The emergency doctor seated across from me had everything mapped out: ideal schedule, six-figure income, esteemed by peers, two children in college, and a mortgage nearly settled. “I should feel grateful,” she remarked, gazing into her coffee. “Yet I find myself wondering — is this all there is for the next two decades?” If you’re in agreement, you’re not alone. That subtle unease isn’t lack of gratitude. It’s evolution.

The narrative we’ve all received

From the very start of medical school, we absorbed the same message: “Be thankful. You’re saving lives. This is honorable work. You knew what you were getting into.” Thus, when that familiar discomfort arises—the one that suggests “there must be more than this”—we don’t challenge the narrative. We challenge ourselves.

But I wish someone had shared this with me sooner: You don’t need to be burnt out to desire change. You don’t have to be unhappy to pursue something else. The most significant transformations occur when we opt for change before circumstances force it upon us. That’s not weakness. That’s insight.

When success feels hollow

The strange aspect of medical training is how thoroughly it teaches us to disregard our internal guide. We learn to persevere through fatigue, to suppress our instincts, to continue onward despite our feelings. Those abilities serve us well during residency. They serve us less effectively when we try to discern what we genuinely want from life.

We become adept at fulfilling everyone else’s expectations while losing sight of our own. We mistake endurance for success, and survival for fulfillment.

The partner predicament

One of the most isolating aspects of desiring change is when those closest to us don’t comprehend. When I began to question my career path, my husband—still deeply entrenched in emergency medicine—couldn’t understand why I would “give up a great job” to pursue something uncertain. His concern stemmed not from judgment, but from fear. Fear of financial insecurity, of answering family inquiries, of the unknown. In retrospect, it was love manifesting as protection.

You don’t need anyone’s approval to seek more. However, you must articulate the difference between wanting change and wanting to flee. Start small. Allow your consistency to speak louder than your justifications.

We’ve lost the ability to dream

Physicians excel at handling responsibility. We show up. We resolve issues. We bear the burden of a flawed system without complaint. Yet somewhere along the line, we ceased to dream. When was the last occasion you permitted yourself to envision a Tuesday that felt fulfilling?

We’ve been conditioned to believe that dreaming is egotistical, that contentment should suffice. But contentment is not synonymous with fulfillment. You may appreciate what you have and still aspire to create something that aligns more closely with the person you’re evolving into.

What “more” truly signifies

Let’s clarify: Wanting more doesn’t equate to abandoning medicine. It involves questioning the elements of your professional life that no longer benefit you and having the courage to make adjustments.

– It may look like declining an additional shift without guilt.
– Delegating tasks you dislike, even if you’re skilled at them.
– Responding “How are you?” with something besides “exhausted.”
– Taking your side interests seriously rather than viewing them as mere hobbies.
– It may mean choosing rest without feeling sorry for it.
– Structuring your schedule around your energy instead of others’ demands.
– Remembering that your value isn’t determined by your output.

Minor choices create momentum. Momentum generates opportunities. Opportunities foster freedom.

Service without sacrifice

Many of us internalized the belief that service necessitates sacrifice—that the more we forfeit, the more virtuous we become. Yet true service arises from abundance, not depletion. You’re more effective when you’re in alignment. More engaged when you’re not merely surviving. More giving when you’re not running on fumes.

The system led us to believe that self-sacrifice was the utmost expression of service. But what if the contrary is accurate? What if prioritizing your own well-being is the most radical act you can undertake?

Your permission note

If you’ve been anticipating someone to affirm that it’s acceptable to desire something different—this is your signal. You don’t have to clarify your aspirations to anyone. You don’t need to justify them. And you certainly don’t have to earn the right to change through burnout first.

That restlessness you’re feeling? It’s not a lack of gratitude. It’s your inner wisdom trying to draw your attention. It’s the part of you that recalls you were someone before donning the white coat—and you’ll be someone afterward, too.

Your life need not become a loyalty test to a system that was never crafted with your well-being in consideration. It can be a creation. A design. A conscious choice. The moment you acknowledge that truth is when everything begins to transform.

Maureen Gibbons has moved from a satisfying career in emergency medicine to one