Quitting residency (AP/CP)

[throwawayacct1284749]

Hi everyone,

As of late I have been disillusioned by my residency program & am contemplating quitting.

I'm in a four-year AP/CP residency but I can switch to AP if I am so inclined.

What do you all think?

I imagined myself calling up my program director and telling him I'm not planning on continuing, although I'd feel really bad about it.

How do I quit with grace? Say after the first year. At least then the call schedule and tumor board will not be affected for next year.

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[shikimate]

There was a period in my training (in Canada) whereby I actually applied to transfer out but got denied and ended up finishing the training anyway.
The early part of pathology residency I find the hardest, I find most of what you learn in med school is FM/IM so the learning is very steep at the beginning of training. But I found a few tricks that really helped me a lot:

1) find the right resource. Nobody told me the usefulness of CAP protocol and WHO blue books and other resources like LibrePathology etc. Once I found these resources a lot of my academic struggles went away and I actually excelled more than my peers. I watched a lot of PathCast videos and sometimes during round I knew more about certain things from these videos than the attendings lol. You want to study hard but also study smart. Prepare for board exam early and find 1 or 2 study buddies to keep each other motivated. Isolating yourself and studying alone is not a good strategy. If possible, regularly meet up with 1-2 other residents to exchange learnings. Even if they are more junior than you, you'll be surprised how much you gain by teaching others and by listening to others correct your mistakes.

2) find 1-2 people that you trust. It's super important to find 1 or 2 close people in your program, could be residents, fellow, attending etc. A lot of comradery is necessary to survive residency so don't isolate yourself thinking you can do it alone. It would be good to regularly do some stuff with your friends outside of work, maybe play sports, play music, eat out, or anything to get out of the hospital. Find some way to dissipate your frustrations safely like sports, but definitely avoid substance and gambling. Outdoor stuff like hunting, fishing, gardening, foraging, hiking are also good ways to dissipate the negative energy. Don't be afraid to invest a bit of money into a hobby or sport or art or something to keep your mental health sane.

3) know where to draw a line. I find it took a year or so to figure out who's your friend and who's your adversary in your program. There'll be people whom you don't like or maybe even someone who tries to get in your way. I find some level of stoicism is required to keep distance from these people. Keep it professional and polite but just know that you don't have to be friends with everyone and can still do well. If you don't like the PD, again just keep it professional and try not to take criticisms personally. You should do a good job but it's not necessary to "keep up with the Jones", let's say there are others who do more research or kiss up to somebody higher up than you do.

4) In a similar vein, you'll find there will be attendings that you get along well with. It's good to have 2-3 people "behind your back" so to speak. Do good work and make them trust your skill and judgement and character. If possible, do some electives in the community and attend some meetings to branch out your connections. Again don't isolate yourself within your program. For jobs and opportunities you never know somebody you shook hands with at some random place could help you in a big way down the road.

 

[Med Director New England]

Is it that you don’t like your program but still want to be a pathologist?

If Yes - it’s only 3 1/2 more years and then you could leave for fellowship(s).

If No (you no longer want to be a pathologist) - get out asap.

 

[wholeheartedly]

Hi everyone,

As of late I have been disillusioned by my residency program & am contemplating quitting.

I'm in a four-year AP/CP residency but I can switch to AP if I am so inclined.

What do you all think?

I imagined myself calling up my program director and telling him I'm not planning on continuing, although I'd feel really bad about it.

How do I quit with grace? Say after the first year. At least then the call schedule and tumor board will not be affected for next year.

what would you plan to do instead?

 

[throwawayacct1284749]

what would you plan to do instead?

I have no concrete plan, but loosely I'm looking for a job as an associate scientist or epidemiologist.

 

[Spaziergängerin]

First year is a hard adjustment and a lot of people become disillusioned. If you don't like CP, switch to AP only and just see if you like the 2nd year better. If not, then quit. In the interim keep looking for a job. You're not an indentured servant and you can quit. Try the DOC website for jobs that don't have residency requirements. If you hate both AP and CP, life is too short, start job hunting now and don't waste your life doing something you hate just because you feel obligated. You'll end up not being good at it and also miserable.

DOC - Innovative healthcare careers for doctors and scientists

DOC is the leading community and recruiting site for doctors and scientists (MD, PhD, Masters, PharmD, etc.) pursuing non-clinical, non-academic jobs. Founded as the Drop Out Club, DOC is now at DOCjobs.com.

www.docjobs.com

If it's the specialty, doctors change residency specialties all the time. Just be honest with your director that path isn't for you, and most of them will help you match to a better fit. You should take elective time in anything you may apply for, and they will help you do that if you are honest about not liking path.

 

[Napoleon1801]

Hi everyone,

As of late I have been disillusioned by my residency program & am contemplating quitting.

I'm in a four-year AP/CP residency but I can switch to AP if I am so inclined.

What do you all think?

I imagined myself calling up my program director and telling him I'm not planning on continuing, although I'd feel really bad about it.

How do I quit with grace? Say after the first year. At least then the call schedule and tumor board will not be affected for next year.

If you trust your program director, schedule a time to talk to them in person about it. Let them know your concerns and maybe they can give you some advice on your options if you decide to go AP only. Announcing your resignation via phone would be seen as unprofessional and probably don't want to burn this bridge if you need a recommendation for another career path.

 

[Diana Prince]

DO NOT QUIT. My program director was an idiot and so I did not confide in her.
I was the worst resident. I ate lunch by myself everyday. Attendings and residents thought that I was a complete ***** when it came to looking through the microscope.
I now make 800K a year amongst all of my businesses. I am a senior director in big biopharma where I oversee a staff of 30 people in a fortune 500 company. I direct 5 smaller labs and I supervise two nurse practitioners. If you ask anyone from my former program, if I would ever amount to that success, they would never believe you.
If you are having a bad day in residency and eating lunch alone, give me a call 323 873 4883

 

[KeratinPearls]

DO NOT QUIT. My program director was an idiot and so I did not confide in her.
I was the worst resident. I ate lunch by myself everyday. Attendings and residents thought that I was a complete ***** when it came to looking through the microscope.
I now make 800K a year amongst all of my businesses. I am a senior director in big biopharma where I oversee a staff of 30 people in a fortune 500 company. I direct 5 smaller labs and I supervise two nurse practitioners. If you ask anyone from my former program, if I would ever amount to that success, they would never believe you.
If you are having a bad day in residency and eating lunch alone, give me a call 323 873 4883

Yeah when you are in residency people will make you doubt your self worth. Don’t ever let someone have power over you. Congrats on the killer salary lol.

 

[Dr Faust]

Is it that you don’t like your program but still want to be a pathologist?

If Yes - it’s only 3 1/2 more years and then you could leave for fellowship(s).

If No (you no longer want to be a pathologist) - get out asap.

This is the key question.

I did not have a good experience during my first year of residency. I got into serious trouble due to attending politics and became the whipping resident for awhile, even when there were inferior residents with less skill and work ethic around. Sometimes, the crappy human elements of residency can jade even the most passionate of individuals. So ask yourself, why are you thinking of quitting? If its the human element, eventually it will pass and you will move onto fellowship at (hopefully) a better institution. If you hate looking at glass, bail out now and save yourself of a lifetime of hating your career.

 

[shikimate]

DO NOT QUIT. My program director was an idiot and so I did not confide in her.
I was the worst resident. I ate lunch by myself everyday. Attendings and residents thought that I was a complete ***** when it came to looking through the microscope.
I now make 800K a year amongst all of my businesses. I am a senior director in big biopharma where I oversee a staff of 30 people in a fortune 500 company. I direct 5 smaller labs and I supervise two nurse practitioners. If you ask anyone from my former program, if I would ever amount to that success, they would never believe you.
If you are having a bad day in residency and eating lunch alone, give me a call 323 873 4883

I remember a med school joke:
- the top third of class becomes great academic staff and scientific researchers
- the middle third of class becomes great community physicians and patient advocates
- the bottom third of class becomes the medical building landlord to the middle third and philanthropists to the top third.

 

[CDX-2]

Hi everyone,

As of late I have been disillusioned by my residency program & am contemplating quitting.

I'm in a four-year AP/CP residency but I can switch to AP if I am so inclined.

What do you all think?

I imagined myself calling up my program director and telling him I'm not planning on continuing, although I'd feel really bad about it.

How do I quit with grace? Say after the first year. At least then the call schedule and tumor board will not be affected for next year.

Hey there,

Apologies if my message has been too late.

I dunno what it's like to work in US / Canada (currently am an AP registrar/resident in Australia), and I'm not familiar with how AP/CP training works there from a logistical point of view.

If you feel comfortable, you could speak to your program director about how you're feeling.

It also helps to do some "research" to try to find out why you're feeling disillusioned, whether it be for academic reasons or workplace-related issues (eg understaffing / bullying / workplace abuse), or other reasons etc etc.

If it's a workplace-related issue, would you be allowed to transfer to another lab to continue training?

I can't help you with the CP component, but if you'd like, I can PM you my AP notes that I made for my RCPA AP Part 1 Exams if it helps you with study.

Do you have other co-registrars (co-residents) that you can do study group with?

I was previously disillusioned during 1st and 2nd year AP as I was initially working in a regional private lab which was very understaffed (I started a separate thread on being disillusioned back in 2018). I got severely exploited by doing lots of IRRELEVANT scientist duties for at least 20 months , ON TOP of specimen grossing/cut-up, without realizing it at the time as I was so innocent and naive, which came at the huge expense of my "Training" and mental health. I also had two co-registrars (co-residents) resign, so I was the "senior registrar/resident" there for ~18 months. There wasn't much supervision and there was very little histology teaching compared to other labs. I got really burnt out and depressed from working there.

I ended up getting sent to another regional private lab for 3rd and 4th year AP, where I was doing cut-up/grossing for 5 days / week, but the consultant (attending) pathologists there were much nicer and appreciative of my work, and there was relatively much more supervision, teaching and guidance compared to my original regional private lab. So I was actually a lot happier there, and gradually stopped becoming disillusioned after changing work environment.

I actually became much more interested in AP after working in the second regional private lab.
But I wouldn't have known that unless I'd worked in a different (much more supportive) lab.

I hope this helps.

 

[throwawayacct1284749]

Bump

 

[KeratinPearls]

Bump

Pathology is chill. Residency and fellowships are the hard part. If you can’t see yourself being a pathologist then quit. Might just be the stress from training. I had a relatively chill residency program. If you can finish residency, just get a job at the VA and chill for the rest of your life. Seriously I talked to the head of a VA hospital who signed out cases for one hour and went to meetings or did administrative work for the rest of the day. Work there for the rest of your career and get that pension plan. Make sure you are in a calm emotional state before making any rash decisions.

 

[caffeinegirl]

Think about why you're thinking of quitting - is it pathology as a field or your residency program? Why did you go into pathology in the first place? Have those reasons changed now that you've been exposed to it? That will help you figure out the reasons behind your feelings. I would spend a long hard time in a calm state of mind to sort through this first.
I would not recommend doing AP only unless you want to stay in academics/research. My program director pushed me into AP only because they had another AP/CP resident drop AP to do CP-only and he wanted full coverage. This severely limited my chances of work in private practice (something the PD knew about but dismissed when I brought it up at the time). If I would do it over again, I would have stayed AP/CP.

 

[Iceman24]

Hate to tell you that, but path is the easiest training ever existed.
If it's hard for you, then of course go for scientist/epidemiologist.

 

[Nilf]

Hi everyone,

As of late I have been disillusioned by my residency program & am contemplating quitting.

I'm in a four-year AP/CP residency but I can switch to AP if I am so inclined.

What do you all think?

I imagined myself calling up my program director and telling him I'm not planning on continuing, although I'd feel really bad about it.

How do I quit with grace? Say after the first year. At least then the call schedule and tumor board will not be affected for next year.

If you can get a residency spot in any clinical specialty, then do it. If you can't, then don't quit. Don't do AP only, it's even worse than AP/CP unless you want to stay in academia for some reason.

 

[KeratinPearls]

If you can get a residency spot in any clinical specialty, then do it. If you can't, then don't quit. Don't do AP only, it's even worse than AP/CP unless you want to stay in academia for some reason.

LOl at worse than AP/CP. So you’re saying overall being a pathologist basically just sucks.

 

[coroner]

So you’re saying overall being a pathologist basically just sucks.

 

[Nilf]

LOl at worse than AP/CP. So you’re saying overall being a pathologist basically just sucks.

Chill bro. The work of pathologist is great. The business of pathology is a dumpster fire in the middle of Bakhmut. But you already knew that. We've been complaining about it for almost 20 years now, in my case at least.

 

[throwawayacct1284749]

Bump

 

[KeratinPearls]

What other advice do you need?

 

[throwawayacct1284749]

I've decided to quit after this year is over. I'm doing this out of respect, since I think quitting suddenly would be a huge screw you to everyone I've worked with so far.

 

[imgtointern]

In a way, I’m happy for you. You’re prioritizing your mental health/happiness. We had a resident who did a few years of residency then quit, then came back, then quit and came back one last time when her co residents from all those years ago had been attendings for almost 10 years. This person quit again, one last time! Truly speaking, I do not think they wanted to be a physician in the first place. For me the first 2 years of residency were absolute fun. It got tougher in the last few years but that was the norm in my program, the newbies were protected and there was always some beef with the seniors. Also, the PD and coordinator gossiped and spread rumors about people’s personal lives even. It was weird! Anyway, its hard for someone else to tell you whether to leave or not but if leaving is what you have decided to do, then figure yourself out. What do you really want to do in your career? How can you get there? Only time will tell if you are right or not. But use this time now to introspect and find your path.

 

[Smoothbrain]

During my APCP residency in the U.S, certain family members of mine became critically ill. I felt guilty having abandoned everyone back at home, and that together with the massive distance from my home country made me quit my APCP residency (despite becoming a Pathologist in the U.S was one of my biggest dreams). I quit after my 2nd year. My program did not show understanding for the situation that I found myself in.

I am currently doing Pathology residency in a comfortable European country, and I do not regret my decision. I also think the residency training experience here is better than what I experienced in the U.S (37 hours, better pay, a lot of support for research and academic activities, the supervision is excellent and grossing is minimal).

I might give U.S another go in the future in form of the Physician Scientist Track, but we will see.

 

[mike-sheree]

During my APCP residency in the U.S, certain family members of mine became critically ill. I felt guilty having abandoned everyone back at home, and that together with the massive distance from my home country made me quit my APCP residency (despite becoming a Pathologist in the U.S was one of my biggest dreams). I quit after my 2nd year. My program did not show understanding for the situation that I found myself in.

I am currently doing Pathology residency in a comfortable European country, and I do not regret my decision. I also think the residency training experience here is better than what I experienced in the U.S (37 hours, better pay, a lot of support for research and academic activities, the supervision is excellent and grossing is minimal).

I might give U.S another go in the future in form of the Physician Scientist Track, but we will see.

37hours?? I guess you get out of it what you put in.

 

[SunBakedTrash]

37hours?? I guess you get out of it what you put in.

Probably depends on the breakdown and how you chose to spend your time. I spent about 37 hours per week pushing glass in residency. I then spent another 37 grossing overflow junk the PAs were too lazy to gross, chart surfing worthless data for “QA projects” and hauling piles of slides up and down the stairs for endless sign-outs.

 

[Smoothbrain]

37hours?? I guess you get out of it what you put in.

I get what you mean, and I agree with you. I think the work week should be 45ish.

I think you have to kill it in residency to become good, and those who do want to become good (not that many), do stay longer than 37 hours, its just not a requirement. I also do agree that the residents in the U.S were way more competent and knowledgeable, but considering how they work twice as much, and have to pass a specialized board exams, its hardly surprising. I am very grateful for my U.S experiences.

 

[TrojanRaggy]

I get what you mean, and I agree with you. I think the work week should be 45ish.

I think you have to kill it in residency to become good, and those who do want to become good (not that many), do stay longer than 37 hours, its just not a requirement. I also do agree that the residents in the U.S were way more competent and knowledgeable, but considering how they work twice as much, and have to pass a specialized board exams, its hardly surprising. I am very grateful for my U.S experiences.

Let any US resident who feels competent and knowledgable take FRCPath and see what happens

 

[mike-sheree]

Let any US resident who feels competent and knowledgable take FRCPath and see what happens

And what would that be? Did they have a section on linear equations or p. chem that would cause some pause?

 

[SunBakedTrash]

And what would that be? Did they have a section on linear equations or p. chem that would cause some pause?

If I’m not mistaken, isn’t performing an actual autopsy part of the exam? I think it also has a 50% pass rate.

 

[caffeinegirl]

Histopathology

www.rcpath.org

 

[mike-sheree]

No autopsy performance. And “back in the good old days” of the ‘80’s it was pretty close to 50% and wasn’t that hard too boot.

 

[throwawayacct1284749]

Thanks for your replies. One of my coworkers convinced me to stay another year, so I renewed the contract for second year. Interesting to hear about your experience Smoothbrain. How did you manage to get into pathology residency overseas?

 

[Smoothbrain]

Dear throwawayacct1

I was in the U.S as an IMG from Europe. I studied medicine in Europe and already had licence to practice medicine. So the road to landing a job here in my home country was pretty straight forward, I just had to apply. : ) Are you asking as an American or IMG yourself? Are you considering Europe?

 

[Iceman24]

Always entertaining how people speak about "Europe" with regard to training or jobs - I guess the experience one receive in Oslo might be quite different from Sarajevo...

 

[RoachUSMLE]

Hate to tell you that, but path is the easiest training ever existed.
If it's hard for you, then of course go for scientist/epidemiologist.

Not true

 

[MetroPath]

Not true

Compared to some other specialties, yes but I would not say it’s easy at all especially AP. AP is tough and stressful at most places if you are at a high volume program. At least in Pathology you can go home and sleep in your bed.

CP was easy for me, basically a mini-vacation where I did residency.

 

[Iceman24]

Not true

Ok then, so what is easier than path?

 

[RoachUSMLE]

Ok then, so what is easier than path?

First, what is your definition of "easy/easier" ?

 

[Smoothbrain]

Nuclear medicine seems easier than AP. No?

 

[Iceman24]

First, what is your definition of "easy/easier" ?

This is simply pathetic.
Schedule, intensity of work, night shifts, and responsibilities - everything is easier in path than any other specialty.
The only reason people are bitching about their "tough" life in residency they have no idea how other specialties are. Send any path resident to medical ICU or floors they would not physically survive till the end or rotation.

My life in AP/CP residency was the best time in my life, counting from birth.

 

[throwawayacct1284749]

Dear throwawayacct1

I was in the U.S as an IMG from Europe. I studied medicine in Europe and already had licence to practice medicine. So the road to landing a job here in my home country was pretty straight forward, I just had to apply. : ) Are you asking as an American or IMG yourself? Are you considering Europe?

I'm an American. Not currently considering Europe, since I'm not from there. But interesting to hear about your experience, anyhow.

Thanks for all the replies.

 

[octopusprime]

This is simply pathetic.
Schedule, intensity of work, night shifts, and responsibilities - everything is easier in path than any other specialty.
The only reason people are bitching about their "tough" life in residency they have no idea how other specialties are. Send any path resident to medical ICU or floors they would not physically survive till the end or rotation.

My life in AP/CP residency was the best time in my life, counting from birth.

lol I'll second that...college was a grind--literally lived in the library, no life, worked my tail off.
Med school was comparatively a party.
Residency & fellowship was a freaking blast.