2nd year depressed resident

[pathology123]

Hello everyone!
I'm currently an extremely depresed pathology resident finishing up my second year. I am in the process of transferring to a program in a better location lifestyle wise ( bigger city, more things to do than where I currently am) however I feel in my gut that I cannot handle the stress of continuing residency. The program I am transferring to is more labor intensive (grossing longer hours) and requires longer hours than I can handle at this point. The problem is that I absolutely do not want to stay at my current program, as the location is depressing me (isolated) and my husband is not supportive at all of my decision to quit. Does anyone have thoughts on taking a year off before I try to re-apply? I find out soon if I can transfer as a pgy-3 but I dont know if I should go through with it, I don't want to take the position of someone else when I am unsure myself of how I can handle it. I am on antidepressants and seeking counseling but the stress of residency has caused depression in a past residency, so I know a significant portion of it is situational. I also realize if I dont finish residency then my career options become significantly limited but at this point I am so miserable I cant see myself continuing no matter how high the income is. Any guidance is truly appreciated! Thank you

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[MetroPath]

Hello,

Well I think the choice is yours whether to continue or not.

You have come a long ways (medical school and residency) that I wouldnt recommend that you quit. You mentioned a past residency? Did you do a residency in a field other than path? If so, why did you leave the previous residency?

If you truly love pathology, I would continue. Quitting because of being depressed because of location of your residency is not a good idea as things can change location wise after you finish your training. You have your husband with you as well. Its not like you are in the middle of nowhere by yourself which would definitely suck. Hopeffully, your family and husband are supporting you.

Ive seen many residents depressed during residency. Its not only you. It is grueling but believe me you just have to get over this hump and things will get better.

You are going to be a pgy3, so I would think that grossing gets better as a third year as you should already know how to gross, its just the workload, which I think gets better as you get closer to 4th year.

I cant gauge your interest in pathology because I dont know you. But if you truly dont like it, I would consider doing something else, as this is something you have to do the rest of your life.

If you still love path, then I would say just try to suck it up for another two years. It will get better with time and experience.

Anyways, good luck, stay positive and things will get better as they always do.

 

[LADoc00]

Hi and welcome. You have what is called a 'Case of the Wussies.' I am well versed in watching fellow residents succumb to this ailment and throw away a life of steady income for instead a future of selling medical weed to junkies outside a "clinic" in People's Park, Berkeley.

You need to suck it up and not transfer. I repeat do not transfer. You will be perma marked as a loser.

You sound like you need to seriously up the dose of SSRIs. I am also confused by your statement "past residency" like this is your 2nd rodeo? You washed out of another program?!

If that is the case, you are in serious trouble changing programs simply wont help. Put your head down, finish your time and find a sleepy job somewhere maybe babysitting a lab so you pay down your student debt.

Hard work should NOT make you clinically depressed. I did month to month 12-hr days with not even a Sunday off, you can too. Not matter how much it sucks, it too shall pass. Assuming your attending is not Bill Cosby, you can physically withstand it.

 

[pathology123]

Thank you for the responses, and I should clarify a few things:
1. I dont have any debt to pay off from medical school
2. The first residency was in psychiatry, and depression curtailed that one as well, after the first year.
3. The decision to transfer is not just based on my decision but my husband's work situation
4. I am continually becoming disheartened by the idea of having to work in such a constrained environment and dealing with politics. Increased stress and responsibility have overwhelmed me in the past as they are doing now. Furthermore, I dont feel like i truly have an interest in pathology anymore. I also know if I continue to push I will deteriorate further. I've already become forgetful and some attendings have made comments. Unfortunately I dont think taking time off is an option without harming me in the future for licensure.

I will up the dose of SSRI's in the meantime, but want to draw the limits somewhere on overmedicating. My attendings luckily are sane so i'm safe there

 

[MetroPath]

We dont know how serious your condition is. Sounds like you have a history of depression? If you transfer, what makes you think you will be able to hack another year? Jumping from residency to residency and then from program to program is not a good thing. I had a resident transfer out of my program and into another to be closer to her husband so it happens. It sounds like transferring to the new program is just going to make you even more miserable.

At least your attendings are sane. Ive met some lunatics in my training who will completely make your life miserable.

I would also make sure your depression is not interfering with your work and all that comes with residency training. If it seriously is, I would take a year off (although I would not recommend it since getting a position as a PGY-3 may be difficult) and you will be asked about the gap numerous times when applying for anything down the road.

Anyhow, good luck in what you choose.

 

[yaah]

If you have to transfer primarily for family reasons no one will look on that as a serious problem. You say your husband doesn't want you to quit but one of the main reasons to leave is because of your husband. That doesn't make sense but that is beside the point since it's your personal issue. You want to transfer because there will be more things to do there. But maybe you should be focusing more on residency training instead of what else you can do for fun? It sounds as though your personal issue is overwhelming your life, and if it is effecting your performance taking time off to address it is not the worst thing. But you need to have a plan. I have no idea whether programs would even be receptive to taking someone transferring in mid-residency after having time off. They might make you start over.

If you're transferring somewhere as a PGY-3 you would almost certainly not be taking someone else's spot. They aren't going to fire a resident to bring in a transfer, I have never heard of that. You would probably be filling an empty spot that was vacated for whatever reason.

However, if you do succeed, taking a year off, to be honest when you are looking for jobs I am not sure anyone potentially hiring you would really notice. Your CV would say you were at X from year A to year B and then Y afterwards.

But the above comments are important, moving from program to program looking for a better lifestyle is probably not going to make you happy. Programs like to see you progress from year to year, that's part of the evaluation of a good resident. You also have to ask yourself what is going to change after finishing residency that would reduce your stress and depression. What makes you think being on staff is less stressful? As a resident you rarely have to make tough calls or actual diagnoses without backup. What's stressful, the hours you put in? If you're on staff it might be worse, particularly if you are inefficient in signing out cases or are a dawdler or you get nervous about pushing the signout button.

I am not a psychiatrist but I think you need to figure out what you want, what is actually stressing you out, and how to fix that. If fixing it involves getting through residency and hoping things are better that is probably not a great idea. Pathology residency is not neurosurgery residency. Pathology residency is humane.

 

[Johnny Sunshine]

Hard work should NOT make you clinically depressed.

That depends on what you're doing the work for. Not necessarily the fact that it's "hard".

Working 12 hour days, most weekends included, for over a decade (4 years college, 4 years med school, 4 years residency, etc.) and not having a life otherwise can certainly make one clinically depressed. A decade of sitting at desks and avoiding the rest of the world? I would be surprised if anyone in such a situation did not feel down.

Working hard itself isn't necessarily the problem. Working hard is fine, as long as it's towards a goal one desires. In that case it's just a hurdle and a case of "doing your time". But some people don't necessarily value a stable income, nice house, etc., at least not enough to justify sacrificing so much of their life for. And even if they do think the road is worth it, the way things are today there is zero guarantee that there is any pot at the end of the rainbow.

It's likely hard to stay motivated when so many years of such hard work have, thus far, led to nothing but even more work, more stress, and more uncertainty about her employment future.

 

[PikminOC]

Thank you for the responses, and I should clarify a few things:
1. I dont have any debt to pay off from medical school
2. The first residency was in psychiatry, and depression curtailed that one as well, after the first year.
3. The decision to transfer is not just based on my decision but my husband's work situation
4. I am continually becoming disheartened by the idea of having to work in such a constrained environment and dealing with politics. Increased stress and responsibility have overwhelmed me in the past as they are doing now. Furthermore, I dont feel like i truly have an interest in pathology anymore. I also know if I continue to push I will deteriorate further. I've already become forgetful and some attendings have made comments. Unfortunately I dont think taking time off is an option without harming me in the future for licensure.

I will up the dose of SSRI's in the meantime, but want to draw the limits somewhere on overmedicating. My attendings luckily are sane so i'm safe there

You shouldn't be making medication changes yourself.
You may benefit from therapy as well as a good psychiatrist you see on a regular basis, esp as this sounds like a chronic problem.

 

[LADoc00]

Grover, it sounds like the OP actually was a psychiatrist...but yes, serious pro help maybe needed.

 

[BlondeDocteur]

It might simply be the case that you don't handle pressure, deadlines and high-stakes decisions well. You gravitated to the two least-stressful fields in medicine (psych and path) with the most humane cultures and hours, but it sounds like you still find surg path in particular stressful. Have you considered something more on the CP side of things, like microbiology, molecular or chemistry?

 

[gbwillner]

I suggest you quit.

I went though something similar with my wife- she wanted to quit and I didn't support that decision. I told her she should stick it out, and doing so would prove to her she had what it took and would boost her confidence. It only resulted in more depression as well as resentment that I didn't support her. I then urged her to transfer to another program that was also better for her in many ways. In the end, despite being in a much better environment, she was still miserable. She realized she'd had enough and quit (this time with my support). I only wish I gave that support sooner.

Bottom line is that this job (medicine) isn't for everyone. It is taxing on the body and soul for some. You are lucky you have no debt. Get out and enjoy your life- not wallow in misery because this is something you (or others) think you should do.

 

[pathology123]

Thank you so much for the responses everyone. I have explored the easiest avenues in medicine and still havent been able to hack it and need to be realistic with what i can and cant do. gbwillner, you hit the nail on the head. I am beginning to resent my loved ones for not letting me quit and this is not how I want to live life. I have become bitter and cynical of everyone who enjoys their work, even the janitor! I really enjoy children and teaching and will explore that avenue, but its scary because I dont have the support of my parents and husband and there will definitely be pushback. However, I know I wont regret the decision.

 

[mlw03]

I don't know you of course, and while I generally agree with the advice given (that medicine is not for you), I don't know if I agree with the diagnosis of depression. Modern society is so quick to throw around psychiatric diagnosis - depression, anxiety, schizophrenic, etc. You're in a situation you find unpleasant and difficult. Your emotional response is reasonable, not pathologic.

But that's going off on a side conversation. If you're not happy after this much time, you probably won't be, so if you don't need to do this for the money, why do it?

 

[gbwillner]

Thank you so much for the responses everyone. I have explored the easiest avenues in medicine and still havent been able to hack it and need to be realistic with what i can and cant do. gbwillner, you hit the nail on the head. I am beginning to resent my loved ones for not letting me quit and this is not how I want to live life. I have become bitter and cynical of everyone who enjoys their work, even the janitor! I really enjoy children and teaching and will explore that avenue, but its scary because I dont have the support of my parents and husband and there will definitely be pushback. However, I know I wont regret the decision.

Glad to hear it. Your husband WILL come around (if he really does care for you). I did. We all think we know what's best for others but eventually we see when our efforts have the opposite than the desired effect.

FYI, my wife was also medicated and depressed. After finally quitting, the source of the depression truly was gone and she went off medication all together after a few months. It's been 5 years, we have 2 children, and couldn't be happier.

 

[jace's mom]

If you don't have to worry about debt, I would say that maybe it's time to leave medicine. You've given it your best effort, and it's just not for you. I was a high school teacher before I went to medical school, so I can give some advice about that route. Depending on the state you live in, you should be able to go through an emergency certification process to teach K-12 (different certifications/tests required for different grade levels, check your local certification programs). In my state (Texas), you can work as the teacher of record while you're completing your certification. You might also check the community college route. When I used to adjunct (in Florida), the rule to teach college-level classes was that you had to have a master's degree with 18 hours in the subject area, with no extra certification process required. You should be able to manage something like that from the sciences. Pay (at least where I live) is similar to residency pay.

Please, please take the necessary steps to improve your health. No job is worth sacrificing your physical and mental health and emotional well-being. If it isn't the right fit, then it isn't, and you shouldn't feel bad about that. Best wishes to you!

 

[Torsed]

I'd encourage you to finish, you've come this far, why not go a little further. I deal with so much b.s. in practice I never dreamed of in residency. Just gotta roll with the punches in pathology.

Absolutely must past boards so focus on that from here until the end of training.

 

[deleted642280]

If you don't have to worry about debt, I would say that maybe it's time to leave medicine. You've given it your best effort, and it's just not for you. I was a high school teacher before I went to medical school, so I can give some advice about that route. Depending on the state you live in, you should be able to go through an emergency certification process to teach K-12 (different certifications/tests required for different grade levels, check your local certification programs). In my state (Texas), you can work as the teacher of record while you're completing your certification. You might also check the community college route. When I used to adjunct (in Florida), the rule to teach college-level classes was that you had to have a master's degree with 18 hours in the subject area, with no extra certification process required. You should be able to manage something like that from the sciences. Pay (at least where I live) is similar to residency pay.

Please, please take the necessary steps to improve your health. No job is worth sacrificing your physical and mental health and emotional well-being. If it isn't the right fit, then it isn't, and you shouldn't feel bad about that. Best wishes to you!

Life is too short to do something you seem to be so unhappy with. It is never too late to change your mind. I agree. Take care of yourself. Go find something else. It does not make you a bad person to try something and find out it is not for you. Take care of yourself.

 

[oldfatman]

Hello everyone!
I'm currently an extremely depresed pathology resident finishing up my second year. I am in the process of transferring to a program in a better location lifestyle wise ( bigger city, more things to do than where I currently am) however I feel in my gut that I cannot handle the stress of continuing residency. The program I am transferring to is more labor intensive (grossing longer hours) and requires longer hours than I can handle at this point. The problem is that I absolutely do not want to stay at my current program, as the location is depressing me (isolated) and my husband is not supportive at all of my decision to quit. Does anyone have thoughts on taking a year off before I try to re-apply? I find out soon if I can transfer as a pgy-3 but I dont know if I should go through with it, I don't want to take the position of someone else when I am unsure myself of how I can handle it. I am on antidepressants and seeking counseling but the stress of residency has caused depression in a past residency, so I know a significant portion of it is situational. I also realize if I dont finish residency then my career options become significantly limited but at this point I am so miserable I cant see myself continuing no matter how high the income is. Any guidance is truly appreciated! Thank you

Perhaps your major source of stress is your spouse and not your residenc(ies).

 

[Diana Prince]

There were prolonged periods in my residency when I was depresssed and wanted to quit, particularly in my first two years of residency. I managed to transfer, finish training at a strong residency and I am completing two fellowships at well-known institutions.
My advice is as follow:
1. Do not make any major decisions about changing your career until your depression has improved
2. Start excerising, A LOT. I used to run to the hospital in the morning and I started lifting weight three times a week during my second year of residency. Even if you had a twelve hour day, you have to exercise
3. Figure out what your stressors are. If you became a teacher, you may still be stressed out because the same stressors emerge.
4. Right now, you cannot change your situtation but you can choose how to react to it.
5. Start writing how you feel for 10-15 minutes a day. The act of writing down your thoughts helps to clear your head.
6. Realize that you can still practice medicine in a variety of ways without having completed a residency. Send me a message and I can give you the links to people who have done this.
7. Lastly, most cities in the U.S. have social activities posted through meetup.com. Your perspective on life changes when you can spend time with people outside of medicine.
You can send me a message and vent when you are having a bad day.

 

[Marjoram]

http://archpsyc.jamanetwork.com/article.aspx?articleid=2173396

You are not alone.

 

[pathology123]

Thank you so so much for your replies! So I actually ended up taking a break from the program, and I will be starting work with an aesthetician soon with the plans of eventually owning my own medical spa. I am feeling better, and if anyone has any input on how to get into the medical spa business I would appreciate it!

 

[WEBB PINKERTON]

I've seen pathologists who left pathology to work at Spas/anti aging clinics. Here is one I am familiar with. You might want to contact her.

http://www.healthgrades.com/physician/dr-tamara-densmore-x9jgl/appointment

 

[sniki]

If you have to transfer primarily for family reasons no one will look on that as a serious problem. You say your husband doesn't want you to quit but one of the main reasons to leave is because of your husband. That doesn't make sense but that is beside the point since it's your personal issue. You want to transfer because there will be more things to do there. But maybe you should be focusing more on residency training instead of what else you can do for fun? It sounds as though your personal issue is overwhelming your life, and if it is effecting your performance taking time off to address it is not the worst thing. But you need to have a plan. I have no idea whether programs would even be receptive to taking someone transferring in mid-residency after having time off. They might make you start over.

If you're transferring somewhere as a PGY-3 you would almost certainly not be taking someone else's spot. They aren't going to fire a resident to bring in a transfer, I have never heard of that. You would probably be filling an empty spot that was vacated for whatever reason.

However, if you do succeed, taking a year off, to be honest when you are looking for jobs I am not sure anyone potentially hiring you would really notice. Your CV would say you were at X from year A to year B and then Y afterwards.

But the above comments are important, moving from program to program looking for a better lifestyle is probably not going to make you happy. Programs like to see you progress from year to year, that's part of the evaluation of a good resident. You also have to ask yourself what is going to change after finishing residency that would reduce your stress and depression. What makes you think being on staff is less stressful? As a resident you rarely have to make tough calls or actual diagnoses without backup. What's stressful, the hours you put in? If you're on staff it might be worse, particularly if you are inefficient in signing out cases or are a dawdler or you get nervous about pushing the signout button.

I am not a psychiatrist but I think you need to figure out what you want, what is actually stressing you out, and how to fix that. If fixing it involves getting through residency and hoping things are better that is probably not a great idea. Pathology residency is not neurosurgery residency. Pathology residency is humane.

If you elect to take time off, how does that affect you in terms of applying for fellowship? How strange does it look? And while taking time off, how important is it to "make the most of it," i.e. should I be looking for research opportunities?

 

[pathology123]

Thank you! I will definitely contact her. You can take time off, but it is important to make the most of it. I would definitely recommend looking for research opportunities. I am not sure about fellowship but when applying for licensure, they will want detailed explanations for any time that you took off.

 

[sniki]

So what is the least crazy way to say, a million stressors all came in at once like a perfect storm, made me feel super anxious, enough so to make me recognize I wasn't doing my best at work and I decided to take time off to recuperate? And how can I reassure fellowships and job interviewers that this is not something that is usual for me and is highly unlikely to happen again?

 

[yaah]

If you elect to take time off, how does that affect you in terms of applying for fellowship? How strange does it look? And while taking time off, how important is it to "make the most of it," i.e. should I be looking for research opportunities?

I don't run a fellowship program, so I am not sure. But I suspect as long as your reasons for being away are valid and you explain them it shouldn't have much of an impact on your candidacy. If you want to take time off to vacation or chill out or whatever, be honest that you wanted to take the time off. I doubt many people would hold that against you. But be prepared to answer questions, because people who take time off for certain reasons may be more likely to not complete a fellowship, or to bail before it starts. That is why you need to be honest, both with them and with yourself.