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Switching from Another Industry to Engineering/CS?
WomensHealth asks: "I am a physician, but contemplating a career change perhaps 5 to 10 years down the road. In addition to medicine, what I've always loved is computers and technology, and I think I have a pretty good appreciation for both. What tips could computer industry insiders offer to one who is willing to pursue an independent educational path towards a career in a Computer Science field? MIT's OpenCourseWare seems well put-together, though one can't get a degree using it. How can an old newcomer break into the industry?"
How bad is being a physician? I'd think you're probably making more than the average starting salary for programmers (keep in mind most of the people I know aren't even getting the average).
If you want to do some good, switch to politics instead and run for national office then pass laws restricting outsourcing.
Let's get real. Why should companies like IBM and HP be allowed to bid on government contracts when they have a large number of their workforce in IT sweatshops overseas?
I can't imagine going from something like medicine where you've got 8-10 years of college invested PLUS residency, into IT. Sure you could do it, and there are jobs that would pay you comparably, but the IT field is so unstable right now that it doesn't seem terribly wise.
Of course the flip side is that if all medicine gets under govermental control you may be in a much less lucrative job than you are right now. I think that if you're serious you should look at the programming/CS degree while you're practicing medicine and then apply both specialties by developing applications for the medical field. It's specialty work like that, where it takes somebody with inside knowledge to really know what is going on with the end result and not just the programming, that will be more difficult to outsource. Also the potential for true innovation from somebody within the medical field attacking programming is enough that you might secure yourself a position with a large company.
It would be a gamble any way you look at it. If you're really into it then find an online part-time CS program and enroll. Take a few classes over the course of many years. It will take you much longer to get the degree due to the changing nature of CS degree requirements, BUT... you'll know better by the end if you really want to leave medicine AND you'll still have the knowledge to grow from later.
CharlesP
wordtrip.com
Something about this questions smells bad, like a pool of stale water left in the corner of the room.
If you were a good physician you would not need another career as you would be rich already...
If you were a bad physician, then a load of CS geeks won't want you...
If it is a hobby you want, you don't need any qualifications
Try a medical informatics program. Google for "medical informatics program", and you'll get a ton of hits. Combines the medical degree and IT, and hard to outsource
Maybe he isn't interested in the money?
I know a couple of people who were one their way to careers in medicine (got accepted to med school etc.) who thought better of it. One became an engineer and the other a techie. Both are probably a lot happier than they would have been as doctors, even if they are also a lot poorer. Remember, some people do this because they like it.
And by the time he switches careers he might be at the point where taking a cut in salary won't be the end of the world. One day when the kids are gone and my 401k is in better shape I would like to spend some time exploring new fields as well.
People couldn't type. We realized: Death would eventually take care of this.
You're on the right track. Basic research in Physics , Chemistry and related fields will not make you rich, but pays reasonably well and is also unlikely to be sent overseas soon.
I wish it were not true, but weapons/defense industry research related to anti-terror and advanced defense technology is once again a promising area. One that is VERY unlikely to be offshored.
"Computers are useless. They can only give you answers."
-- Pablo Picasso
I think it's funny how the story creator, "Dr craig hall" (check out the email address) has a username called "Women's Health!"
Likely he's an ob/gyn (or possibly just weird), but it's still funny...
This is an interesting take on the future.
The bad point: China will be going after space in a big way, a potential impediment to making any money if space goes the commercial route because you won't be cost effective to any multinationals.
The good point: China will be going after space in a big way, a potential gold mine if the US Government decides there is no way it can afford to let China become too competitive commercially and (especially) militarily in space.
Could be interesting.
Leave the gun, take the cannolis.
I wish it were not true, but weapons/defense industry research related to anti-terror and advanced defense technology is once again a promising area. One that is VERY unlikely to be offshored.
That is the one thing that might keep me from changing into a different part of the compsci industry. I currently work in a DOD job where because of security requirements, most Americans cannot work here, let alone Indians. I'm unhappy for other reasons, but job security is not one of them. It's the one thing I have going for me in this economy.
24 beers in a case, 24 hours in a day. Coincidence? I think not!
IT is leaps and bounds above other industries precisely because it is hard to define.
A software sales critter essentially sells ideas and unmeasurable claims. A product which not only does not exist, but also has not been designed!
They promise the V8, 4 wheel drive, A/C, automatic transmission etc. for $20000 and deliver a POS (such as a Yugo as an example of a small cheaply built car) for $40000, and defective to boot. In real estate you can go out and look at the lot, the nieghborhood and the building plan and decide if that is what you want.
The ephemeral nature of software means that any charlatan or con artist can have a field day. And then charge outragous sums for bug fixes called upgrades. Which is one reason I am getting out, I no longer want to be associated with such practices, which are accepted as the norm.
Not all capitalism is immoral and/or unethical, just as not all socialists are lazy. It is just that IT is the worst I have found to date, and I see no good way to improve the situation.
putting the 'B' in LGBTQ+
I am an American medical student with several engineering friendss (pre-meds and engineers have lots in common at the undergrad level). When we contemplated the same question, we devised this: if you want to combine the two fields, please consider prosthetics research. Recent advances in neuroscience, materials science and computer technologies are making this field an up-and-comer over the next two decades.
As long as there is a Second Amendment, there will always be a First Amendment.
I don't know what medicine is like but the IT industry is not pleasent anymore.
From what I've seen of the medical industry, much of the same could be said as well for it. I worked for one of the top ten ranked hospitals in the US, and even there it was an uphill battle for most of the staff to get the patients the kind, and quality of care they really needed. Even getting out of it after a few years, I felt like the constant money money money over people was eating my soul. Posted AC to avoid getting sued.
Given the huge role that technology plays these days in medicine, I'd think that you might do very well to combine your interests in medicine and computer science. For one thing, it'd be a hell of a lot more interesting than tossing medicine altogether and becoming a database administrator or a mid-level systems analyst or whatever. No, you ought to learn enough computer science so that you can talk the talk and walk the walk, and then get involved in developing hardware and/or software that docs can really use to improve health care.
Radiology is perhaps the most obvious field where computers let docs see and do things that they never could before. I'd guess it's also probably the field where you'll find other docs with an interest in computers. You might do well to hang around with some of those folks and see where things are heading, and how they got started. But there are plenty of other fields as well... microbiology, chemistry, pharmacology, hospital IT systems, medical imaging, etc.
If you decide that a degree will really help you, then when the time comes you might consider taking a sabbatical from medicine and pursuing that degree full time. Or perhaps you'd do well to find a position at a university hospital where you could study CS as an employment perq.
Sorry, your experience is anecdotal and deosn't give you enough information to judge accurately. Yale-New Haven is hardly a representative benchmark of all US emergency rooms. Here in Los Angeles, we have County-USC: you'll wait in line for hours there in a room full of undocumented immigrants waiting to be seen. Go to the Northridge Trauma Center and you're treated quickly-- if you have insurance. If you don't (and you're critically injured), Northridge stabilizes you and sends you to County-USC. I suspect you're used to getting the same treatment everywhere and didn't know that YNHH is where only the poor people go. Poor people wait in line here.
If a job's not worth doing, it's not worth doing right.
I'm coming from the other side...currently BSEE doing chip design but recently started a PhD is biomedical engineering, specializing in medical imaging.
If you were to pick up the programming skills (you could get into image registration, segmentation, computer-aided diagnois, etc...) or the EE skills (you could work on the detectors for digital x-ray systems or CT front-end design) you could apply them to imaging diseases of which you already have a fundamental knowledge. This is very powerful and missing in a lot of the research I've seen.
One last word of warning: I would think one reason you got you MD was to help people...I've personally found that a huge portion of the high-tech industry is just out to make money, regardless of the effects it has on it's workers, the environment or the betterment of society. This is why I'm getting out.
First, you need to do what you like to do. I think a warning about the tough times in computing is fair. However, the employment situation is much better for harder skills (i.e. CS versus IT, research level CS versus UML/OOP/J2EE). I think there's still plenty of room for highly educated and motivated people.
Actually I saw a program at Dartmouth for a dual MD and PhD in CS (odd combination, but definitely useful). You may also be interested in the field of computational biophysics. It's all of the same ilk.
The article poster said he was interested in CS. Are you interested in research or business? There are a lot of different routes you could take. Do you want to deal with biomedical engineers, biochemists, or lawyers? Frankly, you were way too broad.
Incidentally, for what ever it's worth. You may get a kick out of http://www.santafe.edu/sfi/People/kauffman/">Stuar t Kauffman's work. He's regarded as one of the best in the field of complexity research. He also has an MD and no PhD. He taught himself quite a bit.
Some good Math and CS books:
"The (New) Turing Omnibus: 66 Excursions in Computer Science" by A. K. Dewdney
This book is a great advanced introduction to all of the major topics of CS (except neural networks). This book has sections on Godel's Incompleteness Theorem, Relational Algebra (database theory), viruses, operating systems, data structures, and more. This is a great book for you.
http://aduni.org/
This site has lectures from an entire CS curriculum online. It was an experimental program designed for people like you.
You'll need a good introductory book on programming. Since you're probably not worrying about polishing up your resume, and you seem to be more interested in learning, you should take a look at:
"The Little Schemer" or "The Little LISPer" by Daniel Friedman.
If you really want the traditional route, take a look at "Thinking in Java" by Bruce Eckel. It's free and most people recommend Java or C++ as a good first language.
If you're really daring, try the "Perl" book by Larry Wall or "Learning Perl" by Randall Schwartz. Although, I think Perl is a horrible first language to learn. It's way too exotic.
Take a look at "Advanced Programming in the UNIX Environment" by W. Richard Stevens. It's a great book on the internals in Unix.
Learn assembly language, it's a poor man's computer architecture course. Try to make a small graphics program (draw some primitives [lines and circles]) with assembly. Of course, you can't do that in Windows (unless you call some Win32 libraries or are VERY good.
"First Order Logic" by Raymond Smullyan
This book essentially covers the mathematics of automated theorem proving. Armed only with this, I was able to read papers in the field. Some knowledge of basic logic (prepositional logic, maybe some slight familiarity with predicate logic) is required. I'd also recommend a whole lot of "mathematical maturity". I recommend any of Raymond Smullyan's books (technical and popular science) sight unseen. Even his thesis (Theory of Formal Systems) was pretty good.
Any book by Howard Whitley Eves or Robert R. Stoll
Both men wrote books on matrix theory (linear algebra and more) and set theory. Actually, both are top-notch textbook writers and many of their books are available from Dover Publications.
Calculus Made Easy by Silvanus P. Thompson (or by FRS [Fellow of the Royal Society] if it's really old) and Calculus by Michael Spivak
The first book is the closest thing to a competent Calculus for dummies. It's almost 100 years old and it's a classic. Incidentally Mr. Thompson was an engineer, not a mathematician. The second book is notoriously rigourous and is almost an introduction to analysis. I don't know if you really care about Calculus. You probably won't
What do you mean my sig is repetitive? What do you mean my sig is repetitive? What do you mean....
Not knowing what your B.S. degree in (assuming you have one, of course, as it's not a requirement for medical school) you should consider graduate study in Biomedical Engineering.
Most certainly you'll have some undergraduate coursework to fill in, but you could go into areas such as biomechanics if you want to get your hands dirty or medical information systems if you want something more on the IT side.
Information systems, medical imaging and image analysis, biosignal analysis and processing, there's a pretty wide range of computational and traditional engineering focus areas that would benefit immensely from your experience.
Biomedical Engineering is still a growth field in this country, particularly in the R&D. Being an M.D. would make you uniquely qualified for clinical research, though that's largely a need outside of the information arena.
If you are interested in this path, talk to some universities that offer degrees and take some of the introductory coursework via satellite programs and get yourself admitted. A M.S. degree will be sufficient to get you into the job market and you can probably pull that off in about 3 years.
Guess what? She tinkered with her knowledge, became a midwife, explored a lot of different areas where she could legally do what she was interested in doing. Sounds an awful lot like non-degree compsci people, no?
The normal path isn't required to become a doctor any more than it is to become a software whatever-the-hell this guy wants to be. It is considerably harder in medicine, due to guild behavior, but I'm sure we'll see that develop in compsci over time as well, as it is becoming as vital as medicine to our economy.
I wonder if you're confusing "insulting" with "threatening."
I wonder if you're assuming MDs are divinity when they're not.
I forget what 8 was for.
From what I've seen so far, the advantage that India has over the US is that it is cheaper. Not that it is better. Not that it is equal. Just that it is cheaper. A small portion of my company has been outsourced to India. Like the Internet, we treat it as 'damage' and try our best to route around it.
Why not just hire a flock of interns in the US? It'd be just as good, and the accent wouldn't be there.
I graduated in 1998 (finished in 1997). Since then, I've come close to nervous breakdown twice (both, admittedly, in the same job -- my first), due to overwork and under-relaxing. Yes, I was young and naive; I didn't realise what I was doing. But the short of it is: I want out. The only issue I have with that is not knowing what I want to do instead. In other words: it's one thing knowing you want to get out of something. It's something quite different to know what you want to get in to. I don't know the latter yet; until I do, I'm staying in IT (the devil you know, and all that).
I've considered a couple of things, but they're either too short term (you physically can't do the job for more than 5-10 years), or require me to quit my job and go back to full time study. The former's not what I want -- I want something for the rest of my life -- and the latter isn't something I can afford to do, not without knowing for certain that I want to do it.
In short, unless you know what you want to do, and why you want to do it, I would very strongly recommend that you stay where you are. You could end up making your situation worse, not better, depending on the reasons for the change.
There seem to be plenty of opportunities to mix computers and medicine for someone with experience/knowledge in both fields.
I'd say if you are considering switching careers, combine an MS degree program with self-study. Academic programs offer contacts and structure.
On the very interesting, but smaller market, side: bioinformatics is a field that obviously benefits from education in both areas. Being highly proficient on both fields could give you a very cool research job.
On the vanilla, but much wider market, side:
- The medical industry is still lagging behind in IT. Most doctors are not computer-savyy, and this has translated in low IT spending and traditional, paper-and-people based solutions for a lot of things. Small to medium medical offices can be positively Luddite.
- There is a desperate need for good software that has not been, and cannot be, satisfied by typical retail software. Think custom applications, vertical markets. The few applications that exist own their respective markets and charge accordingly high bills.
- New regulations (HIPAA for one) and market pressure are forcing the industry in the US to do more than "catch up" and embrace technology much like financial institutions have done for a long time.
- HIPAA et al will not only force a lot of IT investments in that community; they impose new BIG requirements on the vertical applications that already exist. This opens the market to competition that can meet those requirements better and/or faster than the conservative choice (which may not meet them at all).
The difficult part (I believe) is on having medical knowledge and credibility, where a professional of that industry has an advantage. Being able to communicate with doctors, understand what they want and let them understand what they need. That's easier for someone who shares their vocabulary and frame of mind.
Team up with some geeks if you need to (to build an application, for example) and go into the market as a startup. Or knock on the doors of the more stable companies you find in that field.
Freedom is the freedom to say 2+2=4, everything else follows...
If it's what you want, do it. Fear not--I think the number of programming jobs in the USA will grow.
I, too, am a physician in the midst of changing my career to programming. I quit medicine a few months ago, just in time before my head exploded. I finally realized that I had never enjoyed medicine. My background is physics; I could never wrap my brain around medicine.
I'm learning C++. I'm considering game programming and medical informatics. The medical software I've used has been awful (just a hole to throw data into) and I know that I can make stuff that's much better. I'm going to make a software tool for managing chronic illness. However, game programming would be more fun. I think I could write game AI that would walk across the room and smack you in the face.
Would I be wasting my many years of medical education and practice? No. I'm like Dirk Gently: I believe in the fundamental interconnectedness of all things. Whenever I learn anything, I connect it to everything else I know. (Just today I noted that I could easily apply my medical problem-solving skills to assessing avalanche risk.) Also, my work as part of multidisciplanary medical teams will translate to working in programming teams wherein members have differing sets of skills.
Most likely I'll still do some doc-in-the-box stuff on the side to make money, at least as long as I feel competent.
Computers are a really, really, really wide field, as are most. So what you need to figure out, if you want a new carrer, is what about computers instrests you. First, decide which of the major categories you like:
1) Hardware design. These are the guys that start it all, who make the circuts that eventually come into everyone's computers. This is engineering, specifically computer and electrical. It's all about circut engineering and design, simulation, and making it work in the real world.
2) Software design. The next step. You take the finished hardware, and implement the code that makes it usable. This is computer science and is all about writing, debugging and testing code.
3) Support. The final stage. Once everything is designed, out in the real world, and being used, someone has to keep it working. Stuff breaks down, and users can't fix it, so someone must support it. There really isn't a university degree for this, though CIS or maybe MIS would be the closest thing. It's all about solving problems with finished systems.
So, which appeals to you? While you can cross from one to the other, it's generally good to try and pick what you want to do and work to that. HArdware guys should work on an engineering degree, support guys should work on low-level job experience and certifications.
Now once you've picked a general area, you need to look at specifics. What particularly do you want to do. Like if you are a support guy is it networks you like? Computers? Server farms? A mix? I mean within each broad area, there's lots to do.
So, really, what you need to do first is take some basic courses, talk to people, read some literature, maybe get some friends to take oyu on job tours, but try and figure out what it is you like about computers and what you'd want to do. It, like most fields, is broad and there is plenty to do. Try and find the niche that is right for you, then persue it. This isn't 1999 where anything computer related would land you a job in 6 seconds, you need to get relivant skills and experience to what you want to do. So the first step is to figure out what that is.
"Health Information Science is the study of how health data are collected, stored and communicated; how those data are processed into health information suitable for administrative and clinical decision making; and how computer and telecommunications technology can be applied to support these processes." - UVIC
Health Information Sciences (HINF) is probably going to be a growth market in the coming years. With an aging baby boomers demographic, governments are going to be throwing more and more money at healthcare. As health needs grow, so does demand for information infrastructure. This is where HINF could be a good industry segment to get into. Up here in Canada, the government is throwing billions of dollars at health care these days, and it's only going to increase.
Since you're already a physician, you probably have a lot of domain knowledge that will be very useful when desiging software for the health industry. Having that domain knowledge is extremely valuable since you'll have a lot of insight in the processes, laws, and implications of the health industry.
"There is no spoon." - The Matrix
As you will see from the other comments, life in CS sucks. I am a VB programmer with some minimal Linux skills (ducks to avoid rotten tomatoes). Yet I make more $$$ then most of the people posting here. Why? Because I am a chemist. I was hired by a Biotech company to work in their lab. This is "OK", because I have a chemistry diploma. They would never be allowed to hire a pure I.T.-er, because these guys belong in the IT dept. Yet I spend 95% of my time doing IT related work. I like my job and chances for getting fired are almost non-existent. They NEED me.
10 ?"Hello World" life was simple then
I'm the complete opposite -- a tech guy getting out of the Indian Export Business and into the medical field. Right now I'm training to be a paremedic. They damn skippy can't outsource EMS to India or China. A little less pay -- a lot more piece of mind. You would be insane to want to get into the tech industry right now.
If you are a Physician I am assuming you have a large amount of dough or could have that if you want.
Right now is probably the best time ever to find really good computer engineering, software, hardware talent in the U.S. A lot of really good people are looking for work. So if I were you I would get some basic education on areas you may not know as well. I.e. Data modeling, good basic object oriented classes, some Comp Sci history, database Principles, etc. Then start a company with all the good talent around looking for work doing what you enjoy most.
I could think of many areas in medical technology that if good techies were paired up with an actual physician would have extreme potential and it would be very rewarding work.
..medical software? It's a niche market, and even if you don't code, I'm sure you could bankroll some supercool medical idea. Brainstorm with your doctor buddies, do some market research (or hire some market researchers), and fund the project. Make a piece of software that you would like to use in your own practice, then sell it.
TK
Predictably, most of the posters here are relativly low level programmers or 'admins'. Ignore them. You will need a degree for any meaningful job. The meaningful jobs will always be there for qualified people. Don't go for 'IT' (as in MSCE, etc.) theses are usually minimally qualified people for one type of work. True, in the 90's they made in the 60 to 80 K range, but business is waking up to the fact that they couldn't really perform. Hence the fear that they will be 'outsourced' to India, or somewhere else where minimally qualified bodies can be gotten for a low wage.
If you are fascinated by how computers work, then go ahead and go for a masters in CS, otherwise, look to another part of industry. Engineering, particularly EE or Biological are always good. If you do, though, keep your current credentials up. It will not only look good on a resume, but if you decide that medicine wasn't really so bad, you can always go back.
I had a friend who was a Doctor in Idaho, when his wife divorced him, he decided that all the time he spent treating patients was at fault. (Like many physicians, he worked 70 or more hours a week.) He wanted to change his life. He made a complete change. moved to another state, and started teaching science at an inner city school. You know, where he could really make a difference. After a couple of years, he got fed up with the lack of support from parents and administration, the petty politics of high school pecking orders, etc. Now, he is back to practicing medicine in a small town that sorely needed a doctor. He would have done it sooner, but he had let his certification slide, and had to get it renewed. That took over a year.
No matter what you do, there are drawbacks. anything gets old. I'd say, go for real engineering. A Master's level is the minimum level you should shoot for, expect to take about 2 years for most fields. Look first to find what interests you, then go for it. BUT leave yourself an exit strategy
FYI, I am a Registered Engineer (PE). The work is always interesting, but I do recognize that anything gets old after a long enough time. If you really want to change, plan on more college. At least two years, as I said. You might decide that you'd like to stay in Medicine, but specialize. or, combine Medicine and Engineering. Research is also an area where there is always a fresh challenge.
Good Luck
> Work for the federal government. The pay may not be as sexy as private industry was during the dot
> com boom, but I've had a steady job for 6 years now since I got out of college, good raises every
> year, flexible hours, relaxed work environment, etc.
I dunno about you, but civil service (Federal, State, County, etc..) jobs appear sexy as hell to me. I'd have a major orgasm of some sort or another if I could get one.
In my three man clique, I do -- by far -- the most technical, most advanced, most time consuming work, and I have to spend much of my personal time learning more about job related stuff (for example, I'm always lurking on the Yahoo Groups Qt programmers list, and I spend tons of my own time working out how to get ezmlm (just got it perfect this week!) and jabber (damned jabberd2 keeps crapping out with an "sm died" message; I'll have to recompile everything with debugging enabled)), but I also recieve -- by far -- the lowest salary, with Peter the File Clerk showing off as runner up for lowest salary at a pay rate 16% above mine, and that's before you count that my commute is a thousand dollars per year more expensive than his (or anyone else's that I know).
Anthony the network admin, whose job is similar to mine minus the programming, remote administration of out-of-state machine, server maintenance, manual EDI translation and heavy data entry, happens to work for the Federal government. Specifically, he lives it large for the FAA, earning well over twice my own salary. I can't complain, because he's one of the nicest guys in the universe. But I am a bit envious, especially since I have no talent whatsoever in the "job getting" department, and he had a conveniently placed family member who could help him out a bit with the position.
Er. Anyway, government labour is the great equalizer. In financially great times, the pay is substandard but reliable. In financially average times, the pay is standard and reliable. In times like today, the pay is amaing and reliable. After a year of work, the job of LAN Technician in my local county would pay two and a half the salary that I'm getting now, and that's with work that seems extremely low key to me.
Private sector work sucks. I want out!
Sorry for the rant. I had meant to actually say something insightful. Oh well....
--
-JC
coder
http://www.jc-news.com/parse.cgi?coding/main
Oddly, we've been looking for people who sit at the crossroads of clinical knowledge and CS/IT for quite a while. Boring details are at www.patientkeeper.com, but the jobs look something like this:
Here's the skinny:
Clincical Product Manager is possibly the hardest, most satisfying, and most visible job at PK. Product management is the ultimate cross-functional leadership role. Through intellectual horsepower, interpersonal skill, domain knowledge, technical depth and attention to detail you'll be the most respected voice in the organization for your product. Sales, marketing, software engineering, QA, customers, and senior management will all want to know what you think. The job: Design and manage an enterprise clinical application, acquire and synthesize wisdom from customers, clinical experts, engineers, and doctors, and formulate a viable plan for success. A successful tour of duty in product management positions you for a leadership role almost anywhere else in the company and is a time-honored path to senior management (viz. Microsoft's Program Manager role). The downside: high visibility, high pressure, responsibility to make a serious difference and enough rope to hang yourself if you screw it up.
The position requires three major skill sets:
Technical aptitude: you don't need to be a software engineer, but you have to be able to take one to lunch. You must understand, extend, and work with the technical issues as they impact your product. You must master all of the customer-facing details of a product so that seemingly minor issues are NOT solved by otherwise clueless software developers. That takes a lot of horsepower.
Clinical aptitude: we're an enterprise (i.e. hospital) clinical applications company. Customers want to feel that you are capable of understanding physician, nurse and administrative workflows and can discuss the product issues with them in their language.
Social aptitude: this role has been identified as having minimal official resources, maximimum responsibilites and the maximum number of interested parties (ie, executives). You'll sink or swim in this role based on how well you can command the respect of the rest of the organization, for that will determine how well you'll be able to rally various constituencies around your plan. It ain't easy, but it is great training for completing these tasks in a larger pond. Intellectual bandwidth required.
Realistically, nobody has all three skillsets out of the gate. You need to have the social aptitude and one of the two others (technical or clinical) "out of the box", and be able to shore up your weaknesses on the third. Clinical depth is particularly prized.
I work at the county level and I couldn't be happier with my position. My pay is pretty good, not great mind you but at least pretty good. It gets better in small amounts every year though. Raises are regular if not spectacular.
My job security is excellent and that's almost the best thing about it. It gets beat out by my retirement plan. Here we get a set amount deducted from our paycheck every month which my county matches at 220%. Basically when I walk out the door here in another 19 years I'll get a raise. No trying to figure out how to live on a reduced income for me. Cost of living raises continue for the rest of my life (obviously "merit" raises cease when I retire) and of course I've get to keep my medical and dental for life too.
When I die my wife keeps getting my check till she dies (which costs a bit more, I think I throw in another $7 a month for that option).
The benefits are great but it's not like the job stinks. We stay pretty current and there's never a shortage of stuff to do. Since most of my users are also in this for the long haul I'll be supporting a lot of the same people for a very long time. If you want stability this is about as stable as a 21st century IT position gets.
Appended to the end of comments you post. 120 chars.
Don't let some of the people pring you down about "offshoring".
.. people pay for knowledge, you're job would be to convince them you have it.
You would actualy be at an advantage since, not only could you build the solution - you could also understand the problems faster.
An example , alot of the IT people here could build a patient management system - blah balh apachee blah blah mysql blah blah wireless... etc. Many would miss their mark in usability, effectiveness, security, privacy etc.
That's where your value would be - having domain experience