Residency after practicing for a few years? Might be crazy, need advice.

[ckd816]

Hey all, long time no see!! I used to be a regular around these parts when I was applying to vet school, and what a wild ride it's been since then. I'll try to keep things short, but I've recently been entertaining the idea of pursuing a residency. I'm a 2016 grad and I've been working in general practice since then. I had never considered an internship or residency up until this point. I am just feeling restless/stuck right now in GP and I'm looking to change things up. Not sure I can handle doing this until I die.

Honestly, I have other motivations for wanting to do this as well which makes me think it's probably the wrong thing to do. The main reason this idea came to me because of my desire to live abroad again (did my vet degree in the UK, then returned home to the US). At just days shy of 31, I'm single but starting to think about entering the dating pool (don't laugh, I know I'm a little late to the game ). I find myself thinking of starting a family and I don't think this country is the place to do it. I'd love for any future spawn to not have to worry about gun violence or healthcare, and to have a college degree paid for by the government similarly to how things are done in Scotland so student debt doesn't weigh on them like it does on me. I know the salaries are crap if I go back to the UK, and it may be hard to find an employer who would sponsor me for the visa, hence the idea to do a residency program so I could get a visa. I also know it would be somewhat insane to think of starting a family while undertaking something of this magnitude, but I also know it's a little cart before the horse as I'm not even dating yet, haha.

Other bits to consider... I was a **** student. I did not do well with classroom learning but I do great learning on the job. The whole program was a major struggle for me. I do feel a thousand times more confident than I did as a student but still allow the impostor syndrome to occasionally sneak in like the best of us.

Lastly, my student loan debt is insane in the membrane and I have no idea how I'd live on a resident's salary. I'm barely getting by on my vet salary as is!! I also have no clue how whatever is going on with Brexit will impact anything.

Am I off my rocker? And even if I am but decide to think about it anyway, where do I start? I've been thinking about dermatology specifically. I could contact the local specialist to see if I could spend time with them to see if it's something I really want to do. Will my school GPA still hold a lot of weight in my application even this many years out? What else could I do to make an application competitive? I would feel like an idiot applying and being like, yep all I've done since school is GP and nothing specifically derm related as I feel like that would be an automatic no.

Anyway, give it to me straight. Thanks in advance.

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[JaynaAli]

To be completely honest, I would not pursue a residency unless you are fully committed to that discipline of vet med. Residency is hard, sometimes even soul-breaking work even if you 100% love your specialty. If other reasons are your primary driver behind pursuing the residency (i.e. the UK visa), it will be even harder to remain dedicated and do the work and self-driven studying required of a resident. If you're happy in GP, I personally think it would be better to just search for that (possibly unicorn) clinic that will sponsor your visa.

In regards to your other questions about your chances for residency, I think it's harder to predict since most of us who have done/are doing residencies did them in the US. I suspect things will be similar, so I will give you the advice I would give to someone seeking a US-based position. Yes, your GPA will still likely matter. Many programs use that as an initial discriminatory benchmark for the many many applicants they receive. It may matter less to some programs, it may matter more to others. I don't know about derm programs specifically. The fact that you do great learning on the job is excellent, but there is a lot of self-driven book work assocaited with a residency too. I mean I learned a ton on clinics, but I still had to find time to read 2,000 articles plus 8 text books and such and learn them on my own outside of work. That didactic learning is why some places still put emphasis on grades.

Derm is a fairly competitive specialty, I believe, I think mostly because there are very few spots. #1 thing I think you can do it get the most amazing letter of rec from a dermatologist (or whatever specialty). An excellent LOR is one of the most important things for someone who was a sub-optimal GPA, in my opinion. If you applied to my residency program (which was not derm) as a 'career changer' without a LOR from someone boarded in that field, you're almost certainly going to get ranked lower. Shadow in that specialty on your days off, develop those relationships, and hope for the best. I don't think it's impossible by any means to get a residency after being out for a while, but it will probably be more difficult than a student fresh off of clinics.

In regards to your loans, can you do income-based repayment plans when living abroad? That may help, though you'll still need to plan for forgiveness down the line. VIN can be a good tool to use to map out possible repayment strategies.

 

[ckd816]

To be completely honest, I would not pursue a residency unless you are fully committed to that discipline of vet med. Residency is hard, sometimes even soul-breaking work even if you 100% love your specialty. If other reasons are your primary driver behind pursuing the residency (i.e. the UK visa), it will be even harder to remain dedicated and do the work and self-driven studying required of a resident. If you're happy in GP, I personally think it would be better to just search for that (possibly unicorn) clinic that will sponsor your visa.

Thanks for your input and honesty! I think this is the part I knew I would hear. I'm not really happy in GP either unfortunately. Though I do have a relatively cushy job that I mostly like... flexible/few hours and I leave on time, competent staff that feels like family, decent benefits... the pay is just not even what I was making as a new grad so I find myself considering other options solely based on this and the fact that I don't think I can do GP until retirement. Just starting to put my feelers out. Anyway, your point here is likely why I won't end up doing it, but I wanted to get some idea of how feasible it would be.

 

[WhtsThFrequency]

Something else to consider (and I hate to rain on your parade, but it's an important consideration) is the possibility that you would have to do one or two internships before being a competitive candidate for a residency. Some specialties are ok with subbing years in practice (usually several years) in place of an internship as a prerequisite, some are ok with it but it is considered less competitive, and some don't like it at all. An onco resident who is a friend of mine had to do two internships (one rotating, one specialty), I know some others who have done three before they were accepted. Admittedly this is my experience with US programs and I don't know as much about those abroad.

 

[Minnerbelle]

I don’t think of derm as a residency that’s necessarily friendly to those who went out in practice first. Though the fields are small, specialties like nutrition, behavior, and dentistry tend to be more populated by people who went out in practice first. Likely because those are more niche fields that you encounter in gp practice that people realize they like or find a calling in after the fact.

But before you make this kind of jump, what part of gp do you not like, and what parts of practice do you like? I personally can’t imagine deciding to go into derm as someone who hates gp, as that’s such a big part of gp, and I’m not sure what about derm as a specialist would get you away from what you don’t like in gp. The same financial stress is still there for the most part (trust me, I worked in a practice that had dermatologists, and clients are still money conscious there). Itchy cats/dogs with skin/ear infections are still your bread and butter. And the annoying clients are just as annoying.

What actual part of practice do you like? And is there a way you could look for a job where you do mostly what you like, and less of what you don’t like?

 

[VIN-Foundation]

Hey,

I think the first and most important question is "Why do you want to do a dermatology residency?"

There is only one right answer. (Spoiler alert: Wanting to live in the UK is not it.)

Otherwise, it's absolutely feasible to do a residency after being in general practice a few years. I did.

Will my school GPA still hold a lot of weight in my application even this many years out?

Yes. It's not the only factor but is certainly one factor. A residency involves a lot of on-the-job clinical training but it also involves a lot of individual study. And there is a quiz to pass at the end.

What else could I do to make an application competitive?

Do a rotating internship. It will be difficult to get a derm residency in the US without one. I think spending time at the regional specialty practice would be an excellent first step.

Lastly, my student loan debt is insane in the membrane and I have no idea how I'd live on a resident's salary. I'm barely getting by on my vet salary as is!!

Are you eligible for income-based repayment plans?

 

[that redhead]

Hey @ckd816

I think the big points have already been addressed and I agree with what everyone has already said. However, I wanted to say that I’ve had similar feelings lately- namely, is GP something I see myself doing forever? Not really. And that’s with me actively liking my job situation.

I think the idea of vets being able to transition to any part of the field has always been touted as a big bonus but the reality, especially lately, is that that flexibility doesn’t really apply much anymore. Vet med is becoming a lot like human med, and in some ways I think it’s good for the profession, but it also means that some of us have found ourselves a bit stuck. I would try to suss out your different goals, both career and personal, before you dive into something like pursuing a residency. It sounds like your desire to live in the UK is making you unhappy with your current situation- does this mean you’d be happy doing GP work there? Or is it that you’re unhappy with GP work (and why is that?) and your fond memories of vet school in the UK are appealing to you and seem like a way to fix your satisfaction with life overall? Perhaps contacting your school could give you some leads into UK work? Perhaps there is some government work you could do that would allow you to work over there? Just throwing out some ideas.

 

[ckd816]

Thanks all for bringing me back down to earth. I admit I can get a little carried away about ideas I get in attempt to "get out" of GP/the US however unrealistic they may be! Also probably jumped the gun in even making this post because I already knew the answers I would get would confirm my own thoughts about this being the wrong thing to think about.

It sounds like your desire to live in the UK is making you unhappy with your current situation- does this mean you’d be happy doing GP work there? Or is it that you’re unhappy with GP work (and why is that?) and your fond memories of vet school in the UK are appealing to you and seem like a way to fix your satisfaction with life overall?

This. It's terribly accurate. Not sure I'd be happy doing GP work abroad either! I'm probably just that kind of person who is never going to be truly happy no matter what I do; I'm a restless soul. I guess I'm just tired of the whole profession, really, but feel completely stuck due to my debt burden.

It just doesn't feel like my passion anymore which makes me feel cold hearted. Even when I fix a problem an animal is having I don't really get a sense of fulfillment but rather a relief that there's one less thing for me to worry about. I hate emergency/critical cases/stressful surgeries that keep me up at night. Obviously could do without the emotional drain from clients. I realize many of my current annoyances would still be around in one way or another if I specialized or if I moved.

In school obviously graduation was endgame and now that I'm out it's like I'm missing that big goal to work towards and feel a little adrift in just showing up to work more or less doing the same thing everyday until forever. I thought that maybe if I chose an element of GP that appealed to me and truly worked to become an expert in that field that I would then have that feeling of achievement that I'm missing.

As an aside, I have always had going into industry at the back of my head as an "escape plan" even if just to change things up for a little while. For now I'll just stay put and keep that option in mind even though I'm sure it comes with its own drawbacks.

 

[twelvetigers]

Hiiiii frand!!

I found my way out of GP. There are other things you can do. I’d look hard at some different options, especially if you are willing to move. Perhaps if you go work for one of the big guys, they might even have work out of the country.