Switching Medical Specialties Mid-Career

May 11, 2020
By Jason Chiu MD

With the high burnout rate for physicians, it’s common for many physicians to have questioned their career choice. As a mid-career physician perhaps you’re a bit burned out, but not looking to quit medicine yet. Maybe you’re looking to change gears and do something different. You’ve probably lurked in internet chat forums and read blog posts of physicians who did a second residency and started over. Perhaps you have financial and/or family obligations that keep you from making that kind of transition.

However, you may want to consider fellowship as a way to change specialties without the longer commitments or financial strains of a residency. I’ve listed fellowships that are open to any ABMS specialty certification and most only require 1 year to complete. The added benefit is that any of these paths can lead to an additional ABMS board certification:

Addiction Medicine (ABPM):

This specialty deals with the disease management of addiction, and health conditions seen in substance abuse. Physicians in this subspecialty may work in inpatient and outpatient addiction treatment facilities, or have an addiction to medicine private practice.

Clinical informatics (ABPM, 2-year program):

Clinical informatics specialists shape health care practices by harnessing data and technology to improve workflow, optimize clinical processes and decision-making, to positively affect patient outcomes. Clinical information specialists often work in a hospital or managed care settings, or may find themselves as part of a health technology startup.

Emergency Medical Services (ABEM):

This specialty focuses on prehospital emergency patient stabilization, treatment, and transport to hospitals in specially equipped ambulances or aircraft. Graduates in this field may work at the Federal, state, or local government level, providing expertise in tactical medicine, disaster and wilderness medicine, evacuation medicine, or managing an EMS call center.

Hospice/Palliative Medicine (multiple):

Palliative care physicians focus on quality of life improvement for patients by managing pain and symptoms associated with serious illness. Palliative care is often offered in conjunction with other medical treatments. Hospice care is provided to patients in their last year of life. Hospitals typically employ palliative medicine physicians and opportunities exist for home hospice care.

Medical Toxicology (ABEM, ABPM):

These physicians specialize in the prevention, evaluation, and management of injury and illness from exposures to drugs and chemicals, as well as biological and radioactive agents. Medical toxicologists typically work in public/preventive health settings, and maybe directors at poison control centers.

Spinal Cord Injury (ABPMR):

Spinal cord injury (SCI) medicine specializes in the management of traumatic and non-traumatic causes of spinal cord dysfunction. Specialists in this field work in hospitals and rehabilitation centers.

Undersea and Hyperbaric Medicine (ABEM, ABPM):

This specialty deals with the prevention and management of injury and illness due to environmental exposure to high ambient pressures as seen in diving. Common scope of practice includes environmental, occupational, safety, and clinical aspects of diving, hyperbaric chamber operations, and hyperbaric oxygen therapy. Doctors in this specialty may find work in research facilities, ocean-going vessels, oil rigs, construction sites, and hyperbaric oxygen clinics.

Some program websites may state-specific ABMS primary certification requirements (EM specialties like EMS and toxicology may prefer EM grads because they can moonlight in the ER) but my recommendation is to communicate with the program directly. Most of the time these programs are open to any ABMS primary specialty.

Changing careers is not a decision to be made lightly and you’ve got to do your own cost-benefit analysis before committing to a new path. However, a mid-career re-fit might be right for you in dealing with burnout and may reignite your passion to practice medicine.

ABEM: American Board of Emergency Medicine
ABPM: American Board of Preventive Medicine
ABPMR: American Board of Physical Medicine and Rehabilitation

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