If you leave residency, can you ever come back?

[NeedToStudy]

There are a surprising number of threads on sdn about people thinking of leaving residency before they've finished. The question in my mind is if these people actually leave after intern year or after any year but before finishing their residency, can they ever come back? If years down the road they decide that they want to come back to residency, would it be possible? Has anyone know of people who have come back after leaving?

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[doc05]

not to the same program.

 

[Winged Scapula]

It's going to depend on the length of time and what they were doing during their absence. I'd venture that once you get beyond 3 to 5 years your chances of getting back into residency are very slim.

 

[NeedToStudy]

It's going to depend on the length of time and what they were doing during their absence. I'd venture that once you get beyond 3 to 5 years your chances of getting back into residency are very slim.

Does the specialty matter? For ex. would it be easier to return to an IM residency as compared to a Neurosurgery residency? And by leaving residency I mean doing something completely different, like business or something.

 

[psych md jd]

Been there, done that. Twenty years ago. Chances today?

 

[meerkat111]

Depends on why you left.

 

[Winged Scapula]

Does the specialty matter? For ex. would it be easier to return to an IM residency as compared to a Neurosurgery residency? And by leaving residency I mean doing something completely different, like business or something.

I would believe that it would have to.

The surgical literature does have data on skill erosion after maternity leave and other time off. Therefore I would imagine that anyone else would be as concerned that a prolonged break would result in some loss.

Those in a non-surgical specialty could speak to whether or not the same is true for their field.

 

[typhoonegator]

I would believe that it would have to.

The surgical literature does have data on skill erosion after maternity leave and other time off. Therefore I would imagine that anyone else would be as concerned that a prolonged break would result in some loss.

Those in a non-surgical specialty could speak to whether or not the same is true for their field.

Certainly surgical skills are one thing, but the state of the art moves so fast these days that even non-surgical specialties would have to be concerned about fund of knowledge. If you left and were doing something where you could demonstrate that you were keeping up with the literature and such, then maybe. But leaving to spend two years training for the Olympics or climbing a mountain or whatever? I would be hard pressed to let you come back and start learning again.

Luke Skywalker left his training, under Yoda's strenuous objections. It almost did him in. And you sir are no Luke Skywalker.

 

[Winged Scapula]

Certainly surgical skills are one thing, but the state of the art moves so fast these days that even non-surgical specialties would have to be concerned about fund of knowledge. If you left and were doing something where you could demonstrate that you were keeping up with the literature and such, then maybe. But leaving to spend two years training for the Olympics or climbing a mountain or whatever? I would be hard pressed to let you come back and start learning again.

Luke Skywalker left his training, under Yoda's strenuous objections. It almost did him in. And you sir are no Luke Skywalker.

I bet that training for the Olympics and actually making the team would be given special consideration. Random traveling or other assorted activities may not as you note.

 

[atomi]

I bet that training for the Olympics and actually making the team would be given special consideration. Random traveling or other assorted activities may not as you note.

That's silly. Why would it matter more if the reason was you wanted to train for the Olympics? What if I got just as much joy out of sitting at home drinking beer and watching netflix in my basement for 2 years as the guy who ran 20 miles a day for 2 years did? They are both equally non-related activities to the study of medicine.

 

[22031 Alum]

That's silly. Why would it matter more if the reason was you wanted to train for the Olympics? What if I got just as much joy out of sitting at home drinking beer and watching netflix in my basement for 2 years as the guy who ran 20 miles a day for 2 years did? They are both equally non-related activities to the study of medicine.

Joke response? Or can you truly not see how those activities hint at very different character qualities??

 

[Over9000]

That's silly. Why would it matter more if the reason was you wanted to train for the Olympics? What if I got just as much joy out of sitting at home drinking beer and watching netflix in my basement for 2 years as the guy who ran 20 miles a day for 2 years did? They are both equally non-related activities to the study of medicine.

Sports are deified in the USA. I think it's stupid, but that's the way it is.

 

[Winged Scapula]

That's silly. Why would it matter more if the reason was you wanted to train for the Olympics? What if I got just as much joy out of sitting at home drinking beer and watching netflix in my basement for 2 years as the guy who ran 20 miles a day for 2 years did? They are both equally non-related activities to the study of medicine.

seriously?

The qualities that define Olympic caliber athletes are those that are generally aligned with valuable qualities in a resident physician.

Sitting on your couch and watching Netflix requires no where near the physical and mental determination, sacrifice, and hard work.

The point is that you don't necessarily have to do something medically oriented during your time off but it sure as hell better be something special and productive.

 

[dozitgetchahi]

His point (which I think is valid) is that the skill erosion is equal in both scenarios.

 

[22031 Alum]

His point (which I think is valid) is that the skill erosion is equal in both scenarios.

Eh, I don't think it's that valid a point. If skill erosion were that big a deal, you wouldn't have surgical programs sending residents into research years only to jump immediately back into rotations. It's more about how "productive" a hiatus is, as WS stated.

 

[Winged Scapula]

Even if skill erosion were the issue (which it is and of course, is equal whether you were laying on the couch watching Family Guy or training for the Olympics), the point is that a residency program is going to make a subjective judgement about what you did with that time off. Fair or not, if you've chosen to do something non medically related, the resident who chooses something cool, impressive, productive (or what have you) is going to be seen more favorably.

#lifesnotfair

 

[atomi]

His point (which I think is valid) is that the skill erosion is equal in both scenarios.

Bingo. The medical profession is obsessed with with assigning value to the activities one does in their free time and judging people by it, especially when it comes someone who takes time off (because most physicians never do this even if they want to they will have a strong subconcious negative emotion towards people who actually have the guts to do it). When somebody takes significant time off from work they will be judged by their peers when they want to come back. If they did something noble during that time, then it might be accepted. If they did something construed as lazy, then it won't be accepted.

The point is that someone who wants to spend time training for the olympics does so for purely selfish reasons. The same way someone who wants to spend two years hanging out on the beach in Fiji and running fishing/dive charters. The person who chose to spend a few years in Fiji will be criticized because it will be looked at as a vacation because of ill-defined intangible feelings of those judging them. Whereas the athlete is somehow noble even though their motivations are the exact same: pursue something they enjoy outside of medicine. Both people have skill erosion. And the judging of one over the other is totally emotional and non-scientific.

 

[atomi]

Even if skill erosion were the issue (which it is and of course, is equal whether you were laying on the couch watching Family Guy or training for the Olympics), the point is that a residency program is going to make a subjective judgement about what you did with that time off. Fair or not, if you've chosen to do something non medically related, the resident who chooses something cool, impressive, productive (or what have you) is going to be seen more favorably.

#lifesnotfair

I think we understand each other perfectly. My point was to demonstrate how absurd and unfair it is. I'm not denying that it exists.

We only get to live once and people should be able to pursue what makes them happy in life, and have the freedom to seek out new experiences all throughout life, not just in their late teens and early 20s. There should be avenues for physicians and yes, even surgeons, to explore facets of life outside of medicine (you know, to actually try to be a diverse well-rounded person i.e., a human being) and avenues for them to return to practice when they've quenched their thirst for exploration or sometimes just some R&R.

 

[dozitgetchahi]

Bingo. The medical profession is obsessed with with assigning value to the activities one does in their free time and judging people by it, especially when it comes someone who takes time off (because most physicians never do this even if they want to they will have a strong subconcious negative emotion towards people who actually have the guts to do it). When somebody takes significant time off from work they will be judged by their peers when they want to come back. If they did something noble during that time, then it might be accepted. If they did something construed as lazy, then it won't be accepted.

The point is that someone who wants to spend time training for the olympics does so for purely selfish reasons. The same way someone who wants to spend two years hanging out on the beach in Fiji and running fishing/dive charters. The person who chose to spend a few years in Fiji will be criticized because it will be looked at as a vacation because of ill-defined intangible feelings of those judging them. Whereas the athlete is somehow noble even though their motivations are the exact same: pursue something they enjoy outside of medicine. Both people have skill erosion. And the judging of one over the other is totally emotional and non-scientific.

This point is so true.

Guys, do you seriously think that the skill erosion is somehow lessened by, say, training for the Olympics? I agree that the latter shows guts, determination, fortitude etc but that's not what we're judging here. I doubt that the surgical skills of an Olympic trainee are going to be any better than those of a couch potato after an equal amount of time away from the OR.

 

[typhoonegator]

You guys are arguing in circles. No one is saying that skill erosion is dependent upon anything other than time away from the field. What people like WS are saying is that some extracurricular pursuits are more highly valued in our society than others. That's it. If you took two years off and solved wealth disparity in the United States, that would be seen as a more valuable pursuit than taking two years off to extensively Instagram your vegan lifestyle, even though your medical skills would erode equally during both two year blocks. We'd be more willing to tolerate bringing you back up to speed on your return for the former than the latter. If you think Olympic training and Netflix watching are equivalent pursuits, that's fine. But you can't expect everyone to share that world view. This is simply Truth, against which you are more than welcome to flail ineffectually.

 

[mercaptovizadeh]

The problem with medical school is they keep on pushing this well-rounded nonsense which is then either pursued in boilerplate uninterested fashion (we know the resume padding) and is thus outside of the spirit of well-roundedness, or is actively lived and then when these people end up in medicine they are miserable because everything else they enjoyed in life (the concern violinist, the football player, the sculptor, the speaker of 5 languages, the professional chef, the Shakespeare play director, etc. - to take the extreme trajectory of what is cultivated and desired by the med school admissions committees) is denied them by their profession.

Instead, medicine should look only for medicine-obsessed people, those who find nothing interesting but medicine (and maybe animal biology, for good measure), who find no joy in anything but their job. Those people will not take time off to reflect, will not be (as) depressed, and may not even take vacation, so we can be sure the call schedule will remain pristine.

 

[Winged Scapula]

This point is so true.

Guys, do you seriously think that the skill erosion is somehow lessened by, say, training for the Olympics? I agree that the latter shows guts, determination, fortitude etc but that's not what we're judging here. I doubt that the surgical skills of an Olympic trainee are going to be any better than those of a couch potato after an equal amount of time away from the OR.

It looks like you're not following the argument.

The argument was made that taking years off to pursue an Olympic sport was no different than laying on your couch watching Netflix.

My argument was that skill erosion is going to happen regardless of what you do with that time, assuming it's something outside of medicine.

No one ever said that the surgical skills of the Olympic athlete would be any better than that of the person watching Netflix. That's not what we're talking about here. There is good evidence that skills in the young trainee erode at a very rapid rate, even during maternity leave or research years.

However the perception of the value of that time will be significantly different for the Olympic athlete as compared to someone who laid on the couch and watched old movies.

 

[Doctor4Life1769]

I'm surprised this "debate" has still persisted.

 

[Ericslv]

Joke response? Or can you truly not see how those activities hint at very different character qualities??

Interesting discussion. It is true that training for the olympics would demonstrate different character qualities. However, it is still irrelevant to the practice of medicine. Why do we give more importance to someone who can jump higher or run longer or bounce a ball better? We seem to pay them better as well on a professional level.

Are they really that important?

 

[dozitgetchahi]

You guys are arguing in circles. No one is saying that skill erosion is dependent upon anything other than time away from the field. What people like WS are saying is that some extracurricular pursuits are more highly valued in our society than others. That's it. If you took two years off and solved wealth disparity in the United States, that would be seen as a more valuable pursuit than taking two years off to extensively Instagram your vegan lifestyle, even though your medical skills would erode equally during both two year blocks. We'd be more willing to tolerate bringing you back up to speed on your return for the former than the latter. If you think Olympic training and Netflix watching are equivalent pursuits, that's fine. But you can't expect everyone to share that world view. This is simply Truth, against which you are more than welcome to flail ineffectually.

Thank you for highlighting one of those subconscious biases among physicians that simply drives me crazy - namely, the 'he who does more stuff in his spare time (as long as it's 'the right stuff') is automatically better, and should be afforded additional privileges' argument. Other physicians who have spent time away from the profession because of lengthy health issues haven't been allowed back in (seen it personally), but some guy who chooses to indulge (yes, indulge) his love of some Olympic sport over the profession finds the door wide open? It's poppycock, but if you've been around doctors long enough it becomes understandable.

The funny thing is that the argument is never expressed in these terms. Instead, everyone's told it's about 'patient safety' and 'skill erosion'. It's not. If you want to pick and choose which activities you feel are more dignified than others, fine. But we shouldn't be bull****ting people about it.

 

[22031 Alum]

Interesting discussion. It is true that training for the olympics would demonstrate different character qualities. However, it is still irrelevant to the practice of medicine. Why do we give more importance to someone who can jump higher or run longer or bounce a ball better? We seem to pay them better as well on a professional level.

Are they really that important?

Do you truly believe that the sacrifice, self-discipline, perseverance, etc. that is required of athletes is irrelevant to the practice of medicine? Sure, it's not memorizing a biochemical pathway. But if you can't see the parallel between a javelin thrower doing hundreds of reps to perfect their form, and a medical student throwing hundreds of two-hand ties to perfect their form, then I don't know what to tell you.

That's not to say that such qualities only come from sports- the same can be said for the violinist who spends time practicing and the chef who constantly works on their knife skills. Do I think sports are over-glorified in our society? Sure. Do I wish grade schools had billion dollar budgets like sports teams? Of course. But I also don't agree with people who automatically dismiss sports as "bouncing a ball" out of this need to belittle anything that's not "intellectual" enough.

 

[NeedToStudy]

Why are we talking about sports? The question was supposed to be about normal situations. Most Physicians leaving residency aren't leaving to train for the olympics. What if they leave to go into business or join the military for ex. Would that affect their ability to return?

 

[Ericslv]

Do you truly believe that the sacrifice, self-discipline, perseverance, etc. that is required of athletes is irrelevant to the practice of medicine? Sure, it's not memorizing a biochemical pathway. But if you can't see the parallel between a javelin thrower doing hundreds of reps to perfect their form, and a medical student throwing hundreds of two-hand ties to perfect their form, then I don't know what to tell you.

That's not to say that such qualities only come from sports- the same can be said for the violinist who spends time practicing and the chef who constantly works on their knife skills. Do I think sports are over-glorified in our society? Sure. Do I wish grade schools had billion dollar budgets like sports teams? Of course. But I also don't agree with people who automatically dismiss sports as "bouncing a ball" out of this need to belittle anything that's not "intellectual" enough.

Your missing the point. Just because he can throw a javelin and do it to perfection due to his persistence does not mean that he can be a doctor. Both of the processes that lead to success do require persistence but there are many athletes who won't be able to make it through med-school.

But the argument was about if the athlete should be able to take time off to train for a sport and come back. The answer is no because his goals are no more important that the next guys goals. Even if he is going to the olympics. The pursuit of throwing the javelin at the olympics is a purely selfish pursuit. Someone else who didn't have that pursuit could have gotten that residency spot and would have deserved it more because he would have stuck it out and not expected everyone else to accommodate his needs after he has chosen and made a commitment to a program to stay and finish. Perhaps the athlete can finish his olympics career and then go to medical school etc. etc.

Then he can say on his resume: Olympian. That would show the ability to be persistent in difficult situations and under stress. That would not guarantee success but would help.

I'm also not attempting to belittle something that is not intellectual enough. I was a student athlete. Most sports are not that intellectual. Not on a pure level. You do have to have intellectual ability to learn and excel in individual and team sports but not like most other true intellectual careers. That does not mean I think they are all stupid. So I'm not trying to belittle anyone.

But you do have to admit bouncing a ball up and down a court doesn't really take much smarts. Skill yes, smarts?? come on.

 

[ThoracicGuy]

Why are we talking about sports? The question was supposed to be about normal situations. Most Physicians leaving residency aren't leaving to train for the olympics. What if they leave to go into business or join the military for ex. Would that affect their ability to return?

I would think that most training programs would not look on those reasons all that favorably. If you wanted to go into the military, there are plenty of health related options to allow you to do that AND continue your training. Going into business and leaving residency tells me that you are more interested in your business than any medical career. I wouldn't look all that favorably when your business fails and you come back to beg for a spot...

 

[atomi]

If you want to pick and choose which activities you feel are more dignified than others, fine. But we shouldn't be bull****ting people about it.

Agree 100%.

 

[Crayola227]

what hopes for the MD who has a lengthy medical leave to ever get another residency?

 

[typhoonegator]

what hopes for the MD who has a lengthy medical leave to ever get another residency?

That depends. Did they keep their Netflix subscription? Only a GLORY BOY would watch Netflix while on medical leave.

 

[NotAProgDirector]

what hopes for the MD who has a lengthy medical leave to ever get another residency?

It depends upon how competitive you were in the first place, what the medical leave was about, what field you're applying to, how you did in your prior residency program, etc.

 

[michaelrack]

It is going to be an inconvenience for a residency program to take someone who has been away from medicine. Who do you think they would rather have listed on their web page as a current resident (and in the future have as an alumnus of the program): Dr. Smith who made a strong showing at the Olympics, or Dr. Doe who made a strong showing at Morgan Stanley?

 

[as90]

I know this is hard for a lot of people to fathom, but its tough getting breaks in Residency to visit family and spend time with them. Is it looked upon unfavorably if someone takes a year or two off after intern year to pursue other things, like having a child, moving to a safer city, etc.

 

[Crayola227]

It is unfavorable to have any gap between grad and residency even if you need chemo for cancer or get hit by a bus.

Point is, don't do it unless you have to or you are extending your MD program and putting off record of grad year to include a relevant achievement like MPH or biostats or path year or research or other worthy achievement, people will do that to also make the time they spent having a baby or getting chemo appear like less of a time waster. If you have an opportunity just too much to pass up on, like trauma surgery post bus hit or the Olympics or reinstated NASA space program wants you to go on a mission to the moon, you could opt for those