Approaches to retirement planning

Research shows men and women often approach retirement differently.

Women are more likely to work part-time and less likely to work past age 65 years. Female doctors consider other expected income, adequacy of retirement income as well as age, stress, burnout and the availability of part time work when making their retirement decisions.

Male doctors’ retirement decisions are influenced by having adequate income, the age of any dependants, personal stress, burnout or health issues including the health status of their spouse and their other interests.

Some colleges have courses for their fellows on planning for retirement such as the Royal Australasian College of Surgeons.

How will you know you are continuing to work safely?

The best guide is to seek the opinion of your peers. Research shows self-perceived cognitive changes do not always relate to objective measures of cognitive change. Your own views on your ability to practice may not be a reliable basis for making retirement decisions.

Frank and open discussions at credentialing sessions or with your practice colleagues or peer review group may help you to be assured that you are able to continue practicing safely or that you should look at changing the way you practice.

What changes you can make depends on:

• the type of work you are doing
• your specialty (research shows doctors from different specialties retire at different ages)
• your physical and mental stamina, coordination and reaction time
• your judgment and insight.

Several studies, (mainly in surgery or emergency medicine where reactive time, dexterity, fine motor skills, endurance, and eye sight are crucial) record doctors’ concerns that they may lose skill and competence as they age and therefore they retire, possibly earlier than they need to.

Alternatively, concern has also been expressed that some doctors fail to recognise the effects of aging, which may place their patients and themselves at risk. Both personal and institutional problems can arise when doctors continue to practice despite limitations of aging.

To learn more about research and studies on cognitive changes read about studies on competence and cognitive concerns (PDF, 13.04KB).

Can to you reduce your work load and/or work more flexibly?

Discuss with your colleagues, partners, department and employer the options for working more flexibly. This may include:

• reducing overtime
• reducing on call, long or rotating shift work
• reducing night shifts or at least reducing constant changes in shifts
• considering shorter hours or rotation of weeks on and off.

You could also assess if there is potential to job share - maybe with others in the department or practice that also want to work fewer hours or want to take parental leave or have some time off for research or study. Job share positions may decrease the need for locum coverage of acute services and be of benefit to the service.

Working in conjunction with others- maybe there is a trade-off where you can accept week end shifts so younger doctors could have family time at the weekend and you have more time during the week for alternative activities.

If you work in a general or specialist practice you may be able to employ a Registrar who can assist you in the short-term and may eventually be in a position to take over your practice.

Another option is to develop a “portfolio life style” that is practise medicine for part of the year and do other things at other times. Or combine work with travel - do some work in NZ and some overseas. Several doctors from USA come to NZ for part of the year. Could you find someone to job share in another place of country that has a similar practise?

Can you change your work focus?

There are opportunities for some specialties to work differently such as:

• decreasing interventional work.
• doing only office based practice.
• reducing caseload or changing case type.
• doing locum work (but you need to be careful not to work in isolation and move around too much or else you will lose contact with peers). Also you may need to define the limits to your availability. Some Colleges like RACS have special CPD for locums.
• acting as “back up” to others who may be sick or on leave.
• stepping back to a lesser role.
• reducing administrative duties.

Some specific advice has been developed for GPs on selling your practice, doing locum work and information on recertification requirements.

Can you change your work role?

Some doctors move from one specialty to another in their middle or later years, this may be easier if the second specialty College recognises prior learning.

Some doctors move into management positions. RACMA recognises prior learning leading and if the candidate has attained core competencies in management through practical experience or learning they may be accepted into the accelerated pathway to Fellowship and vocational registration in medical management. RACMA runs a range of workshops including Introduction to Medical Administration.

Other work roles - using your skills and experience to work outside clinical practice

There are numerous roles doctors can take on outside traditional practice. Most do require some recency of practice i.e. that you are in clinical practice part-time or you have not been out of active practice for more than three years. Some roles are paid and some are volunteer roles. Some offer training for the role or you can access training via other trainers. Some roles will require you to continue with CPD. The types of roles include:

• assisting with recertification and re-credentialing
• working as medical adviser or assessor
• sitting on a statutory Board for DHBs, PHO and other health groups
• writing medical legal or insurance reports
• reviewing medical insurance claims
• acting as an adviser for organisations like HDC, BPAC and ACC
• research, writing articles and editing work
• assisting with performance reviews and/or up-skilling doctors for organisations such as the Medical Council
• not for profit work and volunteering
• contributing to the work of your College and Association
• being a mentor for younger doctors
• back up for other doctors (the older semi-retired doctors requires virtually no training to take on relief shifts)
• teaching in grand rounds without the restraints of other work, possibly being “twinned” with another consultant. Sharing knowledge through teaching is easier if the doctor does not have tight appointment schedules and constraints on time. Can you develop a new role as a listening teacher? Read more about being a “listening teacher” (PDF, 13.96KB).

It has been noted that doctors are usually “instinctively decision makers” who like to be “in charge”. These attitudes mean that doctors may exclude themselves from alternative jobs or roles as they have concerns about taking on a lesser of position without first considering the possible advantages.

In a “second career” there can be a “shift in emphasis from career and practice building to enjoying practice”.

Read more about other work roles, what skills and experience are needed and where to apply (PDF, 37.26KB).