Thinking about quiting residency

[crazyhands]

I'm an intern and have recently had thoughts of quitting my residency. The thoughts have come up over the last several months and have been more and more frequent. I realize intern year is suppose to be difficult and many people don't like it but I am finding out that there are certain aspects to medicine that I just don't like at all and these aspects will get more intense the more independent I become.

Maybe I am too weak emotionally but one of the worst parts of practicing medicine in an academic center has to be the large number of kids you see who are essentially screwed from the start. In terms of the genes they received, their time in utero, their time in the NICU, their horrible environment they grow up in and the horrible job their parents do (not always). It's so sad to see.
I just had a patient I saw in clinic today and my eyes almost filled up with tears due to his situation. I saw a very unconfident kid who made poor eye contact, very weak voice, who admitted to being bullied in school after I questioned where a bruise came from. Oh yea, he also has a crappy serious chronic medical condition, has learning and behavioral problems at school, is making horrible grades in school, has parents that are divorced and are poor. I feel like these situations are all too common and I become "part of their life" and it becomes part of me and the rest of the day I'm depressed from it. This poor kid is just f***** and there is very little I can do to help him. I hate that feeling and being part of the situation.

I know that I can do private practice, which is a totally different atmosphere but it also has it's own problems. I'm really beginning to think that I will not be happy in medicine because this problem is relatively minor as an intern and get much worse with increasing responsibility. What I am trying to say is that being heavily involved in these kids lives and seeing them do poorly brings me down fast.
There's a lot I do like about medicine. I love learning, understanding things, the mechanism or physiology behind w/e. And oh yea, I love seeing patients do well but it seems like the majority of the kids I see are not doing that well, in one aspect or another. Is it worth it to be in the field if I am clearly not happy most of the time? Has anyone else had similar thoughts? Do others just have a way of separating work from their own life?

I really appreciate everyones thoughts.

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[Modeselektor]

Sounds rough, but they will be screwed whether you are there or not.

At least this way you can try your best to make a difference. IMHO.

 

[luCZky]

Don't do that. You need a specialist. And yes... seeing innocent kids suffering is tough and you probably picked up the worst residency with your mind condition. Maybe switching a residency for something without much contact with patients like radiology can help.. maybe family medicine with specialist support could work too. But do not quit. You have to think about it in the way mentioned above. And maybe at first you should think about what your other career options are. Do you really believe you can avoid seeing people in troubles anywhere else? I don't think so. They are everywhere. Have you ever thought what else you could do? Even a cashier in walmart have to see poor people suffering from lack of money to pay for food everyday. There is no way how to avoid it. This have nothing (or at least not too much) to do with medicine or pediatrics.. it's a society problem.. and in your case it's definitely problem in your mind that you're taking other people's problems too personally. But psychologist/psychiatrist can help you to deal with it.

 

[Rutgers06]

Yeah, it sucks when you feel that there are terrible situations that you don't seem to be able to change much about. I feel that intern year can really magnify those feelings because you're doing so much inpatient, constantly seeing sick kids and are on the front lines. This is about the time of year during intern year that I felt the emotional toll of constantly taking care of sick kids and feeling that I wasn't doing anything, especially for the kids who were G-tube/trached and constantly coming in. What helped me was to talk with other people (co-interns, residents) to get perspective on what I was feeling and realizing that not all kids are messed up. To some extent I had to learn how to take a step back, realize that there were many things that I couldn't control and focus on the things I could control that make a difference in that person's life. I would definitely encourage you to talk to co-interns, residents and/or program leadership because it's not uncommon to feel the way you do, especially during the middle of intern year.

 

[oldbearprofessor]

As noted by others, February of internship is the absolute lowest point of your training. It gets better from here. Spring comes and along with it a future as a PL-2! Find one or more faculty you can trust (not necessarily your PD, that's up to you) and talk with them. They will reassure you that these feelings are common and it almost always gets better. As physicians and pediatricians we do lots of great things for children. It'll be a lot easier to see that as you move away from endless "the G-tube site looks red" calls all night long.

 

[Cuthbert]

OBP is right; this is perhaps the worst time of year (especially as an intern). You need to dig deep right now. There was a reason you went into peds. You sound like a very empathetic person. Just remember that you are making a difference. It might not be the same as some grandiose vision you had prior to this year, but trust me, you are making a difference daily. Invest the time and effort that it requires to continue making that difference.

Also remember to continue to evaluate your likes and dislikes of each rotation. This will help with the choice of general peds vs. specialization. There are many options yet before you at this point other than quitting.

 

[Leo Aquarius]

...Maybe I am too weak emotionally but one of the worst parts of practicing medicine in an academic center has to be the large number of kids you see who are essentially screwed from the start. In terms of the genes they received, their time in utero, their time in the NICU, their horrible environment they grow up in and the horrible job their parents do (not always). It's so sad to see...

I really empathize with you. This is the very reason I decided not to do peds. I couldn't handle seeing children suffering so badly day in and day out. There is a third option for you. Consider changing specialties. It's not too late for you and you will have a peds intern year under your belt. Your happiness is most important because it will impact your care of others. Good luck !

 

[michigangirl]

I agree with several on this thread that February is the darkest time of intern year or any year for that matter, but I feel there is more to crazyhands post. There is a large majority of people who have a very hard time with the depressing side of pediatrics-- instead of bringing out the best in them, it pulls them down more. It's a lot-- feeling like the world has been against a kid from the start. This seems to be affecting the OP in a more intense way than most peds residents-- and their program is like most academic centers, the 2nd year involves more acuity, more poor prognoses-- peds onc, PICU, etc....

You need to talk to someone you trust, tell them how you're feeling-- your own mental health is the most important. Pediatrics is probably still the right choice for you, but the way you are feeling now needs to be addressed sooner than later so that you can take care of yourself.

 

[crazyhands]

Thanks to everyone for their thoughtful comments and advice! Since I posted, I feel much better for a variety of reasons. I'm having intermittent mood issues for sure and now feel like I was extremely negative in my thoughts when I made my original message. I know those feelings will come back but I think I need to take care of myself and realized that my own mood has a lot to do with it as well (aka Depression = hopelessness.)