I really want to quit, how do I tell my family?

[folgersormh]

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I’m an intern in a 4 year residency and I don’t like medicine in hindsight. I guess in medical school I just drudged through it thinking it’ll get better when I had more autonomy (didn’t need my senior resident to sign every order for senna or Tylenol), got paid, and didn’t have to study all the time. But nope. I actually hate it all.

I don’t like being in the hospital or the ED, I don’t like clinic, I don’t like being primary on patients or being a “consultant.” I don’t like thinking through problems for my patients.

I don’t like the city my program is in. I hate the area and should’ve visited before ranking it. I don’t like my program’s crappy education. I don’t like that it’s basically a community program so no one is available to do crap overnight or on weekends. Our “teaching” attendings are awful, they don’t teach and mistakes are treated like you’re just inherently incompetent.

This one will upset people but I don’t care about patients anymore, at least not their diseases. I have stopped “thinking” and I just report it to my attending or senior, like “their head hurts, no neuro deficits. Maybe Tylenol?” and just let them tell me what to do because I don’t care enough to think more about it. I care about them as humans so I don’t wish to harm them but I know my lack of care will harm them. There are interns and seniors who are like “wow!! What a cool disease process!” but I feel like I’m in acrid gravy every day just getting through, and nothing seems interesting.

I don’t like the responsibility of being a doctor/provider. I don’t like being the person everyone turns to to have an answer or plan.

I want to quit medicine. I’m on a small break right now and I feel worse, not better. I have nothing else lined up but I’d literally rather do anything else. I never should’ve gone to medical school, and I should’ve quit when I realized I wasn’t loving the day-to-day of medicine but I deluded myself. I considered maybe it’s just my program I hate but it’s the actual job of being a doctor. I don’t like the ultimate responsibility and making decisions. I can’t even choose a restaurant to eat at, let alone what to do for my crashing patient. I don’t trust myself with patient care. I’ll be an awful attending.

My family will be so disappointed in me, which is the only thing holding me back. They’re so proud that I’m a doctor. Anytime I complain they shut it down and say “well you have to be a doctor” essentially.

 

[ThoracicGuy]

I’m an intern in a 4 year residency and I don’t like medicine in hindsight. I guess in medical school I just drudged through it thinking it’ll get better when I had more autonomy (didn’t need my senior resident to sign every order for senna or Tylenol), got paid, and didn’t have to study all the time. But nope. I actually hate it all.

I don’t like being in the hospital or the ED, I don’t like clinic, I don’t like being primary on patients or being a “consultant.” I don’t like thinking through problems for my patients.

I don’t like the city my program is in. I hate the area and should’ve visited before ranking it. I don’t like my program’s crappy education. I don’t like that it’s basically a community program so no one is available to do crap overnight or on weekends. Our “teaching” attendings are awful, they don’t teach and mistakes are treated like you’re just inherently incompetent.

This one will upset people but I don’t care about patients anymore, at least not their diseases. I have stopped “thinking” and I just report it to my attending or senior, like “their head hurts, no neuro deficits. Maybe Tylenol?” and just let them tell me what to do because I don’t care enough to think more about it. I care about them as humans so I don’t wish to harm them but I know my lack of care will harm them. There are interns and seniors who are like “wow!! What a cool disease process!” but I feel like I’m in acrid gravy every day just getting through, and nothing seems interesting.

I don’t like the responsibility of being a doctor/provider. I don’t like being the person everyone turns to to have an answer or plan.

I want to quit medicine. I’m on a small break right now and I feel worse, not better. I have nothing else lined up but I’d literally rather do anything else. I never should’ve gone to medical school, and I should’ve quit when I realized I wasn’t loving the day-to-day of medicine but I deluded myself. I considered maybe it’s just my program I hate but it’s the actual job of being a doctor. I don’t like the ultimate responsibility and making decisions. I can’t even choose a restaurant to eat at, let alone what to do for my crashing patient. I don’t trust myself with patient care. I’ll be an awful attending.

My family will be so disappointed in me, which is the only thing holding me back. They’re so proud that I’m a doctor. Anytime I complain they shut it down and say “well you have to be a doctor” essentially.

Sounds like you could benefit from talking with someone.

 

[DarkHorizon]

I personally would stick it out, but if you’re that miserable, you should quit. Your post makes you sound very unhappy.

 

[CopaceticOne]

Hard to distinguish burn-out apathy from true dislike on an anonymous forum. I agree with @ThoracicGuy that you probably should talk in person with someone.

Think back about what the motivating factors were for you to originally apply to med school. Did you have a particular reason / motivation? Were you just on the “med school or bust” train and didn’t really think about if you really wanted it towards the end of undergrad.

I recommend reaching out friends, talk to your PD, utilize the programs mental health services (for their impartial perspective on what you tell them).

The first step was identifying your shift from enjoying the medicine. Now it is time to make sure you understand “the why” so that you can try to identify a good path going forward in the event you do leave the field.

 

[comp1]

I think telling your family you want to quit is very different from telling your family that you are quitting. If your family has any physicians in it, they are going to be very understanding about wanting to quit, less so about quitting. I am not sure there is anyone who doesn't want to quit at some point during intern year. You didn't mention what specialty you are in, but intern year is pretty universally the worst. I definitely second and third you needing to talk someone. It might be family, it might be friends or someone professional. Fantasizing about quitting and focusing on a bunch of negative things is normal for short bursts particularly in intern year, but problematic if it keeps up and it seems like it might be for you. But practically, what are you going to do if you did quit? What would you do in terms of a job that could approach the options in medicine? And there ARE options (if you finish.) What you are doing now is not anything like what attending life is. I guess my biggest concern is that your current mood might be more intrinsic to you than your training program and quitting definitely can't fix that. Also, people expecting you to have answers gets a whole heck of a lot easier (and even fun) when you do actually have those answers. This is part of what makes intern year the worst.

 

[comp1]

I think telling your family you want to quit is very different from telling your family that you are quitting. If your family has any physicians in it, they are going to be very understanding about wanting to quit, less so about quitting. I am not sure there is anyone who doesn't want to quit at some point during intern year. You didn't mention what specialty you are in, but intern year is pretty universally the worst. I definitely second and third you needing to talk someone. It might be family, it might be friends or someone professional. Fantasizing about quitting and focusing on a bunch of negative things is normal for short bursts particularly in intern year, but problematic if it keeps up and it seems like it might be for you. But practically, what are you going to do if you did quit? What would you do in terms of a job that could approach the options in medicine? And there ARE options (if you finish.) What you are doing now is not anything like what attending life is. I guess my biggest concern is that your current mood might be more intrinsic to you than your training program and quitting definitely can't fix that. And people expecting you to have answers is a heck of a lot less troubling when you do have the answers. This is part of what makes intern year the worst.

 

[DrMetal]

I’m an intern in a 4 year residency and I don’t like medicine in hindsight. I guess in medical school I just drudged through it thinking it’ll get better when I had more autonomy (didn’t need my senior resident to sign every order for senna or Tylenol), got paid, and didn’t have to study all the time. But nope. I actually hate it all.

I don’t like being in the hospital or the ED, I don’t like clinic, I don’t like being primary on patients or being a “consultant.” I don’t like thinking through problems for my patients.

I don’t like the city my program is in. I hate the area and should’ve visited before ranking it. I don’t like my program’s crappy education. I don’t like that it’s basically a community program so no one is available to do crap overnight or on weekends. Our “teaching” attendings are awful, they don’t teach and mistakes are treated like you’re just inherently incompetent.

This one will upset people but I don’t care about patients anymore, at least not their diseases. I have stopped “thinking” and I just report it to my attending or senior, like “their head hurts, no neuro deficits. Maybe Tylenol?” and just let them tell me what to do because I don’t care enough to think more about it. I care about them as humans so I don’t wish to harm them but I know my lack of care will harm them. There are interns and seniors who are like “wow!! What a cool disease process!” but I feel like I’m in acrid gravy every day just getting through, and nothing seems interesting.

I don’t like the responsibility of being a doctor/provider. I don’t like being the person everyone turns to to have an answer or plan.

I want to quit medicine. I’m on a small break right now and I feel worse, not better. I have nothing else lined up but I’d literally rather do anything else. I never should’ve gone to medical school, and I should’ve quit when I realized I wasn’t loving the day-to-day of medicine but I deluded myself. I considered maybe it’s just my program I hate but it’s the actual job of being a doctor. I don’t like the ultimate responsibility and making decisions. I can’t even choose a restaurant to eat at, let alone what to do for my crashing patient. I don’t trust myself with patient care. I’ll be an awful attending.

My family will be so disappointed in me, which is the only thing holding me back. They’re so proud that I’m a doctor. Anytime I complain they shut it down and say “well you have to be a doctor” essentially.

How old are you? What's your undergraduate degree in? What would you rather be doing? Do you have a debt, how much?

 

[Smurfette]

It's sounds like you may have some depression issues (not giving medical advice).
Take advantage of whatever mental health services your program offers. Get yourself checked out. Make sure that the desire to quit is not just a mental health issue causing you to spin out a bit. Once you know you've addressed any underlying issues, then see if you still feel the same way about quitting.
Will also add that having a lot of doubt and frustration is normal at this point. You've had a lot of change (new location, new training program, no support system, etc.) in a short period of time. Some people take longer to adjust than others. If you do end up deciding to quit, make sure to do so in a way that doesn't prevent you from returning to medicine later---some people find clarity later on that they really do want to do medicine but weren't in the right place/right field/right mindset at the time. The less bridges you burn, the better.
Good luck.

 

[operaman]

Being an intern is very different from being a physician. Two radically different skill sets.

It will get easier each year. You may never love it, but you don’t have to. Most people don’t love their jobs, you just have to be able to tolerate it and for it to allow you the means to do things you enjoy.

Whatever you do, get board certified in something. You can always leave clinical medicine later, but if you do it too early then you don’t have many good options.

 

[NotAProgDirector]

In another thread you started, you mentioned that you ranked this place because of your fiancé and debated the merits of matching to a university program. Perhaps worth exploring how much of your unhappiness is based upon that decision as it could lead to long term conflict with your partner.

 

[folgersormh]

I think telling your family you want to quit is very different from telling your family that you are quitting. If your family has any physicians in it, they are going to be very understanding about wanting to quit, less so about quitting. I am not sure there is anyone who doesn't want to quit at some point during intern year. You didn't mention what specialty you are in, but intern year is pretty universally the worst. I definitely second and third you needing to talk someone. It might be family, it might be friends or someone professional. Fantasizing about quitting and focusing on a bunch of negative things is normal for short bursts particularly in intern year, but problematic if it keeps up and it seems like it might be for you. But practically, what are you going to do if you did quit? What would you do in terms of a job that could approach the options in medicine? And there ARE options (if you finish.) What you are doing now is not anything like what attending life is. I guess my biggest concern is that your current mood might be more intrinsic to you than your training program and quitting definitely can't fix that. And people expecting you to have answers is a heck of a lot less troubling when you do have the answers. This is part of what makes intern year the worst.

No physicians in my family, some aunts/cousins who nurses but I’m the first physician in my family.

If I quit I’d do anything in the short term, and then decide what to do next while in that job. It’s hard to think what I should do next while I’m trapped in this and patients’ lives/well being are at stake. Maybe I’d become a teacher (my “plan B” from the start), or a nurse like my aunts and get the satisfaction of helping patients without the same level of responsibility.

 

[folgersormh]

In another thread you started, you mentioned that you ranked this place because of your fiancé and debated the merits of matching to a university program. Perhaps worth exploring how much of your unhappiness is based upon that decision as it could lead to long term conflict with your partner.

Yes but even when I ask myself “would I be feeling this way at Harvard?” I still think I might be in this position. Maybe not as fiery about it though.

 

[folgersormh]

Being an intern is very different from being a physician. Two radically different skill sets.

It will get easier each year. You may never love it, but you don’t have to. Most people don’t love their jobs, you just have to be able to tolerate it and for it to allow you the means to do things you enjoy.

Whatever you do, get board certified in something. You can always leave clinical medicine later, but if you do it too early then you don’t have many good options.

Sure but in the meantime it’s a lot of “Dr. F the patient refused all of her meds, what do you want to do” or “He’s pulling at his lines and he’s a 96 year old can you order zyprexa and physical restraints, also his DPOA is on vacation in France” and adult patients screaming and crying because their Ehlers Danlos is acting up at 11pm on a Saturday. I can’t do this for over 3.5 years (Neuro intern). It’s not the patients themselves, it’s the responsibility of it. And I considered what if I switch to rads or path but I did rotations in med school and they weren’t for me

 

[folgersormh]

How old are you? What's your undergraduate degree in? What would you rather be doing? Do you have a debt, how much?

27, Cell Bio, I’d literally rather be doing anything else (but to be realistic, maybe teaching), $250k debt. I know it’s bleak.

 

[Dral]

I know you wouldn't plan on it anyway, but if it's the responsibility/accountability aspect of it, path or rads also wouldn't be for you.

Have you thought about the research pathyway? That can be rewarding and will give you opportunity to teach. If you're really into cell bio, you could consider going back for a PhD eventually. You'd probably want to get a job teaching and/or doing paid research first to get some of your debt under control though.

I would second the idea of first talking to a professional in person. Make sure you are making this major decision for the absolute proper reasons. The best would be to finish and then possibly jump ship (since as someone mentioned, you may decide to come back to it later). If you cannot make it all 4 years, making it at least through intern year would be the next best thing if you can do it.

 

[Saddleshoes]

• Did you enter medicine for you or for your family?
• How will you be able to pay off 250K of student loan without moving forward?
• Have you faced difficult times in life to date?

It is time to make some adult decisions.

 

[dozitgetchahi]

How old are you? What's your undergraduate degree in? What would you rather be doing? Do you have a debt, how much?

All this.

Also, it’s hard to place whether the sentiments in OPs post are from disliking medicine altogether, or simply from disliking being an intern, or some of each. What concerns me is that OP is focused on how his family will feel about this; he also alludes to the fact that his family basically forced him into this. This makes it sound more like it was someone who was pushed into medicine without wanting to do it in the first place. This is obviously different from just hating being an intern (which is a very prevalent issue in training, and also one that is transient).

So OP, which is it?

 

[NotAProgDirector]

At a minimum, I would try to complete your PGY-1. As a USMD, with one year of training, you can get a license in some states. And then you can do some sort of clinical work going forward. There's several low stress things you might be able to do. There's one poster here who opened a wound care service for nursing homes. Another does medical case reviews for state insurance companies. A license will give you more options going forward.

You mention here the possibility of being a nurse. You'll find that a big challenge. Many places may be very concerned about hiring you as being overtrained.

If you're miserable, you could consider an LOA to get help.

 

[DrMetal]

27, Cell Bio, I’d literally rather be doing anything else (but to be realistic, maybe teaching), $250k debt. I know it’s bleak.

Ok. So you're young enough, you have a technical degree. You could potentially drop, initiate a huge life change, get a job, go into teaching, etc.

It's doable. I would just have a plan. Don't quit without a plan.

The $250K debt is a tough pill to swallow. Good luck paying that back on a teacher's salary.

What kind of internship, what specialty, what part of the country are you in? If you can stomach it, one might suggest you just push through, finish it, practice medicine as an attending (life is much better, trust us!) for 3-5 years, pay your debt back and make some money . . . then punch out. Sure, you'll be 40 years old, but you'll be debt free and probably have some savings.

 

[folgersormh]

All this.

Also, it’s hard to place whether the sentiments in OPs post are from disliking medicine altogether, or simply from disliking being an intern, or some of each. What concerns me is that OP is focused on how his family will feel about this; he also alludes to the fact that his family basically forced him into this. This makes it sound more like it was someone who was pushed into medicine without wanting to do it in the first place. This is obviously different from just hating being an intern (which is a very prevalent issue in training, and also one that is transient).

So OP, which is it?

I wanted to be a doctor, but I just didn’t really know what it looks like. Shadowing doesn’t really show you, and as a med student/sub I you get a taste but still very different from the day to day, plus a lot of my complaints felt like med student complaints (can’t put in orders, nurses/consultants reach out to the resident or attending and you’re the last to know, etc)

My family is nonetheless obviously proud of me and think it would be shameful to quit. I told my parents a few weeks ago I wasn’t happy at all and they said “well you need to become happy and be a doctor.” We’re immigrants which adds to it.

I hate intern year but I don’t know if I could even like medicine as an attending.

 

[folgersormh]

Ok. So you're young enough, you have a technical degree. You could potentially drop, initiate a huge life change, get a job, go into teaching, etc.

It's doable. I would just have a plan. Don't quit without a plan.

The $250K debt is a tough pill to swallow. Good luck paying that back on a teacher's salary.

What kind of internship, what specialty, what part of the country are you in? If you can stomach it, one might suggest you just push through, finish it, practice medicine as an attending (life is much better, trust us!) for 3-5 years, pay your debt back and make some money . . . then punch out. Sure, you'll be 40 years old, but you'll be debt free and probably have some savings.

IM pre-lim for a neurology residency in the Midwest.

 

[operaman]

Sure but in the meantime it’s a lot of “Dr. F the patient refused all of her meds, what do you want to do” or “He’s pulling at his lines and he’s a 96 year old can you order zyprexa and physical restraints, also his DPOA is on vacation in France” and adult patients screaming and crying because their Ehlers Danlos is acting up at 11pm on a Saturday. I can’t do this for over 3.5 years (Neuro intern). It’s not the patients themselves, it’s the responsibility of it. And I considered what if I switch to rads or path but I did rotations in med school and they weren’t for me

It’s actually only 9ish more months of dealing with that stuff. After that you’ll get some new crap to deal with and the floor bs should fall to the new intern.

The responsibility of it doesn’t really fall on you right now either - it falls on the attending. All you have to do as an intern is gather the data and run a plan by someone senior to you. That basically absolves you of any direct responsibility because people above you have signed off on it. Sure, you lose that absolution gradually as you progress, but by then you’ve also gained the skills that let you manage it well.

You also eventually realize you can’t fix everything and not everything needs a solution. If someone refuses their meds, and that’s not posing an immediate threat to them, then maybe that’s something to discuss on rounds the next day. Nurses can chart the MD knows, and you and the team can address their concerns later. You’ll learn which 96 year olds to snow and which ones to just order 1:1 sitter so the poor night nurse can attend to other patients. You’re definitely not going to fix all the issues of EDS at 11pm inpatient, so you put a bandaid on the acute issue and work with the team to figure out a longer term plan to address their issues outpatient. It’s the old “keep ‘em alive til 7:05” idea.

 

[DrMetal]

IM pre-lim for a neurology residency in the Midwest.

Well, if it makes you feel any better, Neurology has become a pretty sweet gig . . . and you don't have that much 'responsibility'. Most of the diagnoses come from radiology, the invasive interventions come from IR and/or neurosurgery.

Yes, neurologists treat chronic conditions (ALS, MS, dementia) with medications . . . but this is usually to no avail. We have no cures. The expectation bar is rather low. You certainly don't bear the responsibility of an internist or general surgeon.

Life as an attending Neurologist is VERY different from that of an IM intern.

If you can plow your way thru internship year (sounds like you're doing it), may be worth sticking it out and finishing, practicing (could even just do it part time), see how you like it, then punch out. Hell you're 27-yo, you could be out by 35 and debt free!

 

[folgersormh]

It’s actually only 9ish more months of dealing with that stuff. After that you’ll get some new crap to deal with and the floor bs should fall to the new intern.

The responsibility of it doesn’t really fall on you right now either - it falls on the attending. All you have to do as an intern is gather the data and run a plan by someone senior to you. That basically absolves you of any direct responsibility because people above you have signed off on it. Sure, you lose that absolution gradually as you progress, but by then you’ve also gained the skills that let you manage it well.

You also eventually realize you can’t fix everything and not everything needs a solution. If someone refuses their meds, and that’s not posing an immediate threat to them, then maybe that’s something to discuss on rounds the next day. Nurses can chart the MD knows, and you and the team can address their concerns later. You’ll learn which 96 year olds to snow and which ones to just order 1:1 sitter so the poor night nurse can attend to other patients. You’re definitely not going to fix all the issues of EDS at 11pm inpatient, so you put a bandaid on the acute issue and work with the team to figure out a longer term plan to address their issues outpatient. It’s the old “keep ‘em alive til 7:05” idea.

Well I’m in Neuro so next year is another “intern year” for me and it all still falls on me.

Our seniors leave at like 2-3pm and if you’re the intern on call you’re alone until 6pm. Technically you could message the attending but good luck getting a timely response, and they get annoyed. (Of course true emergencies you can just call a rapid and get connected with a senior or attending within 5 minutes).

Re: meds, sure but often it includes Eliquis or an antibiotic. Let’s say they refuse to take it because they’re delirious. They have a stroke… well it’s my fault. They decompensate, well it’s my fault, even if logically it’s not. And half of them are delirious, lack capacity, and I can’t get ahold of their family, then what? I tie them down and inject them with IV vanc and lovenox to bridge them? And then they’re more agitated because they’re tethered.

Re: EDS, then I give them dilaudid and everyone is pissed at me for it because it sets a bad precedent, but I don’t give dilaudid and nursing is pissed at me because the patient’s hitting their call light q10 and yelling at them.

It’s all just endless.

 

[emergentmd]

Suck it up, or change to a non clinical field and finish. Find something that is 3 or 4 years. Suck it up. When you are done, you can find something non clinical and make 200K+/yr. Trust me, this is the way.

Become a teacher? You think being a doc is hard? Try taking daily crap from the kids, then admin, then the parents. You think babysitting 30 kids daily is better?

Suck it up, you will thank me in 3 years.

 

[anonperson]

I’m an intern in a 4 year residency and I don’t like medicine in hindsight. I guess in medical school I just drudged through it thinking it’ll get better when I had more autonomy (didn’t need my senior resident to sign every order for senna or Tylenol), got paid, and didn’t have to study all the time. But nope. I actually hate it all.

I don’t like being in the hospital or the ED, I don’t like clinic, I don’t like being primary on patients or being a “consultant.” I don’t like thinking through problems for my patients.

I don’t like the city my program is in. I hate the area and should’ve visited before ranking it. I don’t like my program’s crappy education. I don’t like that it’s basically a community program so no one is available to do crap overnight or on weekends. Our “teaching” attendings are awful, they don’t teach and mistakes are treated like you’re just inherently incompetent.

This one will upset people but I don’t care about patients anymore, at least not their diseases. I have stopped “thinking” and I just report it to my attending or senior, like “their head hurts, no neuro deficits. Maybe Tylenol?” and just let them tell me what to do because I don’t care enough to think more about it. I care about them as humans so I don’t wish to harm them but I know my lack of care will harm them. There are interns and seniors who are like “wow!! What a cool disease process!” but I feel like I’m in acrid gravy every day just getting through, and nothing seems interesting.

I don’t like the responsibility of being a doctor/provider. I don’t like being the person everyone turns to to have an answer or plan.

I want to quit medicine. I’m on a small break right now and I feel worse, not better. I have nothing else lined up but I’d literally rather do anything else. I never should’ve gone to medical school, and I should’ve quit when I realized I wasn’t loving the day-to-day of medicine but I deluded myself. I considered maybe it’s just my program I hate but it’s the actual job of being a doctor. I don’t like the ultimate responsibility and making decisions. I can’t even choose a restaurant to eat at, let alone what to do for my crashing patient. I don’t trust myself with patient care. I’ll be an awful attending.

My family will be so disappointed in me, which is the only thing holding me back. They’re so proud that I’m a doctor. Anytime I complain they shut it down and say “well you have to be a doctor” essentially.

I did medical school at a large research medical center that is well known. Had some issues in medical school and matched at the second to last place on my list in a very rural part of the country.

Match day was terrible for me.

I felt that my residency program was beneath me. To an extent it was but after getting over myself I focused on getting as good as possible at my craft. Got into fellowship and moved back home to CA. I have a reasonably chill job, 40 hour work week with no call. And no fear of job loss.

These four years pass by quick. Your last year, you will be either applying fellowship or looking for a job which is a nice distraction.

But if you hate it that much, create an exit plan. Don't just quit without having a plan in place.

If you quit, you are throwing away millions of dollars though. Not saying money buys happiness, but it doesn't hurt having a seven figure account, staying in nice hotels on vacation, not ever having to worry about a grocery bills etc.

I know on SDN, a lot of people hate on medicine and think they could have done something else and made a ton of money instead. Except for maybe a few superstars, this is not reality.

The job market is rough right now for a lot of non health related fields. It's not pleasant being unemployed and worrying about your next paycheck.

 

[hamstergang]

...next year is another “intern year” for me and it all still falls on me.
...
Let’s say they refuse to take it because they’re delirious. They have a stroke… well it’s my fault. They decompensate, well it’s my fault

What I've bolded in there -- these are the lies you tell yourself. If your mindset doesn't change, I doubt you'll find happiness elsewhere either.

 

[folgersormh]

Suck it up, or change to a non clinical field and finish. Find something that is 3 or 4 years. Suck it up. When you are done, you can find something non clinical and make 200K+/yr. Trust me, this is the way.

Become a teacher? You think being a doc is easy? Try taking daily crap from the kids, then admin, then the parents. You think babysitting 30 kids daily is better?

Suck it up, you will thank me in 3 years.

What’s something non-clinical that makes that much?

 

[ThoracicGuy]

I wanted to be a doctor, but I just didn’t really know what it looks like. Shadowing doesn’t really show you, and as a med student/sub I you get a taste but still very different from the day to day, plus a lot of my complaints felt like med student complaints (can’t put in orders, nurses/consultants reach out to the resident or attending and you’re the last to know, etc)

My family is nonetheless obviously proud of me and think it would be shameful to quit. I told my parents a few weeks ago I wasn’t happy at all and they said “well you need to become happy and be a doctor.” We’re immigrants which adds to it.

I hate intern year but I don’t know if I could even like medicine as an attending.

Even getting into pure neuro rotations will be much different than your intern rotations and responsibilities. Everyone hates the 1 am tylenol calls from the nurses. But you know what, as an attending I rarely if ever get those sorts of calls. When you're out on your own, you can really make your job what you want it to be. Find a niche that you like and go with that. It's a way to not only pay back your loans, but also give yourself financial stability in life that you aren't as likely to find, particularly with a 250k loan to pay back.

 

[ThoracicGuy]

Well I’m in Neuro so next year is another “intern year” for me and it all still falls on me.

Our seniors leave at like 2-3pm and if you’re the intern on call you’re alone until 6pm. Technically you could message the attending but good luck getting a timely response, and they get annoyed. (Of course true emergencies you can just call a rapid and get connected with a senior or attending within 5 minutes).

Re: meds, sure but often it includes Eliquis or an antibiotic. Let’s say they refuse to take it because they’re delirious. They have a stroke… well it’s my fault. They decompensate, well it’s my fault, even if logically it’s not. And half of them are delirious, lack capacity, and I can’t get ahold of their family, then what? I tie them down and inject them with IV vanc and lovenox to bridge them? And then they’re more agitated because they’re tethered.

Re: EDS, then I give them dilaudid and everyone is pissed at me for it because it sets a bad precedent, but I don’t give dilaudid and nursing is pissed at me because the patient’s hitting their call light q10 and yelling at them.

It’s all just endless.

If a patient is refusing their meds and have a stroke, its not on you. It's not like you can shove it down their throats, even if delirious. You can try talking to the patient, sometimes a delirious patient just needs some reorientation to get them to follow you. Many times it won't make any difference. If it's a persistent problem, deal with it on rounds with the team. It's not all on you.

 

[shaggybill]

Finish intern year and apply occ-med. Trust me, I was in your exact shoes 8 years ago.

 

[emergentmd]

What’s something non-clinical that makes that much?

You can do chart review, be the director of a med spa, etc. Places just need a doc to rubber stamp stuff. You can do telemedicine which you essentially prescribe antibiotics or tell them to go to their PCP/ER.

Trust me, you are better off getting a degree. What you think now may not be what you think in 10 years. Think about this. If you want to teach, any HS would hire you with a medical degree. Lets assume you want kids and a family. Do you want to be

#1 a doc who suffered for 3-4 years in his 20's who has a family making 6 figures. You will be able to provide your family/yourself with security, someone they can look up to, and have work flexibility

#2 A teacher making 80K/yr struggling always in search of a good job regretting that he never finished med school.

 

[dozitgetchahi]

Suck it up, or change to a non clinical field and finish. Find something that is 3 or 4 years. Suck it up. When you are done, you can find something non clinical and make 200K+/yr. Trust me, this is the way.

Become a teacher? You think being a doc is easy? Try taking daily crap from the kids, then admin, then the parents. You think babysitting 30 kids daily is better?

Suck it up, you will thank me in 3 years.

I agree with this.

I find it strange that OP isn’t happy with the idea of being a doctor, but is somehow ok with the thought of being a nurse. I wonder if OP has any direct experience with what being a nurse is like…there’s plenty of BS (including handling actual ****) involved in that job, for like 1/4 the pay at best.

Or being a teacher. Imagine babysitting 30 of today’s bratty children (I have teacher friends, I’ve heard the horror stories of what it’s like in school now) for like 1/6 the pay of being a doctor (or less).

OP, do you have any experience with working other real world jobs? Do you know what it’s like to work in another profession?

(PS: I’m a rheumatologist. With regards to EDS patients - there is no magic solution for those folks. They often hurt everywhere, they basically all have fibro, and there is no silver bullet for all of that. Some of them are absolutely obnoxious as well. I don’t have any better suggestions for them in the OP rheumatology clinic either, but at least in the clinic I can deal with them for 20 minutes and then I’m done. If one is hitting the call bell q10 minutes all night, there’s almost certainly something more psychological going on there too. Don’t feed them opioids and don’t feel bad about it, it’s definitely not your fault.)

 

[operaman]

Well I’m in Neuro so next year is another “intern year” for me and it all still falls on me.

Our seniors leave at like 2-3pm and if you’re the intern on call you’re alone until 6pm. Technically you could message the attending but good luck getting a timely response, and they get annoyed. (Of course true emergencies you can just call a rapid and get connected with a senior or attending within 5 minutes).

Re: meds, sure but often it includes Eliquis or an antibiotic. Let’s say they refuse to take it because they’re delirious. They have a stroke… well it’s my fault. They decompensate, well it’s my fault, even if logically it’s not. And half of them are delirious, lack capacity, and I can’t get ahold of their family, then what? I tie them down and inject them with IV vanc and lovenox to bridge them? And then they’re more agitated because they’re tethered.

Re: EDS, then I give them dilaudid and everyone is pissed at me for it because it sets a bad precedent, but I don’t give dilaudid and nursing is pissed at me because the patient’s hitting their call light q10 and yelling at them.

It’s all just endless.

Neuro pgy2 shouldn’t be nearly as bad and you’ll hopefully have some poor IM interns rotating with you that can do the scut work. You’ll have new challenges of course, but some will end.

You’ll don’t need to necessarily get a response from your seniors for minor stuff. All the things you posted would be part of a blanket update text sometime overnight before bed or early in the morning.

Yeah you’ll need to let yourself off the hook on the responsibility side of things. You do your best, but of course you can’t win them all. Patient refuses meds, talk to them, and document your discussion. People ignore doctors’ advice all the time and suffer the consequences. And eliquis still works for a couple days after stopping, so should be fine for overnight until morning rounds when you can talk rationally in the light of day. Pretty much applies to most meds - if they’re already on it and refuse because they’re delirious, you’ve got time with therapeutic levels to sort things out the next day. The situations you mention are fairly common but also quite challenging from an ethics standpoint. Handling an incapacitated adult without a surrogate decision maker is not easy - you do your best and the team works toward a solution. And if they crump, it’s not your fault; that’s just how disease works.

For the EDS pain patient, there is no winning. Pick your poison - happy nurses or happy team. Personally I was the candyman overnight and anyone who wanted dilaudid and wouldn’t die from it would get it. Yeah, I got crap for it too, but then I finished intern year and never had to worry about that stuff anymore.

Ironically I now have a fairly busy EDS skull base practice, so maybe karma got me in the end! Fairly challenging patients, but some of the happiest and most grateful ones I’ve met once we’re able to get them feeling better. But that’s a multi disciplinary outpatient team endeavor, not a midnight nursing page.

 

[folgersormh]

I agree with this.

I find it strange that OP isn’t happy with the idea of being a doctor, but is somehow ok with the thought of being a nurse. I wonder if OP has any direct experience with what being a nurse is like…there’s plenty of BS (including handling actual ****) involved in that job, for like 1/4 the pay at best.

Or being a teacher. Imagine babysitting 30 of today’s bratty children (I have teacher friends, I’ve heard the horror stories of what it’s like in school now) for like 1/6 the pay of being a doctor (or less).

OP, do you have any experience with working other real world jobs? Do you know what it’s like to work in another profession?

(PS: I’m a rheumatologist. With regards to EDS patients - there is no magic solution for those folks. They often hurt everywhere, they basically all have fibro, and there is no silver bullet for all of that. Some of them are absolutely obnoxious as well. I don’t have any better suggestions for them in the OP rheumatology clinic either, but at least in the clinic I can deal with them for 20 minutes and then I’m done. If one is hitting the call bell q10 minutes all night, there’s almost certainly something more psychological going on there too. Don’t feed them opioids and don’t feel bad about it, it’s definitely not your fault.)

No, I worked retail for a couple months in college and otherwise was basically a lab manager for 1.5 years after college but that’s basically a gap year job and not really “real world” either. So no I don’t have actual career experience otherwise.

I guess the allure of nursing is that I’m not the decision maker, and if I do have a concern I could contact the doctor and ask/advocate for my patient but it’s not my ultimate responsibility. It’s a lot easier for me to say even now “I’d love to give you this medication, but cardiology thinks it might do more harm than good so I can’t” and at least have that as my excuse. I’m just realizing I really dislike making decisions, which is the job description of physicians but I guess I deluded myself into thinking I could do it.

 

[folgersormh]

You can do chart review, be the director of a med spa, etc. Places just need a doc to rubber stamp stuff. You can do telemedicine which you essentially prescribe antibiotics or tell them to go to their PCP/ER.

Trust me, you are better off getting a degree. What you think now may not be what you think in 10 years. Think about this. If you want to teach, any HS would hire you with a medical degree. Lets assume you want kids and a family. Do you want to be

#1 a doc who suffered for 3-4 years in his 20's who has a family making 6 figures. You will be able to provide your family/yourself with security, someone they can look up to, and have work flexibility

#2 A teacher making 80K/yr struggling always in search of a good job regretting that he never finished med school.

I hear you, but my thing is I can’t be a (good) doctor, because I don’t care enough I’m finding. I’m going to hurt people because I just don’t care. I’m not as curious as I used to be, I’m not as motivated to look things up and learn about them, and when I do get teaching on rounds it’s almost like in one ear and out the other. I’m just not cut out for it.

 

[ThoracicGuy]

No, I worked retail for a couple months in college and otherwise was basically a lab manager for 1.5 years after college but that’s basically a gap year job and not really “real world” either. So no I don’t have actual career experience otherwise.

I guess the allure of nursing is that I’m not the decision maker, and if I do have a concern I could contact the doctor and ask/advocate for my patient but it’s not my ultimate responsibility. It’s a lot easier for me to say even now “I’d love to give you this medication, but cardiology thinks it might do more harm than good so I can’t” and at least have that as my excuse. I’m just realizing I really dislike making decisions, which is the job description of physicians but I guess I deluded myself into thinking I could do it.

Second guessing yourself on these things at your point in training is extremely normal. Imposter Syndrome is real. But, as you go through training, you start to get in a rhythm where you figure out whats important, what isn't, what can be dealt with in the morning and what needs attention now. You'll find these concerns won't be your concerns when you're in your second or third year, it'll be totally different things.

This too shall pass.