Being Honest with Yourself—Setbacks, Pivots, and Changes in Career

Abstract Approximately 20 to 40% of physicians change jobs within the first 2 to 5 years of practice, and up to 80% eventually leave their first position. In colorectal surgery—a field that has become increasingly competitive—early career transitions are common, whether across institutions or within the same department. In this chapter, we explore the dynamic and non-linear nature of career development in colorectal surgery through firsthand narratives of surgeons who have navigated shifting roles, institutional limitations, and evolving goals. When selecting a first job or evaluating new opportunities, surgeons must assess their own priorities, values, and vision for the future. A transition in your career is inevitable. Some may involve dramatic changes in practice setting or geography, while others reflect more subtle shifts in role or focus. Evaluating opportunities, stepping out of comfort zones, and knowing the limitations of existing agreements and contracts can highlight when to pivot, persist, or walk away. By sharing real-world experiences, we aim to provide insight and support for colorectal surgeons navigating transitions through all parts of their careers.