Brave Enough to Pivot: Finding Meaning in Medicine When You’re Burned Out

One of my lovely colleagues is about two-thirds of the way through a career pivot.  

She started with an academic interest in the microbiome, literally chasing down poop samples to build a repository.  And she was successful with it: high-powered mentors, manuscripts, the raving support of her division chief.  But her interest started getting pulled towards the business of local farms, and how so much illness comes from how we eat (and the negative impacts our food system has on the environment, which then leads to more illness).  She started learning about regenerative farming and the “Food as Medicine” movement.  She started reading voraciously.  She became so committed to the niche that she shifted her time (and resources) from her microbiome work to getting an advanced degree in food systems that dovetailed nicely into her starting to network with leaders at our institution, as well as local and federal policymakers.  She’s literally been invited to Washington, D.C. to take part in meetings with People Who Get Things Done.  I am so impressed with her and super proud to claim her as a friend.

Now, summing up her past four-ish years in a single paragraph is a simplification.  And if she reads this, I’m sure she’ll be like, “But ugh!  It’s been so clunky!  I lost sleep over my decision to shift my academic focus.   I still have an ulcer from when I told my division head and research mentor that I didn’t want to do microbiome research anymore.  I self-financed yet another advanced degree.  I used time away from shifts to do schoolwork again for crying out loud, and wrote papers while post-call more times than I can count.  This.  Sucked.”

I mean, yeah, sure.  I get that.  But that’s not what I see now.  What I see is that, while she would’ve changed medicine with her microbiome research, she is going to change lives with her Food as Medicine work.  She lights up when she talks about the career she’s building now.  She has purpose.  She is in the service of a greater good.  She is working towards something bigger than herself.

Can microbiome researchers serve a greater good and work towards something bigger than themselves?  Absolutely.  But unless they have a connection with it that makes them light up, gives them that intangible, “This is hard but so very worth it,” motivation that gets them through the frustrating times, the roadblock upon roadblock times, the “WTF am I even doing?!” times, they are burning a costly fuel to keep at it.  They may show up to their work thinking, “I’m miserable, but can’t quit because I have a mortgage and school loans.”  They may procrastinate their manuscript drafts until their PIs send an umpteenth “?!?!” email.  They may have Sunday scaries.  Every.  Single.  Sunday.

Career pivots can be scary.  It’s unnerving to leave a stable path that’s familiar.  But that’s just our negativity bias at work.  That’s just our brain trying to keep us safe.  

Career pivots can feel terrifying, especially for those of us trained to color inside the lines. We spent decades climbing one ladder, only to look around and realize it’s leaning against the wrong wall. But here’s the truth: you’re allowed to pivot. You’re allowed to want something different. You’re allowed to build a career that fits who you’ve become, not just who you were when you applied to residency.

If you’re thinking about making a shift, big or small, start by paying attention to what pulls you. Notice the things that make you light up, even when you are exhausted. Notice the topics you cannot stop reading about. Notice the moments that make you think, “I could do this all day.” Those aren’t distractions; they’re directions.

And when you’re ready to take action, try this:

1. Get curious before you get drastic.

You don’t have to blow up your career to change it. Start with curiosity. Take a class, shadow someone, or talk to a colleague doing something interesting. Call it “research.” Let it be messy and exploratory.

2. Do the math and the meaning.

Yes, logistics matter. The money, the schedule, and the timeline all count. But don’t forget to weigh the emotional return on investment. Meaning and alignment are forms of currency, too.

3. Remember that fear is data.

When you start feeling afraid, that is not always a sign to stop. It is often a sign that you are heading toward growth. Fear simply means your brain has noticed that you are about to do something new, not that you are doing something wrong.

4. Build your scaffolding.

Find your people. Mentors, friends, coaches, therapists, cheerleaders. You do not have to do brave things alone. In fact, you are more likely to keep going when someone else is holding the ladder steady.

5. Anchor in meaning.

Whatever path you choose, make sure it connects to something that feels deeply meaningful to you. Burnout thrives in the gap between what we do and why it matters. Fill that gap with purpose, and the work will sustain you even on the hard days.

Your pivot does not have to be dramatic. It just has to be honest.

And bravery does not mean being fearless. It means deciding that the version of you who wants to grow deserves a chance.

You have done harder things. You can do this too.