Refusing my residency place in path

[JazzPath]

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Hi guys,

For those who don't know me: I'm a 26 year old medical student in the middle of job interviews. I am interviewing for 2 specialties: last week I interviewed for family med and upcoming Tuesday I'm interviewing for pathology.

The head of the path department (and the same professor who's going to interview me Tuesday) has said that if I want to do path, he will give the spot to me. I'm listed first of all candidates who're trying to match.

However, I have decided I want to pursue my dream of going to conservatory for jazz singing. Which is only combinable with my second choice, family med. I'm going to be working part time as a family doc (in order to financially support myself) and combine it with conservatory. It's been a dream of mine since I was a kid to pursue my artistic interests, but I've never really had the guts, and always went the 'safe' route. I decided it's now or never. I decided I don't want to live with a "what if" but give it my best shot.

On the other hand, it hurts giving up this pathology spot. I slightly prefer this above family med as a specialty, as it's very scientific and visual and I could combine this with research, which I like. However, I like path, but I love singing. And it hurts less to give up the path spot than it would hurt living with the 'what if I had the guts to pursue my artistic aspirations' forever. Life is about making choices I guess.

Why I'm posting this, is mainly to share my feelings...

But also, I'd like to ask you guys for advice on how to explain this as considerate as possible to the head of the path department and hopefully not completely ruin my chances if I ever decide to pursue path again... I realize shooting for a career as a singer is not evident at my age, and I realize I only have a very small chance of really making it out there. So I know that, if things don't work out after a year or 3, I might want to go into path again. And I do know it will be a lot more difficult to get in a second time. Is there anything I can do or say at my interview to better my chances of a path spot later on? I'm planning on being 100% honest about my plans of going to conservatory to the head of the path department, as I think honesty is the way to go about this. And I'm planning to explain to the professor that it hurts to give up on the spot but that I need to pursue my true passions in life. Would it be totally out of sorts and misplaced to ask him for a Letter of Recommendation during the interview for if I were to pursue path again later on in my life? Or is that just totally inappropriate and selfish? (and probably even more arrogant than I will already come off when refusing the residency spot...)

Thanks for any input guys! Greets,

Jazzpath

 

[Enkidu]

Hi guys,

For those who don't know me: I'm a 26 year old medical student in the middle of job interviews. I am interviewing for 2 specialties: last week I interviewed for family med and upcoming Tuesday I'm interviewing for pathology.

The head of the path department (and the same professor who's going to interview me Tuesday) has said that if I want to do path, he will give the spot to me. I'm listed first of all candidates who're trying to match.

However, I have decided I want to pursue my dream of going to conservatory for jazz singing. Which is only combinable with my second choice, family med. I'm going to be working part time as a family doc (in order to financially support myself) and combine it with conservatory. It's been a dream of mine since I was a kid to pursue my artistic interests, but I've never really had the guts, and always went the 'safe' route. I decided it's now or never. I decided I don't want to live with a "what if" but give it my best shot.

On the other hand, it hurts giving up this pathology spot. I slightly prefer this above family med as a specialty, as it's very scientific and visual and I could combine this with research, which I like. However, I like path, but I love singing. And it hurts less to give up the path spot than it would hurt living with the 'what if I had the guts to pursue my artistic aspirations' forever. Life is about making choices I guess.

Why I'm posting this, is mainly to share my feelings...

But also, I'd like to ask you guys for advice on how to explain this as considerate as possible to the head of the path department and hopefully not completely ruin my chances if I ever decide to pursue path again... I realize shooting for a career as a singer is not evident at my age, and I realize I only have a very small chance of really making it out there. So I know that, if things don't work out after a year or 3, I might want to go into path again. And I do know it will be a lot more difficult to get in a second time. Is there anything I can do or say at my interview to better my chances of a path spot later on? I'm planning on being 100% honest about my plans of going to conservatory to the head of the path department, as I think honesty is the way to go about this. And I'm planning to explain to the professor that it hurts to give up on the spot but that I need to pursue my true passions in life. Would it be totally out of sorts and misplaced to ask him for a Letter of Recommendation during the interview for if I were to pursue path again later on in my life? Or is that just totally inappropriate and selfish? (and probably even more arrogant than I will already come off when refusing the residency spot...)

Thanks for any input guys! Greets,

Jazzpath

Why is pathology incompatible with going to conservatory? Can't you just do pathology part-time while going to conservatory as easily as you could do family medicine part-time?

 

[cjw0918]

Why is pathology incompatible with going to conservatory? Can't you just do pathology part-time while going to conservatory as easily as you could do family medicine part-time?

No you cannot find part-time path jobs, especially ones that are decent. The OP is correct to choose family med which will offer MUCH greater career flexibility.

To the OP, I don't know if I'd mention the singing thing to the path PD. Honestly it sounds a little flaky. I would just say family med is a better fit for you right now, but you really appreciate the opportunity. Good luck. I hope your dreams comes true and I admire you for following them.

 

[tco]

I agree. In this case, explaining your true reasoning might sound like an excuse. Just tell him that you appreciate the interview, but Family Med is the better fit right now.

 

[yaah]

I don't know man, if there is any chance you want to do pathology as a career I would do the residency now. If you're set on doing something else then do something else. I have no idea how hard it is to get a residency after being out of med school for several years but I suspect it isn't that easy.

 

[lipomas]

So let me get this straight,

1) You have a dream, apparently serious and lifelong, to be Al Jolsen.

2) You like family medicine and believe that it will help you incubate this dream as a side hobby.

3) You "slightly prefer" pathology to family med.


If your priority is being Al Jolsen then do what you need to make that your priority. Are you already in school for the music? I also don't understand why pathology can't let you pursue that just as well. I know lots of pathologists with extensively time consuming hobbies (singing, shooting guns at things, hiding in the woods and waiting to shoot guns at things, skiing, traveling, various underwater things).

Jazz singing is unlikely to be lucrative enough to support your family and lifestyle unless you completely devote your life to it and are good at it. Are you?

 

[sirenomelia]

So let me get this straight,

1) You have a dream, apparently serious and lifelong, to be Al Jolsen.

2) You like family medicine and believe that it will help you incubate this dream as a side hobby.

3) You "slightly prefer" pathology to family med.


If your priority is being Al Jolsen then do what you need to make that your priority. Are you already in school for the music? I also don't understand why pathology can't let you pursue that just as well. I know lots of pathologists with extensively time consuming hobbies (singing, shooting guns at things, hiding in the woods and waiting to shoot guns at things, skiing, traveling, various underwater things).

Jazz singing is unlikely to be lucrative enough to support your family and lifestyle unless you completely devote your life to it and are good at it. Are you?

This. Pathology provides as much control of your time as any other discipline. Residency, especially, will be more time consuming and less flexible and require in-house call for FP. There's a classic rock cover band/ night club group of doc's from our university hospital that gets together all the time and they are from all specialty disciplines and none are from primary care. Your decision makes no sense.

 

[JazzPath]

Hi guys, thanks for the advice and replies.

@lipomas: yes, my image of myself, of what I truely see myself doing, naturally, has always been in the arts. As a singer/actor/comedian/writer/painter/... It happens that in recent years I've focused mainly on singing (while, as a kid, I always drew).

I studied arts (graphic design) for one year after high school but left, probably due to seeing all my other best high school friends excell academically and realizing I could do just as well as them. I guess I felt kind of their lesser friend (silly! I know) and I guess I got it into my head that I could and should use my intelligence to earn a well-respected, good, useful, well-payed job. Not really knowing myself well enough at 20 yo and never really having enough arguments to leave medicine while studying it. And I did exactly that: excell in medicine, but, while it wasn't all bad, and I had fun and met great people, I never felt like I truely belonged in medicine, I never felt like it was my true calling.

I think pathology is a nice job, but if I'm going to be 100% true for myself, I think I need to search the option that will allow me to become what I've always wanted to be: an artist (as silly, naive or crazy that may sound). I guess it's the same feeling that I had as a 5-year old kid, making drawings after school 2 hours a day, that is still popping up 20 years later at crossroads in my life. And I'm starting to realize that's who I am. If I don't stay true to that, I know that I might not ever be truely happy. And I might go into path just focused for 95% instead of 100%, and secretly look forward to making lots of money so I could start working less and spend more time in my spare time pursuing my creative interests. And that's a horrible motivation to start a specialty. Who knows, I might grow into it and start to really like it, but I'm not sure if I'd ever really love it as much.

In answer to your question: yes, this is my 3rd year in music school now. I've tried the admission exam for conservatory 2 years ago, after just 1 year of singing class, and failed. My teachers in music school do believe and say that I have a very good voice and musicality, though, and I believe that, with the right work ethic, I could make it into conservatory. (lol, typing this, it kind of sounds like a delusional person 🙂 I guess there's only so much that typed out words can do for you to word your true feeling about something).

I guess I went into medicine not wanting to become some naive artist never making a dime, but, I guess, in the end, it looks like maybe that was what I was meant to do anyway? And I should stop worrying about the dimes? Lol. Maybe it's because I'm single still and not having any family plans yet, that I'm not considering looking into path more thoroughly. But, anyway, life is too short to not pursue the things you love...

 

[TexasPhysician]

You didn't want to be a poor artist, so you decided to get lots of medical school debt and delay the only thing that could currently provide an income (residency)?

If you are that good, what could conservatory do for you?

 

[JazzPath]

You make a good point there. As an artist, even if I would be good enough, chances of having a good income are very small. I know, it might be a crazy choice. But I would feel crazier ignoring the gut feeling I've had all my life, as a kid, through high school, and med school, and not even TRY what I've wanted to do for so long. How am I ever going to tell my kids "Do what you really want to do" if I was too scared to even try to do that myself? I can't make it sound any more sensible than that I'm afraid. I do admit that it feels crazy making a decision like this, but if I keep having this nagging feeling for so long, maybe I should finally open up to it instead of ignoring it and doing what everyone tells me is the better thing to do.

I guess for crazy decisions like this one this might not always be the case, but I believe that usually, the best decisions are the ones that are based on your own gut feeling, and even though all the sensible smart well-meaning people around your are screaming you are crazy, in the end you have to go with your gut. I know I have a tendency to over-romanticize things sometimes, but I feel like I can't do this any other way.

Also, I think it's important to mention that medical school in my country only costs 600 dollars a year. So I have no debt. I probably wouldn't consider going into conservatory if I had had serious debt, and I'm very thankful that I don't have any.

 

[TexasPhysician]

I guess for crazy decisions like this one this might not always be the case, but I believe that usually, the best decisions are the ones that are based on your own gut feeling, and even though all the sensible smart well-meaning people around your are screaming you are crazy, in the end you have to go with your gut. I know I have a tendency to over-romanticize things sometimes, but I feel like I can't do this any other way.
.

My gut tells me to move to Nashville and date the lead singer from The Band Perry. My brain tells my gut no.

One of my best friends is an Internal Medicine resident, and he spends his free time singing. He has a vocal coach and sings in church. He also finds other avenues to sing when he can.

Is singing something you need to do 80 hours/week? Could you not get a vocal coach and practice on your own?

 

[oldfatman]

"Life moves pretty fast, if you don't stop and look around, you could miss it." Ferris Buehler

Do what you want to do. Pathology is a demanding mistress. Even though the residency hours might be light, you have to do a lot a lot of studying on the side.

 

[JazzPath]

My gut tells me to move to Nashville and date the lead singer from The Band Perry. My brain tells my gut no.

Lol, that totally cracked me up

I know, I've contemplated years and years of how to combine the two. But I figured it's so important to me that I wouldn't be happy doing it just one evening a week and never really getting any good. My housemates tell me they always know when I'm home because they can hear me whistling, mumbling a tune or singing softly in the bathroom for hours on end, lol. It's always on my mind. I get home and all I want to do is look up youtube movies of artists I like. For hours and days on end. I try to calculate how much time I can still waste while doing that, lol 😀 I want to know my potential. I want to learn chords, understand the structure of jazz, feel the music, go 200 % for this, put all my expressivity in it, be the best singer I can possibly be, learn all the fine technical details and voice tricks. Really do this like an athlete.. Put myself up the best I can for this huge challenge. I just know that it'll always be a burning desire unless I try (lol, once again, excuse the dramatism ).

Hmm, hmm. Big day tomorrow. I do admit I'm still contemplating, or I wouldn't be posting all these nonsense, lol 😀. But I need to take responsibility and go for it. If I bang my head against the wall, so be it...

Thanks for your input.

@oldfatman: thanks for your reply. Alas, residency hours for path at my university hospital are hard due to a shortage of residents. Path residents are expected to arrive no later than 8 o'clock, one of the 1st years is never later than 7.30. We usually stay until about 7, but that can easily be 8 o'clock, sometimes 8:30 or a rare 9. The 2nd year resident now used to stay from 8 until 10 during her hardest days as a 1st year. The 1st year residents are typically 3 to 4 weeks behind on their work schedules (yup, disaster, lol), leading to work stress and grumpy whiney phone calls from clinicians the entire day. I just see myself getting unhappy, trying my best to finish my duties as a resident and be forced to totally neglect my social life and singing practice, come home late, being even more tired while trying to study a bit more at home, and just drown in all my ambitions, and then I don't even have a girlfriend right now lol. I'd gladly be making the sacrifice, take the hours, work load and pissed off phone calls, if path was the only thing I really wanted to do, but right now, I feel I would set myself up for disaster, not having sorted out my head. Not being 100% motivated doesn't seem to be the right mindset to start this residency. Then I'd rather seek out what I really want from life, and maybe, if that does turn out to be path after all, come back 200% motivated a few years from now. It'll be difficult, and my chances will be significantly lower, but I believe that if someone is 200% motivated, good things will come to you and there'll always be a way to get what you want.

That's a nice saying you typed out there by the way. It reminds me of another one I like: "Time is the only real currency in life", but I'm not sure whom to quote for it...

 

[JazzPath]

Oh, God, I hate myself for not being consequent.

But I had some loooong conversations with people close to me, classmates, my brother, my mother, ... and maybe it does seem silly to let go of such a golden opportunity. Maybe I should indeed start in pathology, go for it and see where it leads me... Maybe I also need to give all my creative ambitions a new place in my life, and see them as a very precious hobby, that I will always cherish for myself, and hopefully sometimes be able to share with some people close to me.

So indeed, I have taken the job, only have until Friday to refuse it. God, what a weird time.

Pfff! Why am I such a mess? Lol

 

[TexasPhysician]

Don't worry. I'm not in Nashville either.

 

[KCShaw]

Eh, well, your life is your own. I wouldn't recommend making quirky life decisions solely because artisty folk are supposed to be quirky. I've also met people with personality disorders who in some ways played up being..unusual..because it also suited how they -wanted- the world to see them. Depressed starving artist was one of those.

But, frankly, I'm not sure I can predict how a program director in another country with a somewhat different type of practice and somewhat different kind of training system would react to this kind of decision change. Nor do I know whether you meant you wanted to work as a family practitioner but NOT do an FP residency? Generally residency of any sort is a very busy time. Not that it really matters, you have a better idea of what the actual schedule is among the options you're considering. Personally, and no offense intended, but at some point you've got to realize you're old enough to make some decisions you can stick with -- or at least make some decisions on your own that you're comfortable with, even if it means major life changes.

 

[JazzPath]

@KCShaw: thanks for reacting.

To be clear: I don't mean to make 'quirky' decisions just for the sake of being 'quirky'. I only constat that I'm finding it hard to decide on a 30/40-year career after being exposed like 4 weeks to the options I like most. I would think (or hope) that's not abnormal? I have never mentioned to the program director that I was 100% sure I wanted to do FP, but I did honestly mention my doubts between path and FP. At one point, I thought I had practically chosen FP - as you can read in the beginning of this thread - (without mentioning that to the path program director), but after that I realized how many advantages path had, that suited me, and how dreamy some of my motivations to leave would be, and I decided to give path a try.

Of course, if I'd decided on FP, I would have done a residency in FP. I think that speaks for itself.

Call it growing pains, but I don't feel ashamed to mention having doubts about a decision that will mark my life, my personality and my personal/potential family's well being in so many ways. And I don't think I should be. And, indeed, I guess I'm at an age where I should be able to make decisions, stick with them and take responsibility for them. But what if I'm not 100% sure and take longer than normal to decide? If people don't like that about me, so be it... At the end of the day, I'm the one who has to live with the decisions I make, not them... And call me naive, dreamy or childish, but I refuse to just 'wilt in' unless I'm 100% positive I've found the thing I was meant to be doing in life. I realize other people's well being depends on my ability to make and stick with my decision, and I am aware of the fact that I need to be responsible not only for my own sake but also for the sake of others (program director, other residents, other path applicants, patients), but I do have the right to explore my options and take my time to decide what's best for me.

 

[KCShaw]

I think a common misperception is that one must know 100% that one given thing is the right and perfect thing for them for all time, and if it's not then they stay on the hobo wagon looking/waiting. That would leave most of the universe on the wagon, or at least a lot of people jumping back onto it 5 minutes after leaving upon realizing their choice wasn't 100% what they expected so must suck. Life isn't entirely about finding the right place for yourself, it's also about -making- the right place for yourself, and dealing with the imperfections that are always going to crop up.

That's not to say making decisions which are likely to affect your long term future are easy, but they still have to be made -- it's then up to you to choose whether to make the most of it or not, or change your life again with a new future, which is also a possibility despite possible obstacles and challenges.

What I remember of a story which you may or may not think applies is about an elderly man whose wife recently died, had outlived his friends, and was forced out of his home of 50 years and into an assisted living facility. In the lobby he meets a nurse administrator who expects him to be depressed and angry because of his circumstances. Instead he greets her cheerily and tells her what a wonderful place it is and how much he loves it. She asks him how he knows that since he only just got there and has only seen the lobby. In short, he replies that he has -decided- to like it, because he's seen how miserable people can make themselves when they decide -not- to be happy.

While major life decisions, including whether or not to be content with your choices, may not be so simple.. to some extent they are, particularly on two sides of a fence with grass of slightly different, if both potentially pleasant, shades of green. I've seen enough people wallow in indecision or make the teenage decision (cool but totally unrealistic, impractical, and requiring of more work than they understand or are willing to put in) and waffle on that decision later -- essentially all discussions were a black hole, as the points for and against the offered options were already out there and what they really wanted was contentment that can't come from outside.

Either way.. good luck.