When is enough enough?
When is the right time to step away?
I was caught off guard when these questions popped into my head. I’m a pediatric neurosurgeon, and I remain passionate about my work every day, but the questions visited me anyway. I know everyone confronts these questions at some point, but I thought I had at least 10 more years before they caught my attention.
I imagine this is something many senior physicians can relate to.
Unlike many professions, medicine does not offer clear or universally accepted answers. There is no mandatory expiration date for judgment, wisdom, or professional identity. And for senior physicians, especially those who remain sharp, capable, and committed, retirement is rarely a simple or obvious decision.
Experience Peaks Later Than We Admit
One uncomfortable truth in medicine is that senior physicians often provide some of the highest-level care of their careers later, not earlier.
Clinical judgment deepens with time. Pattern recognition sharpens. The ability to anticipate complications, manage uncertainty, and guide teams through complex situations improves with years of experience, not fewer. As long as a physician remains cognitively intact, that judgment only sharpens.
The same is true of technical skill. As long as a physician remains physically capable, those skills do not simply evaporate with age. In many cases, they become more efficient, more precise, and more thoughtful.
For a specialty surgeon like myself, the reality is fairly clear-eyed. Peak surgical years often fall somewhere between 55 and 70—sometimes extending to 75—depending largely on physical stamina. When cases routinely last six to twelve hours, endurance matters. Eventually, the body speaks up, even if the mind remains fully engaged.
But that reality only sharpens the central dilemma.
The Question No One Can Answer for You
Do you need to go until 70? Are you compelled to work until 72 or 75 simply because you can?
Or is 35 years of practice enough? Is it reasonable—even wise—to retire at 65, knowing you may still be at the height of your professional capability?
For most physicians, this decision is almost entirely self-regulated. Systems intervene only in egregious cases. There is no alarm that sounds when it’s “time.” No external authority reliably steps in to say, You should stop now or You should stay.
Instead, most physicians face this decision alone sometime between 55 and 75.
That solitude makes the question that much harder.
Duty, Identity, and the Life Beyond Medicine
At the heart of this decision is a tension every senior physician recognizes.
On one side is duty—to patients, to colleagues, to the profession itself. Accumulated expertise has real value. Experience saves lives. Walking away can feel like abandoning a responsibility you’ve spent decades earning.
On the other side is the recognition that medicine, however meaningful, cannot be the only meaningful part of a life. There are relationships to nurture, interests deferred, health to protect, and time—finite and precious—to be lived with intention.
In my writing on leadership, I’ve emphasized that knowing when to step aside is as vital as knowing when to step forward. Understanding when your continued presence serves the mission and when it may be time to create space for others is a critical aspect of leadership.
Retirement, in that sense, is not failure or dereliction. It is a transition. And like all transitions in medicine, it deserves thoughtful reflection.
An Honest, Personal Reckoning
There is no universal “right” age to retire from medicine. There is only an honest reckoning with a few essential questions:
- Am I still providing the level of care my patients deserve?
- Do I still find meaning in the work, or am I simply enduring it?
- Am I moving toward something, or am I just stepping away?
These are not questions that policy, peers, or institutions can answer. They require self-awareness, humility, and courage.
For senior physicians, if you make your retirement decision about whether you can keep going, you might end up working forever. That can be okay if that’s what you decide you want. But a more productive reflection explores whether retirement aligns with the physician—and the person—you want to be in the years ahead.
That decision is deeply personal. And perhaps fittingly, it is one of the final acts of professional leadership a physician makes.