Regret After Leaving a Medical Career Behind

“Can I look at that book?” said the man next to me in an accent I would soon learn to be Pakistani. I had placed the book face down on the park bench intentionally. In a busy, public place, I didn’t want to broadcast that I was reading The Doctors Guide to Smart Career Alternatives and Retirement.

The back cover contained enough information to pique the polite man’s interest. “Sure,” I said. I was genuinely curious as to why the guy, who has holding a baby boy on a Thursday afternoon in Nickelodeon Universe, would be interested in a book about leaving medicine.

 

One Man’s Regret After Leaving a Medical Career Behind

 

“I left medicine after two years,” he told me. After two difficult years of studying the medical sciences in Pakistan, he decided it was not for him. Now he is a police officer in Pakistan on a one-year leave for an academic fellowship at the University of Minnesota.

Did he regret leaving medicine? Absolutely. His sister and numerous friends are now physicians, earning the equivalent of $10,000 to $30,000 US dollars per month in private practice in Pakistan. He earns about $2,000 a month and lives under the constant threat of being targeted by terrorists as an officer of the peace.

After two months in The States, he has a favorable impression of our nation. He appreciates how people follow the rules and respect private property. He had seen the movie Fargo prior to his arrival, and had read about this “Minnesota Nice” thing, so he had some distorted idea of what to expect.

His wife and three children had joined him just a week prior to our chance meeting, and they were happy to be reunited. They found the people here to be much friendlier than most of the characters in Fargo. The locals actually were nice, and the theme park rides were a hit with his daughters. Their favorite was the log flume; it was my boys’ favorite too.

Yesterday had been a difficult day for them, though. They learned that a fellow police officer, a gentleman he knew well, had been shot execution style as he stepped out of his home. Terrorists.

 

Why Was I Reading That Book?

 

My new friend, whose name sounded something like Andvar — we’ll call him Andy — was curious as to why I was reading this title. Was I planning to leave medicine?

I couldn’t muster a direct answer. While it’s true that I’m at least seriously contemplating a departure, my rationale seemed pretty trivial compared to the guy who takes on criminals in Pakistan for a living.

I explained that the book was written by a friend. A “cop out,” yes, but not untrue. The author, Dr. Cory S. Fawcett and I have been communicating for the better part of a year, I’ve reviewed two of his previously published books (here and here), and we had a chance to meet and chat in person at FinCon.

I went on to chat with Andy about some of the frustrations of physicians in America, and why there were plenty of docs looking to walk a different path. A book like this wouldn’t exist if there wasn’t a market of disenchanted doctors who would find some value in it.

My bench mate was surprisingly understanding. When I told him about the threat of malpractice lawsuits, he told me doctors in Pakistan can’t be sued. I also talked about production pressures, dealing with insurance companies and their denials, the onerous documentation, etc… Again, I felt a bit foolish describing our woes with an electronic health record to a man who wears a bulletproof vest when he clocks in, but he asked, and I was willing to indulge.

 

Physicians Help People

 

Andy could see that there were some issues with our health system, and recognized that many of the irritations we deal with are non-existent in Pakistan. I’m sure they’ve got issues of their own, but I got the impression Pakistani physicians spend more time on patient care, and less time on bureaucratic nonsense than we do here.

“You help people,” Andy said, in an unintentionally guilt-trippy way. “Well, so do you,” I replied in a respectful tone. Andy felt most of his work was directly with criminals, which certainly helps people, but in an indirect way.

Physicians treat individuals directly, which should be more personally satisfying. Some of us might feel that we spend as much or more time with the computer, the dictaphone, or with the patient’s family members as compared to the actual patient, but ultimately our mission is to directly help people live healthier lives in some way. I can see the value in that.

Perhaps these jaded physicians are suffering from a “grass is greener” mentality, Andy hypothesized. That was the case when he left medicine years ago. Sure, it was difficult, but if he knew back then what he does now, he would have stuck with it. Would the doctors who pick up this book feel the same way as he did after leaving a traditional medical career for good?

 

Predicting Regret

 

By definition, regret is something that can only be measured with the benefit of hindsight. One cannot simply calculate how many units of regret are about to be realized as the result of a particular decision. And leaving a medical career behind is undoubtedly a very big decision.

Abandoning one’s clinical career is not a career move to be taken lightly, nor is it easily reversible. Skills diminish, medical knowledge evolves rapidly, and you can’t just walk back into a doctor job after even a couple years off. Is it possible to work as a doctor again after an extended sabbatical? Yes, but probably not without limited options and some remedial education.

There are other reasons a physician might regret a premature exit. I’ve been told some of us have large egos, and that those egos are strongly connected to our statuses as physicians. Pillars of the community, or something like that.

Maybe you’re not ego-driven, but you’ve still got work friends, and that social interaction may be missed. The same could be said to the connection you make with patients. While it can be trying at times, the difference you make for the people you care for gives you a sense of purpose  that cannot easily be replicated away from the exam room or operating table.

Let’s not forget that these physician jobs can pay very well. If financial independence is a goal (as it should be) and you’ve got a ways to go, a non-clinical career may delay that goal for years, and retiring early without a plan to become financially independent may leave you in a difficult financial position in a decade or two.

 

Will I Regret Retiring Early?

 

While I didn’t let on that I had my own reasons to be reading Dr. Fawcett’s latest book, the fact is there is a good chance I will choose to retire from my job as an anesthesiologist before my 45th birthday. I won’t know if it’s a decision I’ll regret until sometime after, but by answering a few key questions, I believe I can come up with a reasonable guess.

Why?

What if?

And what’s next?

 

Why do I want to retire early?

 

It started with “because I can.” It wasn’t until I realized we had attained financial independence that I started to think about retiring so early. When you don’t know that not working is a viable option, you don’t think about it much. Once I wrapped my head around the fact that paid work was indeed optional, I started to consider the alternatives.

I’m not burned out, but there are certainly times where I feel stressed out. I can’t think of one time I’ve been happy to hear the chirp of the pager, and I’ve suffered that chirp thousands of times. When I compare my workdays to my weekends, or to the days I focus on writing, I have a strong preference for the latter two.

I’ve read about the things that make us happy, and it seems clear to me that I’ll be better able to do those things without the doctor job that got me to where I am today. I’m grateful for all I’ve learned and have done in this profession, but I don’t feel strongly that providing anesthesia care is something I need in my life to feel happy and fulfilled.

Yesterday was the first day of a three-week long family adventure, learning the Spanish language in gorgeous surroundings. We met retired couples taking classes at the same school as us who are in the area for several months. One of the couples will return to a motorhome when they go back to the United States. Another slow travels around the world, renting long-term AirBNB apartments ($40 off for you). A three-week trip is amazing; a three-month excursion could be much more so.

 

villa at night

buena vista from our balcony

 

What If I’m Wrong?

 

Since we can’t forecast regret (or lack thereof) with 100% accuracy, it’s prudent to have contingency plans in place. And I could turn out to be completely wrong. Maybe the grass isn’t any greener on the other side.

In some ways, maintaining the status quo is the easiest thing to do. Healthcare is covered. Children are enrolled at a traditional school. Travel planning is limited to short stretches. The paychecks keep rolling in and the retirement accounts continue to grow to a number well beyond enough.

Given my cautious nature, I’m probably a little more likely to work longer than necessary rather than retire too soon, but I hope to be close to that sweet spot on the likelihood of regret scale.

 

likelihood of regret

 

If, however, I decide I want to go back to work after a false start retirement, I’ll make it as easy as possible to do so by taking the following steps as I wind down my clinical career:

  • Renew ACLS and PALS so they’re good for two years
  • Renew my medical license or obtain a new one that is good for two to three years
  • Continue to earn continuing medical education credits to maintain the medical license
  • Do the minimum to maintain board certification or be considered “in good standing”

 

By doing these things, I don’t think it would be difficult to return to clinical anesthesia within a year. After a full year, I may have to rely on returning to a place where my skills and knowledge have been proven. Facilities unfamiliar with me would rightfully be hesitant. After a couple years or more, I realize that some re-training may very well be required.

 


You’re still not using Personal Capital? Track all your accounts in one place like I do.


 

What’s Next?

 

I look at trips like the one we’re taking right now as trial runs for what the first few years of early retirement could look like. The difference would be that I won’t be scheduling trips around my jobwork schedule, or more accurately, squeezing in work around our recreational calendar.

We could travel further for even longer, and make open-ended plans. If we find we’re not content with all that time on the road, we could easily dial back and let our roots grow deeper at home, which is something we would like to do for our boys’ high school years, anyway.

Also, I have no plans to stop writing. This site began nearly two years ago as a fun hobby, and it’s become something of a fun business. As we begin to live the life I’ve been contemplating, I’ll have much more to say about the topics of financial independence, early retirement, family travel, and related topics in personal finance.

It wouldn’t be unfair to say I’d be trading one job for another, but I feel it’s a trade I could make without regret. If I had left medicine after two short years like Andy, I’d probably feel differently.

 

Would you regret retiring early? If you’ve left a medical career, or chosen to pursue a different career path, do you have any regrets?

 

78 comments

  • As always, a very thoughtful and thought provoking post. One that I ponder frequently as we work towards financial independence. Only time will tell, i suppose. As for you, there is a lot of cushion for you to fall back on – professionally and financially. I think i need to read cory’s book next time i am on vacation 🙂 and work on my ‘side gig’.

  • Very good post – in life sometimes the only way to truly know if something is for you, is to do it.

    The fact you have a backup plan of being able to rejoin the workforce if that is what you want to do, then when you are ready and you’re ready to make the leap, by golly do it!

    If it is still challenging to do so, I’d say look into the opportunity cost of leaving vs staying, and also the time you will have doing what it sounds like you love doing more (writing).

    Hope you make the right decision my friend – keep up the great posts.

    • You make some good points, Chris.

      We’re looking at the summer of 2019 as my exit date, and that has more to do with timing of personnel and a smooth transition than anything else. Most of it will be part-time work, so it should easily be manageable.

      Opportunity costs are a good way to look at a question from a different angle. It’s mainly a time versus money question at this point. I feel very fortunate in that I can expect to have an abundance of both, as should anyone who follows the path to FIRE.

      Cheers!
      -PoF

  • The thing that I think I would regret if I retired from my current job is the interaction with people. For my job, I visit with customers each day and I work with them on the different products they are developing. I really enjoy that interaction. Much like you are doing by reducing your work schedule, I’ve looked for opportunities to reduce my workload; however, I have not been successful finding a reduced workload opportunity.

    You are positioning yourself well to be able to come back and work if you need to. Although, I think you are positioned very well to not have to come back and work. Your blog will continue to grow and provide a nice passive income stream for you.

    • There will be a lot of people I miss from work — the nurses, techs, other doctors, and of course, the patients. I think the more extroverted you are, the more difficult it can be to leave that behind.

      The site may provide some decent income and help further my charitable mission, but the way I do it, it’s far from passive!

      Best,
      -PoF

  • First off, have a great time on your trip! Poder hablar español es una habilidad súper práctica tener. 😆 You make some great points about possible regrets if you leave medicine, but it sounds like you’ve thought the decision through for so long that your rational and emotional reasons for leaving outweigh any “what-if” feelings. This was a great post! Thanks for sharing your interaction with Andy.

  • I’ve learned that living your life with regrets can take a toll on you. It’s unfortunate that Andy feels that big regret from leaving medicine too soon.

    We have to look at life as, “everything happens for a reason”. Maybe his reason is coming to the US for his schooling and hopefully staying in this beautiful country.

    It’s great that you have your backup plans if you do decide to leave medicine early/permanently. It’s seems as though you’ve found your calling though -through writing.

    After 6 years of practice, I left my pharmacist career. Not being a stay at home mom was eating away at me from the moment my son was born, six years ago. I finally took the plunge back in May and I don’t have any regrets. Did I lose six figures in income with nothing to replace it, yes. But the reward of being able to be with my three kids daily is worth more than a six figure salary.

    You’re better at that backup plan than I am. I don’t even think I’ll be renewing ACLS or continuing education. I viewed it as time I could spend on my passion projects or my family and considered not going back into pharmacy at all. But I guess I better get my CEs done just in case. 🙂

  • I can’t imagine regretting retiring early from my job as an engineer. I hope to retire in a year and a half when my expat contract is up at age 30. I can imagine the shock of giving up a steady paycheck and then beginning to live off of side income for the foreseeable future, but it is a much better alternative to working my prime years away. I am looking at getting my PE license before retiring so I could start a consulting business or come back with a contractor company later.

    If I learned anything in Boy Scouts it is this: “Be Prepared.”

    • I think having these Plan B’s in place makes it easier to take the leap, even if we never use them. When asked, I often recommend engineering as a great FIRE-friendly career. I didn’t even start my career as an anesthesiologist until I was a few months shy of my 31st birthday, and I didn’t take any time off between high school, college, medical school, or residency.

      Cheers!
      -PoF

  • Hola,

    I actually have a friend who left medicine (nursing) for similar reasons and became a nun so she could help people even more .

    Then she found out there were even more politics, restrictions, resistance to change… there and she hated it.

    After some years she quit, took those tests in order to become a registered nurse again. And she’s now back at being a nurse and enjoying and realized the grass isn’t always greener.

    But I don’t think that will happen to you though. With blogging, you are your own boss and can make your own rules.

  • The transition into retirement is tough, it’s probably even tougher if you’re in the medical field given the impact you have on a day to day basis and the tremendous amount of schooling you had to endure to get there. I retired and that was with only a commitment of 5 years of post-secondary education (B.S. & M.S.) – and even that felt like I was “throwing away” a lot of education.

    But these trips are good because, as you say, they’re mini-retirements. They give you a peek at what retirement could be like and how you feel about it. You may even enjoy the trips more because there’s a discrete end to them!

    • Thanks for your thoughts, Jim.

      I imagine the initial phase will be pure bliss, but the reality and finality of it all will set in that first time I have to sell from the taxable account just to fund our lifestyle.

      This “semi-slow” travel, or as Adam Sandler might say, travel at a medium pace, will be a good glimpse into what the future could hold.

      Cheers!
      -PoF

  • hatton1

    Another thoughtful post. I think most docs have a good bit of ego and self esteem tied up in being a doctor. It is hard to walk away even after FI. I will probably keep enough licensing to be able to write myself a prescription for antibiotics. At 60 I will not keep up with CME etc after I retire because at my age I know I will not return. I know that I will miss the social interaction with patients and hospital staff. I think you might like working part time to continue for a while. Cheers.

    • Thank you, Hatton1. There is some overlap between the considerations of someone retiring before 50 versus after 60, but the earlier retirement has some unique aspects to it. I think when you’re ready to walk away, there’s no need to second guess the plan.

      Best,
      -PoF

  • Great article! I have a lot of regrets in my life, most if not all of which revolve around my academic and career choices. I am happy with where I am now, but sometimes the “what if” question still lingers in my mind. I look at other people who are doing what I once wanted to to and wonder what it would be like if it were me.

    I think the best way to prevent regret is to have a back-up plan so that we won’t be stuck doing what we do. I am exploring new options and career opportunity in my life, so the regret is not so intense. 🙂

  • I’ve met many international medical graduates and seasoned surgeons who end up moving their families to the U.S. for a better life. Due to the need to retrain, many of them take up alternative careers.

    The first step in the process of leaving the medical field entirely is getting to the point of being able to call it quits (financially, I mean)! Kudos to that. I’m still looking to that day. Hopefully it will be sooner rather than later!

    • It’s a long road for the established physician overseas to become a US doctor, with the multiple board exams and full residency requirement regardless of training for most. Not that it’s easy for an IMG who simply completed medical school elsewhere, but at least they don’t have to repeat all their training.

      Best of luck to you in your continued FI journey.

      Cheers!
      -PoF

  • Loved this post. I am in a similar situation financially and have been working through many of the same issues, but with much less concrete action compared to you at this point.
    We have universal healthcare here which eliminates some of the frustrations that you face in the US, but it brings on others instead.
    I think for me, the clincher to keep working is a combination of two things. I want my kids to see me working in my career until they are a little older to appreciate what working in a fulfilling career looks like. The other is that we want them to have strong community roots. That precludes extensive travel in the school year. On the other hand, it may be what ultimately draws me away from practice to spend more time trying to be an actual pillar of the community by volunteering more and using my leadership outside of the hospital.

    • Great insights, LD.

      We frequently talk with our boys (now 7 & 9) about how hard I’ve worked to afford the things we have and do, and they have grown up hearing that pager go off. I have made similar statements to yours about the kids seeing me go to work, but I think being a bigger part of their lives is even more important.

      Regarding travel or community involvement, some people like to use their wings; others like to grow roots. I think we’re more wing people, whereas you sound like you’re firmly rooted. Nothing wrong with either or a combination of both.

      Cheers!
      -PoF

  • Fun2bfree

    In two weeks I will celebrate- yes, celebrate- the 4 year anniversary of my last day wearing a pager, a stethoscope, a white coat, etc. Leaving medicine after “only” 25 years certainly generated questions. But it was interesting that the questions broke down into two groups. Older physicians asked “Why?” Younger physicians asked, “How?” For me there has been no question at all that it was time. No regrets, whatsoever.
    There is no single reason I can give for my exit from medicine, though it is usually described with a single phrase, “burnout.” That is too simplified. There were a variety of personal issues outside of medicine that influenced my decision. Nevertheless, there is no question that the changing landscape in the medical field was a significant factor. My occasional lunches with old colleagues convince me that I was correct in expecting that things in medicine would only get worse.
    PoF describes vacations as a test of retirement and a gauge of whether one might feel regret. I knew it was time to leave when a day feeling too sick to be able to work felt like a welcome break. Vacations do fulfill a need to get away, but retirement is not really a “getting away.” Most successful retirees describe retiring “to” something,. I don’t necessarily think that something has to be an encore career or a side hustle, It is more about a feeling- the difference between being on the run and being free.

    • “Older physicians asked “Why?” Younger physicians asked, “How?””

      That says a lot right there.

      I’ve argued (facetiously) not to retire to something. But I certainly agree with the premise of having post-retirement plans to occupy your time.

      Best,
      -PoF

      • fun2bfree

        I actually agree 100% with your argument about not retiring “to” something. I had nothing in particular in mind to occupy my time when I walked away, nor do I think it is necessary at all.
        I did not communicate my premise clearly. I believe successful retirees are not retiring to an activity, but to an idea–the idea of freedom . Not freedom as a means to pursue some particular activity, but freedom as an end, in itself.

  • I think it’s important to recognize the ego part of the puzzle. While you don’t have to work anymore, you’re also give up the prestige of a position.

    Either way, FIRE is a much better proposition than going into another career you may or may not like.

    While my days still have their ups and downs, early retirement is much better than going into the office! And the longer I’m living this way, the less I feel like I will be able to go back. Even though it’s easier for an engineer than a doctor. I just like spending my time pursuing my passions, even if it doesn’t come with any prestige 🙂

    Hope your enjoying the part time life! Cheers!

    • I can tell you’ve been having nothin’ but a good time since pulling the FIRE trigger.

      Part-time has been good to me so far. I just might like the no-time option when it comes eventually.

      Cheers!
      -PoF

  • Great post! It has been exactly one year since I left my physician career for early retirement. Yes, I miss my colleagues and patients and even the medicine. However, so far the benefits of leaving have still far outweighed the negative for me. Just signed up for CME and will keep board certified for now but I may not next year if I still feel the same way. One thing for sure, this past year FLEW by! Good luck and don’t ever look back with regrets- you can always shape your life into something new.

    • Has it been a year already? My, how time flies.

      I’m glad to hear the pros have outweighed the cons of retiring at 37 for you. I’m thinking the pro / con analysis will favor the early retirement option for me, as well.

      Best,
      -PoF

  • SG

    Great article, I hope you do a book review in the future. I have read Dr. Fawcett’s book starting your practice right. I am 3 years out of my residency and strive for FI to give me options. My hope is to be able to practice the way I intend, and try to cut out things that I do not like doing. If I don’t need to work for money then I could hopefully be able to say no to things. I would love to cut out call, seeing disability, certain conditions of which don’t interest me. If certain insurers make it difficult to practice, I could stop taking them. I would also hope to do it only 2-3 days a week. A man can dream I guess. I feel that this way I can still avoid that regret of giving up a career in medicine early, and still get enjoyment out of it.

    • I probably will review the book. Those posts take a little more time to write, and are not as widely read, but do provide value to the reader. This book in particular is well-suited to the readers of this site.

      Best of luck on your FI journey!
      -PoF

  • Good reflections to think about. I’ve been gone from the corporate world for 5 1/2 years now, and I can safely say I have zero regrets.

    But for the first year, I had plenty of hesitation. And I strongly believe you you will as well. I entertain job offers to test my resolve, and I never could fake my enthusiasm enough to go back to work.

    With more time, you’ll also be able to grow your site more and make more money, which will alleviate some of your fears and regret. The more you travel and the bigger you grow your phone business, the less regret you will have.

    And the less you maximize your time, the more regret you will have.

    There are so many things you’ll be able to do once you retire early. Don’t let anybody say that you’ll start wandering aimlessly.

    For me, the ability for both my wife and I to raise our child from birth matters way more than any amount of money we could earn.

    Sam

    • Excellent commentary, Sam. Hesitation is a good word. I think I’ll experience some of that and perhaps some second-guessing, but I doubt those feelings will evolve into regret.

      Easing into an early retirement with this part-time transition should make it all go more smoothly. We’re currently spending 3 weeks as a family of 4 in a 2-bedroom apartment in foreign lands. I find there’s just enough time to do the things I want to do, ought to do, and need to do as a father, husband, and blogger.

      I haven’t been missing work, but I did have a strange nightmare last night about bringing a really sick patient to the OR after our blood bank had exhausted most of their supplies keeping her alive. And for some reason, the medication she needed (DDAVP) was stored in rats, and one of the rats got away. And when I finally caught it, it defecated on me.

      Can’t make this stuff up.

      Best,
      -PoF

  • PoF- awesome post…regret is a funny thing. I am all about big life changes (like moving out to California). For me it is what allows me to grow and experience new things. Still I understand the hesitancy for sure in leaving medicine.

    I am not sure what my future will hold. Work is good and much more appreciated after a natural disaster. The stability of income is huge. Also it gives me something to do outside of everything else I have to do.

    Still I think retiring and working a few weeks or months a year is the way to go (ok so not truly retired). That way you do not close the door on your medical career.

    • I can tell you’re trying to figure it all out and decide what will be best for you and your family, Triple-D. It’s probably too soon to make any determination, but I expect the right path will become clearer as you approach the time when you need to make those tough choices.

      Cheers!
      -PoF

  • Keith

    Andy is very much correct; it is all about perspective and many physicians definitely have a discrepancy between their expectations coming in and the reality of the life. Perhaps part of the problem is that people don’t give prospective physicians a true picture of what life will be like and so they see what they imagine or they get glimpses of yesteryear.

    I can speak to this with confidence as I came into medicine after having been established in a different career. I also had physician friends who I had heard their complaints. While things may not be as grand for physicians as they once were, it still has many more upsides than down.

    Regardless, your reasons for your desired retirement seem more to do with desire to spend time with your family than desire to escape medicine. That is a fundamental difference which will play into how you feel when you do hang it up. Also, you don’t have to hang it up completely. You could do part time locums as well if you wish.

  • grbkeb

    Okay, I’m 3 years in from walking away from a 7 figure job, the first thing I did after my last day was hop on a plane to Costa Rica for 3 weeks with reservations for only the first night and I just winged it…the freedom was intoxicating. Regret is something that I thought I’d probably feel, and in the beginning it is more challenging than once you ease yourself into it. Each year keeps getting progressively better as I really let go. So far this year I’ve spent a week on each of the big 4 Hawaiian islands exploring hiking & having fun, snowboarded/snowmobiled in Utah/Colorado, slowly traveled the French Riviera, went to Italy for the first time, went to Puerto Vallarta for the hell of it since it sounded fun, hiked the Tetons and explored Yellowstone, captained my own boat exploring the outer islands of the Bahamas, explored the lakes and rivers of northern Michigan, spent the entire summer on the lake surfing/boating/kayaking/general craziness, and in my free time got into the best shape of my life. Next year it is going to be tough to top the awesomeness that has been 2017, but list is already long on what I need to accomplish! No you won’t regret retiring early, you’ll miss the interaction with your contemporaries and occasionally need the challenge that your high pressure career gave you, but your blog will be a great outlet for that. Sometimes I chat with my former partners/co-workers and the competitive juices get flowing because I know I could jump right back in and make a killing…and maybe I will dip my toe back in the water a bit, but I’ll never go back to the life I had before. The marginal utility of money really comes into play once you let go of the rope and experience life on the other side. Buenos suertes!

    • I was hoping we’d hear from you!

      I’ve wondered if it might be true that the more you give up (i.e. a 7-figure salary), the more likely you are to regret it. But if you’ve got the money and the ambition to lead the life you’ve been living, I can see how regret would hardly enter the picture. Seriously, your life sounds amazing.

      Cheers!
      -PoF

  • Fascinating story, great personal reflection. Amazing how viewing things thru the eyes of others has a way of moving your mind into areas in a new light. I can’t imagine being a policeman in Pakistan. Wow.

    You’ve got a good plan to keep your options open. Move forward, and minimize regret. I love living your journey vicariously through your words. Hasta Luego, Mi Amigo!

  • Nicely put, PoF.

    The counterargument for regret is that medicine happens to be an extremely jealous mistress. For those of us less ego-driven to be physicians first and all other roles second, the reason we honestly stick with it as long as we do is because there is no comparable paycheck to transition to for most of us. Yes, there’s opportunity for meaning and satisfaction in caring for others, but this is offset by the brutal grind; the day yoga teaching or guiding whitewater rafting trips yields comparable paychecks, expect a significant exit of talent from the wards.

    I’m guessing the hours getting this site off the ground in addition to your clinical load last year were the equivalent of a job and a half, and while you certainly derive satisfaction from medicine, your success at this site gave you a brilliant taste of the other great possible versions of you that full-time medicine precludes you from being a part of.

    I’d imagine your current travels will give you another great taste of what it’s like to be present all day with your kids during this incredible window where they want to spend time with you.

    Doing something non-medical that you find you both love and develop a new competence in, spending more time with family, getting non-disrupted sleep so that you are less grumpy and more attuned during precious time with your spouse – these are all “gateway drug” experiences that reinforce just how much that jealous mistress is withholding from you on a regular basis.

    Frequent clinical (and occasional personal) experiences validating Hobbes assessment that life can be “nasty, brutish and short” offers plenty of incentive to use what measure of time you are given to realize as many versions of yourself as you can. Docs in pursuit of FI seem to have a healthy sense that their MD identity is part of a larger and richer whole: the names alone (Dads Dollars and Debt, OB Doctor Mom) imply other equally if not more meaningful sources of identity.

    I don’t think you’ll have many regrets as you grow your network of fans and friends online, enjoy the lake property with your kids, travel with your wife and figure out whatever else you were meant to do while you have the health and good fortune to pursue it.

    (Written after a night shift , when mirages are more easily mistaken for truth)

    • If that’s what your post-call prose looks like, you must be a regular Hemingway when fully rested. I’ve got to read more of your stuff.

      You’re onto something with the gateway drug thing — this is the first of three weeks away from the job and our “normal life” and I’m loving every minute of it.

      Cheers!
      -PoF

  • Liz

    As retirement approaches, now one month away, I feel a combination of wistfulness and relief. I am grateful I had the opportunity to care for my patients, some for over 30 years, as their family doctor. Relief, because I find the “quality” metrics financial penalties disheartening, along with the expectation that physicians control patients choices. I tell my patients, “to everything there is a season. I’ve loved being your doctor and will miss that, but am also excited about what this new chapter of life will bring. “

    • That’s a great quote, and I’m both happy for you and sad to hear that the changing environment has you wanting to leave. Your sentiment is a common one.

      Enjoy all that is in your future, and congratulations on your pending retirement!
      -Pof

  • Poor Anwar (that is what I’m guessing his name must have been) – that is rough – to have given up the money and the prestige of being a physician for the constant threat of being in law enforcement.

    Will I regret giving up my corporate career? Maybe. I can’t wait to find out. Being in software development makes this a far easier choice though, than it is for you. I don’t need anyone’s permission to step right back in – all I need is my computer and I can start to code. It might be harder to get back to making the kind of money I do now after a few years, especially if I choose not to code at all for those years – but I can certainly do the fun parts sans permission and probably for a decent-ish chunk of change.

    • Anwar — I’m sure you’re right.

      You’ve got a career that will offer much more flexibility in terms of working less, going back to work, freelancing, etc.. But if you don’t need the money, might as well enjoy the freedom.

      Cheers!
      -PoF

  • I think I would regret leaving the anesthesia world altogether. I can honestly say I enjoy my job… except for the nights and weekends. Once those aren’t an issue, I think I’ll find the schedule sustainable until I can’t technically practice anymore.

    I think you’ll know in the first 6 months to a year if you made the right decision to leave it altogether. I don’t think it’ll be a money issue, it’ll be whether you miss practicing medicine. At that point, you won’t be too far gone to return if you desired, but on your own terms.

    • CM

      “…it’ll be whether you miss practicing medicine…”

      I am very confident that he won’t miss practicing medicine. When Post Traumatic Beeper Syndrome finally fades away, he’ll experience a peaceful feeling he hasn’t known in years.

    • I enjoy my job, too, except for the nights, weekends, evenings, and busy days. 😉 Truthfully, there is a lot to like about the work we do, but given the option of working versus doing whatever my heart desires, I’ll choose the latter.

      I don’t think I’ll miss it or regret leaving, but I may feel a tinge of guilt. There was a good discussion on the WCI forum about shift workers being more FIRE prone as compared to primary care colleagues who have bonded with their patients.

      Cheers!
      -PoF

  • Ann

    If I retired today, I would regret it for sure–I still have fun at work more time than not, and really enjoy seeing patients, especially when my skill set matches with their needs. But would I also regret it at the end of my life if I never made it to Tierra del Fuego, never spent an entire year in Iceland, never spent the summer goofing off with my nephews and nieces? Most likely. These are not bad options to have, and are probably not as mutually exclusive as I have told myself they are. Enjoy wherever you are, and try to truly immerse–you pick up so much more when you don’t cheat and speak English with your family, even though it’s difficult at first. I know from experience as someone who has cheated through many “immersion” experiences, and my Spanish fluency has definitely suffered from it.

    • Muy bien, Ann!

      We are enjoying our classes, but are not at a ponint where we can communicate as a family. It will come eventually.

      Having been to Iceland three times in 15 years, I can say with certainty that a year in Iceland would be both truly amazing and outrageously expensive. I could see us spending more than a few days at a time there, though, which is all we’ve done thus far.

      Cheers!
      -PoF
      -PoF

      • Ann

        My husband and I spent about 2 weeks in Iceland a few years ago, and yes, it is expensive, particularly in terms of food, but staying at rental rooms in people’s homes as well as doing some of our own cooking helped mitigate the costs. I think a year there would be feasible for us financially at some point, but I’m doubtful that I could get my husband to stay there with me through the winter! But it certainly would be an experience. I absolutely love the people and the culture there (as well as the swimming pools and the hiking).

  • I can tell you that I will not regret it one bit. I have plenty of things that will occupy my day, and even have plenty of things that interest me that I have the relationships with other folks. I don’t have the identity issues that docs tend to have. I can see that.

    Plus it helps that the Mrs loves her work, and I love helping her out. It’s hard to imagine our life with out that in it. That might change, but the option is what we are interested in. At this point, she’s going to be doing it, paid or otherwise.

    Great to hear your reflection and thoughts. I’m sure it will work out fine… just remember, the absolute worst thing that could possibly happen is your life as it is today… and that’s really not all that bad.

  • PoF, thanks for the interesting new prospective of my book. I had reservations about how I would do when I pulled the trigger and retired from medicine. Six months after I did I wrote
    a blog on my thoughts titled, What I Learned in the First Six Months of Retirement. I was apprehensive about how I would do when I was no longer a surgeon. Turns out, I did just fine. I believe the key was that I had a new purpose to go to. I didn’t just leave to play golf. I didn’t retire, I repurposed. My hope is that every doctor who is thinking about leaving medicine will read this book before they pull the trigger. We are so much more than a doctor.

  • Nice thought-provoking post! Retiring does seem like a very daunting task especially since it not only took so much hard work to earn a degree in the medical field, but also to advance a career in the field.

    I hope to retire within 10 years, and as others have commented, I feel I will have no trouble finding fulfilling hobbies/side hustles to occupy the 40 hour/week void.

    Best of luck with your exit in 2019. My wife and I will have enough “f you” money towards the end of 2019 to take a 6 month vacation in Europe/Asia. Happy blogging!

  • Pipsquack

    The main reason I am looking to leave medicine is that the malpractice environment is getting out of control. You can be named in a case simply for having your name in a chart. I’m tired of busting my ass and being a sitting duck for money hungry patients and unscrupulous lawyers.

  • Gasem

    I read a lot of FIRE blogs and FIRE forums. One thing I notice is people seem to be reacting to being an employee (working for the man) as much as being employed. Read through this thread and it’s loaded with vague and unknown “alternative jobs but not a lot of “I quit”. I think this is something to consider in understanding FIRE. Nothing wrong with gigging for yourself as long as you understand it’s part of a developed plan beyond something vague.

    In my life I had a lot of jobs. I started as a paperboy at 11, drove a truck, worked in a gas station, drove a wrecker, balled a jackhammer in a stone quarry, Janitor, Delivered pizza, played in a country rock band, became a researcher in neurophysiology, worked as an electrical engineer, went to med school, became a cardiac anesthesiologist, went into the Navy, did locums, started 2 anesthesia practices (in other words became a business man with employees to feed). I’m presently back to electrical engineering working on a fascinating communications technology with a company down in Austin. 10 years ago I started a blog and and a youtube channel both of which made some money but were too much of a task manager. I put on the bottom of my card “ask about our fried chicken” I never had a day where I wasn’t into my life because there is a ton to do and know and enjoy.

    When I left medicine I left the security of the big payday for sure, but I needed my time back. We sold the practice to a management company so the center we were working at would have continuity and coverage and I worked on as an employee for another three years, but I hated corporate medicine. WAY TOO MUCH BS, but I had done right by the people I worked with by leaving on terms where their jobs were assured .

    I don’t miss it a bit. I love many of the people I left but I’m not part of that scene anymore. I’m part of this scene. I see a lot of FIRE as marketing a narrative, and the hesitation as people in their “gut” understanding that at some level it’s a marketed narrative. You read the non Doctor forums and it’s all about 4% or 4.5% WR 20-25x saved taking SS at 62 and hoping to God it all works out. They FIREcalc their butts off all day long but ignore the “past performance….” caveat.

    Doctor forums seem to be about 3% or 3.5% 33x, SS at 70, some side gig in the mean time or real estate crowdfunding (which looks to me like some kind of “timeshare” variant with a concomitant “timeshare” risk profile). Not a fan of K-1 income. If you actually own property and manage it that’s a different issue. I think the the 3 and 33 model with a well understood budget and inflation protection is much more sustainable but still may not cut a 50 year horizon.

    I guess the reality is to have a well reasoned plan not based on internet narrative and contingencies, have a solid rational sustainable budget, not a budget based on tightening if it hits the fan. have more money than you can spend, pull the trigger and have a gas. For that I employed a professional money and risk manager and strategist. My retirement income is staged according to predicted epochs in my life, like “early” “SS begins” “RMD” etc and the tax consequence of each epoch is also understood as much as possible, I’m not betting on “GOMER” over on bogleheads to give me the 411.

    My experience after retiring is I am totally satisfied with my work career. Now it’s time to manage my time. It was like taking the off ramp on 100mph I-95 and slowing down to 30. 30 not 40 I caught up on sleep, my blood pressure went down, my stress level bottomed out. I work out twice a day and actually look forward to it, It’s a really good feeling. To prepare I talked to a lot of retired people. People living the life are not about narrative, they are about living. I wouldn’t go back on a bet. My anesthesia partner of 25 years retired 8 months before I did, but he went back 1099 style because he’s trying to wait till 70 to SS. I have enough money so the only thing I would get from going back is increased risk (malpractice etc.). I think that’s a pretty good criteria to know when, “when” is. Get to the point when your risk is greater than your reward and then reclaim your time.

    If it doesn’t work out there is always Ramen and French toast 🙂

    • Don't know mind

      PoF, great site and thought provoking.
      I do tend to Gasem’s POV. Great points Gasem. I don’t buy into the 3 or 4% narrative either.
      I have about 50x and my perception is that I am the biggest risk in any plan. I have made mistakes in the past and sold assets in bear markets and may well do so again. Well hopefully not, but there must be leeway for making major mistakes. The main reason I keep an employment option is so that I am less likely to puke up risk assets into a bear market. It is a nice cushion to have. Yes it is entirely psychological but that is how my brain works. I currently work 3.5 days a week for myself. This could be 3 or 2 days a week in the next few years, but I will keep the employment option until I have weathered another market cycle. I have a 3M house, no mortgage and 8M in net assets outside the house in non retirement accounts and 1M in retirement accounts. I am 43. I am still really scared I will puke up during the next bear market. Yes, I am going to be the guy puking into the wastepaper basket when they have to do 10 X QE next time. I started investing in stocks and real estate when I was 20. I bought internet stocks from a pay phone at hospital when I was in final year medicine. The internet bubble, those were the days. And I am still that dumb and prone to stuffing up, so that is why I keep a job option. Is that living in fear, yes it is, because I think I correctly fear how dumb I will behave under pressure based on previous past experience.
      As a side note, some people feel this can be solved by knowledge. My problem has never been lack of knowledge and I suspect most people who make mistakes will also not do this due to lack of knowledge. It is a visceral experiential based fear phenomena. I have a theory that bear markets will shake at least 50% of investors out of their positions. They almost need to do this to reach a bottom. So 50% of your readers will know this and still be shaken out. Even if they have a plan to stay the course something will happen to stuff this up.
      You may say, I didn’t hash up the last cycle, so why should it happen this time? Who knows, maybe your position will be larger. Maybe you will feel it more when you are down 800k instead of 80k. Maybe you get sick, a pet dies, something gets to you and you make a mistake.

      • My, you have done well.

        You are absolutely correct in that we can be our own worst enemies. I had some money invested in 2000, but not much. A bit more in 2008, but it was barely six figures. So although I’ve weathered a couple bad storms, I didn’t lose a million dollars on paper like I would if a similar downturn were to happen in the future.

        Oversaving and hanging onto a job you enjoy are two great ways to protect yourself. And a little fear can be healthy. Too much fear can become burdensome. Best of luck in maintaining a happy medium.

        Cheers!
        -PoF

        • Don't know mind

          Good point, I am very fear based.
          With every bear market I’ve found the same doubts come up:
          1. Has the market changed ?
          2. Maybe this time is different ?
          And maybe next time will be different ! Who knows with the amount of QE they will have to do next time, there will probably be headlines about a broken system.
          These doubts are not a bother when your position is small but when you have a large position, it will be louder proportional to how much your drawdown is.

          I think it would be stressful if you have a 30-40% drawdown and you didn’t have a job to fall back on. And that might change how you react to that pressured situation.

          Perhaps you could keep working and use the income from that year to buy some glorious junk that will be left for dead towards the end of the bear market.

          90% stock allocation is going to feel it though.

          Make sure you can get some cash to buy the asymmetric risk situations that will emerge. Those are the highest probability pitches – buy relentlessly liquidated junk that has been absolutely pulverised. You might be able to pick up tesla for $1. The rally off the lows of bear markets is a sight to behold and the bounce from compacted junk – amazing and a nice quick ten bagger. Unless the bear market continues for another year in which case the junk might go to zero. But the asymmetric risk on those investments have a great return : risk 100% loss, reward 1000%.

          To stress test your situation, I would take the worst thing you would expect to be likely in terms of drawdown – ie 2009 and double that and apply it to your portfolilio. It may not double the worst expected drawdown but once you reach 1X it will feel like it was double or on the way to that.

          Do you believe sufficiently in index investing and efficient market hypothesis that you are certain you would not switch under any circumstance. I don’t think I have enough faith in it to pull that off.

  • Mrs FTF ditched work late in 2016. By mid 2017 she was back at it part time. It’s not a money thing either. My wife said privately to me, and something not told to clients, that she didn’t care what they were going to pay she just needed something. Something to drive her each day, something to feel her engineering degree wasn’t a waste, something to feel like she contributes to society. It’s now a different part time outlet, but she needed something.

    • Good for her. My wife transitioned from a volunteer at our boys’ school to an occasional substitute teacher. Once both boys were in school, she had a lot less going on at home, and she found a way to be closer to them.

      Cheers!
      -PoF

    • When I left residency and started my practice,we moved to a new state. My wife gave up her corporate accounting work and became a stay home mom. At first she didn’t know what to do with herself and felt unproductive. Changing diapers, fixing dinner and doing laundry never felt like an accomplishment to her and her accounting skills. She took a spot as the finance person for the local MOPS (Mothers of Preschoolers) group and was taking $3 at the door for the meetings and having to account for the money. This very small task was enough to give her a sense of accomplishment. She then began adding other volunteer jobs where she could help with the accounting so she could continue that sense of accomplishment. She never went back to a paying job, but she did have a separation anxiety when she first stop “working.” The story in my book where my partner asked me “what are you going to retire to?” saved me from going through that same period of feeling a lack of purpose when I quit medicine. It is important for us to feel we have a purpose in life.

  • Great post, very thought provoking. I love the ‘likelihood of regret scale’ and I think that finding the sweet spot on that is something everyone will wrestle with in their life, early retirees and normal ones too.

    I just went semi-retired to part time and although I’m not a doctor, the ego point you discussed of course transcends to other professions. I’m finding I had a little more ego that I though I did tied up in my knowledge and rank at my job. People at work now treat me differently since they know I’m not serious about my career, and it is one of the downsides of my semi-retirement.

    But hey, I’m not at work today 🙂

  • CM

    As long as money is not an issue, you won’t regret retirement for one minute. Trust me, I’m a doctor.

    (Imagine you won $100 million in the PowerBall lottery. Is there any chance you would ever carry a beeper again?)

    Money was a bit of an issue for me when I left in 2001, but I still didn’t regret retirement–because I was beyond burned out.

    Leaving medicine did not affect my ego, but when I fell ill I did wish that I was still on the inside with local connections in the hospital. That is a perq that I missed, but not until I was a patient.

    Now that I’m back and reacquainted with this fire hose of income, I plan to stay long enough to secure a comfortable future for my wife for her 14-15 years of life (according to actuaries) after I’m gone. I already have plenty for single me.

    And…No one believes this (apparently), but you can leave for 13 years, then score in the top decile on your board re-certification exam, and return to practice without missing a beat. Easy Peasy. (Well, not that easy, but you can do it.)

    • $100 Million and I’d wind things down pretty quickly. I’d like to bow out gracefully, but the almost-2 year plan would be cut short.

      The tables would have my wife living an extra 13-14 years after I’m gone, but based on family history and my general good fortune, she doesn’t see that happening. But I’ll make sure she’ll be in good shape regardless.

      On a less morbid note, what you did to come back to a cardiology career is impressive. I have a feeling it’s going to become more and more difficult to pull it off. Every year, there seems to be more requirements put on us just to be allowed to continue practicing. Coming back after an extended absence might not be worth the hassle for most.

      Best,
      -PoF

  • EnjoyIt

    POF,
    Nice article. I am very curious how your part time work is going. Has it revitalized your joy in practicing medicine or has it reinforced your desire to quit completely?

    I think for many who reach or come close to FI there is an inherent fear of pulling the trigger and quitting. The fear of losing that huge paycheck every month, the fear of not having enough, the fear of losing the inside track at a hospital if you or your family gets sick, the fear of regret, the fear of being wrong and having a hard time getting back in, the fear of the next recession, the fear of teaching your kids the wrong example, the fear of the unknown, the fear of . . . . I think I can write another thousand words just listing fears.

    • Fear is the driving force behind the various reasons I plan to work longer than is probably necessary. How is it going so far? It’s too soon to tell how it will play out in the long run, but the freedom of having three-plus weeks off at a time hasn’t made me desire even more freedom any less!

      The work weeks are what they are — an exceptionally busy time with the usual ups and downs. I can’t say I look forward to them or dread them, either, but I do like the fact that I continue to have health insurance, a steady paycheck, and other benefits.

      Best,
      -PoF

      • EnjoyIt

        Fear is a very legitimate concern of mine as well. I plan to follow in your footsteps of part time, ideally within the next 14 months or so. I started a post on bogleheads to discuss the fear a little. Although maybe poorly titled I showed some potential math for a very bad scenario on a 4% withdrawal rate.

        Either way, the fear is real and I have it also. If I go part time it will cut my income by more than half due to full time incentives that completely go away. Therefor it is a really big decision. Plus I fear of going part time and then the next recession hits shortly after and I will not have the extra income to shove into index funds while the market is down.

  • I don’t like thinking about regret as much as I like to focus on “Did I make the best decision I could with the information I had at the time?”

    It’s kind of like playing poker. I may not always win the hand, but did I make the right move with the information I had and the statistical chances I knew were in front of me?

    I know that there are also real things that might make a physician regret staying, too (micromanagement from above, medical malpractice suit, etc).

    Very thought provoking post, though I’d encourage you to make the best decision you can with the information you’ve got!

Leave a Reply

Your email address will not be published. Required fields are marked *