Stay or Leave?

[SD2525]

Hey everyone,

So usually I don’t do this but I’m in dire need of help and thought I would turn to you all for advice. This is a little long so bear with me.

I’m currently in my first year of family medicine residency (about 5 months in) and I don’t like it. It’s not even my program or the people I work with. It’s the fact that I feel that I have been living a lie my entire life. I have always listened to my parents and they always pushed me and forced me into medicine. Since I was a child I have always been good at science, but better at taking tests and doing well in school then actually critically thinking. Even before I was about to go into medical school I remember sitting down with my parents and telling them that I had this gut feeling that I didn’t want to go to med school but I didn’t know what I wanted to do. They pretty much said well if you don’t know what you want to do then you better go to med school. So pretty much like the rest of my life I just brainlessly listened to them and began med school. From the first year I was already having thoughts of not wanting to be in medicine anymore. However, I continued.

I never found medicine interesting nor did I have the curiosity to ask the question “why?” I did not find it fascinating. I kept having this internal struggle of continuing being in medicine vs. feeling like my life just doesn’t feel like my own. I felt like a prisoner in my own life. Like I’m trapped.

Everyday it just keeps growing…that feeling that something just doesn’t feel right with me. The problem is that I really don’t understand or get medicine, I don’t have any desire or drive to study it, and I already have this gut feeling that it just isn’t for me. All I know is that I hate this feeling and it keeps growing deeper and deeper.

My parents and sister tell me that I should just finish off residency and then I can do whatever I want and have medicine as a “back up”. Lol are you serious? A back up? All these years just to accomplish residency just so I never even practice? What’s the point?

So my question to you is what do I do? Do I continue throughout residency and run the risk of not being competent as a second/third year to manage patients just to say I finished residency, should I quit now (like right now), or should I finish off my first year (internship) and then quit? I wish I had the courage to change things sooner, but this is the situation as it is and I'm so confused. I need your help and guidance. Any words of wisdom are well welcomed here. Thank you for having the patience to hear me out.

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[Natividad Resident]

First, you're in your first real job, correct? My first suggestion is to recognize that there's common suckage in any job. Any job. There will always be people you don't like, administrative overhead, stupid processes, bullcrap scutwork, disappointments, etc. All but a few lucky people between the ages of 25-30 are questioning their career choice right about now, because they're meeting the working world for the first time. On average, normal mentally healthy people continue to question their career choice forever, to some extent. This is not to say that you should suck it up. Just understand that bailing out of medicine may not be a solution to your career misery. It's really, really hard to find out what career is going to fulfill your needs and wants.

In other words, if you're going to run away from a career you don't like, make sure you're not just running toward a hope-about-to-be-crushed that another career is going to "make you happy." You can roll the dice (again), or you can go about making a change with all the thoughtfulness and humility and diligence and patience you can muster...so you get better results.

Second, you're about 7 months from being licensed. Finishing intern year means you can work in a doc-in-a-box, making a living wage, while you figure out what to do next. "Living wage" probably means about twice what you're making as an intern, for part time work, depending on where you live. Presumably your parents aren't going to happily fund your retreat. Take advantage of the near opportunity to get good paying flexible work.

Third, you need the people you're working with to get to somewhere else. Don't burn bridges. Identify a mature fellow resident or faculty member you can trust, or two, and get their input on your situation. Be open to suggestions. See if my blathering above is a consensus opinion. Plan on putting a few months into considering a change. Generally your program needs at least 2-3 months to replace you, which they can pretty much only do at the beginning of a program year. You're directly screwing your program if you just up and leave, which means you leave with nothing. If you leave on good terms instead, you'll have good work references for your next job, and you'll keep the seeds of your future professional network. Whichever way you go.

Hope that helps. Don't beat yourself up over this.

 

[kcmd]

Hey, first off congrats on making it through pre med, med school and into residency when medicine is not even a passion of yours! Medicine on a whole a super tough program that many of us physicians fail to remember, and your huge accomplishment should be recognized.

As an MD who quit medicine early on (for similar reasons to yourself), moved into health insurance and has now started my own business, I totally agree with @Natividad Resident.

Sometimes it can just be the shock working your first job, the lack of sleep, huge learning curve etc. that has us frazzled and nerves on edge. If this is the case, I would definitely recommend sticking it out at least until you finish the first year, and then you can reassess, see if you need time off etc. You may need to start incorporating stress management tactics to your day - meditation, time away from phones/screens/TV, getting back to nature through walking, hiking, running etc., writing, taking some "me time". In any idea, it is usually good to at least finish the 1st year, but NOT to the detriment of your health or wellbeing.

However, this sounds like something that has been simmering in the background as you went through med school and now into residence. As we know, MD's are quite protective about their career and usually try to dissuade any other physician from ever leaving - either you get the "you aren't good enough to 'hack' it in medicine" or you go down with the ship (i.e. you shut up and do medicine until you retire or die...). So you may find many MD's pushing to keep you in medicine when you know, deep down, this is not for you.

And contrary to what many believe, this can open up many doors for you. There are hundreds of non-clinical opportunities out there, as well as the opportunity to pursue something you are *actually* passionate about outside of healthcare.

We all know of the doctors who are freakin' miserable with their whole life - they are grumpy, unreasonable, the patients don't like them, and they stomp around thinking they have the most workload, worst shifts and busiest days. Other MD's hate to work with them. Unfortunately, many of these docs don't realize that they are not living in alignment with their true passion, and they also have not given themselves the permission to seek this. So instead, they have been miserable, are miserable, and will stay even more miserable until the end of time. On the flip side, we've all seen those docs that seem to radiate energy, positivity and compassion - the docs that seem to have their life under control, their knowledge-base is unreal and clinical skills on point. These docs have found their passion and are killing it in their field!

So sometimes it takes a while to find what you are passionate about, but step 1 is digging deep and finding out if medicine is right for you. What would your life look like if you didn't practice medicine? Would it be better or worse? What would a *perfect* day look like to you?

Depending on these answers, you would then have a better idea of which direction you should pursue - continue as you are, take time off to do clinical electives in other fields or start exploring non-clinical careers/careers outside of healthcare.

Either route you take, just know that taking the time and patience to give yourself headspace to figure out your life may be one of the best investments you make. Just don't be the miserable doc

 

[deleted480308]

Passion for a job is overrated. You are still in the crappy training portion and no idea what your end job will be like.

Ride this out unless you come up with a seriously viable plan and see what you think after residency when you have less hours and 4x the money

 

[Promethean]

At the very minimum, see it through the first year. You cannot get a license without completing the first year. An MD/DO degree without a license qualifies you to deliver pizza. Indeed, it can be hard to get regular office jobs or even low level science jobs because no one can understand why someone with that terminal degree wants to work for low wages, and so you may find it hard to get jobs that do background/credentials checks. My girlfriend, who left medicine for various reasons, finally had to start leaving the MD off her resume and applications entirely and just talk up her undergrad degree, in order to get considered for positions for which she was exceedingly overqualified.

Having a license, which means finishing first year, gives you a lot more options.

It is difficult to the point of being nearly impossible to come back from quitting a residency midway through the first year. The likelihood that you will find someone to take a risk on you is low, and gets lower the longer you are away. So, if you run now, you are burning bridges that you spent years building. If you can see it out another 6 months, you can at least step away for a year or so and still have some hope of going back and finishing residency, if that is what you decide to do. And you will be able to get a license at that point, as well.

It is normal to feel like this. There are dozens of these threads here on SDN, with people having the "what have I done?" moment, usually during the first half of their intern year. In a great many of those threads, they come back to say that they toughed it out and were happy that they had.

Finally, if it is that terrible, it may just be that it isn't being done right. Family Med has the most scope, the most possibility for you to define how you want to practice, of any specialty. I can't imagine not loving it. I can imagine not loving some ways that it is done, but those aren't the ways that I will practice when I am done with training. Check out www.idealmedicalcare.org to hear from one of my favorite family med evangelists. I keep copies of her Pet Goats and Pap Smears books to hand out to primary care docs that I know and love: http://www.petgoatsandpapsmears.com/

If you do come to the conclusion that you absolutely need out of medicine, and will never ever ever want anything to do with it ever again... hey, good on you. But know what you are running to, not just what you are running from. If you don't have a burning passion that is dragging you away from medicine, then you are just repeating the same mistake that got you into this situation in the first place. That is a very destructive pattern. Maybe talk to a therapist before making any big decisions, just to get a dispassionate third party perspective.

 

[cabinbuilder]

The other thing you have to worry about is how big are your student loans? If you have a 6 figue debt, the only way you will make the payments is by finishing and at least doing urgent care a few shifts a month.