Dmitri Nepogodiev: A thread about switching from surgery to another specialty

Dmitri Nepogodiev, NIHR Academic Clinical Lecturer in Public Health at University of Birmingham, shared on X/Twitter:

“A thread about switching from surgery to another specialty.

When I switched from surgery in 2017 this was relatively unusual but I hear about lots of people considering it now, so thought to share my reflection.

1. There is no shame in changing career
2. Changing career is a risk
3. Changing career will likely be a temporary downward shift
4. Once you’ve decided, don’t delay change
5. Changing career is hard
6. Lean on your supporters

1st (and most important) point: there is no shame in changing specialty/career. It isn’t ‘failure’. Making a change should be a positive move – taking the clinical experience and generic skills you’ve gained in surgery into another field which is a better fit for you personally.

The reality is that until you’ve done a particular job for a while you won’t know for certain whether it is for you. Also, our interests, priorities, and circumstances can change. It isn’t necessarily anyone’s “fault” when things don’t work out the way you initially expected.

2nd point: a change is a risk you have to accept There is unlikely to be any guarantee that you will be happier in career B than you are in surgery. No job, no career is perfect. There is always a trade-off (salary, working hours, working hours, vocation, prestige, challenges).

Work out what it is in surgery that is pushing you to change. Research career B carefully – what are it’s +ve and -ve points? Then make a judgement: is the trade-off in career B likely to be a better fit for you? Remember, everyone’s trade-off is different.

3rd point: a change will nearly always require a temporary downwards shift. Most new careers you will have to start from (close to) square 1. That may mean a shift down in seniority and responsibility and/or drop in salary. Within medicine it prob means extending training.

So it is important to keep in mind that a career change is a medium- to long-term project, not a quick fix. Year 1 in career B is likely to have plenty of challenges. It may be some time before you feel you’ve made the right choice.

4th point: once you decide to make a change, don’t delay People may advise you to complete core training/ get to STX or to pass exams. The reality is that outside surgery these things carry little currency and their marginal benefit is not worthwhile if it makes you unhappy.

Lining everything up to change career and secure a (training) job elsewhere is likely to take some time, so once you’ve made a firm decision to change start planning your transition.

5th point: making a change is hard. You may only really appreciate the benefits of a training post when you decide jump off. You are going from a fairly secure career structure into the unknown. Some people will either try to dissuade you or ridicule you.

If you’re considering a career change you’re likely to be (very) unhappy. There may be other things going on in your life. It’s difficult but you have to keep focused on developing a positive medium- to long-term plan.

6th point: lean heavily on the support of mentors, friends, family. Most people will be fairly indifferent to what you are going through. But a successful transition will be greatly boosted by the kindness, support, and advice of a few key people. Hold on to those people!

Context: I graduated 2012 and started CST in 2014. After about 18 months I was sure I wanted to change career. I resigned run-through NTN and started PhD. In fina year of PhD I applied for public health training. I was luck to be able to start PH in 2020.

For anyone seriously considering a career change from surgery, I’m always happy to share my experience so feel free to get in touch.”

Source: Dmitri Nepogodiev/X