Should I tell my PD I want to leave medicine?

[mcmcmcmcm]

(For the short version of this post, skip to the last paragraph)

I'm a new second-year in a three-year program, but completed a prelim year before starting.

I don't want to bury the lede here, so I'll preface all this by saying that I'm one of the weaker residents in my class based on some feedback I received recently. I haven't been told that I am incompetent, dangerous, or at risk of being fired, but I am at least below average. I'm taking steps to improve my deficiencies, but I have to be honest about my current situation. I'm aware this knowledge has probably influenced my thinking.

That being said, I've mostly made up my mind that I'm not going to practice medicine. I just don't enjoy it, which makes putting up with all the negatives of the job that much more difficult. I realize I have wasted the taxpayers' money and indirectly prevented a more deserving person from obtaining residency training. I feel pretty bad about that.

I don't yet know what I'm going to do instead, which is terrifying. I hope to figure this out soon.

I want to stick it out until the end of residency. Leaving a year early would screw over my co-residents and PD with scheduling (all very nice people who I actually really like). It would probably also negatively affect how I'm perceived in the job market. Some days I think, "oh hey, what's another two years?" But most days I think, "oh god, another two years." If I were to leave early I would definitely let my program know at least a few months ahead of time so they are not caught completely off guard from a scheduling standpoint.

I've had these feelings probably since the start of intern year. I thought it was a slump, but I have come to the realization that it probably isn't.

Should I tell my PD I'm thinking of leaving medicine? It was a bit hard pretending everything was ok during our year-end meeting. She's also a reasonable person who may have good advice for me. However, I also have to think revealing this would make the faculty think even worse of me and make the rest of residency more of a pain. Do any of you have any experience with seeing how residencies treat people who are about to quit or won't practice after graduating?

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[RustedFox]

What are you going to do to pay off your student loans ?

If you have student loans. If you don't; nevermind.

 

[Angry Birds]

Whatever you do, do NOT tell your PD this and do not even let her or anyone else even get a whiff of this. If you do, it's one step closer to the chopping block. I repeat: do NOT say anything. I cannot stress this enough.

Finish your residency. If you're undeserving, the program won't advance you. At least that's how it's supposed to work.

Worst case scenario go into urgent care once you're done with residency. That's a good back up in case things don't work out on your "outside of medicine" endeavor.

If you have student loans the worst thing to do would be to quit residency.

Lastly, please keep open the possibility that your mind will change by the time you finish residency. You may also have a sudden growth spurt and catch up with everyone else. Just try your hardest and try not thinking so negatively. It will hamper your chance of failure.

Moreover, you are one step ahead of the game: most below average residents don't realize their deficiencies. You do. That's great. Work on them. See what happens.

And reassure yourself in times of stress or negativity: "I have the option of urgent care to fall back on." or a really low acuity low volume ER. They exist.

Anyways this thought will make you feel better.

And keep in mind that second year is the slump year where feelings like this are common.

The most you can say to your PD is : " I think I'm gonna pick a really low acuity ER after graduating or even an urgent care." But don't even give a whiff of quitting residency. She may oblige you and pull a resident from somewhere else. Keep in mind she doesn't want to ruin your life but if you say that you're thinking of quitting she may oblige you. Make it obvious that you want more than anything to finish the program and that you will work on your deficiencies.

 

[Angry Birds]

My post was of course advice from your perspective and what's best for you. Not neccesarrily for the system or the residency. I have no idea what type of resident you are so I'm just giving you advice for what's best for you.

 

[PlutoBoy]

(For the short version of this post, skip to the last paragraph)

I'm a new second-year in a three-year program, but completed a prelim year before starting.

I don't want to bury the lede here, so I'll preface all this by saying that I'm one of the weaker residents in my class based on some feedback I received recently. I haven't been told that I am incompetent, dangerous, or at risk of being fired, but I am at least below average. I'm taking steps to improve my deficiencies, but I have to be honest about my current situation. I'm aware this knowledge has probably influenced my thinking.

That being said, I've mostly made up my mind that I'm not going to practice medicine. I just don't enjoy it, which makes putting up with all the negatives of the job that much more difficult. I realize I have wasted the taxpayers' money and indirectly prevented a more deserving person from obtaining residency training. I feel pretty bad about that.

I don't yet know what I'm going to do instead, which is terrifying. I hope to figure this out soon.

I want to stick it out until the end of residency. Leaving a year early would screw over my co-residents and PD with scheduling (all very nice people who I actually really like). It would probably also negatively affect how I'm perceived in the job market. Some days I think, "oh hey, what's another two years?" But most days I think, "oh god, another two years." If I were to leave early I would definitely let my program know at least a few months ahead of time so they are not caught completely off guard from a scheduling standpoint.

I've had these feelings probably since the start of intern year. I thought it was a slump, but I have come to the realization that it probably isn't.

Should I tell my PD I'm thinking of leaving medicine? It was a bit hard pretending everything was ok during our year-end meeting. She's also a reasonable person who may have good advice for me. However, I also have to think revealing this would make the faculty think even worse of me and make the rest of residency more of a pain. Do any of you have any experience with seeing how residencies treat people who are about to quit or won't practice after graduating?

Don't disclose. You just finished intern year. In my experience, at least 50% of us felt like you at some point during our training and sometimes even after training.

Residency is tough. It is depressing. But don't let it get to you. If you have made it this far you are obviously smart enough to tackle residency.

Residency is hard and sometimes it may feel lonely (since no one is talking about these issues in the lounge) but I can assure you that you are not the only one going through this.

I have seen residents that thought they were struggling become great attendings and subspecialists.

There is help out there. Don't be afraid to talk to your sensible seniors. Take a month long vacation if you need to. You got this!

 

[RustedFox]

I'll echo some sentiments listed above: Intern year is tough. I was five-star depressed during my intern year. They threatened to not advance me. I was 7/8 of the SIG-E-CAPS symptoms.

I made it, and my PD was turbo-happy and proud. We're still tight.

 

[Gastrapathy]

You don't have to be the best resident but you should try to finish. You are in the perfect specialty for someone who doesn't like medicine. You can work 4-5 shifts a month and make ends meet while you figure out the rest of your life. You can travel, do locums, whatever. You won't be a slave to overhead. You are 3/4 of the way there and not failing. Finish. Be an EMS director, work in admin and do the occasional shift, or give it all up but do a couple shifts a month and stay employable.

Tell no one

 

[b-real]

Count me in the don't disclose camp. You have 2 years to go; anyone can do anything for 2 years. Trust that your program is doing its job in educating you to be a competent physician. If at the end of residency, you don't like it, leave and find something else. Give yourself that option, though. Graduate and you have options, quit now and you don't. I'll also add that somewhere between 2nd and 3rd year, from what I have seen, the residents who were behind the pack catch up to the rest of the class. Again, have faith in your abilities as well as those of your faculty.

 

[alpinism]

Agree with everyone above.

It would be absolutely crazy to quit with only 2 years left. After all the time you spent getting to this point 2 years is nothing. Even if you do truly hate medicine you can always work part time a few shifts per month or a few months per year. After you pay off loans and save up some money then find a new career.

 

[emergentmd]

You have invested 4 yrs college, 4 yrs med school, 1 yr residency. 9 yrs you can never take back. Leave residency and all of your 9 yrs are essentially worthless.

If you got alot of loans, you are screwed. If you have none, you likely will still have to go back to school to get a decent degree.

Or you can suck it up and finish residency. So what if you are below avg. HALF the class is below AVG and Half above. In most programs, the worst performing resident graduates and really no one will know or even care.

Get Boarded in EM, and the world is your oyster. Work 1 day at a FSED a month and Pull in 4k a month. Work in UC 20 hrs a wk, and make 8k/mo. Do Locums and work 10 hrs/wk and make a min of 12k/mo

Seems like a no brainer to me.

 

[gman33]

Do you have loans?
Do you have a viable alternative plan?

Disclosing that info would help me to better advise you.

In general I'd agree with much of the above.
Don't tell your PD.
If they think you are contemplating leaving they will start looking for your replacement.

Residency is hard.
Working in medicine is hard.

Guess what, working at anything in a high level job is hard. People who have never worked in another career sometimes don't get that part.

 

[canigetawhatwhat]

You arent supposed to like your job. If you do thats a bonus. Its called work for a reason.

Residency is hard. It gets better. What would you do outside of medicine? Would you really enjoy it that much more?

Unless you are going to kill someone after a three year residency, you should really stick with it and see what happens.

 

[canigetawhatwhat]

You arent supposed to like your job. If you do thats a bonus. Its called work for a reason.

Residency is hard. It gets better. What would you do outside of medicine? Would you really enjoy it that much more?

Unless you are going to kill someone after a three year residency, you should really stick with it and see what happens.

Double post.

Dont tell your pd

You ever see the movie Two Weeks Notice? You are Sandra Bullock, my friend.

 

[Brigade4Radiant]

Have you ever had a job before? Have you ever been unemployed? Not liking residency is not a good reason to quit if you don't have something concrete lined up. Yeah it would be nice to quit but how would you pay for your food or rent? Also lets assume you have no debt what job would you do and can you guarantee that you would like that job? What if your new boss is a total jerk that makes you work weekends to accommodate deadlines?

 

[Jelgava]

I disagree with many of the above. If you stay, it should be for the right reasons. I have plenty of colleagues who have left medicine, and wished that they had left earlier. There are plenty of other careers out there. Being in medicine as a default choice doesn't sound like a good idea...

 

[mcmcmcmcm]

Thank you for the advice, everybody. It seems the consensus is that I should keep quiet. I'll carry on with my plan of sticking it out until graduation and getting board-certified.

To answer some of the other questions brought up:
- I'm under no illusions that other jobs are easy or a one-way ticket to happiness. I'm merely trying to get rid of some of the negatives that come with being in medicine. I know I'll just be trading those negatives for other negatives.
- My loans total around 180-200k.
- I don't have any concrete plans yet. I am in the process of looking into a few fields that I could have a non-zero chance of breaking into.
- Quitting before having a job lined up is not an option I was considering.

 

[b-real]

I disagree with many of the above. If you stay, it should be for the right reasons. I have plenty of colleagues who have left medicine, and wished that they had left earlier. There are plenty of other careers out there. Being in medicine as a default choice doesn't sound like a good idea...

Your colleagues graduated residency and were attendings when they left, correct? You are advising a resident who doesn't have a backup to limit his options, which is why others have said to at least get through residency to be board eligible/certified. That keeps doors open. The OP may even come to like/enjoy medicine when he's further along.

 

[deleted547339]

Dude. Residency sucks something terrible. Make it through.

Also, you have to pay off loans.

A much better time to consider this is 1-2 years into being an attending - at that point, you can pay off your loans. If you walk away from medicine debt free, you've lost a lot of time, but you're debt free. You will also likely have a lot more time to be healthy/exercise and be in a better place.

 

[gman33]

I'm all for people pursuing different pathways.
You get one chance at life.
No point wasting it doing something that you don't want to do.

There are plenty of things that sucks about medicine. There are plenty of things that suck about all jobs.

For some more generic advice.

Finish residency.
Work for 2-3 years living just above residency lifestyle.
Pay off all your loans and save a chunk of money.
If you want to do something else at that point, do it and don't look back.

 

[The White Coat Investor]

Not only should you keep quiet and not only should you finish your residency, but you should actually practice for at least a couple of years afterward in at least some capacity. A doc with residency training and with some clinical experience has lots of doors open to them. A mere MD has almost none.

 

[Lostin_space]

(For the short version of this post, skip to the last paragraph)

I'm a new second-year in a three-year program, but completed a prelim year before starting.

I don't want to bury the lede here, so I'll preface all this by saying that I'm one of the weaker residents in my class based on some feedback I received recently. I haven't been told that I am incompetent, dangerous, or at risk of being fired, but I am at least below average. I'm taking steps to improve my deficiencies, but I have to be honest about my current situation. I'm aware this knowledge has probably influenced my thinking.

That being said, I've mostly made up my mind that I'm not going to practice medicine. I just don't enjoy it, which makes putting up with all the negatives of the job that much more difficult. I realize I have wasted the taxpayers' money and indirectly prevented a more deserving person from obtaining residency training. I feel pretty bad about that.

I don't yet know what I'm going to do instead, which is terrifying. I hope to figure this out soon.

I want to stick it out until the end of residency. Leaving a year early would screw over my co-residents and PD with scheduling (all very nice people who I actually really like). It would probably also negatively affect how I'm perceived in the job market. Some days I think, "oh hey, what's another two years?" But most days I think, "oh god, another two years." If I were to leave early I would definitely let my program know at least a few months ahead of time so they are not caught completely off guard from a scheduling standpoint.

I've had these feelings probably since the start of intern year. I thought it was a slump, but I have come to the realization that it probably isn't.

Should I tell my PD I'm thinking of leaving medicine? It was a bit hard pretending everything was ok during our year-end meeting. She's also a reasonable person who may have good advice for me. However, I also have to think revealing this would make the faculty think even worse of me and make the rest of residency more of a pain. Do any of you have any experience with seeing how residencies treat people who are about to quit or won't practice after graduating?

That's a tough spot to be in. I have some similar feelings as you, and it's not a secret that a number of my colleagues also feel the same, difference is that I don't have any loans or debt whatsoever and they do. On a recent conversation i had with some of my fellow residents, most of them agreed that if they knew the committment and what it would take to be a doc, they would have never done it. I am completely in that field. While I like being a doctor and think that I am good at it, I feel miserable with the whole relentless and never ending testing and all the crap that comes with it. maybe I would feel differently if I was not re-studying for step 3, but I see other people who have gone non-medical fields, including my spouse and they have great outcomes with much less effort. I personally don't plan to do medicine forever. I'm thinking that if I can pass step 3 I will complete my residency, maybe do fellowship, practice for a max of 10 years and then do admin work. I can't imagine practicing clinical medicine for more than that. If I can't pass step 3 ever, then i would just quit and be done. I don't have loans to worry about so that would be sad but not destroy my life. In your case, I wuld finish and do something non clinical if you can't stand medicine. Quitting right now would not make sense. 2 years goes by fast.

 

[Angry Birds]

That's a tough spot to be in. I have some similar feelings as you, and it's not a secret that a number of my colleagues also feel the same, difference is that I don't have any loans or debt whatsoever and they do. On a recent conversation i had with some of my fellow residents, most of them agreed that if they knew the committment and what it would take to be a doc, they would have never done it. I am completely in that field. While I like being a doctor and think that I am good at it, I feel miserable with the whole relentless and never ending testing and all the crap that comes with it. maybe I would feel differently if I was not re-studying for step 3, but I see other people who have gone non-medical fields, including my spouse and they have great outcomes with much less effort. I personally don't plan to do medicine forever. I'm thinking that if I can pass step 3 I will complete my residency, maybe do fellowship, practice for a max of 10 years and then do admin work. I can't imagine practicing clinical medicine for more than that. If I can't pass step 3 ever, then i would just quit and be done. I don't have loans to worry about so that would be sad but not destroy my life. In your case, I wuld finish and do something non clinical if you can't stand medicine. Quitting right now would not make sense. 2 years goes by fast.

If you've passed steps one and two, and have advanced through residency, it would be really sad to wave the white flag over step three, one of the easiest tests in your whole medical career.

 

[Lostin_space]

If you've passed steps one and two, and have advanced through residency, it would be really sad to wave the white flag over step three, one of the easiest tests in your whole medical career.

Easy maybe for you I guess not for me. I failed by a few points despite preparing myself fully. Maybe I'm just an idiot.

 

[Gastrapathy]

WRT WCIs advice, you should practice for s couple years but that doesn't mean you have to practice full time. Even a couple shifts a month will make you appear a veteran.

 

[northernpsy]

I realize I have wasted the taxpayers' money and indirectly prevented a more deserving person from obtaining residency training. I feel pretty bad about that.

This part makes me think you are being much too hard on yourself. Taxpayer money gets wasted on far worse things than you all the time. Your presence in this program may have prevented someone who is a much bigger jerk than you are from getting in. If you are feeling really discouraged about things then it might not be a bad idea to try to make time to get evaluated for depression. I think a lot of residents deal with depression but often don't have the time or energy to address it so they just grit their teeth and try to power through. However, if it's getting to the point where you may end up making a huge decision like this based on feeling so down, I would at least look into it first.

 

[The White Coat Investor]

Easy maybe for you I guess not for me. I failed by a few points despite preparing myself fully. Maybe I'm just an idiot.

You're an EM resident who had no issues with Steps I and II and then failed III? That is a bit odd. Bad day maybe.

 

[Apollyon]

You're an EM resident who had no issues with Steps I and II and then failed III? That is a bit odd. Bad day maybe.

I don't think that this person is EM.

 

[Lostin_space]

You're an EM resident who had no issues with Steps I and II and then failed III? That is a bit odd. Bad day maybe.

I'm not an EM resident, but yes I passed all steps prior to step 3 on my first attempt. I failed step 3 by a few points. I agree, I find it exceptionally odd. I'm still holding on to some hope that given the computer glitches something will work out.

 

[Angry Birds]

Easy maybe for you I guess not for me. I failed by a few points despite preparing myself fully. Maybe I'm just an idiot.

You're not an idiot.
You passed step 1 and 2 so you can pass step 3. Just because you didn't pass it this time doesn't mean you can't another. But, you can't just give up over that.

 

[Lostin_space]

You're not an idiot.
You passed step 1 and 2 so you can pass step 3. Just because you didn't pass it this time doesn't mean you can't another. But, you can't just give up over that.

The logical mind would say yes you are correct. It just sucks to have a failure that if nothing is changed, my be on my record forever. It's not like I did not study, that's what sucks. And now I have to re-study and stuff. It also sucks because I'm never going to see 95% of this stuff even again in my field. Really frustrating.
Also obviously the concern of, if I failed once, what would prevent me from failing again? Ugh. Sucks.

 

[Doctor4Life1769]

The logical mind would say yes you are correct. It just sucks to have a failure that if nothing is changed, my be on my record forever. It's not like I did not study, that's what sucks. And now I have to re-study and stuff. It also sucks because I'm never going to see 95% of this stuff even again in my field. Really frustrating.
Also obviously the concern of, if I failed once, what would prevent me from failing again? Ugh. Sucks.

Quit whining and hit the books and qbanks hard
Figure out what went wrong. Nervous or maybe didn't put enough effort the first time? Maybe didn't have the depth of knowledge? Good luck you can pass it!

 

[Lostin_space]

Quit whining and hit the books and qbanks hard
Figure out what went wrong. Nervous or maybe didn't put enough effort the first time? Maybe didn't have the depth of knowledge? Good luck you can pass it!

I did plenty of studying the first time, and if I don't have the depth of knowledge it's not like I can do much about it. I'm not going to be an expert in random things like peds, or ob, etc. I'm almost 5 years into residency (old + new residency) so been away from med school for a while, and I'm typically nervous with tests. I did my best, nothing more that I can do. I've already started studying again.

 

[Doctor4Life1769]

I did plenty of studying the first time, and if I don't have the depth of knowledge it's not like I can do much about it. I'm not going to be an expert in random things like peds, or ob, etc. I'm almost 5 years into residency (old + new residency) so been away from med school for a while, and I'm typically nervous with tests. I did my best, nothing more that I can do. I've already started studying again.

Perhaps board prep where you have something structured? Did not realize you were 5 years removed

 

[Lostin_space]

Perhaps board prep where you have something structured? Did not realize you were 5 years removed

Well I honestly just want to pass and I missed the pass cut off by 3 points, which sadly if I would have taken it last year as I initally planned, I would have passed. I guess they increased the passing score. I think a bunch of things contributed - being out a number of years, nerves, stress from rough rotations for several months prior to the exam, computer crashing/glitches, which led me to getting almost no credit for the cases and not being able to finish some questions on the block, etc. If cases were have gone ok, then it would have been fine. I am going through q bank again, focusing on cases too, have bought the stats review. I don't do well with structured stuff. Also will do some tutoring. Hopefully will be enough.

 

[The White Coat Investor]

I'm not an EM resident,

Why are you posting in the EM forum on a topic that isn't even related to EM then? Odd.

At any rate, if you didn't even finish the test and only missed passing by 3 points, it sounds like all you need to do is figure out how to finish the test in the time allotted to me. No big deal. It's not like you need a good score or anything, right? You just need to pass.

 

[Lostin_space]

Why are you posting in the EM forum on a topic that isn't even related to EM then? Odd.

At any rate, if you didn't even finish the test and only missed passing by 3 points, it sounds like all you need to do is figure out how to finish the test in the time allotted to me. No big deal. It's not like you need a good score or anything, right? You just need to pass.

I initially responded to the OP re: quitting medicine, and I touched upon one of the reasons upon which I would consider quitting medicine (ie=not being able to pass step 3 after trying again). then it all spiraled from there.

 

[Angry Birds]

I initially responded to the OP re: quitting medicine, and I touched upon one of the reasons upon which I would consider quitting medicine (ie=not being able to pass step 3 after trying again). then it all spiraled from there.

LostinSpace, I think you've got a mental block with this test. Visualize passing this test. Know you can pass it. Then you can pass it.

 

[gutonc]

I initially responded to the OP re: quitting medicine, and I touched upon one of the reasons upon which I would consider quitting medicine (ie=not being able to pass step 3 after trying again). then it all spiraled from there.

You've already got your own thread. Leave this one alone.

 

[goodoldalky]

OP, you probably doubt me but believe me when I say that you're not the only one who felt like that during residency. It is sort of designed to break you, make you question your capacity to do the job, freak out, be scared, tired, hungry, and then once you've done all that pop out on the other end feeling like you can handle almost anything anytime. You may or may not end up liking it long term but definitely keep those thoughts of quitting to yourself, power through. You will find it all gets better. Maybe so much so that you like it. And one day you'll actually get paid money to do the job, which makes a big difference. And if after all that you don't like it, you'll have plenty of other non clinical things you can do..... If you finish your residency, that is.