A neurosurgical career is an enormous honor with multiple positive aspects that provide great opportunities to make a difference in peoples lives, to advance care, to set one’s own path and to improve the future of medicine. However, during a neurosurgeon’s career, we experience continuous pressures, long hours and an unfortunate realization that “your time is not your own.” This enormous pressure derives from the:
- Responsibility for patient outcomes;
- Requirement of continuous learning;
- Need to adjust to financial changes;
- Requirements (for many) of academic productivity; and
- Occasionally, multidisciplinary involvement that comes from leadership positions.
There are always long hours when we are responsible for clinical care. This continuous responsibility can lead to fatigue, sleep issues and possible burnout. We, and our families, know that time is never considered controllable.
Eventually, most of us will enter retirement age, a period that could be both tumultuous and disorienting or alternatively healthy and enlightening. When addressing the post-active neurosurgical life, there are various questions to be answered.
Gradual or Acute Change?
In either case, one should consider several fundamental decisions during this process. One should consider the important opportunity of having the time to recover from the continuous pressures of neurosurgical life, to define your own timeline and also to decide what path you wish to follow. If the change is to be gradual, you need to decide under what circumstances you will be involved and whether it will be with clinical activities or in an administrative role. In any case, it might be beneficial to take a break from the continuous pressures and responsibilities of the past. There is an enormous personal benefit to focus on your own health, which could include:
- Increasing sleep duration (often transitioning from four to five hours to at least seven hours per night);
- Committing time to exercise;
- Considering adaptations to insure proper nutrition; and
- Involving oneself in other activities that lead to a healthier and longer life.
What Do I Wish I had More Time to Do or Accomplish?
The fact that time is now your own can be both a remarkable change and an incredible opportunity, but many may find it disorienting after decades of structured life. The capacity to set your own schedule, I have found, is energizing. This is also a time to define what you would like to do in the future. Often, the answer is spending more time with family (especially your spouse, children and grandchildren), or with hobbies, talents and passions. If you have talents outside the clinical arena, now is a time to improve on those talents. If you have a particular passion, this is a time to develop new skills.
Do I Start a Second Career Journey?
There are a variety of alternative paths when making the transition from active clinical practice into retirement. One can consider a continuation in a more narrow clinical arena, whether in the operating theater and/or in an outpatient clinic. Should you continue as a physician at all? Some individuals desire to continue teaching, whether it be in neurosurgery, neuroscience or in general medicine. There can be administrative opportunities in hospitals, health systems or medical schools (e.g., as a dean). Many surgeons consider a legal consulting arrangement.
In addition, non-clinical opportunities often present themselves. Any physician has an opportunity to volunteer their efforts, whether in general medicine or in the neurosurgical or neuroscience fields. One can consider a role mentoring faculty, students or healthcare leaders, depending upon active clinical life experience. This can result in tremendous gratification as a consequence of passing on clinical experience and wisdom to others. Often, consulting opportunities present themselves for national organizations or through personal connections. Usually, these are limited engagements with a finite focus.
Finally, there are industry relationships that could be developed, either in a consultative fashion or by a presence on industry boards. Such relationships are usually focused on technology development, medical devices and clinical processes. One can present their experience as a key opinion leader, addressing technology, physician needs, clinical impact and business issues. This enables you to be involved the development of novel and needed patient treatments. In order for treatments to be brought into practice, it is an advantage to have an advanced understanding of intellectual property, clinical trials and business aspects, including marketing and sales. Some areas of particular interest are the development of minimally invasive treatments; means to minimize patient risks; methodologies to decrease waste in the process of and costs of clinical care; and novel ways to focus more on patient’s desires and needs when developing new institutions and clinical processes. Such industry relationships serve as but one example of how a previously active clinical neurosurgeon can continue contributing to the future of our specialty and improve patient care moving forward.
Retirement is clearly a time when the mind of the neurosurgeon must adapt. If done effectively, it can prove as rewarding as one’s professional career.
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