A blueprint for career change when you don't know what you want to do

Physician Executive,  Nov-Dec, 2004  by Anna Navarro

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What do you do when you are unhappy with your job but aren't sure what you want to do next?

This is a mind-boggling question for anyone. But especially for physicians, who have invested so much of their time, money and effort to get where they are and, consequently, have so much at risk in making career changes.

If you find yourself in this situation, there is a three-step process to help you out of this dilemma. The steps are challenging but doable. They provide a road-tested method that has helped many physicians find their way to satisfying work.

Step 1: Figuring out what you want

The best clues to your future career path are hidden in an unvarnished review of your history and an honest assessment of what you want--and want to avoid--in the future. Stepping back to get perspective is the foundation of a good solution.

Ed, a gynecologist who worked in an academic setting, found that the insights that came out of this introspection freed him to move in the right direction for the first time in his life.

When we explored his past he admitted to himself that he went to medical school because he did well in science and was attracted to the elite status of being a medical student. But the truth was that he had been bored with patient care from the very beginning and he didn't have much interest in his research projects. The part of his work he most enjoyed was lecturing and politicking to win grants.

Though it wasn't easy to acknowledge, Ed came to terms early in our work with the reality that medicine was not the right career for him. But what else could he do?

A careful analysis of his natural abilities revealed he was good at thinking on his feet, quantitative analysis, negotiating, public speaking and persuasion. Investing was one of his passions and acquiring wealth was a life priority.

Additional insights came from exploring working conditions. He had a preference for fast, competitive environments where he was in control of his own work. He worked best as a solo operator who didn't have to engage in teamwork or manage more than one or two support staff.

These clues, and others that emerged, eventually led Ed to becoming an investment banker specializing in the health care industry. He manages initial public offerings, puts together mergers and acquisitions and financing deals for companies that are expanding. In steps 2 and 3 we'll discuss how he figured out what he wanted to do and how he achieved it.

For Janice, an internist who found it very difficult to blend her roles as a physician and single mother of three boys, the clues were very different.

Despite the demands of her situation, she was still fascinated by medicine and the workings of the human body. Like many physicians today, however, she had to work at an ever-increasing pace to make a living in a world where her costs were escalating and reimbursement was declining.

That pace created enormous stress for her at work and at home. She lived in fear of making a serious mistake some day because of the speed with which she had to work and the exhaustion she experienced on a daily basis.

Many of the things she most wanted in a work situation had to do with balancing being a mother and being a professional. Attaining her desires seemed so totally unrealistic to her that I had to constantly urge her to articulate what she wanted, even though she saw no practical way to achieve it.

Her life priorities showed she'd like to be off work by late afternoon when her kids got home from school and that she wanted to be free on weekends, as well. Her job as a mom meant not traveling for work. She also couldn't relocate. The terms of her divorce required her to stay in the same city as her ex-husband.

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Unlike Ed, money was not a central issue for her. She did need to work for a living and save for retirement, but she was committed to living modestly. Her ex-husband covered the kids' needs, including college expenses.

When we analyzed her natural skills, we discovered that she had a knack for writing and really enjoyed it. Our exploration of Janice's passions revealed that patient education and translating technical information into terms patients could understand were tasks that turned her on.

Today Janice is a medical writer who specializes in patient education. She writes pamphlets, books and articles for magazines. She also devotes much of her time to writing for the Web. She works at home before her kids get up and while they are in school, takes a break from late afternoon until after dinner, then sometimes works again for a few hours after dinner. Her weekends are free, except for three or four conferences a year. She makes somewhat less than she did as an internist, but the loss is offset by not needing to pay for childcare after school.

For both Ed and Janice, the clues to their ultimate solutions came from an in-depth analysis that covered their work, education, leisure and social history, as well as their natural and acquired skills, preferred working conditions, financial needs, passions, life priorities, dreams, constraints and location desires.