Quitting vs enduring surgery residency

[train111]

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[Winged Scapula]

I'm starting out my second year in surgery residency and was wondering how "normal" or often do residents think of quitting.

I did at least every other day. Sometimes multiple times during the same day.

I was dead tired and the reckless regard for human emotion, safety, the lack of interest in teaching and the daily humiliation made me wonder if I could tolerate it. We had some truly disturbed individuals in our program (and I was at a place not generally considered malignant). Although in the end I put up with it and am happy with what I do, perhaps being older or a former psychology grad student, I was more shocked at the behavior I saw. There are some really immature people in medicine.

But remember when you finish (if you do), you can tailor your career to however you like it. There are many surgeon authors, musicians (I am going to a show in a couple of weeks for a band made up of physicians), competitive athletes, etc. Of course, you have to get there. Do yourself a favor and at least get a license if you decide to leave.

 

[JackADeli]

...how "normal" or often do residents think of quitting. ...I thought of quitting medicine altogether...

So I just wanted to ask if anyone else during their residency had similar thoughts. ...And if ...do it now than later to avoid wasting any more of my life in this profession.

Residency at all levels and specialties is an endurance marathon and not a sprint. I always cringe when people talk about how great it is after you get past internship. Each year should be a little better. But, there is alot of suck to all years of residency. The prize is when you complete residency, get a job & board certification. Residency is a foundation hurdle. Don't loose focus of the goal.

Yes, I considered quitting on numerous occasions right to the end. I knew plenty that left at differing PGY years throughout residency for other specialties such as FM, ER, etc... All have regrets with exceedingly few exceptions.

You need to do some soul searching and decide if medicine is for you. Quitting a residency which is geared towards what your end-game is, i.e. surgery for a more cushy residency alternative will in the long run be a greater waste of time, etc... You would probably be trading a satisfying 2-3 decade career for ~an enjoyable 3 year training program. That would be a mistake.

AS WS has mentioned, at least complete two clinical years, all USMLE, and obtain an unrestricted license.

 

[filter07]

I thought about quitting so many times during internship. Sometimes constantly, all day. It would be the first thing I think about when I woke up in the morning. The thing is, what you think you can endure, what you think is worth it, and all those things get pretty skewed when you are exhausted. When I'm tired, all can think about is quitting, sleeping for hours on end, and just living a 9-5 M-F life.

Try not to make major decisions under stress situations... lack of sleep is one of them, and it's hard to think straight and have proper perspective under those conditions. I'm in the lab now with low stress and lots of sleep and I have to say, I feel recharged, optimistic about surgery, and feel like I care about patients again. Sometimes even in the lab when I'm staying up late at night to make deadlines I feel pretty crummy about life, but after the deadline passes those feelings subside too.

Anyway it's a personal decision but just keep in mind that your perspective can be pretty skewed when you're exhausted or get yelled at, etc.

 

[JMarshall]

I have to admit being right there. I just finished second year and when I started it, I had the exact same feelings you are describing. I even went so far as to contact someone in the IM program who used to be a surgery resident to discuss it. I think the worst part was feeling like I had to hide the fact that I was unhappy, and feeling like I was alone in this. I am only a 3rd year in research now, but I can say that the end of second year was a little better. Part of what made it better was talking to one of the chiefs and finding out he went through the same thing at around the same time. I hope it helps to know that there are others who have been there or are going through the same thing, I know it helped me. There are probably plenty of people in your program who are still completely pumped with surgery, but there are plenty of people who aren't as well, and that doesn't make them bad people or any worse at their job.

 

[blue2000]

My program director always talked about the "twos blues." I think that you believe that intern year is the absolute worst, that it'll get magically, dramatically better. I can remember thinking as an intern "I'll never have to do CXR recs again" as i filled out thirty every day for the whole thoracic service...and then turning around and filling them out for the entire CTICU service. So it gets better but not a whole lot.

The key though, is that until I was an attending, I thought being an attending was doing the same job for more money. It's not. All different practice patterns are different, with varying degrees of scut and crap, but it's a fundamentally better job. You have to assess whether you want to be an attending surgeon, and reach out to people to talk about it. Residency is such a closed world, you are in this tunnel, surrounded by other people who know nothing about what is on the other end.

Also, are you depressed? Clinically? Is it situational depression, from being an exhausted overworked resident, or is it something that you need to have treated, either by a primary care doc or a psychiatrist. Ultimately, our aiblity to care for ourselves is what separates us from animals. Reach out if you need to.

 

[JackADeli]

...are you depressed? Clinically? Is it situational depression, from being an exhausted overworked resident, or is it something that you need to have treated, either by a primary care doc or a psychiatrist. Ultimately, our aiblity to care for ourselves is what separates us from animals. Reach out if you need to.

 

[ESU_MD]

I ruminated about quitting on a regular basis, luckily I never had the time to quit and find a new job. thus, I was able to finish residency #1 and am quite happy. now if I could just quit my second residency.......

 

[agranulocytosis]

Train111: hang in there! I hope you find the answer that's right for you.

Kind of on the topic, but when is it usually that interns and residents begin to really feel it? I would imagine the winter months in the more northern states, but as others had pointed out in this thread, and as the timing of the OP shows, those feelings can start right back up in the summer of the second year.

I'm sure the other applicants on this forum would like to be prepared for the potential onset of SAD-like symptoms before they hit.

How much of an effect does having an interest in other hobbies help with these feelings?

 

[deleted89854]

I'd say the worst part is definitely around December-January, when you're no longer intimidated by any of the floor or consult work yet you still have six months of drudgery ahead of you before it starts to get a little better and the ABSITE is bearing down on you. I can imagine that the weather in the northeast can be an issue especially when you're commuting to work at 4:30 am. The things that got me through it were strong bonds with the other interns - going to the beach together post-call or out to the bars to relax and unwind. I was also lucky enough to have a girlfriend from a medical family who understood what I was going through and was there to support me.

As much as I bitched and complained those first two years, I'd take it over research any day of the week. It's my second year in the lab and I miss operating a great deal, and it's hard to watch my friends build confidence and experience while I sit in my office writing papers. You have to be careful that you don't decide to leave surgery only to realize you made a decision clouded by fatique, sleep deprivation, and frustration. I miss the constant stimulation and new challenges to face every day.

I agree with those above - if you are actually depressed, seek help (on your own). This forum is littered with posts from those who tried to tough it out, with poor results.

 

[Wifeofaresident]

As my name entails I am a wife of a new surgery resident. We are in the process of talking to people about switching since he is only 2 months into the program. Mostly the "lifestyle" is what is frustrating my husband. He works well over 100 hours at work each week for the past 2 months and when talking to others at this place it sounds like it gets worse rather than better once you get through the program. My husband loved to work in the OR and says that he will really miss that part of the job. However, not being able to be home and realizing that being part of a family will never really be an option until he retires has made him decide this job isn't worth it. Many of the attendings tell him that they are lucky to spend 10 min of a day every now and then with their kids. One of them hasn't had more than a day off at a time in over 5 years. It's sad that people are worked to the point that they are not allowed to be anything other than their job. I admire and appreciate all of you who are becoming general surgeons.

 

[treehorsio]

To Wifeofaresident:

It sounds like your husband is in the wrong program, period.

#1 it is quite illegal to be working 100 hours every week
#2 it is fully within his bounds to be honest about this when he is asked (which he should be, as is required by all ACGME gen surg programs)
#3 I don't think he should think that the life of a general surgeon is that of all his attendings; it's not.

I am in my 2nd year in a lab, have a baby daughter, and will absolutely see her for more than 10 minutes a day (maybe not every day, but most).

I have female attendings with one, two, even three children, who have proved it is possible. (one just got an R-O1).

anyway, perhaps he should look for an open PGY2 spot instead somewhere else.

There's a big difference between hating surgery and hating being exhausted. Presumedly he did plenty of surgery rotations as a student where he worked as hard (if not harder) than as an intern, so I doubt these issues are because of his realization that, shock: surgery residents work hard. harder than any other resident.

 

[former military]

it is human nature to want to quit now matter how many years your residency, how tough or cushy your call schedule is, or how demeaning the attendings, senior residents, or nursing staff can be.

you are always considered, "not a doctor" because you are a resident.
your peers are off making money, being independent, spending time with their families. very depressing.

I finally came to think like this as illogical as it seems:
1) i could be sent to prison for six years
2) i could be in a john mccain style POW camp for six years
3) i could be a homeless street person for six years.

instead I was sentenced to residency and had no option but to finish

obviously my residency was six years.
this grass is greener approach really helped.
nobody will break me.

I encourage you to text your spouse during the day often. have them visit you on call and bring in food for you occasionally. it will help your relationship, parenting, and outlook for grinding through the days.

I also looked at it like I was climbing everest. it is supposed to be difficult and it is supposed to hurt... but the view from the top is magnificent and worth the climb.

this is my amateur psychology tale of getting through in the days before the limit on resident work hours.

 

[chapaquito]

I will not give up my Residency in Surgery,remember read and think :" To gain something you have to lost something".

 

[Zoom-Zoom]

I also looked at it like I was climbing everest. it is supposed to be difficult and it is supposed to hurt... but the view from the top is magnificent and worth the climb.

This is good advice. I feel like I'm climbing everest sometimes...probably on my way to basecamp right about now I'm also often reminded before big exams of the feeling I had before football games back in high school. It's a very similar feeling...you know you're about to be in pain, but if there's no pain there's no gain. The pain is the price you pay as an athlete/student/whatever. I think the ability to value the type of accomplishment that only comes from endurance/perseverance is fundamental to all medicine. We all have it to some extent. With periods of time like residency I think it's a subjective decision about trading those 5-7 years for the view from the summit. Then if you do decide it's worth it, your mission is to make it as enjoyable as possible, like a POW

 

[Winged Scapula]

#1 it is quite illegal to be working 100 hours every week

I'm sure you misspoke but because this comes up every year:

- it is not ILLEGAL to work 100+ hours
- it is against RRC REGULATIONS (which are not law; no one is getting arrested)
- residents ARE allowed to work over 100 hours per week; the current regulation states that the work hours cannot be over 80 hours per week (or 88 in some programs) AVERAGED over 4 weeks

Of course, wifeofaresident does sound like there are some problems in her husband's program and otherwise you are correct - life as a resident does not have to equate to similar lifestyles in other programs or as an attending.

Surgeons and surgery residents who only see their kids 10 minutes a day do so because they have chosen to do so - outside of being in the OR doing a case or on call - there are surgeons/residents who prefer being in the hospital to being at home. I have seen it time and time again. Those who want to make time WILL do so.

 

[gogogo123]

i was in this exact situation once upon a time. as a med student i loved surgery more than anything else. i loved the fast pace, being in the OR, and even the long hours. i liked feeling productive.

i studied my ***** off to get into a good residency and succeeded. i read all the books in preparation, and i was thrilled that i would finally be able to begin my training.

after about 6 months of residency i finally admitted to myself that i was miserable and didn't see a light at the end of the tunnel. i saw the systematic dehumanization of my fellow residents (and myself), i found myself getting irrationally angry at the SICU patients ("why the EFF won't he stop complaining about his EFFING chest pain??!?"), and every morning when i woke up my entire body hurt for no clear reason. on my glorious postcall days i fell asleep eating dinner with my boyfriend, even in restaurants. i fantasized about sleep the way most people fantasize about far more interesting things.

throughout all this i can honestly say that i still loved surgery. i even sincerely liked most of my colleagues. but at the end of the day it wasn't enough-- i realized that everyone only gets to live once and i loved too many other things in my life to devote myself entirely to the OR. i would have gotten to save a lot of lives as a surgeon, but it would have been at the expense of my own.

i switched specialties after my intern year and never regretted it for a second. there are a lot of people here who will tell you you'll never forgive yourself for quitting surgery, etc., etc. keep in mind that the people in this forum are surgery residents, not the people who left for another field (i came upon this thread because a friend sent me the link)...

thankfully there are people out there who do love the OR enough to become surgeons. if i get a perf'ed bowel someday i'll be eternally grateful to the person who comes in in the middle of the night and has to sleep through the next day and miss breakfast with their family.

 

[45408]

if i get a perf'ed bowel someday i'll be eternally grateful to the person who comes in in the middle of the night and has to stumble through clinic the next day and miss breakfast with their family.

Fixed that for ya...

 

[Guile]

As much as I bitched and complained those first two years, I'd take it over research any day of the week. It's my second year in the lab and I miss operating a great deal, and it's hard to watch my friends build confidence and experience while I sit in my office writing papers.

No moonlighting opportunities? Our residents in the lab get a lot of moonlighting in. Trauma needs people all the time. A private hospital here likes having our guys in the CVICU. Our people "in the lab" end up the OR quite a bit...and pull down a lot more than their lab salaries while doing it.

 

[Guile]

i was in this exact situation once upon a time. as a med student i loved surgery more than anything else. i loved the fast pace, being in the OR, and even the long hours. i liked feeling productive.

i studied my ***** off to get into a good residency and succeeded. i read all the books in preparation, and i was thrilled that i would finally be able to begin my training.

after about 6 months of residency i finally admitted to myself that i was miserable and didn't see a light at the end of the tunnel. i saw the systematic dehumanization of my fellow residents (and myself), i found myself getting irrationally angry at the SICU patients ("why the EFF won't he stop complaining about his EFFING chest pain??!?"), and every morning when i woke up my entire body hurt for no clear reason. on my glorious postcall days i fell asleep eating dinner with my boyfriend, even in restaurants. i fantasized about sleep the way most people fantasize about far more interesting things.

throughout all this i can honestly say that i still loved surgery. i even sincerely liked most of my colleagues. but at the end of the day it wasn't enough-- i realized that everyone only gets to live once and i loved too many other things in my life to devote myself entirely to the OR. i would have gotten to save a lot of lives as a surgeon, but it would have been at the expense of my own.

i switched specialties after my intern year and never regretted it for a second. there are a lot of people here who will tell you you'll never forgive yourself for quitting surgery, etc., etc. keep in mind that the people in this forum are surgery residents, not the people who left for another field (i came upon this thread because a friend sent me the link)...

thankfully there are people out there who do love the OR enough to become surgeons. if i get a perf'ed bowel someday i'll be eternally grateful to the person who comes in in the middle of the night and has to sleep through the next day and miss breakfast with their family.

What did you switch into?

 

[glade]

This is the reason you go through rotations in medical school. Everyone focuses on surgery as "this is neat, we get to operate!" If you guys paid attention during medical school, you'd realize that 95% of surgery is putting up with other peoples' s**t, which is why surgeons are constantly rude. Everyone just acts like surgery attracts rude people. Wrong. Surgery turns people into rude people, but that's because of the aforementioned s**t you have to put up with.

For example, take something as integral to surgery and simple as scheduling a case. You know who is in charge of that? Most likely someone who barely graduated high school and therefore doesn't care when that case goes off or comprehend how important or unimportant the case is. It's basically like (and I know everyone has experienced this) "we're working as fast as we can" and then they go back to chewing gum with their open mouth and slack jaws.

Or how about scrub techs? Scrub techs can be very competent, but that's few and far between. Mostly it's like they're just hanging out and day-dreaming. Your field could be filled with blood and they'd just watch while you're yelling for instruments or something. Everyone goes at one speed, whether it's an emergency or it's not. The other day I was trying to control some bleeding and asked for some Prolene and the tech is sitting there laboriously unwinding the suture and straightening it out and finally I just grabbed it from her. All she knows is that I was "rude" to her.

How about other attendings? I'm constantly amazed by primary care physicians or emergency room attendings. You can make all the excuses you want, but some of the consults we get from them are incredibly pathetic. But if you want to see referrals, you just smile and write "thank you for allowing me to participate in the care of this wonderful and interesting patient, I loooooove fibromyalgia and constipation."

Point is, if you were paying attention during medical school, you'd vaguely recall that's why residents were so pissed all the time when their pager went off. I make no effort to disguise any emotions in front of medical students. That's called teaching. I'm teaching them what it's like to be in surgery. If they like it, they can go into it. If they're horrified, then can choose not to. I'm not going to pretend surgery is all candy canes and sugar cookies in front of them, as is the current demand by most institutions, so as to trick them into going into surgery and being horrified one week into it.

Oh, and if you're pissed off at stupid nursing calls, that's because your attendings are pu**ies who allow that to happen. Anyone who says otherwise is lying. If you took all the same attendings and removed their residents and made them answer the same calls, those calls would stop roughly thirty-five seconds into it because they'd be on the phones complaining to nursing supervisors and administrators. But since residents are the ones getting woken up at 3:06 AM to be asked if the patient can have their diet advanced by some industrious nurse lacking any common sense or human decency, that's fine with them.

 

[Guile]

But if you want to see referrals, you just smile and write "thank you for allowing me to participate in the care of this wonderful and interesting patient, I loooooove fibromyalgia and constipation."

And he's back!

 

[Sleeve]

Love glade's post albeit a bit brutal, it is true. Residency can be painful and students need to know that going it otherwise they want to quit 2 months in.

Now, for those who think that life after residency includes only 10 minutes with your family each night, your wrong. That is completely, for most days, up to the surgeon. If you want to kill yourself and make more money, sure, you can make your life absolutely suck. But I have complete control over my life, day in and day out. There are days when you are on call and the bowel perforation hits the door and your evening is shot. But you're on call so you know that's a possibility.

You have to find that practice that will give you the life you want. You may not be super rich, but you'll be happier. It may take a couple of jobs to find that. Balance is what it's all about.

Now I was a rare breed in residency and never had a single day where I wanted to quit. I actually enjoyed residency. Every day was something new. It was awesome. Sure, it was tiring. Very tiring. I had my very bitter moments (i.e. Trauma, trauma, and trauma). I despised that GS was the dumping grounds for trainwrecks. But I knew it was temporary.

That being said, every one of my colleagues voiced contemplating quitting or switching to a more lifestyle friendly specialty. You're not alone and if you really enjoy the field of surgery, hang in there.

 

[45408]

But since residents are the ones getting woken up at 3:06 AM to be asked if the patient can have their diet advanced by some industrious nurse lacking any common sense or human decency, that's fine with them.

There's some dietitian here who called me 15 minutes after the other team signed out to me to ask if she could change the diet order on a patient. Lo and behold, this was the same patient that was signed out to me as "We wrote the diet order we wanted, they questioned us, so we clarified with the attending who said that's what he wanted, so we told them not to touch it." Fifteen minutes later, the dietitian couldn't wait to call the next set of ears to plead her case. Ugh.

 

[glade]

That's nothing, son. Nurses will make suggestions to patients as to what to say to doctors, in an attempt to do what the nurses want. So they'll tell a patient to "ask for a consult from a doctor" (that's not a joke, it happens). And the beauty is that you'd never know a nurse did it because you'd never think to ask "did a nurse tell you to say that?" We have a nurse right now who tried telling a patient's family to withdraw nutritional support because "it's not doing him any good anyways, in my opinion." The only problem is she was stupid enough to confide her plan to me, so I nipped that sucker in the bud pronto.

 

[PharmaTope]

it is human nature to want to quit now matter how many years your residency, how tough or cushy your call schedule is, or how demeaning the attendings, senior residents, or nursing staff can be.

you are always considered, "not a doctor" because you are a resident.
your peers are off making money, being independent, spending time with their families. very depressing.

I finally came to think like this as illogical as it seems:
1) i could be sent to prison for six years
2) i could be in a john mccain style POW camp for six years
3) i could be a homeless street person for six years.

instead I was sentenced to residency and had no option but to finish

obviously my residency was six years.
this grass is greener approach really helped.
nobody will break me.

I encourage you to text your spouse during the day often. have them visit you on call and bring in food for you occasionally. it will help your relationship, parenting, and outlook for grinding through the days.

I also looked at it like I was climbing everest. it is supposed to be difficult and it is supposed to hurt... but the view from the top is magnificent and worth the climb.

this is my amateur psychology tale of getting through in the days before the limit on resident work hours.

i think you have a good perspective on life in general to be honest. i feel like i think this way with things as well. you also outline a good way to stay close with your spouse and not lose focus.

good post here