Specialty Choices for Burned Out Medical Students

Last Updated on March 10, 2025 by Laura Turner

We’re increasingly hearing about physician burnout, with roughly 50% to 60% of doctors⁠ exhibiting signs of burnout. This appears to be getting worse with time. The situation is equally alarming among medical students. Several studies have reported burnout rates in medical students in the range of 75% to 80%.

The high prevalence of burnout in the early stages of medical training is concerning. It sets a rocky foundation for future doctors’ careers and overall well-being.

There are a few strategies that medical students often use to try to address burnout:

• Dropping out. Some students consider quitting medical school. But this overlooks the significant investment of time, effort, and finances already poured into their medical education. It ignores the diverse and fulfilling career paths within medicine that may align well with their aspirations and well-being.

• Not doing a residency. Most medical students who choose to bypass residency end up pursuing nonclinical roles like management consulting or medical writing. While these careers are valid and rewarding, forgoing residency limits the ways you can utilize your medical degree. Residency is a gateway to a huge number of career opportunities.

• The “grin and bear it” approach. Some med students continue down a path of burnout. This can lead to chronic stress, frustration, and dissatisfaction. It culminates in a career spent in anticipation of retirement. This is not a healthy or fulfilling path.

I advocate an entirely different approach. Students feeling burned out should thoughtfully plan their careers, focusing on job satisfaction and reducing major burnout sources. For many, this means considering unconventional career paths in medicine.

What do I mean by “unconventional”? Unconventional jobs deviate from traditional careers involving full-time clinical work in acute care hospitals or outpatient medical practices. A career can be unconventional based on several different factors, including practice setting, area of clinical focus, patient population, employment type, or practice structure. Many unconventional job options for doctors offer less stress, better hours, and fewer frustrations like bureaucratic red tape.

To reduce burnout through taking an unconventional career path in medicine, medical students need to be thoughtful in choosing your specialty. There are a handful of specialties that offer a broader range of unique job options compared to other specialties, and that provide foundational knowledge and skills ideal for unconventional roles. Here are the top five.

Top 5 Specialty Choices for Burned Out Medical Students

Preventive Medicine and Public Health

Preventive medicine and public health is a lesser-known specialty. Many practicing doctors don’t even know it exists as a specialty. Yet, it is a recognized medical field by the American Board of Medical Specialties (ABMS) and has Accreditation Council for Graduate Medical Education (ACGME)-accredited residency programs nationwide.

Preventive medicine focuses on promoting health and well-being, preventing diseases, and slowing the progression of chronic disease. Residency programs run for two years following internship. They include Master of Public Health (MPH) coursework, encompassing epidemiology, biostatistics, healthcare administration, environmental health, and more. This is combined with practicum rotations in various settings, from community health to governmental agencies. It is a broad training for those wishing to impact health and healthcare at a population level.

Training in preventive medicine equips doctors with skills that are well-suited for roles that don’t involve the stress and frustrations that are so common in medicine. It opens doors to numerous unconventional career options, including many nonclinical roles. Some examples include:

• Health Officer at a state or local public health department.
• Medical Officer at federal government agencies like the FDA, CDC, CMS, or NIH.
• Medical Director at health insurance companies focusing on utilization management, population health, or other areas.
• Drug safety and pharmacovigilance physician roles at pharmaceutical companies.
• Consultant with various types of global health organizations and healthcare consulting firms.

There are clinical career options for preventive medicine specialists, too. Physicians can establish medical practices focused on wellness, lifestyle medicine, and disease prevention, for instance.

Occupational Medicine

Occupational medicine (or occ med, as it’s often called) focuses on the health and well-being of workers. It shares many similarities with preventive medicine, including a 2-year residency after internship that includes getting an MPH or similar master’s degree and certification overseen by the American Board of Preventive Medicine. Also like preventive medicine, there is an emphasis on nonclinical aspects of health and medical care and administrative roles; however, clinical jobs are more common in occ med.

Occ med specialists (or occ docs, as they’re often called) have a really diverse scope of job opportunities. Job options include working in occupational health clinics where you evaluate and treat workers’ compensation cases, conduct pre-employment and return-to-work physicals, and address workplace health and safety issues. Another common role is serving as a Corporate Medical Director, especially in the industrial and manufacturing sectors, where you are involved in both health and safety programming and responding to workplace injuries and exposures.

Larger organizations across various industries are increasingly developing robust employee health programs. This trend has led to expansion of the Chief Medical Officer role outside of the healthcare industry. Part-time or contract occupational medicine physicians are also commonly hired to oversee employee health programs run by nurses.

A key advantage of occupational medicine is its work-life balance. Physicians in this specialty usually work normal business hours with little to no on-call responsibilities. Clinic schedules are often more laid back than in other clinical settings.

Internal Medicine

Internal medicine is familiar territory for medical students. It’s a staple of medical education, with rotations in both inpatient and outpatient settings and exposure to various subspecialties. The foundational medical school coursework, like pathology, is heavily centered around the bread and butter of internal medicine. So, on the surface, this seems like a conventional choice. But it’s actually an entryway to a wide array of unconventional career opportunities.

While there are plenty of traditional roles for internists, such as hospitalist or primary care doctor, there is a lot more versatility to this specialty. Internal medicine’s many unconventional career paths include correctional medicine, travel medicine, urgent care, convenient care, and student health, to name just a few.

The variety of subspecialties within internal medicine further expands its potential. Each subspecialty facilitates a path to other, less conventional work environments and roles.

Internal medicine is also excellent preparation for a “niche” medical practice, in which you focus on a specific type of patient or clinical presentation that you are passionate about. This strategy potentially reduces the stress associated with dealing with less preferred cases. It also helps to streamline the processes used in your practice by decreasing variability across appointment types, billing codes, and other factors.

Here are a couple examples of niche practices stemming from internal medicine training:

• After residency, you could pursue a sports medicine fellowship and then have a career treating athletes, ranging from conducting pre-participation physicals to serving as a team physician.
• Obesity medicine is another growing field, and internists can develop expertise in the medical management of obesity. Subspecializing in gastroenterology also offers opportunities to treat obesity in a niche practice, due to multiple emerging endoscopic treatments.

Another perk of internal medicine is that it offers one of the fastest routes to board certification, with a quick 3-year residency. This allows for a relatively brief transition to less stressful, off-the-beaten-path careers when compared to other residency types.

Internal medicine presents career possibilities that tend to be inadequately advertised during medical school. It’s an excellent choice if you’re feeling unsure about your long-term career path.

Psychiatry

There is growing demand for psychiatrists in both conventional and unconventional roles. There has been increased attention from schools, employers, healthcare systems, the media, advocacy groups, and the public on mental health in the past several years, which has expanded the need for psychiatrists in diverse practice settings.

Being a psychiatrist isn’t limited to treating severe mental health disorders in psychiatric hospitals or treating common psychiatric issues in an office setting. There are many less conventional options, which are particularly appealing to early-career doctors concerned about burnout. Here are just a few of them:

• Specializing in treating eating disorders in adolescents.
• Working in addiction treatment, including detox centers and methadone clinics.
• Providing mental health services in jails, prisons, and long-term care facilities like nursing homes.
• Engaging in forensic psychiatry, which includes conducting forensic examinations.
• Unique roles with the federal government, such as psychiatric Regional Medical Directors for the Department of State to support foreign service staff, or working within the CIA’s Medical and Psychological Analysis Center.
• Developing niche practices geared toward psychiatric needs of specialized groups, like performing artists, business executives, patients with sexual dysfunction, or professional sports teams.
• Involvement in psychedelic medicine, such as using ketamine for treatment-resistant depression and potentially MDMA and psilocybin for certain mental health conditions.

There are also fellowship opportunities that are often overlooked by psychiatry residents but can lead to highly specialized and exciting practices. Notably, psychiatrists can pursue fellowships in pain medicine, sleep medicine, and hospice and palliative medicine — areas traditionally associated with other primary medical specialties.

These are just a few examples that illustrate the breadth of opportunities available with board certification in psychiatry. The rise of virtual psychiatric practices presents even more options. The field is expanding, with certain jobs offering significant flexibility.

Emergency Medicine

Emergency medicine may strike you as an outlier on this list. It is known for its high-stress environment, irregular hours, and intense pace. For these reasons, it isn’t pursued by many med students who already feel burned out.

However, if you can make it through residency, then board certification in emergency medicine provides you with a whole assortment of unconventional career paths that can lead to a fulfilling career without burnout.

For students who love to travel and may be willing to accept lower pay for unique experiences, emergency medicine offers opportunities such as cruise ship medicine, wilderness and expedition medicine, humanitarian medicine, and maritime and undersea medicine. While many opportunities in maritime and undersea medicine are with the military, there are also civilian roles, like consulting for private diving companies or conducting fit-to-dive and fitness-for-employment exams for mariners.

There are options for additional income from side gigs include serving as a Medical Director for an EMS agency or getting involved with Independent Medical Examination (IME) work.

Pursuing a fellowship in toxicology can lead to roles in hospital toxicology consult services, managing poison control centers, or legal consulting in forensic toxicology.

As with psychiatrists, emergency medicine specialists have access to a variety of fellowships and subspecialty certifications typically obtained by physicians in other specialties. These include sports medicine, pain medicine, hospice and palliative medicine, and transfusion medicine. Pursuing these as an emergency medicine doctor can really set you apart. The jobs that accompany these are often conducive to a balanced lifestyle, without the usual stresses of emergency medicine practice.

While many nontraditional paths for emergency medicine-trained physicians may not offer the same financial rewards as full-time work in a busy emergency department, they come with significant advantages. You can have greater control over your work schedule, remote work opportunities, and the possibility of part-time ER work supplemented by less stressful, well-paying side jobs.

Learn more about how an unconventional career can mitigate burnout

These five specialties choices are just a few of the options that offer unconventional career paths with less stress and fewer of the common frustrations that physicians experience, perfect for burned out medical students.

If you’re a medical student feeling burned out, start addressing your burnout now. Give some serious thought to the type of job you want to have after residency and to learn about the various routes you can take to get there.

Take time to explore less traditional career options. I invite you to read my book, 50 Unconventional Clinical Careers for Physicians. Your interest will be piqued by at least a handful of the careers described. Early burnout as a medical student doesn’t have to define your entire medical career or, worse, lead you to quit! Be proactive in molding a career that aligns with your aspirations, values, and well-being.

References

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