A second career in academic medicine.

Career changes in all vocations are relatively common in the forties age group due to a variety of factors which include a crisis period caused by polarities of Generativity versus Stagnation as conceptualized by Erik H. Erikson. Generativity is served not only by procreativity but also by guiding the next generation through teaching. The result can be the strength of Care. Stagnation can result in unhappiness, irrational and destructive behavior, or withdrawal. Concepts of young, old and mortality also come into focus. A successful career change from private practice to academic medicine depends upon a combination of power, opportunity, and character. To be successful, the change should be made for positive reasons and be based upon youthful concepts in the cold reality of the financial and intellectual challenges of a new and competitive career. If properly done, both the personal rewards and the contribution to future medical care can be quite positive.