It’s not that Stanley Liu, MD, wasn’t happy in his position as an attending cardiologist. He was. He loved helping patients and teaching medicine. The problem was: he couldn’t walk his son to the school bus.

It was just after COVID, not far removed from the days when Liu moved his wife and young children out of his home to keep them safe while he worked in Baltimore’s packed ICUs. Now they were back together, and his oldest son was starting kindergarten. But again, the demands of his doctoring life left him feeling separated from his family.

To recoup the losses of the pandemic, Liu’s employer was pushing for more billable clinic time. Teaching was largely cut. Liu was expected to see patients from 8 AM to 5 PM, 5 days a week. “That means, by definition, I cannot walk [my son] to the bus stop ever,” Liu told Medscape Medical News.

“Eventually, I had to choose between being the father and husband I wanted to be vs being part of this organization,” he said.

At what is supposed to be the pinnacle of their career, many US doctors — like Liu — find the work is not what they expected. Overwork, financial constraints, dissolution, and work-life tension all build on a sense of dissatisfaction. Many imagine changing their career path.

This is not unique to doctors. But physicians carry a distinct set of baggage and mindset issues that can raise the stakes of navigating career changes. Along with financial concerns, these can leave highly trained professionals feeling stuck.

Medscape Medical News spoke with doctors who managed to make career changes, and they found that the obstacles are real but not insurmountable. Success takes strategy and the unlearning of some core beliefs that go all the way back to medical school.

Baked Into the Training

The difficulty with becoming unstuck in a medical career is that it requires risk and the unknown. Doctors spend decades training in a medical system that avoids both.

“First, do no harm.” Doctors are taught from the very beginning to avoid unnecessary risk, to consider the downside, Liu said. And it seeps into their personal lives. There are student loans, mortgages, families to feed, and the opinions of esteemed colleagues to consider. A career pivot is full of unknowns that put all those variables at risk. For many doctors, the possibility of failure overwhelms any potential upside from making a change. They stay safe — and maybe miserable.

“If you start a business, yeah, it could fail. It could be embarrassing; you could be humiliated. But if it took off, there’s no limit to how well you could do or what other ventures you could take,” Liu said. The shame and stigma doctors carry around potential failure isn’t entirely of their own making. “That’s part of the culture that was ingrained in us.”

In fact, the very traits that keep doctors stuck in unfulfilling roles are the same ones that made them a success in training, said Sabrina Vogler, a career coach who works with physicians. “The same stamina, the same conscientiousness, the high-intelligence, and perfectionism.”

While perfectionism might help with MCAT scores and away rotations, it doesn’t leave room to experiment with new opportunities, start ventures that might fail, set limits at work, or even admit that you’re unhappy and need a change.

‘Climb Over the Rail’

To be fair, medicine has changed radically in the past few decades, and many currently practicing physicians came of age in the middle of that transition. They faced skyrocketing training costs and competition, the plummet of private practice, pandemic losses and the sweeping ownership and profit pressures of private equity. The nature of doctoring has shifted beneath their feet.

In many ways, “becoming and working as a doctor is like being on a moving sidewalk at the airport,” Liu said. Everyone enters the same way, and it can feel like there’s no way off once you’re riding. “No one tells you can just climb over the rail.”

Once Liu and his wife agreed that his job didn’t leave room for the life they wanted, they started planning. His wife worked, but if Liu quit, that would still mean a six-figure salary cut and the hit of an 18-month, 20-mile noncompete. They decided to bet on his ability to get locum tenens work outside the radius.

Liu started saving up what he called his “courage fund,” enough to cover them for 12 months. It took him 6 months to reach that sum, but that’s not prescriptive, he said. Every doctor’s needs and cash flow are different.

Before leaving his job, he started connecting with locum tenens agencies. Though none actually panned out, he managed to land a direct contract with one hospital. It was still going to be tough. He gave his family an out, telling his wife that if her quality of life was worse after 18 months, he would go back.

“We just ground it out, and then when that period was over, I was able to find new work in Baltimore,” he told Medscape Medical News. In the first year, the noncompete constrained his income enormously. But when it lifted, he made more than he ever had. He now more than replaces his attending income with a combination of locum tenens, contract work with a senior primary care network, and a financial advising firm, DocEmpowered, that he started for physicians.

Oh, and he eats breakfast and dinner with his kids every day.

The Courage to Try

Change doesn’t have to come all at once. Harry Karydes, MD, made a pivot without ever leaving the bedside.

The Illinois-based emergency room (ER) physician started to feel his limits during the COVID pandemic. He was adjusting to a new leadership role in the emergency department where he worked. As the pandemic and demands of the job wore on, burnout crept in.

Karydes never wanted to leave medicine, but “there has to be something more,” he recalled thinking, “because I can’t just do [only this] for the next 20 years of my life.”

At the same time, Karydes was finding an unexpected relief: studying leadership. It started with swapping stories and problem solving on weekly calls with hospital system leaders. He quickly realized he wasn’t alone in his lack of leadership training. He sought out mentors, department heads with long tenures. He offered to share what he was learning and how he was using it at grand rounds.

Word about his newfound interest spread organically. Other local hospitals invited him to speak. Younger ER docs sought him out for mentorship. He spoke at a regional emergency medicine conference and started posting on LinkedIn.

He was giving so much advice that he saw the opportunity for a coaching business and hired a coach himself to help sharpen his skills. He then signed up for a certification process. First, he coached doctors. Now he’s broadened his offerings to newly promoted leaders in any industry.

“You [can] feel that you’ve locked yourself in and that you’ve only developed one skill set,” said Karydes. “I don’t think doctors recognize that those skill sets can be transferable.”

When Karydes first started building his coaching business, he volunteered for night shifts in the ER, which meant he could choose the specific days he worked and have more control over his schedule. As his business grew, he could offset more of his ER earnings and eventually traded full-time work for locum tenens.

“I think you have to be curious and willing to try,” Karydes told Medscape Medical News. Maybe the next right move is locum tenens, expert medical witness work, or start-up consulting. You don’t know until you risk it and try something new. “Give yourself that courage to just try.”

‘You Have Permission to Evolve’

The trouble with trying something new is that it can feel like devaluing what you have already achieved. By the time physicians land a stable gig, they’ve invested so much of their life and resources that “wanting to change direction can almost feel irresponsible,” said Erhime Badejo, MD, an ER doctor with the US Department of Veterans Affairs who also runs a telehealth platform. But that’s where they’re wrong, she believes.

Badejo has led a career of changes. Twenty years ago, she was a nursing assistant before becoming a registered nurse, then a nurse practitioner, and finally an emergency medicine physician in 2018. She credits her mother with instilling her courage to do something new and face the many setbacks along the way.

“You have permission to evolve,” she said. Becoming a doctor is a huge accomplishment, but “that is not all that you are.” Medicine can be a platform.

After 7 years in the ER, Badejo wasn’t surprised when she felt it again: the need for change, to do something more. In early 2026, without leaving her position at the hospital, she launched a low-cost telehealth service for patients who can’t afford care or a prescription refill. Soon after that, she realized a long-time dream and she and her team built the Rapha Haven Health Network, a growing global network of physicians committed to strengthening healthcare delivery in Nigeria and West Africa.

Fundraising, technical platforms, hospital renovations — it’s all new to her and none of it’s easy. She depends on the guidance of mentors and expects to make mistakes. But that’s okay with her because “finding fulfillment and being competent are very different things,” Badejo said. “You can be very good at your job. You can be very smart…But it’s okay to realize that this is no longer the place where my greatest contribution lies.”

Unlike medicine, where the path-to-entry is straightforward and structured, there’s no one-size-fits-all road map to the right career change. It takes trial and error, experimenting with interests and asking questions. Liu didn’t discover his interest in financial planning until after he left his attending position and was managing his own career transition. It wasn’t an easy or straightforward move, he said. “But for the last three and a half years, I have never had to ask anyone’s permission to take a Tuesday off with my child when they were off school, to build incredible memories with them. For me, that about sums it up.”

The experts cited in this article had no relevant disclosures.