Career Planning, Transitioning and Avoiding Burnout
Advice to radiology students, residents and fellows on setting realistic goals and achieving work-life balance
As a medical student and resident/fellow, your career steps are well-outlined. Study for the next test, pass boards, apply for residency, fellowship, or your first job. After training, your next steps become more ambiguous. A wrong move or non-ideal job can lead to significant stress, burnout, loss of income, or even the end of a career. With appropriate planning, savvy decision-making, and smart guidance, mistakes can be avoided and your career can be successful and satisfying.
1) Know thyself, and define your priorities. When at a crossroads in your career, ask yourself these questions:
- Do you want more free time for yourself or a better work-life balance?
- Would you prefer a part-time job with a lower salary but more time off?
- Are you interested in a research-oriented academic career? A clinical/teaching oriented academic career?
- Do you enjoy teaching and working with residents?
- Do you want to be in a particular geographic area?
- Do you prefer working as part of a team or independently?
- Would you prefer to read only in one particular subspecialty or are you willing to read general radiology/multiple different subspecialties?
- Do you like doing procedures? Dislike them?
- Are you willing to work nights or weekends in exchange for more time off?
These are the questions you must understand about yourself to know in what kind of job environment you can be successful and happy. You cannot know what type of job would best fit you until you have clearly defined your goals and priorities to yourself.
2) What if I am unhappy in my current job/role?
Unfortunately, sometimes due to unforeseen circumstances, changing life priorities, or just time and situation, we may find that we are unsatisfied in our current job and position. If this is the case, it may be time to re-evaluate and possibly find a different role.
Ask yourself: what is it about this job that is causing my dissatisfaction? If possible, meet with your manager/director or chairperson. It may be possible to restructure your current job or move to a different role within the same organization that better suits your needs.
If this is not possible, then you must consider your situation before looking to change jobs. What are your contractual obligations to your current employer? Have you signed a non-compete agreement in your contract? For how many months out into the future are you scheduled to work? Make certain you understand these considerations before seeking a new position. Consult an attorney if necessary.
When seeking a new job, try to ensure that the new position will help you achieve more of your goals and priorities. Keep in mind that in attempting to attract employees, organizations will put their best foot forward. Try to talk with anyone you know within the potential new organization to get the real honest story. While interviewing, ask people what they would change about their jobs or organization if they could. Make certain you understand the terms of your employment, and as above, consult an attorney or contract-specialist if needed. It would be unfortunate to leave one non-ideal situation and immediately enter into another one.
As always, be open and honest with your current employer if you decide to leave for a different position. Try to give them as much time as possible to fill your position, and try to time your change with your scheduling cycle so that your previously scheduled shifts do not need to be filled in by your colleagues. Be politically smart about giving helpful feedback without burning any bridges. You never know if your former boss may again later be your boss or colleague at a different organization or the same organization. Remember radiology and medicine are small worlds.
3) Develop mentors both within and outside of your organization.
Mentors can be a great source of advice when you are at a crossroads in your career. Although some organizations may have a formal mentorship program, most people will need to actively find and develop mentors. Before you approach potential mentors, you should have a list of finite realistic goals and objectives. Do you need strategic career guidance? Want to achieve technical procedural expertise? Author a paper? Submit a letter to the editor of a journal? With a solid goal in mind, begin to talk to potential mentors.
Once you have found a potential mentor, cultivate the relationship by offering to help them with their work and lives in any way that you can, as mentorship is a two-way street. Keep your mentors updated with your career as it develops. When you have questions about your job or other potential career changes, your mentor network is a great place to seek advice.
As a resident and fellow, it can be difficult to cultivate mentors outside of your institution, but as you finish training and change institutions and groups, you can maintain your mentors from training as well as develop new mentor relationships within your new practices and institutions. This will provide you with a network of internal and external mentors. When you have questions or concerns about a particular job or position, communicating with your mentors that work in a different environment may be helpful as they are removed from the situation and can offer candid non-biased advice. Additionally, external mentors may know of other job opportunities for you to pursue.
4) Maintain a sense of self-awareness, take pride in your work, and prioritize your own health and well-being.
A primary reason for burnout is doubting the quality and importance of your work. We are especially at risk for this in radiology, as we rarely get positive feedback from patients or other physicians regarding the manner in which we help them, although we do help them every day. Radiology is a bit of a thankless job, but we all know what would happen in the hospital if we were not around to do our work and help our patients. Despite the lack of active gratitude, remember that the impact we are making every day is positive and huge.
Keep in mind there is more to life than work, and maintaining a healthy work-life balance will help you stay happy and healthy. Take care of your body with rest, exercise, nutrition – all the things we likely neglected in our training. Do your best to maintain healthy relationships with the people you love including friends and family. These things are easier said than done, but the yield is tremendous.
5) If you need serious help, ask for it
We all need to look out for each other. Physicians have a substantially higher rate of substance abuse and suicide due to the high pressure environment in which we work, and sense that reaching out for help and support is a sign of weakness that could have negative career implications. This is not true. Asking for help is a sign of strength- a willingness to seek change and improve your circumstances or at least begin to receive support that you feel you are lacking. Reach out to friends or family. They likely would be happy to hear from you. If you feel that you are in need of immediate assistance, there are many resources available, including support groups and hotlines.
J. Paul Nielsen, MD, MPH