Mindful Journaling for Re-Thinking Your Career in Medicine: Staying, Leaving, or Practicing Differently

There comes a time for many physicians when troublesome questions begins to surface:

• Can I continue practicing in this way?

• What needs to change to make my practice sustainable?

• Is it time to move on?

• Are there other ways to use my skills, knowledge, and gifts that I haven’t yet imagined?

These questions, which may arise at any phase of your professional life, don’t always yield easily to analysis. In fact, thinking harder, what we might call ruminating, often makes problems feel less resolvable. Instead of finding clarity, you may begin to feel more uneasy, more torn, caught in a whirlwind of what-ifs and afraid of making the wrong choice.

This is a good time to tap into your inner wisdom, and this is where journaling can help.

In my work with physician clients facing difficult questions, I often encourage journaling as a reflective practice. It’s a simple, analog way to get in touch with your own inner life. In many ways, it’s a form of mindfulness. Writing by hand often works best, as this tends to create a strengthen the mind-body connection and deepen awareness. But choose what feels most comfortable and accessible for you.

The journaling reflection that follows is not meant to force a decision. Instead, it is an invitation to listen differently, to slow down and give your mind the space it needs to breathe.

To begin, set aside anywhere from 10 to 30 minutes. Choose a time when you can take a quiet and uninterrupted pause, maybe at the beginning or end of the day. Let your intention be to meet your own presence rather than productivity.

Step 1: Name the Question (Without Answering It)

Write the question that keeps returning for you. Perhaps that’s:

• Is it time for me to change the way that I am working?

• Is there a way to practice that feels more sustainable?

• Who am I if I am not in my current practice?

• What would it mean to me to leave medicine altogether?

Your question could be something else entirely. Perhaps it’s very personal, or maybe it’s connected to your family. No matter what question you choose to sit with, choose something that matters to you.

Once you’ve acknowledged your question in this simple way, write:

Right now, I don’t need to answer this question. I am simply acknowledging that it is here.

Pause, breathing in and breathing out, before moving on.

Step 2: Notice How the Question Lives in the Body

Without analyzing, reflect on:

• Where do I feel this question in my body?

• What does it feel like? Is it tight, pressing, restless, dull, vibrating, sharp, or charged? Maybe it is simply a weight, or something else.

• What happens if I stop trying to solve it, even briefly? How does the sensation change?

Write what you notice. If an answer feels clear, sit with it for a while. If it doesn’t, give it time. Resist the urge to fix.

Step 3: Release the Urgency to Decide

Complete one or more of the following phrases:

• When I try to force an answer, I notice that I feel…

• What I am most afraid would happen if I don’t decide soon is…

• If I trusted that clarity will come in its own time, what would soften right now?

Allow your writing to be honest and unedited.

Step 4: Remember How Insight Has Emerged in the Past

Think of a time, whether personal or professional, when an important decision became clear without effort.

• What was happening around that time?

• What was my state of mind or body?

• How did that sensation of knowing feel when it arrived?

Write without trying to draw conclusions.

Step 5: Give the Answer Time to Grow

On a new page, write:

I am allowing this question to rest.

Then ask yourself:

• What helps me stay grounded while this question matures?

• What kind of space, support, or pacing allows clarity to emerge naturally?

• What would it mean to trust my capacity to find my way?

• Who or what might support me in staying present with this question, rather than rushing toward an answer?

A Closing Reflection

Before you stop writing, choose one sentence you can return to when stress or anxiety rises. For instance:

• I don’t need to have all the answers right now.

• I can rest here in this moment, and it’s ok.

• I trust myself and my inner wisdom.

Life is not a board exam. Some decisions are not meant to be rushed. They are meant to be lived with until, in their own time, they resolve themselves into something that feels steady, clear, and right. This is not the same as avoidance.

Keep this in mind:

• You are not behind.

• You are not failing.

• You may simply be in a necessary period of transition.

Allowing uncertainty to remain present is not procrastination or a dismissal of its importance. It is a necessary first step. Action taken without intention can easily lead you off course.

Return to your journal daily if possible; even a weekly practice can be transformative. With time and mental space, the next step often becomes clear. If the weight of the process feels heavy or unwieldy, a physician coach can serve as a trusted thought partner, helping you to reflect, stay grounded, and find your own way forward.

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