SCCM Pod-473 Changing Careers Means Changing Perspectives

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Healthcare professionals who want to make a job change often do not know how to go about it. Impending job searches seem daunting. Ludwig Lin, MD, was joined by Mojdeh Heavner, PharmD, BCCCP, BCPS, FCCM, during SCCM’s 2023 Critical Care Congress to discuss the dos and don’ts of changing jobs mid-career.

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Transcript:

Dr. Lin: Hello and welcome to the 2023 Critical Care Congress edition of the Society of Critical Care Medicine podcast series. I’m your host, Dr. Ludwig Lin. Today, I’m joined by Mojdeh Heavner, PharmD, FCCM, to discuss how to change your job mid-career. Professor Heavner is associate professor and vice-chair for clinical services at the University of Maryland School of Pharmacy in Baltimore. She is the coordinator for the Pharmacotherapy Residency Program, and her research interests are in delirium and sleep in the critically ill population. She also finds time to practice as a clinical pharmacist in the medical ICU. I’d like to welcome Dr. Heavner, and thank you for making the time because I think this is such an interesting topic for our membership. Before we start, do you have any disclosures to report? 

Dr. Heavner: I have no disclosures relevant to this topic. 

Dr. Lin: I think I’d like to start broadly. What prompted you to want to speak on this topic? 

Dr. Heavner: Well, I have to say, when Judy Jacobi says, “Jump,” you say, “How far?” That had something to do with it. But I felt like, with the LEAD committee, we were exploring the various topics that we were thinking about for the program. This topic stood out to me as something that I had recently experienced personally. So I felt a little bit drawn to it. I certainly didn’t feel like necessarily an expert on it per se from a research standpoint or anything like that. But again, from that personal experience, I was interested.

Dr. Lin: That’s cool. Can you share with us your own personal career journey? 

Dr. Heavner: Sure. I did my residencies at Yale New Haven Hospital and organically fell into an ICU role there after completing residency and stayed there for a number of years in a clinical role in the medical ICU and then a supervisor of clinical services. I took on a residency director role, residency program in critical care there for a number of years, and felt quite stable honestly. I felt like my career was aligning exactly how I would’ve envisioned ideally. The only issue was that I am a Marylander. So ultimately, I really wanted to end up back home close to family. Family means a lot to me, and that was really my primary driver for eventually making a job change. I had friends and colleagues who were teasing me from early on that “Mojdeh was considering a job change since 2009,” and that’s probably true because my eyes were always open for that next opportunity. 

But the ideal role really wasn’t available to me until essentially mid-career when I felt like I actually was already very established in my career, professionally as well as personally, and made the leap to leave that very stable job and trajectory and pull my husband along with me and move back to Maryland to take on my current role.

Dr. Lin: That’s pretty cool. I would like to ask you a couple follow-up questions about this. It sounds like you knew geographically where you wanted to wind up. It also sounded like you had been extremely successful professionally in New Haven already. How did you plan or how did you visualize the job change, or did it all happen organically? Did it just suddenly happen? Did you seek things out? I just want to know more basically.

Dr. Heavner: I think superficially it probably looks like it fell together organically. But honestly, in looking into this subject for the LEAD program, I reflected on my own experience and realized that I was probably more strategic than I gave myself credit for. So I had a lot of the things that I talked about at the LEAD program, I diversified my portfolio and made sure that I had some experiences that would lend themselves to potential job opportunities that maybe weren’t necessarily this ideal role that I ended up in. Maybe some of that is a little bit of serendipity that that opportunity became available. But I was working hard toward establishing that potential job change for a number of years and fairly aggressively networking and making sure that I had the connections to the various professional opportunities in Maryland when we were ready as a family, honestly, to make that change. I think it was years in the making actually, with a lot of careful thought behind it. Even though it felt maybe at the time like, Oh, things are just aligning, in reflecting back, I think a lot of the things that I did that I worked really hard to do actually helped me get there.

Dr. Lin: I can totally see that. It sounds like this is analogous to something that people talk about in sports. There’s no luck. People create that. My next question for you is this: It sounds like your career transition was somewhat intentional in that you knew you wanted extra skills before you thought about it. When you were looking for your next opportunity and when you were gaining new skills, did you have a job or a job description in mind, or did you diversify with the hopes that something will stick? 

Dr. Heavner: I guess this exploration phase of trying to figure out what is the ideal job that I would like to have, and when I define that for myself, that was really ideally in academia, which I think to a lot of people in healthcare sounds like, OK, well, academic medical center, you were already there. But it wasn’t an academic role from a pharmacy standpoint, so I didn’t have an official appointment at a school of pharmacy. But I really envisioned myself in that kind of role, educating the future of my profession. I really envisioned myself continuing to take care of medical ICU patients. There were definitely other aspects that I would’ve ideally liked to have in terms of job flexibility that maybe I didn’t actually have in my past role when I was at Yale New Haven and maybe comes with some of that academic flexibility too.

I think that I set that vision, but I also kept a broad mindset in terms of, there really aren’t that many of those opportunities with that exact fit, all of those components that I’m looking for. I pursued all kinds of things. I explored, Hey, do I want to pursue a medication safety role potentially? I went out of my way to become a high-reliability organization trainer because I thought those jobs are growing in the pharmacy world. Maybe that’s where I get my in to move back to Maryland; maybe that’s the position. I definitely pushed in terms of the academic role, I made sure that I was attending conferences like SCCM and pharmacy organizational meetings and things like that, that I was publishing. I moved into an administrative role. As I mentioned, I became supervisor of clinical services. Part of it, I don’t know that that was strategic in thinking that that would be my stepping stone to the next job change in my ideal geographic location, but I thought that potentially having that added skill of leadership would potentially open some doors as well as, of course, it was the natural progression in my own career.

At the same time, I realized that, by stepping into a more administrative role, I was almost discouraged from practicing as much as I was. I really was stepping away from my role in the NICU and I needed to make sure that, if my next job change was a clinical role, I was actually going to go back into more of clinical practice that I needed to actually maintain those skills. So, despite my mentors and my managers telling me, “You don’t have time for this,” I made sure that I covered those clinical shifts in the NICU. I even covered the emergency department and our internal medicine pharmacists just to make sure I had a little bit of those kind of skills too and diversified my portfolio there.

Dr. Lin: Good for you. 

Dr. Heavner: I tried.

Dr. Lin: Yes. I’m really impressed by that because it sounds like what you were doing was you were maintaining your skills and you were also at the same time refining your vision of what you wanted, like you knew you wanted to continue in a clinical capacity, and you made sure that you retained that. That’s really great. Now that you’ve made this entire progression, and congrats on that, are you surprised by anything that happened? 

Dr. Heavner: I think the thing that surprised me most was that I was very prepared, I think, in this vision of making the job change back to a clinical role, academia really focused on scholarship and research and the grant funding and all the stuff that comes with that. I actually never thought that I would go back into administration. My next job change, really once I moved, made the geographic move, was to step into my current administrative role as vice-chair. I never thought that would be something that I would be interested in, but I think it is so interesting that the past experiences that you have, you really never know how they’re going to lend themselves as being stepping stones for your future steps. I really think having the supervisor of clinical services role, I didn’t realize at the time would really be the justification, of course, now stepping into this advancement into vice-chair within the academia world, separate worlds, but movement in parallel. 

Dr. Lin: Yes. It sounds like it totally worked out. Well, let’s try to broaden this conversation so that we can help the listeners apply it to their own careers and lives. So, job changes, I think in medicine we oftentimes default to valuing longevity and loyalty, and you just keep on plugging away because you’re a good team player. That’s definitely the way I was trained as a resident. What do you think are some of the biggest taboos about changing career direction? What were some of your own? Did you debunk them? How can we share this with the listeners? 

Dr. Heavner: I’ve had a lot of really great conversations with colleagues from all over the world at this meeting, and there have been a lot of individuals that have had job changes in the last couple years since we had our last in-person Congress. I do notice that the conversation around that job change is almost apologetic, like, Yes, I moved into an industry role as an MSL, or Yes, I changed jobs into a more regulatory role, as if that’s the wrong thing. I do feel like we need to get away from that because the reality is that we have job changes, it’s expected that we should have job changes. But I think in medicine, you’re right, it’s absolutely almost frowned upon to move around and explore different angles. But I think it’s important that we’re open to it as a healthcare community because I think it’s healthy and it gets people into the right roles that are a good fit for them.

Dr. Lin: Yes, I totally agree with you. I wanted to ask you about a couple of really interesting slides in your presentation. One was about the trend of the overall number of job departures and the “great resignation” that happened in 2020 being attributed to COVID. It was already happening. Is that really what was going on? So whether COVID happened or not, more people would’ve left their jobs. Is that true? How do you explain that for us? 

Dr. Heavner: I am sure that there are data somewhere proving that it is true that there was a great resignation, just like everything we’re hearing in this conference. There are conflicting data all over the place, but I think it was very interesting to me to see some of the data from the Bureau of Labor Statistics that there is essentially a linear trend over time with an expected number of people leaving their jobs per year and that there was actually a drop-off in 2020, which I think, anecdotally, I felt that too. We were all waiting, like everyone was holding their breath, doing what they were doing or just surviving. I didn’t hear about a lot of people leaving at that point, right? We were just trying to survive day to day. You see that in the data. You see the drop-off at that point from that normal linear trajectory. 

Then in 2020, we had vaccines, people were starting to reevaluate. We were feeling like we could survive this pandemic, but we were reevaluating our lives and our missions and our profession, and I think that people did start leaving again. But I think the perception is that people left at a higher rate. Perhaps that’s true within certain professions. I hear about nursing and certainly we have some shortages. But I think if you look at the overall workforce data, it actually fell back onto that linear trend that we were expecting from year to year. It was a pretty abrupt change from 2020 to ‘21. But, over the course of the eons of time, it actually was following that natural progression. 

Dr. Lin: Gotcha. I think this period is going to be analyzed ad nauseam for who knows how long because all of these things have impacted us. 

Dr. Heavner: And all different angles.

Dr. Lin: Yes. I think for us in healthcare for sure, there were so many different forces at work. It will be very interesting to see how anthropologically this plays out. I want to ask you about another slide you had. You made sure that you pointed out to people the distinction between job and career, and I wanted to get you to elaborate on that in this podcast. 

Dr. Heavner: I noticed in looking into this subject and reflecting on it and looking into literature around this subject, I found that there was a lot of back and forth between those terminologies of career and job, and I saw some inconsistencies. Like all of us in medicine, I wanted to know, what is the correct term? Are we using these terms correctly and what is the appropriate semantics for this? Essentially, where I landed in my understanding of these terms is that your career is the overarching umbrella of where you are headed in your life professionally whereas your job is really in that moment, what you’re doing functionally at that moment in time. I like to think of it as like a raindrop. Every job that you have falls out of the sky. It’s kind of how I felt with my current job. It may or may not overlap to some degree with your overall career trajectory, may or may not hit your umbrella. But to some degree, it’s going to impact the skills that you have, your perspectives overall for the length of your career, but to varying degrees.

The analogy I used for the presentation was that I think my overall career is really being a pharmacist in some capacity. If I were to make a career change, that would be something like moving from being a pharmacist to being a rockstar, which I certainly cannot be because I have a horrible voice despite all of my good intentions. But that would be a career change, a major change, probably would not contribute to my overall career trajectory as a pharmacist if I jumped into a role as a rockstar. But changing jobs, what I did was moving from a pharmacist who worked in an academic medical center, in an administrative role, into a pharmacist working in an academic medical center in an academic role. That is a job change to me. 

Dr. Lin: Yes, and thank you for that. I feel like that’s a really important thing for all of us to keep in mind. My own bias in interpreting what you’re saying is that, for me, for sure, the career is more worth evaluating than a particular job. But at the same time, I do think, just as we were discussing earlier that we do have a tendency to equate the two and to think, this is the job and I need to be in this job.

Dr. Heavner: Forever. 

Dr. Lin: Yes, like ad infinitum. And maybe that’s not the way it has to be. But I think we’re all different. You need to define, not you, but one needs to define what one’s goals are. Is it to get a really awesome job or is it to develop a very satisfying career arc? Maybe those two things are not similar. What do you think?

Dr. Heavner: Where you are in your life personally as well, and modifying, adapting where you choose to spend your time as far as a job based on your personal life as well. For me, I knew that my husband and I have one child, we’re hoping to grow our family, we’re basically struggling to maintain a balanced personal life with no family near us. So it was an important factor and it was probably the most important factor in making that decision about the job change. Not a career change, but just a job change in that moment in time. It was right for me, for my family and where I was at that moment. 

Dr. Lin: Yes. The career is really what matters over the long run, and your work-life balance. This is such a great discussion. This is actually a really good segue into one of the other questions I wanted to ask you, which is for people who are thinking about perhaps changing jobs, no matter how much anxiety that produces, is there a particularly good time in one’s professional life to do that, and why?

Dr. Heavner: I feel like this question is like, what should your second vasopressor be in sepsis? That’s a very nerdy answer, but I don’t think that there’s a right or wrong answer to that. I don’t think we have enough information to be able to answer that question right now. 

Dr. Lin: I love it. I love it. 

Dr. Heavner: I think it’s very patient-specific, professional-specific, what that ideal timing is. As I said, my colleagues were joking around with me that I was looking for a job since 2009, which is true. But I don’t know that I was in the right place with everything else in order to actually make that job change. For whatever reason, the stars aligned and it all worked out. But I think it’s very individual-specific and there’s no clear algorithmic approach to it, or no black and white this-is-the-ideal-time. I will say that most people, the average age for a job change is 39. Mid-career is when most people make their job change. However, if you look at the prevalence of job change over our age ranges, it tends to be on the younger side, that in our younger years we tend to jump around a little bit more as we’re exploring different opportunities. But still, the average age actually is 39.

So, I don’t know. I haven’t myself looked into all of the scientific reasons for that necessarily. But I think that mid-career time is definitely a time in our careers where we’re reflecting on our trajectory and it’s kind of that fork in the road. It’s like, OK, am I happy with where things are going in this current place, or are there factors that are maybe pushing me to go in a different direction? That may be personal factors like it was for me, or it may be professional factors, this job is not satisfying, or there are limitations with the job itself that actually make me want to make that change. 

Dr. Lin: Thank you. I think that is a really nice way to answer that question. I totally see your point, which is that there is no formula. It’s not cookie-cutter, there’s nothing to follow. That’s important for people to remember really. What is your list of dos and don’ts when looking for a new job opportunity, especially what are the don’ts?

Dr. Heavner: I would say the number one don’t, to start with the negative, is quitting the wrong way. I looked into some of the literature and what’s been published on the science behind quitting. It was really fascinating and I will tell you when I printed out those articles, my department chair was probably not very happy seeing me printing all of these job-quitting articles. I’m sure that got her brain running about where I was headed. But I think it’s really important to be transparent and fairly honest with your employer and hopefully people have a good enough relationship with their employer that they can have those conversations, which I think is a separate issue maybe if they don’t. But it’s very important to be honest about what went into your exploration phase and what are the reasons why you were maybe seeking this job change.

A lot of times if you’re transparent about those things and it’s something actually related to the job itself, a good employer potentially would be able to modify your role or add responsibilities in order to meet the needs and maybe you don’t need to make that job change. At the same time, for me it was a personal reason to leave and so just being very transparent about this is what I’m seeking and it’s the best thing for me and my family, the employer can actually be and your mentors can be very helpful in that transition and potentially seeking the opportunities that are there to make that next step. 

Dr. Lin: They become your allies. 

Dr. Heavner: Absolutely. The other thing I thought was interesting that was, I guess a do and a don’t, was obviously make sure to give enough time, whatever your employer requires as far as the time before you leave, your number of weeks or whatever. But at the same time, you don’t want to give too much time. I thought that was really interesting because I actually did give a lot of time, perhaps because I was so transparent about my goals for this. But there’s a thought that if you give too much advance notice that you’re planning to leave, that things start getting stagnant and the dynamic starts to change. I thought that was a really interesting perspective that I really hadn’t thought about myself. 

Dr. Lin: That is interesting. I wanted to also ask you how to not burn bridges when departing a job, but I almost think you just answered that. I think you were going to tell us that it’s important to be transparent, yes?

Dr. Heavner: Yes, absolutely. You never know how those ties are going to benefit you in the future. Obviously, that comes from a genuine perspective. I think I’m not trying to always be strategic with everything. Of course, you want to maintain those ties, just like we want to have those relationships, those friendships, in the long term. But actually, thinking about it strategically from a career development standpoint, I think it’s very important to maintain those ties with your previous employer. You never know how that network is going to help you with your future career steps. Just like you couldn’t maybe anticipate this current job change, you’re not going to be able to anticipate what that next job change is either. You just never know as you’re growing that network and maintaining that network, it could help you in the future. 

Dr. Lin: I love that. I knew this was going to happen. The time has flown by. It’s time for us to wrap this up. But I wanted to ask you if there were any other points that you really wanted to get across to our listeners.

Dr. Heavner: Gosh, I guess the take-home that I think honestly just having all of these conversations with colleagues at this meeting is that people shouldn’t feel bad. Back to the taboo question, I don’t think people should feel bad about exploring opportunities because ultimately you have to do what’s right for you. In a way, if you explore the other opportunities for the job change, you’re at that fork in the road and you’re looking into all of these various roles, maybe you’re even building that portfolio. But if you go back and you’re reflecting on all this and you decide you actually don’t want to make the job change, you’ve actually solidified your happiness and your security in your current role. I think it’s a healthy thing to think about job change. I hope that, as a medical field, we can shift that mindset from, it doesn’t have to be all or nothing. It doesn’t have to be like when you’re fed up or something is when you’re thinking about making the job change. It should be something that we’re actually always kind of thinking about and strategizing and building those networks and building our portfolio because I think it’s the healthy thing to do.

Dr. Lin: I love that. I think that’s a really nice way to frame this. I think, on that note, we will conclude this edition of the Society of Critical Care Medicine Podcast. For the entire podcast team, we would like to thank Professor Heavner for spending the time with us. Thank you for listening. I’m Dr. Ludwig Lin.

Ludwig Lin, MD, is an intensivist and anesthesiologist at Sutter Hospitals in California, and a consulting professor at Stanford University School of Medicine, where he teaches a seminar on the psychosocial and economic ramifications of critical illness. 

This podcast was recorded during the Society of Critical Care Medicine’s 2023 Critical Care Congress. Access essential education online through Congress Digital. More than 120 sessions are available on an easy-to-use platform. Continuing education credit is also available. Some SCCM members receive complimentary access to Congress Digital. To learn more, visit sccm.org/congressdigital.

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