Choosing a Different Path: Reflections on a Career Beyond the Hospital

In this article, new Chair of the Faculty of Remote, Rural and Humanitarian Healthcare (FRRHH), Dr Thomas Pols shares his journey from embarking on a career within medicine to exploring the world of policy, business, and diplomacy. Thomas speaks on the twists and turns along his career path and discovering his true passion.

Like many doctors at the start of their careers, I assumed mine would remain firmly rooted in clinical medicine. I trained in emergency medicine, and those early years gave me invaluable experiences at the sharp end of patient care. During my time with Médecins Sans Frontières, I became particularly interested in surgery. The ability to deliver immediate, life-saving interventions in resource-limited settings felt both vital and rewarding.

Yet over time, I became increasingly curious about the factors that decide whether surgical care is even possible in those environments. Why do some clinics have reliable access to theatre, while others struggle with the basics? It was this interest in the systems behind health outcomes that led me to step away from clinical work and explore management and policy.

That choice was far from easy. Clinical work provides not only a clear identity but also a well-marked career path. Moving away from it felt uncertain, and at times like walking away from something deeply valuable. But I came to believe that once a decision is made, it must be pursued wholeheartedly. Dividing one’s efforts rarely serves either path well.

A turning point was my time as a Fulbright Scholar at the Fletcher School of Law and Diplomacy. Choosing a non-medical degree was deliberate: I wanted to immerse myself in new disciplines – international relations, negotiation, economics – and learn how the wider world thinks about health. It was uncomfortable at first to step outside the professional sphere I knew so well, but it gave me the tools to connect medicine with the worlds of policy, business, and diplomacy.

That shift opened doors I had not imagined: leadership roles in global companies, responsibility for the health and wellbeing of thousands of employees, and partnerships with organisations such as COVAX and UN agencies. To this day, my work continues to focus more on the systems, organisations and partnerships that allow care to happen – whether in humanitarian settings, remote worksites, or global companies.

Looking back, I see a thread connecting those decisions. Whether in a rural clinic in Pakistan, a refugee camp in South Sudan, or a corporate boardroom in Europe, the question is the same: how do we create systems that allow people to thrive? For me, the answer has been found less in trauma bays and more in strategy.  

For early-career doctors, my advice is this: do not be afraid to make tough choices. If your heart pulls you towards the operating theatre, pursue it with commitment. But if you sense your contribution might lie elsewhere – whether in public health, humanitarian practice, or policy – give yourself permission to take that path. A career outside the hospital can be equally rewarding, even if it is less clearly signposted.

The Faculty of Remote, Rural and Humanitarian Healthcare exists to support those who make such choices. For surgeons interested in roles that extend beyond the operating theatre, there is a community here to help you navigate what can be an uncertain, but ultimately rewarding, path.