Leaving the Bedside.

This excellent book begins with a lengthy list of examples of why physicians are leaving clinical practice. The author concludes that physicians feel both pushed and pulled toward different careers. The push forces are "Disillusionment with medicine, third-party interference, the physician's own medical problems, financial considerations, threat of increased litigation, and environmental factors. The pull factors include changing needs, values, and interests, and the desire to make a contribution elsewhere."

The author describes the possible agonies involved in making a career change: giving up what society views as the highest status career; negative reactions of family, friends, and colleagues who wonder why you can't be happy with all you have; and change in income and lifestyle. Being aware that these things might happen can help you be prepared and thus gradually detach from the criticism.

The book contains excellent questions to help you determine your values and goals, a discussion of the benefits of career counseling, a lengthy description of the opportunities in the pharmaceutical industry, and the pros and cons of getting a law degree. The section discussing physician executives positions is sketchy, but other books are recommended to fill the gap. The author also tells what should be included in a curriculum vitae and how to work with search firms. The final section of the book is a 26-page appendix listing "Nonpractitioner Positions Held by Medical School Graduates" that was originally published in Careers in Medicine: Traditional and Alternative Opportunities.