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Module 2 was on the Medical Device Industry. I found this one to be especially interesting because my significant other works in an international medical device company. I did not know very much about medical devices to begin with, so felt like I learned a lot. The module contained 11 mini-modules. I was able to go through the module while waiting for a meeting to start!  Module 3 was next and it was about the diagnostics industry. IT was only 6 mini-modules long. I was able to squeeze it in while waiting for my dinner to be baked in the oven. Module 4 was about rules governing healthcare providers and pharmaceutical companies. Module 5 was another quick and interesting one about health economics outcomes research.  I'm really enjoying these lessons!
Tonight, I went ahead and began my first module of the training. As an overview, there are a total of 20 modules and each module contains mini-modules. This first module contained 17 mini modules inside it.  The module was an overview of the pharmaceutical industry and process, including details on the pharmaceutical industry history, drug development phases, etc.  There are many diagrams and photos to help consolidate the information. There was even a section on Artificial Intelligence and Blockchain technology in clinical trials, which I thought was pretty cool. The entire module and quiz took me about an hour and a half to finish, so totally doable. The module started off with a quiz to assess your knowledge (or in my case, lack of knowledge). I got a whopping 30% on the pre-quiz. At the end of the module, you take the quiz again and must get 80% in order to pass. Initially, I got a 50%, but on my second attempt I passed with 80%. I found the questions helped me interpret and recall the information I learned. I also went back to re-read a few sections as well to better understand the questions. So far, so good! I like how I pretty much did this entire training in my pajamas on my comfy sofa and got CME credit from it, while building up my knowledge in drug development.  Onto Module 2 tomorrow night.
While I am currently in a clinical role, I have been focusing on improving my skill set so I can one day make the transition to non-clinical roles, if I were to desire to. Pharma has always been something in the back of my mind, so after extensive research into how to break into this industry, I decided to enroll in the Board Certification in Medical Affairs Specialist program (BCMAS). Three years, before starting my current role as a medical director, I tried to enter into the pharmaceutical industry. It made perfect sense, I have an MD as my background and I live in an area with dozens of pharmaceutical companies. Not only that, I had several friends who were already in these companies who could do personal referrals for me. I really thought that if I made the perfect resume, reached out to recruiters, and got personal referrals from friends at their companies, I'd be a shoe-in. On top of that, I took free online courses on every website I could find about "clinical research", patching together information to create a baseline knowledge. But, I didn't know how difficult it would be to break into the role. Not only that, I still actually had no idea what medical affairs actually entailed. Every recruiter I spoke to, asked me what experience in clinical research I had, and every job application asked for some type of clinical research experience.  No, research in the medical field did not count. It also did not matter that I had a medical background. Things got so difficult, I even considered taking on an intern role to get the experience in the pharma industry. Even those roles were difficult to land and I was beaten out by undergraduates looking for internships in their last year of college. Tough times. Obviously, I did not know what I know now. That there is an accredited program to give you baseline gold standard knowledge in medical affairs. I don't know where it was when it popped up, probably when I started looking into non-clinical roles and searched "MSL and medical affairs". After that, I read reviews about the program, listened to podcasts with people who had taken the course, and done a lot of research on the program. I decided to take it for several reasons: 1) It is the ONLY program that is accredited, meaning it meets the highest quality and standard 2) 70% of the BCMAS graduates actually work in pharma right now 3) There's mentorship and help with obtaining a role as an MSL after completion of the program 4) You become part of a database for pharma companies recruiters to reach out to you for open positions 5) You get CME  6) It is entirely online and self-paced so you can do it while you have your current job (perfect for me with my full-time job, while making my transition into non-clinical roles) 7) It's affordable at 1,999 dollars (my annual conferences I go to are 1,000 for registration alone) So my plan is to take this course, become board certified, fix up my resume, reach out to recruiters, and apply to pharma companies again. I will take you along every step of the way. I'm excited this time around because I know, I will actually be prepared and a better candidate with this program experience.  I'll see you in the next post, when I start the first module!
I recently connected with an extraordinary individual, who is a Renaissance Physician in the fullest sense! Dr. Roger Cicala is a fully transitioned, 100% non-clinical physician. I think Dr. Cicala's story is so engaging and powerful to me because, I cannot even fathom taking that 100% plunge into the non-clinical realm. A part of me continues to cling to clinical medicine because I'm scared. I'm scared I won't be good at something outside of medicine or healthcare, and I'm scared I won't be good enough to make a living doing it.  My friends and family know I have a business where I help medical clinic owners grow and scale their clinics so they can work as much or as little as they want and build long-term assets. But this is my part-time business, something I've been growing over the last year. I've learned about business, friendships, sales, life, etc.  I'll be the first to admit, when I lose money or something doesn't go right (and I learn a huge lesson) in my non-clinical business, I still have that comfort knowing that I still have a successful clinical career. I can see a paycheck every month. So how does one take that plunge to go all in, 100% non-clinical? Let's find out! ----------------------------------------Start Interview--------------------------------------- 1. Please tell us what you currently do today. I’m the founder and part- owner of, which is the world’s largest camera and lens rental company. If you see photographs from a sporting event, watch a commercial or a music video, chances are pretty good it was made using our equipment. I own two smaller companies; Olaf Optical Testing, which tests camera lenses, and C-4 optics which makes specialty camera lenses. I am retired from the day-to-day operations at Lensrentals but still fairly active there as a consultant. The other two businesses take up perhaps 20 hours a week of my time and honestly are mostly because I think they’re cool. 2. When did you decide you wanted something more than a clinical career? Did something happen that triggered this? Were you at a certain point in your career or life? I was in my early 40s. I’d always been happy in medicine, but I wasn’t a ‘die with my lab coat on’ kind of doctor. I loved medical school and enjoyed practice, but it wasn’t my life. I made a good income, lived a good lifestyle, but didn’t have a lot of financial plans for my future. When my father passed away, I was suddenly aware that I had made no financial plans for my future and needed to do something to be secure financially. At the same time medicine was changing, I realized I was never going to make more money than I was making. 3. How do you deal with other physicians and non-physicians (and possibly your family and friends) who don’t understand why you want to leave clinical medicine? Well, at first, they all thought I was out of my mind. I mean “You’re leaving medicine to rent camera lenses??????? Roger, maybe you need some therapy.” When I announced I wanted to go part time for 6 months and then leave, the medical director of my group patted me on the head and told me to talk our business manager so he could explain things to me. I showed the business manager my books and in 15 minutes he said, “you need to go part time to run this and leave in 6 months. This is awesome.” After that the rest of the docs thought we were both nuts. I stayed friends with most of my partners and a few came and saw what I was doing. You know, they noticed I worked Monday to Friday and didn’t take call, etc. Within a year they talked about me like I had made parole early. “He got out. He’s doing great out there. He won’t be back.” At this point I can’t think of one of my physician friends who isn’t a little envious. 4. What were the first few side hustles/businesses you tried? How did you decide on these to start with? I had contributed to medical textbooks so I started writing as a side gig. At first contract work; I would ghost-rewrite physician chapters in textbooks when brilliant docs couldn’t write well. Then I started doing contract work for textbook companies, ghostwriting chapters in Nursing, paramedical, and medicolegal textbooks. Honestly, the money wasn’t worth the time it took; I made about $5,000 a chapter but a chapter took a month or more to finish. Next I wrote some medical books for lay people, got an agent, the whole deal. The idea was they had a 5 to 7-year life, I’d be getting royalty checks that whole time. I thought after I had 4 or 5 books out, that would be a great income stream. It ended up being an income trickle. I remember one 6-month royalty check that was about enough for a nice dinner out. 5. When did you make your full exit from clinical medicine? What were the steps you took to get there? Did you plan years in advance? I started Lensrentals in 2006-2007. For a couple of years it was strictly a side gig, although it was growing rapidly. After that I wanted to keep my medical income so I didn’t have to take money out of the LR income stream to live on, I wanted to reinvest it all. By 2009 I thought I’d have to leave medicine and in late 2010 I did. 6. Were you scared the first year out of clinical medicine? No, I was too busy to be scared. We were growing at 100% a year and I was working 80 hour weeks. I kept my licenses active and kept my CME current for a couple of years ‘just in case’, but really never considered returning. 7. How did you decide to go the route you did; why not pharma? Well, my goal was more to build a business and equity, not to get a good job. I despise multi-level marketing; I know some people do really well with it but it’s too much rah-rah yay team stuff for me. 8. What is your day structured like now? Well, I’m trying to learn how to retire, I don’t need to work financially, but I don’t have much in the way of hobbies. So, I’ve cut down to 8 hour days, and very little of the work I do know has deadlines. Olaf is a research company, we develop new testing methods and I employ a bunch of graduate student interns on and off site. I am retired from Lensrentals, other than, as they put it being “Our lovely and talented spokesmodel”. I go in and do whatever interests me, but I take a lot more time off than I used to. I bought a house at the beach this summer and go down there once a month. I plan on maybe working two weeks a month next year. Unless I get bored. ☺ 9. What do you do with MD degree? Do you still renew your licenses? I did for about 3 years, but stopped after that. I felt like I was too far removed to just walk back into practicing and was comfortable by then that I’d never need to. 10. Did you take business courses? How do you know how to do all of this? Do you have a mentor? No, I had no clue, and no. I looked into business mentors and incubators and consultants. It really felt like each of them had a fairly set ‘method’ they would push on me, and I’m cynical. I kept thinking ‘if this method is so great, why aren’t you out there making a fortune off of it instead of just charging consultant fees. I had a very simple Southern philosophy: “Go where they ain’t”. When they said ‘462 people were successful doing this’ I heard ‘462 people already have a head start on you’. I got an idea that no one else was doing, my target market was the entire United States, and there was no competition. That made more sense to me than hearing ‘this is how Joe was successful in his town and you could do it in your town’. That played out well. Around 20 other companies emulated our business model eventually. They were too late; we had too much of a head start. We grew really quickly because we were filling a vacuum. They entered into an area that already had established competition. Of those 20 other startups, one is still alive and doing OK. We absorbed 4. I think all the others have gone under. All that being said, I’m really lucky. When I started this my son and daughter were in college. My daughter and her husband are both MBAs, my son is a JD and CPA. So, I had business consultants on deck when we got large enough to need them. The hardest part wasn’t starting the business or making it successful, though. It was recognizing that after a certain size it wasn’t so much about my great idea and awesome guerilla marketing campaign. It was about good business practices that I knew very little about, and that it was time to turn it over to people who understood those practices. I did that (and I’ll admit there were some claw marks where I had trouble letting go) and the business went from ‘bigger than I had hoped’ to ‘bigger than I had ever dreamed possible’. As a physician, I was used to managing small groups: 7 people, a dozen. When we got to 20 employees, I realized we needed structure and hierarchy that really, I didn’t have the skill set to provide. I think it’s around 180 employees now. I’d have long since lost my mind trying to manage that. 11. If a physician wanted to leave clinical medicine, what would you say to that doctor? What would be the steps you recommend? First get your finances in order. I see a lot of people who want more income to let them buy a bigger house and a newer Porsche. If you’re in debt up to your eyeballs, you are going to have problems raising capital. Then be ready to take a risk and to work your butt off. There will come a day when you have to say “Wow, I could lose everything!” and you believe in yourself and take a chance. There will come a day when you ask yourself if the extra hours are worth it. About a year after that day I looked around and went ‘wow, I can retire now’. I didn’t, but I could have. 12. Did you work with a physician coach at any point? Do you recommend transition coaches? No, I didn’t and I really don’t have an opinion on that. 13. What kind of financial situation do you recommend a physician to be in, when he/she is ready to make the exit? Should all their loans be paid off, should they have a certain amount in savings, etc? I don’t think there’s a point. You don’t have to be debt free, certainly. You need to have more capital available than you expect, and if you’re juggling credit cards and have more debt than you should you won’t be able to get it. But reasonable debt with a good payment history won’t be a problem. My watershed month was this: I had spent all my savings, borrowed against my house and taken out a personal loan. I was out of funds and demand was huge. I ran up an $80,000 Amex bill buying more equipment and that bill was due at the end of the month. That month we did $82,000 and made the payment literally the day it was due. I was never badly stressed again, but I didn’t sleep much that month. If I was to recommend an advisor for anyone it would be a “capital procurement helper”. I tried to get loans my first few years and got turned down right and left. When my daughter, the MBA, came on board I told her there was no way to get a loan, we hadn’t been in business long enough. She said OK, and the next day went out for an hour and came back with a $250,000 line of credit from a bank that had turned me down 6 months before. She said, “They remembered you. You went in there and talked about cameras and lenses and ideas. I went and talked bank.” --------------------------------------------End Interview------------------------------------- Wow, I learned so much! I loved the advice of "go where they ain't" and get a head start on your competitors! Also, it's very helpful to have lawyer and/or CPA in your family (hehe).  I'll leverage my friend for that advantage. Most of all, I'm so inspired that Dr. Cicala saw more to himself and his life (no pun intended) and pursued something entirely new. You can tell he pivots and adapts to change quickly, a major trait that is crucial to success in all aspects of life. Thank you Dr. Cicala for sharing your time with us!
Hi everyone, today's interview is a pretty fascinating and interesting one. Many physicians I work with and those that I know personally, are looking for various ways to create and invest their money so they can work towards building long-term assets and generating additional and/or passive income. While I don't think everyone's goal is to retire early and stop working entirely, we want to have the choice to change careers and find new passions and, most of all, I think we want control in our lives, so that our livelihoods aren't determined by external forces outside of our control like politics, acquisitions, mergers, etc.  I've been quite interested in real estate investing myself, but haven't really taken a big step towards it because, honestly, I don't know very much about it and I'm afraid of doing something wrong. So in attempt to learn more, in this last month, I joined a new Facebook group for physicians looking to learn about creating passive incomes, one of which is real estate investing. It was to my delight when I spoke with Dr. Thomas Black, a physician and real estate investor who cofounded his own company to help other physicians grow their personal wealth through real estate investment.  So I knew I had to pick his brain to learn more! Hope you enjoy the interview! Start Interview:  1. Can you tell us more about yourself and your journey? I’ve had a rather circuitous journey in both my medical and investing careers. After barely graduating high school, I joined the Navy, where eventually I decided to become a doctor. So, after I left the Navy, I went to undergrad and medical school where, to everyone’s surprise, I graduated at the top of my class. I then did my post-grad and residency in Indianapolis and bought my first house with my wife. As we discovered three years later, we had purchased our home at the peak of the real estate market, and by the time his time in residency concluded, the housing market had changed drastically. We were unable to sell the house at the price we required and decided to mitigate our loss by renting it to an incoming resident. This is when my fascination with real estate and the passive income it generates began.  Following residency, I began practicing in an extremely high-volume trauma center in East Texas, and although the income was good, I was working incredibly long and stressful hours, rarely saw my family, and was very quickly getting to a point where I was completely burned out. In fact, I had started to question whether I’d made the right choice in becoming a physician. I owned several single-family homes in Houston at this time and for whatever reason, decided to develop an apartment complex from the ground up on some land I’d purchased in town. This project is what gave me the idea that I could reduce my workload if I could create enough passive income from my real estate investments. Thankfully, my wife was a huge support and we decided to aggressively pursue this financial path. I resigned my partnership in the practice to move to the Dallas/Fort Worth where I could easily access what I was not focusing on, which was commercial and multifamily real estate. Right after that, my brother Tim retired from his 32-year career. His most recent position had been with Great Wolf Resorts as their Chief Operating Officer. He had led them in opening eight resorts during his tenure there, so he had and still has a phenomenal mind for operations. Once Tim understood the benefits of multifamily and the cash flow it creates, we decided to put our skills together, and we founded Napali Capital. Our hope is that we can provide physicians with diverse, strategic, tax-incentivized investment opportunities to help them create the cash flow and sustainable passive income to create wealth and allow them some flexibility in their professional time commitments. We’ve been up and running as a company for two years in December, and we currently own more than 1200 doors in 3 states. We’re proud of our company and team. 2. Do you currently actively practice?  Yes, I do currently practice and I’m also a Regional Medical Director for eight Baylor Scott and White Emergency Hospitals. When I’m not working my “day job,” I’m investing through Napali Capital. The structure of my day is a little hard to explain because, thanks to the cash flow I’m generating and reinvesting through the company, I have flexibility when it comes to how many shifts I take. I still enjoy practicing medicine, so I do a few shifts per month. 3. For someone who is investing and generating passive income, was this something you  always wanted to do or how did you get into it? It was a gradual shift for me. As I mentioned, it was out of necessity that we rented out our first house but that was the catalyst for me to really think about real estate in a different way. Once I had that shift in thinking and started applying what I’d learned through experience (and some mistakes), and realized the potential, it became more exciting. That’s when I got really aggressive with seeking out opportunities. 4. For those interested in real estate and assets, how much cash flow would someone need  before they can start investing in real estate? There’s not a right amount. There are so many different types and classes of real estate that if it’s something you want to do, just find what fits your budget and knowledge base. And if you don’t have that knowledge base, find someone who does who can help. So often, we hear form our investors that they put off real estate investing because they either a) thought they didn’t have enough money to start or b) didn’t know enough about it. And honestly, that’s one part of why we started the company: to allow for people to jump in with someone who’s done it and can help get them invested. You just have to jump in – responsibly, of course - or it will never happen. 5. What were some ways you made passive incomes? My passive income has been primarily through my real estate investing. I’ve done both single-family and multifamily, NNN leases and development. I’ve also authored a book, “The Passive Income Physician: Surviving a Career Crisis by Expanding Net Worth.” 6. What are the major challenges you face now, given that you’re at a high level of  investing/passive income? I think the challenge is managing the time to find that next opportunity that meets all the requirements we’re looking for. And now, I invest through our company alongside many other individuals who put their trust in us. We take that responsibility seriously, so there is a certain amount of pressure to make sure that what we invest in, what we offer our investors, is going to be profitable for everyone. To do that, you have to look at many, many deals before you find the right one—and that takes time. Fortunately, we have a team who is great at narrowing the options, though, and that helps a lot. 7. What’s the next step for you?  The next step is to continue to grow my personal wealth and the wealth of my peers through Napali Capital. As a company we have some really exciting developments coming in the upcoming months, so I’m eager to continue pushing those to fruition with the team!  8. What’s one piece of advice you can leave our physicians with?  Easy. Change your mindset, and you’ll change your life. In speaking with other physicians, the most common obstacle I come across that limits their ability to achieve financial freedom is that they can’t make that shift their mindset to get past thinking that after years of training, they need to just stay the course and focus on working as hard as they can until they retire. It’s amazing to see the transformation once they can look beyond that and think of how to create a stable, continuous, additional source of income that allows them to call the shots. Financial freedom and the freedom of professional choice go hand in hand. End Interview. The more I speak to physicians doing all sorts of different careers, side hustles, etc, the more I get the resonating message that improving one's mindset is the first step to making any change. This is very powerful. Your mind will truly be your biggest enemy or friend. Dr. Thomas Black was also so kind to send me a copy of his book. I'm awaiting it anxiously so I can read and learn more. I'll let you know what I learn from it in a later review :). You can check out his website at
I am beyond excited to present my interview with Dr. Marie Phalime. I remember the first time I came upon her work, I was up late and on YouTube (of course). I typed in "leaving medicine", scared and curious what I would find as the result. Her TEDx talk came up and I was enthralled. Her speech gave me chills. I love TEDx speeches and can binge through a dozen at a time, but for some reason, I stopped watching and, instead, felt compelled to reach out to her. I went on LinkedIn to search for her name, find out what she did now, and to let her know how powerful her speech was. I found her profile and sent her a long message about how much her speech meant to me and how it made me feel. I was surprised to hear back from her so soon and how kind she was (exactly how I'd imagine!). Of course, her generosity extends to this interview where she shares her journey, experience, and advice to everyone. Before you read the interview, check out the TEDx speech titled "The Doctor Who Walked Away": Begin Interview: 1. Tell me a little about yourself and how did you come to do your TedX talk?   I grew up during the apartheid years in South Africa, so life was tough for me as a Black girl living in a segregated country. I came from a working class family, and sacrifices needed to be made in order to keep the family going. I was fortunate, however, that my parents were firm believers in the value of education. They saved and sacrificed to send my brother and me to private school, which opened my eyes to possibilities beyond the circumstances I was born into. I did well at school, and I wanted to make a difference. So, when I was in high school I decided I wanted to be a doctor. I enrolled at the University of Cape Town, first for a Bachelor of Science degree and then Medicine. I loved studying, and when I graduated I anticipated having a long and successful career as a doctor. Unfortunately, my career didn’t work out that way. I burned out as a junior doctor, and I elected to leave clinical practice. In 2014 my memoir titled “Postmortem – The Doctor Who Walked Away” was published, which chronicles my journey through Medicine and the reasons I chose to walk away. After the book was published I was invited by the organisers of TEDx to share my story on their platform. 2. What was your life like after TedX? The talk enabled me to spread my message beyond South Africa’s borders. I have come to realise that many of the challenges I faced in my medical career are common to the practice of Medicine, irrespective of the country context in which people work. 3. You’re a career coach, life coach, speaker, and award-winning author; wow! How did you learn how to do all of this? After my book was published I was approached by many doctors who shared their own stories with me. I then realised that, even though I had intended for my book to bring closure to my medical journey, the book had also opened up a new chapter that required me to keep sharing my story and to help other doctors to thrive despite the challenges they face. This is why I qualified as a coach – to empower others. 4. If our readers wanted to become one of the things you’re doing, how can they learn these skills? Do you help physicians transition into doing coaching, speaking, and writing themselves? I help physicians to identify their career goals, to get clear on what it’s going to take to achieve them, and I support them on their journey. I’ve learned that often we think “it will be better over there”, whereas we need to find better ways to deal with what’s going on over here. 5. There are so many coaches out there, how do physicians pick the right one for them? I think it helps for physicians to be coached by other physicians who have qualified as coaches. The culture, training and challenges within Medicine may be difficult for people who haven’t walked that path to understand. Coaching happens through conversations; it helps when you speak the same language. 6. When does a physician know that it may be the time to seek the help of a physician coach? We all need a helping hand from time to time. Coaching is about getting the help you need to achieve the goals and results that are important to you. Therefore, the times to reach out to a coach are typically: when you feel stuck; when you are overwhelmed by a particular goal; and when you are in transition – either out of the profession or moving into a different level of responsibility. 7. What is a coaching program like? How is it structured? How long is it? How much should physicians budget aside for coaching services? Coaching programs differ, but the essentials of any program are: getting clear on what the client wants to achieve through the coaching; identifying where they are, their strengths and challenges; sketching out a roadmap to get the client from where they are to where they want to be through building their inner competencies such as self awareness, new habits and ways of being; ongoing feedback and review to ensure that the client is continuing to move in the desired direction. The actual coaching journey is co-created by the coach and the client, taking into account the particular challenges and circumstances of the client. Fees vary considerably! Physicians looking to hire a coach need to ensure that they speak to a number of prospective coaches to ensure the right fit between their styles, methodology and fees. In addition to a monetary budget, a physician considering coaching needs to also “budget” time and energy to allocate to the coaching process. 8. What are tips you can share for any physician dealing with burnout? Firstly, understand that burnout is not an indication of a personal failing or weakness. Burnout arises as a consequence of working in environments that predispose people to burning out. Therefore, dealing with burnout is not only about bringing changes into how we live and work, it’s also about addressing the workplace conditions that drive and perpetuate burnout. Valuable questions to ask yourself are: - How can I do more of the things that fuel me? - How can I do less of the things that drain me? (This includes self-inflicted stressors like perfectionism and perpetual success chasing). - If I can’t change anything in my work environment, how can I create opportunities for recovery and replenishment (e.g. scheduling leisure time with loved ones; pursuing hobbies; learning new skills; finding interesting projects to work on) - How will I know when I’m running on empty? What is my “go-to” strategy for coping? - Who can reach out to for support? End Interview The interview made me think a lot about how stress and burnout are finally being discussed in medicine. A few months ago, I went to a conference for physicians in my state and one of the workshops with the highest attendance rate was the one on physician burnout. I think it should've been its own conference because many physicians experience this, yet they may not actually have anyone to support them or feel comfortable sharing these feelings with. As physicians, we put high expectations on ourselves that, like Dr. Phalime says, things like burnout feel like a symptom of failure. I always get chills when I think about Dr. Phalime's speech where she says "some dreams must be allowed to die" because that's how you go on to live a better life for yourself.  Check out her  website  and book "Postmortem". For further questions, you can reach out to her by email ( ) or via social media (Twitter: @MariaPhalime)  
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