The Wandering Koi

Stepping away from clinical medicine raises real questions — about licensure, boards, hospital privileges, and professional identity. Before committing to a sabbatical, we spent a lot of time reading policies, asking questions, and planning carefully.

This post shares what we learned — and what surprised us.

What “Re-Entry” Actually Means

Re-entry ≠ remediation ≠ retraining Applies to voluntary, non-disciplinary gaps Most formal pathways apply after years, not months

Licensure, Credentialing, and Boards Are Different

State licensure often doesn’t require active practice Hospital privileges and liability coverage are separate Specialty boards set their own standards

Maintaining Certification During a Sabbatical

Both of our specialties allow continued maintenance Online CME and assessments make this possible Staying current simplifies return

The Human Side — Talking to Leadership

We started with intention, not logistics We gave early notice We focused on continuity and professionalism These conversations shaped how we felt walking away

A Career Gap Isn’t an Exit

It’s a pause It requires planning It doesn’t erase a career And it doesn’t have to close doors

This isn’t advice — just what we learned while doing our homework. Policies exist. Pathways exist. And with planning, stepping away can feel intentional rather than risky.