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PHYSICIAN
RETIREMENT

My Retirement From

Academic Medicine

By Rajam Ramamurthy, MD

The Academic ‘Bug’ physicians’ retirement decisions include: general environment at work,
While explaining the total and differential WBC (White blood cell decreasing income, employment of spouse, income after retirement
count) to the student who was assigned to me when I was a senior (Social security income, pension or annuity other sources like rental
houseman in the General Hospital pediatric ward in Chennai, India, property) current age, the existence of dependents in the family, years
I turned around to see that a group of students and nurses had gath- of service as a physician, the health status of self and spouse,
ered behind me. One commented, “Thank you, Ma’am. No one ex- stress/burnout, personal interests and the availability of part-time jobs.
plains simple things to us; it is taken for granted that we know those Once the decision is made to retire, there is almost no road map for
things and we are too shy to ask, fearing we will be judged as stupid.” that physician, particularly in the psycho-social aspect, which has
That statement has stuck with me all my teaching life. prompted this article.
During my pediatric residency at Cook County Hospital in It was the last time I would give this lecture to medical students and
Chicago, I was doing a newborn baby physical examination. It was residents which I did once a month. It was about skin conditions in the
customary for me to always request that the mom come and be with newborn baby. I had pictures of skin problems with a ‘wow factor’ of
me so I could finish talking to her during my exam of the baby. The 10 on a scale of 1-10, as the students called it. I had mentioned that it
group of students who were assigned to neonatology would gravitate was my last teaching session; I retired that week. At the end of the ses-
to where I was. Part of what I did and spoke was work, but part of sion the residents rushed to finish their work, the students rushed to
what I did was showmanship, nicely said; role modeling. However, at the cafeteria to grab lunch. I sat down for what felt like a very long five
some back corner of my conscience an image of myself was building, minutes. Is that it? Forty-two years of a teaching career and no one in
it was that of a teacher- ‘Guru’ in the Sanskrit language (Gu meaning the institution cares? You just pack up, turn the projector off and walk
darkness and Ru- light, literally a teacher who removes the darkness away? It certainly seems like there could be something we do in recog-
and shines the knowledge of light). A taste of this is intoxicating; it nition of a last teaching session, last surgery, last clinic patient, last day
drives your career choice and is the most difficult one to withdraw at work, to put closure to a lifetime of work for most physicians.
from as one contemplates retirement from academic life. Bitten or
smitten by the academic bug is no understatement. Life after retirement
Ideal retirement means something different for each physician. The
Decisions to enter and exit academia: most common statement I hear is that they are relieved that they do not
The environment of one’s training greatly influences a physician’s ca- have to follow any schedule. That was true for me. It was followed by
reer path towards clinical care, research or teaching. A person with an using that unscheduled time in committing to unnecessary activities like
MD or DO degree who chooses an academic career balances on one listening to online webinars, attending lectures, book clubs and planning
leg of this so called ‘three-legged stool’. Teaching was the leg I stood on. to have lunch with other retirees. Others plan vacations they should have
One study shows that the primary reason women chose an academic taken at a much younger age when their stamina and agility would have
career is an interest in teaching. The same study showed that women allowed them to walk the long trek to Petra and back instead of staying
choosing academic medicine did so not as a planned decision but a back looking at the facade. Those who are grandparents among us over-
serendipitous one realized almost at the end of fellowship. Silver et al, commit to taking care of grandchildren, finding ourselves in the familiar
in a study involving 4,572 physicians, found that the average age at re- place of playing the role of parents. However, this is among the things
tirement for most physicians was 65 years, but women physicians tend grandparents do that is probably the most pleasant engagement that in-
to retire on the average 4.1 years earlier than men. Also, about 40% of fuses youthfulness and joy in one’s life.
the physicians reduced their activity by at least 10% for 3-4 years prior My retirement planning started two years before actual retirement.
to retirement. This should enter the calculation when work force num- I was in my office preparing a lecture, an activity I thoroughly enjoyed.
bers are calculated based on the number of licensed physicians. It occurred to me that I can do this forever. I love to write! I should
Although there are several papers regarding pre-retirement prepa- do that while I have the clarity of thought and physical wellness. It was
ration, there are very few studies addressing the period surrounding at that point I decided I will set a retirement date. I felt that my work
retirement and post-retirement. Factors affecting male and female environment was ready for that as well. I have written a lot since then,

18 SAN ANTONIO MEDICINE • April 2021