To Young Doctors

Advice from a Mid-Career Physician on Side Gigs and the Lure of Life Outside Traditional Medicine

I occasionally have medical students and doctors-in-training (residents and fellows) reach out to me about side gigs and transitioning to careers outside of traditional medicine. It’s no surprise given the current state of healthcare and the historical levels of burnout throughout the profession. Many are curious about taking on permanent roles within startups, health tech companies, or Big Tech. Despite the time and money (debt) it requires to get through medical school and residency, some are willing to forfeit sunk costs. Honesty, I’m torn by what the best advice is here. First, while I have carved out a successful and satisfying side gig career, I’m still in full time clinical practice. Though I’ve had the opportunity to experience digital health startups in various stages as an advisor and investor, I’ve never worked for one. I’ve also been in practice for 15 years and have the benefit of hindsight, a stable and fulfilling day job, and a measure of financial security I didn’t have when I first started. It’s sad and alarming (yet understandable) that so many want to stop before they’ve really even started. What follows are my own thoughts on factors to consider when standing at the crossroads of a career inside or outside of traditional healthcare.

The author during residency.

Practice Medicine

Here’s a little secret: getting a medical degree is perhaps the least important part of becoming a doctor. Sure, you’ve made it through four difficult years, passed multiple tests, and survived life at the bottom of the healthcare hierarchy. But, in truth, you know little about how medicine actually works. Medical school gives you a baseline level of knowledge and sets the foundation for what comes next. Leaving medicine right after obtaining your degree makes you a doctor in name but not in practicality. Being a subject matter expert means understanding medicine in a deep and insightful way beyond what you learn as a medical student. Residency teaches you how to take care of patients and fellowship hones those skills. Still, life in training (especially at an academic medical center) gives you a skewed perspective. While you are more equipped and more experienced than a medical student, there is still much to learn about medicine in the real world. Being out on your own, experiencing healthcare delivery firsthand, and building a practice are medical life lessons training simply can’t teach you. I was years into practice before I began to understand and appreciate the complexities of healthcare policy and economics, the business side of medicine, and other important topics our training doesn’t teach us.

Though it’s tempting to get your degree or complete your training and bail out, I’d encourage you to practice for at least a few years. Life as a practicing doctor is often different than life as a trainee. Don’t let your experience as a medical student, resident, or fellow sour you on what a career in medicine can be. Despite all the negativity swirling around healthcare these days, there are few jobs as rewarding and fulfilling as taking care of patients. It’s easy to forget this through all the dour discourse. There’s no shortage of opinions about what’s wrong with medicine, and doctors (despite a brief stint as “heroes” during the pandemic) have seen their Q ratings decline in recent years. Before you make up your mind, spend some on the frontlines. Of course, no one should force themselves to pursue a career that simply isn’t for them. This is especially true in healthcare where burnout can negatively impact patient care. If you ultimately decide medicine isn’t for you, your time spent practicing will be an invaluable experience you can draw on in the future. In summary, spending at least a few years in practice is imperative for understanding how to drive change in medicine (IMO).  There are so many companies and people trying to "fix" healthcare who have almost no experience actually delivering it. We need more people who have walked the walk.

Don’t Romanticize Startup Life

For all its faults, a career in medicine provides a level of stability and job security few other professions can match. While the current job market is relatively strong, Big Tech companies and digital health startups have undergone a painful series of job cuts. Pursuing a career outside of medicine carries with it tremendous risk. While that risk can end up being incredibly rewarding, understanding your risk tolerance is critical. Feeling trapped in medicine can be disheartening. But you’re better off running toward your future instead of running away from your past. Consider keeping at least one foot in medical practice. It’s a shame there aren’t more opportunities for doctors to balance clinical work with innovative work, but they do exist. Better yet, if possible, create and shape your current role to allow for more balance and the ability to pursue tangential interests.

Also realize that, while the allure of life in the startup or Big Tech world seems appealing and exciting, the reality can be different. There is a tendency to romanticize life at a startup based on confirmation bias and what you might read on social media or in health tech articles. Glitzy conferences, rubbing shoulders with venture capitalists, big funding rounds, and even bigger exits. In Superman II, Clark Kent gives up his superpowers to pursue an idealized life with Lois Lane. But Kal-El quickly realizes the mistake he made — not only in romanticizing life with Lois, but also in losing his identity. Life at a startup or tech company can mean sacrificing what it means to be a doctor. Though our profession isn’t viewed the same way it used to be, there is still something special about being a practicing physician.

Though I’ve never worked for a startup or Big Tech company, I’ve had conversations with docs who have. Some are happy and fulfilled. Others are frustrated by what they perceive as a loss of autonomy, lack of fulfillment, and a sense that they are merely cogs in the machinery. Sound familiar? Running away from a situation to end up right back in the same situation can be crushing. Before you make the leap, talk to those that have made the transition. There are many health tech communities where you can connect with clinicians who have successfully switched careers (or switched and found it wasn’t for them). Some of my personal favorites: Health Tech Nerds, MDisrupt, Matchday Connect, and HealthTech Founders. Also consider that landing a job at a digital health startup or Big Tech company isn’t as easy as it may seem, especially in the current climate. Funding is tight, stock options aren’t what they used to be, and many companies (including Big Tech and Big Retail) aren’t really sure what their path forward is.

Take Your Time

Coming to the end of medical school or residency can feel like the perfect time to transition away from medical practice. Struggling in the first years of practice may make escaping seem like the natural choice. My advice is to play the long game.  Set realistic short- and long-term goals and build your network (social media is great for this). Gain meaningful experiences, be humble and willing to help others when able, and develop a growth mindset. Start by mentoring or advising startups. Participate in hack-a-thons. Launch a newsletter. Appear on podcasts. If you have the means, do a little angel investing. Awkward though it may seem, don’t be afraid to put yourself out there. Heck, maybe even start your own company. You might be surprised what interests you and what doesn’t. Also, gaining a little footing, making a little money, and pursuing side gigs may help you stave off burnout and increase your chances of success. Fifteen years into my own career, my experiences in health tech have allowed me to stay engaged, develop a sense of purpose and fulfillment beyond clinical practice, and find that work-life harmony that is critical for doctors.

Pursuing leadership roles while still in training or early in your career is a great way to expand your knowledge base and experience beyond clinical practice. There are ample opportunities to get involved in leadership roles within your local hospital/health system, within your department/practice, or within national societies. It can be eye-opening to see how non-clinical healthcare decisions are made. A word of caution: be careful not to get sucked into time-wasting positions.  I learned the hard way that some roles are a lot of meetings and talk with little action. Your limited time may be best spent elsewhere.

Finally, a bit about additional degrees. I obtained an MBA through an online program with the goal of becoming more comfortable with business concepts. While I’m a big believer in constant growth, I’m less certain that a non-clinical advanced degree is absolutely necessary. Outside of an MBA, there are healthcare administration degrees (MHA), public health degrees (MPH), and clinical informatics degrees. All have their use cases, but none should be viewed as a means to an end. Pursue such degrees as a way to become more knowledgeable or effective in your current roles. Most of these degrees require substantial time and money — make sure you’re doing it for the right reasons.

Healthcare needs doctors. It also needs people with clinical experience and expertise in positions to shape the future of our ailing system. If you’re in med school, finishing your training, or early in your career, consider what fulfills you and gives you a sense of purpose. Times are challenging, but medicine is still a rewarding career, and the grass may not be greener elswehere. Ultimately, a career in clinical practice may not be for you, but set yourself up for success by being honest with yourself.