How I actually left medicine
Not the highlight reel. The real version: every fork in the road, what I chose, why, and what it cost me. I have kept the exact figures vague on purpose, but the decisions are exactly as they happened. If you are trying to work out whether to make a move like this, read how one real one actually went.
Most of what I post on TikTok is a thirty-second slice of a much longer story. People watch the slice and assume there was a plan. There was not a plan. There was a series of decisions, most of them made with incomplete information and a fair amount of fear, and this is the honest record of them.
I am laying it out as a decision log rather than a tidy narrative, because the tidy narrative is a lie that gets told after the fact. What you actually face is forks: moments where you have to choose without knowing how it ends. Here are mine, in order.
I was a third year medical student working out which specialty to aim at, and I had settled on cardiothoracic surgery. The honest reason is that it was one of the hardest things to get into and I like a challenge. So I was doing what you do once you have picked your track: going to conferences, building the portfolio, making myself competitive. I want to be clear that I liked medicine. It is genuinely rewarding work, and coming from a disadvantaged background there was something in being the person others looked to for help. That is an honour, and I have never pretended otherwise.
At those conferences I got into the habit of asking surgeons one question: if you could go back twenty years, would you make the same choices again? Almost every single one said no. None of them said it bitterly, which somehow made it land harder. They were just being straight with a student. At the same time the NHS was visibly coming apart. This was around 2017 and 2018, the structural and political problems were obvious, and the privatisation conversation was just starting up. I was willing to keep going. But I had to be honest that whichever specialty I picked, this was the life. Not a rotation you rotate out of.
I ran the audit there and then, in third year, rather than sitting on it. What am I actually good at, what am I bad at, and what would I enjoy doing every day for thirty years. The honest answer was that I was better at building things than most people around me, I was good with tech, and I had far more agency than my peers, most of whom were waiting to be told what the next step was. So I took an intercalated degree in business.
Third year is the cheapest moment there is to ask the question. I had not sunk a decade into a training programme, there was no consultant salary propping up a mortgage, and nobody had built expectations around a specialty I had already committed to. Everything I have seen since says the question does not go away. It just gets more expensive to ask. Those surgeons were proof of that. So I asked it while it was still cheap.
It is one of the most isolating things I have done. Nobody around you is up before sunrise on a weekend teaching themselves full stack engineering. Nobody is writing their own curriculum for a career none of their friends are having. Nobody goes travelling alone just to work out where they are and what has to happen next. There is no cohort for it and nobody to compare notes with. I did not cut myself off. I had good friends at work and I liked being around them. But the thing I was actually building sat outside all of that, and it stayed there. In the end you get two options. Go all in and take the isolation as part of the deal, or back out because it is frightening and take the comfortable path instead. I am used to discomfort. I have been all my life. So I took the first one.
The rest of the story
- When leaving became thinkable. The first crack
- Choosing to actually go. The decision
- Joining a founding team in San Francisco. The first move
- Becoming a VC due diligence advisor. A second door opens
- Starting a company in the Middle East. Building my own thing
- What I gave up, and what I miss. The honest ledger
- Was it worth it, and what I would do differently. Looking back
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This is educational career guidance, not a promise of a job, a salary, or any specific outcome, and not financial or legal advice. Your results depend on your own effort and circumstances. Make big decisions with proper professional advice where it matters.
Do not resign a training post or change your contract on the strength of a quiz or a plan. Talk to your deanery, your educational supervisor, and your medical defence organisation first. Leaving and re-entering training has real consequences worth understanding before you act.