A physician needs to complete at least one year of training in a certified residency program and must pass all three parts of the USMLE to become qualified to apply for a medical license. Residency entails a 3-7 year minimum commitment of training to attain clinical skills and board eligibility. Residency is highly sought after, and there are hundreds of candidates who do not match each year.
If you answered yes to any of the above questions, then you need to stay in your residency to become qualified.
Your discouragement is understandable, but dropping out will not help you get where you want to go.
If you answered no to all of the above questions, then move on to the following questions.
If you answered yes to that question, then you need to develop good relationships with your program directors and transfer into a different residency.
You deserve to practice the specialty you want to- and even if you waste a few years of training to get the specialty you want- you will find the extra training well worth it.
If you answered no to all of the questions so far, then move on to the next question.
I am sure you don't want to hear this, but, completing your residency actually puts you on par with non-MDs who are qualified in their own areas.
If you have still answered no to every question so far, then move on to the next question.
If you answered yes, then leaving residency is probably in your best interest. Residency, board eligibility and board certification will not help you attain these types of positions any more than just having a graduate degree. In fact, this is the only instance in which you will waste time professionally by remaining in your residency. But, be aware that your medical school and your residency will not be helpful in getting you the job you are looking for, and that you will have to start at the bottom and work your way up.
For more information on how to find a non-clinical job, see Careers Beyond Clinical Medicine. Find out more about your specific career options without residency here.
How to Get a Non-Clinical Job in Healthcare
I hear from so many doctors who tell me that they are trying to leave clinical medicine and can't seem to get a job outside of direct patient care. Sometimes, a physician looking to make a transition outside of patient care needs to acquire just a few additional qualifications to become a strong candidate for the job. It's important to make yourself the best candidate you can be for the non-clinical positions that you want to apply for, and you can do that by devoting a reasonable amount of time and attention to the process.
Below are a few examples of common non-clinical careers for doctors and what you need to do to get there.
If you want to work as a lead researcher in a pharmaceutical company, you need to gain demonstrable research experience. If you have not already built experience during your medical school and residency, you can enter into the area of research later in your career. And some physicians work in the research field without doing a residency—usually starting at an entry level and gradually taking on more and more responsibility and leadership.
You can acquire experience by starting in an entry level position:
If you want to work in the business side of medicine, either on the payer side or on the administrative side, you can start by joining a hospital committee or by taking your specialty organization courses on medical finance. Some doctors choose to take the MBA route. All of these strategies can work.
The key is to learn the language and processes that drive healthcare administration and business and to practice working with others to achieve demonstrable outcomes. Learn how you can better understand the business and/or regulatory side of medicine here.
If your objective is to become a leader, you need to start by proving that you can lead. Surprisingly, this doesn't mean that you should demonstrate that you know how to intimidate people or boss them around. You need to start by making things work within your professional environment—and that means making agreements happen and making things run smoothly. When others can vouch for your leadership capabilities by saying that you are the person to turn to in times of need,you can confidently say that you have what it takes to be a leader.
In order to be paid to write, you have to prove that you can write well. This is a tough area to break into, but you can begin by working on a team to write an academic paper for a peer reviewed journal or by submitting an article to an online blog. You cannot expect to be paid to write until you have demonstrated that your writing is good enough for a company to pay you to write for them.
You can get started by submitting an article to nonclinicaldoctors.com to see how an audience responds to your writing and also to use the article as a writing sample if you apply for a writing job.
The world of utilization review is becoming more regulated. Clinical practice or previous work on specialty guidelines is often an unofficial prerequisite for this type of work. A medical license or board certification is typically a requirement for medical review work.
Consider serving on your hospital utilization committee or participating in your specialty guideline group if you are considering applying for a position in utilization review. See a list of chart review companies here.
Applying for a non-clinical job should not be stressful. Be prepared to devote some time and energy to learning about non-clinical jobs before you apply. A knowledgeable applicant is the strongest applicant.
Once you know the qualifications a doctor needs to get a non-clinical job, be honest with yourself as you ask yourself whether you are a strong candidate?
There are several ways to figure out if you are a strong candidate:
Making yourself a strong candidate
To build your qualifications for the non-clinical job you want, you need to be purposeful in your approach. You need to establish skills or qualifications if you don't have them already.
The biggest mistake doctors make when applying for non-clinical jobs is saying, "I can do any job." Find out how to avoid mistakes when looking for a non-clinical job.
Having an online presence is becoming an important part of building and maintaining a professional reputation. For your customers, clients or patients, visiting your website is one of the most important ways they use to 'screen' you to decide if they want your professional services. Constructing a website can be intimidating, but even if you are not experienced with computers, you can tackle it in a few manageable steps.
1. Decide why you want a website. Determine whether the priority of your website is to attract customers to your offline business or whether you want a website for the purpose of interacting with your patients.
A simple informational website may have plenty of material, articles, links and pictures without interactive features beyond a simple email/contact feature for your web visitors to ask you questions. An interactive website allows visitors to create their own profiles or to order items. If you want an interactive website, the process of building the website is much more involved than if you want a website that provides information.
2. Search for a web host. A web host is a service that is already designed to help you build and publish your website. A web host is to a website as PowerPoint or Prezi or keynote is to a presentation. Popular and easy to use web hosts include weebly.com, wix.com, wordpress.com, go daddy.com, bluehost.com, and squarespace.com among others.
All of these web hosts have easy to understand tutorials for do-it-yourself web builders. The web hosts typically offer a free web building package as well as additional add-ons that you can pay for, such as a domain name or a dedicated email. As you navigate the do-it-yourself instructions, you will get an idea of which web host is more in line with your goals for your website and whether you want to move forward with building your website yourself of hiring someone to do it for you.
3. Decide if you are going to move forward by building and managing your own website or by hiring someone to do it for you. There are an abundance of web designers who you can hire. You might choose someone who is local, or you might even find a web designer by searching online. Often, your web host can provide this service for you at a cost determined by how complex and interactive you want your website to be.
4. If you are going to proceed with the do-it-yourself path of building and managing your website, you need to choose a web host. Typically you can 'buy' different packages from the web host, and most web hosts have a free basic package that includes easy to follow instructions. You can usually upgrade if you want additional features at a future time.
11. When it comes to earning income from your website, good content is the key. This means that if your site is not useful, or if you have a title that promises more than it delivers, visitors will only stay on your site for seconds and will not return or recommend it to others. So of you want to earn revenue from your website, the number one method of doing that is by having good content that is relevant for your readers.
As a physician, you are a highly educated and trained medical professional who has the most prestigious educational qualifications - and you have earned a highly sought after license to take care of patients when they have medical problems. Yet there is no reason that any doctor should be limited to a particular career blueprint.
If you want to take a professional path that allows you to achieve your professional and personal priorities, you have a variety of options.
*Dr. Snyder is a clinically busy gastroenterologist who is very active on influential local hospital committees and boards. A private practice physician in a group of 5, he has built strong relationships with the senior level hospital administration and has been able to negotiate a convenient and optimal scheduling process for his group's GI procedures. He also oversees a strong financial arrangement at the hospitals where his group has privileges. He has a great deal of influence on the group practice decisions as well as on hospital wide decisions.
*Dr. Perez is a nephrologist who runs three clinics with adjoining outpatient treatment facilities. He employs 68 staff members, 7 of whom are physicians. Dr. Perez no longer sees patients and he personally manages all of the contracting with payers. He has had to deal with costly staff turnover at the busiest of his facilities due to mismanagement of staff relations by one of the mid level managers. While morale is down at that location, revenue has remained healthy. He is working on adding clinical research services to his business as another revenue stream.
*Dr. Levine is a family practice doctor who works part-time for a private group in a suburb of a medium city. She does not manage financial contracts and has arranged for a convenient schedule and a modest part-time salary. She knows many of her patients from the neighborhood or from her children's school and she is loved by her patients and by the staff, who always strive to make her day go smoothly.
*Dr. Lee is a neurologist who has a full-time tenured appointment at a major university. She has obtained research grants and runs a basic science research lab, occasionally consulting for pharmaceutical companies. Her work consists of about 10-20% patient care, with the remainder of her time devoted to research and teaching.
*Dr. Lamii is a surgeon who worked full-time for a start up medical device manufacturer after obtaining an MBA a few years into practice. He worked on the financial side of the company for three years, and was laid off after the company was purchased by another company. He then took a job as the head of scientific communications for a pharmaceutical company.
*Dr. Stucco is an OBGYN who no longer practices medicine and works as a full-time administrator in a medium sized suburban hospital. She has already changed professional administrative titles twice in the past 3 years, and, while she loves her job and is compensated generously, she does not have a guaranteed position for more than one year at a time.
*Dr. Johnson is a PMNR specialist who holds a full-time job working for a national publisher. He edits medical books, educational videos and medical research articles. He also works with several medical schools on curriculum development.
*Dr. Kumar is a pediatrician who is one of 20 partners in med/peds group that covers 5 hospitals over a large geographic region. The financial reimbursement of each doctor in the group is based on volume. Dr. Kumar is proud that she works between 10-12 hours per day, seeing patients whenever the office is open. She takes more call than most of her partners, as the reimbursement for call is generous and straightforward, and some of her partners prefer not to take weekend and night call. She also takes emergency room shifts about twice per month. She is very happy with her arrangement and is building a large patient base.
*Dr. Halgon is an internist who has just opened her own medi-spa as part of a medi-spa franchise. She plans to rent an adjacent space and to add more medical services and a fitness center to her business within the next 2 years.
Do you see yourself in any of the above stories? Or do you see a completely different career trajectory for yourself? One of the strategies I often tell doctors to use in constructing a realistic career path is building a narrative. Write a few paragraphs describing your own ideal bio 2 years from now so that you will have a defined objective in your sight as you work towards building your career.
Explore nonclinicaldoctors.com to find job openings, and company links and to learn more about the methods you can use to reach your goals as you work towards making your ideal professional bio a reality. Or use Careers Beyond Clinical Medicine to learn the details behind each type of non-clinical position.
As an added incentive for yourself- send your future bio to nonclinicaldoctors.com today and then send in your story in 2 years to be featured as a physician success story!
There are a number of projects that physicians can pursue to earn additional income while maintaining patient care responsibilities. Some doctors take on these types of projects to earn additional income, and some are more interested in gaining experience and exposure to other aspects of medicine. A number of these options can also provide a salary to replace full time clinical practice.
Doctors who want to transition into non-clinical jobs often don't know where to begin. There are many physicians and health care professionals who want to find non-clinical jobs- for a variety of reasons. The following steps can make that transition happen smoothly.
4. Strategize to determine the right approaches you need to take for the jobs that fit your goals. Become an expert at understanding the ins and outs of your future career. Careers Beyond Clinical Medicine provides you with thorough insight into non-clinical job opportunities and shows you in detail how to get the job. I did all the research for you, so you don't have to. If your only complaint is that I have provided too much detail then I have done my job- because I want to provide you with as much guidance as you could ever need!
5. Taking Initiative
As you map out your next steps, there are three methods that you can use to approach your career transition:
6. Accept a good job and continue to prove to yourself and to others that you are an asset. Doctors can succeed in a variety of non-clinical fields. When doctors thrive on the non-clinical world, there are many winners, including the health care delivery system as a whole.
If you decide at any time throughout this process that you want to stay in clinical medicine, but you think you need to make some changes to your current work environment, don't delay improving your situation. Your patients will be better served if you are in a situation that is fair and productive. Every physician can and should achieve career satisfaction.
If you are a physician looking for a teaching position, there are several options open to you, including college, graduate school and a professional school teaching positions. Teaching jobs in elementary through high school usually require an education degree and a teaching license, which takes several years of additional schooling, even if you already have an MD or a DO.
Teaching is a joy for some and a drag for others. It is often a suitable fit for doctors who are good at interacting with students and peers. But teaching is not usually the right choice for doctors who want to escape from patient care, and students deserve to be taught by professors who enjoy teaching. It takes time and energy to find a teaching position, and doctors who are not genuinely interested in teaching may find the time involved in searching for a teaching job discouraging. If you consider teaching a desirable option, there are some useful tips to consider first.
By Dave Denniston, CFA
Have you ever wondered… is my business a hobby?
You may have heard that having a small business is one of the best tax deductions out there.
But… when is a business a business and when is my ‘business’ a hobby?
Question# 2: Do you depend on income from the activity?
Let’s take a look at a couple of examples.
One physician I work with is an expert witness. He does this ‘on the side’. He makes substantial income- 100k+ a year from this activity in addition to his work at an academic hospital.
He depends on this activity to help save for retirement, pay off his mortgage, etc. So, in this case, he is dependent on the income.
He could take a year off and only make $10k from this business and still do some write-offs.
Definitely a business and not a hobby. There’s a history of profits here.
Question# 3: If there are losses, are they due to circumstances beyond your control or did they occur in the start-up phase of the business?
This gives you some grace in a really bad year or if you are just getting started.
There is NOTHING wrong with taking a write-off when you are launching a business. You may not yet have revenues or they may be very meager.
There is also NOTHING wrong with having a bad year and taking a fat write-off in the process.
The problem is when you never ever, never ever make a profit and it doesn’t appear to be anywhere on the horizon after 2 years.
You can always launch and try a new business after those 2 years and take another write-off.
Although, after a while… you might wonder if your money was better invested elsewhere.
Doctors often wonder about whether a non-clinical job could offer more work-life balance, more autonomy, a better income, or more job satisfaction than clinical practice.
In the changing healthcare climate, non-clinical work may be a better fit for some doctors. But it is important to examine the characteristics of non-clinical jobs before assuming that they may offer what you are looking for.
How to know if a non-clinical job is the right solution for you
I hear from doctors from all over the country every day.
The physicians who reach out to me are feeling beaten down and having trouble keeping their heads above water. Many doctors tell me that clinical work used to be rewarding, but that high quality patient care is becoming incompatible with the increasing financial and regulatory requirements demanded by employers and payers. Most established physicians don't want to settle for lower quality patient care, and faced with a difficult dilemma, thousands of physicians think about changing direction.
Young physicians who are still in the midst of residency training often have a gut feeling that a career centered on direct patient care is not the right fit. And medical students frequently contact me- already considering applying for non-clinical jobs straight out of medical school, instead of applying for residency.
But is the grass really greener in non-clinical medicine? It all depends on what you want to get out of your work.
*Are you looking to escape from excessively documenting every detail of your patient care by transitioning into the non-clinical world? You can finally achieve that with some non-traditional medical jobs in areas such as medical writing and chart review, but you can drown in a different type of documentation.
In fact, many non-clinical positions essentially entail a whole day of documentation or reviewing another health care provider's documentation. Of course, if you work in a non-clinical role, the documentation portion of the job is work that you will be paid for, in contrast to clinician medicine, which requires documentation as a prerequisite to reimbursement for patient care.
Pride in What You Do
When you move into the non-clinical aspects of medicine, you could be put in charge of reducing cost, trying to get a new device approved, or running a non-profit. If you believe in the integrity of your cost containment strategies, the safety and efficacy of the device, or the value of the non-profit, you may feel even more pride and satisfaction in your work than you did in patient care. But if you find yourself forced to communicate in ways that you do not believe in, you could end up craving the integrity of patient care.
*Money is a vital component of any job. A number of non-clinical options offer stellar compensation if you can demonstrate your value. On the other hand, some non-clinical jobs offer salaries equal to or even lower than your job as a practicing physician. See Careers Beyond Clinical Medicine for more information about salaries of non-clinical jobs.
Emotions at work
All jobs have the potential to be highly volatile. Clinical medicine, however, requires a particularly cool head and an ability to calm others down amid the fear of a bad diagnosis and the stress of unpredictability. On the average, day-to-day work in the non-clinical arena is more predictable and less frequently fraught with emotionally unstable interactions.
One of the biggest complaints that doctors express is the growing sense that someone is 'looking over your shoulder' and second guessing everything you do. Industry is inherently designed to be much less autonomous than medicine. This is an important consideration to keep in mind if you want to transition out of patient care. The frustration of what you consider to be excessive and superfluous oversight may follow you in the non-clinical arena as well.
Find out more about the reality of non-clinical jobs for doctors and learn how to make yourself a strong candidate for the job that is most suitable for you by exploring nonclinicaldoctors.com or Careers Beyond Clinical Medicine.
When I hear from doctors who are looking for good non-clinical jobs, physicians often include a list of positive attributes such as 'I work well with others,' 'I am eager to learn,' or 'I have a strong interest in starting my own business.'
While these attributes are valuable in achieving success, they often don't help in gaining credibility in the transition to the non-clinical workforce, or in negotiating a competitive salary.
Your most valuable tool for finding a non-clinical job is expertise in regulations and policies.
Expertise is one of the most valuable tools that health care professionals possess. Doctors already have expertise in medical care. However, the current medical atmosphere has led to an overwhelming growth of policies in areas of coding, billing, licensing, accreditation, practice parameters, best models of health care, patient privacy, cost containment, documentation and electronic medical records- to name just a few of the complex regulatory matters that affect every aspect of health care.
Whether you aspire to work in an executive or administrative role or to start your own business, a mastery of these hard to grasp regulatory issues will serve you well and can potentially make you irreplaceable. When you customize your own areas of non-clinical healthcare policy expertise, you will reap the benefits of your invested time and energy.
"I can do anything"
I have received this question hundreds of times from doctors in the US and abroad:
'I am a doctor looking for a career switch. I can provide medical advice for any company. I can speak, write, advise, and consult. I can do just about anything you need. Can you recommend something for me? I need to continue to make at least my current income.'
Ironically, expressing too much flexibility in your job search can backfire.
A physician's career is no longer limited to patient care, as it once was. Almost 50% of US medical students envision themselves doing some amount of non-clinical work. There are a variety of ways that doctors can make a great impact. Doctors now can take on jobs with a wider range of responsibilities and can enjoy more roles outside of the clinical setting than ever before. Over the course of a physician's career, an evolving professional structure allows a physician to use a medical background to lead healthcare, influence public policy, educate the public, and cure disease.
Doctors can change the course of medicine
When doctors who want to change direction learn about the alternatives and the right routes to achieve their goals, non-clinical physicians can move the course of medicine in the right direction for patients and for practicing physicians. The physician career pathway may not always involve exclusively clinical practice. Doctors who are itching for a change can have a tremendously positive impact on health care and on the world as a whole while achieving new career goals.
Find out if you need to change your career path by re-evaluating your goals and learn how to make the transition if that is the right course of action for you.
Non-clinical work is undoubtedly becoming a direction that more and more young physicians want to take. Given the lack of formal preparation for this path, if you are considering a non-clinical job at any time in the future, you must take the initiative to understand what you have to do to best position yourself for a job in the medical field that is not centered on patient care. Explore nonclinicaldoctors.com and Careers Beyond Clinical Medicine to learn where non-clinical jobs are and to become the best candidate for a nonclinical position.
Doctors who are unhappy with their work environment can end up feeling trapped.
If you are dissatisfied in clinical practice, it is important to know your options so that you won't miss out on opportunities that could be a better fit for you. Your practice setting may be inefficient, unprofessional, or toxic. If that is the case, you should remember that you are in demand, you can find another job, and you are not trapped.
You are not trapped in a health care career that you do not want. There are options out there.
In medicine, the top 3 measures of a physician's value lie in certification, certification and certification.
This is especially true in the United States.
I have heard from doctors throughout the country who want to know if the United States Medical Licensing Examination (USMLE) is a necessary pre-requisite for non-clinical positions.
The answer to this frequent question is - sometimes the USMLE helps and sometimes it doesn't.
What is the USMLE?
You are required to pass parts 1 and 2 of the United States Medical Licensing Examination (USMLE) in order to get your MD degree from a US medical school. And you cannot receive a medical license without passing parts 1, 2 and 3 of the USMLE.
The tricky part is that it is recommended to take part 3 of the USMLE after your internship- and it has been getting harder and harder for foreign medical graduates, international medical graduates, and some US medical graduates to match into residency programs in recent years. More doctors can't match into an internship than ever before, and thus they cannot get a medical license.
And some doctors-in-training already know that they want to get out of clinical medicine early in the medical training process. This is where the question of how to succeed without taking the USMLE comes up.
To find out more about 'dropping out' of residency, see here.
What if I can't take the USMLE?
If you absolutely cannot take the USMLE, but still want to work, you have to really decide whether you want to stay in the medical field or not. There are other ways to work in the medical field, and becoming an expert in regulatory matters is one of the most powerful steps you can take.
Fortunately, even without the USMLE, there are a number of non-clinical entry level positions which require some form of official specialty certification. For example, a clinical research associate can earn between $40-75/hr without residency, and must take a specialized training course.
Learn more about jobs for doctors without residency or licensing here.
Health care providers, including doctors, nurses, physician assistants and therapists, among other health care providers, are often interested in health writing. Given the abundance of websites and articles on the Internet, many professionals interested in educating the public about wellness are looking towards authoring magazine articles and online articles to help educate the public about health issues. That is certainly an achievable goal that can be rewarding and enjoyable. Here are questions to the most frequently asked questions about jobs for health writers.
Are there jobs for physician medical or health writers?
There certainly are jobs for health and medical writers. Writing positions for healthcare professionals include textbook writing and editing, authoring test prep materials, professionally editing articles for peer reviewed journals, scientific writing for pharmaceutical companies and medical device companies, technical writing for health regulators, and writing health articles for online websites, magazines, and newspapers.
What are the qualifications to become a medical writer?
The majority of these jobs do not specifically require an MD, but they often require subject matter expertise, such as a graduate level or undergraduate degree in the health sciences. Subject matter proficiency beyond the stated job requirement is not necessarily an advantage.
The most important criterion that you will be evaluated on when you apply for a job as a medical writer is the demonstration that you can write for the publication’s target audience. If you want to get a paid job as a health or wellness writer for a public audience, you will be asked to submit writing samples that have already been published in order to show your writing skills. Getting your first few writing samples published is a crucial step in this process because your written pieces are the most important part of your application.
If you are considering applying for a medical writing job at some point in the future, it is worthwhile to work on building a portfolio that includes at least a few published writing samples in advance.
If you want a job editing scientific manuscripts or medical textbooks or journals, you should begin by authoring several peer-reviewed articles as the lead author. If you envision yourself writing health articles for a general audience, you can start by submitting articles to blogs, websites and magazines.
If you are interested in health, wellness or medical writing as a career or as a supplement to a career, it is important to work on your writing to make it as good as possible. Even established writers who have written many publications continue to improve writing skills to be able to communicate more effectively with readers.
If you are a biology, chemistry or health sciences major with a pre-med mindset in college and then changed your mind, you might feel a bit lost right now. Colleges report that between 45%-65% of entering pre-med freshman are no longer pre-med at the time of graduation.
One of the most frequent comments that I hear from doctors is, “I really want to write a book.”
I had the same feeling a few years ago when I wanted to write a book for doctors about the subject of non-clinical careers. But I did not know where to begin. When I was starting something completely new to me, I was fortunate enough to receive some great advice and guidance from trustworthy people in the publishing industry along the way. If you are thinking about writing a book, here are several points you need to think about.
If you are thinking about making a career transition, you probably have a "gut" feeling of what you want to do. But often doctors go against that gut feeling accepting the first non-clinical job offer that comes their way- neglecting important priorities.
Before you spend time (or money) searching for a new career path, it is useful to sit back and objectively rank your priorities from most important to least important so that you can see in clear terms what you really value in your career.
If you are considering a change, you need to make sure that you transition to a job that still gives you the job characteristics that you rank at the top of your list.
One of the huge advantages of being a doctor is that you have choices.
Solutions Based Approach to Medical Career Problems
It seems to be a recent trend in the media to feature stories of doctors who are going broke, being driven to despair, and quitting what used to be viewed as an altruistic and rewarding profession. The news articles and segments certainly feature accurate depictions of disillusioned and unhappy doctors, but there is more to a medical career than despair.
The practice of medicine, not unlike many professions, is undergoing a transformation. While there are definitely too many unproductive cooks in the kitchen trying to grab a piece of the ever-shrinking healthcare pie, there are other developments in medicine besides the worsening bureaucratic crisis.
Medicine is NOT all doom and gloom. There are solutions for the bumps in the road of a medical career.
Keep Long Term Goals in Mind
Being a doctor is a great privilege. Women physicians need to take hold of opportunities to become leaders in health care. The physician career can have many stages, including clinical practice, but not excluding other options such as leadership, entrepreneurship and innovation. Understand that a physician career is a continuum of education, clinical practice, leadership, and creativity. You have the power to take your career in any direction you want to- at any time.
Know Your Options
Physicians have so many career options. Knowing your options is a critical part of planning how to set the stage to reach your goals. And it is an important part of being able to choose the right job without 'settling' for a position that is not really fulfilling your professional and personal goals.