burned out or depressed

[Minnows]

Hi,

I am a long time lurker and this is my first post.

I am in my intern year at a categorical neurology residency.
I don't know whether I am just burned out, or depressed, or both, but I am honestly not excited or looking forward to my actual neurology program.
Every time I hear about how hard the PGY2s have to work, (ie several 24 hours calls during the week), I start to regret my choice in doing this specialty. I keep trying to reason the calls by thinking that all other subspecialties have to work just as hard, like if you were a first year cardiology or GI fellow. I have been able to find some solace in that fact, however I don't even know if I find the field interesting any more,. I guess since I am a very introverted person, and I see all the residents having to present in front of a bunch of neurology attendings absolutely intimidating. 'I thought about doing something more hands on but I don't even know how to even get around to switching specialties. But to be honest, I think I would switch, get tired, and start to wonder whether I should give up and switch fields again. I thought about how the job prospect is probably not going to be that great afterwards, and how I have heard from some of the attendings how outpatient clinic is really tough to do.

I guess I feel like I am in a long dark tunnel and the light at the end of the tunnel is also bleak. I feel like I need to talk to a psychologist/counselor.

Thanks

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[Chibucks15]

Hi,

I am a long time lurker and this is my first post.

I am in my intern year at a categorical neurology residency.
I don't know whether I am just burned out, or depressed, or both, but I am honestly not excited or looking forward to my actual neurology program.
Every time I hear about how hard the PGY2s have to work, (ie several 24 hours calls during the week), I start to regret my choice in doing this specialty. I keep trying to reason the calls by thinking that all other subspecialties have to work just as hard, like if you were a first year cardiology or GI fellow. I have been able to find some solace in that fact, however I don't even know if I find the field interesting any more,. I guess since I am a very introverted person, and I see all the residents having to present in front of a bunch of neurology attendings absolutely intimidating. 'I thought about doing something more hands on but I don't even know how to even get around to switching specialties. But to be honest, I think I would switch, get tired, and start to wondering whether I should give up and switch fields again. I thought about how the job prospect is probably not going to be that great afterwards, and how I have heard from some of the attendings how outpatient clinic is really tough to do.

I guess I feel like I am in a long dark tunnel and the light at the end of the tunnel is also bleak. I feel like I need to talk to a psychologist/counselor.

Thanks

I'm just an M4 but definitely talk to a counselor at minimum...you can do it!

 

[Yoyomama88]

Switch into psychiatry. Many pgy2 openings available

 

[xenotype]

Hi,

I am a long time lurker and this is my first post.

I am in my intern year at a categorical neurology residency.
I don't know whether I am just burned out, or depressed, or both, but I am honestly not excited or looking forward to my actual neurology program.
Every time I hear about how hard the PGY2s have to work, (ie several 24 hours calls during the week), I start to regret my choice in doing this specialty. I keep trying to reason the calls by thinking that all other subspecialties have to work just as hard, like if you were a first year cardiology or GI fellow. I have been able to find some solace in that fact, however I don't even know if I find the field interesting any more,. I guess since I am a very introverted person, and I see all the residents having to present in front of a bunch of neurology attendings absolutely intimidating. 'I thought about doing something more hands on but I don't even know how to even get around to switching specialties. But to be honest, I think I would switch, get tired, and start to wondering whether I should give up and switch fields again. I thought about how the job prospect is probably not going to be that great afterwards, and how I have heard from some of the attendings how outpatient clinic is really tough to do.

I guess I feel like I am in a long dark tunnel and the light at the end of the tunnel is also bleak. I feel like I need to talk to a psychologist/counselor.

Thanks

I hated internal medicine(including med school as well), and my most miserable year for sure was intern year even though I worked much harder and under crazier conditions in PGY2 by far. Several of the neurology attendings I know will directly admit they are introverted and seeing patients saps their energy. They still love the field and are happy overall. My attendings were great in residency, early on even when you were totally off track when presenting they were generally very kind about it and help steer your thinking where it needs to go. I would bet this applies to your program too. If you want hands on, there is plenty of it with botox, EMGs, headahce procedures, neurocritical care, or gun for interventional pain or neurointerventional if you want procedures all the time. Some people in neurology like clinic the best and hate hospital care. Most people don't like their residency clinic so that isn't a good metric. Once you are done with training you'll be able to work entirely from home if you desire. Job prospects in our field are fantastic and unlikely to change soon due to little change in residency graduates per year.

Use the EAP your program certainly has. Things will get better- in PGY2 it was much more interesting work day to day. If you might like procedures do not switch to psychiatry...

 

[DrSatan]

Burn out = depression.

PGY1 can be isolating for sure, especially if you're an introvert. You'll develop camaraderie in PGY2 year with your neurology co-residents. Keep in mind COVID has made it more difficult for people to be social, so in any other year you may have flourished. Take advantage of your time off & do things for yourself. Set reasonable goals for yourself. Don't push yourself too hard & try to just go with the flow if you can. PGY2 will be harder, but likely far more interesting. It'll also feel new which will be both daunting & exciting. Making a career change while you're depressed is not a great idea. Also, it'll only stress you out far more. Definitely seek some sort of help (friends, family, therapist, etc.). You may consider reaching out to your chief or the medicine chiefs for guidance.

Also psychiatry sucks, don't transfer. A neurologist with psychiatric traits (empathy, patience, not autistic) truly goes a long way & the field will be lucky to have you (unless you just wanted to transfer because it's easier rather than interesting, PDs will also be able to see through this ploy).

Best of luck, feel free to PM me if you need.

 

[neglect]

Hi,

I am a long time lurker and this is my first post.

I am in my intern year at a categorical neurology residency.
I don't know whether I am just burned out, or depressed, or both, but I am honestly not excited or looking forward to my actual neurology program.
Every time I hear about how hard the PGY2s have to work, (ie several 24 hours calls during the week), I start to regret my choice in doing this specialty. I keep trying to reason the calls by thinking that all other subspecialties have to work just as hard, like if you were a first year cardiology or GI fellow. I have been able to find some solace in that fact, however I don't even know if I find the field interesting any more,. I guess since I am a very introverted person, and I see all the residents having to present in front of a bunch of neurology attendings absolutely intimidating. 'I thought about doing something more hands on but I don't even know how to even get around to switching specialties. But to be honest, I think I would switch, get tired, and start to wondering whether I should give up and switch fields again. I thought about how the job prospect is probably not going to be that great afterwards, and how I have heard from some of the attendings how outpatient clinic is really tough to do.

I guess I feel like I am in a long dark tunnel and the light at the end of the tunnel is also bleak. I feel like I need to talk to a psychologist/counselor.

Thanks

The beginning of things is a fragile and difficult time. Be kind to yourself and explore your expectations. Neurology isn't medicine without the mess (it is more like medicine without the infinite lists). Your ability to present will greatly increase, and you'll actually become friendly with your mentors, so don't worry about introversion/extroversion scales.

You remind me a ton of myself, not that I had your obvious self-knowledge. During PGY-2 I was despaired, "oh boy, this is it?" At the time, total onslaught from idiotic ER/medicine consults, dumps, nonsense, angry patients/families, just trying to keep my head above water. But all the bad, chaos, nonsense, and idiocy was offset by some of the great attendings, senior residents, and my fellow residents - most of whom turned into my lifelong intimate friends.

Hang in there. Steer your boat where you want to go. In addition to the many other great recommendations, I think taking the initiative to book a lunch with your program director or the current PGY2s to feel them out might be a good move. Obviously: caution on oversharing.

Switch into psychiatry. Many pgy2 openings available

This doesn't follow at all. Having lost interest in neurology doesn't entail one is now interested in psychiatry. One dude who matched at my program no-showed to go into derm!

 

[Yoyomama88]

The beginning of things is a fragile and difficult time. Be kind to yourself and explore your expectations. Neurology isn't medicine without the mess (it is more like medicine without the infinite lists). Your ability to present will greatly increase, and you'll actually become friendly with your mentors, so don't worry about introversion/extroversion scales.

You remind me a ton of myself, not that I had your obvious self-knowledge. During PGY-2 I was despaired, "oh boy, this is it?" At the time, total onslaught from idiotic ER/medicine consults, dumps, nonsense, angry patients/families, just trying to keep my head above water. But all the bad, chaos, nonsense, and idiocy was offset by some of the great attendings, senior residents, and my fellow residents - most of whom turned into my lifelong intimate friends.

Hang in there. Steer your boat where you want to go. In addition to the many other great recommendations, I think taking the initiative to book a lunch with your program director or the current PGY2s to feel them out might be a good move. Obviously: caution on oversharing.



This doesn't follow at all. Having lost interest in neurology doesn't entail one is now interested in psychiatry. One dude who matched at my program no-showed to go into derm!

No you're right it doesn't mean he will like psychiatry. But if he wants to escape the grind that is present in most areas of medicine, psych will be easier from a lifestyle perspective

 

[DrSatan]

No you're right it doesn't mean he will like psychiatry. But if he wants to escape the grind that is present in most areas of medicine, psych will be easier from a lifestyle perspective

Only during residency. You can have a great lifestyle as an outpatient neurologist.

 

[Dr G Oogle]

Not a neurologist but sometimes scroll to see what others are going through. Definitely normal to go through what you’re going through especially during this time where camaraderie is even more attenuated than normal due to COVID and we can’t rely on support systems at will like we used to. I highly recommend a counselor, I started with one this year and it has been immensely helpful just to unload all your thoughts on them. I also felt like you did during residency and then switched into obgyn and felt kinda the same way, but also after i switched I met my GF (now wife) and developed a close circle of friends so my improvement probably had more to do with my social situation improving and odds are I would have been just as happy in my original specialty. I am also an introvert and presenting to people is my definition of a nightmare, even now when I have to give talks a few times a month I kick myself for agreeing to do it because I hate it so much, but it does get easier the more mastery you get of the material.

TLDR: you’re probably both burn out and depressed, compounded by COVID, get a counselor/therapist just to talk and relieve some of the burden and things do and will get better. Maybe reward yourself with a PS5

 

[neglect]

Only during residency. You can have a great lifestyle as an outpatient neurologist.

And a terrible one as an attending psychiatrist.

If someone feels called to psychiatry, that’s great. Shortages in psychiatry are horrible and real. And doctors can make huge differences for patients.

I just object to the idea that psychiatry is “light neuro” which is silly.

 

[Yoyomama88]

And a terrible one as an attending psychiatrist.

If someone feels called to psychiatry, that’s great. Shortages in psychiatry are horrible and real. And doctors can make huge differences for patients.

I just object to the idea that psychiatry is “light neuro” which is silly.

No doubt both in neuro and psych, stress will be determined by the type of job you will be working. However I do honestly think calling psych "neuro lite" has merit.

The stress of worrying about physical harm to the patient is more frequent in neurology or medical fields than psychiatry. Sure psychiatrists worry about suicide and homicide, but it's not something that most of the time can be really be prevented in an evidence based way. As opposed to missing someone's small SAH etc in neuro where it's on you. You can get away with being less up to date with advances in psychiatry and still practice effectively, but cannot say the same for neuro. Just think you can prioritize other areas of life more easily in psych than neuro. Just my 2 cents.

 

[90sportsfan]

No doubt both in neuro and psych, stress will be determined by the type of job you will be working. However I do honestly think calling psych "neuro lite" has merit.

The stress of worrying about physical harm to the patient is more frequent in neurology or medical fields than psychiatry. Sure psychiatrists worry about suicide and homicide, but it's not something that most of the time can be really be prevented in an evidence based way. As opposed to missing someone's small SAH etc in neuro where it's on you. You can get away with being less up to date with advances in psychiatry and still practice effectively, but cannot say the same for neuro. Just think you can prioritize other areas of life more easily in psych than neuro. Just my 2

No doubt both in neuro and psych, stress will be determined by the type of job you will be working. However I do honestly think calling psych "neuro lite" has merit.

The stress of worrying about physical harm to the patient is more frequent in neurology or medical fields than psychiatry. Sure psychiatrists worry about suicide and homicide, but it's not something that most of the time can be really be prevented in an evidence based way. As opposed to missing someone's small SAH etc in neuro where it's on you. You can get away with being less up to date with advances in psychiatry and still practice effectively, but cannot say the same for neuro. Just think you can prioritize other areas of life more easily in psych than neuro. Just my 2 cents.

In Psychiatry the threat of physical harm is "from" your patients rather than to them. I'm just joking, but that is the stereotype, and some med students just can't see themselves comfortable treating psych patients, although even forensic psychiatrists say it's nothing like you see on TV or in the movies. Also, I've heard psychiatrists are well-trained in how to stay safe and residency rotations in prisons, etc are largely uneventful. But the thought of working with psychiatric patients still freak a lot of people out for fears (largely unfounded but due to what we see in pop-culture).