Considering leaving residency. Sincerely need some guidance.

[LearningToFly]

Thank you all in advance for contributing to this thread. So here's my story...


I'm currently starting the 2nd year of a 5 year residency. I've finally decided that clinical medicine is not my cup of tea. There are many reasons for this, but I'm not sure that listing them here will really provide anything productive for my goal of this thread. Suffice it to say that I’m confident I want out. I’m really more curious as to what you think about the current options that I am considering.

From the research that I've done and the contacts that I've spoken to, if I leave residency now, that pretty much guarantees that I won't be able to come back to residency should I want to. Being board certified seems to open more doors than only having a medical license. In this regard, I mean that there are more opportunities in medically related fields i.e. EMR development, sales, finance, etc. Fortunately, or maybe unfortunately, I'm not really interested in any of these fields. My main interest would be to teach, ideally at the college or community college level. At least from the research I've done, it seems like having an MD isn't so much help and you really need a Phd, or at the very least a Master's degree (someone please, please correct me if I'm wrong). This leaves me with teaching high school, something I think I would also enjoy. I taught privately prior to med school and loved it. I'm not sure how much of the bureaucracy of the public school system I'll be able to endure, but I'm not sure if that's something I'll ever be able to figure out until I actually commit to doing it. Either one of these options obviously dramatically lowers my earning potential, but I've done the math and I think I can make it work. I'm not going to be rich, but I'm not going to be poor either and I'm ok with that fact. The other options I've considered are going back into engineering, which is also a previous career of mine, but doing so in more of a medical way such as device design. But unfortunately that seems to require a Master's degree, and honestly I would probably need it because I've been out of practice so long. The last option would be doing research, ideally medically related. But that too seems to require a Masters or Phd, particularly if you want to work in pharma.

So...someone please correct me if I'm wrong, but leaving residency now seems like it only leaves me with the option of teaching. There is the opportunity perhaps in the next 5 years to go back and obtain a Masters, but that currently is not an option. When I think about the situation above, I can't help but feel more than a little anxiety, because I know that once I leave, there are a tremendous number of (well paying) doors that are now closed. It seems to be a very final decision and I think this is true.

My other option would be to cross my fingers and hope that a residency spot opens up for a 3 year program at 1 of 3 schools (this part is entirely due to family obligations). Without saying the residency program that I'm in, I could transfer to a gen peds program and my first 2 years of my current residency would count. With this option, I tough it out and do something that I honestly have no desire to do for 2 years. Doing this would not be because I think I would ever practice clinical medicine again, but because it would provide me with more backup options if for whatever reason teaching didn't work out i.e. I need more money, etc. I don't want to stay in residency any longer than I have to, but I really can't decide if "wasting" another 2 years of my life is something where the pros outweighs the cons. I certainly don't think that taking another 4 years to complete my current residency is worth it, at least to me. I know opinions will vary on this, but staying for another 4 years is not an option for me. It's unfortunate that I've placed myself in the position that I am. As you know, the huge opportunity cost of getting to where I am now will provide little benefit to me if I leave now. I’m at peace with this fact, and I’m just trying to look at the future and make the best decision I can. Anyway you guys can help will be greatly appreciated.


And as an aside, if anyone knows of ways to supplement one’s income on a part time basis with only a medical license would be really helpful. So far I’ve only discovered performing physicals for medicare, which pays $100 per person. If anyone has any other ideas this could really help in my decision making process.


Thank you all so much.

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[Winged Scapula]

I'm going to give you a HUGE piece of advice: please edit your post to include several paragraphs. Right now it appears as a giant block of text that most people are going to pass by.

 

[LearningToFly]

I'm going to give you a HUGE piece of advice: please edit your post to include several paragraphs. Right now it appears as a giant block of text that most people are going to pass by.

Agreed, and changed Thanks.

 

[RadOncDoc21]

I'm going to give you a HUGE piece of advice: please edit your post to include several paragraphs. Right now it appears as a giant block of text that most people are going to pass by.

It still didn't work... Best I could do was 2 sentences in and I skipped to the responses.

I admit I didn't read all of the OP's post but from my experience on this forum you will receive the following advice:

1) Get professional help since there may be some underlying depression.
2) Stick it out for a little longer.
3) Follow your heart.

My answer would be 1, reevaluate yourself and then decide on either 2 or 3.

 

[ThoracicGuy]

Thank you all in advance for contributing to this thread. So here's my story...


I'm currently starting the 2nd year of a 5 year residency. I've finally decided that clinical medicine is not my cup of tea. There are many reasons for this, but I'm not sure that listing them here will really provide anything productive for my goal of this thread. Suffice it to say that I’m confident I want out. I’m really more curious as to what you think about the current options that I am considering.

Deciding that clinical medicine isn't for you is a bit of a big decision after having gone through medical school and intern year. What aspects of clinical medicine do you not like?

From the research that I've done and the contacts that I've spoken to, if I leave residency now, that pretty much guarantees that I won't be able to come back to residency should I want to. Being board certified seems to open more doors than only having a medical license. In this regard, I mean that there are more opportunities in medically related fields i.e. EMR development, sales, finance, etc. Fortunately, or maybe unfortunately, I'm not really interested in any of these fields. My main interest would be to teach, ideally at the college or community college level. At least from the research I've done, it seems like having an MD isn't so much help and you really need a Phd, or at the very least a Master's degree (someone please, please correct me if I'm wrong). This leaves me with teaching high school, something I think I would also enjoy. I taught privately prior to med school and loved it. I'm not sure how much of the bureaucracy of the public school system I'll be able to endure, but I'm not sure if that's something I'll ever be able to figure out until I actually commit to doing it. Either one of these options obviously dramatically lowers my earning potential, but I've done the math and I think I can make it work. I'm not going to be rich, but I'm not going to be poor either and I'm ok with that fact. The other options I've considered are going back into engineering, which is also a previous career of mine, but doing so in more of a medical way such as device design. But unfortunately that seems to require a Master's degree, and honestly I would probably need it because I've been out of practice so long. The last option would be doing research, ideally medically related. But that too seems to require a Masters or Phd, particularly if you want to work in pharma.

If you leave residency, you may have a chance at coming back after a year away, but that is questionable. So yes, you are likely closing the door on medicine if you quit residency. As far as teaching, the bigger question is what is your loan situation. A high school teacher's salary is unlikely to get your loans paid off very easily.

So...someone please correct me if I'm wrong, but leaving residency now seems like it only leaves me with the option of teaching. There is the opportunity perhaps in the next 5 years to go back and obtain a Masters, but that currently is not an option. When I think about the situation above, I can't help but feel more than a little anxiety, because I know that once I leave, there are a tremendous number of (well paying) doors that are now closed. It seems to be a very final decision and I think this is true.

Which is why most people suggest sticking through residency enough to be able to get board certified. You then have far more options available and you can come back to medicine much easier if you realize that you do like it after all.

My other option would be to cross my fingers and hope that a residency spot opens up for a 3 year program at 1 of 3 schools (this part is entirely due to family obligations). Without saying the residency program that I'm in, I could transfer to a gen peds program and my first 2 years of my current residency would count. With this option, I tough it out and do something that I honestly have no desire to do for 2 years. Doing this would not be because I think I would ever practice clinical medicine again, but because it would provide me with more backup options if for whatever reason teaching didn't work out i.e. I need more money, etc. I don't want to stay in residency any longer than I have to, but I really can't decide if "wasting" another 2 years of my life is something where the pros outweighs the cons. I certainly don't think that taking another 4 years to complete my current residency is worth it, at least to me. I know opinions will vary on this, but staying for another 4 years is not an option for me. It's unfortunate that I've placed myself in the position that I am. As you know, the huge opportunity cost of getting to where I am now will provide little benefit to me if I leave now. I’m at peace with this fact, and I’m just trying to look at the future and make the best decision I can. Anyway you guys can help will be greatly appreciated.

I'm assuming you are in a EM/Peds program. With Peds being 3 years total, would you be able to use two years of your current training plus one more year in peds to be able to be done? If so, go anywhere. You can do it for one year. Limiting yourself to 3 locations in your situation makes a difficult situation much harder.

People that say they want to quit residency, from what I've seen on here, is usually due to things outside of medicine - they don't like the location, family pressures, depression, etc. Before you quit what you have, you need to really figure out why you are wanting this and if that is a rational course to take. Talk with some trusted friends/mentors that are outside your own family. Get some other perspectives on your decision.

And as an aside, if anyone knows of ways to supplement one’s income on a part time basis with only a medical license would be really helpful. So far I’ve only discovered performing physicals for medicare, which pays $100 per person. If anyone has any other ideas this could really help in my decision making process.

No, that's probably about the extent of what you might be able to do...

 

[Mad Jack]

You can teach at community colleges in my area, and likely elsewhere as well. We've got a couple podiatrists that teach A+P (they were my professors back in the day, actually), if they can do it an MD certainly could as well. Also, there were two pulmonologists that taught my cardiopulmonary A+P courses in RT school. While the MD is not a research doctorate, it is still a doctorate degree and should allow you to teach in positions that require a nonspecific master's degree. The pay is pretty awful and it would be a fight to get out of adjunct status though, hence why both the pods and the docs did it more as a way of giving back in their off time than a way to pay the bills.

 

[NotAProgDirector]

First advice is to be sure you're really unhappy with clinical medicine. Have you considered Pathology? PM&R?

A medical degree + residency is required to practice medicine. You mention above that you "must" have other degrees (Masters) to do other jobs -- which isn't strictly true. Much of the other careers you've laid out are more about connections than about degrees. You're going to have to "work the system" to make those other careers happen. It's not clear that a residency really helps you in Pharma, or EMR's, etc.

 

[rokshana]

you could teach at a CC with the MD degree…but you probably need to have some teaching experience to get a spot….you could look for a adjunct position teaching a class or two, but of course that doesn't pay much since you get paid based on the number of credits you teach.

have you though about looking into what research is available at your program? you can do research with just the MD, but again you need to have some experience…you may be able to incorporate some research into your current residency (do research months for electives for example).

if you are in a combined program is there a way that you can switch to one or the other and do just the 3 years…and in the mean time do some things that could take you out of clinical medicine or you may find that you like it outside of intern year.

 

[Serous Demilune]

I'm assuming you are in a EM/Peds program.

I think child neurology also might fit the bill.

 

[LearningToFly]

Thanks guys for all the responses so far. I'll try to do my best to address all the topics that were brought up.

RadOncDoc - #1 is checked off. The same feeling I have now is the same feeling I had about 2 or 3 months into the 3rd year of residency. Professional help is in place That's not really the issue. Am I burned out? Yes, I think by every definition of the word, I am. Am I depressed with my current situation. Yeah, probably. But I've taken a long time to really try to separate all the emotions and generally unhappy feelings that go along with residency and put those aside. I've tried very hard to look at attendings and private docs and imagine myself living that life, and that's where I run into a big problem. I think at the very least I would be unhappy with my career, but I think my dissatisfaction would be so strong that it couldn't help but overflow into other areas of my life i.e. my family. I think my biggest problem is that I don't enjoy, and my skill set is not truly suited, for clinical medicine i.e. taking symptoms and turning them into differentials. I love interacting with people. That's not the issue. I just miss dealing with basic science on a detailed level and on a regular basis. Can that happen as a physician. Sure. But I feel it is the exception, not the rule. That's not really the role of a physician. Understand basic science, sure. Be intimately involved with the details and use of it regularly, no. I made a misguided career decision and I think it really boils down to that.

ThoracicGuy- There is no question that many of the things you mentioned have factored into my desire to leave clinical medicine. I am in a location I don't like. I am separated from my family. Those are definitely factors in my decision. But they aren't the primary drivers. The feelings I described above started well before any family, location, program, etc. issues. I certainly think having these factors in play have exacerbated the problem, and perhaps made them more real. I think because of these problems it has forced me to do deal with these feelings that I've had, rather than do what I've been doing, which I would equate to burying my head in the sand and just expecting that it's going to get better. When I was in 3rd year of med school I remember thinking to myself, "If I can only get out of med school and out of this city I'm living in, then it will get better." But residency has just served to intensify my initial feelings. And now I'm left with the same exact decision. Do I tough it out for another 4 years just to realize what I've known for 3 years now? I don't know, but at the moment it just doesn't seem to make too much sense to me.

I have completed 1 year of residency. I could stay where I'm at for another year. This would get me 2 years that would be transferable to a 3 year program (right now I'm in a combined program and it is 5 years), in which I would then need to do one year there. I know I'm being a little vague here, but that's on purpose. So in this scenario I would have to put in two more years. I've thought about this a lot, because I feel it's the best option to still leave jobs on the table that you need a residency for. But at the very best, this seems like a backup plan. One with a very huge opportunity cost. I don't intend to reenter clinical medicine. And as I and others have stated, board certification really doesn't get you a lot in terms of teaching, research, or engineering. The way I see things, it would be there purely as a financial backup plan, which certainly isn't the worst thing in the world. I just don't know if the sacrifice of doing this is worth it for a backup plan, and one that I wouldn't really enjoy at that i.e. clinical medicine.

As far as the debt goes, I have a ton, but I'm honestly not worried. I'm doing pay as you earn and the public service loan forgiveness program so it's only 10% of my gross income minus poverty level for the next 10 years. Can congress defund both of these programs and essentially shut them down. Absolutely. Is it likely, probably not. But certainly if it did happen I would be screwed. But honestly, my current field is "fairly" low paying in comparison to others. So even practicing clinical medicine, if these programs were canceled 7 or 8 years from now, I would still be in a very bad situation. Because I'm sure as you know, your payments either don't cover the interest or barely cover the interest. So if it gets canceled, either way it would become impossible to pay them off. That's the risk of these programs. I don't really like it. But with my amount of debt ($315K accruing interest), there's not much of an alternative, at least as I see it. Barring I don't start a reality TV show or get a whole lot better at playing basketball. So, I'm not super stressed about this. If the programs are canceled, then yeah, I'm in a pretty bad spot.

aProgDirector - I could be wrong, but I've done a fair amount of research online, I've spoken with a physician career coach, and I've spoken with some contacts in engineering and research. And by a fair amount of internet research, I mean I've literally read every single thread on this forum and others like MomMD over the past 9-10 months regarding leaving medicine and alternate career paths. I feel like I've truly exhausted the internet on this subject, and hence why I'm posting this. The conclusion that I've come to is that you do need some type of advanced degree for the above stated careers. If I was not so far removed from engineering (almost 10 years), I think it would be easy to get back in with out any further education. But I think at the 10 year mark people really start to doubt your skills, and honestly I doubt my engineering skills as well.

I don't have a research background, at all. And this again, at least from the people I've spoken with, seems like you need an advanced degree to get into the field. If I'm wrong about this or anyone could share specific details with me, please shoot me a PM. I'm all ears for opportunities that may be possible that I've ruled out in my head.

And then there's teaching. I don't have many contacts in the basic sciences at CCs or universities, so much of what I've said has come from online research. I know a couple of people mentioned that they knew some MDs that taught at a CC. Maybe that's possible and I've ruled that out too soon. If anyone could give more specifics on this I would certainly appreciate it.


I hope this helps address everyone's questions and concerns. If more come up I'll try to answer them as timely as I can. Thanks again for your help.

 

[deleted480308]

An MD can certainly teach. But let me be your friend for a second. If you have done so little evaluation of eduction as a career that you think an MD needs more degrees to teach, you haven't looked enough into the current adjunct crisis facing those hoping to be professors to quit a residency for education.

Be very careful about this decision, remember that life as an attending will be very different from residency

 

[LearningToFly]

I've actually done quite a bit of research actually. That has been the focus of most of my free time over the past year-ish. Can you please expand on your comment in a way that will be productive for me and those in similar situations.

 

[Shikima]

Have you thought about writing your GRE and getting your PhD?

 

[DreamLover]

Speaking from some experience.

I got my MS after my BS and taught at a community college on a year to year contract for two years (A&P in the nursing program) as well as other anatomy classes at another University in town.

I taught year round: 3 sections A&P + labs ......I liked the teaching....for me it got mundane (maybe it was the topic-anatomy never does change much)

Sure it was pretty low stress but it was even lower pay. I made more at my third job, bartending on Fri and Sat nights. Without juggling all those jobs, I could not pay my rent and bills and student loan payments...that I was trying to defer like mad. It was a constant paycheck to paycheck deal and the pay for teaching has not improved but the cost of living has gone up and your student loan debt is 10X what mine was at that time. (Its enormous now though, so don't feel bad)

After teaching for a year, I decided I couldn't make a good living doing what I was doing and it was always going to be a struggle. Sure I could stick out the CC and maybe get hired full time and get some sort of benefits...MAYBE....but I was NEVER going to be able to pay my bills and live the way I wanted. Thus....I went back to school.

I spent the next year teaching and applying for medical school. That, for me, was the hard part. Medical School and Residency kicked my butt, but now that I am out and into a job that I really love and jumped the current hurdles (board certifications etc), it was totally worth the sacrifice.

Fast forward to now and I am SO happy I went back and sacrificed and have a much more stable future for myself. Granted, we are different because I like what I do clinically. That is not saying I like all aspects or all fields because I don't, but I am lucky to like anesthesiology.

You've amassed a massive amount of debt and and dedicated years of your life at this point, so I know you will not take this decision lightly, but speaking from the CC teaching aspect...I would in no way give up what you have now, with that as your goal. Make sure you have something concrete and dependable....you need to feed yourself and pay your bills.

The grass is not always greener. I wish you luck in your decision.

 

[HighPriest]

There's always medical consulting as well. Sorry if that's been mentioned, but I got tired of reading these long posts. I know two people who left their residencies at various times and started working for consulting firms (both in D.C.). Both of these characters had only the M.D., and both are doing fairly well for themselves and are happy (one about three years out, and one around a year)

I'm not talking about giving patient's or other physicians medical advice, BTW, I'm talking about consulting hospital administrators on logistics, practice improvement, and what not.

Here's where one of them ended up:

http://www.mckinsey.com/

 

[QofQuimica]

Have you thought about applying to Preventive/Occupational Medicine? You've already done an intern year, so you'd only need two more years to be BE in PM/OM, neither of which would be clinical, and you could then take their boards and at least be BC in something. Might be worth looking into if you haven't already.

If you're not interested in PM/OM, then I agree that trying to switch into peds and sucking it up for two more years is the best plan in terms of giving you the most options for your career and being able to repay your loans. That's basically analogous to what I wound up doing (but it was a fellowship I wound up not doing instead of a second residency).

The other thing I'd point out is that intern year is by far the suckiest part of medical training for most people. You do a lot of scut, you don't know much yet, and you work the most hours. PGY3 in particular is a lot more tolerable, especially if you have elective time and/or your program front-loads a lot of the harder rotations like mine did. So the good news is that, while you probably still won't love your last two years of residency (I didn't either), they probably will be a bit less painful than your intern year was.

 

[cognitus]

Thank you all in advance for contributing to this thread. So here's my story...


I'm currently starting the 2nd year of a 5 year residency. I've finally decided that clinical medicine is not my cup of tea. There are many reasons for this, but I'm not sure that listing them here will really provide anything productive for my goal of this thread. Suffice it to say that I’m confident I want out. I’m really more curious as to what you think about the current options that I am considering.

From the research that I've done and the contacts that I've spoken to, if I leave residency now, that pretty much guarantees that I won't be able to come back to residency should I want to. Being board certified seems to open more doors than only having a medical license. In this regard, I mean that there are more opportunities in medically related fields i.e. EMR development, sales, finance, etc. Fortunately, or maybe unfortunately, I'm not really interested in any of these fields. My main interest would be to teach, ideally at the college or community college level. At least from the research I've done, it seems like having an MD isn't so much help and you really need a Phd, or at the very least a Master's degree (someone please, please correct me if I'm wrong). This leaves me with teaching high school, something I think I would also enjoy. I taught privately prior to med school and loved it. I'm not sure how much of the bureaucracy of the public school system I'll be able to endure, but I'm not sure if that's something I'll ever be able to figure out until I actually commit to doing it. Either one of these options obviously dramatically lowers my earning potential, but I've done the math and I think I can make it work. I'm not going to be rich, but I'm not going to be poor either and I'm ok with that fact. The other options I've considered are going back into engineering, which is also a previous career of mine, but doing so in more of a medical way such as device design. But unfortunately that seems to require a Master's degree, and honestly I would probably need it because I've been out of practice so long. The last option would be doing research, ideally medically related. But that too seems to require a Masters or Phd, particularly if you want to work in pharma.

So...someone please correct me if I'm wrong, but leaving residency now seems like it only leaves me with the option of teaching. There is the opportunity perhaps in the next 5 years to go back and obtain a Masters, but that currently is not an option. When I think about the situation above, I can't help but feel more than a little anxiety, because I know that once I leave, there are a tremendous number of (well paying) doors that are now closed. It seems to be a very final decision and I think this is true.

My other option would be to cross my fingers and hope that a residency spot opens up for a 3 year program at 1 of 3 schools (this part is entirely due to family obligations). Without saying the residency program that I'm in, I could transfer to a gen peds program and my first 2 years of my current residency would count. With this option, I tough it out and do something that I honestly have no desire to do for 2 years. Doing this would not be because I think I would ever practice clinical medicine again, but because it would provide me with more backup options if for whatever reason teaching didn't work out i.e. I need more money, etc. I don't want to stay in residency any longer than I have to, but I really can't decide if "wasting" another 2 years of my life is something where the pros outweighs the cons. I certainly don't think that taking another 4 years to complete my current residency is worth it, at least to me. I know opinions will vary on this, but staying for another 4 years is not an option for me. It's unfortunate that I've placed myself in the position that I am. As you know, the huge opportunity cost of getting to where I am now will provide little benefit to me if I leave now. I’m at peace with this fact, and I’m just trying to look at the future and make the best decision I can. Anyway you guys can help will be greatly appreciated.


And as an aside, if anyone knows of ways to supplement one’s income on a part time basis with only a medical license would be really helpful. So far I’ve only discovered performing physicals for medicare, which pays $100 per person. If anyone has any other ideas this could really help in my decision making process.


Thank you all so much.

You may want to consider finance clubs. You should join the Drop Out Club (DOC) for MDs just as jaded as you. Go to www.dropoutclub.org. You'll have access to higher paying jobs where your MD knowledge can help if you can actually get one.

 

[rokshana]

or have you thought about switching to a more non clinical residency? pathology utilizes a lot of basic science, radiology?

 

[LearningToFly]

HighPriest - That's actually something that I haven't really come across yet. I'll look into it.

In regards to other residencies mentioned above. Yeah, I've pretty much thought through them all. I really tried to make myself like path or rads during medschool, but there were parts of it that just didn't fit. I just don't do well with visual objects.

DreamLover - Thanks for the feedback. I realize teaching at anything other than the middle/high school level is pretty unrealistic financially (assuming no PhD to teach at the university level). I thought it wouldn't hurt to throw it out here again for feedback. Yours confirms that, so thanks.

Anyone have any part time ideas with only a license. The only thing I've found so far is what I mentioned in my initial thread about doing medicare physicals for $100 a piece. The only problem is the one company I can find that does this, Censeo, doesn't operate in my state. So this would require travel. Still doable, just not ideal. Any other ideas?

Thanks again guys. Really appreciate the feedback.

 

[TexasPhysician]

Really consider finishing a residency. Any residency. Board eligibility opens many doors. Push through any program and then you can pick and choose anything your whole life without worry.

Consulting involves extensive travel and the top forms want people from pedigree firms. People burn out fast in consulting as well.

 

[DreamLover]

Really consider finishing a residency. Any residency. Board eligibility opens many doors. Push through any program and then you can pick and choose anything your whole life without worry.

Consulting involves extensive travel and the top forms want people from pedigree firms. People burn out fast in consulting as well.

I'm in agreement with this. I'd power through and maybe even consider starting an MPH degree at your current institution or online etc to see if you can make it work.

Ideally, you could finish residency and the MPH together and get into health policy and/or management.

Being Board eligible is a pretty big deal and you're so much closer than you feel you are. I've been there. Good luck again.

 

[shopsteward]

If you have read all the threads on SDN on careers for those leaving medicine, you should be pretty clear that not completing residency (which a number of posters have had forced on them rather than choosing) usually leads to debt and regret rather than financial security and career satisfaction.

You've been an engineer. You've been a teacher. You are currently a doctor in clinical medicine and not liking it much, so you are thinking of going back to one or other of the careers you disliked so much when you were doing them that you went to the time, trouble and expense of going to med school to get away from them. I suspect that you whatever you are looking for in life is something that you are not going to get from any professional job.

I think you should say to yourself:
*I need to work to pay my way on this planet.
*I'm not going to love my job whatever it is, so I just need a job I can live with while I'm paying my debts.
*The only job that will enable me to pay my debts is being a Board Certified Doctor, and I'm only 2 years away from that, so that is what I will settle on doing.
*I will get my satisfaction in life from the things I do outside my job, and once I have paid my debts I will go and do them full time.

Good luck.

 

[LearningToFly]

I'm not sure this really changes your opinion much shopsteward, but I was actually never a paid teacher. I just taught a few classes at a nonprofit and I tutored GED students during med school. So considering teaching is not really going back to a career I had, and it's certainly not one that I didn't like. I love teaching. That's why I tutored in med school. That was my release valve, as crazy as that may sound. I hear what your saying about jumping careers in search of happiness. That's a valid point. I honestly don't really think that my goal is to be happy, with my career at least. I would say it's more to not be miserable and do something productive for society. To be satisfied maybe.

And again, I don't really think the debt is a perfectly valid point for reasons I stated above. Please prove me wrong if I'm missing something. I don't believe that being a physician is the only way to pay my bills, otherwise I wouldn't be looking into this at all.

Thanks guys.

 

[deleted480308]

Finish residency and take a faculty/admim job at a medical school?

 

[shopsteward]

I'm not sure this really changes your opinion much shopsteward, but I was actually never a paid teacher. I just taught a few classes at a nonprofit and I tutored GED students during med school. So considering teaching is not really going back to a career I had, and it's certainly not one that I didn't like. I love teaching. That's why I tutored in med school. That was my release valve, as crazy as that may sound.

OK, you love teaching and you are the next Jaime Escalante. Just a warning: the sort of teaching of which you have done a very little is not at all the same as the year-round grind and discipline problems of a large class in a Title 1 school, and you could be earning as little as 10% of what you would as a doctor (for instance, your chances of ever owning your own home and/or retiring before age 65 might be low in significant areas of the USA).

And again, I don't really think the debt is a perfectly valid point for reasons I stated above. Please prove me wrong if I'm missing something. I don't believe that being a physician is the only way to pay my bills, otherwise I wouldn't be looking into this at all.

You need to check teacher eligibility for PSLF pretty carefully before you commit yourself to that route, and be as sure as you can be that it will apply to all your student loan debt and to the sorts of teaching jobs you are likely to want, get and stay in until the debt is resolved. I would be concerned that a switch out of medicine now which leaves you with unpayable medicine-sized debts could make you unhappier in the long run than just a few more years in medicine. But if you have found a route out of medicine which works for you, better that than staying and being miserable.

 

[LearningToFly]

Finish residency and take a faculty/admim job at a medical school?

That would be ideal honestly. From what I've read and those that I've talked to at my previous med school, it seems like the way 99.9% of people that get into true teaching roles is through a PhD. Are there MDs at med schools, obviously. But at least where I was at and from what I've heard they're more in clinical roles i.e clinical skills type things. It seems pretty difficult to land a gig at med school teaching, at least from what I can find out so far.

 

[LearningToFly]

OK, you love teaching and you are the next Jaime Escalante. Just a warning: the sort of teaching of which you have done a very little is not at all the same as the year-round grind and discipline problems of a large class in a Title 1 school, and you could be earning as little as 10% of what you would as a doctor (for instance, your chances of ever owning your own home and/or retiring before age 65 might be low in significant areas of the USA).



You need to check teacher eligibility for PSLF pretty carefully before you commit yourself to that route, and be as sure as you can be that it will apply to all your student loan debt and to the sorts of teaching jobs you are likely to want, get and stay in until the debt is resolved. I would be concerned that a switch out of medicine now which leaves you with unpayable medicine-sized debts could make you unhappier in the long run than just a few more years in medicine. But if you have found a route out of medicine which works for you, better that than staying and being miserable.

I agree. Teaching HS is not going to be like the teaching I've done in my past. Exactly what it would be like, I think it's impossible to know. Certainly there's a lot of paperwork and bureaucracy that teachers seem to loathe, at least the ones I've spoken to. Is there a chance that I will dislike/hate that part, most likely yes. I don't think it would be a "perfect" job where everything is rosy all the time. It just seems like something I would generally like to do, and worst case, I wouldn't be stressed out all the damn time. Or at least not near as much. I would have more time with my family. More involved with my kids. These are all the positives.

The negatives are exactly what you said. I would start out making $43K plus maybe another $5-%10K in tutoring. Maybe $50K. My wife makes $50K ish in a stable and flexible job so we would be at $100K total. Is that less then if I continue as a physician, yes. It's about a 1/4 of what I would make, although I would most likely be working fewer hours. Honestly, though, finances are my biggest concern and this is probably the last big hurdle for me to cross in my mind before I would decide to jump ship. 100K is fine, but it is going to be difficult to plan for retirement, etc. I think it's doable, it's just going to be very hard. I'm trying to determine to the best of my ability if me being happier and having more time with my family is worth the financial sacrifice. Both affect my family and myself. This is a tough one for me.

 

[gutonc]

The negatives are exactly what you said. I would start out making $43K plus maybe another $5-%10K in tutoring. Maybe $50K. My wife makes $50K ish in a stable and flexible job so we would be at $100K total. Is that less then if I continue as a physician, yes. It's about a 1/4 of what I would make, although I would most likely be working fewer hours. Honestly, though, finances are my biggest concern and this is probably the last big hurdle for me to cross in my mind before I would decide to jump ship. 100K is fine, but it is going to be difficult to plan for retirement, etc. I think it's doable, it's just going to be very hard. I'm trying to determine to the best of my ability if me being happier and having more time with my family is worth the financial sacrifice. Both affect my family and myself. This is a tough one for me.

Look...residency is rough from a time perspective. But it's a time limited issue and the pay during that period is 10-25% better than you're looking at as your top income possibility teaching. FWIW, the teachers I know, while they get 2+ months off each year, work 50-60 hours a week the rest of the time.

You talk a lot about time with family, which is important to some people (like you and me) but not others. My daughter was born at the end of my intern year and, while I did my best, my parental involvement was pretty small during her first 2 years. But then things got better in my training and I was able to be the one to pick her up from daycare/school most days for the last 3 years of my training. I now have a 3/4 time job in my chosen sub-specialty where I work 3 days/wk (~30h in the clinic) with an income (salary+bonus structure) pushing $250K in a desirable area where salaries are generally lower than many other places (I could move 2 or 3 hours away and bump that salary by 50K without working any harder). I'm not going to get rich doing this but I've got plenty of money to do all the things I want and need to do and I've got 2 full weekdays off each week to live my life.

TL;DR - Finish a residency, get a job as a physician, even PT or locums, make more money than you need (and much more than you'll make as a teacher).

 

[Substance]

Don't quit.

Play the long game.

If you quit now, you'll be living paycheck to paycheck, and I guarantee you will regret it.

If you slog through it, and it will be a slog, you can work for a substantially higher income for a few years, save it up, and exeunt as soon as you can. Then you can go teach at any and all community colleges without worrying about how to pay the bills.

Stick with it. You can hate your job, sure, but if you leave you will hate your life.

 

[TexasPhysician]

That would be ideal honestly. From what I've read and those that I've talked to at my previous med school, it seems like the way 99.9% of people that get into true teaching roles is through a PhD. Are there MDs at med schools, obviously. But at least where I was at and from what I've heard they're more in clinical roles i.e clinical skills type things. It seems pretty difficult to land a gig at med school teaching, at least from what I can find out so far.

Not true. There are plenty of academic jobs with less clinical time. A lot could be supervising and teach residents, pa students, research, admin, lectures, organizing clerkships/residencies, etc.

My program has multiple faculty with only 2 half-days of straight clinic/week. You probably want this to keep your skills up anyway. Even if you find those 8 hours unpleasant, show me a job without 8 hours of unpleasant activities. Teachers have to sit and grade dozens of tests. Scuba guides clean equipment, etc.

 

[rokshana]

locums…that's an idea…you can work a week a month, make 10K and keep around half after taxes…you would be making 120k gross and have 3 weeks free to do whatever you wanted….

 

[gutonc]

Not true. There are plenty of academic jobs with less clinical time. A lot could be supervising and teach residents, pa students, research, admin, lectures, organizing clerkships/residencies, etc.

My program has multiple faculty with only 2 half-days of straight clinic/week. You probably want this to keep your skills up anyway. Even if you find those 8 hours unpleasant, show me a job without 8 hours of unpleasant activities. Teachers have to sit and grade dozens of tests. Scuba guides clean equipment, etc.

The issue here is that the OP doesn't even want to finish a residency so would not have any clinical duties and would only basically be a lecturer rather than any of the things that an MD typically does at a med school.

But this did make me think that perhaps teaching at a PA school would be a good approach. There are plenty of those in places without associated med schools.

 

[LearningToFly]

Hmm...interesting thought about the PA schools? Anyone happen to know anything more about this? I wonder if you would run into the same problems with CCs I.e. Low pay, no benefits,etc. Good idea though. Something I haven't thought about. I'll try to do some digging when I get a chance. Thanks.

 

[ratherbefishing]

Not sure why you couldn't teach at college level. There are many subjects that a MD would be as suited or more suited to teach (saying this as an MD-PhD). Also, consulting is an option. You could "teach" your clients for big bucks. I've also heard that some private tutors for kids with well-off parents can do quite well (there is a NYTimes article about this in the Hamptons).

 

[Igor4sugry]

**If you have student loan debt the answer is: you need to finish residency, otherwise you will live in poverty into your 60s/70s.

I think you should look at things in a practical manner. I think you are making a quick decision as 1st year of residency is tough. Also, you were doing engineering before, switched to medicine, now you want to switch into teaching. Not clear what makes you uncomfortable.

Also, just to let you know you are in the "grass is greaner on the other side" situation. You hope that teaching in a public school or a college will be more enjoyable. I suggest reading about current environment in uniersities which are basically run by hoards of adjunct professors who live at poverty level, have no benefits, and must reapply for their jobs every 6months. Thats likely what you will face (read bellow) Teaching in high school will be even more painful. Do you know how far 50-60k/year gets you?
Why not finish your residency; work part-time 3days per week and make your $100+k/year. Find things outside of work to enjoy, friends, hobby, have a family, kids, etc.

Be more practical, its not all about liking your job.

http://www.pbs.org/newshour/bb/is-academia-suffering-adjunctivitis/
http://www.salon.com/2012/04/04/the_disposable_professor_crisis/

 

[LearningToFly]

I know this thread is dying out, but I just wanted to say thanks to all that contributed. Feel free to keep posting if anyone has any more thoughts though

 

[becomingamd]

I know this thread is dying out, but I just wanted to say thanks to all that contributed. Feel free to keep posting if anyone has any more thoughts though

What did you end up doing? just finished 4th year, started residency a couple days ago, not even close to burnt out...I'm realizing that I didn't miss clinical rotations. I enjoying being there for my patients on their worst day but it ends there.

 

[Perrotfish]

I loathed residency, and by the end of Intern year I had developed very negative feelings about medicine in general. Now, as an attending, I really like my job. Residency is to a medical career what a transatlantic flight is to a European vacation.

 

[Free2BMe]

Posting under an alias as I have been a member here since 2006.

I quit residency this year. Primary care. Had underlying doubts about medicine starting in third year. Kept pushing myself to continue. People kept saying it was going to get better. 4th year sucked even worse, even though it was great in most aspects. Matched at my number one program and had completed intern year and most of second year with the most amazing faculty and co-residents I could have asked for before calling it quits. I have no taste for medicine. Every day was a drag, and I hated what I was doing. My interests and skills lay elsewhere. I am now doing a job that I love. Yes, I have a buttload of student debt that I doubt I will ever pay off unless my new career allows for (which it very well could). That's kind of a downer, but I'll just hope the REPAYE loan program is never terminated in the meantime. But otherwise, I had no idea this level of happiness was possible, and I had no idea of how truly depressed I was being a doctor.

You have one life. Do what makes you happy.

 

[Goro]

Th

What did you end up doing? just finished 4th year, started residency a couple days ago, not even close to burnt out...I'm realizing that I didn't miss clinical rotations. I enjoying being there for my patients on their worst day but it ends there.

OP was last seen here in 2014

 

[twospadz]

Currently a second year resident. I really hated medicine. I hated medical school, was depressed, and overall felt like a drag. I would constantly think of different ways I could get out all the time. But I dug deep and realized something. Medicine was just a scapegoat for my true underlying issue. Which was I had no passion in life. I did not have things that I really looked forward to or made me happy. There was nothing that pushed me to look over the horizon. Since then, Ive found my passion: traveling around the world. Ive been to amazing places, met amazing people, dated amazing foreign women and have had a blast. This is what motivates me to keep pushing and working in my career. But traveling cost money too. So the good things in my life like traveling now outweighs the bad (medicine). You need to find the thing that gets you excited. Even Kobe bryant said "Don't rely on basketball for your happiness, because its not gonna happen." Translation: your career won't bring you happiness. Find the things that will outside of your job. Its obvious you are jumping careers looking for happiness but realize none of them will truly bring you satisfaction.

 

[Free2BMe]

Find the things that will outside of your job. Its obvious you are jumping careers looking for happiness but realize none of them will truly bring you satisfaction.

I strongly disagree with this. A job can absolutely make your life miserable. This is especially true in medicine. It is way too demanding for someone who doesn't like it to still be happy just because they fun hobbies outside of work. This is probably one of the reasons physicians have the highest suicide rate of any profession, they hate their job but they are trapped by debt and feeling they can't leave because they worked too hard to get there/family expectations/lifestyle demands/etc. I had a ton of fun hobbies I did outside of work. That didn't change how miserable I felt because I knew come the next day, I would be going back to the job. Changing careers for me made all the difference. I love what I do, and I love my life.

 

[mvenus929]

Currently a second year resident.

Then why does your status say 'Attending Physician'?

 

[AI2015apps]

If you have read all the threads on SDN on careers for those leaving medicine, you should be pretty clear that not completing residency (which a number of posters have had forced on them rather than choosing) usually leads to debt and regret rather than financial security and career satisfaction.

You've been an engineer. You've been a teacher. You are currently a doctor in clinical medicine and not liking it much, so you are thinking of going back to one or other of the careers you disliked so much when you were doing them that you went to the time, trouble and expense of going to med school to get away from them. I suspect that you whatever you are looking for in life is something that you are not going to get from any professional job.

I think you should say to yourself:
*I need to work to pay my way on this planet.
*I'm not going to love my job whatever it is, so I just need a job I can live with while I'm paying my debts.
*The only job that will enable me to pay my debts is being a Board Certified Doctor, and I'm only 2 years away from that, so that is what I will settle on doing.
*I will get my satisfaction in life from the things I do outside my job, and once I have paid my debts I will go and do them full time.

Good luck.

By far, the best response.

Most people in this world do not like their jobs. That is OK. You need to get your satisfaction in life from other things besides your job, such as hobbies, friends and families. Are you married or do you have kids? Kids give you a ton of satisfaction, everyday. Anyways, you have to do your job to pay back your bills. And you need to finish your residency.

Also, with Pay as You Earn, I believe it is only eligible if you do make it through residency. In other words, paying 10% of your salary. If you quit residency, I think it goes back to paying the full amount because you are not working in a health shortage area. Correct me if I'm wrong.

 

[deleted480308]

By far, the best response.

Most people in this world do not like their jobs. That is OK. You need to get your satisfaction in life from other things besides your job, such as hobbies, friends and families. Are you married or do you have kids? Kids give you a ton of satisfaction, everyday. Anyways, you have to do your job to pay back your bills. And you need to finish your residency.

Also, with Pay as You Earn, I believe it is only eligible if you do make it through residency. In other words, paying 10% of your salary. If you quit residency, I think it goes back to paying the full amount because you are not working in a health shortage area. Correct me if I'm wrong.

You are incorrect

 

[mvenus929]

Also, with Pay as You Earn, I believe it is only eligible if you do make it through residency. In other words, paying 10% of your salary. If you quit residency, I think it goes back to paying the full amount because you are not working in a health shortage area. Correct me if I'm wrong.

You are incorrect. To elaborate... even those who don't work in healthcare are eligible for PAYE, assuming they meet all the other requirements. As long as OP certifies income every year, they may continue to use PAYE. They just won't be eligible for PSLF if they don't work for a non-profit organization.

 

[AI2015apps]

Finish residency and take a faculty/admim job at a medical school?

You are incorrect. To elaborate... even those who don't work in healthcare are eligible for PAYE, assuming they meet all the other requirements. As long as OP certifies income every year, they may continue to use PAYE. They just won't be eligible for PSLF if they don't work for a non-profit organization.

ok got it. thanks. I get confused between PSLF and PAYE. I'm just paying it off the traditional way.

 

[Redpancreas]

opportunities in medically related fields i.e. EMR development, sales, finance, etc. Fortunately, or maybe unfortunately, I'm not really interested in any of these fields. My main interest would be to teach, ideally at the college or community college level. At least from the research I've done, it seems like having an MD isn't so much help and you really need a Phd, or at the very least a Master's degree (someone please, please correct me if I'm wrong). This leaves me with teaching high school, something I think I would also enjoy. I taught privately prior to med school and loved it. I'm not sure how much of the bureaucracy of the public school system I'll be able to endure, but I'm not sure if that's something I'll ever be able to figure out until I actually commit to doing it. Either one of these options obviously dramatically lowers my earning potential, but I've done the math and I think I can make it work. I'm not going to be rich, but I'm not going to be poor either and I'm ok with that fact. The other options I've considered are going back into engineering, which is also a previous career of mine, but doing so in more of a medical way such as device design. But unfortunately that seems to require a Master's degree, and honestly I would probably need it because I've been out of practice so long. The last option would be doing research, ideally medically related. But that too seems to require a Masters or Phd, particularly if you want to work in pharma.

So...someone please correct me if I'm wrong, but leaving residency now seems like it only leaves me with the option of teaching. There is the opportunity perhaps in the next 5 years to go back and obtain a Masters, but that currently is not an option. When I think about the situation above, I can't help but feel more than a little anxiety, because I know that once I leave, there are a tremendous number of (well paying) doors that are now closed. It seems to be a very final decision and I think this is true.

My other option would be to cross my fingers and hope that a residency spot opens up for a 3 year program at 1 of 3 schools (this part is entirely due to family obligations). Without saying the residency program that I'm in, I could transfer to a gen peds program and my first 2 years of my current residency would count. With this option, I tough it out and do something that I honestly have no desire to do for 2 years. Doing this would not be because I think I would ever practice clinical medicine again, but because it would provide me with more backup options if for whatever reason teaching didn't work out i.e. I need more money, etc. I don't want to stay in residency any longer than I have to, but I really can't decide if "wasting" another 2 years of my life is something where the pros outweighs the cons. I certainly don't think that taking another 4 years to complete my current residency is worth it, at least to me. I know opinions will vary on this, but staying for another 4 years is not an option for me. It's unfortunate that I've placed myself in the position that I am. As you know, the huge opportunity cost of getting to where I am now will provide little benefit to me if I leave now. I’m at peace with this fact, and I’m just trying to look at the future and make the best decision I can. Anyway you guys can help will be greatly appreciated.


And as an aside, if anyone knows of ways to supplement one’s income on a part time basis with only a medical license would be really helpful. So far I’ve only discovered performing physicals for medicare, which pays $100 per person. If anyone has any other ideas this could really help in my decision making process.


Thank you all so much.

Seriously man...the “another options” or “asides” in this are obnoxious. Lots of options does not equal success. In fact, some would say that options and success are inversely correlated. Pick one thing and get it done. This post tells me that you’re not really one to commit to one thing and that while this is going to sound like paternalism, I think you should finish residency at the very least.

 

[Kissmyabjj]

I taught for 2 semesters at a community college. The pay was horrible. What was worse though was the complete apathy of most of students.