Not so interested in doing a residency. Should I still do intern year? How?

[Law2Doc]

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If you're truly not interested in practicing as a physician, then I don't know why on earth you'd do an intern year. To put yourself through hell just for the fun of it?

Plus if you decide to go back years later, you'll have forgotten everything you learned during intern year and will be potentially dangerous as a PGY2.

I also don't know why people are telling you to do PM&R. Because it's easy? It might be easier than other residencies, but it's certainly not for people who don't want to be a doctor at all.

I agree with the people who said to consider pathology. Pathology has lots of research and you actually don't even do an intern year at all. Pretty sweet deal. There are other non-clinical residencies too, like prev med.

No no no. You do an intern year mainly so you can get licensed. If you are licensed, you can come back to the profession. If not, you are going to have a tougher time. For most states, there is a finite time between taking Step 1 and Step 3. Also it's pretty impossible to get an internship as someone coming from another field, but if you already had that, you should be able to see what's open off cycle. Pathology doesn't really work for OP. He wants a 1 and out kind of route -- something that will enable him to get licensed, get some basic clinical skills and take off. For pathology, you might get your license, but if you came back and wanted to do something clinical, you are hosed. Because 1 year of pathology doesn't lead into any other field besides pathology, probably doesn't really make it possible to come back an start on your second year of pathology, and doesn't give you something that you can walk into the local clinic and see patients with on a "moonlighting" type basis. It's the worst possible option. You want an internship, plain and simple. Prelim IM is what works. That leaves doors open to continue in any advanced residency (and still get fully funded), lets you work at the local clinic and other "moonlighting" type gigs as is, and lets you hold yourself as a licensed GP to the extent other fields want to hire a practitioner, rather than simply someone with an education but no clinical experience.

And to clarify "internship" = PGY-1. It's your first year of residency. You ARE a resident. Basically it's a holdover term from the day (back in the 1980s) when every person graduating from medical school was taught to be a generalist first, and specialize later, and thus everyone did the equivalent of an IM prelim year before focusing in on their desired categorical field, be it pathology, or medicine or PM&R. The advanced programs held true to this model, things like pathology and other purely categorical paths broke away. Either way, you are an "intern" your first year -- it's the year with the steepest learning curve, where you bear the brunt of being the low man on the totem pole.

But again, if OP wants a 1 and out type set-up, to get licensed and move on, a categorical residency doesn't make sense for him.

 

[Law2Doc]

Ah I see. So, let's say you did a prelim year, got a license, then left to do non-clinical work. When or if you decide to return to medicine, wouldn't you still be in a crappy situation of having to apply for residencies after leaving medicine for an extended period of time? ...

Crappy, sure. As crappy as if you didn't get your license? no way.

 

[bronx43]

Crappy, sure. As crappy as if you didn't get your license? no way.

So, you're saying residency programs would take a person with a license, but quit residency over a person who never applied to residency?

 

[michaelrack]

residency programs would take a person with a license, but quit residency over a person who never applied to residency?

depending on the time frame, yes

 

[Law2Doc]

So, you're saying residency programs would take a person with a license, but quit residency over a person who never applied to residency?

That is what I am saying. (Although you wouldn't have "quit residency" -- you would have "completed internship" -- that is how it would be sold. Which is why doing a year of a categorical path doesn't work).

 

[cartoondoc]

Can't you take Step 3 even if you're not in internship? He wouldn't be able to get licensed, but at least he'd be done with his exams. Furthermore, will every state in the country provide a license after only internship?

Maybe the OP will change his mind, but if he is truly that jaded and miserable about being in medicine, I think doing internship now is a mistake. That is a grueling year and to do it without having any purpose in mind seems like a recipe for depression. And it's not great for the patient care either.

Plus if he stayed out from medicine for like five years, he'd probably having to repeat internship anyway if he was going in for a categorical program. Can you imagine doing internship twice? A fate worse than death.

The only reason to do the internship is if he is truly counting on getting a job (or moonlighting) that requires a license but no residency. Or if he thinks there's a reasonably good chance he'll change his mind in the near future and want to do a full residency. He should research possible career paths and try to figure out if it's worth it.

 

[Law2Doc]

Can't you take Step 3 even if you're not in internship? He wouldn't be able to get licensed, but at least he'd be done with his exams. Furthermore, will every state in the country provide a license after only internship?

Maybe the OP will change his mind, but if he is truly that jaded and miserable about being in medicine, I think doing internship now is a mistake. That is a grueling year and to do it without having any purpose in mind seems like a recipe for depression. And it's not great for the patient care either.

Plus if he stayed out from medicine for like five years, he'd probably having to repeat internship anyway if he was going in for a categorical program. Can you imagine doing internship twice? A fate worse than death.

The only reason to do the internship is if he is truly counting on getting a job (or moonlighting) that requires a license but no residency. Or if he thinks there's a reasonably good chance he'll change his mind in the near future and want to do a full residency. He should research possible career paths and try to figure out if it's worth it.

In most states taking Step 3 without internship is meaningless, you cannot get licensed. The OP already said there is a good chance he will change his mind at some point. So he needs to do what he can to leave a door open when he leaves.

Yes, doing internship twice would be grueling, but if he doesn't do it now, doesn't get licensed, and then tries to come back in a few years he probably will be SOL. He won't have nearly the opportunities he might had he gone away with license in hand, plain and simple. So yeah, it might be that he comes back and they say we need you to do internship again. But that's a lot better than saying, sorry, we have no interest in someone several years out of med school who never got licensed and we'd rather have someone fresh from school who isn't going to have licensing issues.

 

[cartoondoc]

In most states taking Step 3 without internship is meaningless, you cannot get licensed. The OP already said there is a good chance he will change his mind at some point. So he needs to do what he can to leave a door open when he leaves.

Yes, doing internship twice would be grueling, but if he doesn't do it now, doesn't get licensed, and then tries to come back in a few years he probably will be SOL. He won't have nearly the opportunities he might had he gone away with license in hand, plain and simple. So yeah, it might be that he comes back and they say we need you to do internship again. But that's a lot better than saying, sorry, we have no interest in someone several years out of med school who never got licensed and we'd rather have someone fresh from school who isn't going to have licensing issues.

Well, ultimately, it sounds like he should do an internship only because he changed his mind once in the course of his post, so will likely end up just finishing residency entirely and being a doctor. Everyone gets burned out during third year.

 

[Parts Unknown]

Thanks for sharing that. Just curious, is her case kind of unique? It seems like most of the people doing OEM work for academic type centers and the quoted salaries seem pretty low.

Just curious.

Unusual, yes, but certainly not unique. Most people obviously go to medical school to practice, and the money isn't too bad. But if you're willing to think outside the typical boundaries, and you're lucky, you can find some amazing opportunities in niche markets.

The richest dentist I know doesn't do any dentistry anymore. He hired about a dozen other dentists, set them up in a nice facility with excellent support, and basically makes their lives as easy (and therefore productive) as possible. Everyone is happy, and he makes serious bank. Good thing for him, as he's superCatholic and has about ten kids to put through college.

 

[Parts Unknown]

Pathology doesn't really work for OP. He wants a 1 and out kind of route -- something that will enable him to get licensed, get some basic clinical skills and take off. For pathology, you might get your license, but if you came back and wanted to do something clinical, you are hosed. Because 1 year of pathology doesn't lead into any other field besides pathology, probably doesn't really make it possible to come back an start on your second year of pathology, and doesn't give you something that you can walk into the local clinic and see patients with on a "moonlighting" type basis. It's the worst possible option.

I can't speak for anyone else on this thread, but I personally didn't suggest pathology as a 1 and out route. Perhaps I should have been more clear, but I felt it may be a viable long-term option for someone who hasn't cared for much of what M3 year has to offer. The fact that the PGY-1 year of pathology residency is spent doing path and not clinical medicine is gravy.

 

[cartoondoc]

I can't speak for anyone else on this thread, but I personally didn't suggest pathology as a 1 and out route. Perhaps I should have been more clear, but I felt it may be a viable long-term option for someone who hasn't cared for much of what M3 year has to offer. The fact that the PGY-1 year of pathology residency is spent doing path and not clinical medicine is gravy.

Yes, that's what I originally meant too. It all sort of got lost in the semantics of what to call internship, but what I was initially trying to say is that pathology might be a good specialty for someone who doesn't want to do clinical medicine. And like you said, the lack of a clinical year is a big bonus for someone like the OP.

 

[toomuch]

I think the OP might be interested in occupational medicine.

It is only 2 years after an internship and one of those years is spent mostly doing an MPH and the second year is rotations with no weekends and practically no call. Also, in real practice it is practically 90% musculoskeletal also with no call or weekends.

 

[OwnageMobile]

Thanks for the info, guys. I'm going to try to keep an open mind during this whole thing ... maybe I can resurrect this thread in several years and let you know what happened.

 

[JaggerPlate]

Unusual, yes, but certainly not unique. Most people obviously go to medical school to practice, and the money isn't too bad. But if you're willing to think outside the typical boundaries, and you're lucky, you can find some amazing opportunities in niche markets.

The richest dentist I know doesn't do any dentistry anymore. He hired about a dozen other dentists, set them up in a nice facility with excellent support, and basically makes their lives as easy (and therefore productive) as possible. Everyone is happy, and he makes serious bank. Good thing for him, as he's superCatholic and has about ten kids to put through college.

Great post! Couldn't agree more with your analysis!

 

[Rothbard]

nm

 

[OwnageMobile]

Thanks for the info, guys. I'm going to try to keep an open mind during this whole thing ... maybe I can resurrect this thread in several years and let you know what happened.

Oh man, here I am, 8 years later, resurrecting this thread! I got a pm from another user who was curious about my path so I'll share some info.

At MS3/4 I indeed decided to not do residency. I started prototyping a microphone product for gamers (a device I made for myself, where one can attach a mic to any headphones). We moved to Oregon for her residency and I bootstrapped my business out of our 2nd bedroom and 8k I had saved up. I studied mechanical engineering in undergrad so that helped with the product creation. Eight years later, business is going well and I've paid off my 221k in loans.
My story is unique and may not be all that helpful for others in the spot of not wanting to go into medicine yet mostly through med school and in a lot of debt.

• My SO was going to be a secure source of income if the business didn't work out
• My product ended up doing well in the market despite my many many mistakes and crappy units sent out- (I've had other products fail. Only make products that you yourself would buy, IMO)
• My prior education and interests aligned well with entrepreneurship

Not sure if I've got any worthy advice:

• II deferred my loans for many months (at the cost of ~20k or so) and then started paying smaller payments with income-based repayment. I'm not suggesting that one defers, just that it's possible and easy to do. You don't have these 2k checks that you have to pay every month or else have your kneecaps broken. They systems isn't too hard to work with to figure out a payment schedule. This was 8 years ago, so maybe it's changed.
• While one shouldn't choose a partner solely on their future earning potential, med school is a great pool of interesting and accomplished people. Just ... keep an open mind and push yourself to socialize if you aren't already. Again, I'm not suggesting that you go get someone to marry you- just saying that I think it's a bad place to not be looking. I joke that med school was my $200k dating service, to my wife's chagrin.
• From my point of view, internship/residency looked like hell as I watched my wife go through it. I was very glad to not be in it, though I do miss a lot about medicine and wonder every so often what I'm missing out on.
• It's a fun party fact about my having an MD but I don't think it's ever helped me as much as I hoped it might. E.g. Made an app for migraine sufferers and the MD alone seemed to do little to help the startup's legitimacy when it came to getting funding or partners. Most ultimately seemed to understand that I was missing a lot by not going to residency.

I'm happy where I am now. I don't think it was the wrong decision to not do residency.

J

 

[Doctor Christmas]

Oh man, here I am, 8 years later, resurrecting this thread! I got a pm from another user who was curious about my path so I'll share some info.

At MS3/4 I indeed decided to not do residency. I started prototyping a microphone product for gamers (a device I made for myself, where one can attach a mic to any headphones). We moved to Oregon for her residency and I bootstrapped my business out of our 2nd bedroom and 8k I had saved up. I studied mechanical engineering in undergrad so that helped with the product creation. Eight years later, business is going well and I've paid off my 221k in loans.
My story is unique and may not be all that helpful for others in the spot of not wanting to go into medicine yet mostly through med school and in a lot of debt.

• My SO was going to be a secure source of income if the business didn't work out
• My product ended up doing well in the market despite my many many mistakes and crappy units sent out- (I've had other products fail. Only make products that you yourself would buy, IMO)
• My prior education and interests aligned well with entrepreneurship

Not sure if I've got any worthy advice:

• II deferred my loans for many months (at the cost of ~20k or so) and then started paying smaller payments with income-based repayment. I'm not suggesting that one defers, just that it's possible and easy to do. You don't have these 2k checks that you have to pay every month or else have your kneecaps broken. They systems isn't too hard to work with to figure out a payment schedule. This was 8 years ago, so maybe it's changed.
• While one shouldn't choose a partner solely on their future earning potential, med school is a great pool of interesting and accomplished people. Just ... keep an open mind and push yourself to socialize if you aren't already. Again, I'm not suggesting that you go get someone to marry you- just saying that I think it's a bad place to not be looking. I joke that med school was my $200k dating service, to my wife's chagrin.
• From my point of view, internship/residency looked like hell as I watched my wife go through it. I was very glad to not be in it, though I do miss a lot about medicine and wonder every so often what I'm missing out on.
• It's a fun party fact about my having an MD but I don't think it's ever helped me as much as I hoped it might. E.g. Made an app for migraine sufferers and the MD alone seemed to do little to help the startup's legitimacy when it came to getting funding or partners. Most ultimately seemed to understand that I was missing a lot by not going to residency.

I'm happy where I am now. I don't think it was the wrong decision to not do residency.

J

What kind of app did you make for migraine sufferers?

 

[OwnageMobile]

It's called Migraine Coach- it uses machine learning and passive/active data gathered from the app to try to better predict/understand the users' headaches. We had some cool results but never really got a lot of traction. It's just so hard to gather good data without bothering people too much.

Haha, I can't post links because my post:like ratio is < 1% @ +700:2 since I'm old and returning to a new paradigm. Just search the name on google if you're interested in checking it out.

 

[Chip N Sawbones]

Oh man, here I am, 8 years later, resurrecting this thread! I got a pm from another user who was curious about my path so I'll share some info.

Did you get a lot of pushback from your wife when you told her you weren't interested in medicine anymore? I've tried discussing switching to a different career with my wife, but she isn't at all open to the idea of me doing anything else.

 

[chocomorsel]

Oh man, here I am, 8 years later, resurrecting this thread! I got a pm from another user who was curious about my path so I'll share some info.

At MS3/4 I indeed decided to not do residency. I started prototyping a microphone product for gamers (a device I made for myself, where one can attach a mic to any headphones). We moved to Oregon for her residency and I bootstrapped my business out of our 2nd bedroom and 8k I had saved up. I studied mechanical engineering in undergrad so that helped with the product creation. Eight years later, business is going well and I've paid off my 221k in loans.
My story is unique and may not be all that helpful for others in the spot of not wanting to go into medicine yet mostly through med school and in a lot of debt.

• My SO was going to be a secure source of income if the business didn't work out
• My product ended up doing well in the market despite my many many mistakes and crappy units sent out- (I've had other products fail. Only make products that you yourself would buy, IMO)
• My prior education and interests aligned well with entrepreneurship

Not sure if I've got any worthy advice:

• II deferred my loans for many months (at the cost of ~20k or so) and then started paying smaller payments with income-based repayment. I'm not suggesting that one defers, just that it's possible and easy to do. You don't have these 2k checks that you have to pay every month or else have your kneecaps broken. They systems isn't too hard to work with to figure out a payment schedule. This was 8 years ago, so maybe it's changed.
• While one shouldn't choose a partner solely on their future earning potential, med school is a great pool of interesting and accomplished people. Just ... keep an open mind and push yourself to socialize if you aren't already. Again, I'm not suggesting that you go get someone to marry you- just saying that I think it's a bad place to not be looking. I joke that med school was my $200k dating service, to my wife's chagrin.
• From my point of view, internship/residency looked like hell as I watched my wife go through it. I was very glad to not be in it, though I do miss a lot about medicine and wonder every so often what I'm missing out on.
• It's a fun party fact about my having an MD but I don't think it's ever helped me as much as I hoped it might. E.g. Made an app for migraine sufferers and the MD alone seemed to do little to help the startup's legitimacy when it came to getting funding or partners. Most ultimately seemed to understand that I was missing a lot by not going to residency.

I'm happy where I am now. I don't think it was the wrong decision to not do residency.

J

Very happy for you. Glad things worked out for you. Your creative side and engineering background sure came in early.
As far as finding someone in medical school, not a bad idea at all. Wish I had found someone in medical school or allied health. Instead I found a parasitic sociopath four years later who I am now divorcing.

 

[Keona]

Do you like any type of clinical medicine? Which rotation are you on right now? Have you been on any clinical rotation where you missed being there when you weren't there? What type of engineer are you? You could do a residency and transition into clinical research faculty in a medical school, or could finish your MD and go to teaching instead, any combined programs at your med school where you could add on a masters to your MD while you are figuring out what you want to do with your life? Doing only 1 year of a residency can be very annoying for any program that isn't a transitional year program. It's hard on your coresidents to split the work between less residents.

 

[Chip N Sawbones]

Do you like any type of clinical medicine? Which rotation are you on right now? Have you been on any clinical rotation where you missed being there when you weren't there? What type of engineer are you? You could do a residency and transition into clinical research faculty in a medical school, or could finish your MD and go to teaching instead, any combined programs at your med school where you could add on a masters to your MD while you are figuring out what you want to do with your life? Doing only 1 year of a residency can be very annoying for any program that isn't a transitional year program. It's hard on your coresidents to split the work between less residents.

If you're replying to the OP, that was an eight year old post. He quit medicine long ago and is happy in his new career.

 

[deleted547631]

Oh man, here I am, 8 years later, resurrecting this thread! I got a pm from another user who was curious about my path so I'll share some info.

At MS3/4 I indeed decided to not do residency. I started prototyping a microphone product for gamers (a device I made for myself, where one can attach a mic to any headphones). We moved to Oregon for her residency and I bootstrapped my business out of our 2nd bedroom and 8k I had saved up. I studied mechanical engineering in undergrad so that helped with the product creation. Eight years later, business is going well and I've paid off my 221k in loans.
My story is unique and may not be all that helpful for others in the spot of not wanting to go into medicine yet mostly through med school and in a lot of debt.

• My SO was going to be a secure source of income if the business didn't work out
• My product ended up doing well in the market despite my many many mistakes and crappy units sent out- (I've had other products fail. Only make products that you yourself would buy, IMO)
• My prior education and interests aligned well with entrepreneurship

Not sure if I've got any worthy advice:

• II deferred my loans for many months (at the cost of ~20k or so) and then started paying smaller payments with income-based repayment. I'm not suggesting that one defers, just that it's possible and easy to do. You don't have these 2k checks that you have to pay every month or else have your kneecaps broken. They systems isn't too hard to work with to figure out a payment schedule. This was 8 years ago, so maybe it's changed.
• While one shouldn't choose a partner solely on their future earning potential, med school is a great pool of interesting and accomplished people. Just ... keep an open mind and push yourself to socialize if you aren't already. Again, I'm not suggesting that you go get someone to marry you- just saying that I think it's a bad place to not be looking. I joke that med school was my $200k dating service, to my wife's chagrin.
• From my point of view, internship/residency looked like hell as I watched my wife go through it. I was very glad to not be in it, though I do miss a lot about medicine and wonder every so often what I'm missing out on.
• It's a fun party fact about my having an MD but I don't think it's ever helped me as much as I hoped it might. E.g. Made an app for migraine sufferers and the MD alone seemed to do little to help the startup's legitimacy when it came to getting funding or partners. Most ultimately seemed to understand that I was missing a lot by not going to residency.

I'm happy where I am now. I don't think it was the wrong decision to not do residency.

J

Great post! Thank you for the update!

 

[JGimpel]

Finishing a year of residency will enable you to apply for a license. You will have tons more options if you do this. Even if you haven't changed your mind at the end of the first year, you will at least earned a medical license worth of credit for most states. Most programs require that you pass COMLEX 3 before they give you another contract, so prep for that too. A lot of us can tell you that your wife usually knows you best and will stand behind you while you stay in medicine, rather than drop out of the game before you've even started. Residency will be difficult and time-consuming at best, but you'll both be happier when you get home.

 

[shemer77]

thanks for the update. Glad things worked out.