People often come to me and say they want to leave clinical medicine, but they have no idea where to begin. I understand that feeling, because when I left there were no visible examples, no clear maps, and no obvious next steps. Medicine offers an illusion of certainty, with a fixed salary and a defined career path. Leaving that safety can feel reckless, even when staying feels unbearable.
If you’re stuck in that in-between place, know that your confusion makes sense. Leaving medicine is not about being indecisive, it’s about designing a life without a template. You are being asked to create a path that contradicts everything you were taught about safety, success, and responsibility.
A framework that helped me was Designing Your Life by Bill Burnett and Dave Evans. The key lesson is that good lives are built through iteration, reflection, and testing, not through finding the perfect alternative career.
Pause and Define Your ‘Why’
Before you make any big moves, pause. Not to talk yourself out of leaving, but to collect internal information. Your reason for wanting to leave has to be clear enough to carry you through uncertainty. Leaving medicine will cost you something, and you need to know exactly why that cost is worth paying.
When your peers are collecting diplomas, getting reg posts, or opening their own practices, it is easy to forget the reasons you wanted out in the first place. Your written ‘why’ becomes an anchor when doubt creeps in.
You will have days where you question everything. You will wonder if you made a mistake, if you were overexaggerating, if you are weak, and worst of all, if you should go back. That is normal. The point is not to avoid those feelings, it is to have something solid to return to when they come up.
The Price of Entry
One of the most useful shifts for me was letting go of the idea of a perfect job. Every path has a price of entry. Medicine has a very high one like the long hours, emotional depletion, loss of autonomy, missed life events. Other paths also come with costs, like uncertainty, financial variability, slower external validation, and sometimes loneliness. The question is not where you will pay nothing. The question is where you are willing to pay.
Understanding that changed everything. I stopped asking, what is the safest option, and started asking, which set of sacrifices aligns better with the life I want to live?
Give Yourself Permission to Grieve
This is not a dramatic flourish. Medicine is more than a job, it becomes part of who you are and part of the life you planned to live. When you leave, you are letting go of a version of yourself and a future you once believed was inevitable. You feel like you are losing a community, a social identity, and a sense of purpose that was built into your daily life.
It is okay to mourn that.
It is okay to miss parts of it, even if the overall experience was damaging. If you try to skip this step, it will follow you into the next phase, and it will show up as doubt, guilt, or a longing to return to what is familiar.
Reframe the Fear
One of the core lessons from Designing Your Life is that fear is not the opposite of courage. Fear is part of the process.
The fear of leaving medicine is understandable and compounded by lifes endless list of responsibilities. But fear alone is not proof that you are making a mistake. Fear is proof that you are stepping into the unknown. Growth will always feel uncomfortable. The real question is, how can you step into the unknown with a plan and with compassion for yourself?
Take Action, but Rest First
Fear and depletion are a brutal combination. When your body is exhausted, it is difficult to take even small steps toward change. Rest matters. But rest alone will not create a new life.
Here is the practical truth: action is the driver of clarity. You cannot think your way out of the mess, you have to build your way out. The act of doing creates momentum, and momentum creates competence, which later creates confidence. Don’t wait for yourself to be ready, act your way into readiness.
But be honest with yourself here. It is easy to stay in the trap of 'if I’m not killing myself, I’m not doing it right'. You are not likely to make sound decisions from that place. Clarity comes after your basic human needs are met. Doctors are ironically the ones who need to be reminded of this most. Your identity will not collapse if you rest, it will set you up for making decisions that are coherent.
So the plan is simple:
1. Rest enough to be functional
2. Then take small actions consistently
Even tiny steps matter, because they move you from a place of paralysis into a place of possibility.
The Life Design Toolkit*
Here are some of the most useful tools from the book, translated into practical steps for someone considering leaving medicine:
1. The Good Time Journal
Track your daily activities for 1-3 weeks, noting when you felt energised and engaged (in a state of flow). The goal is to identify what you should do more of, and what you should do less of.
For doctors, this is especially powerful because we often interpret exhaustion as a sign we need to work harder, not a sign we need to change direction. The Good Time Journal forces you to see patterns and to acknowledge that your energy is a signal, not a weakness.
One of the positives about being a doctor is that you have a huge number of transferable skills. You do not have to feel like you are starting from zero, because that is not true. What you need to do is find the overlap between the transferable skills you already have and the ones that energise you. That overlap gives you a useful starting point for your next step.
Perhaps you enjoy the patient interaction, so a client-facing role might suit you. Or maybe you love the hands-on, practical side of medicine, like surgery, in which case a role that involves technical skills could be a better fit.
2. The Workview and Lifeview
This is a simple but profound exercise. Write at least 250 words on each and put pen to paper (don’t just do it in your head).
In your workview, explore what work means to you and why it matters. This exercise is not about finding the perfect job, but about understanding what you are trying to build your life around. Ask yourself:
• Why work at all?
• What is work for?
• What makes work meaningful or worthwhile?
• How does work relate to the individual, to other people, and to society?
• What does “good work” look like, and what values should it reflect?
• What role does money play?
• How does it sit alongside growth, fulfilment, purpose, and impact?
In your lifeview, articulate what matters most to you. Ask:
• Why are we here?
• What does a meaningful life look like to you?
• What is the relationship between the individual and others, and where do family, community, country, and the wider world fit in?
• What do you believe about good and evil, and what guides your sense of right and wrong?
• Do you believe in something transcendent, whether a higher power, spirituality, or a sense of purpose beyond yourself, and how does that shape your choices?
• What role do joy, sorrow, love, justice, peace, and struggle play in your life?
The key is to compare the two.
• Where do your workview and lifeview align, and where do they conflict?
• Does one drive the other?
• Are you living in a way that reflects your values, or are you compromising them to fit a path that was chosen for you?
If your workview and lifeview are not aligned, the mismatch will eventually create suffering, no matter how successful you become.
3. The Odyssey Plan
The Odyssey Plan asks you to imagine three different versions of your life for the next five years. Not as fantasies, but as real possibilities. Think about both your work and life and create three 5-year plans:
1. Plan A is the life you would likely continue on if you stayed on the current path.
2. Plan B is a version of life where Plan A is no longer an option. If you couldn’t be a clinician, what could your life and work look like?
3. Plan C is a version of your life where money and image were no object.
The point is not to decide which one is ‘right’ but to expand your thinking. When you write out three distinct futures, you begin to see that you have options, and that your life is not a single line. Check your plan against four questions:
• Do I have the resources to execute it?
• How keen are you about the plan?
• How confident do I feel, remembering confidence follows action?
• Does it align with my workview and lifeview?
A Call to Action
If you are standing at the edge, unsure but restless, commit to taking action this week. Give yourself the space to complete these exercises. If you do these three things, you will start to move. And movement is the only real antidote to fear.
Now What?
This exercise will give you a starting point to understand how far you should deviate from your existing path (because you can literally do anything). Maybe you find you want to stay in healthcare, but in a research capacity. Maybe you want to start a farm in rural Malawi. Maybe you realise that medicine is actually where you want to stay. The answer is already within you, it is just about figuring it out. Remember, most choices are flexible and not final. You can always pivot, refine, or try something new.
*Burnett W, Evans DJ. Designing your life: build the perfect career, step by step. Random House; 2018.