Leaving Medicine

I am pretty certain I want to leave medicine and go into a related but different area, like biotech or pharmaceuticals. I am looking for advice and guidance, particularly if people have worked in those sectors and have ideas for where to start out!

I've finished 4/5th of med school, I'm intercalating in a masters of therapeutics at the moment. The academic clinical route is interesting to me, but I would like to have the training flexibility to work in other countries and not sign on for such a long time to reach CCT, to have more time for family, to be paid something comparable to my friends outside of medicine, to actually feel valued and supported, and to still have my work advance patient care.

Hello again! Already seen you on another thread.

I’d just like to suggest GP to you. I’m hoping to pursue GP in the future because I want a lot of the same things from a specialty that you do. Work-life balance, training in other countries, comparable salary (in fact it’s very well paid IMO), short training pathway, advancing patient care etc. GP ticks all these boxes and still offers enough flexibility for you to be able to explore other career options on the side.

As I mentioned on the other thread, practical experience is key whatever sector you want to go into. In 3 short years you could have that sorted out as well as being a fully qualified specialist. Pharmaceutical jobs look highly on practising doctors, especially consultants/GP’s. It sounds to me like you still enjoy Medicine and are committed to it but maybe you haven’t found the perfect specialty to train in. I don’t know how much thought you’ve put into leaving Medicine but I would suggest you apply for an internship in Pharmaceuticals. Use this to find out how you would strike a balance between this and clinical practise, if that’s what you want to do. Alternatively you could do FY1&2 and then just locum while you apply for pharma jobs. I’m sure locum positions still count towards experience even if you don’t choose a specialty to train in.

Hi again! Thanks for messaging

I have an internship in a pharma company in a few months, as part of my mphil, for exactly the reason you say, informing whether it is more rewarding than clinical practice. I spent my elective in clinical pharmacology, and to my surprise, I found the non-clinical things most exciting (research, collaborations with companies and unis etc), and the pharmaceutical physicians seemed to have fantastic careers! My current plan would be to leave after FY1 or 2, the reason I'd want to leave so fast is to join my partner in China, which is another reason I am looking for jobs outside of medicine, to allow me to work in different countries. The couple of pharma physicians I talked to said joining around FY2 is certainly possible, they did suggest trying to get MRCP done if possible though.

One thing I'd like to know much more about is the number of different areas doctors can enter pharmaceuticals into, beyond a pharma physician role -- I imagine the most scientific roles require a PhD, but I see managers of groups or whole companies who only ever took a BSc!

GP is worth considering, I suppose I had discounted it a while ago because I want to specialise in an area, something that lets me be researching at the forefront of that area. However, like you say it does achieve many of my general complaints about hospital medicine! My reservation would still be how general it is, how it makes pushing forward an area of medicine much more difficult, I think my desire for this is something that is not too likely to change (but ofcourse it could do).

That’s good you’ve already taken steps forward by securing an internship! And I think the pharma physicians have given you good advice. Professional qualifications such as MRCP or MRCGP in addition to experience would put you in a good position for pharmaceutical jobs. I personally am not a fan of research so that’s not something I would want to take up. But doing a job that allows you to collaborate with other companies and give speeches at universities does sound appealing. It’s good you’ve taken advantage of intercalating in a Masters as well. For someone like myself it’s not really an option to intercalate but like I say there are several possible routes you could take to transition from Medicine into another job that maybe ticks more boxes for you.

I have a feeling the people you know in management positions with a BSc probably committed many years to working their way up in the company and applied at a time when it was less competitive. I imagine the requirements for entry level jobs or higher up will get more sophisticated every year with competition, and that’s true of most financial sector jobs too. This is why I think it’s important to keep up your skills in clinical practise while you transition, in case your plans don’t work out. I personally have chosen to follow GP because I can’t see myself working irregular hours and antisocial shifts in hospital medicine. Having skills as a generalist applies quite well to consultancy as most firms will give you experience in a range of sectors. But keeping that foundation in practising Medicine is important IMO, whether it’s as a locum or on a training pathway. Have you thought about clinical pharmacology specialty as a doctor? That would probably put you in an even better position for pharmaceutical jobs. Re. travelling, you might not get a choice of countries you have to travel to and it’s possible you won’t be based in China for as much time as you would like. Are there any particular companies based on China that you’re looking to join?

Why don't/didn't you fancy intercalating?

That makes sense with people joining earlier, although it reinforces what I've often been told that the key way for rising up in many jobs is experience in the job once you're through the door. Although pharma is keen for its' doctors to keep practising, and they do pay all the fees to enable you to do it. I was thinking of clin pharm but then when I saw more of it, it was lots of general internal medicine training for people who mostly wanted to do things at the end that were 98% non-clinical -- it seems like a lot of training (inc PhD often) for a very different job! Pharmaceutical medicine is faster, but zero patient contact, and it seems like it sets up a glass ceiling, which may not be present if trying to rise up in a non-medical section of pharma? So at this point I am trying to explore non-medical options, maybe things where people from pharmacy, chemistry or management backgrounds etc would be applying for -- I'd like to know more about what these may be?
The pharma people I was talking to thought work in China would perhaps be best from getting a secondment from a UK base, so I will get my internship with one of the local companies like gsk, astra zeneca, mundi pharma, takeda etc and ask as much about the practicalities of this as possible. Otherwise there are Contract Research Organisations or Biotech, but I want to find out more about those as I don't currently know enough at all! Any pointers for CRO/biotech?

I see what you mean. It’s not worth training in clinical pharmacology for 5+ years if you’re hoping not to do majority clinical work afterwards. I like the fact that pharma companies would support you to continue practising Medicine if you wish. There is definitely a ceiling in the NHS with pay caps everywhere and a lot of public scrutiny on doctors’ earnings. But my impression is that there is no ceiling (or at least a much higher one) in the private sector, and this is why I would encourage all medics to explore options with the private sector. If you go into non-medical pharmaceuticals I imagine you would be much better supported to earn a higher income from all your interests instead of being forced to declare your earnings to the GMC or whoever. Something like this could potentially become compulsory for all NHS doctors in the future. GP practices already have to declare the average salary they pay to their doctors. Obviously the salary you would be paid in pharmaceuticals depends on the field, the company and the level you work at. However, all the other benefits such as health insurance, gym memberships, exam fees etc are quite appealing and a mainstay in private sector jobs but unheard of in the NHS.

I don’t know a lot about biotech but have heard from other people going down that route. I have a friend who graduated in Biomedical Science then did 2 Masters degrees. First in Cancer Biology, next in Bio-Business/Technology. He spent a long time working with a start-up in biotech but around 18 months into a project, the whole thing fell apart and everyone else on his team jumped ship. They also lost funding from their investors who I’m guessing had lost confidence in the product. As you can imagine, that was really frustrating for him and he spent a while picking himself up afterwards. He’s only recently got another job but not in biotech - it’s something else tech related but quite far removed from what he was doing before. He’s admitted that he knew a lot about current tech and observed it in practise but didn’t have a lot of knowledge about how to create and develop his own product, hence why he joined a team. But IMO the best chance of success you will have is with something of your own creation.

Innovation in technology is not well supported in the NHS and the uptake of new methods is VERY slow. So if you’re hoping to use your work in biotech to implement new technology in the NHS, be prepared to meet a lot of resistance and bureaucracy. If you go down the biotech route I would suggest you try and do it full-time because it takes a lot of dedication. From listening to my friend’s experiences, my impression is that it’s less difficult to succeed when you’re pitching your own product to an established company, rather than working with other people from a range of backgrounds who may or may not know what they’re doing. I think my friend got really unlucky with the people he was working with. If you take control of your own product you can grow it from the ground up and have more say in how the money is spent, whether you choose to spend it on employees or put it back into growing the product. You also have to spend time and effort developing and testing, pitching to investors etc. Whereas if you join a start-up you could potentially be unpaid until the company turns a profit. I think my friend spent the whole 18 months unpaid and then got nothing out of it at the end. There’s a lot of risk involved whichever route you take. Biotech is an emerging field right now which means all the start-ups are in their infancy and the people behind them may not have a lot of business experience. Something for you to consider - if you want to succeed in biotech you will have to spend time developing business skills, which are a complete ly new concept to lots of medics. Product development and pitching to investors is a lot of trial and error but having that valuable skill set will make the process much easier. For something like this I would recommend doing an MBA. My friend considered this but it was too expensive for him at the time.

I also know two guys who graduated from medical school but never started FY. Instead they chose to go down the entrepreneurial route and become full-time developers of an app they created at medical school. It lets the user create and share MCQ’s in a range of subjects for revision at university level. They spent more time developing this app, finding investors and picking up awards than studying. They were in university newspapers back then but I’ve lost touch with them now and I never heard anything about them or the app again so I imagine they aren’t turning over much profit. Things like this take a lot of time and careful management before they can make money, but if they do, you can potentially see the income grow exponentially. It’s got to be able to stand on its own in a competitive market. I think the problem these guys had is that there are just too many other (more established) apps out there offering the same thing. Hence why it’s necessary to have clinical practise as a springboard. Finding flexibility in the right specialty pathway or doing locum work while you develop your product on the side until you’re in a position to take it full time and start earning from it. This seems like a good approach to me.

Thanks again!

The pay scrutiny is interesting, I had no idea that was increasing. The pharma physicians said the same sort of thing with pay etc, their base salary was pretty similar to NHS, but bonuses would double it or something and all the other benefits (including good HR!) meant they actually felt valued for their work.

The entrepreneurship route is fascinating, but pretty scary! From stories like you've talked about I would be very uncomfortable putting my hopes in a startup without other work. Some mphil coursemates and I want to give a startup a go, so I'm hoping we can go through the process and learn from it alongside the studying I'm looking forward to a couple of modules of this course that teach business and entrepreneurship skills in biotech/pharma, I think it'll all be new to me! An interesting option one of my coursemates wants to pursue is healthcare venture capitalism, so they can then be involved in lots of startups without having the personal risk -- plus can be incredibly lucrative.

The slow movement of NHS techs and biotech in general is quite a turnoff, it makes something where you can work on them, but not be dependent on a single risk, more appealing -- things like venture capitalism, or working in bigger private companies that may acquire and merge them, or even academics who can spin-off companies while having their university employment (but the latter is a very long route involving PhDs, so as good as it can sound I'm apprehensive about spending any more time at university!).

I think I see what you mean about starting speciality training. My aversion is wanting to have more of a sense of freedom and flexibility in working abroad etc when in my mid-twenties, rather than committing to another significant stint of training (I don't want to know I will be stuck to a training post when a good opportunity somewhere else comes up, or I need to move to be closer to family, or to live with my partner somewhere else). I feel like in many private sector jobs this rigidity is nowhere near as apparent, do you think this is accurate or a misperception?

Thanks again!

The pay scrutiny is interesting, I had no idea that was increasing. The pharma physicians said the same sort of thing with pay etc, their base salary was pretty similar to NHS, but bonuses would double it or something and all the other benefits (including good HR!) meant they actually felt valued for their work.

The entrepreneurship route is fascinating, but pretty scary! From stories like you've talked about I would be very uncomfortable putting my hopes in a startup without other work. Some mphil coursemates and I want to give a startup a go, so I'm hoping we can go through the process and learn from it alongside the studying I'm looking forward to a couple of modules of this course that teach business and entrepreneurship skills in biotech/pharma, I think it'll all be new to me! An interesting option one of my coursemates wants to pursue is healthcare venture capitalism, so they can then be involved in lots of startups without having the personal risk -- plus can be incredibly lucrative.

The slow movement of NHS techs and biotech in general is quite a turnoff, it makes something where you can work on them, but not be dependent on a single risk, more appealing -- things like venture capitalism, or working in bigger private companies that may acquire and merge them, or even academics who can spin-off companies while having their university employment (but the latter is a very long route involving PhDs, so as good as it can sound I'm apprehensive about spending any more time at university!).

I think I see what you mean about starting speciality training. My aversion is wanting to have more of a sense of freedom and flexibility in working abroad etc when in my mid-twenties, rather than committing to another significant stint of training (I don't want to know I will be stuck to a training post when a good opportunity somewhere else comes up, or I need to move to be closer to family, or to live with my partner somewhere else). I feel like in many private sector jobs this rigidity is nowhere near as apparent, do you think this is accurate or a misperception?

Honestly


Honestly don't do training if you don't like medicine. It's literally just a waste of time. So many older doctors tell me they regretted staying out of fear. Medicine is not the only career in the world. If you're hard working enough to have gotten into medicine you can clearly work hard and succeed in a career that's more complementary to your aims. I haven't enjoyed medicine since first year and now I'm doing F1, guess what? It still sucks. I'll be leaving finally at the end of this year with no regrets.

No worries. I’ve enjoyed having these discussions on this thread and in the IB/Consultancy and Business & Management forums. Check those out too!

I can definitely see the scrutiny of public sector pay in the NHS increasing in the coming years. It’s beneficial for the public to see where their tax money is being spent, but it’s detrimental to the work of doctors who are being forced into a position where they have to justify themselves being paid every penny. I think that’s wrong. Not only do doctors deserve to be paid every penny but they deserve even better pay than they already get and shouldn’t have to fight for it tooth and nail. HR being a pain everywhere only adds to the problem with contract ambiguities, payroll errors and doctors being underpaid, having to chase money they are owed etc. But it’s all part of the government drive to tighten purse strings on the NHS and watch closely where the money is being spent. There is wastage everywhere and managers routinely being paid 6 figure salaries for a few months of work. But doctors make easy targets, having been undersold and sold out by the BMA time and again. The profession itself is divided along many lines which means doctors will have less and less control over their pay in the coming years. The fact that we may be approaching new legislation on doctors’ pay becoming public knowledge tells us a lot about how things will be changing.

Start-ups are definitely high risk whatever sector you set up in, but some of them do work and are known to be quite lucrative. Like I say, good business skills are crucial here in addition to experience of the healthcare sector. Your mention of healthcare venture capitalism sounds very interesting! It makes sense to minimise risk by spreading the investment across different start-ups. It sounds simple but never occurred to me earlier, haha. I’ve learned along the journey that a reliable way of supplementing income is to make smart investments whether it’s in property, businesses etc. Your course mate who wants to pursue this has got the right idea! I would suggest a few of you band together and invest in something as a group. Like you say, you’re thinking of trying it so I say go for it! That brings me back to staying in clinical practise though. Any money you earn from working as a doctor, you can invest and make some returns on. Without an income it would be much harder to do that. And the best way to ensuring you have regular cash flow is to create multiple sources of income. If you practise Medicine part time, work in pharma the rest of the week and put some time aside to handle your investments, you’ll be sorted. I have a similar approach in mind for myself.

I would avoid going into an academic clinical career because it doesn’t have flexibility. Even if you’re permanently employed on a research contract for example, there will always be other commitments that compete for your attention, such as teaching. Not to mention the salaries have been going down for university staff and there’s been strikes in the last few years. Like you say, it’s also a long route and probably not worth it unless you want to do research on a more full time basis. I don’t think you would get the travel opportunities either unless you’re regularly invited to speak at overseas universities.

I expect you would have to commit to working a certain number of years in a London office before your company gives you a choice to transfer to another office. If you sign a year-long contract with a company I don’t think you could just up and leave because you want to be somewhere else. No job is fully flexible to all our needs in any sector, and I think private sector jobs are still pretty rigid but maybe not as much as Medicine. You’ll still get lots of travel opportunities but at least you won’t have to move up and down the country training in hospital medicine. The guy on the IB/Consultancy forum who works for MBB says he was travelling nearly every week all over the world. Provided your pharma company deals with overseas clients, you could potentially be doing the same. I’m not sure exactly what you want from the travelling side, whether you want to be based in different places for more than a few days at a time? If you want to be based somewhere on a more permanent basis then you would probably have to work your way up in the company for a few years before they allow you to transfer. I could be wrong but that’s my impression.

Speaking of investments, I would recommend you watch this video on a doctor who made serious money in property investment. There are some big opportunities there. As I type this I’ve just found another video with guidance on how to get into pharma so I’ll leave that here too. If you have a spare 30-40 minutes, check them out! I recommend you follow the YouTube channel Medic Footprints - they have lots of other similar videos about alternative careers for doctors.

Thank you for the videos, the one on pharma was just what I needed! Giving some ideas of common entry level positions to aim for: Medical Science Liaison, Medical Advisor, and Clinical Research Physician... which can then allow people to later become Medical Directors and Chief Medical Officers. I can now have a look at the job descriptions and key requirements
I was glad he said speciality training is not the key consideration, it is how well you sell yourself for the specific role in question. It was good to hear that he had lots of movement options internationally, when he was part of a big international company. I was not so interested by the other options in pharmacovigilence and safety, and he didn't particularly talk about Clinical Development or Discovery Medicine, which the previous pharma physicians I talked to work in and sounded fascinating. Finally, it was nice to hear that he feels he has time for family, time off, and that he feels valued and respected in this work.
I need to have another look at the Faculty of Pharmaceutical Medicine (FPM), as that is what he is under for this advisory role. It sounds like that helps with revalidation, as they understand he doesn't see patients anymore but keeps the GMC registration.
It sounds like once he got a foot in the door lots of opportunities became available, particularly for part-time roles which wouldn't have been available to 'outsiders'.

It will probably be a while until I personally invest in things, namely because I'd like to use income rather than savings. But it would be an interesting way of getting some experience and understanding in finance, as I do find VC and IB curious, I'm not sure I'd really want to go into the cutthroat world of IB where you are not doing anything positive for patients though. A good friend wants to pursue some more of the things you've mentioned so I will pass them on, I think particularly finance, so he is intercalating in an MSc at LSE.

how can you intercalate at LSE. I didn't think they offered degrees to intercalating students. It is a shame there aren't more degrees which allow you to intercalate in management, finance etc.

Intercalated bachelors degrees (where you study one year and get the same bachelors as the cohort you joined the final year of) are rather limited. However, masters degrees can be taken as intercalations anywhere, as theyre already one year and you will have studied three or four years at med school. There is almost no restriction, although there are forms to fill out and Imperial College and one or two other places dont allow intercalating masters for some reason. I know students who intercalated in management, business (including MBAs), finance etc, from Cambridge to EU unis to all places, so thankfully there aren't immovable restrictions! It is worth bearing in mind postgrad admissions decisions are done.on a.much more individual basis, so if you can make a persuasive argument then you can be accepted.anhywhere really!

Thank you. The degree you get after 3 years is unclassified isn't it though? So you don't have a 1st or a 2:1 or 2:2. Does that effect your admission onto masters courses?