So, you’re a physician with a love of travel — awesome! One week of your salary allows you to travel anywhere in the world (coach, at least) — double awesome! But, as you are acutely aware, there is a catch … a big one. As a full time doc, how do you possibly get the time off to explore new cultures, hike/bike amazing trails and eat/drink around the globe?
As physicians we have legal, professional and ethical obligations which limit our ability to get out of town. We have an obligation to patients to be available for their postoperative care, an obligation to our hospitals to cover their emergency room and floor consults and an obligation to our partners to assist with coverage of the patient and overhead load.
Here are some ideas to find the time to travel as a physician:
1. Residency. While you may be an MD, this is the most difficult time to travel. Many residents have 15 non-consecutive days per year (in five-day blocks) of vacation time. A salary of $50K/year means that many residents spend these limited days moonlighting to pay down >$200K in average medical school loans.
2. Humanitarian trips and conferences are two ways to increase the available days to travel nationally and internationally. Program chairpersons usually appreciate residents who participate in research, humanitarian trips and national conferences. Review your department’s policies regarding conference attendance. If one doesn’t exist, or is vague, consider submitting abstracts to conferences in places you’d like to travel or organizing a humanitarian trip and pitching the idea to your program director or chairperson. Often, there is funding available for such pursuits, and it is a win-win for the department that gets to advertise the academic/humanitarian pursuits of their residents, the resident who gets to travel and the patients who are benefiting from the research/humanitarian work.
3. Transition time. The easiest way to find some time to travel is to delay the start of your first job out of residency from July 1 to January 1. Obviously, the huge downside is the opportunity cost of lost income. You can either choose to eat this loss of income, take a couple of weeks-long locums gigs during this time, or find a job share position in a location you’d like to live for a bit but not settle down permanently.
4. Negotiating a permanent job position. The break between residency and your first job is only a short term fix. If you truly have a passion for travel, you’ll be chomping at the bit to fly away by February 1. This is where negotiation is critical.
5. Negotiating your first contract is a topic for which books are written and entire professions are dedicated. If you prioritize time for travel over maximizing income, then you have some room to negotiate. Most employed MD contracts have a guaranteed base salary period from one to three years. If you plan to travel significantly, then attempt to extend the guarantee as long as possible and negotiate for extra CME and PTO days. You may need to reduce the sign-on bonus and base salary to achieve these goals, but in our experience, it is certainly achievable. Some people think of “travel” as drinking yourself into a stupor in Cancun, so I recommend framing the desire for extra CME or PTO time as an opportunity to present research, expand your practice skills and offerings or providing humanitarian work abroad.
6. Changing jobs. If your current position does not offer enough time for travel, you always have the option to change jobs. This allows a significant break to travel and also allows you to reset with a new employer or group regarding your travel priorities. If you are experiencing physician burnout and feel a lack of time to travel is part of the problem, this may be one of the most viable options to continue practicing.
7. Downgrading privileges. ER Call obligations can often be burdensome and make leaving for extended periods of time impossible. Most hospitals have courtesy privileges which allow a certain number of patient contacts during the privilege period without a requirement to take ER call. I have known several doctors who drop to courtesy privileges until this “patient touch” number is reached and often avoid 12-18 months of ER call in a 24-month appointment period. I’m not endorsing this method (especially as I’ve been on the bad end of this — taking extra call for these docs who have dropped out of the call pool), but am listing it as a possibility to pursue and consider if the alternative is burnout.
8. Locums. Locums Tenens is another alternative to obtain significant time off. We negotiated with our current hospital to provide locums at set intervals for A and I to be able to travel internationally. Ideally, having a hospital cover this call is key as it can be very expensive depending on the specialty ($1500-$3000/day). Many hospitals may offer to cover this for a week or two at a time as an alternative to their docs dropping to courtesy privileges indefinitely.
9. Sabbatical. There is at least one multispecialty group in the West Coast of which I’m aware that offers their docs a one-year sabbatical after 10 years of service. Docs I spoke with use this time to do a mini-fellowship, do locums work or just chill out locally or abroad. Alternatively, joining a single specialty group of like-minded docs could make this a possibility. A group of five could allow someone to take a three month leave every 15 months or so in rotation. That would be sweet, right? I think this may become more common as millennial docs take over the majority of positions of single specialty groups in the next few decades.
10. FMLA. Family medical leave act — have or adopt a child, get your hernia repaired abroad or finally admit that your anxiety/depression requires a bit more than a couple of beers a night to treat. We have federally protected leave, and it can be used for many reasons. As far as I’m aware, there is no legal requirement that the entire maternity/paternity leave be taken in Wisconsin instead of Copenhagen.
11. Financial independence. Save, save, save. If your expenses are low and your savings rate is high then it won’t be long until you can take a part-time job or you can stop working entirely.
“Sightsee, MD” are surgeons who blog at their self-titled site, Sightsee MD.
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