In medicine, we’re trained to stay. To endure. To prove our worth by how much we can carry and how long we can carry it. Our roles become our identities. Our achievements and labels become scaffolds of self-worth. In medicine, stepping down is often labeled as a sign of weakness. So we hold on to roles even when they no longer fuel us. We are usually still doing the job superbly and are well respected in the role, but inside, we’ve started to feel bored, depleted, or disconnected. What if stepping down is not a weakness but an evolution? What if it’s graduating?

Graduating from a role isn’t quitting. It honors everything we contributed. It acknowledges the growth, mastery, impact, and the time when the role has run its course. Stepping down shouldn’t require a crisis. We don’t have to wait until we’re depleted or miserable to justify stepping down. We don’t have to burn out to walk away. We can leave when we sense that staying might come at the cost of our spark. Subtle restlessness, loss of joy or energy, or the sense that you’re wearing something that no longer fits is not a sign of failure. It’s an invitation. An invitation to pause and listen.

We are taught to override cues of discomfort in medicine. Pushing through pain and discomfort is what good physicians do. So we stay. We wait for an acceptable reason to leave, one where we won’t be judged or disappoint others. We wait for what comes next before we leap. Our tendency to catastrophize leads us to worry that nothing meaningful will come. We don’t trust ourselves not to regret our decision, so we don’t make one.

Letting go before we burn out is the path to joy, meaning, fulfillment, and feeling alive in medicine. When we release something that no longer fits, we make room for something that does.

That’s what happened when I recently stepped down from a leadership role. I had held it for five years. It was meaningful work. The moment I stepped down, I not only felt relief, but I also saw clearly that there were also other roles I had outgrown. I was able to recognize my pattern and see other spaces where I was staying because I was comfortably uncomfortable.

Stepping down from roles and identities (even worthwhile roles where we are doing an exceptional job) isn’t about abandoning anyone or anything. It is about not abandoning yourself. Choosing to let go is choosing to stay engaged.

One tool I often use to make decisions about letting go and stepping down (both for myself and those I coach) is Martha Beck’s Body Compass. It’s simple and powerful. You imagine a role or commitment and notice how your body responds. If it feels heavy, constricted, or draining, it might be a sign of a -10. If it feels light, expansive, and alive, it might be a +10. It’s usually somewhere in between. Even a zero is valuable data. Inner clarity is transformative. It cuts through fear-based thinking and our habitual patterns and directs us to what is true NOW rather than what was true when we first said yes. The body rarely lies. We’re just not practiced at listening to it. In medicine we learn to listen to other people’s bodies, but we are taught not to listen to our own.

Labeling stepping down, pivoting, or letting go as graduating rather than quitting is a cultural shift that’s urgently needed in medicine. It almost always takes more courage to step down from something that is out of alignment than to continue staying. If we begin to normalize evolving, stepping down, and handing over the reins while we are still engaged, we will create space for others to do the same. Graduating allows others to grow and evolve as well. Stepping down before we have burned out in a role is a sign of trust in ourselves, others, and the system. Choosing to graduate and evolve into new roles and identities demonstrates that we not only believe in the skills and leadership of our colleagues but also believe there is sufficient space for all of us to grow and develop. Being willing to let go of leadership roles that no longer fit, rather than hoarding them, models how to step out of a scarcity mindset and fear-based decision-making into one of trust and belief. It’s an act of leadership itself.

Jessie Mahoney is a board-certified pediatrician, certified coach, mindfulness and yoga teacher, and the founder of Pause & Presence Coaching & Retreats. After nearly two decades as a physician leader at the Permanente Medical Group/Kaiser, she stepped outside the traditional medical model to reimagine what sustainable well-being in health care could look like. She can also be reached on Facebook and Instagram.

Dr. Mahoney’s work challenges the culture of overwork and self-sacrifice in medicine. She helps physicians and leaders cultivate clarity, intention, and balance—leveraging mindfulness, coaching, yoga, and lifestyle medicine to create deep and lasting change. Her CME retreats offer a transformative space for healing, self-discovery, and renewal.

As co-host of the podcast, Healing Medicine, she brings self-compassion and presence into the conversation around modern medical practice. A sought-after speaker and consultant, she partners with organizations to build more human-centered, sustainable, and inspired medical cultures.

Dr. Mahoney is a graduate of Dartmouth College and the University of California, San Francisco, School of Medicine.