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POSTED: June 19th, 2026
POSTED IN: 2026 EM Pulse Q2, EM Pulse - The Official Newsletter of MOCEP, forum, Forum Topic,

Written by: Douglas Char, MD

Career transitions are an essential part of the evolution of one’s professional life. Transitions can take place at any time and for a variety of reasons. The most obvious transition is entry into practice at the end of residency or fellowship. As physicians get older, they face a period of transition during which they must decide whether to continue practicing or retire from a life in medicine.  Dr. Sonia Ramamoorthy (Clin Colon Rectal Surg 2023) notes that crafting your career is one of the most important things we do with our lives.  She says it is no different from other important life decisions and will have significant repercussions for years to come.

We are all different with different priorities. While mentors and role models can show us what is possible, ultimately, we must find our own path. Dr. Ramamoorthy encourages physicians to take time to contemplate their careers and ask: what am I passionate about, what are my strengths, what do I struggle with, and what are my short- and long-term professional goals? Simultaneously, we must consider how our professional goals integrate with our personal definition of fulfillment and happiness. Along this line we must ask ourselves: whom do I care deeply about that will be impacted by my career decision, am I achieving a work-life balance, what am I willing to sacrifice to get what I want, and am I caring for myself?  Most transitions are driven by personal ambition or life events. These moments require careful consideration, planning, and reflection.  Physicians have invested significant time in education and training, often delaying other critical milestones such as marriage, children, travel, and self-discovery.  The idea of deviating from the familiar and safe path can seem daunting and risky.  Transitioning with the goal of living your “best professional self” should be your north star.

Emergency Medicine Careers Options

Emergency Medicine practice is defined by its 24/7/365 activity. This can often be equally rewarding and frustrating at times (NYACEP newsletter) as we proceed through our careers.  If one is looking to change from a full-time clinical role, there are options for emergency physicians. The most obvious is intermixing clinical work with other roles.  Engaging in medical education (teaching) is a popular and rewarding approach. Administrative roles within the department or hospital can also substitute for clinical work (e.g., department leadership, quality management, physician advisor/utilization review). Maintaining clinical practice but in different roles and environments can reinvigorate practice (telehealth, urgent care, changing practice sites). Acting as a consultant (toxicology, addiction medicine) and legal advising (expert witness) are opportunities if one has the right background and training. However, most of these endeavors are not sustainable in replacing significant clinical hours.

Career Transition Opportunities

Look for On-Ramps and Off-Ramps.  Consider obtaining additional education.  We have seen huge shifts in finances, innovation, and workforce projections in the past decade.  Traditional medical education has not kept pace with these changes. Increasing one’s knowledge of finance, operations, and management principles is necessary to advance in a large health care system. Gaining expertise in relevant and complementary fields is invaluable in health care today. Degrees in health care administration, bioinformatics and public health are popular. Many professional societies have leadership training programs and educational opportunities.

Timing is everything. Every professional opportunity must be carefully considered for its potential impact on a person’s work-life balance.   You may have to forgo an opportunity if it doesn’t mesh with your family’s needs. Especially for women, being a parent often takes priority over career moves. At other times, it’s possible to make adjustments at home to allow the physician to entertain a change.  The goal is to make a clear-eyed assessment so that you don’t regret the decision. Early career transitions often focus on three categories: 1) recognition of a preferred practice environment – academic, community or private practice.
2) relocation to a preferred destination (being closer to family or spouse’s job)
3) Need to change jobs due to conflicts arising from the practice environment (not what one anticipated or a poor “fit”).

Don’t pressure yourself to find the perfect job.  Median job tenure is the shortest it’s been in decades (3.9 years). Almost 50% of physicians newly out of training change jobs after  two years. Avoid the burden of searching for a mythical “perfect job”.

Mid-career is the time to focus 10-15 years into the future and ask yourself where you want to be and if you can achieve your career goals in the current position. If not, do you need to transition into doing something different? Mid-career transitions tend to occur around the following: 1) job satisfaction, 2) compensation (financial and time), and most commonly 3) opportunities for career growth (looking for a new challenge, intellectual stimulation). Making a mid-career change is challenging due to its impact on other stakeholders (family, staff).  One needs to be sure the “grass is truly greener” before committing. 

Create a team – don’t try to research and make big decisions alone. Tap into professional and social networks.  Talk to mentors and consider professional coaches. Make use of opportunities to get yourself in front of others (show off your administrative and leadership skills). Sharing your ideas and misgivings with others will help you gain greater clarity and insight into the decision. Doing this will ensure that you are making a fully informed decision.

Focus on your values and what matters to you. It’s vital to look beyond the highest salary or best benefits.   Think fundamentally about the uniquely varied career options available to physicians.   What is your goal? What do you want to do? Every physician has different family needs, financial situations, and personal interests. Craft a personal mission statement. An online written values exercise is helpful to clarify what matters to you.  Finding something that aligns well with your personal values will make your career transition easier. Be open to unexpected opportunities. It may not be the job you were looking for, but the job that was presented to you.  Be open to finding revitalization in your current position.  Make sure that you have not soured on your current position due to burnout that will not be remedied with a big move.

Personal Financial Literacy should guide your decision

While money should not be the sole factor in deciding a career transition, making career decisions without considering the financial implications can be a huge mistake. Financial literacy among physicians is often underdeveloped and can limit your career options. Don’t allow yourself to get into a situation where you feel handcuffed to one lifestyle or job. Being flexible and thinking of money as a component of your career, not the end goal, will help keep options open. For most physicians, clinical income is what allows us to take on non-clinical roles. It’s the clinical practice setting that allows us to move into and out of novel and unique careers. Experts suggest maintaining 20% clinical practice to serve as a transition buffer if you decide to pursue a non-clinical career opportunity. One option is to engage in locum tenens work while between jobs or starting new non-clinical endeavors.  A locums position early in one’s career allows you to try out different practice settings and decide what fits best. For mid-career physicians, it can help fill an employment gap while searching for the next career-building position. For late-career physicians, locum tenens opportunities might be a way to keep practicing while transitioning to retirement.

References:

Sonia Ramamoorthy. Clin Colon Rectal Surg 2023; 36:338-341 Career Transitions: What are other options to clinical practice that may align with new or evolving priorities/goals? https://pmc.ncbi.nlm.nih.gov/articles/PMC10411194/  

Career Transition for Emergency Physicians. NYACEP https://nyacep.org/issue/career-transitions-for-emergency-physicians/

Early retirement? 5 factors physicians should evaluate https://www.ama-assn.org/practice-management/career-development/early-retirement-5-factors-physicians-should-evaluate

7 Tips for family physicians thinking about a career transition. https://www.aafp.org/news/practice-professional-issues/physician-career-transitions.html

3 Ways physicians use locum tenens for career transition https://locumstory.com/spotlight/physician-career-transition