I left for a multitude of reasons. The pandemic forced me to reevaluate my priorities and the type of growth I wanted in clinical and nonclinical work. While I valued my colleagues, my patients and the work we did together at the FQHC, I wanted more growth than my job could offer.

At first, I tried to find ways to stay by changing hours, taking on grant projects and diversifying activities outside of work. After much agonizing, I realized I just needed to find something else.

I also needed time to figure it out, so I took a leap of faith and left. Quitting was scary enough ― to quit without a plan felt reckless. I recognize that not everyone can take this chance. For me, however, it was the right move, a way for me to take time to reevaluate what I wanted and where I wanted to go.

As new physicians, I don’t think we’ve ever been taught how to quit purposefully and gracefully. I don’t think we’ve ever been taught to quit at all. I’ve learned there’s value in walking away and there’s even more value in doing it well. So, while I’m hardly the expert on this, I thought I would share some of the lessons I learned when I quit.

1. Remember who you are. While our interests may have shifted since we began our pre-med courses, there was a kernel of truth to whatever big picture goal existed for us then. There is a good chance that we lost touch with it in the weeds of training. Take some time to remember and rebuild your passions and interests that may have been stripped throughout training.
2. You have choice. Throughout training, as long as I completed each task, each exam, each rotation and passed, I moved on. Being immersed in this framework for years meant that I relied on external plans, and I wasn’t sure how to stop and reassess what I actually wanted. It’s easy to get caught up in doing the “next thing.” While this modus operandi can lead to finding interests you never knew you had, there’s also value in being discerning about what you take on. Unlike during training, when you had to follow a set path, you now have the power to choose what you want.
3. You have agency. In line with the above, the apprentice-like model of training that characterizes medicine often creates a disconnect with our autonomy and agency. There is a benefit to this model while we’re learning; having an attending to rely on is healthy and comforting as a resident. However, remember that your employer is not your attending or mentor. While most managers are looking out for you, their primary job is not to teach or ensure your well-being as a trainee. Like the oxygen mask on airplanes analogy, you have to know how and when to take care of yourself so that you can take care of others. You get to decide what that looks like.
4. Clarify your goals. Your inspiration to leave might be about walking away from a toxic work culture or lack of opportunities. But it always feels better to leave if you know what you are walking toward. Be clear about what you are looking for. Do you want to do more inpatient care? Do you miss prenatal care? Do you want more CQI work? Do you want to write or learn management and leadership? Create a loose narrative of what that future looks like. As you flesh it out, you might be surprised. That exact opportunity could exist at your organization; you just didn’t know to ask before. Or, more likely, visualizing this future could set you toward exploring paths that weren’t even on your radar.
5. Ask for what you want. If you realize what you want does exist with your current employer, ask for it. While at the FQHC, I started working on a grant project that had components of what I wanted to learn. I knew I wanted to continue the work, but I didn’t want to stay on as a full-time clinician to do it. So when I notified my managers of my intention to leave, I took a chance and asked to continue on the grant as they searched for my replacement. Thankfully, we made it work. The experience was valuable and also provided me with a small income during my time off. It never hurts to ask in good faith. If you’re not sure how to ask, consider a session with a career or negotiation coach.
6. Be kind to your managers. If you’ve had a good working relationship with your manager, it’s in everyone’s best interest to leave amicably. Even if you haven’t had a good relationship, the crux of quitting well is to at least try to leave on good terms. Schedule a formal meeting with them to make it clear that something’s up. Try to do it with their convenience in mind, but also within a week of asking so that you’re not sitting on your decision for too long. Have your future narrative ready. It helps indicate to your manager that you’ve tried to explore opportunities for your interests and ambitions within your current job but don’t see a path to achieve them. Luckily, in my case, by the time I finished telling my managers what I envisioned for my future, they actually seemed excited for me to take the next step.
7. Give enough notice. You may be leaving because of bad experiences on the job, and leaving quickly may be the best way to go. If that is the best option, try to do it as gently as possible to not affect morale of other staff members. Check your contract to see how much notice you have to give before you leave. It may be at will, it may be six months. I was told by a few primary care managers that three months is courteous notice. Giving full notice allows your employer to find a replacement for you within a reasonable period of time. For me, the three-month window was a fulfilling time to say goodbye to my patients and the staff and led to some really beautiful shared moments of closure.
8. Ask for an exit interview, and be constructive. If there’s not already an opportunity for an exit interview, ask for one, and ask to actually speak with a human resources representative. Talking it out can flag issues that a simple exit survey often doesn’t. Give feedback that is more than a laundry list of complaints. Identify where they currently stand, both culturally and organizationally, where you think they could be, and offer ideas on how to bridge that gap. They may not take any of your feedback, but having this conversation can make the quitting experience feel more meaningful and complete

Ultimately, I am really thankful that I could be so deliberate about leaving my previous workplace. I am also really grateful I had the privilege (and gumption) to actually leave.

Since leaving, I’ve processed a lot. The first three months allowed me to regroup. (I had a lot of weird and stressful dreams during that time.) The second three months helped me reevaluate my priorities and make decisions about my next steps. The final three months have been about preparation and transition, including a cross-country move to California, where I’ll start a combined clinical and managerial position in November. I’m finally feeling more grounded and ready to start a new chapter, with newly defined priorities guiding my decisions.

I hope some of you find this helpful. I wish you all the best in your own career explorations and transitions moving forward!

Lalita Abhyankar, M.D., M.H.S., is a family physician in transition. She will be starting a new role in the San Francisco Bay Area in November 2021. You can follow her on Twitter @L_Abhyankar.

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