Career Path

Mobility in Medicine

It is estimated that an orthopaedic surgeon will change his or her job approximately 2-3 times during the span of their career, which seems relatively infrequent in comparison to other professions.  It has been quoted that 54% of physicians change their jobs within the initial 2 to 5 years of practice.  This would imply, that after the first job change, physicians are relatively immobile.  Reasons for choosing a new job can vary, but the most frequently stated reasons for leaving a practice include relocating closer to family, compensation, poor personal fit with the practice, and a spouse’s career.  I would postulate that the reasons surrounding a mid-career change are likely different than those spurring a relocation within the first few years of practice. Although the data is pooled, the specific motivation for leaving a practice, as well as the frequency of job changes, likely differs among hand surgeons in private practice versus an academic setting.

During surgical training, there is potential for multiple changes in geography.  A decision to select the next phase is forced at the end of medical school, residency and fellowship, often necessitating relocation.  However, making a change when it isn’t mandatory (i.e. the previous chapter isn’t ending) can be challenging. Change is hard.  Uncertainty is unnerving. Leaving a practice means leaving a system with which you have become comfortable, leaving patients, leaving colleagues, starting again. There is a sense of disloyalty in the relocation of a physician, but this stigma is rarely associated with a change in the business world.

Millennials entering the fields of media, entertainment and government are reported to change jobs 4 times in their first 10 years after college graduation.  Their frequent job changes are typically motivated by promotion, both in rank and likely in salary. These are more probable reasons for hand surgeons to relocate later in their careers or potentially within an academic setting.  Yet, in the sparse literature published that analyzes job changes within hand surgery, these reasons are not listed.

Surgeons are planners.  We are careful and meticulous, but there is certainly an element of our job that requires an ability to take risks.  Although I don’t often embrace this aspect of our profession, it is inevitable.  When one considers a job change that isn’t spurred by a need to relocate for a spouse or family and isn’t motivated by compensation or issues with your current practice, it is potentially harder to commit to this change.  It can be risky to choose the relative unknown.  However, in the business world, changes of this nature are commonplace and encouraged.

I had hoped that I would be a part of the minority of hand surgeons who would spend their entire academic career in one place, somewhat of a unicorn in today’s environment.  When a new opportunity presented itself, I struggled with giving up that romantic notion and with feeling disloyal towards my colleagues and patients whose trust and respect I had worked hard to earn. However, the prospect of a job that represents the next chapter, whether that chapter means doing more of what you love, an academic promotion or really for any solid reason, should be embraced. Mobility in medicine can be a positive – bringing new ideas and people to new places.  And yes, change is still hard…but it can be good too.

References:

  1. Finding and Keeping Your Job as a Surgeon: Maximizing Success. Retrieved from womensurgeons.org
  2. Smith, A et al. Dissatisfied Hand Surgeons: What Causes Them to Change Jobs. Hand (2006) 1:14-18.
  3. Dopirak, R. Evaluating Orthopaedic Practice Opportunities. Retrieved from aaos.org
  4. Long, H. 2016, April 12.  The new normal: 4 job changes by the time you’re 32.  Retrieved from money.cnn.com

Article written by:

Dr. Fishman is a hand and upper extremity surgeon within the Yale Department of Orthopaedics in New Haven, CT. Her academic interests include pediatric/congenital upper extremity, brachial plexus and tetraplegia. Away from the hospital, she enjoys running, avidly following Duke basketball and all Boston sports teams.

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