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[Seeking advice]

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My situation:
AMG, got an MPH too, good med school, solid record, matched into a competitive specialty. Developed some health issues, really disliked the specialty, resigned and matched into something else. The second specialty chosen for a number of reasons. I also more and more have developed an interest in non-clinical stuff, and one of the reasons I went into the second specialty is because I thought it could help me in part be a good springboard into administrative stuff.
I have not enjoyed the second specialty. My interest has progressively dwindled. Also given that I am physically fatigued very frequently as a result of some of the health issues experienced in residency #1, it's becoming more and more difficult.
I have at this point decided that I really don't want to pursue clinical medicine and would much rather have an administrative type work - whether it's insurance type work, hospital admin, utilization review, etc.

I am thinking of maybe switching into a residency like Occupational/Preventive med.
Any thoughts? How do I navigate a situation like this? Would PDs give me a hard time? My PD seems moderately helpful in general but have not talked to them about this at this point. I am thinking that since many of the Occu/Prev med programs don't go through the match I could contact PDs and kind of explain my situation.

Also one of my parents is ill and I would like to go back home and help take care of them. My med school has a good program in this field. I got my MPH at my program too although did not really deal much with my program's faculty.

What do I do?

 

[Top Gun]

The problem then is that you will have resigned from two residencies. This is going to raise concerns about your ability to commit to training. Any PD you contact is going to think, "What if s/he suddenly decides s/he doesn't like occupational medicine?" I think your best bet is to finish out your current program. There are plenty of ways to get into the administrative stuff, if you wish to do so after graduating. But you probably won't if you don't finish some sort of residency. Board certification, or at least board eligibility, is becoming more of a requirement for doctors employed in utilization review and insurance companies, and you can't get that without completing a residency. Also, I'm kind of wondering why you think your current program is toxic. You said your current PD is helpful. That doesn't sound like a toxic environment.

 

[Seeking advice]

The problem then is that you will have resigned from two residencies. This is going to raise concerns about your ability to commit to training. I think your best bet is to finish out your current program. There are plenty of ways to get into the administrative stuff, if you wish to do so after graduating. Also, I'm kind of wondering why you think your current program is toxic. You said your current PD is helpful. That doesn't sound like a toxic environment.

The PD is helpful and overall reasonable, but the rest of the attending staff is toxic to say the least, and there are horrible politics. There are countless issues in the program, countless complaints against several attendings, we've had some attendings fired for sexual inappropriateness, nurses fired for inappropriate sexual behavior, other staff fired for fraud, attendings leaving residents entirely alone, and even our chair recently apologized for the disaster that hings have been for the past few years. We've had over 5 faculty members leave recently. We've had several residents leave/take leave, negative action taken against them, etc. I also find that I simply dislike clinical medicine. I think occupational medicine with a less clinical focus would be much better. I also have medical issues which cause incredible fatigue and it's become very difficult for me to pull through incredibly early hours (like 5:30am start times) which I feel will likely become an issue.

Is it worth writing PDs?Occupational med is short training, and I already have an MPH so it would be even shorter. Also with a health issue with one of my parents back home it becomes difficult to deal with things from here.

 

[Top Gun]

The PD is helpful and overall reasonable, but the rest of the attending staff is toxic to say the least, and there are horrible politics. There are countless issues in the program, countless complaints against several attendings, we've had some attendings fired for sexual inappropriateness, nurses fired for inappropriate sexual behavior, other staff fired for fraud, attendings leaving residents entirely alone, and even our chair recently apologized for the disaster that hings have been for the past few years. We've had over 5 faculty members leave recently. We've had several residents leave/take leave, negative action taken against them, etc. I also find that I simply dislike clinical medicine. I think occupational medicine with a less clinical focus would be much better. I also have medical issues which cause incredible fatigue and it's become very difficult for me to pull through incredibly early hours (like 5:30am start times) which I feel will likely become an issue.

Is it worth writing PDs?Occupational med is short training, and I already have an MPH so it would be even shorter. Also with a health issue with one of my parents back home it becomes difficult to deal with things from here.

Maybe. Your current environment does sound toxic. But you'll need to find a way to prove to any occupational medicine PDs you contact that you can commit to training.

 

[Seeking advice]

Maybe. Your current environment does sound toxic. But you'll need to find a way to prove to any occupational medicine PDs you contact that you can commit to training.

It is unfortunately. I don't want to "blame" per se, but between a) the toxic environment to the point of dreading coming in to work every day b) my significant dislike of clinical medicine c) medical issues causing difficulty on my end to pull hours that i am physically finding it difficult to do so d) parent health issue
and e) having my med school where i did my md and mph that has a large occup/prev med residency i am hoping that it's an option

I don't want to leave completely. i do want to have a residency completed, but at the same time i don't want to continue in this environment

 

[droption]

Just suck it up.
Man, who is going to hire a guy that left two residencies?
Just finish this one and don't ever think about leaving until you are done.
You are going to thank me later for this advice.

 

[BoardingDoc]

I am thinking that since many of the Occu/Prev med programs don't go through the match I could contact PDs and kind of explain my situation.

Just reading through the list of occ health residencies, it looks like a lot of them only require that you've completed one year of a standard residency so you're probably fine if you've done that. That said, I agree with everyone else here who says that it's a massive red flag to do this. You're already on your second residency. You will seem completely and utterly unreliable jumping into a third without having committed to anything thus far.

 

[gutonc]

It would be (kind of) helpful to know which specialties you've been in already. Are you one of these people who just chose your specialty poorly, or someone who shouldn't have gone into medicine at all?

 

[Seeking advice]

It would be (kind of) helpful to know which specialties you've been in already. Are you one of these people who just chose your specialty poorly, or someone who shouldn't have gone into medicine at all?

I don't want to disclose too much, but I had a very serious and rare medical issue during residency #1 - so rare, in fact that even specialists at MGH had difficulty treating it. I even wrote and presented a case report on myself! It made continuing in that specialty impossible, and I also did not like the specialty. The second specialty tends to be a lot less hard core if you will in general, although as mentioned, my program tends to have a number of issues, and some of us are scape goated. On an academic level I'm doing well, but there are a lot of issues with staff, including attendings (some issues noted above), nurses, etc. In general though, I agree with you that I should not have gone into Medicine. I don't do well with politics and while a good doctor, I'm sick of dealing with the countless regulations, politics, angry nursing staff, dysfunctional attendings, etc.
With that said, with all that I've invested, I have to do something even if not practicing clinical medicine.

 

[Gastrapathy]

You need to share your current specialty to get good advice.

 

[gutonc]

I don't want to disclose too much, but I had a very serious and rare medical issue during residency #1 - so rare, in fact that even specialists at MGH had difficulty treating it. I even wrote and presented a case report on myself! It made continuing in that specialty impossible, and I also did not like the specialty. The second specialty tends to be a lot less hard core if you will in general, although as mentioned, my program tends to have a number of issues, and some of us are scape goated. On an academic level I'm doing well, but there are a lot of issues with staff, including attendings (some issues noted above), nurses, etc. In general though, I agree with you that I should not have gone into Medicine. I don't do well with politics and while a good doctor, I'm sick of dealing with the countless regulations, politics, angry nursing staff, dysfunctional attendings, etc.
With that said, with all that I've invested, I have to do something even if not practicing clinical medicine.

Look, we get that you're a special snowflake. But if you want helpful responses, you need to give at least some useful background.

1. I matched into a super competitive specialty, because I'm awesome.
2. I developed a magical disease that I cured by myself and wrote a case report on...even those a-holes at Man's Greatest Hospital couldn't figure it out...but I did.
3. I decided to go with another specialty that doesn't really deserve my amazing knowledge and skills because everybody in it sucks.

That is a concise and accurate review of your posts so far. Read that as if it's written by someone else (me maybe if that helps) and see how that sounds. Then either come back with useful answers to the questions you've been asked or just don't come back. Nobody can help you if you're not willing to help yourself.

 

[evilbooyaa]

Look, we get that you're a special snowflake. But if you want helpful responses, you need to give at least some useful background.

1. I matched into a super competitive specialty, because I'm awesome.
2. I developed a magical disease that I cured by myself and wrote a case report on...even those a-holes at Man's Greatest Hospital couldn't figure it out...but I did.
3. I decided to go with another specialty that doesn't really deserve my amazing knowledge and skills because everybody in it sucks.

That is a concise and accurate review of your posts so far. Read that as if it's written by someone else (me maybe if that helps) and see how that sounds. Then either come back with useful answers to the questions you've been asked or just don't come back. Nobody can help you if you're not willing to help yourself.

I think this is a bit harsh on OP but I still chuckled.

OP - I know you are trying to stay anonymous, but answer me these few questions:
1. Was your first residency something surgical (Ob/Gyn, Gen Surg, any surgical subspecialty)?
2. Is your second residency FM/IM/Peds/Psych?
3. How many years of residency do you have left?
4. Have you completed 1 full post-grad year and are thus capable of going for Occ/Prev?

I would informally reach out to some Occ/Prev PDs regarding a hypothetical candidate like yourself before you jump out of whatever residency you're in now.

Most likely, you'd be best off just completing the residency you're in now as it will give you an ability to do administrative tasks but have a fallback of clinical medicine.

 

[Seeking advice]

Look, we get that you're a special snowflake. But if you want helpful responses, you need to give at least some useful background.

1. I matched into a super competitive specialty, because I'm awesome.
2. I developed a magical disease that I cured by myself and wrote a case report on...even those a-holes at Man's Greatest Hospital couldn't figure it out...but I did.
3. I decided to go with another specialty that doesn't really deserve my amazing knowledge and skills because everybody in it sucks.

That is a concise and accurate review of your posts so far. Read that as if it's written by someone else (me maybe if that helps) and see how that sounds. Then either come back with useful answers to the questions you've been asked or just don't come back. Nobody can help you if you're not willing to help yourself.

To answer some of your questions concretely,

1-No I don't think that I am a special snowflake
2-I won't give the specialty away, but it's one of the ROAD specialties - I never referred to myself as awsome
3-Disease was not magical - it's very rare, and I never said Mass general didn't do a great job - they did a FANTASTIC job but they had a hard time figuring things out and treating it - ultimately I had surgery with the director of dept and he did a spectacular job - ultra kudos to him!

Not a special snowflake, but I'm sure anyone who in the last knows me could figure this out if they read further details and I'd rather remain anonymous.

So to recap - ROAD specialty, got sick, transferred into less competitive, more "chill" specialty, not feeling it/toxic environment. I also find that while I'm good at clinical medicine, I really don't enjoy it that much, and I'm terrible at dealing with politics. So would like to go into more administrative type position - so I was thinking occupational med. I have contacted a few programs, including my med school, and I've gotten some response from a number of places.
I guess that's my situation in a nutshell.

 

[Seeking advice]

I think this is a bit harsh on OP but I still chuckled.

OP - I know you are trying to stay anonymous, but answer me these few questions:
1. Was your first residency something surgical (Ob/Gyn, Gen Surg, any surgical subspecialty)?
2. Is your second residency FM/IM/Peds/Psych?
3. How many years of residency do you have left?
4. Have you completed 1 full post-grad year and are thus capable of going for Occ/Prev?

I would informally reach out to some Occ/Prev PDs regarding a hypothetical candidate like yourself before you jump out of whatever residency you're in now.

Most likely, you'd be best off just completing the residency you're in now as it will give you an ability to do administrative tasks but have a fallback of clinical medicine.

No, I despise surgery so not surgical. We'll leave at it was a ROAD specialty. Residency #2 not in primary care. I have less than 2 years left, which is roughly same time frame that I would need for an occupational med residency given my already in hand MPH. Yes to your question about completion of 1 full post grad year.

Yeah I have reached out to a few programs, most have gotten back to me with reasonable answers, and some seem amenable. I don't want to anger my current PD though!

 

[evilbooyaa]

No, I despise surgery so not surgical. We'll leave at it was a ROAD specialty. Residency #2 not in primary care. I have less than 2 years left, which is roughly same time frame that I would need for an occupational med residency given my already in hand MPH. Yes to your question about completion of 1 full post grad year.

Yeah I have reached out to a few programs, most have gotten back to me with reasonable answers, and some seem amenable. I don't want to anger my current PD though!

Well I think if you go to your PD, who gave you a second chance, and tell him that you're looking into transferring locations (again) and specialties (again), he will likely be somewhat annoyed with you. He will likely not take a second residency person in a boat similar to yourself in the future if he can avoid it.

That's all for naught, because you have to do what you feel is best for you. It's a risk to consider switching residencies one time. It's a much bigger risk to consider doing it twice. I would think long and hard, because 1) it's going to be hard to get into a 3rd residency anyways. You're probably running out of a proportion of GME funding at this point. 2) If for any reason it doesn't work out, your career is most likely over. Generally administration is rarely something you jump directly into while having 0 clinical experience... but I'm not as sure about this, tbh.

 

[Top Gun]

Um, you don't like hospital politics and you want to get into administrative stuff? That's like jumping from the frying pan into the fire!

 

[Top Gun]

And by the way, just in general OP. At some point in their lives, everybody has to grow up, pick a career, and stick to it. You can't just keep jumping from profession to profession. The grass is not always greener on the other side. Case in point: when you transferred from your first residency into your second one. Maybe you should have thought more about whether you wanted to do clinical medicine before you even entered med school.

 

[Seeking advice]

And by the way, just in general OP. At some point in their lives, everybody has to grow up, pick a career, and stick to it. You can't just keep jumping from profession to profession. The grass is not always greener on the other side. Case in point: when you transferred from your first residency into your second one. Maybe you should have thought more about whether you wanted to do clinical medicine before you even entered med school.

Umm, right, because I CHOSE to get a rare massive tumor that created issues with motor skills. I find that you are a reasonable poster in general, so I'm going to do the adult thing, give you the benefit of the doubt, and assume you skipped the part of my post where I said that I dealt with health issues. I just nilly willy said one day, "Hey! How about I opt for a tumor today? Woot woot! Maybe I can go to Mass Gen. and have those people figure it out! Woot woot!"
Right!

 

[Top Gun]

Umm, right, because I CHOSE to get a rare massive tumor that created issues with motor skills. I find that you are a reasonable poster in general, so I'm going to do the adult thing, give you the benefit of the doubt, and assume you skipped the part of my post where I said that I dealt with health issues. I just nilly willy said one day, "Hey! How about I opt for a tumor today? Woot woot! Maybe I can go to Mass Gen. and have those people figure it out! Woot woot!"
Right!

Well, I apologize for my comment about the transfer to a second residency. If your first residency was in a procedure-oriented specialty, then I totally get it. A tumor causing motor skill impairment would certainly be a major issue in that case. But now you want to switch to a third residency, so my point still stands. It would have been better if you had given more thought to the second residency before even applying. Or even if you really wanted to do clinical medicine in the first place when you applied to med school.