[Editor's Note: Today's guest post was submitted by Dr. Gayle Galletta, an Associate Professor of Emergency Medicine at the University of Massachusetts, the mother of three teenagers, and an 11-time Ironman triathlete. Her solution to physician burnout was a sabbatical with her family in Norway. We have no financial relationship.]
I had always regretted not taking a study abroad year and mastering a foreign language while in college. After practicing Emergency Medicine for twelve years, I finally decided to do something about it. I took a sabbatical. The year was 2012, and I was getting burned out, primarily from drug-seeking patients. My stay-at-home Norwegian husband and I packed up our three children, ages 8, 9, and 10 at the time, and moved to Norway for a sabbatical. There was a lot of planning involved, but it was well worth the effort.
Taking the Leap
Curing my burnout by taking a sabbatical wasn't my first course of action. I initially proposed to my boss that I would go down to 0.25 FTE, working two weeks every two months. This was rejected due to fear that my colleagues would want the same, which would make staffing more cumbersome. Instead, I was granted a one-year, unpaid leave of absence.
Saving for a Sabbatical Year
Galletta Family in Norway
We saved up enough cash for one year of living expenses in Norway. I had paid off my student loans within a couple of years out of residency. We had a reasonable mortgage on our primary home and owned two duplexes. We were fortunate to find a family relocating from Australia that rented our home, inclusive of our two dogs and minivan. A real estate agent acquaintance was hired to manage the duplexes. The rental income was enough to cover our mortgage in the US plus the rent on the modest home that we rented in Norway. We sold one of our cars in the US and used that money toward purchasing a car in Norway. My individual disability insurance, that I had purchased at the end of residency, was portable and gave me peace of mind while I was biking, skiing and traveling around Europe. My husband and children are all dual citizens and I was residing in Norway on a student visa, so our health insurance and expenses were covered by Norway, where healthcare is considered a basic human right. Since we were living on a fixed income, we set up a budget for the first time ever and cut costs where we could, like cutting the kids’ hair ourselves.
The Sabbatical Experience
Our children went to elementary school where my husband had grown up, and I became fluent in Norwegian by attending adult language classes with immigrants from around the globe. Six months into my sabbatical, I flew back to the US to work 10 shifts with a locum tenens company to refill the coffers and keep up my skills. Shortly after returning to Norway, I was unexpectedly hired to lead a pilot project staffing Norway’s largest emergency department with attending physicians to supervise the residents. My one-year sabbatical had now become two. I converted my student visa to a work visa and renewed our tenant’s lease back in the US. My husband also needed a project and bought an antique Italian wooden Riva motorboat to restore.
During the year I worked on this pilot project in Norway, I utilized my newly obtained Norwegian language skills and learned about the inner workings of single-payer medicine. There was no malpractice insurance to pay since there is already a system in place to financially support patients who have been injured or have poor outcomes. I paid Norwegian taxes. There are no 401(k)s nor 529s, as retirement and education are also covered by the state.
The Rewards
Restored Antique Italian Wooden Riva Motorboat
Although my pilot project ended after one year, we had set the stage for emergency medicine to become a recognized specialty in Norway; a goal that was achieved in 2017. My husband’s boat is restored and has won “best in show” at three separate events around Europe. We traveled around Europe during school vacations which, in addition to creating priceless memories, resulted in my son acing a pop quiz on European geography upon repatriation to the US. And I may have hit the jackpot with my decision to take an unpaid sabbatical, as my oldest is now a senior in high school and hoping to attend university in Norway next year, which is tuition-free.
Returning Home
When I finally returned to the US after two years abroad, my previous job was no longer available. I took a position an hour from my home and learned first-hand about contract management groups. My contract was bought and sold twice in the span of 18 months. As soon as a position opened, I returned to my prior place of employment where I have remained ever since.
My Biggest Regret
Dr. Gayle Galletta
My biggest regret was not doing Roth conversions. I received a salary once I started working in Norway, but it was about 1/3 of what I earn in the US. I should have used those two years with lower income to do Roth IRA conversions while I was in a lower tax bracket. I had been so focused on not running out of money, that I squandered an opportunity to grow my tax-free retirement savings. I had also been offered a lucrative real estate investment a few months prior to my sabbatical. I turned it down because it would have involved taking on debt and increasing stress. In retrospect, it was the wrong decision, but there was no way that I could have known that at the time. Hindsight is 20/20.
Lessons Learned from My Sabbatical
Taking a sabbatical can reduce burnout and help rekindle one’s passion for medicine. In order to do this, however, you have to have all of your financial ducks in a row.
- Eliminate any debt that you may have, including student loans.
- Have a steady stream of income, such as real estate, or save up enough money to live on.
- I initially took my sabbatical time as a “practice run” for retirement. Prior to starting work in Norway, I did Pinterest-like things, like picking wild, edible mushrooms and making homemade gingerbread houses. I learned that I am not psychologically ready for retirement yet.
- You must also be willing to take a risk. Moving outside of your comfort zone will help you grow.
- Have a goal to accomplish during this time such as learning a language, experiencing a culture, slow travel, or writing a book. Do not squander this amazing opportunity that you have worked so hard to create.
- Document your journey via blogging, photographs, or a journal and inspire others.
Prior to embarking upon my sabbatical, a colleague had warned me that I would be taking a career risk by leaving my stable academic position. Now, each time I renew my state medical license, I must explain any gaps of more than three months in my employment history. But I write this explanation with fond memories. My sabbatical provided me with a unique experience that helped to create my niche within emergency medicine. I returned home with a renewed passion for my career, unforgettable family memories, and a beautiful boat.
Have you taken a sabbatical to reduce burnout or as a “practice run” for retirement? What did you learn? What would you do differently next time? Comment below!
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“This is truly an outstanding course. I would encourage any physician at any level of training to commit to completing it. The long term benefit to you and your family is beyond measure.” -HG
Interesting article, but she left out some additional “lessons”:
– Have dual citizenship in a desirable, safe country
– Be reasonably fluent in a second language
– Have a spouse who is able to travel freely
– If you have children, make sure they don’t have any serious medical conditions that require specialized care
– Be willing to leave your pets with strangers for a prolonged period of time
– Make sure that when you move back, you do so in a robust job market and not a recession, or even worse, a pandemic!
I usually enjoy WCI articles and find them educational, but this was just incredibly privileged and really tone deaf, I’m sorry. And I say that as an EM doc who’s lived abroad and shares many of the author’s privileges.
Mostly correct, bar she is not a dual citizen only her family is, where one takes a sabbatical can be arranged to have as good as or better medical care than that available at home for any needs, to accept one’s pets, and/or where they speak English. (Many European countries have BETTER care and education available for, say, autistic disorders) All the rest are privileges many physicians have or can obtain with less trouble than an out of country move. As many have pointed out, this whole website is tone deaf for many who aren’t at or above US physician level incomes.
Just about any experience or challenge a doctor shares with colleagues (including all of my own) are privileged, tone-deaf, first world problems. That’s all this website is about. But every “beef” you list above has an alternative.
Dual citizenship- not required
Fluency- Go to England, Australia, or New Zealand
Spouse- Leave them temporarily and have them drop in for a week or two at a time throughout the year, have them work from home, have them quit their job too, have them take a sabbatical etc. All of this of course must be planned and coordinated in advance.
Kids with medical conditions- Obviously this is going to keep you from choosing Guatemala, but there are plenty of developed countries out there with solid medical care.
Pets- Why wouldn’t you be able to bring your pets?
Recessions- Docs get jobs in recessions all the time. While not quite “recession-proof” they’re more so than most careers.
Besides, one can do a “sabbatical” without actually going anywhere.
Thank you for your comments. Just to clarify, I am not a dual citizen and was not fluent in Norwegian when I moved there. I traveled to Norway on a student visa and enrolled in language classes for immigrants. My classmates were immigrants and asylum seekers from around the world including Eritrea, Sri Lanka, Hungary, Brazil, Iran, Afghanistan, and Russia. I am fortunate that my husband is able to travel freely. When we had children, we made the decision that he would stay home to care for them. Our dogs were one of our biggest concerns, but we were extremely fortunate that the family that moved into our home was eager to have them. Our Plan B was to fly them over and quarantine them. After a risk/benefit analysis, we decided it was best to leave them in their home with their temporary family. We are fortunate to all have good health, but the healthcare system in Norway is excellent and free. Finally, if we were abroad when a pandemic or recession struck, we always had the option of staying there. I am not suggesting that anyone do exactly what I did. I am merely trying to share my experience and perhaps provide a spark for another high income professional who may be looking for a possible way to combat burnout.
Thanks for sharing!
Thanks for sharing your story! It’s easy for some to try and poke holes or fall back in limiting beliefs but it sounds like this was an amazing decision for you and your family. I appreciate you putting it out there!
Thank you!
Thank you for the great post.
I think perhaps I could take a three to six month sabbatical, but I am not sure about a year or more. It might be too big of a leap.
Changing your environment and routine helps with daily stress. It gives a different perspective.
We have neighbors who are tenured professors at a local university and are offered a sabbatical every seven years. They keep all of their benefits except pay is cut in half. They have been in a position to plan out the experience which has made it enjoyable. Usually, they exchange teach at another university and are able to have a good transition to job and school for their kids. They have had experiences of a lifetime.
You have hit on something that works for you and your family. Don’t be discouraged by the naysayers who can’t see the benefits or maybe are afraid to step out of a comfort zone. We all are creatures of habit and find comfort in routine.
Perhaps your next one will be in a different part of our country.
Best of luck to you!
I took many sabbaticals once I switched from Army doc to Army wife. The resume issue is they’re worried you were in prison, rehab, or a mental institution. In military towns (where I have mostly lived) I would mention in my cover letter that my husband’s military career and moves, short duration of stay, or being in a foreign country were the reasons I have gaps in my work. More an issue for my skills than for my attractiveness as a job candidate (except of course they knew I might leave again soon and that I wasn’t desperate for the pay).
Strongly disagree with those saying this is tone deaf. She had an interesting experience and I, for one, enjoyed hearing about it… What I’m curious about is how you had the mental energy to drop back in after two years off from a dysfunctional system. I took two months off between jobs and found I just didn’t want to deal with the petty battles that plague academic EM (really, all of American medicine).
I remember lying awake eastbound over the Atlantic in a mini-panic. What had we just done?
My wife had quit her “golden handcuffs” job and I would be “commuting” across an ocean (as infrequently as possible.) I was the only one in the family that spoke the local language, including 2 kids that would enter the public school – and take to it like fish to water.
We went through all of the same challenges, except the dogs came along.
One year turned into 5 and would have been more, but for COVID. We are back in the US now and the culture shock has been something.
If you’re even slightly inclined to try an adventure like this, GO! Kudos to the author for taking the leap. I know from experience that she’s far richer for it, despite skipping the Roth conversions 🙂
I have met several physician families who moved from the US to New Zealand with their children for a one year sabbatical and never came back.
There are many specialties that can easily take a sabbatical and return to work quickly without much repercussion.
Specialties like Emergency Med, Anesthesia, most hospital employed physicians would fit these criteria to name a few.
However, for many other specialties or owners of small practices such as Primary Care, Dentistry, Dermatology, Ophthalmology, Plastic Surgery etc taking a sabbatical for greater than 2-3 weeks is really not an option. This is especially true if you own a practice with less than 3 physicians, but even in slightly larger groups of 3-10 physicians it is logistically very difficult. Staff, Overhead and Patient base are all enormous factors to consider.
So although I am FI and could afford a 1 year sabbatical or a 20 year sabbatical, if I were to take this, it would mean starting at an entirely different position or starting an entirely new small busines/practice on my return. So any short term sabbatical is unlikely in my career.
Definitely easier in some specialties and practice types than others. It’s hard just to take a one week vacation when you own your own primary care or surgical practice given the overhead. Makes a lot of docs feel trapped.
Love my specialty and don’t feel trapped by it at all. Overhead is a hard reality though. So lets just say there are definitely times when I am envious of my ER and Anesthesia colleagues!
Flexibility to move and travel was among the many reasons why I chose Emergency Medicine as a specialty over two decades ago.
Awesome, thanks for sharing. I have the money and ability to take off a year…but I am lacking the family buy-in.
Leaving the house is an issue; not sure I’d want a stranger or even an acquaintance living in my home. And the animals, what to do about them!
Good luck with the family buy-in! Hopefully you can find something that everyone agrees on. I am glad that we did this sabbatical when our kids were too young to protest (although there was some of that). It would be vastly more difficult with teenagers.
I loved reading this article. A sabbatical clearly doesn’t work as well for specialties that have a clinic based practice with longitudinal care, but that doesn’t mean it’s not possible with enough colleague support.
My biggest takeaway was that amazing, restorative life experiences are made possible by being in the financial position to take advantage of them. Low debt levels, savings, and passive rental income gave Dr. Galletta the power to do this. Inspirational!
Thank you!
Interesting perspective. Obviously each physician’s financial and career situation is going to be different, and some specialties are going to be more amenable to hiring someone who may have been off the saddle for an extended period of time (as some other commenters have highlighted).
My take-home message is that going on a sabbatical can be a good litmus test for burnout–if you still feel burned out after a year of doing something else it means that you’d better find out what else could be your problem.
I specifically scheduled some locum tenens work so I would never go more than six months without practicing clinically. I had three months maternity leave on two occasions prior to my sabbatical, and it really wasn’t much different from that.
What an amazing adventure. Despite having some built in draws to Norway, it still takes guts to pull the trigger and go! My medical practice just doesn’t lend itself to easily taking that much time off, so I plan on retiring a few years early while I’m still young enough to do some of the things I want to accomplish outside of medicine. Proud of you for following through as this life moves quickly !!
Thank you! A minor health scare is one of the reasons I decided not to wait until retirement to have an adventure like this.
Ah… just admit it- you wanted to train for Norseman and wanted to find a legit excuse for it! And those views from Hardangervidda never to be erased from your memory! :)))
I sense a stalker, or a fellow Norseman ;). Earning my black shirt was the first thing I did, just days after moving to Norway. It was an unforgettable experience and did help earn me some respect.
wow, so you trained in the States?? And my respect goes to you for sure for getting a black shirt!! in and of itself it can be the accomplishment of a lifetime.
and your husband was probably your support team 🙂
speaking of bucket lists… always dreamed of doing it, but alas…. . I can probably survive the fjord, but the Zombie Hill…
In my youth I worked at Sykehuset i Rogaland in Stavanger , and still listen to Janove Ottesen and Kaizers Orchestra!
Yes, I trained in the States. I just happened to be in the right place at the right time. Shortly after I moved to Norway for my sabbatical, word got out that there was an American EM trained physician living on a potato farm in rural Norway, teaching swimming lessons. They cut the red tape and recruited me to help start the specialty as a pilot program in Norway’s largest Emergency Room. I was at an EM conference in Stavanger in 2018.
My husband, kids, and sister-in-law were my support for Norseman. The fjord was refreshing, and orcas had been spotted there the day before the race. Zombie Hill did devour a couple of my competitors.
I felt burned out midway through my career in medicine. I almost quit because of it. Then a friend asked me if I was being called to leave medicine or if I was just having a bad day. I didn’t know the answer at that time. Through a series of events over the next week I knew I was not being called to leave medicine. So he suggested taking a short sabbatical to clear my mind. I looked ahead on my schedule to where it was clear and booked out a month off, but did not book any travel. I planned to stay home and relax and do some fun reading for the month. I figured out what was causing the problem during that month and came back to medicine refreshed and ready to continue on. Sometimes you just need a break to refresh. A one week vacation does not provide that. I found it takes at least three weeks. That is why I took three weeks off most summers during my career. I’m adding this article to my Fawcett’s Favorites next week. Thanks.
Dr. Cory S. Fawcett
Financial Success MD
Good advice, Dr. Fawcett! In Norway, everyone has a right to three weeks consecutive time off in July and/or August, and that includes doctors too. Thank you for sharing my article.
Gayle, is there anywhere that I could read more about your adventures? It sounds very interesting.
Thanks
Thank you for your interest. I have published two other accounts of my time in Norway. You can read them here:
https://www.acepnow.com/article/emergency-medicine-in-norway/?singlepage=1
https://onlinelibrary.wiley.com/doi/full/10.1002/emp2.12197
Thanks!
Loved hearing your story Gayle! Our family spent a yr in France when the kids were in 1st and 4th grades. While the kids were learning French, I enjoyed spending time with the expat community and wandering around Paris. My spouse was able to work from home to keep income coming in and we used his health insurance. We found a family on a home exchange website to live in our house and take care of our cats. It was an amazing opportunity to travel since the French take so many long vacations. It’s so easy to see a lot in Europe by train or a short plane ride. I enjoyed taking a year off after 12 years in primary care. When I returned home I thought about my next career phase and decided to return to primary care with the same company. A sabbatical is doable!
Great story, Erin! I’d love to hear more about it. Can you contact me at [email protected]?
Loved hearing your story Gayle! Our family spent a yr in France when the kids were in 1st and 4th grades. While the kids were learning French, I enjoyed spending time with the expat community and wandering around Paris. My spouse was able to work from home to keep income coming in and we used his health insurance. We found a family on a home exchange website to live in our house and take care of our cats. It was an amazing opportunity to travel since the French take so many long vacations. It’s so easy to see a lot in Europe by train or a short plane ride. I enjoyed taking a year off after 12 years in primary care. When I returned home I thought about my next career phase and decided to return to primary care with the same company. A sabbatical is doable!