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TLDR; Would love to hear people's experience with psychiatrists being able to take moderate length breaks and vacations every now and then. I imagine times like switching jobs would be ideal, but would like to hear if anyone has been able to swing such things in the context of a long-term commitment to patients.


Hi friends, first SDN post ever after years of checking in here and there from afar.

So I love the mind and neuroscience and talking to people and I love psychology and philosophy and literature and thinking about what makes a good life. Psych seems to have everything I would want in a career in that it seems more related to these things than just about any other field. That said, I am not a fan of bashing "the others" and I think I could be moderately happy in just about anything in medicine (though the dark tunnel of a surgery residency at certain institutions might give me a run for my money).

I value free time and life experience and people-watching and nature and witnessing the human experience far above money. With only one life to live on this fragile Earth (and possibly part of a life to live on Mars if Elon Musk makes good on his word), I would prefer to spend more time in a field related to the questions of what it means to be human and what it means to have meaning in life and to think about how to deal with suffering. I recognize psych will be hard at times, though, and cannot pretend to know just how challenging it will be.

All that said, I had been thinking about EM for the longest time before having my 3rd year psych epiphany of realizing it's not all about SSRIs, and was going to make EM my thing up until a couple months ago. Besides being perceived as a bit of a badass, the variety and the opportunity to meet all types of people, I really liked the idea of being able to do shifts and to go home without open loops going in my head about things to remember, i.e. loops overshadowing a deeper enjoyment of life and the present moment.

I am okay with not needing to show I am a badass through my career (I think how you show your love and appreciation for people matters much more than how cool your career sounds... although psych still sounds cool to me) and I'm okay with having some open loops going with psychiatry. My clinical experience in psych 3rd year seems to be loop-creating, but the value it adds to life (having a sense of purpose in thinking about your patients) seems to be worth the slight loss of peace of mind.

So here's the rub: I am keen on travel, and believe an ideal society ought to allow citizens to take extended breaks in their careers in order to rejuvenate and experience life, so long as they spend a decent portion of their life as servants to others. I want to know for those who are practicing psychiatry and who know people practicing in psychiatry: how realistic is it to take a month off (or more) every couple years or so?

I had always wanted to be a teacher before medical school, and absolutely loved the idea of summers full of exploration and reading and learning before returning to your students in the fall. My mom is a teacher and so I have seen how incredible this is to have in your career.

Can I possibly take a month off every so often as a psychiatrist? Can I take a year off at age 42 to travel the world? And at age 54 as well? Will I ever be able to do such things without worrying terribly about letting patients down or not being there when someone is deeply in need? I know that if you are doing inpatient stuff, this is less of a worry. But for those who have long-term patients, how have you dealt with these questions? I know this is also tricky with research commitments too.

Many thanks for any candid responses you have to offer.

TZ
 
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splik

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actually it is pretty standard for private practice psychodynamic psychiatrists to take the summer off. i think this is is becoming a less common but i dont get psychotherapy supervision during the summer for this reason. but you couldn't really take a year off if you were doing long term therapy. and patients to feel abandoned, attempt suicide, get hospitalized etc.

if you are doing inpatient, ER, or consults work then you could take time off depending on the employer etc if you wanted to take a year off unless you had tenure you would probably have to resign (if employed) otherwise you could take a sabbatical. i believe kaiser allows for sabbaticals if you work for them long enough (?)

if you were doing outpatient consultation work it wouldn't matter if you took a significant amount of time off (in terms of abandoning patients). and if it was a collaborative care type gig you wouldn't be seeing patients at all so even better!

in pp there is nothing stopping you taking as much time as you like off. but you do have to tell your patients that you may not be the most reliable psychiatrist and aren't around for long periods of time so they can vote with their feet if you're going to start overdosing all over the place because of your abandonment. you also need to arrange alternative care for them or have someone cover for you. this might not be easy

freud used to vacation with his patients so thats another alternative :eyebrow:
 

shan564

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You can definitely take a month off without causing significant obtruction to care. Few patients require follow-up more often than monthly, and if they do, you could have a colleague cover for you during that time.

As for a year - it'd be hard to pull that off if you are doing long-term outpatient and want to keep your patients. But there are lots of things you can do in psychiatry that would be amenable to a 1-year break... inpatient, consults, ECT, collaborative care, etc. Also, many places would be willing to hire you for a temporary outpatient contract, and then they'd pass your patients off to somebody else when you finish.
 
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Nope. We can't take vacations. :arghh:
Seriously though, it depends on the setting. It is most difficult if you have a solo private practice because you also wouldn't make money during that time and you would lose any new business that you would generate. If you are going to gone for more than a week or two, then you probably wouldn't take new patients for an appropriate period of time before you left. New patients tend to need the most follow-up as they tend to show up in crisis and you start them on a new medication that may or may not help. For a year absence, you might as well close up shop and start over when you get back.
 

TikiTorches

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You can definitely take a month off without causing significant obtruction to care. Few patients require follow-up more often than monthly, and if they do, you could have a colleague cover for you during that time.

As for a year - it'd be hard to pull that off if you are doing long-term outpatient and want to keep your patients. But there are lots of things you can do in psychiatry that would be amenable to a 1-year break... inpatient, consults, ECT, collaborative care, etc. Also, many places would be willing to hire you for a temporary outpatient contract, and then they'd pass your patients off to somebody else when you finish.
I think it is difficult in outpt psych as patients don't want a covering psychiatrist, as this is usually someone who doesn't know anything about them or has met them. This isn't like IM.
 

shan564

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I think it is difficult in outpt psych as patients don't want a covering psychiatrist, as this is usually someone who doesn't know anything about them or has met them. This isn't like IM.
Yeah, I'd be reluctant to do it for any more than 5ish patients for 1 visit as needed. If I'm seeing a patient at a 2-week interval, it's probably to monitor a manic episode or psychotic decompensation, so I could ask a colleague to look for certain symptoms, monitor for side effects, and "do X if you notice A, and do Y if you notice B" just for a brief visit to hold them over.
 

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Kinda funny all this talk of changing psychiatrists being bad for pts or the difficulty of treating pts you don't know. Given that at many programs pts are going to be lucky to get more than a year out of a resident and residents seem to be constantly assuming care of pts they don't really know. Obviously some programs do much better job of getting continuity than others.
 

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My Psychiatrist does both emergency psych and long term psychotherapy treatment of trauma based issues (c-ptsd), personality disorders, etc. He takes holidays on a fairly regular basis, when he's not flying interstate or overseas for various conferences. I've never found it to be an issue as a patient, patients in earlier treatment stages are generally told in advance (depending on their individual needs) when he has planned time off, and are then given the opportunity to express or discuss feelings about it - at the stage of treatment I'm at now I don't know when he's on holidays and I don't need to know, unless he's going to be away in excess of 4 weeks or more (typically for family situations) he doesn't really tell me and I don't ask. Just personally I'd much rather my Psychiatrist take time off and be a better therapist for it, than work himself into the ground and end up giving a slip shod service. So yeah, sure I think you can have holidays when you're a Psychiatrist, but it just depends on what patient population you specialise more in and how you handle things.
 
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Kinda funny all this talk of changing psychiatrists being bad for pts or the difficulty of treating pts you don't know. Given that at many programs pts are going to be lucky to get more than a year out of a resident and residents seem to be constantly assuming care of pts they don't really know. Obviously some programs do much better job of getting continuity than others.
Our patients can destabilize when there is a significant change in their lives. A change in providers could be that destabilizing change. There are a lot of factors to weigh in this equation and a thoughtful provider considers those factors. That is part of the standard of care. Does that mean we don't go on vacation? No. Although some neurotic providers might have difficulty with that. I like to think of it using the construct of optimal frustration. In other words, mommy can't always be there and that helps infant develop ability to regulate themselves. If she is gone too much though...
 

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Kinda funny all this talk of changing psychiatrists being bad for pts or the difficulty of treating pts you don't know. Given that at many programs pts are going to be lucky to get more than a year out of a resident and residents seem to be constantly assuming care of pts they don't really know. Obviously some programs do much better job of getting continuity than others.
The academic environment is more supportive than it appears. As a resident, you feel like you're flying in and out, but the patient is known to the institution and faculty. At any given university, most faculty know the high risk, high acuity, frequent ER-visiting patients in the panel, so as their care is transitioned, it's not the same as the patient transitioning from clinic to clinic in the community.
 

splik

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Kinda funny all this talk of changing psychiatrists being bad for pts or the difficulty of treating pts you don't know. Given that at many programs pts are going to be lucky to get more than a year out of a resident and residents seem to be constantly assuming care of pts they don't really know. Obviously some programs do much better job of getting continuity than others.
which is why there is a lot in the literature about transitions of cares as suicides etc are most likely to occur when patients are transitioned from one patient to another.

this actually is a problem. in my program we are strongly discouraged from passing on patients to residents when we graduate and find more long term care. i just got a patient who has been passed from several residents and each time the resident graduates, the patient becomes floridly manic and hospitalized. upshot is i won't be seeing this patient anymore and establishing them in longer term care.
 

TikiTorches

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Our patients can destabilize when there is a significant change in their lives. A change in providers could be that destabilizing change. There are a lot of factors to weigh in this equation and a thoughtful provider considers those factors. That is part of the standard of care. Does that mean we don't go on vacation? No. Although some neurotic providers might have difficulty with that. I like to think of it using the construct of optimal frustration. In other words, mommy can't always be there and that helps infant develop ability to regulate themselves. If she is gone too much though...
I have seen where some patients have changes made in their medication regimen right before a psychiatrist leaves on vacation. Changes that were needed, but may lead to problems when the doctor is gone for a significant period in time.
I don't see this as a "mommy" issue.
 
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I have seen where some patients have changes made in their medication regimen right before a psychiatrist leaves on vacation. Changes that were needed, but may lead to problems when the doctor is gone for a significant period in time.
I don't see this as a "mommy" issue.
No, optimal frustration is a "mommy" concept that I was broadening to refer to changes in patient's environment which includes medication. That is why it could be a problem even if you have another psychiatrist filling in for you.
 

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I think the deal is that if you have pretty unstable patients, you work as part of a system (community MH, DBT practices, the VA, etc) where you have built in coverage and potentially some institutional transference. If you do solo pp, you don't see unstable patients, although anxious patients who are fairly stable can still seem unstable when they need a lot of reassurance (although as STP is saying, sometimes not giving all that is good, too). Private practice psychiatrists and therapists in my community seem to take 2 to 3 week vacations with some regularity. I've never heard of taking the whole summer off and think that might be problematic if you're doing analysis or intensive psychodynamic treatment as the time around the vacation is also lost to some extent.

If you really want to not be committed to anything and have space to take extended vacations, you could do lots of locums type of work, which as far as I can tell so far, is a very realistic possibility for a psychiatrist.
 

Ceke2002

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Our patients can destabilize when there is a significant change in their lives. A change in providers could be that destabilizing change. There are a lot of factors to weigh in this equation and a thoughtful provider considers those factors. That is part of the standard of care. Does that mean we don't go on vacation? No. Although some neurotic providers might have difficulty with that. I like to think of it using the construct of optimal frustration. In other words, mommy can't always be there and that helps infant develop ability to regulate themselves. If she is gone too much though...
Yep, agreed. Admittedly I don't struggle with emotional disregulation in the face of perceived abandonment (or fear thereof) to the extent I once used to (except for my occasional Chicken Little 'rocks fall, everyone dies!' type moments, that I am quick to recognise, reality check on and then bring to the attention of my Psychiatrist in an upcoming session); however, even now, and even looking back at past difficulties, I do still find it helpful on some level to have it demonstrated to me, in a consistent, empathetic and balanced manner, that yes people can go away and they will come back, and no things won't have changed and no you won't suddenly be forgotten about. As I said though because it's not an area I struggle with to a huge extent in the here and now, I probably don't need that type of demonstrative reassurance as much as perhaps once would have, but I can see how it would benefit other patients who are perhaps at a less stable phase of their treatment process.

And on a somewhat related note I also think if you're dealing with patients who have been through some sort of childhood trauma (neglect, abandonment, abuse, sudden loss, etc), and who have also experienced at least some degree of parentification or spousification during childood, then it can actually be helpful as well for a therapist to outline some of the self care techniques they might use, including taking regular breaks and going on planned holidays, so that the patient becomes less likely to slip into the role of pathological caretaker (at least that's been my experience).
 
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TikiTorches

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I think the deal is that if you have pretty unstable patients, you work as part of a system (community MH, DBT practices, the VA, etc) where you have built in coverage and potentially some institutional transference. If you do solo pp, you don't see unstable patients, although anxious patients who are fairly stable can still seem unstable when they need a lot of reassurance (although as STP is saying, sometimes not giving all that is good, too). Private practice psychiatrists and therapists in my community seem to take 2 to 3 week vacations with some regularity. I've never heard of taking the whole summer off and think that might be problematic if you're doing analysis or intensive psychodynamic treatment as the time around the vacation is also lost to some extent.

If you really want to not be committed to anything and have space to take extended vacations, you could do lots of locums type of work, which as far as I can tell so far, is a very realistic possibility for a psychiatrist.
I have seen destabilization in private pp patients during these breaks....it doesn't have to be a hospitalization. They can irritate at work and get written up...lose their jobs...they have to function at a much higher level so the destabilization doesn't have to be much to get in trouble...
 

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I have seen destabilization in private pp patients during these breaks....it doesn't have to be a hospitalization. They can irritate at work and get written up...lose their jobs...they have to function at a much higher level so the destabilization doesn't have to be much to get in trouble...
But regardless, you still go on vacation because it's not reasonable to expect 100% year round availability from any specific medical provider.
 

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I think at that point into your career, a bigger concern would be your family ties. Will you be able to take a year off away from your family? Or even a month, will your child be out of school during that month? Will your spouse be able to take the time off? etc.
 

Doctor Bagel

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I think at that point into your career, a bigger concern would be your family ties. Will you be able to take a year off away from your family? Or even a month, will your child be out of school during that month? Will your spouse be able to take the time off? etc.
These are probably true considerations for most people, but there are plenty of people in their 30s and 40s who are single or have a partner who is also interested in travel and who don't have kids. And depending on your kid's age, you could take them with you. I've known people who taken a year to travel with their whole family.
 

TikiTorches

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TLDR; Would love to hear people's experience with psychiatrists being able to take moderate length breaks and vacations every now and then. I imagine times like switching jobs would be ideal, but would like to hear if anyone has been able to swing such things in the context of a long-term commitment to patients.


Can I possibly take a month off every so often as a psychiatrist? Can I take a year off at age 42 to travel the world? And at age 54 as well? Will I ever be able to do such things without worrying terribly about letting patients down or not being there when someone is deeply in need? I know that if you are doing inpatient stuff, this is less of a worry. But for those who have long-term patients, how have you dealt with these questions? I know this is also tricky with research commitments too.

Many thanks for any candid responses you have to offer.

TZ
This is what I was responding to.
 

Trismegistus4

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If you really want to not be committed to anything and have space to take extended vacations, you could do lots of locums type of work, which as far as I can tell so far, is a very realistic possibility for a psychiatrist.
This is probably the OP's best bet if living that way is really his/her main priority. I'm currently doing locums and can see that it would be very easy to just schedule a bunch of assignments with 1-2 months off in between each. The only downside would be the stigma of having many people think there was something wrong with you for not getting a "real" job.
 

Doctor Bagel

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This is probably the OP's best bet if living that way is really his/her main priority. I'm currently doing locums and can see that it would be very easy to just schedule a bunch of assignments with 1-2 months off in between each. The only downside would be the stigma of having many people think there was something wrong with you for not getting a "real" job.
Screw those people. Even though I've admittedly been guilty of having similar thoughts.
 

vistaril

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Screw those people. Even though I've admittedly been guilty of having similar thoughts.
There are upsides to locum, but downsides too:

1) you aren't going to be able to set up your schedule job to job exactly how you want it. You may have more time off in between jobs in some cases than you like, and less in others. Overall this is going to depress income.
2) not having any sick or vacation days depresses income.
3) if you have to travel, where are you going to live? You guys may not know this but they don't put you up in awesome fully furnished homes. If they even provide lodging(some don't)
4) the experience is not good for building a career. Period. It may be ok to do for a short time, but locums jobs are not good jobs to get experience and become a good psychiatrist. Anyone who spins it otherwise is high.
 
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Hi all,

Thanks a lot for the responses. It's very helpful. Another thing I was thinking of was how a lot of orthopods take a month off every year to do volunteer work in another country (their skillset is more amenable to short term gigs of course), but things like that. It sounds like these things would be pretty tough in psych, unless 1. doing longer term global health work (which I might) or 2. switching jobs, which might be the one or two times in a career where it would be alright to take a longer break (and 3. being locums work I suppose). Maybe that makes the most sense. Do something for 10 years, take a break for X amount of time, start something new, with little two-week breaks each year to keep healthy and sane enough in order to do your best for your patients and your family.

I suppose I could also always considering just spending a couple years in another country practicing after paying off all the loans!

And the kids and family would come too of course, that's the point! Life is short, and spending your whole life in one place is like reading only one page of a book (I think someone said once).

Anyway, thanks again for the responses! I hope the thought of wanting to travel/ explore the world with the people you love doesn't sound too selfish. Patients come first of course and so that's why I asked.

TZ
 

Doctor Bagel

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There are upsides to locum, but downsides too:

1) you aren't going to be able to set up your schedule job to job exactly how you want it. You may have more time off in between jobs in some cases than you like, and less in others. Overall this is going to depress income.
2) not having any sick or vacation days depresses income.
3) if you have to travel, where are you going to live? You guys may not know this but they don't put you up in awesome fully furnished homes. If they even provide lodging(some don't)
4) the experience is not good for building a career. Period. It may be ok to do for a short time, but locums jobs are not good jobs to get experience and become a good psychiatrist. Anyone who spins it otherwise is high.
About experience, why not? The locums people I've seen are working right alongside the non-locums people in the same job. How is the experience for the locums person different than for the non-locums person? I get that continuity gives you something, but I know locums people who have held the same job for several months at least. Although I guess with a locums job, you're not going to get much mentorship. However, I'm getting the feeling this is the reality for many non-locums jobs as well.

Which I guess points to another question, which should maybe be its own thread. How do you build a good career in psychiatry? What does a good career look like?
 
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vistaril

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About experience, why not? The locums people I've seen are working right alongside the non-locums people in the same job. How is the experience for the locums person different than for the non-locums person? I get that continuity gives you something, but I know locums people who have held the same job for several months at least. Although I guess with a locums job, you're not going to get much mentorship. However, I'm getting the feeling this is the reality for many non-locums jobs as well.

Which I guess points to another question, which should maybe be its own thread. How do you build a good career in psychiatry? What does a good career look like?
the difference is that the work requirements, demands, clinical expectations, etc of the truly locums people typically aren't the same. Now I've seen some people work the same locums job for a year and the nature of the job changes a bit. IMO, its not a locums job anymore in that case. It may be classified as such for payroll, but the nature of the work may have changed.

I say that the work requirements and clinical expectations aren't typically the same because how could they be? Frankly if the system is set up that someone in their 2nd week is going to be able to do as much as well as someone in their second year there, that indicates a problem with the system. Now granted all aspects of psychiatry in a day to day sense aren't like flying running a fortune 500 company, but there should be some advantage in terms of being there, knowing the system, knowing the resources. And in the case of continuity of care knowing the patients.

The very concept of locums goes towards a stand in....someone to prevent things from collapsing. The idea isn't equivalency of performance.
 

Trismegistus4

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Screw those people. Even though I've admittedly been guilty of having similar thoughts.
I agree for the most part. The only problem is that some of "those people" are the same people who may be making a decision about hiring you when you apply for a permanent job. Shortly before I graduated, I had some attendings caution me not to do locums for very long. Of course, there were also others who were intrigued and probably a little envious, saying they would have loved to do locums, but now they have a family...

There are upsides to locum, but downsides too:

1) you aren't going to be able to set up your schedule job to job exactly how you want it. You may have more time off in between jobs in some cases than you like, and less in others. Overall this is going to depress income.
2) not having any sick or vacation days depresses income.
Presumably if being able to take extended vacations is the OP's priority, he (she?) is OK with taking the hit in income. There's a huge demand for locums, so you most certainly can schedule your jobs almost any way you want.

3) if you have to travel, where are you going to live? You guys may not know this but they don't put you up in awesome fully furnished homes. If they even provide lodging(some don't)
Have you ever done any locums work?

I glanced at the OP again and noticed continuity of care seems to be a priority for him. In that case, locums isn't the best choice. And as for the "the world is a book, and those who don't travel read only a page" philosophy, this is an example of how the limousine liberal SWPL crowd lives in such a bubble. Regular international travel is an extreme luxury. It's ridiculous to say it should be a standard part of life. Not to mention that usually those who have the ultimate disdain for those Bible-thumping rednecks driving their gas-guzzling pickup trucks down dirt roads in flyover country are the same people who apparently think everyone should spend thousands of dollars and burn thousands of gallons of jet fuel every year so they can experience fire-dancing on a beach in Thailand or whatever.
 

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Which I guess points to another question, which should maybe be its own thread. How do you build a good career in psychiatry? What does a good career look like?
I think there is way too much individual variation in the answers to this question. I think my career is great--but not likely attractive to everyone, and I'd lose my mind in a straight outpatient setting no matter what the patient population was. Psychiatry in particular lends itself to myriad job configurations and career trajectories.
 

Psychotic

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And as for the "the world is a book, and those who don't travel read only a page" philosophy, this is an example of how the limousine liberal SWPL crowd lives in such a bubble. Regular international travel is an extreme luxury. It's ridiculous to say it should be a standard part of life. Not to mention that usually those who have the ultimate disdain for those Bible-thumping rednecks driving their gas-guzzling pickup trucks down dirt roads in flyover country are the same people who apparently think everyone should spend thousands of dollars and burn thousands of gallons of jet fuel every year so they can experience fire-dancing on a beach in Thailand or whatever.
WTF are you raving about?
 

Psychotic

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I don't see what there is not to understand about that paragraph, so why don't you tell me what you don't understand about it?
I "got it" or understood it, but I think your opinion is baloney, and your choices in maligning people with broadbrush, sweeping insults is disgusting.

Your use of "limousine liberal" and "white people" for instance has exactly what to do with anything with regard to travel? Seeing value in traveling abroad has NOTHING to do, for most people at least, myself included, with being a "limousine liberal" and bringing race into it is obscene.

Same thing with equating people who value and seek abroad experiences with those who disdain "bible thumping rednecks."

Other than that...
 

Trismegistus4

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I "got it" or understood it, but I think your opinion is baloney, and your choices in maligning people with broadbrush, sweeping insults is disgusting.

Your use of "limousine liberal" and "white people" for instance has exactly what to do with anything with regard to travel? Seeing value in traveling abroad has NOTHING to do, for most people at least, myself included, with being a "limousine liberal" and bringing race into it is obscene.

Same thing with equating people who value and seek abroad experiences with those who disdain "bible thumping rednecks."

Other than that...
Well, if you traveled the world during and between college and med school, then unless you already had hefty savings and investments from a previous career, or won the Powerball, you did it on other people's dime, so check your privilege.
 
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I agree with Psychotic above. I also hear trismegistus that it is a privilege to get to spend time studying or working abroad. That is definitely true. I do not come from any money, though I could likely match in derm if I wanted. I'm not after money.

Most people I know in the peace choir or fighting Ebola or doing other global health work abroad are not wealthy either. I did global health work out of a desire to help other people.

I also just really like to meet people that are different from me and to see and experience new things. In continuing the book metaphor, you might realize on the other pages that outside of your familiar page, people are suffering in other places, motivating you to make their lives better even though they are not your next door neighbor, or even though your own neighborhood isn't perfect either. You also might learn information about countries other than your own that is helpful when you work with patients from those cultures. You also might learn new ways of thinking that are valuable to your patients, such as Buddhist thought. You might also learn a thousand other things you might not have if you didn't get the opportunity to travel. You might also be more relaxed and loving with your patients upon your return.

Not everyone gets to travel. Indeed, not everyone gets to read books or can even read either. That doesn't mean those who can shouldn't do those things. Those who can travel and read should work hard to allow more people to get to read and to travel themselves. I agree it's important to consider the environmental impact of traveling abroad, but also think the world would be a better place if everyone got to be exposed to myriad people and places different than their own.

Ironically, despite my Arizona username I come from the flyover farmfields myself, pickup trucks and all. Maybe that's why I have felt the need to get out of Dodge every so often ;)
 

Psychotic

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Well, if you traveled the world during and between college and med school, then unless you already had hefty savings and investments from a previous career, or won the Powerball, you did it on other people's dime, so check your privilege.
I came from a background most would recognize as "underprivileged" (or, to put it bluntly, poor) and attended college on need based grants and scholarships (as well as academic scholarships), majored in a foreign language / cultural studies program without an inkling I would eventually become a doctor, did a year abroad during college immersed in that culture, and post college was a Fulbright Scholar and spent a year abroad doing mental health research.

Travel / living abroad isn't always about "privilege" or "stuff white people like" or "limousine liberals" and other phonies avoiding "rednecks." My travels and living abroad are a big part of what makes me who I am and my childhood interests in language/culture led me to learn about and observe a culture quite different from the one(s) most Americans live in, and those accumulated interests and experiences in mental health research led me to psychiatry through med school.

I have read your post history, and I see that what motivated you to attend medical school was the ace idea that being a doctor would help you pick up women. How'd that work out for you, doc? Do you let your conquests read through your posts here where you describe women as "skanky whores" along with your many other disparaging labels for people who follow the beat of a different drum?

Your sick, perverted POV - your disparaging labels and attributions of "privilege" - disgust me.
 
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I came from a background most would recognize as "underprivileged" (or, to put it bluntly, poor) and attended college on need based grants and scholarships (as well as academic scholarships), majored in a foreign language / cultural studies program without an inkling I would eventually become a doctor, did a year abroad during college immersed in that culture, and post college was a Fulbright Scholar and spent a year abroad doing mental health research.

Travel / living abroad isn't always about "privilege" or "stuff white people like" or "limousine liberals" and other phonies avoiding "rednecks." My travels and living abroad are a big part of what makes me who I am and my childhood interests in language/culture led me to learn about and observe a culture quite different from the one(s) most Americans live in, and those accumulated interests and experiences in mental health research led me to psychiatry through med school.

I have read your post history, and I see that what motivated you to attend medical school was the ace idea that being a doctor would help you pick up women. How'd that work out for you, doc? Do you let your conquests read through your posts here where you describe women as "skanky whores" along with your many other disparaging labels for people who follow the beat of a different drum?

Your sick, perverted POV - your disparaging labels and attributions of "privilege" - disgust me.
Wow! I read the post much differently than you did, but I was just taking it at face value. I didn't think he was saying that travel and the success in life that affords that luxury are necessarily bad, but is it not a luxury? The critique I had was there appears to be a naïveté or unintentional condescension in the concept of travel should be part of life. Very few of my patients are afforded this luxury because of lack of resources and not just financial. Some of them can barely get to the next town. My wife and I are going to drive three hours to get to a Costco and buy about 1k worth of stuff. Meanwhile, many of my patients are going to the local Walmart the day after the government checks come in to try and stock up for the month. When I spent a week in Cape Cod last month learning and playing, that is privilege. Don't get me wrong, I worked hard for that and was at the welfare office at one time in my life, but also I have to realize how fortunate I am in comparison to the majority of people in the world.
 

Psychotic

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Wow! I read the post much differently than you did, but I was just taking it at face value. I didn't think he was saying that travel and the success in life that affords that luxury are necessarily bad, but is it not a luxury? The critique I had was there appears to be a naïveté or unintentional condescension in the concept of travel should be part of life. Very few of my patients are afforded this luxury because of lack of resources and not just financial. Some of them can barely get to the next town. My wife and I are going to drive three hours to get to a Costco and buy about 1k worth of stuff. Meanwhile, many of my patients are going to the local Walmart the day after the government checks come in to try and stock up for the month. When I spent a week in Cape Cod last month learning and playing, that is privilege. Don't get me wrong, I worked hard for that and was at the welfare office at one time in my life, but also I have to realize how fortunate I am in comparison to the majority of people in the world.
You still don't read his post for what he is saying about people who value travel? Limousine liberals, etc?

Wow!

Whatever, I am moving on from this discussion. I know exactly what he wrote and intended, and it is disgusting to me even if nobody else "gets it."
 
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I am not sure why the term limousine liberal is so disgusting to you. Is bible-thumping conservative just as disgusting? They both seem like apt descriptors of certain types of people. I also like nature loving pot smoking hippies sometimes referred to as tree huggers. I really identify with that label except I gave up the smoking pot part many decades ago. :D
 
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Trismegistus4

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Wow! I read the post much differently than you did, but I was just taking it at face value. I didn't think he was saying that travel and the success in life that affords that luxury are necessarily bad, but is it not a luxury? The critique I had was there appears to be a naïveté or unintentional condescension in the concept of travel should be part of life.
Bingo. If the OP had said "I, personally, like taking extended trips. Would it be feasible to become a psychiatrist and fit such travel into my work schedule?" I probably would never have brought the subject up. It was his statement that "society ought to allow citizens to take extended breaks in their careers in order to rejuvenate and experience life" and the negative attitude toward "spending your whole life in one place" that rubbed me the wrong way.
 

Psychotic

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Bingo. If the OP had said "I, personally, like taking extended trips. Would it be feasible to become a psychiatrist and fit such travel into my work schedule?" I probably would never have brought the subject up. It was his statement that "society ought to allow citizens to take extended breaks in their careers in order to rejuvenate and experience life" and the negative attitude toward "spending your whole life in one place" that rubbed me the wrong way.
And if your first reply had only been written as you have just now done, absent the labels, but targeting exactly what "rubbed you the wrong way" about his post, I would not have chimed in.

My point is that it is possible to express an opposite opinion on forums like this without resorting to offensive broad brush strokes and labels and assuming that anyone who crosses a border is wealthy or privileged or simply trying to evade "rednecks."