No LOR from gap year job

[gemmmyguice]

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I graduated this May and am planning to take two gap years. I started working as an MA at a private practice with a solo doc and was originally planning on continuing this for at least one year. However, I recently requested to work only three days a week so that I could study for the MCAT, which the doctor allowed. He is understandably upset by this as I initially agreed to work full time and we are severely understaffed. I get his frustrations but now I’m worried that even if he does agree to write a LOR, it will not reflect positively since he has said how disappointed and surprised he is at the change. He’s not going to hire anyone else so I’m sure the clinic will get behind.

Is it a red flag if I continue working here, but end up not having a LOR? This is pretty much all I’m doing, EC-wise, in my first gap year besides some light volunteering so I wouldn’t be able to get a LOR out of my gap year at all basically which I feel like is suspicious. Or should I at this point cut my losses and look for another job, ideally part time so it’s easier to study, and try to get a LOR from someone there. Especially since my relationship with this doctor seems already tarnished. Any advice would be appreciated, not sure if I’m overthinking this but it’s been really stressing me out lately.

 

[Mr.Smile12]

Welcome to the forums.

One of the preprofessional competencies is "reliability and dependability." Working in the private practice that is understaffed, you should understand his POV. Sure, you both may have agreed about your MCAT prep schedule when circumstances were a little different. Had you reminded him about your impending plans? Had you both talked about it? It doesn't sound like you did, and you "surprised" him.

This is where having a fifth sense of your surroundings helps you. If you intend to drop to part-time, what are the consequences? I presume you have another doctor letter, but this one would likely give better insight if he saw you at work every day and considers you such a vital part of the team. The worst thing that could happen would be that you got fired so that you could start studying for your MCAT earlier; that doesn't help his practice, but he wants reliable, dependable people more than ever.

You should have been meeting with this doctor every week, planting seeds for the best LOR possible at each meeting, working with him to come up with an adapted schedule given the short-staffing situation so you can study and help the practice. Adaptability is also a strongly desired competency for entering students, and having him attest to this is also quite helpful.

People have disagreements all the time, but as a direct report/employee, you must consider ways to repair the relationship or cut bait to another option. If you have no other immediate option, ask for forgiveness, adapt your plans to adjust to his circumstances, and make it work. That's what professionals do.

 

[Butalbusaur]

I graduated this May and am planning to take two gap years. I started working as an MA at a private practice with a solo doc and was originally planning on continuing this for at least one year. However, I recently requested to work only three days a week so that I could study for the MCAT, which the doctor allowed. He is understandably upset by this as I initially agreed to work full time and we are severely understaffed. I get his frustrations but now I’m worried that even if he does agree to write a LOR, it will not reflect positively since he has said how disappointed and surprised he is at the change. He’s not going to hire anyone else so I’m sure the clinic will get behind.

Is it a red flag if I continue working here, but end up not having a LOR? This is pretty much all I’m doing, EC-wise, in my first gap year besides some light volunteering so I wouldn’t be able to get a LOR out of my gap year at all basically which I feel like is suspicious. Or should I at this point cut my losses and look for another job, ideally part time so it’s easier to study, and try to get a LOR from someone there. Especially since my relationship with this doctor seems already tarnished. Any advice would be appreciated, not sure if I’m overthinking this but it’s been really stressing me out lately.

You kinda knew what you were getting yourself into by getting a full-time job, knowing you had to allocate time to prep for your MCAT. That’s probably why he’s a bit blindsided by your request to drop down to part-time. On the route to medical school, you’re going to be given opportunities and if people stick their neck out for you, then you have to have their backs. For you, this might be a clinical experience, but for the doc, that’s his/her livelihood. That’s how they feed their kids and pays the bills, so them being upset is understandable.

Try to study for your MCAT while working full-time. It’s hard, but do-able. If you can’t, make the request again, but at least you TRIED to do both.

 

[polymerization]

Don't worry. If the past decade has taught me anything, physicians generally don't care about your academics at all. They are probably already searching for your replacement. Don't bother asking for an LOR, they may say yes just to stab you in the back by either speaking ill of you, or holding it over your head as leverage (only to disappoint you when it's time to submit).

You've just entered a sort of space where, unfortunately, much of the real communication is happening in the subtext. While the doctor may understand your position, that doesn't mean they will have empathy for you. They will have empathy for themselves, feeling that they did not go through years of medical school and residency to do their own MA work.

I am not trying to be mean here, it's just the very likely reality that they were hiring an MA to be a permanent fixture at that office—and I do mean permanent as in someone who shows up early and stays way past closing hours. I can tell because it's impossible to run a solo practice with a single MA. I tried several times and repeatedly failed.

Who is putting together the superbills and charts and imaging and patient notes? Who rooms and interviews patients? Who writes the note? Who fields patient calls and handles emergencies? Who is turning over the exam rooms before clinic starts, after each patient, and closes up the rooms at the end of the day? Who's processing pharmacy requests that come in stacks of 20 multiple times a day? All of the other specialty-specific stuff like assisting in procedures/biopsies and communicating with labpath? One dude?

I've worked too many jobs like this. The more you try to placate increasingly unreasonable standards by working at an increasingly unsustainable pace, the more disappointed and angry the doctor gets when the house of cards comes falling down. And it does come falling eventually.

If you can, taking the time to study for the MCAT full-time without any distraction and then devoting yourself to full-time work after it's over would be preferable. The job market flies completely independently from medical school admissions. The people who are able to navigate both at the same time are usually the physician's own kid or their friend's kid, who does not face the risk of being fired and are hired primarily for the title. For those of us without those connections, we're meeting a genuine need and are often thrust into these roles with minimal training, which just accelerates the whole process.

I could keep going, but this is already pretty long.

 

[Rachapkis]

Unless you are sure that this doctor will give you a strong LOR, I would be hesitant to ask. Someone who is "understandably upset" with you is not the person you want with the pen in their hand. That said, if you are otherwise able to get recommenders to deliver strong LORs, you should be able to salvage the less than ideal situation you put yourself in. I doubt that many ad coms will be asking themselves why you didn't obtain an LOR from this particular source.

 

[gemmmyguice]

Thanks for the input everyone! I am the only employee (other MAs quit and the billing people were fired) so I am responsible for all the admin/billing stuff too, which is why he depends on me so much (and is also part of the reason I dislike the job, since he only sees patients 2 days per week and spends the rest doing admin work, and I also do personal admin tasks for him like scheduling his own doctors appointments). I know he’s not looking for a replacement because he didn’t find a replacement for the other two MAs who left shortly after I joined, and if he did he would need my help to post it online. Therefore if I leave he will have no help at all, and I don’t want to leave him in such a bad spot. He has some memory issues and has a bad time with technology so I really do think he needs help or the practice may close.

I’ve already been trying to study for the MCAT for the last three months while FT, with little success. I thought I would be able to do it, but I didn’t realize how difficult it would be for me to study now that I’m out of a school environment. I know it’s unprofessional though so I might propose staying late the three days I’m working so that I can keep helping with billing while still having full days open to study.

 

[polymerization]

Thanks for the input everyone! I am the only employee (other MAs quit and the billing people were fired) so I am responsible for all the admin/billing stuff too, which is why he depends on me so much (and is also part of the reason I dislike the job, since he only sees patients 2 days per week and spends the rest doing admin work, and I also do personal admin tasks for him like scheduling his own doctors appointments). I know he’s not looking for a replacement because he didn’t find a replacement for the other two MAs who left shortly after I joined, and if he did he would need my help to post it online. Therefore if I leave he will have no help at all, and I don’t want to leave him in such a bad spot. He has some memory issues and has a bad time with technology so I really do think he needs help or the practice may close.

I’ve already been trying to study for the MCAT for the last three months while FT, with little success. I thought I would be able to do it, but I didn’t realize how difficult it would be for me to study now that I’m out of a school environment. I know it’s unprofessional though so I might propose staying late the three days I’m working so that I can keep helping with billing while still having full days open to study.

It sounds a whole lot like this physician would like you to do your job, the jobs of like 4 other people, and his own. A medical receptionist, medical assistant, scribe, a biller/coder, and apparently, a personal assistant. It sounds like this was not discussed in the interview and it was a bit of a bait-and-switch. Obviously as a pre-med, you're looking to spend your time at work doing stuff you can talk about on your application.

I'd love to propose an alternative frame: the person who was truly manipulated and damaged here was you. Do you really think, as a practicing physician who has been doing this for decades, that you can fire everyone in your practice and expect one person will keep it afloat? Someone at the entry-level who is expecting to be trained, no less. You are making excuses on his part and infantilizing him as if he were not a late-stage career professional.

My guess is that the turnover was not just incidental. I have a feeling this guy knew what was coming, he was just expecting the burn-and-churn cycle to last longer than the few weeks it did.

Psychological defense mechanisms will come into play quickly, so don't worry about his feelings. This was not a good fit for you, and it's still early enough that it's not like you're reneging on a blood pact. Once you leave, you will just be another nincompoop that just "can't handle the pace of medicine." MAs are a dime a dozen, and the pre-meds are even better because they're so eager to please. He will find the next pre-med, who will go through exactly this process. Be grateful it didn't take you longer to realize what was really going on, and run far and fast!