Considering quitting residency, how does this work?

[GlovesOff]

PGY-1 here. Unhappy, but definitely not depressed. Great life and love everything I do that's outside of the hospital. However, I haven't been enjoying medicine, at all, and really haven't since 3rd year of medical school when the novelty of introducing myself as a student doctor got old. I'm at a great program, great location, #1 spot in the match. Wife and I love where we are. Family and friends are all close by.Super great faculty, staff, fellow residents. Not a person at this program who wouldn't bend over backwards to help a resident out. Couldn't ask for improvements on anything. Problem is, I just don't seem to like medicine.

I've always felt like with improved knowledge base and familiarity, it would start growing on me. The patients, the relationships, the satisfaction that comes with helping people in need, that it would all start to come together. Problem is, I just dislike it more and more each day. With the huge commitment that medicine is, to be happy in medicine, you have to really enjoy it, even love it. I don't think I do. I know it's early and I'm only 9 months in, but the thought of staying in medicine long term makes me feel like I'm not doing what could truly make me happy. My wife feels similar, though she is at the ACP (NP) level.

Now an opportunity has presented itself where my wife and I can assume ownership of an already successful business over the next couple of years that is in a sector that we've always talked about doing, with little risk given the circumstances of the situation and massive room for growth. I've always wanted to do business, but also liked science so my original plan was do both and open my own medical practice. Now the thought of even being in medicine stresses me out, and I think the fact that for 3 years I have not really enjoyed any aspect of this route is a sign for me to bow out before I waste more time.

So all that to ask, what does one do if they want to quit residency? This decision isn't final, and I will definitely be taking at least a couple more months before making anything even remotely resembling a real decision, and talking to lots of people in the meantime about the many details that need to be considered in such a decision. But this is step 1 and I'd like to start getting some information.

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[Naijaba]

PGY-1 here. Unhappy, but definitely not depressed. Great life and love everything I do that's outside of the hospital. However, I haven't been enjoying medicine, at all, and really haven't since 3rd year of medical school when the novelty of introducing myself as a student doctor got old. I'm at a great program, great location, #1 spot in the match. Wife and I love where we are. Family and friends are all close by.Super great faculty, staff, fellow residents. Not a person at this program who wouldn't bend over backwards to help a resident out. Couldn't ask for improvements on anything. Problem is, I just don't seem to like medicine.

I've always felt like with improved knowledge base and familiarity, it would start growing on me. The patients, the relationships, the satisfaction that comes with helping people in need, that it would all start to come together. Problem is, I just dislike it more and more each day. With the huge commitment that medicine is, to be happy in medicine, you have to really enjoy it, even love it. I don't think I do. I know it's early and I'm only 9 months in, but the thought of staying in medicine long term makes me feel like I'm not doing what could truly make me happy. My wife feels similar, though she is at the ACP (NP) level.

Now an opportunity has presented itself where my wife and I can assume ownership of an already successful business over the next couple of years that is in a sector that we've always talked about doing, with little risk given the circumstances of the situation and massive room for growth. I've always wanted to do business, but also liked science so my original plan was do both and open my own medical practice. Now the thought of even being in medicine stresses me out, and I think the fact that for 3 years I have not really enjoyed any aspect of this route is a sign for me to bow out before I waste more time.

So all that to ask, what does one do if they want to quit residency? This decision isn't final, and I will definitely be taking at least a couple more months before making anything even remotely resembling a real decision, and talking to lots of people in the meantime about the many details that need to be considered in such a decision. But this is step 1 and I'd like to start getting some information.

Hi GlovesOff, I worked in industry before medical school so I can provide some perspective. Medicine has an unbeatable combination of job security and salary. If you have any doubts about the viability of your new business complete your independent medical license before you quit. Check out this link out to find out how many years that would take. Under no circumstances would I leave residency without hitting that minimum. There are many jobs for MDs who do not want to practice, but these all require an independent license. Should your business fail, you can you get a non-clinical medical job in business or research.

 

[AdmiralChz]

Interesting story, probably the most important missing information is what field you are in - or at least primary care residency (where intern year directly applies to your future practice) or specialty residency (where your intern year may be completely separate and totally different from your chosen field).

Many interns go through stages like this, especially in Feb-April where you've been doing scut work long enough to be completely over it and there are still several months left so the light isn't exactly at the end of the tunnel yet. Know that next year things will probably get better (in just about all fields, I'd wager) as you start to gain more autonomy and more responsibility for your actions. But that may not be what you are looking for.

And I echo what Naijaba says above - although it can be rough to compare yourself to those in business or other fields with high salary, know your job security is much, MUCH higher than theirs will ever be. They would do anything to have all the protections and easy access to jobs that a board certified physician has.

 

[Crayola227]

You're always always better off doing what it takes for board certification, even to be hired for non-clinical jobs in the future, some require it.

If you leave this residency, the chances you would ever get to come back to any residency ever in the future, are almost zero.

It depends on what field you're in if your intern year can qualify you for an unlimited license to practice as a GP in most states, and I think it matters if you are an IMG. That license is also required for some non-clinical jobs.

My advice is always complete intern year!!!!!!!!

My advice is also 99.99% of the time complete your residency!

Then if you quit after, you will still have a lot of opportunities available to you.

 

[Crayola227]

Getting good work with only an MD is extremely difficult.

Name a job, and I can probably tell you what additional education, degrees, internships, entry level work experience you need to do it, because an MD alone isn't that good for much.

 

[nlax30]

Honestly this is going to be a very personal decision as only you will be able to truly sort our what will ultimately make you happy. If you can figure out what that is (the hard part), then do that.

I agree with the above in that at the VERY least complete intern year, and ideally residency as well if this other business opportunity can hold off for another couple years, or at least your wife take on the business while you are finishing training.

If you do leave to pursue this other opportunity and a couple years down the road realize it wasn't what was going to fulfill you then the chances of getting back into a residency are heavily stacked against you.

 

[GlovesOff]

Thank you all for those replies.

The link states 1 yr for independent license, thank you for posting that.

I am in Family Medicine. US grad.

If I were to quit residency, I don't see myself ever returning to medicine.

The business we are considering assuming ownership of has been established for 20 years, family business (our family) and far removed from the medical world. It has quadrupled in size in the past 3 years, with the owners putting in admittedly little effort because they have no desire to get much larger before retiring.

I will undoubtedly be finishing intern year and taking step 3 before I step away (if that's what I end up doing). I considered the possibility of picking up urgent care shifts to supplement income if needed, though I realize UC shifts may not be an option and I will need to look further into this and am certainly not counting on it. But my wife plans to continues to work as an NP for some time while the transition occurs and our combined income at the start would be > $120k so supplementing the income wouldn't really be necessary anyway.

I think the hardest part about all of this is honestly the reactions I would get. First and foremost from my residency program, which has been unbelievably good to me from the very beginning. I can't begin to explain how supportive my PD, PC, attendings, and upper levels have been for all of us interns. Even the specialists are awesome around here. And the thought of leaving a space in the roster for others to pick up the slack is...troubling. Secondly is the reactions I will get from family and friends who will no doubt repeatedly ask how I can throw away all those years of hard work. I don't know, it doesn't really bother me any, but I guess others might feel differently.

One thing I am concerned about is that I'm not taking Step 3 until late summer. I will have already signed my 2nd year contract by then. Are there any obligations in residency contracts concerning leaving? These are things I've never thought of before...

 

[Crayola227]

I think most have a 30 day notice clause like most jobs, but obviously notice like that can burn bridges....

I don't know, if it were me, I'd finish out the two years, but you're your own person

I say that cuz yeah, job security, and even if you don't come back to clinical medicine, BC is a good thing for employment even for those

 

[NotAProgDirector]

If you're planning on leaving, the professional thing to do is complete your PGY-1 and not sign a PGY-2 contract. You mentioned that your program and PD have treated you well. You should consider doing the same. Giving them adequate notice to find someone new. Sure, no one can stop you from signing a PGY-2 contract and then just bailing. But that's going to leave your colleagues in a bad situation, something you should think about.

 

[nlax30]

What in particular about medicine are you not enjoying? The training aspect? Actual patient interaction/care? EMRs and the required paperwork and data entry?

Since you're in primary care and have this interest in business maybe you should look into doing concierge medicine or a "direct primary care (DPC)" type of practice. If the frustrations with medicine revolve mainly around the rat race to see more patients, spend little time with them, and then spend a bunch of time documenting into a crappy EMR then this may be an option. Plus it may appeal to the business side of you. Beyond many websites, blogs, and podcasts on the subject I'm sure there are some primary care docs on here that could offer their opinion.


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[Gastrapathy]

So, really, you are talking about quiting for the last 24 months of the 84 month path from starting med school to finishing a residency. FP can be very flexible and by working an Urgent Care shift/week, would be a major additional source of income. It's also an incredible back up plan for your family if the business suddenly changes (I know, its impossible for your business to fail but its really just not) provided you've maintained minimal clinical work over time.

Medicine really doesn't have to be a huge commitment in practice and you can try to find something you at least tolerate if you finish residency. Don't discount burnout as the source of your feelings.

I'd try to do both for 2 years. Also, $120k/year isn't as much as you think.

 

[darknecrosforte]

Alternate perspective:
What is "doing business"? Most people who can get through med school have demonstrated character traits that make them terrible at business and finance (ie. pathological altruism, poor understanding of basic economics, poor project management, etc.) which is low-key why "security" is touted as a benefit to pursuing the medical career. If you don't have a high tolerance for risk, failure, and pain (which is somewhat showing right now by your willingness to inherit a "low-risk, turnkey" business) you will get your throat slit by your competition, lawyers, regulators, or clients. What will very likely happen is that you will cause the slow death of the family business over time because you haven't actually developed business skills yet (unless you haven't told us yet about how you have started a business or managed one previously). Don't be so hasty to jump into the deep end of the pool right now. You can always destroy your family business later.

Food for thought here:
First, a statement to meditate on. Then an anesthesiologist asks about doing mergers and acquisitions on private practices. Then a medical student asks if they should just forgo their training since they want to do M&A anyways. Dan tells the student to finish training even though it is years away because when building a Board or seeking financing for leveraged buyouts, life is much, much easier as a physician, even if it is in title only.

Also, you are literally doing what Dan says to the medical student: you're giving some business people, who want to exit, a way out. You think it'll be a rosy transition and that you can scale up, but it's unlikely that you have the skills that could get you to have such a business in the first place and it's unlikely that you have the skills required to scale up. This is just based on probability (yay semi-free markets).

I'd suggest that unless you are very old, you finish your 2-3 years and actually take over ANOTHER business before killing the one your family built with your probably non-existent management skills. OR learn about M&A and use the family business as the initial deal, find other similar businesses to buy, hire a competent CEO/COO and sell off the bundle to a private insurance company, pension fund, or exit via IPO. The fact you mentioned scaling means you don't intend to "run the business" very long, but the steep learning curve and existing training wheels you have will give you no option.

 

[ProfMD]

Don't think of it as quitting with 1 year down and 2 to go. More like 5 down and 2 to go. Also, intern year is the toughest with regards to time commitment.

I worry that you are suffering from he "grass is greener" syndrome. It is normal, particularly during intern year, to look at your mom-medical friends and wonder why you are doing this to yourself.

Personally, I would finish residency. That leaves you with the most options in the future. Because, if you leave there is no coming back.

If you do decide to leave, finish out your R1 contract and don't sign an R2 contract. This is the most professional way to deal with it.

 

[gutonc]

I was wondering when this year's thread would show up. It's a little late this year.

To the OP, I don't have anything to say that hasn't been said above (other than, nothing that's been said above hasn't already been said in the dozens of other threads here which ask the same question). The somewhat unique issue for you is that you have a viable (for now) plan for what to do if/when you bail on medicine. Most people who ask this question figure that McKinsey or Amgen will knock on their door the day after they quit and beg them to come on as a consultant.

I agree that you'd be "best" off by finishing your residency. Nobody likes being an intern...you might like being a physician though.

 

[mcl]

Completely anecdotal and I recognize that you are not my brother, but feel that I should share this personal cautionary tale: My family's business was very successful and expanding. My brother worked in that business as Vice President of Operations (with Dad being President & COO) for most of his adult life. Because he was ensconced in the business and didn't enjoy school, he never took any business courses let alone pursue a business degree (much to Dad's dismay). He simply took over after Dad retired. He ran that business into the ground in less than 10 years, and now is trying to live off $1000 a month.

Finish your residency. Take some business courses before you commit to the career change. Your future self will likely be much happier.

 

[GlovesOff]

I was wondering when this year's thread would show up. It's a little late this year.

I know, I felt a little bad being "that guy" this year. I've actually been a member here at SDN for 11 years and have seen this post every year as well. Never really thought I'd be the one making it though. I appreciate the thoughts. And I appreciate everyone so far that has taken the time to give me their opinions. I take all of them seriously. This is not going to be a rash decision. I will take the next several months to think about it and look at the options and what I ultimately want out of life, and whether the thought of leaving medicine is only transient and will pass after another month or two. The catch is that the owners are wanting to transition out of the business over the next 3 years. I suspect it will take that long to become familiar with the ins and outs of what they do and be as successful when they hang it up. They are very good at what they do and have a lot of knowledge in this business to learn from. It's a business that is centered around what my best skill-set has always been. I'm ok at medicine at my level, but not good. My brain really struggles at times with all of it. I'm not a fast thinker, I need time to mull over things and consider it from all angles, which there is little time for in medicine. I have managed to get by so far (albeit bottom 15% of my class), but I'd be lying if I said that using my strengths with people skills hasn't likely gotten me to where I am today. People say that I will make a great doctor, but it has nothing to do with being good at medicine, it's because I can read people like a book and can connect with anyone. I may not be the best at business yet and it may take years to get there, but I know in the interim the key is to surround myself with people who are, and these people are already in place (including the owners).

Anyway, all that to say, I won't be quitting residency anytime in the next 4-5 months, so I have plenty of time to think about it. I'm a planner. I research everything before I do anything. My wife makes fun of me for it. This situation is no different. Just gathering information. Again, I really appreciate yall taking the time to give me your thoughts.

 

[Gate Closed]

Honestly, if I were you, I would NOT quit residency. It's not even like you are in a long residency program and still need to "suffer" for the next 5 years. Just be patient, complete your 3 years and if you still feel that this is not the right profession for you then go ahead and switch. Simply deleting all your training thus far in order to start competing with more qualified (in business) people, doesn't sound like a good plan to me.

 

[rokshana]

I know, I felt a little bad being "that guy" this year. I've actually been a member here at SDN for 11 years and have seen this post every year as well. Never really thought I'd be the one making it though. I appreciate the thoughts. And I appreciate everyone so far that has taken the time to give me their opinions. I take all of them seriously. This is not going to be a rash decision. I will take the next several months to think about it and look at the options and what I ultimately want out of life, and whether the thought of leaving medicine is only transient and will pass after another month or two. The catch is that the owners are wanting to transition out of the business over the next 3 years. I suspect it will take that long to become familiar with the ins and outs of what they do and be as successful when they hang it up. They are very good at what they do and have a lot of knowledge in this business to learn from. It's a business that is centered around what my best skill-set has always been. I'm ok at medicine at my level, but not good. My brain really struggles at times with all of it. I'm not a fast thinker, I need time to mull over things and consider it from all angles, which there is little time for in medicine. I have managed to get by so far (albeit bottom 15% of my class), but I'd be lying if I said that using my strengths with people skills hasn't likely gotten me to where I am today. People say that I will make a great doctor, but it has nothing to do with being good at medicine, it's because I can read people like a book and can connect with anyone. I may not be the best at business yet and it may take years to get there, but I know in the interim the key is to surround myself with people who are, and these people are already in place (including the owners).

Anyway, all that to say, I won't be quitting residency anytime in the next 4-5 months, so I have plenty of time to think about it. I'm a planner. I research everything before I do anything. My wife makes fun of me for it. This situation is no different. Just gathering information. Again, I really appreciate yall taking the time to give me your thoughts.

ask them if they can wait to transition over in 5 years...that would allow you to finish the residency and have the option to take over the business.