OMS-2 with zero desire to practice clinical medicine

[garrettp]

I'm in my second year, and I've come to the realization that I don't really want to practice clinical medicine. I had an idealized conception of what working with patients would be like during my pre-med years, but over time, I've come to the conclusion that it's not for me. I don't like being around ungrateful, unreasonable sick people or touching people in intrusive ways or memorizing algorithms or doing procedures. It all stresses me out, and I'm dreading clinical rotations during the upcoming two years.

I'm almost halfway through med school, and I'm unfortunately >$100k in debt. I've gotten mostly B's in school, and I'm somewhere in my class's third quartile. I only have an undergrad degree with a crappy major, and limited work experience. The job market would not treat me well if I dropped out.

I've thought about sticking it out and then going into preventive medicine/occupational medicine, but I'm not sure about the job outlook. I've also thought about getting a master's degree after med school and then trying to become an academic in public health or health administration or something. I've considered the corporate track (healthcare consulting and whatnot), but I'm not sure if it's open to DOs. I don't care very much about money, as long as I'm able to pay off my $300k debt. I enjoy problem-solving, writing, and statistics.

Any suggestions?

(Please refrain from the "you should've thought about this before matriculating" stuff. I don't have access to a time travel machine, so I gotta just try to pave a decent path for myself going forward.)

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[Sardonix]

If you can handle doing one of the shorter residencies, do FM --> Administration

 

[Prehealth1011]

I have friends that hated everything and picked Psychiatry

 

[garrettp]

I have friends that hated everything and picked Psychiatry

I've looked at that option, but it seems like psych is getting sort of competitive nowadays, especially for DOs. I'm not sure if I'll be able to do super well on boards. :\

 

[garrettp]

If you can handle doing one of the shorter residencies, do FM --> Administration

What does the transition from fm to administration entail? Is it easy to do?

 

[AnatomyGrey12]

Do psych. And you haven’t taken boards yet so start studying.

 

[Sardonix]

What does the transition from fm to administration entail? Is it easy to do?

You graduate FM residency and do minimal time in practice before moving into administrative duties for a hospital. No idea on the exact logistics of it, but FM is very versatile and often a lot of admin physicians are FM docs.

 

[DrZoidbergDO]

I've looked at that option, but it seems like psych is getting sort of competitive nowadays, especially for DOs. I'm not sure if I'll be able to do super well on boards. :\

psych still isnt that competitive, though from what i understand.

 

[Mad Jack]

psych still isnt that competitive, though from what i understand.

You don't need high numbers to match but your chances of matching are lower than many other fields because of the sheer number of applicants

 

[thepoopologist]

I don't like being around ungrateful, unreasonable sick people or touching people in intrusive ways or memorizing algorithms or doing procedures

You won't be able to escape this in psych.

I don't like being around ungrateful, unreasonable sick people or touching people in intrusive ways or memorizing algorithms or doing procedures

You will be able to escape this in psych

I enjoy problem-solving, writing, and statistics

Generally speaking, psych offers this, although some problems you may want others to solve.

 

[garrettp]

You don't need high numbers to match but your chances of matching are lower than many other fields because of the sheer number of applicants

How can a DO stand out amidst the million psych applicants?

 

[thepoopologist]

psych still isnt that competitive, though from what i understand.

I see all my patients via computer screen while sitting in a private office.

Let the feeding frenzy begin!

 

[DrZoidbergDO]

You don't need high numbers to match but your chances of matching are lower than many other fields because of the sheer number of applicants

ah I see, ty. wonder what's driving the increased number of apps?

 

[Prehealth1011]

I've looked at that option, but it seems like psych is getting sort of competitive nowadays, especially for DOs. I'm not sure if I'll be able to do super well on boards. :\

It's competitive in a different sense. I have classmates with 210s that are destroying it this cycle. How? They have multiple Psyc LORs, did a couple of sub-Is etc. You can check the NRMP stats. Your odds don't vary much going from 200s to 230s. Psyc really values commitment to the field. Obviously try do as well as you can in your boards

 

[FutureDoctor5000]

Psych is not competitive, please stop that myth. Just take step and if you can score like a 210 you can match at most low tier universities and community programs plus any of the former DO programs. You can prbly match at many places with just comlex as well. And obviously do well on your psych rotation and get a good letter, and do some community service related to psych to show commitment because they really care about that stuff in psych...but it’s not derm or ortho lol

 

[Cath Up]

Could consider radiology as well.

 

[Wjldenver]

I'm in my second year, and I've come to the realization that I don't really want to practice clinical medicine. I had an idealized conception of what working with patients would be like during my pre-med years, but over time, I've come to the conclusion that it's not for me. I don't like being around ungrateful, unreasonable sick people or touching people in intrusive ways or memorizing algorithms or doing procedures. It all stresses me out, and I'm dreading clinical rotations during the upcoming two years.

I'm almost halfway through med school, and I'm unfortunately >$100k in debt. I've gotten mostly B's in school, and I'm somewhere in my class's third quartile. I only have an undergrad degree with a crappy major, and limited work experience. The job market would not treat me well if I dropped out.

I've thought about sticking it out and then going into preventive medicine/occupational medicine, but I'm not sure about the job outlook. I've also thought about getting a master's degree after med school and then trying to become an academic in public health or health administration or something. I've considered the corporate track (healthcare consulting and whatnot), but I'm not sure if it's open to DOs. I don't care very much about money, as long as I'm able to pay off my $300k debt. I enjoy problem-solving, writing, and statistics.

Any suggestions?

(Please refrain from the "you should've thought about this before matriculating" stuff. I don't have access to a time travel machine, so I gotta just try to pave a decent path for myself going forward.)

Do a short residency FM or IM so you can become board certified. This will serve you well even if you pursue a non-clinical career long-term. Work to get into a T-20 MBA program and consider a consulting career with a top firm (McKinsey, Bain, Boston Consulting Group). Bookmark and become familiar with this site:

Welcome to Look for Zebras - Look for Zebras

Welcome to Look for Zebras This is a place for unconventional physicians and medical professionals vying for fulfillment. Look for Zebras is guided by a few principles: Your career doesn’t need to fit anyone else’s idea of what a “doctor” does. Don’t wait for opportunities to find you. Seek them...

lookforzebras.com

Good Luck!

 

[Ho0v-man]

Path

 

[Mad Jack]

ah I see, ty. wonder what's driving the increased number of apps?

Many things. Decent lifestyle, don't need super high numbers to match, ability to own your own practice with minimal overhead, low malpractice, high demand, geographic flexibility, and a lot of time with your patients are probably high up the list

 

[garrettp]

Path

I hear you have to do multiple fellowships and that the job market is terrible, which doesnt sound appealing tbh

 

[SunBakedTrash]

I hear you have to do multiple fellowships and that the job market is terrible, which doesnt sound appealing tbh

Being geographically flexible, speaking English and not being a douche usually helps with fellowship number required, jobs and salary. Worth consideration based on what you are asking for. No intern year either.

 

[Ho0v-man]

I hear you have to do multiple fellowships and that the job market is terrible, which doesnt sound appealing tbh

If you don’t want clinical medicine and don’t care about money it’s pretty cool. Just be geographically flexible.

I’d suggest rads, but you sound like you don’t think you’ll do well on boards and you don’t like procedures anyway.

 

[feeling-dizzy]

Do pathology. No actual human interaction. You do have to look at microscope though.

 

[AMEHigh]

I’d recommend doing a family medicine residency to give you a lot of versatility and then get out of academic medicine.

I’m not going to go in to details, but I do a decent amount of work outside of direct clinical care "on the side". I’ve thought about getting more of a full time job outside of clinical care, but for my interests there are no jobs that pay close to what physician jobs pay.

So if one of your main concerns is in regards to a salary to pay off student loans I’d definitely go through with residency so you can at least have the option of practicing medicine if you want.

Becoming a doctor is a long and difficult road at times, but in general the pay is really good and pretty much guaranteed, which can’t be said for many professions. Therefore, I’d at least give yourself the option of being board certified before moving on to another type of job.

 

[Neopolymath]

Path

Bonus points for no BS intern year to deal with. This is OPs answer. Path and then manage the bloodbank as well some administrative position. It's a sweet gig.

 

[AcesCracked]

Best options are path, rads, and psych like many people above have mentioned.

 

[deleted859689]

First think I that of was rads when reading this

 

[Lawpy]

Yes i agree with the pathology suggestions

 

[AlbinoHawk DO]

You should do whatever residency you want like occupational, FM, or preventative and then do a fellowship in clinical informatics

 

[MotherofDragonflies]

I am glad to see several people here recommend Pathology. There are numerous avenues to pursue and it provides a decent living. Definitely look into doing an elective. From what I gather, as others here have said, if you are geographically flexible you will be fine with any of the specializations. If you want to exchange a bit of pay, for guaranteed job prospects there is always forensic pathology. There is desperate need of more forensic pathologists worldwide. For the most part, the field is not all about autopsies. You'll be at the scope, chilling with people who know they don't have call and get to go home before traffic gets bad.

If you have any interest, check out Pathology twitter or the subreddit. They're more active than here and you get a broader perspective. I called up a local pathologist several months ago asking to shadow him. Due to COVID he said he couldn't but he spent nearly an hour talking about his work, why he works where he does, etc. Guy was chill and really nice. Maybe call one up and ask if they'd answer some questions for you? Can also check out the podcast Specialty Stories and listen to some docs talk about their day-to-day lives.

Whatever you choose, I do wish you the best and hope you find something that makes you happy.

 

[Lexdiamondz]

I'm in my second year, and I've come to the realization that I don't really want to practice clinical medicine. I had an idealized conception of what working with patients would be like during my pre-med years, but over time, I've come to the conclusion that it's not for me. I don't like being around ungrateful, unreasonable sick people or touching people in intrusive ways or memorizing algorithms or doing procedures. It all stresses me out, and I'm dreading clinical rotations during the upcoming two years.

I'm almost halfway through med school, and I'm unfortunately >$100k in debt. I've gotten mostly B's in school, and I'm somewhere in my class's third quartile. I only have an undergrad degree with a crappy major, and limited work experience. The job market would not treat me well if I dropped out.

I've thought about sticking it out and then going into preventive medicine/occupational medicine, but I'm not sure about the job outlook. I've also thought about getting a master's degree after med school and then trying to become an academic in public health or health administration or something. I've considered the corporate track (healthcare consulting and whatnot), but I'm not sure if it's open to DOs. I don't care very much about money, as long as I'm able to pay off my $300k debt. I enjoy problem-solving, writing, and statistics.

Any suggestions?

(Please refrain from the "you should've thought about this before matriculating" stuff. I don't have access to a time travel machine, so I gotta just try to pave a decent path for myself going forward.)

I would wait until you've actually done clinical year before making any decisions regarding whether or not you want to practice clinical medicine.

You're an M2, you really don't have any idea what clinical medicine is like yet, so it's hard to say whether or not you will love or hate it.

As for options for non-clinical practice, most of those require some sort of post graduate training

 

[NatInternationalMD]

You haven’t done your 3rd or 4th year yet so maybe something will click then. If not there are NIH research fellowships that would love you to help with statistics and solving problems, some forgive loans as well.

 

[Dreamstoo]

I’d recommend doing a family medicine residency to give you a lot of versatility and then get out of academic medicine.

I’m not going to go in to details, but I do a decent amount of work outside of direct clinical care "on the side". I’ve thought about getting more of a full time job outside of clinical care, but for my interests there are no jobs that pay close to what physician jobs pay.

So if one of your main concerns is in regards to a salary to pay off student loans I’d definitely go through with residency so you can at least have the option of practicing medicine if you want.

Becoming a doctor is a long and difficult road at times, but in general the pay is really good and pretty much guaranteed, which can’t be said for many professions. Therefore, I’d at least give yourself the option of being board certified before moving on to another type of job.

I'd actually say FM academic medicine is a great gig if you like teaching and prefer to be around pre-clinical students. One of the nicest doctors I ever met and had the pleasure of talking to multiple times was my DO school's pre-clinical dean who was FM trained and practiced I believe 12-18 hours a week I think at our school clinic. He seemed to love his job and he was great at helping out students (mentally and academically). Definitely helped he was a relatively young/middle aged attending and was able to relate well with students.

 

[Tangerine123]

I'm in my second year, and I've come to the realization that I don't really want to practice clinical medicine. I had an idealized conception of what working with patients would be like during my pre-med years, but over time, I've come to the conclusion that it's not for me. I don't like being around ungrateful, unreasonable sick people or touching people in intrusive ways or memorizing algorithms or doing procedures. It all stresses me out, and I'm dreading clinical rotations during the upcoming two years.

I'm almost halfway through med school, and I'm unfortunately >$100k in debt. I've gotten mostly B's in school, and I'm somewhere in my class's third quartile. I only have an undergrad degree with a crappy major, and limited work experience. The job market would not treat me well if I dropped out.

I've thought about sticking it out and then going into preventive medicine/occupational medicine, but I'm not sure about the job outlook. I've also thought about getting a master's degree after med school and then trying to become an academic in public health or health administration or something. I've considered the corporate track (healthcare consulting and whatnot), but I'm not sure if it's open to DOs. I don't care very much about money, as long as I'm able to pay off my $300k debt. I enjoy problem-solving, writing, and statistics.

Any suggestions?

(Please refrain from the "you should've thought about this before matriculating" stuff. I don't have access to a time travel machine, so I gotta just try to pave a decent path for myself going forward.)

I'll chime in with psych and path. I was in a similar position after med school and went into Psych. Something nice about Psych is that (some people will kill me here) it doesn't always feel like medicine. You brush up on subjects in the humanities branches and delve deep into psychology.

With Path you can go into clinical path to supervise and manage a lab. Genetics, blood bank, immunology etc.

Research is always an option in any branch. I know some MDs working with animal and celular models in translational medical research. Epidemiology and Public Health are also great options.

 

[EcnarM]

I'd actually say FM academic medicine is a great gig if you like teaching and prefer to be around pre-clinical students. One of the nicest doctors I ever met and had the pleasure of talking to multiple times was my DO school's pre-clinical dean who was FM trained and practiced I believe 12-18 hours a week I think at our school clinic. He seemed to love his job and he was great at helping out students (mentally and academically). Definitely helped he was a relatively young/middle aged attending and was able to relate well with students.

I agree, very few people consider academics and every school in the country has open positions, particularly in primary care as well as in OMM if you have knowledge and skills in that area. Pay is lower than private practice/clinical practice, but still sufficient to get out of debt and lead a comfortable lifestyle. Interacting with students keeps you sharp and on top of medicine if you put the effort into it. Seeing students find their path year after year is very rewarding. Plus, if you do want to do some clinical work, it is still there available. Better yet, find a medical school that is affiliated with a residency and provide resident oversight as your clinical practice. You mentor them and they see the patients. You stay in touch with clinical practice, but don't have to spend much time with each patient as the residents take care of the majority of that.

 

[FireInWonderland]

Could consider radiology as well.

I was just coming to suggest this. Look into radiology.

 

[Shanilg]

CDC’s Epidemic Intelligence Service (EIS) Public Health.

 

[TwistedTea]

Don’t finish residency and go teach OMM somewhere

 

[mcat_taker]

I just want to repeat what others said. Wait until after clinical rotations. Something might click then. Focus on doing as well as you can on boards don't write off anything yet as too competitive as you haven't even sat for your boards yet and have no idea how you would do.

The beauty of going into medicine is that there is something out there for everyone and every field is so different. Focus on exploring your interests more in rotations. Maybe neurology, lots of problem solving there. Radiology offers minimum patient contact.

Agree with clinical informatics fellowships being something that you might be interested in if you love stats.

 

[Dreamstoo]

I agree, very few people consider academics and every school in the country has open positions, particularly in primary care as well as in OMM if you have knowledge and skills in that area. Pay is lower than private practice/clinical practice, but still sufficient to get out of debt and lead a comfortable lifestyle. Interacting with students keeps you sharp and on top of medicine if you put the effort into it. Seeing students find their path year after year is very rewarding. Plus, if you do want to do some clinical work, it is still there available. Better yet, find a medical school that is affiliated with a residency and provide resident oversight as your clinical practice. You mentor them and they see the patients. You stay in touch with clinical practice, but don't have to spend much time with each patient as the residents take care of the majority of that.

Yeah pay seemed to be the biggest issue at our school. Know a few FM/IM doctors who left to join urgent cares/private practice because the pay wasn't high enough (they openly told students this).

 

[LimpSpatula]

Reading the OPs post and then seeing some people say go into psych is incredible. OP if you truly feel that way, you will be miserable practicing psychiatry. Psychiatry will have the biggest percentage of ungrateful, unreasonable and sick patients. Not wanting to have much patient interaction and psychiatry is an oxymoron.

 

[LimpSpatula]

OP, why did you go into medicine in the first place? And what about that has changed? Is it possible you could be influenced by outside forces/burnout?

 

[Dr.SPAC3MAN]

Forensic Pathologist/Medical Examiner?

 

[FrechToastFries]

Psych → lots of patient interaction and doesn't sound like you will enjoy that
Radiology → relatively competitive, if you're willing to grind for it, it's a great option for you

Pathology honestly sounds like it's right up your alley. No patient interactions, more of the science-y side of medicine, could probably get some good teaching gigs out of it too, pay is pretty good, not that competitive.

 

[Candidate2017]

Reading the OPs post and then seeing some people say go into psych is incredible. OP if you truly feel that way, you will be miserable practicing psychiatry. Psychiatry will have the biggest percentage of ungrateful, unreasonable and sick patients. Not wanting to have much patient interaction and psychiatry is an oxymoron.

It really depends on the P's:

Payor mix (Medicare vs Medicaid vs insurance vs good insurance vs cash).
Practice setting (Beverly Hills vs inner city DC, inpatient vs outpatient)
Private practice (ability to say no, see a subset of patients you're interested in vs employed and seeing whoever The Man tells you to).

All 3 are inter-related and contribute greatly to physician satisfaction, as well as determine how sick or ungrateful your patients will be. To some extent these 3 are specialty dependent and dependent on how aggressive you pursue them. This is something that behooves med students to examine carefully beyond just simplistic comparison of income, cut vs not cut, procedure vs nonprocedural etc.

Anyway, I doubt OP being a 2nd year, truly knows if they like clinical practice. Probably some combination of burnout and misplaced anxiety.

 

[DasNotRacist]

Do a short residency FM or IM so you can become board certified. This will serve you well even if you pursue a non-clinical career long-term. Work to get into a T-20 MBA program and consider a consulting career with a top firm (McKinsey, Bain, Boston Consulting Group). Bookmark and become familiar with this site:

Welcome to Look for Zebras - Look for Zebras

Welcome to Look for Zebras This is a place for unconventional physicians and medical professionals vying for fulfillment. Look for Zebras is guided by a few principles: Your career doesn’t need to fit anyone else’s idea of what a “doctor” does. Don’t wait for opportunities to find you. Seek them...

lookforzebras.com

Good Luck!

good luck getting into a T20 MBA and MBB lol

 

[LimpSpatula]

It really depends on the P's:

Payor mix (Medicare vs Medicaid vs insurance vs good insurance vs cash).
Practice setting (Beverly Hills vs inner city DC, inpatient vs outpatient)
Private practice (ability to say no, see a subset of patients you're interested in vs employed and seeing whoever The Man tells you to).

All 3 are inter-related and contribute greatly to physician satisfaction, as well as determine how sick or ungrateful your patients will be. To some extent these 3 are specialty dependent and dependent on how aggressive you pursue them. This is something that behooves med students to examine carefully beyond just simplistic comparison of income, cut vs not cut, procedure vs nonprocedural etc.

Anyway, I doubt OP being a 2nd year, truly knows if they like clinical practice. Probably some combination of burnout and misplaced anxiety.

Are you a psychiatrist? I feel like those things have nothing to do with how grateful or sick people are. You are speaking in platitudes though, so that fits.

 

[dial1010usa]

Psych is not competitive, please stop that myth. Just take step and if you can score like a 210 you can match at most low tier universities and community programs plus any of the former DO programs. You can prbly match at many places with just comlex as well. And obviously do well on your psych rotation and get a good letter, and do some community service related to psych to show commitment because they really care about that stuff in psych...but it’s not derm or ortho lol

and do some community service related to psych to show commitment because they really care about that stuff in psych.

what does this mean? How and where do you do this?

 

[Stagg737]

I'm in my second year, and I've come to the realization that I don't really want to practice clinical medicine. I had an idealized conception of what working with patients would be like during my pre-med years, but over time, I've come to the conclusion that it's not for me. I don't like being around ungrateful, unreasonable sick people or touching people in intrusive ways or memorizing algorithms or doing procedures. It all stresses me out, and I'm dreading clinical rotations during the upcoming two years.

I'm almost halfway through med school, and I'm unfortunately >$100k in debt. I've gotten mostly B's in school, and I'm somewhere in my class's third quartile. I only have an undergrad degree with a crappy major, and limited work experience. The job market would not treat me well if I dropped out.

I've thought about sticking it out and then going into preventive medicine/occupational medicine, but I'm not sure about the job outlook. I've also thought about getting a master's degree after med school and then trying to become an academic in public health or health administration or something. I've considered the corporate track (healthcare consulting and whatnot), but I'm not sure if it's open to DOs. I don't care very much about money, as long as I'm able to pay off my $300k debt. I enjoy problem-solving, writing, and statistics.

Any suggestions?

(Please refrain from the "you should've thought about this before matriculating" stuff. I don't have access to a time travel machine, so I gotta just try to pave a decent path for myself going forward.)

I actually would also consider psych. Yes, it's a lot of patient interaction, but it's completely different from every other field in medicine. Other than EM, we've got the best stories out there and psychotic patients are just a ton of fun to work with. Psych is the non-surgical field least suited to algorithms and requires a lot of cognitive flexibility and actual thinking about treatment plans. It sounds dumb, but there really is an art to psychiatry. It's also got way better job security and flexibility than almost any other field. If you really hate patients, go into forensics and write legal reports. If you match psych you can literally get into any fellowship field without difficulty. Like others have said, give clinical rotations a change. I was 99% sure I'd never do psych and ended up loving it. Many people had similar experiences.

Bonus points for no BS intern year to deal with. This is OPs answer. Path and then manage the bloodbank as well some administrative position. It's a sweet gig.

Psych also does not have an intern year. Managing a blood back can be a very sweet job though.

then do a fellowship in clinical informatics

This is actually a fantastic idea. We have an IM doc at our hospital who did this and loved it. He still does still see patients on the floors, but he also said he could drop all of his clinical responsibilities today and work full time running QI projects and clinical research if he wanted to. Adds a very nice dimension to your CV and can open a lot of doors both clinically and administratively.

Psychiatry will have the biggest percentage of ungrateful, unreasonable and sick patients. Not wanting to have much patient interaction and psychiatry is an oxymoron.

You won't be able to escape this in psych

Debatable, but I had a similar mindset to OP going into 3rd year in terms of non-compliant or ungrateful patients. Yes, this is an issue in psych, but we can actually treat that aspect in many patients who end up very grateful later. Plus, patient interactions are just different. It's also not that difficult to minimize the number of ungrateful/unreasonable patients you have. Just stay away from CMHCs, addiction, or obvious personality disorders. Most people, even in psych, are reasonable when you spend more than 2 minutes with them.

 

[hallowmann]

...Debatable, but I had a similar mindset to OP going into 3rd year in terms of non-compliant or ungrateful patients. Yes, this is an issue in psych, but we can actually treat that aspect in many patients who end up very grateful later. Plus, patient interactions are just different. It's also not that difficult to minimize the number of ungrateful/unreasonable patients you have. Just stay away from CMHCs, addiction, or obvious personality disorders. Most people, even in psych, are reasonable when you spend more than 2 minutes with them.

Some of the most grateful patients I've met were in substance use treatment through MAT. I think you will find that to be the case in most places that follow a harm reduction model. CMHCs also vary widely, and depending on the site you could have very reasonable or unreasonable, very grateful or ungrateful patients.

Forensic Pathologist/Medical Examiner?

You'll have to touch a lot of patients (and their organs) though. You'll also have to testify in court, which can certainly be stressful given OP finds patient interactions stressful.

what does this mean? How and where do you do this?

Get involved with local and national organizations, NAMI, community service or mental health resources locally, suicide hotline, harm reduction organizations, housing first initiatives, etc. There's really a lot that you can do, but you need to look at what is available in your community. And just so we're clear, you should be doing these things because you actually enjoy/want to do them, not solely for resume padding. They are generally not worth the time given potential application benefit solely for that reason.