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Medical student Christopher Nmai discusses his article, “Leaving medicine is not a failure: It might be the change you always needed.” Christopher shares his deeply personal decision to forgo residency and explore non-clinical paths, highlighting the toll that chronic illness and burnout took during his training. He contextualizes his story within a broader trend—rising rates of physician dissatisfaction and exits from clinical practice—citing stress, administrative burdens, and mental health stigma as driving forces. Christopher advocates for systemic reform, increased flexibility, and destigmatizing alternative careers, arguing that true success in medicine includes honoring one’s well-being and passions—even if that means stepping off the traditional path.

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Transcript

Kevin Pho: Hi, welcome to the show. Subscribe at KevinMD.com/podcast. Today we welcome Christopher Nmai. He is a medical student. Today’s KevinMD article is “Leaving medicine is not a failure. It might be the change you always needed.” Christopher, welcome to the show.

Christopher Nmai: Thank you for having me.

Kevin Pho: Alright, so your story is really contained in your KevinMD article. So just briefly tell us about your article and your story for those who didn’t get a chance to read it.

Christopher Nmai: So, essentially, you know, my story kind of begins with my own personal career. I originally was born in Cleveland, Ohio. You know, grew up in that area, went to Harvard for undergrad, where I studied history and science within the medicine and society track. I would say going into my senior year of high school, I was really invested in a medical career and wanting to practice clinically down the line. This originally started out within interventional cardiology. You know, fast forward several years, and I now find myself actually applying to jobs and, you know, looking into the job market, wanting to impact health care, but not from a clinical lens.

And so I think, you know, there’s a lot of detail within that story itself that influenced it. I think, for me, one of the main reasons was that between my first and second years of medical school, I had to take some time off as a research year. But, you know, I say it’s a research year, but it was honestly a year for me to heal due to some health issues. And so from there, my trajectory really changed. I started to appreciate, you know, some of the other aspects of life that, you know, sometimes medicine doesn’t really afford you. And that really influenced my article. Speaking specifically about my article, I talked about how there’s a rising rate of burnout within the medical profession, which is something that’s been growing significantly from year to year, causing physicians to leave, you know, explore other career options. And, you know, it’s become a pretty significant event that’s been taking place. And so I wanted to draw attention to some of the other options that do exist for individuals who, you know, are feeling a little bit burnt out or feeling dissatisfied with the way that their medical career has been going so far. And I wanted to offer, you know, hope and perspective and, you know, give people a way to channel these emotions and really be able to figure out what is best for them moving forward.

Kevin Pho: So you mentioned that you took a year off or a year away from medical school between first and second year, and it was in that year where you got a perspective outside that medical education journey bubble, and it really changed your perspective in terms of what you want to do in medicine. Talk more about that year and what about being outside that medical bubble made you change your perspective and made you see what life may be like outside of medical school and clinical medicine.

Christopher Nmai: So, like I said, a lot of the year was really focused on treatment. You know, I was diagnosed with bipolar disorder, you know, kind of during my medical school career, and I think that was something that was a big shock to my system—having more or less good health throughout growing up and continuing throughout school. And so this was something that, you know, I was able to see the perspective of a patient a bit more. And, you know, having my medical background, or at least that limited first-year background, I was able to really say, you know, what do I value in my life? You know, is it my career? Is it my own well-being and my health? My mental health? And I think that was a really profound experience where I needed to reassess some of my options.

You know, I had mentioned that I was interested in interventional cardiology leading up until that point. And I realized that that’s a career that demands so much from you, and just given the circumstances that I was going through, I wasn’t necessarily sure if that was something that I would still want to pursue moving forward.

Kevin Pho: So when you made the decision not to pursue clinical medicine—so you’re going to finish medical school and look for a nonclinical job, likely within medicine—what was the reaction of people around you, whether it’s your mentors, professors, colleagues, family? What was the reaction?

Christopher Nmai: So it was really varied. I think from the school perspective, it was quite supportive. You know, they understood my story; they had been with me for all of these years, and they felt that, you know, just my rationale and justification for doing so made a lot of sense. And so they were supportive in me not pursuing the match and wanting to go forward with residency applications.

From my family perspective, I think it was a little bit tougher. Both of my parents are Ghanaian immigrants, and so I think academics are very, very strong within the household. But, you know, after I really explained to them my reasoning for not wanting to pursue residency and a career in clinical medicine, I think, you know, slowly but surely, they began to understand and realize that, you know, this is my life that I’m living, and the best way to proceed forward is to be supportive in that process.

Kevin Pho: How common is it for medical students not to pursue clinical medicine and not go through the match after they graduate?

Christopher Nmai: So it’s definitely a rarity. I would say that out of my graduating class, the majority of students went into the match. I know there are schools—for example, I believe there’s a statistic out of Stanford that I saw where maybe 10 to 20 percent of students actually go into other careers, given the impact of Silicon Valley and other finance-type careers in that area. So it’s very variable across the board, but I would say the overwhelming majority of students do pursue residency.

Kevin Pho: And what kind of options are typically available for students who don’t go through the match and want to pursue a career outside of clinical medicine?

Christopher Nmai: So that’s definitely—there are a wide variety of different options. I think some of the common ones that you frequently see are consulting, private equity, venture capital. But there are a lot of options within the startup space, especially with medical devices and new AI technologies that are coming in to try and assist with administrative burden and other types of aspects that have been plaguing medicine for a while. Medical writing is another option that’s highly sought after. And then also just general project management work is another option, where you can work within either a health care space or a non–health care space and be able to utilize some of the skills that you’ve developed in medical school, such as critical thinking, to advance health initiatives.

Kevin Pho: Now, where did you turn to for guidance? Because, as you said, the vast majority don’t do the path that you’re taking now. Did you have any mentors or guidance in terms of how to steer you to the right path?

Christopher Nmai: Yeah, so there was actually a student who graduated from our school a handful of years before me. We overlapped just briefly my first year. I’ve had his contact information, and he’s currently in the pharmaceutical industry. So he has definitely been someone I’ve reached out to in terms of advice, wanting to get perspective on how that journey has looked for him.

Outside of that, honestly, I think, you know, one area that I believe medical schools could do better is in terms of actually providing more robust career-options services for students who don’t decide to pursue the match. Because, you know, I think while each school’s goal is to have as many people match as possible, there needs to be an anticipation that there will be some students who decide not to do so. And being able to support them in the same way is critical.

Kevin Pho: Do you ever feel that there’s a possibility that you may regret not going into clinical medicine? Because not going into the match certainly seems like a final decision that’s very hard to come back from. Do you ever think that you may change your mind going forward?

Christopher Nmai: You know, that’s definitely something that I’ve thought about recently, especially going through the arduous nature of the job search. I catch myself because I think I need to remind myself of the original reasons why I didn’t pursue residency to begin with, and recognize that those reasons aren’t necessarily going to change. I don’t envision myself coming back into clinical medicine in the same capacity. Research, on the other hand, I think that’s something that is up for debate. I actually applied to some PhD programs this past cycle and have a research passion that I’m still very interested in. So, you know, that’s definitely something that could be on the cards in the future.

Kevin Pho: So you mentioned one of the factors earlier that influenced your decision was the rate of burnout, certainly within medical school. Talk about that. We always talk on the podcast and on my site about burnout within attending physicians, but even within medical school, medical students’ burnout is rampant, right?

Christopher Nmai: I think definitely burnout. You know, we often see the physician statistics, but I think it’s really understudied how medical students fare when it comes to burnout. And, you know, I think it really depends on the nature of the support systems within the medical school, but regardless of that, just the nature of the work that we are doing day in and day out—constantly switching rotations, juggling our clerkship year, for example, which is one of the most stressful times of the process, handling our step exams, financing our step exams and our studying, and just trying also to be humans outside of it—is something that takes a toll at the end of the day. And I think that for me, I found myself doing well in my medical school coursework, but still not feeling like I was living my fullest, most complete life. And this was something that really spurred me to want to reconsider my decision to pursue medicine and see what else lay on the horizon.

Kevin Pho: Now, do you think it’s plausible that going forward there may be more medical students who may follow your path and opt out of clinical medicine, opt out of the match, and pursue nonclinical careers?

Christopher Nmai: You know, I think one of the main reasons that I actually considered it heavily was because of the student who previously did not pursue residency. And so I think just having examples of individuals who are able to leave medicine—still have their very robust clinical training but then utilize it in a different way—serves as an example to other students to show them that this is possible for you, this is something you would be able to do if the circumstances ended up panning out that way for your life. And I think it’s really just normalizing the practice that it doesn’t have to be a one-stop shop in terms of coming to medical school, going to residency, becoming an attending physician, and then staying in the career for however many years. There are a variety of different things that you can do, and I think there are ways that you can enrich your life outside of just being a practicing physician.

Kevin Pho: So now with your unique lens, tell us what are some of the ways that you would like to see medical schools perhaps supporting nonclinical careers. Like if you were in charge of a medical education program, what would you like to see happen?

Christopher Nmai: Yeah, I think definitely embedding within the curriculum—protect the first, second years, do the clerkship year, do all of that. But I think as you’re entering into the late stages of the medical school experience—your third, your fourth year—really having a diverse variety of electives for students to be able to partake in. One of the main reasons that I wrote this op-ed was that I was on a medical journalism elective hosted by Dr. Mark Siegel, who does Doctor Radio. And I think that experience was one of the most enlightening ones that I’ve had in all of medical school. I got to meet with journalists, other people within publication, doctors who are on TV, things along those lines. And I saw that there’s so much more that exists beyond just being a practicing physician, but that you can actually utilize those skills in a meaningful way and disseminate information in countless ways.

Kevin Pho: We’re talking to  Christopher Nmai. He’s a medical student. Today’s KevinMD article is “Leaving medicine is not a failure. It might be the change you always needed.” Christopher, let’s end with some take-home messages that you want to leave with the KevinMD audience.

Christopher Nmai: So I think primarily, you know, as a medical professional, as a medical student, really take a look at your life. You know, ask yourself, what do you truly value? What are the things that get you up in the morning? What are the things that make you excited? What are the things you’re really passionate about? And I think have a perspective where, if where you are currently isn’t necessarily fulfilling all of those buckets, take a step back and try and evaluate what exactly it is that you might be able to do or switch within your career to allow you to feel more fulfilled. Because at the end of the day, we only do have one life that we’re living, and we need to prioritize— it may sound selfish, but I think we need to prioritize our health and our well-being more than anything. Because regardless of whether you decide to stay in medicine or not, we can only be the best individuals possible if we’re truly taking care of ourselves.

And so I think that, you know, really take burnout seriously. Burnout kills at the end of the day, and it’s something that shouldn’t necessarily be tolerated if you’re truly, truly struggling. I think also medical schools can do better by offering a diverse array of electives and selectives for students to really explore what else is possible out there, whether it be policy, finance, medical writing, journalism—things along those lines. They really are enriching experiences, and they allow students to explore other interests that they may have come into medical school with but haven’t had the time to address, given the nature of the curriculum.

Kevin Pho: Christopher, thank you so much for sharing your story, time, and insight, and thanks again for coming on the show.

Christopher Nmai: Thank you for having me.