Apr 1, 2016
12
1
Status
Medical Student
I did well in med school and can recite the differential of a tall R wave in V1, and matched well, but I can't do residency. My body and mind are simply breaking down. I want to get in my car, drive home, and never look back. I nearly got in a car crash yesterday because I was too tired to drive properly. I haven't brushed my teeth in days. I can't do this. What can I do? I am so worried about talking to my program director, it would be so foolish if they wasted a residency spot on a failed resident like me. I would also be letting down all the interns that would have 1 fewer person to share the load with. I don't know what to do besides continue to suffer in a way that I just can't take anymore. Should I just tell my program director this, finish the block, call it quits? Would that be the end of ever being a doctor? I almost don't really care. I just want to know before I sit down and talk to him. Please help me.
 
  • Like
Reactions: bannie22

Crayola227

The Oncoming Storm
5+ Year Member
Oct 22, 2013
15,934
17,754
All of Time & Space
I did well in med school and can recite the differential of a tall R wave in V1, and matched well, but I can't do residency. My body and mind are simply breaking down. I want to get in my car, drive home, and never look back. I nearly got in a car crash yesterday because I was too tired to drive properly. I haven't brushed my teeth in days. I can't do this. What can I do? I am so worried about talking to my program director, it would be so foolish if they wasted a residency spot on a failed resident like me. I would also be letting down all the interns that would have 1 fewer person to share the load with. I don't know what to do besides continue to suffer in a way that I just can't take anymore. Should I just tell my program director this, finish the block, call it quits? Would that be the end of ever being a doctor? I almost don't really care. I just want to know before I sit down and talk to him. Please help me.
Typically I advise that people do whatever they can to avoid the scrutiny of the PD or the Chief, but you seem to be in crisis.
DON'T make any big life decisions right now.
Don't worry about others' workloads for the moment.
I know you're overwhelmed - but you needed to seek help like yesterday. That's OK, I know it's hard.
There should hopefully be an employee wellness center that you can contact. They can usually help get you counseling. You need to get in with a PCP and consider any recs they have re: mental health.

What specifically at work are you having a hard time with? Malignant coworkers? Volume of work? Notes? Plans? Presentations? Pages? Difficult patients? Sadness from their plights? Sense of responsibility? Inadequate support from seniors/attendings? Fund of knowledge? It helps if you can identify what's killing you, especially when you go see the Chief or PD. Work hour violations?

Try contacting the Chief first about this. Likely you will need to see the PD.
They can arrange an LOA pretty quickly if that is what you need to not quit. They don't want you to quit. They want you to succeed. They too will want to know what, if anything, you can point to, to make your job seem doable again. They too with employee wellness, can help you figure out a PCP, counseling. However, you want any mental health help you get to be outside your system or at least a separate EHR.

You can get into a pattern where 2/2 inefficiency/volume, you work a 16 hour day, and then only get 5-6 hours sleep, then the next day, which should be 12 hour, takes you longer because not only are you inefficient, the inefficiency is made worse by sleep deprivation, leading to another day that is too long, leading more sleep deprivation, more inefficiency, and on and on. You'd be surprised how a few days of sleep can help reset you and break the cycle.

I don't want to add to your feeling of being trapped. However, many interns get to a point where they feel like quitting, that's normal, and it can be dealt with to get a reasonable outcome for all parties involved (you, program, colleagues).

If you or the life of a patient is not currently in danger, I would advise that you stick it out and talk to your PD. Don't quit. As you mentioned, quitting can be the end of the road careerwise.

That said, if you are in danger or hurting yourself you should immediately contact a suicide helpline you can google, go to the ED (preferably a different hospital), or call a friend/loved one and your PCP. (if you don't have one try the above strategies to get one, or contact your insurance, they can help you find one). Going to work isn't worth your life.

Please reach out for help. Just be careful. Document everything.

Do you have a hx of mental health issues?

You can PM me with anything.
 

mpdoc2

10+ Year Member
7+ Year Member
Apr 2, 2009
482
218
Status
Attending Physician
I did well in med school and can recite the differential of a tall R wave in V1, and matched well, but I can't do residency. My body and mind are simply breaking down. I want to get in my car, drive home, and never look back. I nearly got in a car crash yesterday because I was too tired to drive properly. I haven't brushed my teeth in days. I can't do this. What can I do? I am so worried about talking to my program director, it would be so foolish if they wasted a residency spot on a failed resident like me. I would also be letting down all the interns that would have 1 fewer person to share the load with. I don't know what to do besides continue to suffer in a way that I just can't take anymore. Should I just tell my program director this, finish the block, call it quits? Would that be the end of ever being a doctor? I almost don't really care. I just want to know before I sit down and talk to him. Please help me.
Stop being a perfectionist and let things go. I found that the most frustrated interns are the ones who try to do things perfectly.
 

Crayola227

The Oncoming Storm
5+ Year Member
Oct 22, 2013
15,934
17,754
All of Time & Space
Stop being a perfectionist and let things go. I found that the most frustrated interns are the ones who try to do things perfectly.
Word.

OP - you're always taught the refrain not to cut corners but the reality is that you must. The key is learning which ones can be safely cut.

I didn't link you to my intern megapost because I didn't want to overwhelm you. Let us know if there are specific things we can help you with.
 
  • Like
Reactions: northernpsy
Apr 30, 2016
34
9
Status
Resident [Any Field]
change to a different specialty or quit while youre ahead. psych and family are particularly forgiving.
dont decide to quite when you are a pgy3 and have already invested so much time.
 

QofQuimica

Seriously, dude, I think you're overreacting....
Staff member
Administrator
Lifetime Donor
10+ Year Member
Oct 12, 2004
18,915
4,165
Florida/Fellowship
Status
Fellow [Any Field], Attending Physician
Your hospital should offer access to free and confidential counseling for residents in crisis, which you are. Call them and get help, ASAP.
 

aProgDirector

Pastafarians Unite!
Moderator
10+ Year Member
Oct 11, 2006
8,276
7,135
Status
Attending Physician
Based on post history, OP is a Canadian who attended a US MD school and matched into IM, is now on an OPT visa.

As others have mentioned, you need help. We can't tell what the problem is, but you clearly need help. Maybe you will walk away from medicine completely. Perhaps you'll switch to a new field. Perhaps you'll stick with IM but at another program. Or perhaps you'll be fine right where you are. But none of those are an option in your current state.

You should go talk to your PD. Or your GME office. Or whatever system they have in place for counselling. It really doesn't matter where you start, because all three are going to get looped in. You'll probably need an LOA to get this under control -- and that's fine. Do not quit -- doing so would be the end of your visa, and the end of your income. There's a good chance you'll be placed on medical leave -- that will leave your health benefits and salary in place. Or maybe they will just re-jigger the schedule so that you're on an easier rotation for awhile. Who knows? But they will work with you to find success.

This type of thing happens "all the time". I am always managing LOA's of one flavor or another. Once you're better, you can make an informed decision. Call a chief resident. Drop by my office. Call my cell. Don't go it alone, because you're not alone.
 

bannie22

Hero
10+ Year Member
7+ Year Member
Apr 6, 2009
3,693
1,107
Do not talk to anyone at your program until you have discussed this with people outside of medicine.

Dont trust anyone in medicine to have your back especially not during a difficult time.
 

northernpsy

Psychiatrist. No, I'm not analyzing you
Jan 20, 2016
285
538
Status
Attending Physician
I did well in med school and can recite the differential of a tall R wave in V1, and matched well, but I can't do residency. My body and mind are simply breaking down. I want to get in my car, drive home, and never look back. I nearly got in a car crash yesterday because I was too tired to drive properly. I haven't brushed my teeth in days. I can't do this. What can I do? I am so worried about talking to my program director, it would be so foolish if they wasted a residency spot on a failed resident like me. I would also be letting down all the interns that would have 1 fewer person to share the load with. I don't know what to do besides continue to suffer in a way that I just can't take anymore. Should I just tell my program director this, finish the block, call it quits? Would that be the end of ever being a doctor? I almost don't really care. I just want to know before I sit down and talk to him. Please help me.
I definitely think you are doing the smart thing by starting to reach out for help - first by getting advice here and then by talking to your program director.
As someone who used to be involved in resident discipline/promotion issues, the one case I saw where a resident failed out happened because the resident waited too long to admit they needed help and couldn't recover from how far they had fallen behind.
You sound extremely exhausted and overwhelmed right now so I definitely think that trying to get a little break from things to collect yourself and figure out what you really want without being in the thick of the misery and sleep deprivation would be a good idea. Please keep posting so we know how you're doing.
 
  • Like
Reactions: Crayola227

Perrotfish

Has an MD in Horribleness
10+ Year Member
May 26, 2007
8,066
3,984
Status
Attending Physician
I did well in med school and can recite the differential of a tall R wave in V1, and matched well, but I can't do residency. My body and mind are simply breaking down. I want to get in my car, drive home, and never look back. I nearly got in a car crash yesterday because I was too tired to drive properly. I haven't brushed my teeth in days. I can't do this. What can I do? I am so worried about talking to my program director, it would be so foolish if they wasted a residency spot on a failed resident like me. I would also be letting down all the interns that would have 1 fewer person to share the load with. I don't know what to do besides continue to suffer in a way that I just can't take anymore. Should I just tell my program director this, finish the block, call it quits? Would that be the end of ever being a doctor? I almost don't really care. I just want to know before I sit down and talk to him. Please help me.
1) You need to talk to your program director, your family, your friends, and a mental health professional. You sound like you are in the middle of a deep dark depression. You can get through it, but you shouldn't try to get through it alone.

2) As an adjunct to getting help, you need to buy any time you have not yet bought. If you live more than 10 minutes away from the hospital you need to move closer. If you are a cleaning your own home or cooking your own meals you need to hire someone to do those things. If you have pets you need to hire someone to walk them.

3) You should not quit. Not yet. You are not in a position to make that decision right now. If you were a good student then odds are quitting or switching specialties is the wrong choice for you, but even if it is the right decision you don't have a way to know that its the right decision for you until you come out of this depression.

Many of us, to various degrees, entered a period of depression at about this time in Intern year. With enough stress and sleep deprivation everyone just starts breaking down. You are not alone, and you will make it through this.
 
Last edited:

ranvier

I can't anesthetize a rumor.
10+ Year Member
Jul 17, 2006
248
127
Status
Attending Physician
There should be a moratorium on making any big decisions during intern year but obviously life doesn't respect such an ideal. What support system can you lean on? Parents, friends, spouse, etc? There is some good advice posted above. You are not the first to struggle and many have successfully navigated through dark times. Please keep posting and update us. Seeking help within the program seems program dependent but you must get help.
 
  • Like
Reactions: The Anhedonia

194342

10+ Year Member
7+ Year Member
Mar 18, 2008
7,990
1,323
Status
Resident [Any Field]
Dude how do you not have time to brush your teeth? You really need to seek out therapy.
 
Last edited:
  • Like
Reactions: newbie04
Aug 14, 2016
1
1
Status
Resident [Any Field]
I did well in med school and can recite the differential of a tall R wave in V1, and matched well, but I can't do residency. My body and mind are simply breaking down. I want to get in my car, drive home, and never look back. I nearly got in a car crash yesterday because I was too tired to drive properly. I haven't brushed my teeth in days. I can't do this. What can I do? I am so worried about talking to my program director, it would be so foolish if they wasted a residency spot on a failed resident like me. I would also be letting down all the interns that would have 1 fewer person to share the load with. I don't know what to do besides continue to suffer in a way that I just can't take anymore. Should I just tell my program director this, finish the block, call it quits? Would that be the end of ever being a doctor? I almost don't really care. I just want to know before I sit down and talk to him. Please help me.
OP, I'm I'm in a very similar spot. I've already considered everything from quitting to suicide to just running away and becoming a bum to escape...not sure if I could restart my life with all that debt hanging over my head, or at least wouldn't know how. I'm also very ocpd which doesn't help my situation. with each day I feel more and more like a zombie and don't have time to think about how much my life sucks. My plan is to get thru as much of it as I can and hopefully it'll get easier. I dont know about talking to your PD because I don't know what he/she is like...I feel like it can go either direction, but seeing a therapist if you have any energy to climb out of bed on your one day off a week wouldn't be a bad idea.

...I don't brush my teeth either, but my coffee breath masks my halitosis.
 
  • Like
Reactions: Crayola227

calvnandhobbs68

I KNOW NOTHING
7+ Year Member
May 20, 2010
3,308
1,329
Status
Fellow [Any Field]
Start with brushing your teeth, one step at a time.

Don't get in a car crash, sleep in a call room for a little bit if you're too tired to drive back.

I agree with the posters above who DO suggest talking to your leadership. I'd start with talking to the chief you feel most comfortable with or the PD if you feel you can go to him/her directly right away. They will most likely want to help. You're right, they don't want to lose someone and be a resident down either. They'd much rather shuffle rotations around or have you take a shorter leave of absence.
 
  • Like
Reactions: tiedyeddog

Phloston

Lifetime Donor
7+ Year Member
Jan 17, 2012
3,660
1,353
Osaka, Japan
I did well in med school and can recite the differential of a tall R wave in V1, and matched well, but I can't do residency. My body and mind are simply breaking down. I want to get in my car, drive home, and never look back. I nearly got in a car crash yesterday because I was too tired to drive properly. I haven't brushed my teeth in days. I can't do this. What can I do? I am so worried about talking to my program director, it would be so foolish if they wasted a residency spot on a failed resident like me. I would also be letting down all the interns that would have 1 fewer person to share the load with. I don't know what to do besides continue to suffer in a way that I just can't take anymore. Should I just tell my program director this, finish the block, call it quits? Would that be the end of ever being a doctor? I almost don't really care. I just want to know before I sit down and talk to him. Please help me.
I agree with QofQuimica that your hospital should be able to offer services for people in your situation. External pyschs are fine, but will take time to organize, and it seems more immediate help is important.

And btw, ignore the people on this thread who are responding to you negatively. Your situation is common and you'll be okay. I just find it amusing, since no one would ever talk to a patient this way, but of course we're on a (mostly) anonymous forum, so people can take their issues out on you.
 

The Anhedonia

Winner Winner Chicken Dinner
10+ Year Member
Feb 18, 2009
999
435
Boston
Status
Resident [Any Field]
Sorry to hear about all this :(

When I was an intern (OMFS intern year --> not ACGME protected) i seriously contemplated quitting the 2nd day. I got out of the OR at 5pm with 10 pending trauma consults, still had to round on all the inpatients, oh and i had to prepare for conference the next day. I was miserable. It was so painful to be physically in the hospital for about a month. It was probably the 'darkest' time in my life - i thought about all the implications if i quit, and the fact that EVERYTHING that I had worked for up to this point lead to the suck of being an intern. My hospital provides counseling services for residents specifically for this reason and i took advantage of it. Long story short, the utter gloom only lasts about a month IMO, seek out help from available resources, and use the gloom to commiserate with your co-interns (its like surviving boot camp together, now we are as close as family because we stuck through it together). And Im SO GLAD i didnt quit and look fondly at that time as an immense period of personal growth.

Stick with it bud.

And since i'm also a dentist, i think you'll feel better after you brush your teeth :D
 
Last edited:

Psai

This space for lease
Removed
5+ Year Member
Jan 2, 2014
11,519
23,499
ヽ(´ー`)ノ
Status
Resident [Any Field]
Sorry to hear about all this :(

When I was an intern (OMFS intern year --> not ACGME protected) i seriously contemplated quitting the 2nd day. I got out of the OR at 5pm with 10 pending trauma consults, still had to round on all the inpatients, oh and i had to prepare for conference the next day. I was miserable. It was so painful to be physically in the hospital for about a month. It was probably the 'darkest' time in my life - i thought about all the implications if i quit, and the fact that EVERYTHING that I had worked for up to this point lead to the suck of being an intern. My hospital provides counseling services for residents specifically for this reason and i took advantage of it. Long story short, the utter gloom only lasts about a month IMO, seek out help from available resources, and use the gloom to commiserate with your co-interns (its like surviving boot camp together, now we are as close as family because we stuck through it together). And Im SO GLAD i didnt quit and look fondly at that time as an immense period of personal growth.

Stick with it bud.

And since i'm also a dentist, i think you'll feel better after you brush your teeth :D
Oh my god dude, you have all my sympathy. Everyone says that the transition to intern year is really rough and I didn't really believe it. It's better now but I also almost quit that first week. Trying to figure out a whole new emr as people tell you to write this transfer summary about a patient you don't know, put in that order on this other patient, renew this drip order, check that urine output, go see that patient from the ed, bring up that floor patient...holy **** that sucked. Those silly work hour restrictions are incredibly unrealistic.