Plan B for Bullshit: What to Do When You’ve Had Enough of Medicine

David Wandless
Jul 5
5 min read

Updated: Jul 6

At some point, if you haven’t already, you’re going to hit a wall.

Maybe it’ll be subtle — a creeping exhaustion, a half-hearted sigh when you wake up and realise it’s another Monday full of rotas, bleeps, and patients who’ve all become strangely fluent in TikTok medicine.

Or maybe it’ll be catastrophic — the kind of burnout where you find yourself weeping into a Pret napkin in the back of your car, composing resignation letters in your head.

I’ve been there.

I’ve hit the wall, clawed my way over it, tried to make a home on the other side, only to realise I forgot to pack a bloody roof.

And that’s what this is. Not a motivational talk. Not a top-10-listicle. Just an honest map of the scorched landscape you may find yourself standing in, wondering what the hell Plan B even is.

“I’ll Just Become a GP”

Let’s get this out of the way.

It’s the emergency exit you hear in every overheard corridor chat. “I’ll just switch to GP. That’ll be easier, right?”

It’s funny. Even I used to think that, and I am one. I am one and I did that. I get people calling me at odd hours asking how I did that.

General Practice isn’t the kiddie pool. It’s not the soft option. It’s clinical reasoning without a safety net,

it’s dealing with complexity in 10-minute soundbites, and it’s having fifteen people shouting at you — eConsults, duty doc, reception, the patient in front of you, your inbox, your own children — and none of them care that you’ve run out of glucose and patience.

Yes, GP can be fulfilling.

Yes, it gave me back some agency.

But I switched at the end of a breakdown, not the beginning of one. And that difference matters.

So don’t romanticise it. Don’t use it as a parachute. Because this isn’t a soft landing — it’s a lateral move into a minefield with a different map. The same workforce erosion, patient demand overload, and systemic moral injury still await you. The only thing that shifts is the acronym above your door.

Is It Medicine — or Is It You?

Before you torch the whole thing, ask yourself this — and be brutally honest:

Is medicine the problem, or am I burning out because I’ve forgotten how to be a person outside of work?

If you’re not eating properly, not sleeping, disconnected from people who love you, spending evenings refreshing NHS Jobs, then yeah, everything is going to feel like a flaming dumpster.

It might not be medicine. It might be that you’ve let the job become your whole identity.

That you’ve stopped saying “no.”

That you’ve got no boundary between you and the fire.

When I fell apart, it wasn’t just medicine that broke me. It was me, hollowed out by a system that teaches you to equate tiredness with weakness and overcommitment with worth. Most doctors internalise this long before they hit clinical walls — because we are trained to see disintegration as personal failure rather than a symptom of vocational collapse.

If You’re Still Reading, You’re Probably Already Halfway Out

Let’s say you have done the self-reflection.

You’ve had therapy, or at least one of those 3am moments staring at the ceiling wondering if this is it.

You’ve spoken to your partner (or haven’t, because you're scared they’ll ask why you’re even doing this in the first place). You’ve googled “careers for ex-doctors” and landed on sites full of smiley ex-clinicians now dubbed “clinical informatics officers” or “medical engagement leads.”

You’re not alone.

We’re told we have transferable skills. But outside the NHS, few employers understand how to convert them — especially when the doctor in question is exhausted, disillusioned, and terrified of starting again at the bottom.

Research shows that career transitions post-medicine are not only poorly supported, they’re also actively stigmatised — seen as exits to be explained, rather than decisions to be respected.

Even now, the NHS has no robust strategy for managing the emotional fallout of doctors who leave. Many are tracked only statistically, with minimal insight into why they exit or how they recover.

On Time, and Taking It

If you don’t know what to do next — take time.

Not a long weekend. Not a “bit of study leave” where you still end up checking results at 11pm. I mean time.

Sabbaticals, breaks, fuck-it years — whatever works.

Because burnout recovery isn’t a project plan. It’s grief. And grief takes space. Not performance space, not reflective practice sessions.

Real space.

Structured pause points, time away, and even temporary exits are among the few interventions that measurably reduce emotional fatigue and facilitate safe return — yet they remain inconsistently applied, poorly promoted, and financially risky.

Though take it from me - if you don't find a clean cut and try to keep a foot in the door it will be repeatedly tested for conviction by slamming it hard.

No-one likes to be the back-up option, and no-one likes to feel ran away from. It will serve neither master well, and leave you limping when you needed to keep the running pace (maybe even sprint to catch up with the pack).

The Real Plan B

Here’s the kicker.

There is no Plan B.

There’s only you, trying to figure out what you’re no longer willing to lose in order to stay.

Maybe you leave. Maybe you retrain. Maybe you stay — but renegotiate the terms, the hours, the version of you that’s still worth preserving.

But don’t wait for the system to validate your pain. It won’t.

It will let you burn.

It will offer yoga and e-learning and a two-day delay on your complaint outcome letter — and call it support. It will treat your collapse as administrative inconvenience. It will call your emotional wreckage “lack of resilience.”

Leaving medicine doesn’t mean you failed the vocation. Often, it means the vocation failed to make room for the person you became while trying to stay. And even that decision — to go — is often pathologised or ignored.

So, What Now?

Take a proper break.
Get a therapist. Not an app. Not an AI. A person.
Talk to someone who’s been there — not just the ones with corporate rebrands and polished slides.
Don’t make major decisions in your first month off. You wouldn’t trust a drunk version of yourself to do life admin. Burnout-you shouldn’t call the shots either.
If you're thinking about leaving, make it a choice, not an escape. It’s not enough to know what you’re walking from. You need to learn what you’re walking towards.