists since our job market has been pretty tight the last 5-7 years, although it does appear to be getting a little better as of late. (just my n=1)

Leaving medicine is hard.

You have to have a plan or a good amount of money stored up, preferably both. Like I’ve alluded to before, you can’t just quit your job without having another one lined up. Medical knowledge deteriorates quickly and if you have been out of work for a few months or a year, people will be hesitant to hire you. The safest solution is to save enough money to drop-down to part time while you find another job to do outside of medicine, but as I described above, that isn’t easy.

What other job?

Good question. There are a lot of posts about this, but leaving medicine completely is difficult. You have a very specific knowledge base with expertise in a small area. It is not easy to apply outside of medicine. However, I think being a consultant to a large firm is reasonable. You can leverage your medical knowledge and knowledge of the health care system there. Alternatively, you can shift gears completely and become an entrepreneur, although that carries a significant amount of more risk.

Is there another option?

Of course, there are always other options. However, they require thinking outside the box and a complete change in mindset. Let’s say you were really frugal and were able to save 50% of your $250k salary for 5 years. $125k x 5 is $500k. So you have a $500k nest egg. Can you retire on $500k?

I just googled that phrase and a bunch of articles came up. The most recent one is this:

Retire at 45 with $500k: Is it Possible? from Investopedia

The take home message from that article is this: “If you have $500,000, the math comes out to $20,000 a year, assuming a 4% withdrawal strategy.”

However, this assumes you are 45 and withdrawing $20k a year. That isn’t exactly a comfortable retirement, but it can be done if you are willing to do it. You also need to remember that you can’t have any other additional expenses. Your student loans and any other debt would need to be zero and you would most likely have to own a house outright. Renting out any additional rooms in your house would also be helpful of course. Like I said, this kind of early retirement and leaving medicine requires a fundamental change in mindset.

Can you live off of $20k a year?

Once again, a quick google search and you find a bunch of articles, the most recent is: HOW TO LIVE COMFORTABLY ON JUST $20,000 PER YEAR

The title is kind of click-baitish, but hey it worked! I ain’t even mad.

The golden nugget from this article is this budget:

Housing: $550
Utilities: $235 (Including the cheapest cell phone plan)
Car Insurance $40
Gas (Car): $150
Health Insurance: $93 (employer sponsored)
Groceries: $350
Entertainment/Miscellaneous: $250
Total Monthly Budget: $1,668

So, look at those numbers and ask yourself if it’s possible for you. You would need to live in a very low cost-of-living area and budget every month.

Additionally, the employer sponsored health insurance would not apply to you because you wouldn’t be working anymore, and would need to budget to pay for your own insurance.

Sounds rough. However, it’s not impossible. It’s a choice.

Ok, well, that seems pretty impossible for me, what about your other friend?

Oh yes, my other friend. He didn’t explicitly tell me that he’s leaving medicine, but he’s definitely positioned himself to leave medicine. He’s a radiologist, like me, but he works two different jobs. At one time, he was working THREE jobs. He’s one of those work hard, play hard types. However, he’s been putting away a lot of money as well as buying investment properties. Honestly, working this hard is not sustainable and I think he knows that. I think he is trying to acquire enough investment properties in the next 5-10 years while paying back his student loans. Then he’ll be senior enough to drop down to part time at one of his jobs and supplement his income by renting out his other properties.

Now, if you read my blog, you know I don’t advise having an income property unless you have the desire and are good at it. This friend is the exception. He bought a house during residency and rented it out during fellowship. I think he still rents it now. Was it a hassle? Probably. But it was worth it for him. Like I said, he’s been acquiring properties since fellowship. I imagine it’s all part of his master plan to be a small time real estate mogul with multiple income properties.

However, he’s also single with no plans to get married or have kids. So his risk tolerance is significantly higher than mine. Honestly, I think he positioned himself to leave medicine while he was still a resident. He tailored his fellowship and his job(s) to allow him to maximize making money in the shortest amount of time, save money, and buy properties.

What prevents physicians from leaving medicine?

The number one thing preventing physicians from leaving medicine is student loans. A close second to that is the being accustomed to a certain lifestyle. Then after that, you have to decide about how to make up for the lack of a physician income. You can transition into consulting perhaps and make a reasonable salary, or you can try to get other passive forms of income like income properties like my friend above, or both. However, you have to have plan. This is why I think people believe physician burnout is a problem 10-15 years into your career. It’s not.

Physician burnout happens very early in your career in my opinion. The reasons above are why we don’t see its effects until 10-15 years in.

Both of my friends are extremely good radiologists, and exceptional physicians in general. Losing either of them this early is a great loss in general.

However, they have other interests that they want to pursue more and I understand that. Nonetheless, I hope they still do radiology at least part-time…

Unfortunately, I think that if either of them ever did leave completely, they wouldn’t come back.

TL;DR

Leaving medicine is hard.

Student loans, lifestyle needs, and lack of other skills makes it difficult.

You have to have a plan in place before you can leave.

Physician burnout is not a mid-career problem, it’s an early career problem.

-Sensei

Do you want to leave medicine? Why and how? Let me know.

Agree? Disagree? Questions, Comments and Suggestions are welcome.

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