I experienced burnout as a trainee and considered leaving medicine - now I'm back in love with work again

This blog post by Dr Annalie Clark is part of the Thrive in Psychiatry campaign.

I started psychiatry training in 2014. I have worked less than full time since returning from my first maternity leave in 2017. By January 2023, I’d nearly completed ST5. I was working in a female psychiatric intensive care unit. Life outside of work was hard, with two young children and family illness.

I felt I was on a relentless treadmill that didn’t give me time to stop and check I was still going in the right direction. 

Looking back now, I think that I was scared that struggling was a reflection of personal failure and inadequacy, so I just kept trying to plough on.

I was in a constant state of anxiety about work. I couldn’t switch off at home and was working in the evenings and on my non-working days.

I couldn’t relax enough to play with my kids, I wasn’t able to be the mum I wanted to be. I struggled to sleep, and when I did, I dreamt about patients and the unit.

'I hit breaking point'

Every morning I awoke with an all-encompassing sense of dread about what the day would bring. Then one morning, I got to work and just couldn’t push through the dread to get out of the car. The tears wouldn’t stop flowing. I had hit breaking point.

 I was off work for about 4 months with burnout.

At the beginning, I was in a constant state of anxiety, with an incessant critical voice in my head, questioning why I couldn’t cope like everyone else.

In the midst of it, I couldn’t see the systemic factors that had weighed heavily to contribute to my burnout. I saw my GP, restarted antidepressants and started assessment sessions with DocHealth, a not for profit psychotherapy service for doctors.

Should I leave medicine?

At the start, I couldn’t see how I could possibly continue working as a doctor. I spent hours searching for alternative careers outside of medicine.

With time, as my chronic levels of anxiety gradually came down, I was able to start reflecting on what I really wanted to do next.

I was scared about taking the leap of leaving medicine but I felt I needed more time before jumping straight back on the juggernaut of training, hurtling towards a goal that I didn’t know that I wanted.

At the same time, I didn’t think that an extended period off work would help, I needed to see whether it was possible to be the person I wanted to be, working as a doctor in the system.

I felt stuck. The only path that I’d ever thought possible was the conventional training route, I didn’t know anyone who had deviated from that track.

Out of Programme Pause

 In the midst of my internet searching for options, I discovered that something called an Out of Programme Pause existed. It meant that I would be able to work in a non-training post in the NHS for up to a year without giving up my training number.  

I had known since CT3 that rehabilitation psychiatry was what I wanted to do – if anything was going to persuade me to stay in medicine, it was working in rehab again.

I got in touch with a consultant I had worked for in rehab previously.

By a huge stroke of luck, it turned out that they were going to be recruiting a specialty doctor for maternity cover at the rehabilitation unit I had previously worked on. It felt like fate!

I approached my educational supervisor with my plan. Although she hadn’t heard of an Out of Programme Pause before, she was incredibly supportive and with the support of the new trust and the deanery, we managed to get my out of programme application processed and accepted to line up with the start date of the new post.

Scary return

I returned to work as a specialty doctor at a community rehabilitation unit in May 2023.

Even though I wasn’t returning to training, it was scary going back. I didn’t know if I would cope or fall into a whirlwind of anxiety again.

Returning to a team that I was familiar with, to a unit that I knew shared my values was so important. I was open with my clinical supervisors and shared my goal of wanting to find a work-life balance that was sustainable in the long-term.

Although I increased to working 4 days a week, having a predictable 9-5 working pattern without on-call commitments gave a real sense of stability.  

During this period, I also commenced long-term psychotherapy with a local therapist who DocHealth had supported me to find.

Again, having a regular schedule without on-call commitments, helped with being able to commit to a regular weekly therapy session.

 From the start, I started practising being more boundaried and only working my working hours. My trust in my team meant that I could leave work at work and know any issues would be dealt with appropriately.

No longer in a chronic state of heightened anxiety, I was able to give time to nurture relationships in work, something that I had previously never felt that I had time to do with all the busy clinical priorities.  

'I fell back in love with work'

I developed really important, meaningful relationships with colleagues, discovering shared interests and values which was replenishing.  

I fell back in love with work. I knew this was the patient group that I wanted to work with, in a holistic, multidisciplinary way with a focus on therapeutic relationships.

Without the pressure of training requirements and clinical commitments spilling into my non-working hours, I found I had more headspace outside of work. Along with the improvements this made to my home life, I also re-found my love of reading that had been lost. I came across Open Dialogue.

Absorbing everything I could find on it, I was filled with excitement and hope for the possibility of bringing change to existing systems.

I returned to training in March 2024. I used the Supported Return to Training (SRTT) resources which I found helpful to structure discussions about my return.

I felt empowered to have an open discussion with my training programme director about what I needed to support the transition. I was able to return to a job I had worked in previously and I had a graded return to the on-call rota. I was also able to access coaching through SRTT.

These sessions focused on maintaining my wellbeing, considered strategies to build my confidence and assertiveness and helped develop strategies to help with time management and managing multiple priorities.

 It wasn’t easy returning to training, but the break from training had given me the time and space to make a conscious decision that I wanted to continue on this path.

Using my experience of burnout to be a compassionate leader

I was able to hold the certainty of knowing I wanted to a consultant rehabilitation psychiatrist and this gave me hope. I had a new found awareness of the impact of systemic factors on individuals working in the NHS – I knew I wanted to use my experience of burnout to be a compassionate leader supporting a team to provide excellent patient care, in a manner that valued each member and was sustainable for everyone.

Using special interest time to explore my growing passion for relational psychiatry and Open Dialogue also helped to sustain me.  In March 2025, I started acting up as a consultant in a community rehabilitation unit and I finally obtained my CCT in August 2025.

What pulled me back from the brink?

So what helped to pull me back from the brink of leaving psychiatry and medicine? 

Relationships have been so important - being able to turn to relationships with trusted colleagues when I was struggling and taking time to build relationships and discover shared interests and values with colleagues who I work with every day.  

Having my own personal therapy has been invaluable – I would highly recommend DocHealth and am so grateful for their support. 

Exploring options outside of conventional training undoubtedly helped me with continuing as a psychiatrist. I was lucky to happen across the out of programme pause option.

Prior to burning out, the training treadmill was the only path I knew. I didn’t know anyone who had taken alternative paths, and I think to me, even considering an alternative to continuing training felt like failure.

Raising awareness of alternative pathways through Thrive in Psychiatry feels so important. 

Dr Annalie Clark,  Consultant in Rehabilitation Psychiatry.