Your department probably won’t give you a sabbatical. Take one anyway.
- Christie Mulholland
- Oct 8, 2025
- 10 min read
Updated: Jan 15
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'd put in my six years. I had a clear(ish) plan for how I'd use the time. And while I was getting my job done well and hitting my metrics, I was also irritable and disillusioned from the demands of patient care. I was in need of 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—to step away from my academic medical career on my own terms—has transformed not just my career trajectory, but my entire relationship with medicine. Taking three months completely off from medicine, and returning on a part-time basis, was one of the hardest and most rewarding things I've ever done. It allowed me to launch my coaching business, to rest and connect with nature, and to move forward in my career with renewed purpose.
But here's what haunts me: I wish I didn’t have to go rogue to make this happen.
The Sabbatical That Exists Only on Paper
To be clear: my institution isn't the villain here. They seem to be following a standard that's pretty consistent across all of academic medicine. Many medical schools say (or suggest) associate professors could be eligible after six-ish years of service. But in reality, only full professors get approved. And by the time you reach full professor—if you ever do—you're 15 to 20 years into your career, probably closer to the end than the beginning.
Since 1880, when Harvard first introduced sabbaticals for faculty, universities have offered this benefit as a cornerstone of academic life—a time for rest, renewal, and intellectual growth. Medical schools include sabbatical policies in their faculty handbooks. The mechanism exists—in theory.
But a 2021 survey of US medical schools found that only 53% of schools reported any faculty taking sabbaticals in the past three years—and among those schools, the median number was just three faculty members. Sabbatical-taking by medical school faculty is, quite simply, rare.
The barriers are predictable: who will cover patient care responsibilities? How will clinical revenue be maintained? What about teaching commitments and administrative duties? These are real logistical challenges. They're also the same challenges that must get solved when physicians quit permanently and get a job somewhere else—more on that later.
Why This Matters Right Now
This isn't just about a malfunctioning policy. It's about a profession in crisis at a moment when we can least afford to lose more doctors.
Nearly half of all physicians—43% in 2024—report burnout. More alarmingly, 28% of physicians think about leaving medicine at least once a week. That's not occasional doubt—that's sustained malaise. While there has been some indication of improving sentiment in the last couple of years, we have yet to see what the latter half of the 2020’s brings. You see, these are still “unprecedented times."
To be a physician in 2025 means feeling the ground shifting beneath you in ways that make practicing medicine harder, more frustrating, and more demoralizing than ever:
Insurance companies are tightening their grip. Physicians now complete 39 prior authorization requests per week, spending countless hours fighting for approval to provide the care we know our patients need. 93% of physicians report that prior authorization delays patient care, and 89% say it contributes to burnout. Reimbursements remain stagnant while administrative burdens multiply and the cost of practicing medicine rises. Doing more with less often means less staffing, and fewer people to share the load.
Government leaders are undermining established science and cutting funding for healthcare. We're watching vaccine recommendations change based on politics rather than evidence, seeing decades of public health progress threatened by ideology. The current administration has tried to cut $4 billion from medical research, terminated hundreds of grants at major institutions, and capped student loans at levels that don't cover medical school costs. At the time of this writing, the federal government is shut down while Democrats and Republicans fight over massive budget cuts to healthcare.
AI is upending... well, basically everything. While artificial intelligence models offer reasons to be optimistic (maybe it will help us write our notes!) it also presents an entirely new skillset for clinicians to learn quickly, and to some, an existential threat (what if it can replace us?)
These aren't abstract issues. They're daily erosions of our ability to do our jobs well, to feel proud of what we do, and to believe that the system we work in values our expertise and our patients' well-being.
We can't afford a mass exodus. But medicine as currently structured offers physicians a binary choice: you're either all in—grinding through the bureaucracy, the moral injury, the exhaustion—or you're out entirely. There's no middle ground. No pressure valve. No way to step back, recharge, and return with renewed commitment.
Sabbaticals could be that middle ground that helps some doctors stay in the fight. But only if we stop gatekeeping them until it's too late.
There's no one-size-fits-all solution to this conundrum. It isn't lost on me that I'm arguing for doctors to take breaks by naming all the important work there is for doctors to do. But I believe that we need is a culture that makes space for doctors to exist outside the box. Space for all of the bright minds that don't want to walk away from these challenges—just to renegotiate the terms of their relationships with medicine. Here I propose one such culture-shifting idea: normalizing sabbaticals.
What Athletes and Smart Companies Know That Medicine Doesn't
Elite athletes and forward-thinking companies understand something that medicine has forgotten: rest is not the absence of training—it's part of the training.
The winning athlete isn't the one who trains the most, but the one who trains the best. Athletes build recovery into their schedules because they know that without it, stress builds and becomes overwhelming. They know that strategic rest prevents injury and extends careers. In athletics, four to twelve weeks of rest is standard treatment for burnout.
Not as a reward for surviving the gauntlet. As a tool to survive it.
We're doing it backwards.
Companies like PayPal, Adobe, and Zocdoc now offer sabbaticals after just five years. Some offer them after three. Why? Because they've learned that employees return recharged, with deep institutional knowledge intact, and the sabbatical creates a powerful retention effect: "I want to stick around for five years and take a sabbatical."
What the System Should Do
If I could wave a magic wand, here's what would change:
Normalize sabbaticals throughout a career—and reimagine how we think about them. Start offering them at the associate professor level (6-8 years in), when physicians are deep enough in their careers to benefit from perspective, but not so burned out they're already fantasizing about leaving medicine. Frame them as prevention, not reward—strategic career maintenance like an athlete's recovery protocol, not a prize for surviving to full professor.
Change the culture from "in or out" to "sustainable career." Right now, medicine treats any deviation from full-time clinical intensity as career suicide. Want to take a few months off? You're unreliable. Need to step back for a year? You're not serious about medicine. But this binary thinking is precisely what's driving physicians away permanently. If we want doctors to stay in medicine for 30-40 year careers, we need to normalize ebbs and flows—periods of intense engagement followed by intentional rest and renewal. Sabbaticals aren't about opting out; they could be about opting in for the long haul.
Recognize that physicians are already taking "sabbaticals"—by finding new jobs. Anecdotally, physicians create their own breaks by leaving one position and waiting months before starting another. This means institutions pay the full cost of turnover—recruitment, onboarding, lost continuity of care—when a sabbatical policy would have retained the physician and guaranteed their return. It's not whether physicians will take breaks; it's whether institutions will benefit from those breaks or lose talent because of them.
These aren't radical ideas. They're just ideas that remain stubbornly theoretical in medicine.
What You Can Do Right Now
But here's the thing: I'm not optimistic about institutional change happening quickly. There are too many competing priorities, too many financial pressures, too many reasons why "now isn't the time."
So I'm here to tell you what I wish someone had told me earlier: you don't have to wait for the system to catch up.
You can create your own sabbatical. It takes planning, courage, and sacrifice, but it's possible. Here's how:
1. Start Financial Planning Now
This is the foundation. You need runway.
I spent a few years educating myself on personal finance with the goal of gaining more freedom. My diet included resources like the White Coat Investor (podcast, books, and blog) and other personal finance podcasts, like Jillian Johnsrud's Retire Often, which features stories from people across professions who've taken career breaks, sharing important insights and strategies. I worked toward key financial milestones: getting out of student loan debt, building an emergency fund, maxing out retirement contributions. Once I had achieved those, I was in a position to start building a sabbatical fund.
J.L. Collins, a prominent personal finance writer, coined the colorful term "F-You money"—enough financial cushion to have the freedom to take a calculated risk like a career break. That's what you're building toward.
Here's how to start:
Calculate your sabbatical budget: How long do you want off? What will you need to live on? Six months? A year?
Build your sabbatical fund: Start setting aside money specifically for this. Treat it like any other career investment.
Reduce fixed expenses: Can you downsize, pay off debt, or eliminate expenses that make you dependent on your current income?
Consider creative funding: Some people travel and rent out their homes during sabbaticals. Others do locums work part-time to supplement savings.
As you've probably surmised, planning for a sabbatical can take months or years. If you think there is even a chance you might want one in the future, why not start saving now? Trust me, you won't be upset if you never end up taking that sabbatical and end up with an extra pile of cash to use for something else.
2. Define Your Purpose and Structure
A sabbatical without structure can become just an extended, anxious vacation. You need intention.
When I took mine, my purpose was clear(ish): transition my career, spend time outside of New York City and in nature, and launch my coaching business. For you, it might be different:
Learning a new skill or subspecialty
Writing a book or research project
Traveling and broadening perspective
Simply resting and reconnecting with family
Exploring a different type of work
Whatever it is, write it down. Create a plan. One physician I read about drew a Venn diagram with three circles—career, family, community—and put "self" at the center. That became his roadmap.
Structure doesn't mean rigidity. It means clarifying your most important values or "North Stars" and keeping sight of them.
3. Build Your Re-Entry Plan
This is crucial. How will you return to earning?
Will you go back to your current position? Negotiate this up front if possible. Part of doing this well involves leaving for your sabbatical gracefully—explaining your intentions to your boss with a positive outlook. This is easier if you take a break before you are already burned out or "crispy," like I was. I definitely wish I'd done this part better.
Will you look for a new role? Build a plan for networking and getting the word out that you're open to hearing about job opportunities while you're on sabbatical.
Will you transition to part-time or a different practice model?
Will you launch something new alongside clinical work?
I spent my sabbatical preparing to launch a coaching business that will give me flexibility, while reinvigorating my passion to make an impact on the culture of medicine. My re-entry wasn't about going back—it was about going forward differently.
Don't assume re-entry will just "work out." Plan for it. Talk to colleagues who've taken breaks. Know what credentialing, licensing, or CME requirements you'll need to maintain.
Find the allies within your institution. When I made my intentions clear that I was taking my sabbatical regardless of official approval, a few key people stepped up to help me navigate it. They made my re-entry possible—I'm now back working part-time at the same institution because of those relationships. Those people exist in your system too. Your job is to find them.
4. Get Your Support System in Place
This isn't just financial or logistical—it's emotional.
Talk to your family. How will this impact routines, dynamics, and plans?
Look for mentors or colleagues who've done this before
Join communities of professionals reimagining their careers, even if that means listening to podcasts—hearing their experiences can normalize what feels radical
Work with a coach (yes, I'm biased) who can help you think through the transition
Taking an unsanctioned sabbatical will feel vulnerable. You need people who believe in you. People who remind you to bet on yourself.
The Permission You've Been Waiting For
Here it is: You don't need your institution's permission to take care of yourself.
The system tells you to wait. Wait until you're promoted. Wait until the timing is better. Wait until you've proven yourself worthy of rest.
But what if the cost of waiting is your health, your relationships, your passion for medicine?
I'm not saying it's easy. I'm not saying there's no risk. But I am saying it's possible—and for many physicians, it's necessary.
We spend our careers taking care of everyone else. At some point, we have to ask: what would it look like to take care of ourselves with the same intentionality?
For me, that looked like an unpaid sabbatical that terrified me and changed everything. It gave me space to build something new, to reconnect with my purpose, and to return to medicine on my own terms.
It would have been easier not to have to go rogue to make it happen. But I'm glad I did.
And if you're reading this, wondering if you could do the same—wondering if it's irresponsible or selfish or naive to even consider it—I want you to know: it's not.
It might be the most responsible thing you ever do.
What's your experience with sabbaticals, career breaks, or burnout in academic medicine? I'd love to hear from you in the comments.
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