thinking about leaving medicine...

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triscuit

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but I'm terrified about the unknown. I know this topic has been beaten to death, but I'm an intern in pediatrics now and I just can't, for the life of me, see any light at the end of the tunnel. I hate almost every moment of work. I don't really mind the long hours...it's tiring, but that's not really the problem. I just really don't enjoy the day to day of medicine as much as my co-interns seem to.

I worked in research for a few years, and didn't do a phd, and now I'm really regretting it. I loved my time in the lab, and even though I was putting in long hours, I genuinely wanted to go to work everyday.

So my big dilemma is...stick it out to end of residency or bail after intern year? I feel like life is too short to do 2 additional years of something I hate, and I'm not quite sure what I would do with general peds training anyway...but leaving after intern year just seems scary, and I will basically not be qualified for much of anything with just a year of residency.

And, because I know it will be asked, there really isn't anything else in medicine I can see myself doing. crazy, I know, but I've thought about this a LOT.

Any advice or input would be appreciated.

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I would be hesitant about deciding anything early on during internship year just because it supposedly sucks so much regardless of what you're doing. Also, you mentioned having happier co-workers, but are they really happy or better at faking it? We medical people have been conditioned to act like we love everything, so I wouldn't necessarily assume you're the only unhappy person based on the outward appearances of everyone else.

Also, as you mentioned you're trying to decide between leaving after internship or finishing the residency. Either way, you're staying for several months, so why decide now? Try to be as positive and open-minded as you can and see how you feel in the spring. You don't have to decide anything now, so why try to?
 
but I'm terrified about the unknown. I know this topic has been beaten to death, but I'm an intern in pediatrics now and I just can't, for the life of me, see any light at the end of the tunnel. I hate almost every moment of work. I don't really mind the long hours...it's tiring, but that's not really the problem. I just really don't enjoy the day to day of medicine as much as my co-interns seem to.

I worked in research for a few years, and didn't do a phd, and now I'm really regretting it. I loved my time in the lab, and even though I was putting in long hours, I genuinely wanted to go to work everyday.

So my big dilemma is...stick it out to end of residency or bail after intern year? I feel like life is too short to do 2 additional years of something I hate, and I'm not quite sure what I would do with general peds training anyway...but leaving after intern year just seems scary, and I will basically not be qualified for much of anything with just a year of residency.

And, because I know it will be asked, there really isn't anything else in medicine I can see myself doing. crazy, I know, but I've thought about this a LOT.

Any advice or input would be appreciated.

My advice is to talk to your PD. No, you don't have to tell them what you've written here, just talk to them about your long-term career concerns and ask them to help you identify a faculty mentor, or, if you were assigned one and they aren't the "right" person, someone else.

In general, make sure you are using your free time (what little there is, i know) as best you can and just hang in through this period of time. If, by the middle of the year, you really still don't like it, then you need to have a more open discussion with your PD.

You are also welcome to PM me.

Good luck and take care

OBP
 
Residency usually gets better after Ist year. Believe me life is much better with a medical license and completion of residency as you can do lots of other things.

You have mentioned research. Without residency you will be a 2nd level researcher unless you can produce outstanding papers, presentation and bring in mega $$ for your research. After completion of residency you will a new door open for you in the field of pharmaceutical research. These are usually conducting clinical trials and I heard from few people in the field they want MD with license even though you are not seeing any patients.

I don't know if you already know that, after doing residency, all you need to do is have viable research project, 1 first author paper, MPH to get a faculty position in academia. Most of these people do 80/20 (research/clinic) and some do 100% research. Without residency you have you have to prove yourself to get the same thing.

If you still want to pursue other stuff, then Pathology might be for me. It has great compensation, and work hours.
 
Change residency. Do pathology.

You'll have time in a lab and make six figures.
 
but I'm terrified about the unknown. I know this topic has been beaten to death, but I'm an intern in pediatrics now and I just can't, for the life of me, see any light at the end of the tunnel. I hate almost every moment of work. I don't really mind the long hours...it's tiring, but that's not really the problem. I just really don't enjoy the day to day of medicine as much as my co-interns seem to.

I worked in research for a few years, and didn't do a phd, and now I'm really regretting it. I loved my time in the lab, and even though I was putting in long hours, I genuinely wanted to go to work everyday.

So my big dilemma is...stick it out to end of residency or bail after intern year? I feel like life is too short to do 2 additional years of something I hate, and I'm not quite sure what I would do with general peds training anyway...but leaving after intern year just seems scary, and I will basically not be qualified for much of anything with just a year of residency.

And, because I know it will be asked, there really isn't anything else in medicine I can see myself doing. crazy, I know, but I've thought about this a LOT.

Any advice or input would be appreciated.

Having at least completed an internship is better than having an M.D. and never having done a residency. I.e. you could maybe work for the VA or something . . .

I wouldn't make any big decisions, but it seems like you have done some thought on the issue.

I would consider seeking some counsiling from a psychiatrist on the other side of town from your residency program, and wouldn't necessarily discuss this with the PD yet. Just to make sure that you don't have depression or something, you want to make a good decision in a good frame of mind.
 
Having at least completed an internship is better than having an M.D. and never having done a residency. I.e. you could maybe work for the VA or something . . .

I wouldn't make any big decisions, but it seems like you have done some thought on the issue.

I would consider seeking some counsiling from a psychiatrist on the other side of town from your residency program, and wouldn't necessarily discuss this with the PD yet. Just to make sure that you don't have depression or something, you want to make a good decision in a good frame of mind.


Complete your residency. Make sure that you are in the right specialty for you. You cannot work in the VA with one year of training. Moonlighting can be difficult to come by also. I am speaking from experience. This was over ten years ago. Things are only harder now.

Do not leave your job and do not speak to your PD.

Cambie
 
One more thing I forgot about it. Economy is bad and not sure how long all this up and down now and in the future will last.

You have mentioned research. I know few researchers who has their labs shut down due to lack of funding and some are struggling. Those are good scientists by the way with good recent and over all publication record. Federal funding is not increasing if you factor in inflation.

I would not consult your PD. On paper they say, PD is there for you but in reality PD is there to have motivated, non problem residents and run his program. Think hard before jumping on any conclusion. Having finished your residency can theoratically bring lot more career options.
 
Thanks for all the responses! I know it is early to think about leaving. Looking back, I really always felt like medicine wasn't a good fit, but didn't have the guts to admit it. So I went along with the "plan" of doing residency, knowing that it probably wasn't the career I wanted. This was mostly due to concerns you have all mentioned, such as limitations of having just an MD and trying to do research. I know finishing residency would open up some options.

I don't think I'm depressed, although I have thought of talking to a psychiatrist - mostly because I'm worried that intern year will make me depressed at some point! Intern year is rough, but honestly I'm at a really nice program and work with a lot of great people. And they do a lot to make intern year as bearable as possible, so I don't think it's just intern blues...but I could be wrong.

I've really tried imaging myself as an attending, and I just can't see it. I don't think I particularly like seeing patients.

I actually never gave much thought to pathology when I was a med student...and now I'm wondering why. Would love to hear from pathologists out there what your typical day is like.

I'm definitely going to hold off on talking to my PD until I have a better grasp on what I want to do. But I do want to give them sufficient warning so that they can hopefully fill the position. In the meantime, will try to look on the bright side - happy to at least have a job in a nice place :)

Thanks again for the replies.
 
Triscuit, I am there with you. I was in a peds residency and miserable by this time in the year. I think leaving during the year would be a mistake (unless of course your health or sanity is really at stake). But leaving after intern year is a viable option. Don't listen to people who tell you your life is over if you don't finish residency. I struggled for months with my decision and actually got up the guts to leave. I am now in a job I love, and I'm happy again. I am myself again - I was kind of a husk of myself while I was in internship. Like you said, it was hard, but that wasn't the problem - I just couldn't see myself with a job I wanted if I continued. So here's my advice. You'd be surprised how many people talk to their PD about leaving during intern year. You are not going to torpedo yourself - you're a little nuts if you don't think about leaving. But I would wait a little longer - they don't need to know anything definite until much later, like somewhere in the dec/jan/feb range, but you can wait to talk to them until nov, then they can tell you when you need to decide by.
Talk to your family, talk to your friends, talk to a shrink, be honest with yourself. Life is too short to be miserable for years - hard work is nothing to be afraid of, but misery with no end in sight will change you.
I'm sorry you're feeling this way - I know it's scary, but if you're honest with yourself you can't make the wrong choice.
 
Can you elaborate when you realized medicine was not for you? Were you on the fence when applying to med school? How did you get through third year if you felt this way? What made you stick it through? What do you wish you had known before entering med school?
 
Invitroderm,

I wasn't on the fence at all when I applied to med school. I briefly thought of doing an MD/PhD, but I never doubted I wanted to be a doctor. First 2 years of med school - I didn't love it, but everyone kept saying 1st 2 years are not real medicine, and things get better 3rd year. And then 3rd year things didn't get better, they got worse. Was the first time I realized, it was not for me. It's frustrating, but sometimes in life you have to do something before you know for sure that it isn't for you. I had definitely shadowed and spent a lot of time with doctors and in hospitals prior to applying to med school.
 
Have you looked into public health/prev med residencies? They'd be open to you after your internship. Most include an MPH year and then the follow-on year is the public health residency. There is a clinical aspect to it, but the career seems like it would be flexible enough to have little direct patient contact if so desired. Research would be epidemiologic in nature, but I would think there might still be ways to get back to the bench if so desired. Toxicology fellowship is open to public health trained docs, and I'd think bench research is quite possible in that field. There seems to be a good variety in the ways you can practice as a prevmed doc; you can still have something to do with peds (assuming there was at least an initial draw to the field) without being a pediatrician.
Just another thing to look into.
 
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Triscuit. I am a recent residency grad (not peds though). I want to tell you that I went through almost the same dilemma when I was an intern.
I didn't like first and 2nd years of medical school either, and everyone was telling me that 3rd and 4th years were real medicine years. I didn't like 3rd or 4th year either.
I almost quit during my intern year. I even talked to my PD. I even considered and applied to different residency. In the end, I stayed and I am glad that I stayed. I hated my intern year with passion. 2nd and 3rd years I didn't enjoy either but I saw that the new interns were more miserable even if they were hidding it, so I felt that I was luckier compare to them at that time.
Triscuit, you said that you don't like medicine. Could it be that you hate pediatric medicine? Have you thought about other specialties? I agree with the other posters suggestions but one field that has not been mentioned is psychiatry. I don't want to offend anyone, but psychiatry is kind of unique compare to most other medical fields. Since you are willing to work hard but don't find "traditional medicine" interesting, you might find psychiatry interesting. Just a suggestion.
We all complain but in reality the job that I have right now as an attending is not that bad. During my intern year, I didn't think I would be this happy with my attending job which contributed to the "no light at the end of tunnel" feeling. Now that I am happy at my job, I am realizing that I enjoy medicine more than I ever did.
Someone mentioned that you should talk to your PD, I have to disagree with that. You already said that your program was very supportive of residents. I told my PD about my dilemma and everyone including the residents found out about it(good news travels fast). I was a black sheep for a few months but then everyone forgot about it. Although, you have to tell your PD if you decide to switch specialties. Good luck.
 
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I would encourage you to complete some type of residency before you make any major career decisions. If you're not enjoying your current residency, perhaps you should consider a few others (such as preventive medicine, PM&R, etc.).
 
Im pretty suprised that the whole aspect of needing to pay back student loans hasn't come up yet. Would you be willing to cut your losses and move to another job and pay back your loans that way?
 
Another idea to consider is the ABP's research pathway. I just quickly reviewed it on their website, and the integrated research pathway looks like it shortens a peds residency to 2 years, and then allows you one year (or 11 months) of research time. You could plan on 5-6 months each in your PGY-2 and PGY-3. Honestly, if you plan to go this direction I would plan for one additional year of research time afterwards -- your institution probably has some internal granting mechanism to fund research years for residents and fellows that you can apply, or your research mentor may have some funding on their grant.

The key is this: if you want a research career, you need a research pedigree. Completing a residency would help greatly. Plus, this would create a big "light at the end of the tunnel" -- which would be the 5-6 months of research starting in your PGY-2 year.

This assumes that your PD offers such or is willing to consider it.
 
I am against telling the PD anything about the fact you are thinking of quitting right now. Also, I recommend not telling anyone at your residency, including cointerns. You don't need the gossip and it could lead to lower evaluations, human nature being what it is. People try not to be biased but we all are.

If you do choose to bring this up with the PD, I would simply say that you miss doing research, NOT that you don't like clinical medicine. This way you spin it as being about what you WANT to do, not about what you DON'T want to do.

Pediatrics has a dearth of researchers. You should try looking into research pathways, either @your current institution, or somewhere else like the NIH.

I honestly think that you need to finish some kind of residency, whether it's peds or something else. Even to work for NIH, etc. they want you to be board certified in some specialty, which means you need to finish a residency. PGY2 and 3 tend to be much better than being an intern, so if you can stomach your intern year you can probably stomach finishing. Alternately, you could try to get leave of absence while you go do more research or something...but still if you finish a residency your job options would be much better.
 
I am against telling the PD anything about the fact you are thinking of quitting right now. Also, I recommend not telling anyone at your residency, including cointerns. You don't need the gossip and it could lead to lower evaluations, human nature being what it is. People try not to be biased but we all are.


So true.

I have to tell you, intern year is pretty crappy and not just because it's so much work, etc. Mostly, it's all the other 'stuff,' including being the emotional tether ball of most people in the hospital. Including patients sometimes. Bleh. But! I understand there is a light somewhere out there and it might even come in a set number of days, and with it comes a beautiful diploma that says we judge you competent to practice.

So. Find your happy spot, whether with friends, family or in a nice counselor or pastor's office. Is there some place where you feel you can be yourself and get it off your chest? I would not ever say anything to anyone at the residency. But find an outlet that can help you find your equilibrium. That's what I do; the stress is enormous but I make a point of finding my own sweet spot, where I can come back to myself. If you get your diploma then you will be a more awesome and capable researcher, as people said above. It's better to have the residency diploma and not use it, than to not have it at all. We are here with you brotha, you can do it. :thumbup:
 
You don't need the gossip and it could lead to lower evaluations, human nature being what it is. People try not to be biased but we all are.

If you do choose to bring this up with the PD, I would simply say that you miss doing research, NOT that you don't like clinical medicine. This way you spin it as being about what you WANT to do, not about what you DON'T want to do.

I honestly think that you need to finish some kind of residency, whether it's peds or something else. Even to work for NIH, etc. they want you to be board certified in some specialty, which means you need to finish a residency. PGY2 and 3 tend to be much better than being an intern, so if you can stomach your intern year you can probably stomach finishing. Alternately, you could try to get leave of absence while you go do more research or something...but still if you finish a residency your job options would be much better.

I think that while finishing residency will open doors doing stuff for pharamaceutical companies, you can leave residency for a research career with the NIH if you find you don't like clinical medicine. This is because there are a lot of post-doctoral positions which require a PhD OR an MD for some, you might need to work for a couple years getting lab experience, but maybe not.

Finishing residency would help a lot with career options, but if you 100% don't see yourself doing clinical medicine, then it might be hard to be gung ho about completing residency as you really need to love medicine to get through residency, IMHO.

I would agree with DF that if you bring up anything that even smells like something less than a total life commitment to medicine then it could hurt you. I studied almost every night in medical school, 60+ pages and volunteered too, but during a preclinical medicine clinic rotation during second year got branded as being not as interested when compared to another classmate.

Point being, it is easy to get an undeserved reputation for yourself in medicine and if you start talking about not liking seeing patients to your cointerns or attendings or PD then they will look at you through this lens even if you are doing great work. . .
 
I think that while finishing residency will open doors doing stuff for pharamaceutical companies, you can leave residency for a research career with the NIH if you find you don't like clinical medicine. This is because there are a lot of post-doctoral positions which require a PhD OR an MD for some, you might need to work for a couple years getting lab experience, but maybe not.

The economy is in the toilet right now. Stay employed. research jobs are hard to come by.Please do not speak to your PD.


Cambie
 
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The economy in in the toilet right now. Stay employed. research jobs are hard to come by.Please do not speak to your PD.


Cambie

Probably good advice to keep your residency position until you have a firm plan and job lined up elsewhere.
 
Hey everyone,

Thanks so much for the advice. I know how hard it can be to find a job, and given the current work market, I'm not rushing to give up my job. I'm also pretty certain I won't talk to my PD until I have a clear plan in mind.

Right now, I'm trying to figure out if there are any other specialties I could see myself doing. I think I would be happier with something that involves more procedures and less long-term patient care. People have suggested Anesthesia to me - really never saw myself doing that before, but I'm giving it some thought now.

Again, thanks for all the input.
 
Do not leave residency without finishing. Transfer to another specialty, if you must. But finish. Otherwise, you may lose the time, energy, and capital you have invested. If you need moral support, sign up for therapy. Psychoanalytic institutes typically offer therapy at a discount, where you meet with therapists in training. Give it a shot. Can't hurt. Could help to weather the storm and clarify your thoughts.
 
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Hey Triscuit,

Just came across this thread. I know its more than a year since you posted - (and I'd echo the majority in saying stick it out at least through the intern year, then you can look at other options) - but you may have already made your decision by now.

Just wondering if you stayed on, either till the end of (or after) your intern year, or moved on to something else?
 
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