Non clinical options

bear in mind there are few things that don't require additional training that pay as well. i know several physicians who have gone to the dark side of working for management consultancy firms like McKinsey that do lots of healthcare consultancy work and are very interested in hiring physicians (though they will deliberately put you on non-health related projects at least to begin with). At stanford and ucsf something like 20% of students don't do a residency and instead go an work for some healthcare related start-up. going these routes mean taking a pay cut, job insecurity, and working longer hours however. but some people find it more rewarding and there is the potential to carve out your own path and also earn significantly more than in medicine if successful.

didn't you used to be interested in palliative care? maybe your heart isn't in psychiatry but could switch into working in palliative medicine?

you could also work in preventive medicine, or occupation/environmental medicine which would require additional training including an MPH if you don't already have one.

for pharmaceutical stuff other than being a shill for the drug companies (Speakers' bureau etc), you really do need to have R&D experience, and there are specific fellowships for this now. it may be easier to work for biotech companies but you would need to have some understanding of things like genetics and so on. start ups may be the easiest to get a foot in without additional experience but they offer the least security and again you take a risk and may have to continue doing some clinical work to make enough money, at least to begin with.

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Non clinical options