Quitting Ophtho and Switching to IM/FM

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vannas

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I am a PGY2 and 3.5 months into my residency, and I already feel like quitting.
My program doesn't really give didactics and the amount of learning depends on my own study and clinical exposure, which greatly varies from resident to resident.
I have started seeing patients on my own, and have been scolded for missing important red flag signs including retinal detachments. Not to mention I failed an ophtho exam which I took only 3 months into residency. I was also being gossiped behind my back by colleagues about my clinical skills and attitude, and being compared with my co-residents who performed better than me.
I also felt that I had difficulty suturing under microscope. I started wearing glasses since the age of 3. In fact my stereopsis was only a bare minimum to pass (my program had our eyes checked before starting residency and I think mine was 120 arc sec).
I used to be very passionate about ophthalmology but now I just don't feel like I enjoy it anymore. I fear asking questions and no longer have the motivation to read up after work. I would rather attend IM webinars than ophtho ones.
People here say ophtho is a golden ticket and many people want the lifestyle and the calls. However, I just feel that I am not competent or suitable for ophtho.

I have worked in IM during my PGY1 and I enjoyed the hospital setting more than the clinic setting, the feeling of "saving lives" and being in the frontline.
Ophtho just makes me dump everything I've learnt in med school and I'm learning another completely new language.
I understand that IM could be very stressful and the calls are hell, and I am basically a trashcan of medicine. However I do miss that close relationship with patients and their family during my PGY1 year, when I actually "saved" lives.

Any comments would be greatly appreciated.

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I am a PGY2 and 3.5 months into my residency, and I already feel like quitting.
My program doesn't really give didactics and the amount of learning depends on my own study and clinical exposure, which greatly varies from resident to resident.
I have started seeing patients on my own, and have been scolded for missing important red flag signs including retinal detachments. Not to mention I failed an ophtho exam which I took only 3 months into residency. I was also being gossiped behind my back by colleagues about my clinical skills and attitude, and being compared with my co-residents who performed better than me.
I also felt that I had difficulty suturing under microscope. I started wearing glasses since the age of 3. In fact my stereopsis was only a bare minimum to pass (my program had our eyes checked before starting residency and I think mine was 120 arc sec).
I used to be very passionate about ophthalmology but now I just don't feel like I enjoy it anymore. I fear asking questions and no longer have the motivation to read up after work. I would rather attend IM webinars than ophtho ones.
People here say ophtho is a golden ticket and many people want the lifestyle and the calls. However, I just feel that I am not competent or suitable for ophtho.

I have worked in IM during my PGY1 and I enjoyed the hospital setting more than the clinic setting, the feeling of "saving lives" and being in the frontline.
Ophtho just makes me dump everything I've learnt in med school and I'm learning another completely new language.
I understand that IM could be very stressful and the calls are hell, and I am basically a trashcan of medicine. However I do miss that close relationship with patients and their family during my PGY1 year, when I actually "saved" lives.

Any comments would be greatly appreciated

It sounds like you've had a very difficult few months - sorry to hear it.

Some of this stuff is normal - feeling like you know nothing, having difficulty suturing under the microscope. That will get better over time. Almost every resident feels that. If you put the work in (it sounds like you are trying) then it should come together. For some residents it happens quicker than for others. Progress isn't always linear, either.

You definitely develop close relationships with your patients once you are in practice - in some ways closer than with IM patients. In regards to "saved" lives - people value their vision so much and are always so grateful when you can either save their vision or even improve it.

I can't comment on the culture of your program. Based on your description it doesn't sound great. Sometimes, though, when we are in a "bad place" we fixate on the negative things and minimize the positive things. Do you have a residency director that you are comfortable talking to? If not, maybe it would be worth seeking out someone in the hospital. All hospitals have resources for physicians that are struggling with one thing or another,.

I hope this works out for you. Some people start residency and realize that they don't want to do eyes for the rest of their life - but give it a bit of time before switching.
 
You can easily back into an IM residency spot, not the case the other way around. I would hold tight through the end of the year then consider your options. Talk to senior residents, mentors and anyone else that you think would be able to offer you some solid advice. This is a pretty life altering decision so not one to take lightly or rush into (or out of).

First year is always difficult, drinking through a firehose for sure. We all go through these periods of doubt. Hang in there.
 
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Don't wait until the end of the year to make a decision. You'll want to secure a spot to start IM PGY2 well in advance of July 1. Also, your ophtho program may have a chance to get a transfer to fill your spot if they have advance notice.

I tried to switch to IM after PGY3. Even spent weekends in the MICU so I could get ready to be PGY2 in IM. But by then I was too deeply entrenched in ophtho, had forgotten almost everything relevant for IM, and I couldn't just switch. If I had decided earlier, I think I could have done it. If you know you want to switch, make a decision sooner than later. It's a hard decision no matter when you make the decision, but you need to be happy with your profession to be good at it, so the decision will be worth it if you are happy after the switch. Talk to IM PGY2s and 3s in your hospital to ask if they know someone who switched into their program from some other residency. There always seems to be one or more person who switched out of radiology or anesthesia or something else into IM. Sometimes ophtho to IM.
 
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Holy cow, please do not switch from Ophtho to IM. First of all, IM life is terrible. Second of all, your lifetime earnings will be about 60% less than Ophtho. Just don't switch. Gain some perspective and build some resiliency. There are literally hundreds of people who would give their left pinky to be in your position.
 
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Don't switch - give it time. Your program sounds a bit malignant but if your PD is worth his/her salt, talk to your PD for help. The learning curve is steep but once you get through the toughest parts, it'll be much easier. Usually after 6 months is when things really start falling into place.
 
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Don’t confuse the annoying people at your residency program with what you end up doing for the rest of your life.

I found my medicine residency to be more friendly and with better hands on teaching as well. There are simply more IM physicians who are interested in teaching. But that has nothing to do with how much you’ll enjoy the field once you’re done with residency and fellowship.

My wife is IM/primary care - its an extremely frustrating job.
 
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Remember that ophtho residents are cream of the crop, so of course you're going to feel like you were happier as an intern. You were doing stuff you'd actually studied in med school AND you were being compared to people who probably weren't as competitive (in any sense of the word) as you. Also, it's possible you weren't even really held to much of a standard at all, as your attendings knew you were just passing through and probably didn't care what you did as long as no one died. Now you're expected to perform and you're compared to others who are just as sharp. Plus, even though the attending lifestyle is pretty great, it *sucks* being an ophtho resident. You're usually the only one on call, you probably don't get a postcall day, and the entire f'ing hospital seems to think you're just kicking it somewhere and therefore should have time to see their stupid genetics fishing trip consult, or maybe their viral conjunctivitis, or maybe their K abrasion but hey can you just come take a look and make sure it's not a globe.

It's totally normal to feel overwhelmed and ****ty. That said... I do worry a little if you perhaps don't physically have the stereopsis needed for ophtho. I'm also concerned that you missed an RD. Was it a big obvious one, and you missed it because you didn't dilate or look? Or was it a subtle one that you missed because you couldn't perceive the elevation...? I mean everyone -- even those who think they can do no wrong -- misses something big and important once in a while. But you need to figure out why it happened. If it was carelessness, that can never happen again and you must be better. If it was physical inability to see it... honestly that worries me a bit more because I don't know how to help you, other than tell you to get OCTs on anyone you suspect, and maybe go into a subspecialty that doesn't require much stereopsis.

Finally, it's actually ****ty that your program seems to be malignant. But like others have said, hang in there a bit longer. Not to the end of the year -- the program can't fill if you ditch right before 7/1 and you really shaft your colleagues. But give it at least through March or so. If you still feel like you aren't cut out for ophtho, or are miserable in ophtho, maybe talk to your PD then and see if you can switch into IM or something else.
 
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I agree with the others, except you sound shocked that you have to stop learning IM stuff and now are deeply immersed in ophtho. Also the stereopsis seems like something you would have wanted to know before being tested by your program. If you are thinking of switching, ask yourself why you wanted to do ophtho before and try and figure out (you can use us as a sounding board) if those were good reasons in the first place. And please, not the reason you may have told a PD as a scripted response, but the real reason. I’ve told med students my spiel on how to pick a specialty. It’s amazing how many people pick based off of role modeling alone or practical reasons that have 0 to do with their actual interests. Best of luck.
 
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I agree with the others, except you sound shocked that you have to stop learning IM stuff and now are deeply immersed in ophtho. Also the stereopsis seems like something you would have wanted to know before being tested by your program. If you are thinking of switching, ask yourself why you wanted to do ophtho before and try and figure out (you can use us as a sounding board) if those were good reasons in the first place. And please, not the reason you may have told a PD as a scripted response, but the real reason. I’ve told med students my spiel on how to pick a specialty. It’s amazing how many people pick based off of role modeling alone or practical reasons that have 0 to do with their actual interests. Best of luck.
I would be interested in hearing your spiel on how to pick a specialty. Not sure anyone ever had one with me
 
I am a PGY2 and 3.5 months into my residency, and I already feel like quitting.
My program doesn't really give didactics and the amount of learning depends on my own study and clinical exposure, which greatly varies from resident to resident.
I have started seeing patients on my own, and have been scolded for missing important red flag signs including retinal detachments. Not to mention I failed an ophtho exam which I took only 3 months into residency. I was also being gossiped behind my back by colleagues about my clinical skills and attitude, and being compared with my co-residents who performed better than me.
I also felt that I had difficulty suturing under microscope. I started wearing glasses since the age of 3. In fact my stereopsis was only a bare minimum to pass (my program had our eyes checked before starting residency and I think mine was 120 arc sec).
I used to be very passionate about ophthalmology but now I just don't feel like I enjoy it anymore. I fear asking questions and no longer have the motivation to read up after work. I would rather attend IM webinars than ophtho ones.
People here say ophtho is a golden ticket and many people want the lifestyle and the calls. However, I just feel that I am not competent or suitable for ophtho.

I have worked in IM during my PGY1 and I enjoyed the hospital setting more than the clinic setting, the feeling of "saving lives" and being in the frontline.
Ophtho just makes me dump everything I've learnt in med school and I'm learning another completely new language.
I understand that IM could be very stressful and the calls are hell, and I am basically a trashcan of medicine. However I do miss that close relationship with patients and their family during my PGY1 year, when I actually "saved" lives.

Any comments would be greatly appreciated.
I’m an attending IM specialist. If you are going to quit, I would be ecstatic to take your place in residency.

Not even kidding.
 
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I’m an attending IM specialist. If you are going to quit, I would be ecstatic to take your place in residency.

Not even kidding.
OP, even if this is in jest, this should tell you exactly what you have in store if you switch to IM/FM. Burnout is extremely high in primary care and especially in IM/FM. It's hard to find a specialty in medicine with the pay and lifestyle ophthalmology offers. If you talk to physicians in IM/FM, you will see that a lot of the magic they experienced as a 4th year medical student and resident is no longer there. Your attendings in those fields shield you from some of the issues that cause burnout - satisfaction surveys, endless prior auth phone calls, dealing with non-compliant or patients with unrealistic expectations, worsening midlevel creep, administrative hostilities, I could go on.

If you want that special, close relationship with patients, consider doing a surgical subspecialty. I have this same relationship with several of my patients - when you help someone through a possibly blinding condition and see them through it (to hopefully a good outcome), these patients will remember this and treasure that relationship with you.

If you still think your heart is in IM/FM, make sure you are 100% sure. There's no going back if you make that switch. I hate to say this but it would be better to finish ophthalmology residency, practice a year or two, and if you still hate it, then re-apply for IM/FM. This way, you can be sure in your decision. Unfortunately it would not work the other way (finish IM/FM, then realize you made a mistake and go back into ophthalmology).
 
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OP, even if this is in jest, this should tell you exactly what you have in store if you switch to IM/FM. Burnout is extremely high in primary care and especially in IM/FM. It's hard to find a specialty in medicine with the pay and lifestyle ophthalmology offers. If you talk to physicians in IM/FM, you will see that a lot of the magic they experienced as a 4th year medical student and resident is no longer there. Your attendings in those fields shield you from some of the issues that cause burnout - satisfaction surveys, endless prior auth phone calls, dealing with non-compliant or patients with unrealistic expectations, worsening midlevel creep, administrative hostilities, I could go on.

If you want that special, close relationship with patients, consider doing a surgical subspecialty. I have this same relationship with several of my patients - when you help someone through a possibly blinding condition and see them through it (to hopefully a good outcome), these patients will remember this and treasure that relationship with you.

If you still think your heart is in IM/FM, make sure you are 100% sure. There's no going back if you make that switch. I hate to say this but it would be better to finish ophthalmology residency, practice a year or two, and if you still hate it, then re-apply for IM/FM. This way, you can be sure in your decision. Unfortunately it would not work the other way (finish IM/FM, then realize you made a mistake and go back into ophthalmology).
Even if you are "100% sure about IM/FM," don't do it!
 
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Make the switch if you liked your IM PGY1.

I am IM (hospitalist) and I like what I do. The money is not ophthalmology money but $280-350k/yr is not bad
 
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Thank you all for your kind messages and sorry for the late reply. My program is definitely not benign with a lot of hierarchy and unspoken rules but it has a lot of training opportunities. I guess I will persist for another year first.

Do you have any tips on time management and studying for a first year? I am so drained from daily clinical duties and calls and I felt like it’s so hard to concentrate and study after work.
 
Figure out your learning style first. Some people learn best from watching videos, others from reading or taking notes, or doing questions (the latter which was my approach). Once you figure that out, then make reasonable goals of what to read per week. Keep in mind that what you need to know to pass tests/boards is not the same as what your attendings necessarily want to know or care about, but there usually is a good amount of overlap.

If you see something weird or odd, or need to clarify something, it's sometimes easier just to look it up online - there are tons of resources out there to read up on. Just taking 3-5 min to read something after seeing something helps a ton with retention. If you are drained at the end of the day, try reading first thing in the morning or during a meal. There's no point to study if you are drained, but at the same point, you have to dedicate some time outside of clinical duties to study.

Last, it's not a sprint, it's a marathon. Don't get discouraged quickly. Don't forget that the same is true in other fields in medicine - you may have shined as an intern, but as you go through medicine, the amount of information you have to learn is more granular like ophthalmology and requires this same amount of discipline and time management.
 
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Thank you all for your kind messages and sorry for the late reply. My program is definitely not benign with a lot of hierarchy and unspoken rules but it has a lot of training opportunities. I guess I will persist for another year first.

Do you have any tips on time management and studying for a first year? I am so drained from daily clinical duties and calls and I felt like it’s so hard to concentrate and study after work.
You should consider looking for open PGY-3 ophthalmology spots as it sounds like more of the issues are due to your program and not ophthalmology in general. I know of one resident who left an ophtho program that he wasn't happy at to go into another PGY-3 spot elsewhere in the country. The timing of course has to work out, but there are sometimes opening due to illness, family issues, whatever and you may be one of the only eligible/willing ophtho residents in the country.
 
I was having the same thought during my first year. Somehow I recently graduated from ophtho. I also had the same reasons(the colleagues, the stereopsis) and "tunnel visions"like you did. I embrace all the negative things occured during my first year and let those as a more of reasons why I should quit. Then I decided to continue my program because I want to be responsible for what I chose. If, let said, you change IM, how do you so sure that there won't any reasons to quit IM ? I think every programs has its plus and negatives. Eventually it would down into whether you like surgery or not. If you're into surgery then ophtho will be okay for you. About time management during first year, try to not quit. You don't have to reach high at first year because it will be a burden for you. Learn from the patient you met during the day and keep learning from each case. I hope it helps because I know that feeling very well.
 
All PGY-1s are tough, no matter the specialty. It will get easier as you progress through residency. It should get better. Ophthalmology is a great specialty. In my opinion, way better than primary care IM/FM. Higher pay, better hours, have to deal with mainly one focus area (unlike FM/IM), not much "social work" stuff (unlike FM/IM), and you are the king/queen of your specialty (unlike IM/FM where midlevels are slowly creeping to take over primary care). Plus in ophthalmology you get to have a "Jonathan", not much so in FM/IM :) :





I love Dr. Glaucomflecken!
 
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In Ophtho, you can definitely get into the 8-digit level of net worth relatively quickly. Trust me -- that will make you much happier with choosing Ophtho over IM. Money isn't everything, but it definitely gives you freedom/flexibility!
 
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In Ophtho, you can definitely get into the 8-digit level of net worth relatively quickly. Trust me -- that will make you much happier with choosing Ophtho over IM. Money isn't everything, but it definitely gives you freedom/flexibility!
How quickly are we talking about here? 20+ yrs
 
Just a med student, so take my advice with a grain of salt, but I think the biggest consideration about deciding whether or not to switch is your comfort and desire to do surgery or not. As an Ophto, you are a surgeon working on peoples’ eyes, so being comfortable and wanting to work with your hands and do surgery in a very small space will be part of your everyday life. The need to work with your hands and have fine motor skills will eliminate some people from wanting to pursue this specially. As long as you enjoy that, I’m sure with practice and time you will become proficient and it will become routine.

With IM/FM, with the exception of some IM sub specialties, you will not be working with your hands much. It is heavily diagnostic and being the first stop for the general population’s health. If you were drawn to the surgical aspects of Ophthalmology, would you be happy with being a PCP?

These are kind of on the opposite ends of the spectrum, so I would suggest thinking about it in the long term, and determining whether it’s your residency experience that’s making you second guess or the field of Ophthalmology. I’ve talked to many attendings who had brutal residency experiences that didn’t go smoothly, but after practicing and becoming proficient, they love their specialties.
 
Luck might play a big role because it has been a crazy bull market in the past 10 years

Grinding and hustling every day for a decade creates more "lucky" situations. Those who dismiss people's accomplishments as "luck" assume that only external forces were the cause of those achievements. And attributing everything to "luck" makes other people feel like they cannot accomplish the same.

I have average intelligence (for Ophtho), went to a mid-tier Ophtho program, and had no business experience prior to entering private practice. But I did work relatively hard for the past decade and took some risks early-on. Hard work is not rocket science.
 
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Dear all, thank you for the replies.

A bit of updates:
I have a history of depression since med school and some relapses during intern year which was controlled before starting residency. I have seen psychiatrists and counsellors but things just relapsed from time to time. After starting residency I became anxious, depressed, anhedonic, feeling worthless and useless at work (starting ophthalmology makes me feel like I have never been to medical school before). I forget a lot, have a low self-esteem, avoid socializing and making eye contact with my colleagues, and am tired every day (to the point I fell asleep in the OR a few times, not sure if my senior noticed). I was afraid to call up to my seniors during calls when I wasn’t sure about the signs because I worry my questions are too dumb or I might disturb them.

I work in a busy unit, and I’m generally a slow person but not sure if it is further exacerbated by my depression. Sometimes it caused me to skip lunch and work till very late and I tend to look very rushed all the time. My slowness has been criticised by some seniors but I can’t help. While my ophtho colleagues in general are chill and relaxed compared to me. I generally avoid socializing unless necessary and obviously don’t look as excited as before when I was at work. Some nursing and supporting staffs complained to my senior for having a poor attitude and I am not sure if it is related.

When I wake up in the morning I feel very very anxious and very fatigued and I barely get myself up to work. I also feel burned out maybe because I did not get enough break before residency. My mind is overloaded with a lot of thoughts to the point that I would worry about making wrong management plans before I sleep every day. Sometimes I got so tired that I fell asleep immediately after dinner and skipped shower.

Recently I tried to speed up and increase efficiency, but find myself making even more mistakes, some even caused harm to me and my patients such as frequent needle stick and mucosal injuries to myself, creating a huge epithelial defect in patient during simple wound irrigation.

I have contemplated of taking some time off but am worried that I would be gossiped behind by my colleagues and that I will fall behind my training schedule given that my OR experience is already behind schedule. But I feel very tired and weak to continue the rest of the year and I really can't take care of myself and my patients. I feel I'm not safe to the patient.

I have decided that IM is not for me and I will hopefully stick with Ophtho and complete my residency. But I am not sure if I should just pull it through or take some time off..
 
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Taking some time off might be beneficial. Can you sit down with your Program Director and explain your situation? Health (including mental) is priority #1, because you cannot do anything else effectively without it. Wishing you the best for this New Year.
 
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Dear all, thank you for the replies.

A bit of updates:
I have a history of depression since med school and some relapses during intern year which was controlled before starting residency. I have seen psychiatrists and counsellors but things just relapsed from time to time. After starting residency I became anxious, depressed, anhedonic, feeling worthless and useless at work (starting ophthalmology makes me feel like I have never been to medical school before). I forget a lot, have a low self-esteem, avoid socializing and making eye contact with my colleagues, and am tired every day (to the point I fell asleep in the OR a few times, not sure if my senior noticed). I was afraid to call up to my seniors during calls when I wasn’t sure about the signs because I worry my questions are too dumb or I might disturb them.

I work in a busy unit, and I’m generally a slow person but not sure if it is further exacerbated by my depression. Sometimes it caused me to skip lunch and work till very late and I tend to look very rushed all the time. My slowness has been criticised by some seniors but I can’t help. While my ophtho colleagues in general are chill and relaxed compared to me. I generally avoid socializing unless necessary and obviously don’t look as excited as before when I was at work. Some nursing and supporting staffs complained to my senior for having a poor attitude and I am not sure if it is related.

When I wake up in the morning I feel very very anxious and very fatigued and I barely get myself up to work. I also feel burned out maybe because I did not get enough break before residency. My mind is overloaded with a lot of thoughts to the point that I would worry about making wrong management plans before I sleep every day. Sometimes I got so tired that I fell asleep immediately after dinner and skipped shower.

Recently I tried to speed up and increase efficiency, but find myself making even more mistakes, some even caused harm to me and my patients such as frequent needle stick and mucosal injuries to myself, creating a huge epithelial defect in patient during simple wound irrigation.

I have contemplated of taking some time off but am worried that I would be gossiped behind by my colleagues and that I will fall behind my training schedule given that my OR experience is already behind schedule. But I feel very tired and weak to continue the rest of the year and I really can't take care of myself and my patients. I feel I'm not safe to the patient.

I have decided that IM is not for me and I will hopefully stick with Ophtho and complete my residency. But I am not sure if I should just pull it through or take some time off..
I completely agree with Lightbox. Talk with your PD; chances are he/she has dealt with situations like this before might be able to advise you and offer options you hadn't considered.
Take care of your mental health. Don't neglect it. Take time off, whatever you need to do. Only by being healthy mentally and physically will you be able to become the physician you want to be.
 
I completely agree with Lightbox. Talk with your PD; chances are he/she has dealt with situations like this before might be able to advise you and offer options you hadn't considered.
Take care of your mental health. Don't neglect it. Take time off, whatever you need to do. Only by being healthy mentally and physically will you be able to become the physician you want to be.
I talked to my PD and all I got was very generic suggestions on how to improve my efficiency, despite I already emphasized that I am feeling anxious, burnt out and have sleeping problems. Some other people told me not to bother my PD unless I have solid suggestions otherwise I would just be labelled as a “difficult, challenging” resident. I had hopes before that but now I can confirm this is true.
 
Dear all, thank you for the replies.

A bit of updates:
I have a history of depression since med school and some relapses during intern year which was controlled before starting residency. I have seen psychiatrists and counsellors but things just relapsed from time to time. After starting residency I became anxious, depressed, anhedonic, feeling worthless and useless at work (starting ophthalmology makes me feel like I have never been to medical school before). I forget a lot, have a low self-esteem, avoid socializing and making eye contact with my colleagues, and am tired every day (to the point I fell asleep in the OR a few times, not sure if my senior noticed). I was afraid to call up to my seniors during calls when I wasn’t sure about the signs because I worry my questions are too dumb or I might disturb them.

I work in a busy unit, and I’m generally a slow person but not sure if it is further exacerbated by my depression. Sometimes it caused me to skip lunch and work till very late and I tend to look very rushed all the time. My slowness has been criticised by some seniors but I can’t help. While my ophtho colleagues in general are chill and relaxed compared to me. I generally avoid socializing unless necessary and obviously don’t look as excited as before when I was at work. Some nursing and supporting staffs complained to my senior for having a poor attitude and I am not sure if it is related.

When I wake up in the morning I feel very very anxious and very fatigued and I barely get myself up to work. I also feel burned out maybe because I did not get enough break before residency. My mind is overloaded with a lot of thoughts to the point that I would worry about making wrong management plans before I sleep every day. Sometimes I got so tired that I fell asleep immediately after dinner and skipped shower.

Recently I tried to speed up and increase efficiency, but find myself making even more mistakes, some even caused harm to me and my patients such as frequent needle stick and mucosal injuries to myself, creating a huge epithelial defect in patient during simple wound irrigation.

I have contemplated of taking some time off but am worried that I would be gossiped behind by my colleagues and that I will fall behind my training schedule given that my OR experience is already behind schedule. But I feel very tired and weak to continue the rest of the year and I really can't take care of myself and my patients. I feel I'm not safe to the patient.

I have decided that IM is not for me and I will hopefully stick with Ophtho and complete my residency. But I am not sure if I should just pull it through or take some time off..
I am happy to hear that you have the maturity to truly assess your strengths and weaknesses. Unfortunately the pandemic has made everyone more mentally frayed.

In terms of asking questions and disturbing people, at this point in your training you should not be afraid of calling up your seniors or asking for help. The most important thing is patient safety and making sure the patient is diagnosed and taken care of properly. If your seniors are upset you are calling them, they should also be reminded if that something bad happens and they refuse to come in because you are uncomfortable with something, that is their liability and fault.

I am not am armchair psychiatrist by any means but it does sound like you are about to relapse into another depression. Everything you are describing sounds like it. It is unfortunate your PD is not helpful, so my concrete suggestions would be that you ask for leave of absence to focus on yourself. You may need your psychiatrist and therapist to vouch for this as well. You have ACGME protections for this and it is illegal for your PD to deny this or hand-wave this off. You may have people gossip about you and your attendings may give you the stink-eye, but at the end of the day, you are there to graduate as an ophthalmologist, not be best friends with them, and that may mean standing up for yourself and causing conflict.

Last, it's good you are not switching. I hate to say it but even if you switched, I think you would have the same issues in IM/FM or other fields because there is always more to know and uncomfortable zones, and part of medicine is learning how to embrace and overcome it.
 
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