Leaving EM to raise a family

[blacknblue133]

I am a regular poster but needed to be more anonymous.

Does anyone know men or women who have left Emergency medicine to raise a family full time then return 15 or so years later once the kids are almost in college?

I have heard it is better to keep a foot in the door by getting a prn gig but was wondering if there is a chance to actually just leave and come back after a refresher course/recertification/preceptorship like the ones they offer at Drexel.

Just wondering if this feasible for EM.

Also seems it could happen if you have connections but if you're out that long, you won't have that many connections.

Financially could do without the additional income until kids in college.

Anyone?

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[MelMcT2009]

I am a regular poster but needed to be more anonymous.

Does anyone know men or women who have left Emergency medicine to raise a family full time then return 15 or so years later once the kids are almost in college?

I have heard it is better to keep a foot in the door by getting a prn gig but was wondering if there is a chance to actually just leave and come back after a refresher course/recertification/preceptorship like the ones they offer at Drexel.

Just wondering if this feasible for EM.

Also seems it could happen if you have connections but if you're out that long, you won't have that many connections.

Financially could do without the additional income until kids in college.

Anyone?

Just a resident, so no help here, but there’s an EM physician moms group on Facebook that has been a good source of support. Someone there may be able to help if you’re not getting much here. Best of luck.

 

[eduh]

No much help in actually doing what you're saying but since Hahnemann closed last year the Drexel refresher program is on hold until they find somewhere else to host it.

 

[RuralEDDoc]

Former medical director here. The beauty of EM is that you can work very part time and keep a job. A few shifts a month can keep your knowledge relatively fresh. You probably won’t be a very good doc, but good enough to keep a job. Now take a 15 year break? Forget it. I don’t know many medical directors that would hire someone who did this. Medicine changes quickly. Sometimes it’s the medicine changing, more often it’s the practice of medicine that changes due to regulatory issues.

 

[Brigade4Radiant]

Similarly don’t try to do a fellowship and not practice it for decades and think all of a sudden you are going to do it when you get tired of EM.

After taking 15 years out you would be better off doing stuff like cosmetic medicine or working in urgent care.

 

[gamerEMdoc]

I'd imagine you'd have to keep your board certification (and license) active. I mean you could do it, I don't doubt it, I just think 15 years is a LONG TIME to step away from EM and try to come back. Why not just work 2 shifts a month and not let your skills completely erode? Even if you don't need the income, just put that money into your kids college savings account. Both of you win, you don't lose your skills, they have a college paid for when it comes time to go.

 

[sylvanthus]

Agree, you should try and work a few shifts a month to keep skills up. I work icu and ED currently and can tell you it takes me a couple days to get back in the swing of things in the ED. Would be damn rough if I was out for months, let alone years without working in the ED

 

[Tenk]

Pretty sure if I quit working for 15 years and my future self came to visit me and I told him: “ok time to start working!” he’d slap me across the face and say: “no you.”

Then we’d probably go to In N Out or something.

 

[Birdstrike]

I am a regular poster but needed to be more anonymous.

Does anyone know men or women who have left Emergency medicine to raise a family full time then return 15 or so years later once the kids are almost in college?

I have heard it is better to keep a foot in the door by getting a prn gig but was wondering if there is a chance to actually just leave and come back after a refresher course/recertification/preceptorship like the ones they offer at Drexel.

Just wondering if this feasible for EM.

Also seems it could happen if you have connections but if you're out that long, you won't have that many connections.

Financially could do without the additional income until kids in college.

Anyone?

Apparently your family doesn't not depend on your income alone, which is good. That being said, if you can manage it financially, leave EM and raise your family. Family, and how your kids turn out is much more important than missing out on some shifts you don't need the money from. If you really want to "go back after 15 years" then keep working 4 shifts per month and keep your ABEM cert current. But if you're okay leaving for 15 years, and don't have the urge to go back within the first couple of years of that sabbatical, I doubt you ever will.

I've been out of all EM for almost 9 years now, but I'm still working full time in medicine (Interventional Pain). Although I'd put the likelihood of me ever going back to EM at < 0.01%, I have kept my ABEM cert current. If I ever did go back, I would take an EM board review course, and then probably start doing so urgent care shifts for a few months, maybe a year, and then work up to a low acuity ED. After being immersed in that, if I wanted more, I'd then transition back to full acuity. My ever actually doing that is about as likely as your local Interventional Cardiologist "going back to internal medicine." There's really no reason to ever do it, but if I did, that's probably how I'd do it. But after 15 years, that's tough, without having your foot in the door, at all.

There's more to life than work, though. Enjoy you kids and your family. You've been a doctor, and an ER doctor and you always will be. That s*** doesn't wash out of your DNA. Ever.

But you'll know after a short period of time if you're ever going to have any desire to go back. That's not going to suddenly hit you after 15 years.

 

[cyanide12345678]

Work 4-6 shifts a month if you have plans of returning eventually.

If you don't work for > 2-3 years, it will get fairly difficult to find a job. An attending i knew was disabled, kept his license up to date and his annual cme. Came back to the workforce, no one hired him. He went and took a PA job, worked a year in a supervised position, before shortly being given more responsibility. He now works full-time at one of the places i moonlight at.

 

[Birdstrike]

An attending i knew was disabled, kept his license up to date and his annual cme. Came back to the workforce, no one hired him. He went and took a PA job, worked a year in a supervised position, before shortly being given more responsibility. He now works full-time at one of the places i moonlight at.

Hmm...Interesting workaround. Smart and creative idea for him to think outside the box to temporarily take the PA position as a way of working his way back in the game. A lot of people would have let ego get in the way of making that move. It also underscores the importance of having a really strong disability insurance policy in place.

Here's a question you might not know the answer to and might not want to answer if you do. But if you can answer without compromising his privacy/HIPAA, did his disability go away, or was it something he was forced to work through due to insurance reasons, lack of insurance (or good enough insurance) or something else? The reason I ask, is most docs have pretty good insurance policies and so many disabilities are permanent making return to work, uncommon.

 

[Vandalia]

There is a possible issue with your state medical board. Out of habit I read the board actions, and a couple times a year there are physicians or P.A.'s who wish to return to the practice of medicine after a significant lapse. The application for a license is usually denied, and then the license is placed on probation for a year or two. The probation requirement is usually that the individual has to practice under the supervision of another physician who will then provide reports to the board. After this time, then the full license is issued. There is one case I remember of a woman who did not practice anesthesiology for a number of years - more than a decade I believe - and she was required to complete a year of training at the state university residency program.

I would not try to predict what any state medical board would do, but based on what I know, after a gap of 15 years or so, they will almost certainly demand additional training at a residency program. If you were exceptionally lucky they might allow a supervised practice arrangement, but I sincerely doubt it. Therefore, as others have mentioned, it is best not to completely stop the practice of medicine.

At a minimum, do a couple of shifts a year at a minimum, keep an active license, and keep up with CME and other requirements.

 

[Sushirolls]

Diving in to do family care is fantastic and its own reward.
However, it will get tedious and there will be days where you will simply want respite. Perhaps its actual respite like a beach vacation, or something like work.

Do a bare minimum of shifts per month and find a nanny/baby sitter, caregiver, etc to replace you for those days. Keep your toes in the water, as you have some doubts about completely walking away. Do that for some time, and you can always walk away later.

Keeping your foot in the door with bare minimum of shifts will give you spending money for something fun, or at least cover taxes, etc.

 

[EctopicFetus]

At my hospital system you cant be non clinical for over 1 year somewhere and get credentialed. I think if you work 1-2 shifts a month do that. it saves a lot of headache. Save the money and do something fun with you kids. i wouldnt go completely non clinical. you wont be able to work in 15 years.. things change too quickly. just do a little little bit.

 

[Groove]

I am a regular poster but needed to be more anonymous.

Does anyone know men or women who have left Emergency medicine to raise a family full time then return 15 or so years later once the kids are almost in college?

I have heard it is better to keep a foot in the door by getting a prn gig but was wondering if there is a chance to actually just leave and come back after a refresher course/recertification/preceptorship like the ones they offer at Drexel.

Just wondering if this feasible for EM.

Also seems it could happen if you have connections but if you're out that long, you won't have that many connections.

Financially could do without the additional income until kids in college.

Anyone?

3-4 shifts/mo and attend a big CME conference once a year or figure out some other way to keep up to date on EM literature so you don't get antiquated. Taking 15 years off, or even 3-4 years off is suicide IMO.

To answer your question, no I don't know anyone who has taken that amount of time off and managed to circle back to EM.

 

[cyanide12345678]

Hmm...Interesting workaround. Smart and creative idea for him to think outside the box to temporarily take the PA position as a way of working his way back in the game. A lot of people would have let ego get in the way of making that move. It also underscores the importance of having a really strong disability insurance policy in place.

Here's a question you might not know the answer to and might not want to answer if you do. But if you can answer without compromising his privacy/HIPAA, did his disability go away, or was it something he was forced to work through due to insurance reasons, lack of insurance (or good enough insurance) or something else? The reason I ask, is most docs have pretty good insurance policies and so many disabilities are permanent making return to work, uncommon.

Nope no idea on those things.

 

[Mbekweni]

I think you can easily explain 1-2 years off after a child and then work your way back in without too much trouble. More than that and you will likely have a harder time retaining your skills and getting that first job back. I suspect it would be possible to start in a less desirable place likely further from home and then work your way back, and/or the PA route mentioned above. However I would be quite hesitant to take 15 full years off. Additionally, while I'm sure you are confident in your relationship, anything from the death of a spouse to divorce or disability could rapidly change the equation with regards to who needs to work. Keeping one toe in the water can keep your options open, give you more financial independence and also add variety to your daily experience. Daycare 2-4 days a month could also be good for the kid too!

As my wife and I are rapidly approaching financial independence and kids at the same time we are planning on her going down to about 25% time, I'll go to 80% time and we can cruise like that for the near future. It also allows me to have more time with the child rather than just her and putting me to work 100-110% time.