In the first episode of The Pitt season 2, Dr. Robby reveals he’s taking a three-month sabbatical, his last shift before heading to a UNESCO World Heritage Site in Canada. For a primetime medical drama to feature a physician stepping away for three months signals something important: Sabbaticals are entering the cultural conversation about how doctors survive in modern medicine.

But here’s what the show doesn’t tell you: Most physicians can’t just announce a sabbatical and walk away.

When I asked my department for a sabbatical last year, the answer was swift: No. I was an associate professor, technically eligible according to our faculty handbook. I was getting my job done well and hitting my metrics, but I was also irritable and disillusioned. I needed a break, in a way that others around me were starting to notice.

But the unwritten rule was clear: Sabbaticals are for full professors. Come back in another decade, maybe.

So I did something that felt simultaneously terrifying and obvious: I took one anyway. Unpaid.

That decision transformed my career and my relationship with medicine. Three months completely off, returning part-time, launching a coaching business, one of the hardest and most rewarding things I’ve ever done.

I wish I didn’t have to go rogue to make this happen.

The sabbatical that exists only on paper

My institution isn’t the villain. They’re following a standard consistent across academic medicine. Since 1880, when Harvard first introduced sabbaticals, universities have offered sabbaticals as a cornerstone of academic life. Medical schools have sabbatical policies. The mechanism exists, in theory.

But a 2021 survey found that only 53 percent of U.S. medical schools reported any faculty taking sabbaticals in the past three years. Among those schools, the median number was just three faculty.

The barriers are predictable: Who will cover patient care? How will clinical revenue be maintained? These are real logistical challenges. But is it better when physicians quit permanently and find jobs elsewhere?

Why this matters now

This isn’t just about a malfunctioning policy. It’s about a profession in crisis.

Nearly half of all physicians, 43 percent in 2024, report burnout. Alarmingly, 28 percent think about leaving medicine at least once a week.

To be a physician in 2025 means feeling the ground shifting beneath you. Insurance companies tighten their grip. Government leaders undermine established science and cut medical research funding. AI upends everything. These are daily erosions of our ability to do our jobs well, to feel proud of what we do, and to believe the system values our expertise.

Medicine offers a binary choice: You’re either all in, grinding through bureaucracy and moral injury, or you’re out. There’s no middle ground. No way to step back, recharge, and return with renewed commitment. Sabbaticals could be a pressure valve that provides relief and balance.

What athletes and smart companies know

Elite athletes build recovery into their schedules because strategic rest prevents injury and extends careers. In athletics, four to 12 weeks of rest is standard. Not as a reward, but as a tool. Companies like PayPal and Adobe offer sabbaticals after five years because employees return recharged. Medicine is neglecting this powerful tool.

Create your own sabbatical

I’m not optimistic about institutional change happening quickly. So here’s what I wish someone had told me: You don’t need your institution’s permission to take care of yourself.

You can create your own sabbatical. Here’s how:

1. Start financial planning now: You need runway. Calculate your budget. How long? What will you need? Build your sabbatical fund. Reduce fixed expenses by downsizing or paying off debt. Consider creative funding like renting your home or supplementing with locums. Start now. You won’t regret extra savings even if you never take the sabbatical.
2. Define your purpose and structure: A sabbatical without structure becomes an anxious vacation. My priorities were: nest with my new family (I got married, took a honeymoon, and became a dog mom), reconnect with nature, and launch my coaching business. Yours might be learning a new skill, writing, traveling, or exploring different work. Write it down. Create a plan. But leave some flexibility for your time off too, as that’s kind of the whole point. Structure doesn’t mean rigidity; it means keeping an eye on your “North Stars.”
3. Build your reentry plan: How will you return to earning? Return to your current position? Negotiate upfront. Leave gracefully before you’re too burned out. Look for a new role? Build a networking plan. Transition to part-time or launch something new alongside clinical work? I launched a coaching business that gives me flexibility while reinvigorating my passion for changing medicine’s culture. My reentry wasn’t about going back; it was about going forward differently. Plan for credentialing, licensing, and CME requirements. Find allies within your institution. When I made my intentions clear, key people stepped up and made my part-time reentry possible.
4. Get your support system in place: Talk to your family. Find mentors who’ve done this. Join communities of professionals reimagining their careers. Work with a coach. Taking an unsanctioned sabbatical feels vulnerable. You need people who believe in you.

The permission you’ve been waiting for

The system tells you to wait. Until you’re promoted. Until you’ve proven yourself worthy of rest. But you don’t need your institution’s permission.

I’m not saying it’s easy. It takes courage to go off on your own. But it’s possible, and for many physicians, it’s necessary.

We spend our careers taking care of everyone else. What would it look like to take care of ourselves with the same intentionality?

For me, it looked like an unpaid sabbatical that terrified me and changed everything. It gave me space to build something new, reconnect with my purpose, and return to medicine on my own terms. It would have been easier not to have to go rogue. But I’m glad I did.

And if you’re reading this, wondering if you could do the same, I want you to know: It’s not irresponsible or selfish.

It might be the most powerful thing you ever do.

Christie Mulholland is a palliative care physician and certified physician development coach who helps physicians reclaim their sense of purpose and connection in medicine. Through her work at Reclaim Physician Coaching, she guides colleagues in rediscovering fulfillment in their professional lives.

At the Icahn School of Medicine, Dr. Mulholland serves as associate professor of palliative medicine and director of the Faculty Well-being Champions Program. Affiliated with Mount Sinai Hospital, she leads initiatives that advance physician well-being by reducing administrative burden and improving access to mental health resources.

Her recent scholarship includes a chapter in Empowering Wellness: Generalizable Approaches for Designing and Implementing Well-Being Initiatives Within Health Systems  and the article, “How to Support Your Organization’s Emotional PPE Needs during COVID-19.” Her peer-reviewed publications have appeared in Cancers and the Journal of Science and Innovation in Medicine.

She shares reflections on professional growth and physician well-being through Instagram, Facebook, and LinkedIn. Dr. Mulholland lives in New York City with her husband, James, and their dog, Brindi.