The Three Stages of Career Transition

Waking Up

There may come a time when you realize you are unhappy enough to want or need a career change. That’s the time to do a brutally honest assessment of what has worked in the job and career and what has not; what is fun and what you hate. Then, determine what is reasonably under your control.

Let go of what is not working or what you hate and hold on to what is working and enjoyable. This is an imperfect and impractical task that will yield temporary relief and provide some clarity. The Serenity Prayer comes to mind: "Grant me the serenity to accept the things I cannot change, power to change the things I can, and wisdom to know the difference.”

Expect to experience some powerful emotions in this first stage. Early in the transition you may feel out of synch and strangely detached or lost. You will begin to question your entire professional role as a physician and your relationships with other professionals in your field. William Bridges has described this stage as a time of disengagement, dis-identification, disenchantment, and disorientation.

You also may feel energized to be turning over a new leaf, leaving a frustrating position, or starting something new. You may feel anxious and insecure about entering the unknown, about taking new risks. You may feel sad about leaving old friends and comfortable ways.

All of these emotions may be confusing for someone who has always been centered and self-confident. Realize that these emotions and experiences are common to all people in transition. Allow yourself to feel these feelings, recognize and name them. Talk about them with trusted friends and allies, coaches, mentors, therapists, and spouses/partners. Write about them in your journal. Pray and meditate about them in private. Unprocessed feelings may become roadblocks to success in the upcoming transition.

In some ways, when you give up a familiar job, money, prestige, you will go through a grieving process. Kubler-Ross identifies the stages of grieving as denial, anger, bargaining, sadness, and finally acceptance. These stages are not always experienced in this exact sequence, but completing the grieving process requires you to experience all of these feelings, process them, and pass through them to the next chapter of your life.

Processing these feelings can best be done with a professional career coach, mentor, or therapist. Once you establish a plan for the next chapter and begin moving toward that vision for yourself, the uncomfortable feelings of the grief process will pass.

In this first stage of transition it is also important to acknowledge and celebrate what has worked. Plan a formal celebration to remember the good things and the people who have helped make this job and your career a success. Endeavor to leave former jobs and colleagues with a positive memory. Acknowledge their contributions. Do your best not to burn bridges.

Taking Stock

During the second stage of career transition, you begin to move out of the Doldrums and into the phase of Cocooning. At this stage, you need to answer a number of important questions before the transition can move forward. Some of the questions are practical and relate to basic resources; others are more elusive questions that probe the very depths of your own self-understanding. These questions include:

• What financial resources do I have available to assist me in transition? Are they enough? Will these resources support a 3–6 month leave without pay?

• If my financial resources aren’t adequate for an extended time without pay, how much time can I comfortably take to work through my transition while still working? Do I need to work full time or can I reduce my clinical work to part time?

• What professional resources (e.g., career coach, therapist, mentor, accountant, financial planner, insurance agent) am I willing and able to make use of?

• What non-professional sources of support can I make use of (e.g., spouse, family members, mentors, friends)?

• Given my age, how many more years do I need to continue to work? How many more years do I want to work regardless of income?

• Do I have the support of my key loved ones? If not, how can I best go about getting that support?

• What is my calling in life? Am I following it?

• What is really important to me: what are my specific values and what is my purpose?

• What am I passionate about? What are my marketable skills?

• What aspects of work bring me joy and satisfaction, and what aspects of my work do I dislike and wish to give up?

• What activities consistently yield personal meaning for me, in or out of the work place?

• How will I continue to find personal meaning, a sense of personal contribution, and personal connection to others once I retire from the practice of medicine?

• What legacy do I wish to leave in this world?

Success in Stages 3 and 4 requires that you clearly identify your personal values, personal purpose, sense of calling, and unique skills and abilities that have value in the marketplace—answering these questions can help you do that. By using and integrating this knowledge of yourself, you eventually are able to craft a new vision for your career or for retirement—one that is filled with passion, commitment, and is well integrated with your deeper values.

Of all the questions above, the ones pertaining to values, purpose, calling, and meaning are the most important and the most difficult for physicians to answer. They are questions that probe the soul and the spirit of the individual.

Answers require time alone to think and to reflect. Meaningful answers will come more easily and more quickly to those who seek help from mentors, certified career coaches familiar with the lives and challenges of physicians, therapists, and family and intimate friends. Those who are successful learn to be patient and wait for the answers to become manifest. Rushing this phase of transition usually leads to a poor career decision—one that is not consonant with your inner self.

Those choosing to cocoon will begin to do the self-exploring mentioned earlier and have lots of time to answer all of these questions. Those choosing the mini-transition will usually spend less time on the deeper questions, using the more practical questions to begin planning specific action steps to reengineer their work and/or obtain new skills/training.

Taking the Leap of Faith

The third stage of transition is the actual process of activating a plan for a mini-transition or a full-life transition created in Stage 2. In this third phase, specific steps propel you toward the future you envision for yourself. Action steps should be “SMART”: Specific, Measurable, Achievable, Relevant, and Time-specific. My experience is that physicians in this stage benefit from having a career coach or mentor to help them formulate their action steps and help them stay on target and be accountable.

During both mini-transitions and full-life transitions, you can anticipate Stage 3 to be stressful. Therefore, first and foremost, ensure a sensible self-care plan is in place. Ideally that plan includes regular aerobic exercise at least 30 minutes three days a week, at least 50 hours of sleep a week, a healthy diet, a program of regular spirituality, and time for friends and fun. Such a plan for life balance is the most powerful form of stress busting available.

Now is the time to implement values-based time management and values-based money management strategies with professional support as needed. This may include a career/life coach and/or a certified financial planner.

Those who have been down this path successfully recommend that you engage in continuous learning, explore your fondest dreams and wishes without internal judgment or self-criticism, learn to ask for help, and finally, never look back! Above all else, transition is a spiritual path that requires a leap of faith, trust in yourself, and willingness to act despite your fear and inability to predict the outcome.

Excerpted from The Three Stages of a Physicians Career: Navigating from Training to Beyond Retirement by Neil Baum, MD. Chapter written by Peter S. Moskowitz, MD.