Is this it?

[Nucevoger]

Excuse me if this turns into a rambling mess, but I just can't anymore.

So I'm in fellowship. For this program I moved across the country away from all my family and friends. To say the least, it's been rough. I'm in a major metropolitan area where people just aren't friendly and I've had hardly any luck making friends (exacerbated by the time demands of this program, not leaving much time for socializing). I don't like the environment here and honestly just want to go home. But for various reasons that's not an option, so I'm left hearing about all the events I'm missing out on several times per week while I sit staring at the wall of my tiny-ass apartment.

I'm definitely clinically depressed. The physical effects of all of this have been terrible--body aches, insomnia (cannot medicate most nights thanks to being on call), fatigue, hair loss, weight loss (20-25 lbs at present), etc. I went to a program through GME (this started as classic burnout and spiraled from there) and am seeing a psychologist, but the jury is out on how helpful that will be.

The pace of my work has been insane lately, to the point that I pulled an all-nighter to get some data collection done last week and have been averaging 2-3 hours of sleep per night. I had to do work-related things all this past weekend (when I wasn't on call), but by last Sunday I just needed a break and took a few hours to see a show. I posted something about it on social media, honestly mostly to make myself feel like I don't hate my life as much as I do (pathetic, I know). Well today I get chastised by my faculty for posting that I was doing something during business hours. On a Sunday. When I wasn't on call.

This all brings me to the question whether this is really it? I've worked my butt off for now 13+ years since high school, always telling myself that it would pay off in the end. But it really doesn't seem like it. The pace just gets busier and busier with worsening pressure each step of the way. Is this really what I've put so much time and effort into the entire medical training process for? I'm in no way fulfilled and absolutely wish I had never chosen this profession. But now I have no other marketable skills to fall back on. If this is all that life will be for the next 30+ years, it just doesn't seem worth it.

Looking for some insight, I suppose, because I'm just about done with all of this. Thanks for your input.

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[anonperson]

Sounds like a miserable fellowship.

If its that bad, why not quit fellowship and just do your primary specialty?

 

[rokshana]

Sounds like a miserable fellowship.

If its that bad, why not quit fellowship and just do your primary specialty?

there is that, but to the OP, are you just only a month into fellowship? There is a lot of adjustment that comes with having moved, starting a new job at a new hospital, and figuring out how things work...give yourself some time...but you may not necessarily make a lot of new friends in fellowship since there are generally fewer people than in residency and people tend to have their own lives more established by the time they are fellows.

I know when i was a fellow, I traveled more than i did in residency...went to visit family and friends to get some socialization and love... and checked out touristy things around on free weekends. Slowly made friends that i could hang out with...just give it some time.

 

[Nucevoger]

13 months in. Thought things would get better, but they've just gotten worse. It's only 1 fellow per year and incredibly isolating (both work and this city). Would love to travel, but this city being what it is, you cannot plan on being able to get to the airport without a 3-4 hour cushion on a Friday night, which makes it hard to get away for a weekend.

 

[ThoracicGuy]

13 months in. Thought things would get better, but they've just gotten worse. It's only 1 fellow per year and incredibly isolating (both work and this city). Would love to travel, but this city being what it is, you cannot plan on being able to get to the airport without a 3-4 hour cushion on a Friday night, which makes it hard to get away for a weekend.

How long is your fellowship?

 

[Nucevoger]

How long is your fellowship?

3 years. 23 months from today I can GTFO from this hellhole.

 

[BigPikachu]

Mate. Sounds pretty to clear to me you're burnt-out and hating the job. You need a break. Happens to the best of us. After a good break, come back and reassess when your head is in a better space to make decisions. It's what's best for the patients and for you. If your supervisors can allow you to take leave, then great; if not, then you've got to probably do what's best for you and give notice to resign; notwithstanding if you can take sick leave after seeing a family physician or psychologist-psychiatrist -- probably doesn't hurt to see your own doctor if you're in a bad place. That said, no point doing a job if you're going to be miserable. If you're already a fellow and board-certified for a specialty, then perhaps just practice as a boss in that instead of stressing yourself out with more sub-speciality training. I had the option of dual training, and frankly finishing one training program was enough for me; I had enough of putting-up with the **** as a trainee that sadly came from un-sympathising bosses and an archaic system that overworked trainees.

 

[deleted480308]

Make your social media private

 

[Nucevoger]

Make your social media private

It is. Attendings here friend the trainees. I've got nothing to hide (or so I thought)...it was literally a picture of the program and some text saying that I needed a break and decided to see a show. I figured that was allowable on one of my days off.

 

[deleted480308]

It is. Attendings here friend the trainees. I've got nothing to hide (or so I thought)...it was literally a picture of the program and some text saying that I needed a break and decided to see a show. I figured that was allowable on one of my days off.

Stop posting about anything then since you screwed up an friended them

 

[Nucevoger]

Stop posting about anything then since you screwed up an friended them

They requested me, not vice versa. I feel like you're in between a rock and a hard place when that happens if you're conflicted about it. But that wasn't really the point of my post, just an illustration of how craptastic my life is anymore that I cannot even take a few hours for myself without it backfiring.

 

[deleted480308]

They requested me, not vice versa. I feel like you're in between a rock and a hard place when that happens if you're conflicted about it. But that wasn't really the point of my post, just an illustration of how craptastic my life is anymore that I cannot even take a few hours for myself without it backfiring.

You can take the few hours

You just can’t post about it

And I had unaccepted friend requests sitting in my profiles for 4yrs during med school

 

[cubsrule4e]

I was literally about to start typing the whole "suck it up for a year" bit, but if youve been doing this for 13 months with 2 years to go it sounds like its not worth it to me. I sacrificed 8 years away from everything i knew and loved to get where I am, but that was the absolute necessity of the whole madness. Dont see where you posted your primary area of training but doing an "optional" fellowship and being that miserable sounds like you were never meant to do it in the first place. Get out of that hellhole and "fall back" on your basic training. If its all in the name of prestige or additional salary and youre this miserable, trust me, its not worth it. You state that going home is "not an option," but why? Even Primary care you can do with a basic medical license, and even as miserable as that is for some, it sounds much better off than you are now if youre able to do it where you want to be.

 

[Nucevoger]

You state that going home is "not an option," but why?.

No jobs available in my primary specialty. They were there when I was finishing residency, but now they're gone. If history is any guide, it'll be a couple years until there are openings again. I'm not sure I have the depth of background to do primary care--urgent care is going to bring up conditions I don't currently treat and I certainly don't have the training in complex management of many of the chronic medical conditions if I tried an outpatient gig.

 

[cubsrule4e]

No jobs available in my primary specialty. They were there when I was finishing residency, but now they're gone. If history is any guide, it'll be a couple years until there are openings again. I'm not sure I have the depth of background to do primary care--urgent care is going to bring up conditions I don't currently treat and I certainly don't have the training in complex management of many of the chronic medical conditions if I tried an outpatient gig.

Surely there are options within 1-2 hours of your preferred location that would still trump your current situation. Then when an ideal position becomes available you jump on it. I know Im somewhat unintentionally trivializing the matter, but that still has to be greener grass than your current situation. Worst comes to worse you apply for a different residency in something youre more interested in. The beauty of medicine is that its such a vast area you can really go anywhere you want and do anything youre interested in to a certain degree. I just feel the pain in your original post and am trying to give you any recommendations that would best your miserable current setting.

 

[Nucevoger]

The pain is real and relentless, I appreciate your thoughts. Thank you.

 

[Raryn]

No jobs available in my primary specialty. They were there when I was finishing residency, but now they're gone. If history is any guide, it'll be a couple years until there are openings again. I'm not sure I have the depth of background to do primary care--urgent care is going to bring up conditions I don't currently treat and I certainly don't have the training in complex management of many of the chronic medical conditions if I tried an outpatient gig.

I'm trying to figure out what field

A) Offers you the opportunity to do primary care
B) Has the option of intense three year fellowships
C) Has a shoddy job market for non-primary care jobs

The only thing I can think of is Peds->NICU/PICU. For IM, there's no market in the country you wouldn't be able to find a hospitalist job. In addition, from my understanding, other peds fellowships usually lighten up a ton after the first year - just with more of a focus on research. I have no personal peds experience though.

Even if I'm wrong about the field, regardless,

You are trained in your primary specialty. You theoretically have no less training in "complex management of the many chronic conditions" than the people actually doing said management in whatever that specialty is. If you're so miserable in your fellowship, it may be reasonable to just go and get one of those jobs. If none are available in your hometown, find one somewhere else. Ideally somewhere else that is a close flight from your hometown. There's very few fields where the job market is so bad you can't find one anywhere, whether a locums job or a permanent position, and it sounds like you're truly miserable in your fellowship.

Edit: Removed needless speculation.

 

[OrthoTraumaMD]

Sounds terrible. I went through 5 years of a brutal residency. It’s survivable. Just keep looking at that light at the end of the tunnel—2 more years of your life is a lot, yes, but you’ve already sacrificed so much—and after it’s over, you have 70+ more years of doing what you want, where you want.
There are times when it was dark for me. I remember months on night float where I did not see sunlight at all. Other months when I just cried all the time. But you just do what the Navy SEALs do, no excuses, keep pushing forward. Own your pain instead of trying to ignore it or push it away, and then keep going. It was hard to imagine back then how happy I would be. I am very happy now. I have faith that you will be too.


Sent from my iPhone using SDN mobile

 

[Crayola227]

pain is weakness leaving the body

 

[Perrotfish]

So my advice would vary depending on what you are doing, and practicularly how this fellowship will affect your future job prospects , job satisfaction, income, and workload.

 

[Saddleshoes]

First, let me say this advice is coming from an old guy that trained in the days before cell phones...

Your NOT in Kansas anymore!
1. Get off the phone and plug into your new community. Make new friends. Get to know your neighbors. Look into the history of your new town. Develop a supports system of the local shop keepers, the local dentist, the local bar tender, the health club workers, etc. Go to church in your new neighborhood. Find the local bike club and go for a ride. Volunteer with _____. Etc.
2. When you walk away from the hospital leave it all behind! Learn to compartmentalize your life. If you take the work "home with you" it will drive you crazy.
3. IT"S A JOB! I'm guessing that until this point in time you have basically been a student. You are not a student anymore. You are a skilled doctor. You have been training for this moment for years. Quit crying, suck it up and go Do Your F^&%ing Job! If the job is too much for you then get out now and move on to something else. There is no shame in walking away from a bad job on your terms.
4. I don't mean to sound harsh. In fact I hope to sound like you Father. My comments are made with love, believe it or not.

 

[evilbooyaa]

Agree whole heartedly with sb247. Now that you've friended your attendings who chastise you on facebook or whatever (the difference between chastise and joking around with you is minimal, but based on your stress level and outlook you likely don't have a friendly relationship with your attendings) you can no longer post anything on social media.

Only you can decide if this is worth it or not in terms of pushing through. However, fellowship is the first time in medical training that additional training is VOLUNTARY and if you can stomach your primary residency, you can get a job as an attending in that. I almost guarantee you, that if you are willing to move, there is a job somewhere that is willing to take you in your primary specialty. You're not DR or Path (no 3-year fellowships in those fields AFAIK) so fellowship isn't mandatory to getting a job.

 

[Telamir]

I got rid of all social media and I could not be happier. For what it's worth, if you mainly use facebook to keep in touch with family you can keep the messaging app while deleting your profile, etc.

 

[0ncogene]

I would quit the fellowship in a heart beat. I would not sacrifice an additional 3 years of my life for more bull****. Like the poster above said, you actually have a choice in fellowship. Go get job in your primary specialty.

 

[ThoracicGuy]

I got rid of all social media and I could not be happier. For what it's worth, if you mainly use facebook to keep in touch with family you can keep the messaging app while deleting your profile, etc.

Or put those attendings in a different group that doesn't see updates.

 

[Gastrapathy]

It really depends on the fellowship and the primary specialty whether I would bail.

 

[MBBS_124]

Gosh that sounds aweful ..