Leaving Residency - Please help

[dh1986]

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I am not sure if anyone still reads this forum. But if there is anyone out there I would appreciate the advice.

I have just started my PGY-1 year in IM and am considering leaving the program. It is a very good program, but I have many reasons for wanting to leave. I'm not sure I want to work clinical anymore and I definitely do not want this specialty. I want EM. I am certain of one thing, if I cannot be an EM physician I do not want to work clinically. Also, there are other personal reasons.

I am only 2 weeks in, but I am miserable and cannot continue the year. It's not the work hours (i'm an IMG and have done an internship before). I just feel stuck in this field and if I don't get out now I never will and will never pursue what I want and what makes me happy.

I will attempt to get into a residency in Canada, if not then I am more than happy pursuing a life in academic research. I will reapply to the Match in Canada which is a different system, so I will not mention that I was in a residency position in the states. And I have read other blogs that suggest complete the intern year and such, but completing it might harm more than benefit me, since some provinces in Canada do not allow you to apply if you have previous post-graduate training

My concern is I do not want to leave the program on bad terms. I will explain my reasoning (partially - omitting the specialty part) and will be leaving after the 45-day period that is enforced by NRMP (as not to be considered a match violation) i.e I will be leaving in September. I will do research in the meantime while I apply for residency in Canada

Any advice on when I should tell my PD? I have reviewed their housestaff manual and it says 14-30 day notice, but that seems like a short period. I would like for them to be able to find a replacement before I leave.

It's more or less of a career change. I have graduated from med school 3 years ago and have been doing research (other than a 1 year internship). So I know my chances of getting accepted to another residency program might be slim, but I am willing to take those chances. If that doesn't work then I will do research.

I would appreciate any advice.

 

[Paddington]

At the start of the year, they'll replace you no problems. There's countless unmatched posters just here on this forum who will take your position, probably a half dozen will have sent you a message already asking which program you are in so they can call your PD.

To me, it would seem your chances of matching in EM would be slim to none, just based on:
1) IMG
2) long gap after medical school
3) previously left a residency program mid-year

You need to be very realistic about your chances of ever getting back into medicine, if you go through with this move to leave your current position.

 

[dh1986]

Thanks for your reply.

I know my chances are slim for EM. But Canada has alternate root where you into Family for 2 years and then do EM. Still I do understand those chances.

IMG is nothing I can change. The long gap after med school, I can gain some clinical experience in Canada via observerships and a certain program designed for IMGs. As for previously leaving a program, the programs in Canada do not have to know that. Can't I simply ommit this from my CV?

 

[ThoracicGuy]

You do realize that there are many ERs that are staffed by FM/IM doctors, particularly in rural ERs, right? Your current IM residency could be a path to doing ER work in the future. I would give this more time and thought before just rushing through and quitting your current program. I think your chances in Canada are probably poor and omitting your US residencies will not be overlooked. They will ask about it if you got an interview, I'm sure. Think very hard about this choice... talk to some trusted attendings, even if they are in other specialities before you make this irreversible decision.

 

[NotAProgDirector]

You're very, very unlikely to get any training spot in Canada.

The first question is whether you are a Canadian citizen or not. If no, then your chances of getting a residency in Canada is exactly zero. There is no functional visa system in Canada for medical residents. You will not get a spot.

If you are a Canadian citizen, then you're still very unlikely to get a spot. Competition is fierce. If you have not done rotations already in Canada, you have little to no chance. Go read the IMG threads on the Canada board here on SDN. Its humbling.

Bottom line -- a residency in Canada is not a plan B. It's a hail mary pass.

Next: if you train in IM, you can still work in an ED. Many ED's are staffed by IM docs. You can probably use your elective time to do more ED work, perhaps even some Peds experience, etc. You won't be working in a big academic ED, but smaller community hospitals are staffed by IM docs. You might run into trouble by the end of your career -- as more docs finish ED training, it might get to the point where only EM board certfied docs are considered for ED spots. But that's a long way off. Of note, you could train in the US and then go work in Canada (again, you need to be a citizen) -- a MUCH easier pathway than trying to do a residency in Canada.

If you do apply to Canada, OF COURSE you'll need to tell them about all of your prior training. Lying on your application is a VERY BAD IDEA.

Are you certain you actually have a career in research? Sure, it's relatively easy to get a poorly paying job in someone's lab with your MD/MBBS. But developing a healthy research career with a medicine background is not easy. You weren't specific, so perhaps you have a PhD or some other research training -- in that case, your chances are better.

If you give up this IM spot, you'll probably never get another chance. You need to be 100% certain. Could you finish the 3 year IM residency with a plan to work in a rural ED? Or be a hospitalist (if you dislike clinic)?

 

[dh1986]

Thank you for your reply ThoracicGuy.

The thing is my current IM residency will not really help me work in Canada. It makes it difficult for me to work there given that they require extra years and additional exams (ie another 3 years wasted). And I cannot work in an ED there if I am not EM certified anyways. My goal is Canada because that is where my family is (or will be to be exact).

As for asking during interviews, I do not have to mention that I applied to the match or was in a residency program. I have asked and the Canadian Matching System does not inquire about you match history in the US. If I were applying via NRMP then yes, I cannot omit that information.

I hate to have to do this. I truly do. But I am unhappy in this field. Even EM is a last resort for me. If that doesnt work I don't want clinical as I am not fond of the sacrifice that medicine requires. I would be very happy not working clinical but rather working in Quality Improvement projects (possibly with paramedics). It feels odd pouring these thoughts out there, but I feel trapped in medicine. It was not completely my choice to do it. Now I have an MD degree and I'm stuck with the idea that I have to work with it. So much money was invested into that degree and it would seem wrong not to work with it or work in something related. But the problem is, the options seem limited for someone with just an MD degree and no residency. If I could go back I would not go into med school. But there's no changing that.

 

[dh1986]

aProgDirector thank you for replying.

I am a Canadian Citizen. I had applied to the match in Canada last year, got 4 interviews (which is unusual for many IMGs) but I didn't rank any. That's where my mistake was.

I do not want to lie on application. I hate the fact that I might have to, but in this case it only seems best not to mention it. Of course I will re-consider this if and when the time comes to apply.

As far as working with IM in an ED, that can be done here in the US, but not in Canada. Even hospitalists in Canada are Family Medicine trained not IM. And if you have any information on how to go about working in Canada after residency in the US, I would appreciate that. From what I have read and researched it seems complicated and difficult.

I do not have a PhD, but I do have some research experience working as an RA and a Research Coordinator. I was considering doing an Masters in Clinical Epidemiology and going into academic research at a university. But I do not know how far one can advance in that area honestly. I am still searching this option before I make my final decision.

 

[dh1986]

Also, I would like to ask you aProgDirector does the fact that I have been away from clinical since June 2011 affect my chances. How do programs look at that with respect to IMGs. I know the US is more IMG-friendly than Canada. So I am wondering if Canadian programs would place less of an importance on that and more on exam grades, LORs, clinical experience in US or Canada.

Thanks

 

[ThoracicGuy]

I believe that your best chance of completing a residency program is in your current program. Yes it is three years of a specialty that you may not like, but it can be a way to get where you want. If you really wanted EM, you could finish the IM residency and then apply for an EM residency. Or you could continue in your IM residency and look for open IM/EM combined residency spots that you could try and join as a PGY2. Of course you always have the option of not completing a residency, but as you said the money spent already is massive and you're going to have a hard time paying it back in a low-paying research assistant type job.

Not mentioning prior residencies even in a Canadian application is a bad decision. If you fail to mention it and a program finds out about it, you'll likely find yourself fired from your position and that's a can of worms you really don't want to open.

Step back and think about it a bit. You're only 2 weeks into training. How do you know you won't find some aspect that you enjoy? Give it a few more months and think about it. I fear your ability to get a training program after this one is going to make things very difficult for you in what appears to be a very difficult situation already.

 

[ThoracicGuy]

You should also check out this thread... Make sure you realize exactly what options you have in the Canadian system (which appears to me to be about zero):

http://forums.studentdoctor.net/showthread.php?t=469613

 

[Dral]

You could look into preventive med residency if u can make it through intern year. Good way to make use of MD without having to do clinical. Usually get MPH concurrently with it. Hopkins has a good program, but it's not the only one.


http://www.jhsph.edu/academics/residency-programs/general-preventive-medicine-residency/

 

[AStark]

Thank you for your reply ThoracicGuy.

The thing is my current IM residency will not really help me work in Canada. It makes it difficult for me to work there given that they require extra years and additional exams (ie another 3 years wasted). And I cannot work in an ED there if I am not EM certified anyways. My goal is Canada because that is where my family is (or will be to be exact).

You only need four years of postgrad training in IM to be eligible to sit the Royal College exams. Doing the MCC exams is not a big deal (and if it is for you, that is something that ought to give you pause).

As for asking during interviews, I do not have to mention that I applied to the match or was in a residency program. I have asked and the Canadian Matching System does not inquire about you match history in the US. If I were applying via NRMP then yes, I cannot omit that information.

Yes it does. You absolutely must declare any previous postgraduate training experience in the CaRMS process because ANY such prior training makes you INELIGIBLE for the first iteration of CaRMS. Hence you will only be eligible for the second iteration (rough equivalent of the scramble/SOAP), in which there is likely to be - at best - 1 or 2 open EM spots that you will be extremely unlikely to get. Many FM spots will be available, but you will be competing with hundreds of other IMGs along with Canadian grads who went unmatched in the first iteration. You might possibly get an FM spot, but it's likely to be in an undesirable location. Although you do not necessarily need extra training for EM, for any moderately larger centre you will need at least the "+1" year which is increasingly competitive.

I hate to have to do this. I truly do. But I am unhappy in this field. Even EM is a last resort for me. If that doesnt work I don't want clinical as I am not fond of the sacrifice that medicine requires. I would be very happy not working clinical but rather working in Quality Improvement projects (possibly with paramedics). It feels odd pouring these thoughts out there, but I feel trapped in medicine. It was not completely my choice to do it. Now I have an MD degree and I'm stuck with the idea that I have to work with it. So much money was invested into that degree and it would seem wrong not to work with it or work in something related. But the problem is, the options seem limited for someone with just an MD degree and no residency. If I could go back I would not go into med school. But there's no changing that.

Or you could stay in IM and go into rheumatology or geriatrics and enjoy a pretty nice lifestyle. In any case, your chances in Canada are slim to nonexistent. Sorry to be so blunt.

aProgDirector thank you for replying.

I am a Canadian Citizen. I had applied to the match in Canada last year, got 4 interviews (which is unusual for many IMGs) but I didn't rank any. That's where my mistake was.

I do not want to lie on application. I hate the fact that I might have to, but in this case it only seems best not to mention it. Of course I will re-consider this if and when the time comes to apply.

It was a terrible mistake. In some cases you may be able to omit some details on an application, but you cannot hide prior postgraduate training or any gaps in training.

Also, I would like to ask you aProgDirector does the fact that I have been away from clinical since June 2011 affect my chances. How do programs look at that with respect to IMGs. I know the US is more IMG-friendly than Canada. So I am wondering if Canadian programs would place less of an importance on that and more on exam grades, LORs, clinical experience in US or Canada.

I cannot say exactly how Canadian programs assess IMGs re: examination scores, but clinical experience and LORs can be key. Having any gaps in training is a serious problem. Leaving a previous residency program is a serious problem. Canadian residents can switch programs without re-entering the match through somewhat informal processes, but that is not what you're trying to do. Moreover, any prior postgraduate training renders you ineligible for EVERY spot in the first iteration of CaRMS, leaving you to compete with hundreds of other IMGs, some Canadian grads, and many others who have no or minimal gaps in training, but do have Canadian electives and LORs. Note that you will NOT generally be able to obtain elective rotation placements as someone outside any educational program.

This is a very, very bad and ill-conceived idea. I urge you to reconsider.

 

[NotAProgDirector]

It sounds like you're making bad decisions. You need someone to talk to so you can work this out.

Let's be 100% clear:

1. If you leave this program, your entire career as a physician is likely over. It's highly doubtful that any US program would consider you after hearing that you left your first program after a week. As above, you no longer qualify for the 1st iteration of CaRMs, and the 2nd iteration isn't a picnic.

2. I wonder if you'd really be happy in ED. Sure, med students often gravitate to a field -- but my experience is that most students could be happy in a number of fields. You say you would only be happy in ED. I think there's a good chance that you're simply unhappy as a physician in general.

3. If so, then walking away from medicine is a fine plan.

4. Make sure you understand that there are not many research or QI jobs that will pay anything near what a physician makes. We do see threads here on SDN asking "where do I get a research job that pays $150K so I can pay back my loans?". The answer is: "There are none".

5. It's interesting that you say you don't want to train in the US and then go work in Canada because of the "extra years" and "exams" required. Yet, you're willing to consider a Master's degree which will consist of extra years and exams.

Get help from someone you trust. Make sure you're not depressed. The decisions you're considering are irreversible. If you have loans, they are yours forever. You've mentioned that you've made some bad decisions so far -- make sure you don't make another.

 

[hamstergang]

I have just started my PGY-1 year in IM and am considering leaving the program. It is a very good program, but I have many reasons for wanting to leave. I'm not sure I want to work clinical anymore and I definitely do not want this specialty.

The part I don't get is why you applied for the residency spot and showed up. I mean, you knew what you were getting into, as you claim:

i'm an IMG and have done an internship before

so why now, 2 weeks into this, have you suddenly realized this wasn't what you wanted?

 

[brotherman]

Agree with the previous posters. Finish the IM residency, do whatever it takes. If you want to meet the canadian requirements to practice, you can always do a chief year in internal medicine, which would, depending on how the curriculum is set up, grant the requisite forth year of training. I know of several individuals who are currently pursuing that as a means to meet the requirements.

 

[Mantich1]

I am not sure if anyone still reads this forum. But if there is anyone out there I would appreciate the advice.

I have just started my PGY-1 year in IM and am considering leaving the program. It is a very good program, but I have many reasons for wanting to leave. I'm not sure I want to work clinical anymore and I definitely do not want this specialty. I want EM. I am certain of one thing, if I cannot be an EM physician I do not want to work clinically. Also, there are other personal reasons.

I am only 2 weeks in, but I am miserable and cannot continue the year. It's not the work hours (i'm an IMG and have done an internship before). I just feel stuck in this field and if I don't get out now I never will and will never pursue what I want and what makes me happy.

I will attempt to get into a residency in Canada, if not then I am more than happy pursuing a life in academic research. I will reapply to the Match in Canada which is a different system, so I will not mention that I was in a residency position in the states. And I have read other blogs that suggest complete the intern year and such, but completing it might harm more than benefit me, since some provinces in Canada do not allow you to apply if you have previous post-graduate training

My concern is I do not want to leave the program on bad terms. I will explain my reasoning (partially - omitting the specialty part) and will be leaving after the 45-day period that is enforced by NRMP (as not to be considered a match violation) i.e I will be leaving in September. I will do research in the meantime while I apply for residency in Canada

Any advice on when I should tell my PD? I have reviewed their housestaff manual and it says 14-30 day notice, but that seems like a short period. I would like for them to be able to find a replacement before I leave.

It's more or less of a career change. I have graduated from med school 3 years ago and have been doing research (other than a 1 year internship). So I know my chances of getting accepted to another residency program might be slim, but I am willing to take those chances. If that doesn't work then I will do research.

I would appreciate any advice.

I would advice you NOT to leave the residency. Complete 1 year and then you can explain that you want to change specialties. It is very bad to leave a residency at any point starting or in the middle. Try to make alliances with positive persons in the residency. If you have issues with the leadership find the right channels, seek advice within the program, with people you can trust. Don't tell any of your peers you want to leave. Just try to survive, with low profile. You will be singled out and not even in Canada will they take you if you resigned. If it is something you can prevent, don't do it. If the situation is impossible to handle, you have to leave in good standing. But it is going to put you in a very difficult position. If you can avoided don't leave. The majority of the places have advisors, psychologist that work with the residents. Seek for that advise. Good luck and I understand the need to leave but try to hang in there. Regards

 

[cabinbuilder]

Be happy you have a residency at all. Quitting now will slit your throat. Don't jack up your future after only 2 weeks of being a resident. The first 4 months are hard and miserable for everyone. Just finish where you are and seal your career.

 

[QofQuimica]

As the others have said, if you leave this program. you're done as a physician. Forever. So I agree with them that you should stick it out, unless you're absolutely sure that you're not going to work as a physician and you have a fully-fleshed out Plan B for how you're going to support yourself, which it doesn't sound like you do. That's a big problem.

For the record, you're not alone; residency is a crappy experience for many people. You're also not the only person who would not have gone to med school if they could do it all over. But the fact remains that you did go to med school, and you can't do it all over. So now you have to make the best of a less than optimal situation. As others have said, you've made some bad emotionally-driven decisions in the past, and you're contemplating making yet another one. Stop. Step back for a minute. There's no good time to make a decision about dropping out of residency while you're still a resident, but your first month of intern year is for sure not a good time to be making this kind of decision. And completing a residency in *any* specialty so that you are BE (and BC if you take the exams) will give you a lot more flexibility and open more opportunities for your career. Objectively, staying the course is the most sensible thing for you to do. You can do it.

I'd be lying if I said that being a resident suddenly became great as you got farther along, but the truth is that it does get less crappy. I think most people who have been through residency will agree that intern year was the worst year. So take things one day at a time, and keep your eyes on the prize.

 

[Substance]

I was trained and currently practice in Canada, so I can kind of weigh in on some things for you.


1. Do not omit your american post-graduate experience from carms. When someone finds out you've left this out, you're done.

2. The Canadian government, in all its PC glory, has instituted a ******ed separate parallel IMG matchin the first round so as to not anger the whiny masses. This means programs, and many of them are competitive specialties like EM, are forced to match IMGs in the first round. I think the fact that you've done some residency in the states might exclude you from this, but I would call carms and ask them. But often times it doesn't matter since a lot of programs purposely keep these IMG spots unfilled so as to not water down program quality.

3. Your best bet is to go into round 2, where there will be absolutely NOTHING good, and apply to all of the really remote unpopular family medicine spots; I'm talking the Atlantic provinces, Manitoba, and Saskatchewan. If you speak French, you could also apply to the Quebec programs, which is a big deal since 33% of the total unmmatched spots are French only. Another alternative is to try to match to one of the other fields that are IMG heavy: psych and path come to mind. But since both are as far away from the ED as fields can get, this might not be the best option.

4. You're correct in saying that one can do family medicine and then add a third year of EM training on to it. Keep in mind that these EM spots are also ridiculously competitive in their own right; but then again, I've seen absolute *****S who were IMGs match CCFP-EM in good centers, so anything is possible once you're at that stage. Even if you don't match, you can still work in super-rural EDs with only your family medicine cert.

I would not quit your residency, but I would not rule out applying to Canada in the meantime either. I don't know how it works between countries, but here in Canada if you are to secretly go into carms and match while already in a residency, your contract is automatically restarted with the new program without needing your prior program director's permission.

 

[AStark]

2. The Canadian government, in all its PC glory, has instituted a ******ed separate parallel IMG matchin the first round so as to not anger the whiny masses. This means programs, and many of them are competitive specialties like EM, are forced to match IMGs in the first round. I think the fact that you've done some residency in the states might exclude you from this, but I would call carms and ask them. But often times it doesn't matter since a lot of programs purposely keep these IMG spots unfilled so as to not water down program quality.

Programs aren't really forced to do anything other than have the IMG spots on paper. They'll generally happily NOT fill an IMG spot in the first iteration, which is why there are always some random spots left over in the second iteration.

In any case, from the basic eligibility criteria:

Only applicants without previous postgraduate training are eligible to attain a position through CaRMS in the first iteration. Applicants with any prior postgraduate training in Canada or United States are eligible to apply in certain provinces in the second iteration only.

(Emphasis theirs)

So, yeah. Two weeks of postgrad training disqualifies you from the first iteration.

3. Your best bet is to go into round 2, where there will be absolutely NOTHING good, and apply to all of the really remote unpopular family medicine spots; I'm talking the Atlantic provinces, Manitoba, and Saskatchewan. If you speak French, you could also apply to the Quebec programs, which is a big deal since 33% of the total unmmatched spots are French only. Another alternative is to try to match to one of the other fields that are IMG heavy: psych and path come to mind. But since both are as far away from the ED as fields can get, this might not be the best option.

Actually Memorial typically fills most spots since there are a decent number of people interested in the rural/remote training. But that's a big difference from, say, a program in Sarnia or Moncton. There really isn't any English-speaking program that has that many spots left over. On the other hand, almost half of open FM spots in the second iteration this year were French-speaking programs in Quebec.

If you're not at least strongly bilingual, the second iteration will be a very tough slog indeed. But that is the only route available.

4. You're correct in saying that one can do family medicine and then add a third year of EM training on to it. Keep in mind that these EM spots are also ridiculously competitive in their own right; but then again, I've seen absolute *****S who were IMGs match CCFP-EM in good centers, so anything is possible once you're at that stage. Even if you don't match, you can still work in super-rural EDs with only your family medicine cert.

This year there were at least a few Canadian grads who couldn't even match to family in the second iteration. In the case of the guy I know, he was simply overly restrictive about where he wanted to go. It was a stupid move on his part, but then the CaRMS match at this point has far more to do with our choices and, often, luck than anything else these days.

I would not quit your residency, but I would not rule out applying to Canada in the meantime either. I don't know how it works between countries, but here in Canada if you are to secretly go into carms and match while already in a residency, your contract is automatically restarted with the new program without needing your prior program director's permission.

Chances are very slim in the second iteration. The OP might end up at a new FM program in Fort McMurray or Goose Bay. More likely, he would end up unmatched.

 

[deleted116380]

Finish 1 year and switch to something else if you must. I'm a prelim and don't enjoy intern year much, but smiled when my first paycheck was deposited last week. 🙂 I started mid-June (mandatory orientation for a few days then training) so I'm close to 4 weeks in now. It gets better when you get the hang of it, but your options will be limited leaving now.

Job market as a whole sucks and research jobs or other small jobs won't pay much or even be stable for that matter. Even though you may not like it, your current job is the best thing you have going for you now and in the foreseeable future.

Don't let go of one branch before you've got your other hand firmly griped to another if you do decide to leave...

 

[NERDY]

There's a PGY I US EM spot open.
http://www.saem.org/membership/services/residency-vacancy-service

 

[dragonfly99]

I have to agree with others who posted on here.
It sounds like you want to be in Canada and maybe not in clinical medicine, but you don't have a job lined up to go to up there. I know just about zero about Canadian residency, but from what others posted on here it sounds like it will be hard for you to get a residency there. I think you need to stick it out at least for 1 year and in the next few months you can use your off time to figure out what your options are. And in the mean time, remember you are engaged in the job of helping people...even though it seems like all you do is get up early, work too hard and fill out paperwork (I did IM residency too...).

I think this post is kind of a cautionary tale for people whose family or outside forces are urging them or "making" them apply to medical school. It's just not a good job for people who weren't strongly wanting to do it in the first place.

If the original poster does finish residency, he/she would have more job options (nonclinical, even). Could go work for FDA, CDC, or those types of agencies in Canadian government, I would think.

 

[dh1986]

Thank you to all those who took the time to reply.

What are the options for someone who just has an MD degree without residency? What can they do?

I know chances are better if you have completed residency, but I don't want to do it as I am sacrificing something very important to me by being here (and yes I mean a relationship). This is why I am thinking about leaving now and not in a year or in 3 years. I don't like the work, and it's not intern year. It's the whole career as a physician that I don't like. The reason I like EM is its work hours, minimal patient interaction, lack of follow up and good money. It seems the best option. Don't get me wrong I am good at what I do. But come to think of it, being a good physician requires you to stay up to date constantly (ie still 60 and studying). I don't want to do that for the rest of my life. So in brief, I don't like being a physician but if I just suck it up and do it then I'm losing my better half. So why waste my time and do it to begin with?

I am looking for an alternative. If it's not clinical, I don't care. I'm not a big fan of clinical obviously. And thankfully I have no debts to pay off. So I'm not really worried about the pay. But what can you do with just an MD degree? It seems like such a useless degree to me if all you can do with it is either residency or be poor!

 

[NotAProgDirector]

What can you do with an MD but no residency?

The same thing you can do with a BS and a Masters. Anything. And nothing.

You'll need to forge your own path. You could do research. You could try to get into administration. You could try to work for a technology company of some sort. All of those things you could do without an MD also.

 

[deleted116380]

Thank you to all those who took the time to reply.

What are the options for someone who just has an MD degree without residency? What can they do?

I know chances are better if you have completed residency, but I don't want to do it as I am sacrificing something very important to me by being here (and yes I mean a relationship). This is why I am thinking about leaving now and not in a year or in 3 years. I don't like the work, and it's not intern year. It's the whole career as a physician that I don't like. The reason I like EM is its work hours, minimal patient interaction, lack of follow up and good money. It seems the best option. Don't get me wrong I am good at what I do. But come to think of it, being a good physician requires you to stay up to date constantly (ie still 60 and studying). I don't want to do that for the rest of my life. So in brief, I don't like being a physician but if I just suck it up and do it then I'm losing my better half. So why waste my time and do it to begin with?

I am looking for an alternative. If it's not clinical, I don't care. I'm not a big fan of clinical obviously. And thankfully I have no debts to pay off. So I'm not really worried about the pay. But what can you do with just an MD degree? It seems like such a useless degree to me if all you can do with it is either residency or be poor!

You could live a comfortable life being a science teacher in high school or community college (medical school lecturing would be difficult without residency let alone being an attending). I have a few friends that teach grade school and love their jobs. Pretty straight forward work hours, but you do sometimes take work home (grading stuff), good vacations/holidays off, etc. Pay is not great, but you have no debt and significant other may make decent amount of $.

 

[thesauce]

Thank you to all those who took the time to reply.

What are the options for someone who just has an MD degree without residency? What can they do?

I know chances are better if you have completed residency, but I don't want to do it as I am sacrificing something very important to me by being here (and yes I mean a relationship). This is why I am thinking about leaving now and not in a year or in 3 years. I don't like the work, and it's not intern year. It's the whole career as a physician that I don't like. The reason I like EM is its work hours, minimal patient interaction, lack of follow up and good money. It seems the best option. Don't get me wrong I am good at what I do. But come to think of it, being a good physician requires you to stay up to date constantly (ie still 60 and studying). I don't want to do that for the rest of my life. So in brief, I don't like being a physician but if I just suck it up and do it then I'm losing my better half. So why waste my time and do it to begin with?

I am looking for an alternative. If it's not clinical, I don't care. I'm not a big fan of clinical obviously. And thankfully I have no debts to pay off. So I'm not really worried about the pay. But what can you do with just an MD degree? It seems like such a useless degree to me if all you can do with it is either residency or be poor!

I've never heard EM described as "minimal patient interaction."

 

[Gastrapathy]

It is a useless degree without a residency. Finish. Then quit if you want. Do a sleep fellowship or something.

 

[rokshana]

so if you had not gone to med school...what do you think you would want to do?

only leave the residency if you are willing to let go of doing anything in medicine ...because without the clinical background and certifications that residency gives, your MD isn't worth the paper your diploma is written on...you might as well not have the degree.

and why do you think EM has minimal pt contact? it may not be in-depth pt contact, but i would think EM has the MOST pt contact, day in, day out, everyday you work is about seeing pts in EM...if you really want no pt contact, seem like switching to something like path or radiology would be more appropriate (path is more feasible than radiology, but still...)

if clinical research is what you feel is your calling (and not just an option you think you can do just because you have an MD), then use the time in internship to get connected with someone's lab and then see if you can then switch to a PhD program or a post doc and be mentored to do research.

it sounds more like you dont want to stay because of pressure your other half is putting on you...uh, did this person not know you were a med student and you had to do residency? You regret the pressure placed on you by outside forces to even go to med school...how much of an effect will pressure from an outside source make when you have no chance at a career in medicine because you left your residency?

most programs have psych support of some sort for their residents...maybe you could reach out to them and talk to them...

maybe medicine isn't what you should be doing at all...it sucks, but just start over...it will take awhile but hopefully in the end you will be happier...

 

[sair]

I am a Canadian and IMG, who did not match this year. I had a few interviews in States but none in Canada. That being said, I think it is a terrible Idea for you to leave. I would kill to be in your position. Anyway, a few thing you should keep in mind.

1) you might not get an interview again in canada, this time around.

2) If you leave the way you are planning, you will definitely never be able to come back to a residency in states. When I was going through the soap, I was chatting with a few people on a forum. Some of them left a residency program like you are planning. Now when they were re-applying, they are getting interviews based on computer screening, but some of the PDs (during soap) did not even go further with the interview.. once they found out. Not sure to what extent this is true, but you will be labelled as a flight risk and no one wants to take a chance when there are so many other options. Its actually better for you to consider doing a Resident Swap with someone in FM. Not sure if they work but a better option. check residentswap.com (no i dont work for them).

3) If you do IM in states, you can do a chief year or a fellowship to make up the extra years that are required by canada. Talk to ppl in Carms, they might be able to give you a better insight.

4) I am not certain but if you take your step 2 and 3, Ontario exempts you from a few MCCQE. Once again call Carms.

5) Personal Note: Even though I worked for 6yrs before I started medical school, I could not save up the money to pay for it. My No loan situation is on the good graces of my parents. EVEN if i was in your situation and hated my residency program and my field, I would stick it out for 3 yrs. If not for me, it would be for all the people who supported me and believed in me. Hate sitting here and being a burden on people. At age 33, I should be supporting my parents and not the other way round. (Sorry, if i offended you. You might not be in the same situation as me, this is just to bring a perspective).

Listen to the people on this form, they are very experienced and are giving you really good advice.

 

[dragonfly99]

It sounds like you don't want to do clinic medicine, and you are in a better position than I thought if you have no med school debt. Some people are in your position but have 200-300k debt to pay off.

If you like medical research you could go into that field, most likely. However, be aware than if you do a PhD that is LOT of work also, and that the job situation can be more difficult...especially if you want to do academics. I'm not sure about in Canada, but in the US there are a lot more people wanting faculty jobs than there are academic jobs to go around. Personally, if I just wanted to work in research and didn't feel compelled that I had to be the "top person/boss" I would just get a master's degree. You can do a lot of the stuff the PhD people end up doing (most of them) with only 2 years of school instead of 5 or 6 plus a post-doc.

It does not make sense to me to quit 2 weeks into a new job. Can your significant other not come to stay with you for a while, or you can visit frequently over the next few months? I don't think you should finish an entire residency, in any field of medicine, if you have zero student loan debt to pay off and you are sure you don't want to practice clinical medicine. Some people would do it, and it might improve your job prospects (even for nonclinical jobs) if you want to go into business consulting or clinical research or something.

Make sure you are not making a rash decision due to depression or something else. If not, I would suggest to stick it out for the next few months, and ideally the year of your contract, because I usually advocate not quitting a job unless you have another job lined up. Also if you were to give your program several months notice that you are leaving (like next winter or next spring) then you have not really "screwed them over" too bad and they might even be able to help you forge an alternate career path. Is residency really so bad that you can't do this even for a few months? I know it sucks being an intern, but remember the resident and attending supervising you are ultimately responsible for what goes on there - you do need to show up every day, see your patients, etc. but you are not expected to know everything, and if you remember that it makes the stress a little bit less.