R1 with regrets

[psychrez]

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Hey everyone....so perhaps it's that time of year for these posts, but I'm definitely fitting the bill for this topic.

I am a long-time reader, and have posted in the past, but due to my wishes to remain anonymous, I've created a new account name and will reveal very little about myself in this post.

To sum things up, I went with a big-named program in the Midwest, and now am wishing I had picked a residency closer to family and friends. While my current residency program is a decent size, and the attendings and enviroment has been great/helpful/friendly, I have very little opportunity to meet anyone outside of work. Also, I have very little in common with the other residents. I find myself just wishing I were closer to home and friends, and thinking of how much of a better place I'd be in if that were the case. If I could go back a year, I'd emphasize the importance of location in choosing my residency.

Don't get me wrong....I'm very grateful to be at a good program. So far, I think I've done a pretty great job too. But I honestly just feel like I want out. The thought of being in this city for another 4 years with only 3 weeks off a year to leave sucks🙁. I've been thinking about this a lot, and don't think my mind will change much in the months to come.

I'm stressing because I don't even know how possible it IS to change programs. I think I read in another post that your PD has to okay it. I become anxious even envisioning that convo, but what's worse--having to have that convo, or be stuck in a crappy situation for years to come?

I do, however, know that changes are possible. Heck, a 4th year in my program came to us from another program at the end of his first year.

You guys give some excellent advice on a regular basis. If anyone would like to reply to the thread or PM me, I'm all ears. How should I go about this process? I made some strong connections with other PD's during interview season....should I contact them and find out if their program can accept another R2 next year? Would I have to infrom my PD of my intent first? If she outright refuses, am I stuck here? Ughhhh. What should I do?

 

[Shalom77]

Personally, I would give yourself a little more time to adjust before taking action. I'm moving back from far away from my family and friends to a city much closer (where I actually went to school) and I feel lonely at times, so there's definitely an adjustment period after starting residency no matter what the location.

Although I do know that it can be hard when you find yourself (a single person) as in the midwest (which definitely has its own different culture) and 99% of your fellow residents are married and have different interests.

Be sure to make an effort to do social things no matter how tired you feel. Usually there are some GME events open to residents from other departments where you meet others. A "big" midwestern program is likely connected with a "big" university - consider attending graduate/professional student events to meet others.

Invite family (and friends) to visit you.

It usually does get better - not necessarily to perfect - but usually to livable.

 

[Faebinder]

It takes at least a year before you know you truly can't tolerate a place. Honestly, I would hold out. Get through residency and move to a different place for a fellowship.

I bet after a few months in your program you will mingle and make some good relationships. Maybe the next year interns will be more fun and will mingle better.

 

[whopper]

I have very little opportunity to meet anyone outside of work.

Unfortunately that is true in PGY-1. When one works most of the time, there is little oppurtunity to learn the area, and meet people outside residency. During my PGY-IV, whlie working in the ACT team (called PACT in NJ), the person I was assigned with drove me to the homes of those we treated. As we were driving around, I noticed several things I didn't even know existed during my 4 years. When one simply drives to work & back, sees the girlfriend, and is trying to recover from sleep, all those little nice cute things around the town you miss.

I have always thought that the happiness factor has to be taken into account. The prestige & learning oppurtunities of the program of course are important as well, but if you're not happy (or healthy) the successes you may have in the program just may not matter.

Another life development factor that I've had to face is with each additional change of location, and more education, lots of your friends will grow more distant. You may be in a different location, you cannot relate to several of them in terms of what you're dealing with, you will not see them as much. If you've commited yourself to a field such as medicine, you're going to change locations a lot, and lose contact with people who otherwise could've been lifelong friends.

I've lost contact with those I went to medical school with, with one exception. He popped back into my life thanks to Facebook, and because he's actually becoming an attending where I did residency. Several of my college friends, I still do contact them once in awhile, however if Facebook didn't exist, I probably wouldn't have been able to re-establish contact. As for residency-similar to college...most of the people have moved to different locations, though at the same time those in my class that were the nicer guys--were somewhat asocial (they kept to themselves or were slightly schizoid--I mean that in a good way because they were good people). Those that were very social--well let's just say that I wouldn't want to keep in contact with them because they contributed to the gossip mill to a degree I thought was histrionic. There were other residents I was friends with--but they've moved to new situations where they are working hard in fellowship or are still in residency, and don't have time to talk.

These are some of the reasons why location & friends & family need to be considered in choosing a residency. Medical School puts us in a level of uber-educated vs the rest of the general population. In our ultra-competitive environments where several of us have been put in scenarios where 1/4 of the class fails--several times, & we survived, we sometimes forget that there's things to life more important than getting into the program with the most prestige.

This could be as simple as just taking some more time. Going to a new place can take time. I figure you've only been in residency now for what--1.5 months? You're still in that stress/heck period where everything's very new. I'd give it more time. You will have some landmark events such as the next MATCH application dates to consider if you still want to leave your program. Take those into consideration, plan ahead, but also have an open mind to giving your program a chance. From what you're mentioning it seems like a good program.

 

[psychrez]

You guys have given some pretty awesome advice so far. Thank you all so much. I guess I really am on the fence....I'm gonna stick it out until the holidays, and see what happens. In the meantime, keep the good advice coming. Thanks again to all who have replied.

I do think that the lack of friends is what's gotten to me the most so far. In med school, while isolated from fam/friends, you were at least part of a group, and I was able to make immediate friends and form relationships with the people that I was spending most of the time with. But now, I never see my fellow residents (except for didactics). It seems like other residencies (IM, EM, etc...) where they're working together more often, have bonded way more than we have. And like what one poster has mentioned, I'm working most of the time, anyway.....on the one day off or so a week that I do have, it's hard to do anything but catch up on sleep. I guess though that to a certain extent, this is what intern year is all about.

 

[fMRI]

Hey,

it is actually good that you feel lonely, because it means that you ain't dating any of your patients! 😛

I hope that brought a smile back to your face. It's Friday and I'm in a silly mood (and hope it didn't offend you). Always look on the bright side of life, http://www.youtube.com/watch?v=jHPOzQzk9Qo

On a more serious note, you just discovered how it feels when somebody might be displaced against their wishes. Imagine what it must feel like to be a refugee... or in the military... or started residency in XY...

I think you can stick it out and feel great about yourself later. *You* might just have 3 weeks of vacation/year, but your *friends and family* can come and see you and discover the new town you are now in.

😀

 

[cleareyedguy]

Internship is rough, but it's only been a month. Plenty of time for things to turn around.

There's also plenty of time before you even have a chance to apply to transfer out. I'd give it at least a few more months and would then reconsider your situation. If you really want out, it is reasonable to send a tactful letter to the PD's at a cluster of programs that you would consider transfering into. Tactful as in politely and briefly describing your interest and without suggesting that you are a never-satisfied, paranoid, underachieving malcontent.

That first letter could probably go out in, say, October or November, but, unless you get an explicit NO!, a letter should be again sent out in January. It does not have to go through your own PD, and the second PD should recognize that discretion would be useful, at least in the first phase of the inquiry. Also remember that PGY 2 spots open and fill rather randomly, and so you could end up getting turned down from a place at which you should be a shoe-in and accepted at a place that would have been a reach last year.

Good luck, and hope things turn around for you, especially if you feel obliged to sacrifice a quality education for location.