Alternatives to Residency

[deleted1095841]

I like the science of medicine, diagnosing things, and developing treatment plans. I also love talking to patients. But clinical year has not been enjoyable. The hierarchy, the gunner classmates, the anxiety over grading, the angry nurses and scrub techs, the turf wars, the long hours, and seeing patients fall through the cracks, make me feel somewhat disillusioned. Most of the residents I've worked with are nice, but they seem to be miserable. I'm not sure I want to sign up for 4 (or more) years of this.

What are some ways I can use medical knowledge and help patients other than the typical path of residency and clinical practice?

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[Goro]

Go into an allied health profession:
Respiratory tech
PT
Xray tech
ultrasound

Clinical trials mgr

Stuff of that ilk.

 

[deleted1095841]

Go into an allied health profession:
Respiratory tech
PT
Xray tech
ultrasound

Thanks for the advice! But those people don't seem particularly happy either, at least at my hospital.
Edit: I forgot to mention this, but I'm halfway through my MD, and I plan to finish no matter what, so I was hoping the degree would open some doors.

 

[deleted1095841]

Normally, I would just ask friends further along in med school, but at my school everyone seems to be going the traditional path.

 

[EdgeTrimmer]

Thanks for the advice! But those people don't seem particularly happy either, at least at my hospital.
Edit: I forgot to mention this, but I'm halfway through my MD, and I plan to finish no matter what, so I was hoping the degree would open some doors.

May be MD/MBA and work for drug companies or hospital management?

 

[Osminog]

Have you considered just doing your residency training in a lifestyle-friendly specialty at a chill community program? The experiences you've had at your rotation sites aren't necessarily reflective of clinical medicine as a whole; don't overgeneralize based on the limited exposure you've had during MS3. There are happy residents out there who work reasonable hours and aren't subjected to a toxic, cutthroat culture.

Also, don't delude yourself into thinking that non-clinical careers don't have anxiety, gunners, hierarchy, turf wars, long hours, etc. Most of the workplace problems in clinical medicine are ubiquitous outside of clinical medicine as well. If you were to opt out of residency training, you'd inevitably end up facing many of the same workplace struggles that you'd face as an attending physician—but you'd be drastically more limited in terms of professional and financial independence.

I would strongly recommend staying the course.

 

[deleted1095841]

Also, don't delude yourself into thinking that non-clinical careers don't have anxiety, gunners, hierarchy, turf wars, long hours, etc. Most of the workplace problems in clinical medicine are ubiquitous outside of clinical medicine as well.

True, but I worked several years before going to medical school, including at places I thought were toxic, but medicine seems to be worse.

 

[operaman]

Would definitely push through and try to complete something. At the very least, complete one year so you can get licensed. It's not really feasible to do something else and then go back and do residency after years of non-clinical work, so if you can get a spot after graduation, it's probably worth it.

Just aim for more chill programs and laid back fields. And focus on the work itself - the people and culture can vary drammatically and you just may be in a place with a crap culture. My residency was awesome and we were all very happy. Ditto for most programs at my med school, though some were not. If you enjoy clinical practice, you may want to consider finishing training. The hierarchy gets better as you climb up the ladder. You're not looking at 4 more years of being a MS3.

 

[deleted1095841]

hospital management?

How does one do this? I would like to help create an oasis of positive culture and wellness wherever I end up.

 

[Dantes]

Go into an allied health profession:
Respiratory tech
PT
Xray tech
ultrasound

Clinical trials mgr

Stuff of that ilk.

Gonna be tough to pay off med school debt in an allied health profession.

OP, realistically going into clinical trials, consulting, or hospital administration. However, most of these roles will pay more if you complete a residency and look for people from name brand schools. Occupational/preventive medicine might be the path of least resistance. Have you rotated through specialties like path or rads? Is there anything you enjoyed?

I agree that medicine is more toxic than other fields I've worked in as a non-trad, but doing some kind of residency might still be in your best interest.

 

[Just D.O. it]

I like the science of medicine, diagnosing things, and developing treatment plans. I also love talking to patients. But clinical year has not been enjoyable. The hierarchy, the gunner classmates, the anxiety over grading, the angry nurses and scrub techs, the turf wars, the long hours, and seeing patients fall through the cracks, make me feel somewhat disillusioned. Most of the residents I've worked with are nice, but they seem to be miserable. I'm not sure I want to sign up for 4 (or more) years of this.

What are some ways I can use medical knowledge and help patients other than the typical path of residency and clinical practice?

Academic medicine and being a resident are their own unique beast.

Once you're finished with residency you have a lot more flexibility in where you are and how you practice. Just for starters, you no longer answer to, get berated by, or graded by anyone. Scrub techs will not be thing in non procedural specialties, and most outpatient staff is much nicer in my experience than inpatient.

Residency itself can be tough and you generally don't get a say in how tough, but I promise life gets better once you get through it. You're only signing up for 3-4 years of it. The rest of your working life will have much better respect, control, and schedule if you want to.

Non clinical options (at least those that won't require residency) with comparable pay are slim pickings, even slimmer if you didn't get your MD from a name brand school.

 

[EdgeTrimmer]

How does one do this? I would like to help create an oasis of positive culture and wellness wherever I end up.

You can do MD/MBA with focus in hospital management. Work culture varies by location also. As others said how medical students and residents are treated is completely different from how physicians are treated.

 

[Goro]

Gonna be tough to pay off med school debt in an allied health profession.

OP, realistically going into clinical trials, consulting, or hospital administration. However, most of these roles will pay more if you complete a residency and look for people from name brand schools. Occupational/preventive medicine might be the path of least resistance. Have you rotated through specialties like path or rads? Is there anything you enjoyed?

I agree that medicine is more toxic than other fields I've worked in as a non-trad, but doing some kind of residency might still be in your best interest.

There's also teaching or working for insurance companies and denying g people's claims.

 

[GoSpursGo]

Honest truth is that most of the good nonclinical options still require you to be board certified in something, which requires residency +/- fellowship training. So I'd find something you don't completely hate (ideally with a 3 year residency), and then bail after 1-2 years as an attending for something nonclinical.

 

[Shunsui]

Occupational med and chill

 

[Splenda88]

Gonna be tough to pay off med school debt in an allied health profession.

OP, realistically going into clinical trials, consulting, or hospital administration. However, most of these roles will pay more if you complete a residency and look for people from name brand schools. Occupational/preventive medicine might be the path of least resistance. Have you rotated through specialties like path or rads? Is there anything you enjoyed?

I agree that medicine is more toxic than other fields I've worked in as a non-trad, but doing some kind of residency might still be in your best interest.

As non trad as well, that has not been the case for me. I find that the patients are more problematic than the people I work with. In fact, the people I work with are very chill (for lack of a better term). Again, I am on my year 2 as an attending.

I was a RN ~8 yrs and I found that the people in nursing were a lot MORE toxic than medicine.

OP should do a short residency (IM/FM etc...) and work part time. I have noticed the few people who work part time in my group seem happier...

 

[Dantes]

As non trad as well, that has not been the case for me. I find that the patients are more problematic than the people I work with. In fact, the people I work with are very chill (for lack of a better term). Again, I am on my year 2 as an attending.

I was a RN ~8 yrs and I found that the people in nursing were a lot MORE toxic than medicine.

OP should do a short residency (IM/FM etc...) and work part time. I have noticed the few people who work part time in my group seem happier...

Yeah I've seen that nursing can be pretty toxic too unfortunately. And not there yet but I do hear it gets better as an attending a lot, so I'll take your word for it lol

 

[Splenda88]

Thanks for the advice! But those people don't seem particularly happy either, at least at my hospital.
Edit: I forgot to mention this, but I'm halfway through my MD, and I plan to finish no matter what, so I was hoping the degree would open some doors.

I would strongly advise you to finish. I ran into 1 of my classmates who left during MS2 (after a brutal microbiology exam) to get a PhD in biochem and he told me he regrets it. He said the job he is doing right now, he would have been able to get the same job as a licensed physician and make more money.

I am not sure why he would get more money doing the same job because he has a medical license.

 

[Splenda88]

Yeah I've seen that nursing can be pretty toxic too unfortunately. And not there yet but I do hear it gets better as an attending a lot, so I'll take your word for it lol

I cant speak for all specialties, but for the few years that I have been in medicine, I notice that PCP, psych physicians are chill people.

 

[operaman]

It’s hard to overstate just how much better things can be after school and training. And I say that as someone who genuinely enjoyed medical school and residency and especially loved fellowship.

There will always be nuisances. You’ll trade residents and attendings for admins and insurance companies. There’s always a windmill at which to tilt. But the day to day gets really really good. Or at least it can.

Like in my current world, I admit all my post ops to the Hospitalist and just function as a consultant. They handle all the floor and medical stuff and I just manage the surgical part. When I’m with residents I’m making the decisions and I decide how much of any case I want to do or let them do. I round when I want to, arrange my clinics how I see fit. Basically there’s a certain amount of stuff that definitely has to get done, but I decide how to do that and everyone I work with is really friendly and supportive.

So it definitely gets better. And even if you end up not liking clinical practice, being BC lets you do locums and moonlight. ENT locums jobs can pay $30-50k per month depending on the details. You could work 3-4 months a year and be off the rest if you want. I’ve known docs who do just that.

 

[deleted1095841]

Thanks for all your helpful responses! What if I just did an IM residency but no fellowship? I believe this is only 3 years. What new options would that open up?
However, I should note that because my clinical grades are terrible, I probably can't match at a brand-name residency.

 

[Splenda88]

Thanks for all your helpful responses! What if I just did an IM residency but no fellowship? I believe this is only 3 years. What new options would that open up?
However, I should note that because my clinical grades are terrible, I probably can't match at a brand-name residency.

CMO, medical director, big pharma clinical trial, lab director, telemedicine, associate professor etc...

If you still want practice clinical medicine on a part time basis, you can work 7 days on and 21 days off, and still make good money (150k+/yr)

 

[aldol16]

Apply to MBA programs. Your school might have one or you should be able to apply to others. The MD is valuable and your role as a medical student will be seen as a plus. You will be exposed to a lot of career options that value your future MD but are not in clinical medicine. Obviously this comes with a price tag and you should look into it and do your research before applying but you should definitely look into it. MDs go on into management roles, finance roles, etc. Consulting is another arena - McKinsey has a program for MD candidates (no MBA required).

 

[AhhThnacks]

Day trade

 

[Kardio]

But clinical year has not been enjoyable. The hierarchy, the gunner classmates, the anxiety over grading, the angry nurses and scrub techs, the turf wars, the long hours, and seeing patients fall through the cracks, make me feel somewhat disillusioned.

I would challenge that “disillusioned” is the best way to conceptualize the experience you’re having right now, which predominantly revolves around frustration with colleagues. It does sound more like “bogged down in the bul**hit” to me, for lack of better words.

You seem to enjoy the meat and potatoes of the gig. Like has been posted already, seems like you’d get along well in a lower stress residency.

 

[Dral]

Look into Preventive medicine. Have to get through intern year, but then you could move toward something non-clinical after that. I think depending on where you go, you could probably learn some management skills if that is what you are interested in doing. Usually they involve getting your MPH.

 

[deleted1095841]

I also feel that many attendings feel an internal sense of despair that they are not able to give every patient their 100% in terms of attention and care. Not just due to time pressure, but also due to insurance, health system dysfunction, and patient lifestyle/social issues. In a way, it's good, because it means they care, but it also seems to affect their mood and behavior (and how they interact with students).

 

[Anakinmemer]

If you come from a target school (aka prestige) you have a good shot at MBB without an MBA. They directly pull from Harvard/Stanford/Columbia and the like. More difficult from other schools but not impossible, and there are many firms that hire MD's beyond just MBB. The pay scale is quite favorable, the pic below is starting comp and it is close to what primary care physicians make (MD's and PhD's start on the same scale as MBA's). Additionally, unlike medicine you can actually expect your income to keep up with inflation! Disclaimer: this includes 30k one time signing bonus

P.S. There is a common misconception that you need residency for consulting, this is false and I have spoken directly to a Mckinsey recruiter about it. You need residency and experience if you want to be an EXPERT consultant, which is different from management consulting.

 

[Dantes]

If you come from a target school (aka prestige) you have a good shot at MBB without an MBA. They directly pull from Harvard/Stanford/Columbia and the like. More difficult from other schools but not impossible, and there are many firms that hire MD's beyond just MBB. The pay scale is quite favorable, the pic below is starting comp and it is close to what primary care physicians make (MD's and PhD's start on the same scale as MBA's). Additionally, unlike medicine you can actually expect your income to keep up with inflation! Disclaimer: this includes 30k one time signing bonus

P.S. There is a common misconception that you need residency for consulting, this is false and I have spoken directly to a Mckinsey recruiter about it. You need residency and experience if you want to be an EXPERT consultant, which is different from management consulting.

Interesting. How do the work responsibilities and lifestyle differ comparing management consulting and being an expert consultant?