Can I Quit Tomorrow?

[Adam21]

To All,

I am miserable in my residency!!

Does anyone know what the legal consequences would be of my quitting tomorrow, with no notice, i.e., to the state board and data bank?

They know that I am depressed and seeing a psychiatrist; I don't know if this helps me or hurts me.

They also know that I was in a car accident last month and have been having trouble sleeping, but they pretty much blew that off.

They don't know I have diabetes and am TIRED, WIPED OUT.

I want to come back to some other program at some point, if possible.

Please help,
Adam

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[Tired]

I have no knowledge and nothing to contribute, but am just curious what your specialty is.

 

[southerndoc]

You are under contract for the remainder of the academic year or residency, depending on the contract your institution made you sign.

Bailing mid-year will likely cause you to not get into another residency. Not being in residency will also make you responsible for any payments on your student loans.

I'm sorry things are so bad for you. I hope they get better.

 

[southerndoc]

By the way, I noticed you have posted this topic in multiple forums.

Please refrain from doing that in the future. It's a TOS violation. I don't want to see you get banned over something you had no idea was not allowed.

 

[Adam21]

Southerndoc and All,

My specialty is psychiatry.

I also posted this in that forum, and I did not realize that this was a violation of the rules.

I profusely apologize.

To whomever is in charge, please keep this thread on the general issues forum if you can, delete from psychiatry. Sorry again.

Thanks,
Adam

 

[Solideliquid]

Adam21,

I'm also in psychiatry, albeit a first year. I'm deeply sorry to hear that you are in so much pain. I read your post when you asked for a poll and I thought you should stay until the academic year is at an end.

However if things are this unbearable I would highly suggest you stop reading these forums and seek the knowledge and skills of a good attorney who specializes in contracts, with an emphasis on medicine. I think he/she will be able to take it from there, but from my extremely limited experience it would be best for your attorney to contact the administration and you not say a word.

I happen to know a few attorneys in my area, through them you may be able to find what you need. If you are in the South feel free to PM me and I will try my best to help.

 

[organicmatter]

To the OP,

You're not alone in being having a tough time with residency. I recently had to take a week off for depression and being overwhelmed. I recommend, if you haven't already, talk to a chief resident/attending you trust. Ask for a little time off if you need it. You might be surprised at how supportive they are. I definitely would recommend against just quitting suddenly. Good luck to you. Feel free to email me privately if you need some input from somebody who has been there.

 

[Faebinder]

OP... hold out... not much longer to go... it's 6 more months.. life will get better... I wish you the best of luck and strength..

PS: Seek a councilor ...ask the program director for a person who can talk to you about your feelings and social problems... usually it's a combination of problems that kills like that.

 

[amyl]

try to stick it out... we all have had enough from time to time...hell i am a third year med student and want to quit sometimes. hang in there, you are not alone.

 

[EctopicFetus]

I think you could go to your PD tell him how you are feeling. They should be supportive.

 

[JMK2005]

I think you could go to your PD tell him how you are feeling. They should be supportive.

True... they may understand that psych is not for you and may help you when applying for another residency. Another program will likely want a letter from you current program as to why you left.

Transferring to another psyche program... hmm... that may be a sticky issue.

 

[Wednesday]

You should talk to your program director, that is his/her job. I imagine that in psych, of all fields, they will be likely to understand. It sounds like you just need some time off to get some rest and maybe some treatment. They know you and at some point liked you (they ranked you, right?) and will likely want to see you get better and come back to work. It is more likely that your residency program will be understanding than take a chance on another program that doesn't know you at all and the most recent piece of history they have about you is that you dropped out of another program without notice.

I think "stick it out" advice is very bad, especially given to a depressed person. I didn't get from your post that you want to transfer to another program (if so, beware, the grass is always greener), but if so the PD is the person to start with. Just make sure you talk to him/her before you just quit. Good luck. You are definitely not alone in feeling this way.

 

[elizabeth5863]

Hi Adam21,

What about residency is making you miserable specifically? You mentioned that you're seeing a psychiatrist, right? How long have you been seeing one and are you on any medications? If so, has it been at least 1 month or more and is the psychiatry counseling sessions helping? If it's not, I think that your psychiatrist should know in order to help you. If it hasn't been even 1 month yet, I would give it time. (By the way, you don't have to answer my questions. It's just something for you to think about. And of course, you know much more about this than I do since you're in psychiatry yourself ).

I wouldn't try to quit right at this point... Depression sucks, I know... but try to find out the root cause(s) of your depression. Is it because you don't like your field anymore? Or the people you work with? Or academic difficulties? Or being too far from family/support group? Or are the patients too emotionally taxing? (They were draining for me when I did my psychiatry rotation during my M3 year).

I think it is very hard to switch to another psychiatry residency program, but easier if you change residency fields if you decided to switch. As I recall correctly, "First Aid for the Match" said that psychiatry residency programs seek to rule out any psychiatric problems in the residents they admit. Although depression is very common and many people go through it, I think that because they know you are depressed, it might make them reluctant to write you a letter of recommendation to another psychiatry residency program (unless if the cause of your depression is something that is easy to fix, i.e. being far away from family and support group, in which case I think they would be happy to help you get into a program closer to your family/support group, etc.). If it's to switch to a different field, then I don't think it would be a program.

Anyway, just something to think about.

P.S. There is a website I've found and frequently visit. It might help you some. www.postsecrets.com

Cheer up! There must be something that can make you smile. Maybe get a pet! They're very therapeutic.

 

[fuzzyerin]

Last year, in my program, there were 4 interns. This year, there are 3 second years, because one of my colleagues quit. I have no ill-will against this colleague, as she had been telling us since early in the year that she wanted to quit, to which our reply was "no, you can make it! it sucks for everyone! you can do it! it'll work out in the end, stick it out/suck it up!" That was, until the day in June she looked me in the eye and said "I hate everything we do." She left July 4. Part of me feels responsible for spending all that time telling her to stay when she full well identified to us that she wanted to go.

If you want to go, go. You can get out of your contract. As far as getting to go somewhere else, that I don't know about. My former intern colleague isn't in medicine anymore.

 

[elizabeth5863]

If you want to go, go. You can get out of your contract. As far as getting to go somewhere else, that I don't know about. My former intern colleague isn't in medicine anymore.

Is she not in the medical profession anymore? Or just not in the internal medicine field anymore? (just curious).

 

[Tigger14]

I agree with the other replies that there is help. I would add, have you tried changing your medication? Certainly, some antidepressants work for some people and not for others. Also, be sure you talk to your doctor as well. As it was already pointed out, a little time off may be what you need.

There have been times I would have quit if it were not for the student loans I would have to deal with. It does not make it easier for you, but you are not alone.

 

[fuzzyerin]

Is she not in the medical profession anymore? Or just not in the internal medicine field anymore? (just curious).

Not in the medical profession.

 

[Tired]

If you're in a Psych residency, do you get free psychiatric care?

 

[NotAProgDirector]

I'll add a PD perspective.

First of all, you can legally quit any day you want. Your contract can't force you to work. If you received any "upfront" benefits -- i.e. a signing bonus, or a computer, or anything like that, they can make you return it (Yes, I know, no one gets a signing bonus in internship...just trying to be complete). Your contract might have a "both parties must give 60 days notice" clause, but that is more for your employer than for you, as there is nothing your employer can do other than fire you, which would be equivalent to quitting.

That being said, I agree with the above posters that there may be other options than quitting. Some programs include disability leave, which might be used in a situation like this. A leave of absence for 4-8 weeks might help bring some perspective to the situation. Do you dislike psych, just your program, medicine in general, etc?

Talking to someone is key. I highly recommend talking to your PD. Another option is meeting with someone in the GME office.

 

[Doctor Bagel]

Really stupid question -- do residents have FMLA protection? Normally, you just need to work for a place with more than 50 employees for more than a year to be covered. Is there some special exemption for residents? Also, if you have disability coverage through your residency, I'm sure there's some way for you to take official leave and use it without big repercussions. I worked in disability insurance before I went back to school and did see claims from residents. I'm not sure how the residency political world works, but would it be a horrible faux pas to talk to HR about your options for taking leave? Theoretically, HR is supposed to be confidential about this type of stuff.

 

[whopper]

Posted this in the other thread that was locked

I hate saying it but several programs I've seen have several violations with things such as duty hours, following guidelines so residents can drive home safe etc.

Though its slowly dying out, the old culture where residents can be treated like slaves still persists in several programs.

From what you're telling me, if your case is legit, they ought to let you have time off.

Does anyone know what the legal consequences would be of my quitting tomorrow, with no notice, i.e., to the state board and data bank?

I don't know. However abandoning a position where you are a health care provider at worst can be considered quite negligent. In the absolute worst sense, it can be percieved as not taking responsibility when you signed a contract that stated you would provide health care services to those in need.

However if your case is legit, you are in a position where you can't perform your duties.

I hate saying it but maybe you ought to call a lawyer. I would do that before deciding to drop out.

 

[Gem134]

I wonder about just quiting, not going in one day. And I am a third year. Sometimes I just physically do not want to walk in the door of the hospital/clinic.

I agree with some posters who said that if it were not for the $$ already outstanding, I would try and find a way out. I have wondered if others felt the same way. I thought that in residency that at least some money was coming in and somehow that would make things feel better.

I think medicine is a rough field, especially in the begining. I think it is easy to get depressed.

 

[elizabeth5863]

I wonder about just quiting, not going in one day. And I am a third year. Sometimes I just physically do not want to walk in the door of the hospital/clinic.

I agree with some posters who said that if it were not for the $$ already outstanding, I would try and find a way out. I have wondered if others felt the same way. I thought that in residency that at least some money was coming in and somehow that would make things feel better.

I think medicine is a rough field, especially in the begining. I think it is easy to get depressed.

Are you a third year in medical school or in residency?

 

[McDoctor]

I wonder about just quiting, not going in one day. And I am a third year. Sometimes I just physically do not want to walk in the door of the hospital/clinic.

I agree with some posters who said that if it were not for the $$ already outstanding, I would try and find a way out. I have wondered if others felt the same way. I thought that in residency that at least some money was coming in and somehow that would make things feel better.

I think medicine is a rough field, especially in the begining. I think it is easy to get depressed.

Third year and internship year are probably two of the worst years in medical training. I think this is because suddenly the bar gets set so much higher and you are in a position where patients and attendings will expect a great deal more knowledge and competency in the hospital setting. But in reality, your level of experience at these stages in training doesn't always prepare you for what is asked of you. Alot of people feel the way you do in third year. It will get better.

It sounds like the OP has more medical problems than the typical stressed out intern. I guess I should be surprised that a psychiatry program is not more sympathetic to one of its interns suffering from what sound like symptoms of depression or PTSD, but in reality I am not. You are entitled to medical leave under the Family Medical Leave Act, if your illness severity warrants it. I would look into that. You need to take care of your own health before you can take care of others.

 

[Winged Scapula]

Really stupid question -- do residents have FMLA protection?

They do, having used it myself, however, I couldn't say whether or not you had to work for a year before using it. I would venture that anyplace someone is training has at least 50 employees so that shouldn't be a problem.

 

[8744]

I wonder about just quiting, not going in one day. And I am a third year. Sometimes I just physically do not want to walk in the door of the hospital/clinic.

I agree with some posters who said that if it were not for the $$ already outstanding, I would try and find a way out. I have wondered if others felt the same way. I thought that in residency that at least some money was coming in and somehow that would make things feel better.

I think medicine is a rough field, especially in the begining. I think it is easy to get depressed.

Man. I definitely felt like that last year. I would wake up at 0500 feeling lousy, get dressed, get in my car and make the short drive to a medical center I will just call "Earl" to avoid the usual vitriol and ponder, during the drive, how much I hated both the specialty I was in and the medical center. Not to mention loathing the prospect of spending the next fourteen hours working towards a goal that I wasn't even that crazy about. I loved nothing better than being allowed to leave to go home. (I mean, I still like quitting time but this year I usually leave tired but mostly satisfied with the way the day has gone).

It was only my finely-tuned working-man reflexes that forced me to even get up (no job, no money, kids starve, wife leave me). That and the hope I had of successfully matching into a different specialty at a different hospital.

I still have days like that, of course, where I dread walking into the hospital but not very often.

And no, the money doesn't do a thing for me. I never see my paycheck and we feel just as poor now as we were in medical school. It's not like they pay us enough where we can do anything but just scrape by. (Which we are not doing, actually, sinking as we are into more and more debt every year. 2009 is going to be a race between our debt which will finally claw its way out of the box in which we have stuffed it and my first real paycheck. We can keep the wolves at bay for another year or so but I don't see how we're going to make it during the last year of residency. I hope to moonlight like a big dog.)

 

[Doctor Bagel]

They do, having used it myself, however, I couldn't say whether or not you had to work for a year before using it. I would venture that anyplace someone is training has at least 50 employees so that shouldn't be a problem.

Good, I was getting worried there. To the op, I think you should definitely looking into going on leave then before quitting. It sounds like you shouldn't have any trouble getting approved. Of course, I don't know what the political repercussions would be -- either way, though, it has be better than just quitting.

 

[gutonc]

They do, having used it myself, however, I couldn't say whether or not you had to work for a year before using it. I would venture that anyplace someone is training has at least 50 employees so that shouldn't be a problem.

The federal FMLA law has a one year work requirement before you can take covered leave. Local or institutional law may vary. Oregon has a state law that kicks in at 180 days which is doing to come in handy at the beginning of May.

 

[Doctor Bagel]

The federal FMLA law has a one year work requirement before you can take covered leave. Local or institutional law may vary. Oregon has a state law that kicks in at 180 days which is doing to come in handy at the beginning of May.

Yep, FMLA is sort of the bare minimum. Lots of states have extra provisions, especially for maternity leave.

 

[Winged Scapula]

The federal FMLA law has a one year work requirement before you can take covered leave. Local or institutional law may vary. Oregon has a state law that kicks in at 180 days which is doing to come in handy at the beginning of May.

thanks for the clarification. I took it during my 4th year so that wasn't a problem - perhaps the OP is in a state like Oregon with some more liberal provisions for FMLA.

 

[Gem134]

I am a third year medical student.

I know a resident who switched from psych to IM, and is much happier. I am not sure how they did it, but I sort of like the family leave act idea. Medicine is so "lockstep," it's hard to figure out how to step out of line and do something different. But sometimes we have to, I think.

I also heard of a female resident who got pregnant because she wanted to leave her program and return at a later date, but to a different program. It would be great if we had more or other, options.

 

[whopper]

As much as I love being a doctor and my own program, residency programs in general treat residents like scum.

Its not right.

I'm glad my program treats the residents well.

 

[Gabujabu]

I am a third year medical student.

I know a resident who switched from psych to IM, and is much happier. I am not sure how they did it, but I sort of like the family leave act idea. Medicine is so "lockstep," it's hard to figure out how to step out of line and do something different. But sometimes we have to, I think.

I also heard of a female resident who got pregnant because she wanted to leave her program and return at a later date, but to a different program. It would be great if we had more or other, options.

That's interesting! My mother switched from IM to psych and became much happier. I guess it really depends on the individual programs.

 

[step1]

Deciding to quit immediately depends on several factors.

First, I know a couple people who left their job or residency as an impulsive decision during a shift, and I don't think they will ever forget that for the rest of their lives! and I don't recommend it at all. If you're desperate, please give yourself at least a week or few days to discuss this.

Next, consider the condition of the department and hospital. You may have the option to go on "Disability" and take time off to recouperate or take a lighter load. Talk about disability with a knowledgeable psychiatrist.
Be cautious though as some institutions may not have the sophistication yet to properly manage Disability.

Next, what is going on that makes you depressed?? Don't think this is "entirely you". Unless perhaps there is long term major depression, I would not attribute your feelings as being entirely endogenous.

-Is there a major problem in your department? Serious work law violations? Poor treatment or harassment?

-How are the interactions with other residents? Are they aware of your issues and bringing you down in some way?
Once a resident is considered "problem", it is very difficult to re-establish yourself while in active illness. It may take 'some time away' to come back strong.

-Is this the right field for you?? Do you feel out of place? Check out the other departments in the hospital and see if there somewhere you feel the fit or see the passion.
I would stay away from consistent 75+ hr/wk residencies if there is a chronic illness like diabetes, and there is nothing wrong with that.

If you do take time off by quiting, taking sick days, or going on disability:
think about what you do with that time off. I do not recommend 'vegging out to recovery'- doubt that works. Keep your body and soul active to where you can handle.
-Visiting old friends or family if they are available

-There are spiritual courses, wellness centers, life-seminars (I know someone who traveled to do a "Landmark Education" course- but ask people if they have ever participated in wellness activities or seminars). Don't just read a book, search the internet, or sit in the psych's office alone!
Be active and go to it, you will interact with others who are looking to improve their own lives as well.

-Participate in activities to re-boost your self-esteem like taking a college course or recreation at which you're good at.

Lastly, if you do leave, leave on GOOD terms. Don't tell them to F-Off. Let them know you appreciate the training they have provided up to this point.

 

[ocean4]

Hi Adam, if you perhaps start a thread with people that are unhappy with their residency maybe you could talk to people as a support system.
Again I am no expert at anything, but I would hate to see you walk out of the hospital one day even if I do not know who you are.
Perhaps more knowledgeable people can comment on this.

 

[Coordinator]

Your primary concern is that you do not cause harm to your patients. If your situation means that you are putting your patients in jeopardy, then you should immediately stop treating them.

To be honest, from the program's point of view...you are a high-maintanence resident and although we care about you and we want you to pull it together and succeed, you are kind of annoying us. If you can't pull things together (at least until the end of the academic year), then move on but try to give as much notice as possible. Since you are in a training program and not employed, you are likely not held liable if your drop out of the program.

Please be advised this can create not only a hardship for your program, depending on the size, but also for the residents forced to cover the rest of your schedule.

It is likely that you will face great difficulty down the road when you have to explain the situtation to another program you are applying to, licensing boards and every job you apply for in the future. It will be a permanent part of your record. If possible, hang in there. Look for alternatives such as a leave of absence.

Best of Luck.