Residents Expressing Most Regret; Psych Ranked 5th

[twospadz]

This is odd since most psych residents I know are content. Psych residency is mostly chill compared to other specialties. Also, psych physicians are known to be one of the most happiest. Medscape did a report on this (below). Maybe we are ranked higher because its only first year psych residents doing the report which have to do 6 months of medicine. Any opinions?

Specialties with highest regret
Residents in these medical specialties have the most regrets | American Medical Association

Medscape happiest physicians
Medscape: Medscape Access

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[Old&InTheWay]

Read the full article on JAMA. Only 3.4% of psych residents regret their speciality choice (among the lowest). The AMA article referenced puts psych in the top five of career (not speciality) regret. It looks pretty common across many specialties for about 15-20% of physicians to regret becoming a doctor (but I’m always curious what they would prefer to do).

I’ll add, this feels like kind of sloppy, click-baity, science reporting from the AMA.

 

[Shufflin]

Clarification is in order here. I read the key points and Abstract of the original JAMA study this AMA article is referencing.

First, career choice regret here was defined as whether, if able to revisit career choice, the resident would choose to become a physician again. Not change to another specialty or regret being in that specific specialty.

Second, the JAMA study concludes that "In a multivariable analysis, training in urology, neurology, emergency medicine, and general surgery were associated with higher relative risks (RRs) of reported symptoms of burnout (range of RRs, 1.24 to 1.48) relative to training in internal medicine. " The problematic residencies do not include Psychiatry, but instead points to:

- Urology
- Neurology
- Emergency Medicine
- Gen Surg

Third, you are correct. Psychiatry enjoys the most satisfied physicians, and residents are less stressed than those in other specialties.

Hope this clarifies.

 

[MrChance2]

I think a lot of people go into psych because they don’t want to deal with a lot of the garbage involved in medicine that you may not realise going into medical school. I could see how that is kinda related to regret of becoming a doctor.

I’m probably one of those. I love psych and think I’ve gotten decently good at it and will have a good career in it, help a lot of people and make some good money while doing so. At the same time there are plenty of days I see my similarity hard working friends already making the type of money I’d make as an attending doing other fulfilling careers that didn’t have to go through medical school and residency. Don’t have to deal with a lot of the other corporate, insurance, etc, pressure residents and doctors deal with, and wonder if medicine in general was the right choice. I know I’d be way less happy if I matched into a different specialty though.

 

[raisinbrain]

Or this is data from an older generation of psychiatrists where some couldn't match into their desired specialty, and are thus less happy overall with how things turned out? You never know... (don't blast me for sayin this... eep). The field's been a-changin'. (also, I haven't read the article, will admit)

 

[Old&InTheWay]

I think a lot of people go into psych because they don’t want to deal with a lot of the garbage involved in medicine that you may not realise going into medical school. I could see how that is kinda related to regret of becoming a doctor.

But that doesn't really make sense when you look at career regret across all the listed specialities. 16.9% of psychiatrists regret becoming a doctor but it's not so far off the average of ~14%. They're all over 10% except for plastics, ENT and FM. Path and Anes are the highest by far which makes sense to me because those folks went into medicine then realized they don't like (living and awake) people.

Or this is data from an older generation of psychiatrists where some couldn't match into their desired specialty, and are thus less happy overall with how things turned out? You never know... (don't blast me for sayin this... eep). The field's been a-changin'. (also, I haven't read the article, will admit)

Except you are ignoring the data that says that 96.6% of the psychiatrists surveyed do not regret their specialty choice.

Again, the AMA article above is garbage science reporting (might as well have been from HuffPost).

 

[AD04]

At the same time there are plenty of days I see my similarity hard working friends already making the type of money I’d make as an attending doing other fulfilling careers that didn’t have to go through medical school and residency.

What jobs do they have? Are they making the same $ / hr as psychiatrists? Very curious.

 

[MrChance2]

.

 

[Old&InTheWay]

Mostly tech and small-mid business owners, a few Finance guys make more than I probably ever will but mainly legally(?) scam rich people.

And these careers seem equally fulfilling as being a physician to you? If you could do it all over, would you seriously go into tech or finance?

 

[Stagg737]

Except you are ignoring the data that says that 96.6% of the psychiatrists surveyed do not regret their specialty choice.

So my response to that is that there are many older psychiatrists who ended up in psych because they initially wanted to be a physician but couldn't do anything else. After practicing for years, they realize they didn't actually want to be a physician but were happy they were in psych because they can still make better money than 95% of other jobs and still only work 40 hr/wk or less. Thus, highly satisfied with the field they ended up in, but not happy that they are docs. I've had several physicians express this sentiment to me, and a lot of them said something along the lines of "well at least I ended up in psych and don't have to work surgeon hours."

 

[futuredo32]

3.5 years out. I totally regret it.

 

[NITRAS]

Mostly tech and small-mid business owners, a few Finance guys make more than I probably ever will but mainly legally(?) scam rich people.

Other healthcare can do pretty well too. Dentists can crush it. Owning a PT clinic with a few PTs and PTAs under you can do quite well and has 3 years vs 8 years training.

Stay off Facebook. It isn't real life.

I'd say that physicians don't have the only way to help others out and make money doing it, we certainly have one of the most unique ability to though.

 

[Old&InTheWay]

3.5 years out. I totally regret it.

What exactly do you regret? What different choices would you have made?

 

[AD04]

Mostly tech and small-mid business owners, a few Finance guys make more than I probably ever will but mainly legally(?) scam rich people.

Other healthcare can do pretty well too. Dentists can crush it. Owning a PT clinic with a few PTs and PTAs under you can do quite well and has 3 years vs 8 years training.

Your friends are really lucky then. Anyone in tech, law, finance, or business who can make as much as an average doctor per hour is really atypical. For every non-medical person like that, 50 of his peers don't even come close.

Being a doctor and being a business owner is not mutually exclusive so the upsides are available to physicians as well while the downsides are covered.

Then again, I love psychiatry so I may be biased.

 

[Amygdarya]

What exactly do you regret? What different choices would you have made?

Oh please don’t get this started again. Instead, read her past posts; she’s been writing about it a lot.

 

[Old&InTheWay]

Oh please don’t get this started again. Instead, read her past posts; she’s been writing about it a lot.

Ok, will do. Wasn’t try to stir anything up.

 

[MrChance2]

Yeah. This is a bit off from my original post. Making creative programs that thousands-millions of people use seems pretty cool and fulfilling. I’m not sure if it would have been the better choice or not. Putting big time effort into something for 8 years and being decently smart can have some pretty good results. And pretty much all my friends that had the smarts and drive to become doctors are doing something cool with their lives. You can do lots of fulfilling stuff with money and free time as well. But I wouldn’t go into finance for sure. I deleted Facebook years ago. Regardless I was replying to the article posted not trying to argue whether or not psychiatry is the best field in the world. It’s certainly a good one from my perspective and I think it will be a fulfilling career as I detailed earlier. I read a lot of psych, enjoy learning, enjoy seeing good outcomes, and usually enjoy my work. Still not totally sure I’d do it all over again.

 

[pbdoctor1]

Aside from the money, I'm curious if anything can be done to make the quip about "psychiatry being the new derm" a reality for incoming applicants? They have the lowest burnout rate in among PGY2 residents. Anyone have any suggestions to changes such as reducing malignancy the training process, mentoring early physician practice decisions, etc that would make the field more appealing?

I find it interesting that the article mentions a high prevalence of burnout by psychiatry residents i think over 43% despite the supposed chillness of psychiatry residency. It mentions that burnout from attending practicing physicians was highly correlated to trainee burnout as a mirroring effect. I'm just shocked that family medicine has a lower burnout rate 37% despite not being chill. Anyone have any ideas why that is?

 

[Shufflin]

Aside from the money, I'm curious if anything can be done to make the quip about "psychiatry being the new derm" a reality for incoming applicants? They have the lowest burnout rate in among PGY2 residents. Anyone have any suggestions to changes such as reducing malignancy the training process, mentoring early physician practice decisions, etc that would make the field more appealing?

I find it interesting that the article mentions a high prevalence of burnout by psychiatry residents i think over 43% despite the supposed chillness of psychiatry residency. It mentions that burnout from attending practicing physicians was highly correlated to trainee burnout as a mirroring effect. I'm just shocked that family medicine has a lower burnout rate 37% despite not being chill. Anyone have any ideas why that is?

Psychiatry enjoys a burn-in rate, not burn-out. Residents from other specialties tend to transfer INTO psych residency. I haven't heard of anyone switching out.

 

[uhmocksuhsillen]

Mostly tech and small-mid business owners, a few Finance guys make more than I probably ever will but mainly legally(?) scam rich people.

Other healthcare can do pretty well too. Dentists can crush it. Owning a PT clinic with a few PTs and PTAs under you can do quite well and has 3 years vs 8 years training.

For every tech guy making doctor money there are 100 others nowhere close...I say this having been in tech in the bay area. Owning your own business, regardless of industry can be very lucrative if it suceeds. Getting into those super high paying IB jobs are often more competitive than med school.

While there are absolutely jobs which require less school and pay as much or more than a doctor job, the path into them is far riskier and for the vast majority pursuing then, never materializes.

 

[psychMDhopefully]

I have a question, how emotionally draining is it dealing with psych patients? For psychiatrist I imagine it wouldn't be that draining if you mostly deal with med management.

 

[Old&InTheWay]

I have a question, how emotionally draining is it dealing with psych patients? For psychiatrist I imagine it wouldn't be that draining if you mostly deal with med management.

This will vary a ton person to person. While it's not always easy, I have found (in my career prior to medicine as well as in med school) that I am kind of energiezed by the more challenging, difficult people. I think you also need to develop in psych a healthy way to manage some of the really sad and sometimes horrific stories you hear.

I’m not sure why med management would be any easier, unless you did it poorly and didn’t really talk/listen to your patients.

But I can understand how certain people could burn out in psych; which is why it will
never really be a lifestyle specialty...I could see someone being really miserable if they went into psych for the wrong reasons.

 

[Mad Jack]

This is odd since most psych residents I know are content. Psych residency is mostly chill compared to other specialties. Also, psych physicians are known to be one of the most happiest. Medscape did a report on this (below). Maybe we are ranked higher because its only first year psych residents doing the report which have to do 6 months of medicine. Any opinions?

Specialties with highest regret
Residents in these medical specialties have the most regrets | American Medical Association

Medscape happiest physicians
Medscape: Medscape Access

Psych has higher practicing physician regret, which is likely due to the current generation of attendings largely being made up of people who had psychiatry as a backup specialty and wanted to do other things but were not competitive enough. Psych has gotten more competitive, and residents in psych had fairly low dissatisfaction since most of them, you know, actually wanted to be in the field

 

[futuredo32]

What exactly do you regret? What different choices would you have made?

I find it monotonous. I miss the rest of medicine. I don't mind some psych, but I miss the REST of medicine. I am applying and crossing my fingers HARD for a second residency in FP next cycle. I think a psychiatrist as a PCP would be a huge asset as many patients go to their PCP first or only for psych care.

 

[futuredo32]

Psychiatry enjoys a burn-in rate, not burn-out. Residents from other specialties tend to transfer INTO psych residency. I haven't heard of anyone switching out.

I am going to try to switch out. I am not the only one. I am perhaps the only one who will post it but I get a decent number of pms from people in the same boat as I am in.

 

[splik]

Psychiatry enjoys a burn-in rate, not burn-out. Residents from other specialties tend to transfer INTO psych residency. I haven't heard of anyone switching out.

we had quite a few people switch out of psych at my program. in my experience people who switch into psychiatry don't usually do so out of any great passion for psychiatry, but because they no longer want to be a doctor and psych is about as far from being a real doctor as they can get while still enjoying a good remuneration and not having start again. we also had a lot of people switch into psych from other specialties at my program and a large proportion regretted a career in medicine and considered other careers but staying as a physician is the safe option

 

[mymembernames]

we had quite a few people switch out of psych at my program. in my experience people who switch into psychiatry don't usually do so out of any great passion for psychiatry, but because they no longer want to be a doctor and psych is about as far from being a real doctor as they can get while still enjoying a good remuneration and not having start again. we also had a lot of people switch into psych from other specialties at my program and a large proportion regretted a career in medicine and considered other careers but staying as a physician is the safe option

just curious, why did people switch out of psych from your program?

 

[splik]

just curious, why did people switch out of psych from your program?

because they realized they liked the medicine/peds/neuro/insert relevant specialty part of their intern year more than psych. there were no opportunities to double board at my program so you had to switch. also, because it was very easy to replace residents, if someone wanted to leave, the PD never tried to talk them out of it and would help them switch.

 

[AD04]

I read a lot of psych, enjoy learning, enjoy seeing good outcomes, and usually enjoy my work. Still not totally sure I’d do it all over again.

I understand what you mean. I probably hated medical school the most in my class. It is a long road from MS-1 to attending.

Personally, I would do it again and I don't plan on ever retiring.

 

[Candidate2017]

I have a question, how emotionally draining is it dealing with psych patients? For psychiatrist I imagine it wouldn't be that draining if you mostly deal with med management.

With medication management you will have a fair share of patients begging, cajoling, threatening for their benzos or stimulants, schizophrenics not wanting to take their meds, and others seeking a quick fix woth a pill. Patients who pay for and come to weekly therapy on the other hand, are highly motivated, psychologically minded, willing to change and work on themselves.

 

[ridethecliche]

we had quite a few people switch out of psych at my program. in my experience people who switch into psychiatry don't usually do so out of any great passion for psychiatry, but because they no longer want to be a doctor and psych is about as far from being a real doctor as they can get while still enjoying a good remuneration and not having start again. we also had a lot of people switch into psych from other specialties at my program and a large proportion regretted a career in medicine and considered other careers but staying as a physician is the safe option

I've also heard of a fair number of people switching into psych because they were no longer able to practice in their respective field. I've heard of atleast one surgeon that was injured and had to stop operating and retrained in psych. Quite a lot of the surgeons and EM docs I've met have actually said that they found psych really interesting so it wasn't ALL that surprising to me.

I don't think I'm competitive enough to really be considered for those programs, but I loved the idea of doing a med psych or neuropsych residency because I love medicine. I just don't like hospital medicine in practice and can't see myself being happy as a resident there even if it works out in the long run. Who knows... Maybe something will come up during residency, but I doubt it. I have a bunch of other administrative/advocacy/policy interests that I think psych lends itself to very well.

 

[Monocles]

I find it monotonous. I miss the rest of medicine. I don't mind some psych, but I miss the REST of medicine. I am applying and crossing my fingers HARD for a second residency in FP next cycle. I think a psychiatrist as a PCP would be a huge asset as many patients go to their PCP first or only for psych care.

omg why would you ever go through residency a second time???

 

[QueenJames]

TBH I'm excited to see all of these people entering psych with super high board scores who only care about lifestyle to only regret their decision and realize that they truly never had a passion for mental illness or the treatment and then leave after the 1st-2nd year of residency.

Then I shall transfer in

MUAHAHA

 

[FFH]

Currently interviewing for psych only. I think I would consider getting additional training in FM or IM, if some years down the road I realize that I had overestimated the popularity and opportunity of CL psych and collaborative care. I've very happy with what I've been seeing on the trail so far.

Even if I go out and get trained in medicine, I imagine it would be for complimenting the psych care and giving me a bit more leverage when I see something on the medical side that could use some change.

In the only two incidences I know in which someone switched out of psych, both have switched back.

 

[futuredo32]

omg why would you ever go through residency a second time???

To have a career I like. Its only three years.

 

[Crayola227]

Currently interviewing for psych only. I think I would consider getting additional training in FM or IM, if some years down the road I realize that I had overestimated the popularity and opportunity of CL psych and collaborative care. I've very happy with what I've been seeing on the trail so far.

Even if I go out and get trained in medicine, I imagine it would be for complimenting the psych care and giving me a bit more leverage when I see something on the medical side that could use some change.

In the only two incidences I know in which someone switched out of psych, both have switched back.

I'm shocked they could switch out of a specialty, and then switch back into that very same one

 

[Crayola227]

omg why would you ever go through residency a second time???

my view is that in many, many cases, psych is either for you or it isn't

most people seem to be able to figure that out pretty early on, but not everyone

 

[Attending1985]

Currently interviewing for psych only. I think I would consider getting additional training in FM or IM, if some years down the road I realize that I had overestimated the popularity and opportunity of CL psych and collaborative care. I've very happy with what I've been seeing on the trail so far.

Even if I go out and get trained in medicine, I imagine it would be for complimenting the psych care and giving me a bit more leverage when I see something on the medical side that could use some change.

In the only two incidences I know in which someone switched out of psych, both have switched back.

It might not be very easy to do more training for various reasons keep that in mind

 

[ridethecliche]

Regarding the utility of psych:
-an uncle left practice, got an MBA, and started working for a company in healthcare/insurance
-the CMO of UVM is a total badass... and a psychiatrist (Desjardins Named Chief Medical Officer at UVM Medical Center)

I feel like it's the field that has the most transfer over into public health and administration, likely up there with IM,FM,EM.

It might not be very easy to do more training for various reasons keep that in mind

Trust me when I say that FFH is a total BAMF and would be able to do just about whatever they set their mind to. Much like her, my 'compromise' so to speak was to fall for consult psych. My rotation showed me that I really couldn't get lazy with the medicine stuff I enjoyed learning, but I could still connect with patients and be a resource to the medicine team in a way which I really enjoyed. Dream would be to end up at a bigger center with more involved medical care so I'd have to know more about therapy and procedures. I doubt I'll have the same amount of time as I do while I'm a med student, but I've really enjoyed empowering patients and helping them understand what exactly they were about to go through in terms of treatment. A lot of the time you have to create a space for someone to ask the questions they feel stupid asking...

I'm pretty big on patient education ish in general.

 

[Marasmus1]

I am a psychiatry resident. I hate everything about my job except directly psychiatry related work. My job consists of writing notes, being grilled by a senior or attending, being grilled by a patients family member, being grilled by a nurse, spending more than 5 hours everyday in EMR system and spending around 10-15 minutes with each patient I have everyday. I would say psychiatry consists of 15-20% of my typical work day. So my answer to that survey would be full of regrets. I am not surprised with the results whatsoever.

 

[futuredo32]

I am a psychiatry resident. I hate everything about my job except directly psychiatry related work. My job consists of writing notes, being grilled by a senior or attending, being grilled by a patients family member, being grilled by a nurse, spending more than 5 hours everyday in EMR system and spending around 10-15 minutes with each patient I have everyday. I would say psychiatry consists of 15-20% of my typical work day. So my answer to that survey would be full of regrets. I am not surprised with the results whatsoever.

I want out of psych, BUT being an attending is much better. You are more respected by the nurses, you can use any EMR you want or paper and pen (I do this on a template way faster) and you can pick what niche you want.

 

[Marasmus1]

I want out of psych, BUT being an attending is much better. You are more respected by the nurses, you can use any EMR you want or paper and pen (I do this on a template way faster) and you can pick what niche you want.

This is exactly why I have not quit yet. Because when I am done with this bull**** work what they call residency, I will start working in psychiatry. Then I will start enjoying the job aspect of my life. Unfortunately, I will always regret being physician. Not that I do not respect the field or like medicine, it is just not worth it. Neither financially nor emotionally.

 

[Shufflin]

I am a psychiatry resident. I hate everything about my job except directly psychiatry related work. My job consists of writing notes, being grilled by a senior or attending, being grilled by a patients family member, being grilled by a nurse, spending more than 5 hours everyday in EMR system and spending around 10-15 minutes with each patient I have everyday. I would say psychiatry consists of 15-20% of my typical work day. So my answer to that survey would be full of regrets. I am not surprised with the results whatsoever.

If it makes you feel any better lots of residents feel this way; there were days I felt exceedingly frustrated so much so that I wanted to quit. I felt like a glorified paperwork pusher some days. BUT, I realized this is normal. Residency is very hard, frustrating beyond measure sometimes, but stick it out.

Now, working as a head attending the tables are all turned. It turns. You make the decisions others follow. You call the shots. Staff help you. It's completely reversed.

 

[futuredo32]

This is exactly why I have not quit yet. Because when I am done with this bull**** work what they call residency, I will start working in psychiatry. Then I will start enjoying the job aspect of my life. Unfortunately, I will always regret being physician. Not that I do not respect the field or like medicine, it is just not worth it. Neither financially nor emotionally.

I agree PA school would have been way better

 

[Crayola227]

yep, too bad that you guys didn't do enough soul searching, know yourselves well enough, have an accurate picture of what you're getting into, went in for the wrong reasons, etc etc

I'm just so tired of the whiners that have done this 180 that being a physician isn't for them at all

I TOTALLY get that residency isn't really for anyone, or some specialties, or the way that medicine is practised

if you're not happy with your MD/DO degree somewhere in all this, I just seriously wonder how you could have made such as error in judgement

I've paid a higher physical, emotional, financial, family cost than most, and in some ways I'm one of the most bitter of people you see on here, but it's a calling and at the end of the day it's just the person that I am and I wouldn't change it if I had a time machine except for 2 very specific conditions (a wonderful hubby and baby in my arms, and avoiding a certain health issue). And I'd have to have assurances passing up that degree would have led to those outcomes. Since there's no way of knowing it would have, I've made peace with not having that machine, and I'd do it all again.

I can't fathom the hate except to say, how did you end up so wrong about who you are, what you are good at, and what you enjoy?

 

[Marasmus1]

yep, too bad that you guys didn't do enough soul searching, know yourselves well enough, have an accurate picture of what you're getting into, went in for the wrong reasons, etc etc

I'm just so tired of the whiners that have done this 180 that being a physician isn't for them at all

I TOTALLY get that residency isn't really for anyone, or some specialties, or the way that medicine is practised

if you're not happy with your MD/DO degree somewhere in all this, I just seriously wonder how you could have made such as error in judgement

I've paid a higher physical, emotional, financial, family cost than most, and in some ways I'm one of the most bitter of people you see on here, but it's a calling and at the end of the day it's just the person that I am and I wouldn't change it if I had a time machine except for 2 very specific conditions (a wonderful hubby and baby in my arms, and avoiding a certain health issue). And I'd have to have assurances passing up that degree would have led to those outcomes. Since there's no way of knowing it would have, I've made peace with not having that machine, and I'd do it all again.

I can't fathom the hate except to say, how did you end up so wrong about who you are, what you are good at, and what you enjoy?

The answer of your question may vary depending on the individual. I am an international medical graduate. In my country we are expected to make career related decisions when we are 17 years old which is the last semester of high school. On top of that ( sending regards to my family), my family somehow convinced the elementary school where i grew up to enroll me when I was 5 years old. So long story short I had to make that decision when I was 16 years old. When I found myself, as you fairly well explained above, I was 22-23 years old. I was holding an MD degree and diplomat in my hand and reciting many times what kind of bs i got involved with.

Then I came to US. I found psychiatry. Something so stigmatized in a 3rd world country that I finished my medical school without seeing any psych patient. I loved it and immediately fall in an illusion that If I started making a career in that field I would be extremely happy and successful. And again I was wrong. Psychiatry is what I liked and what I wanted to practice but not long after I started residency I found myself in a ****show where there is too much attitude, too much drama, too many inflated ego`s, too much scutwork and a little bit of psychiatry. People say it would change once you become an attending, I doubt but just because I want to see the end I will continue but as of now I can honestly say that I am full of regrets.

 

[Amygdarya]

Yeah, I wouldn't be so hard on people who found they really disliked medicine by the time they're done with residency.

First of all, people are notoriously bad at predicting what will make them happy in the future. (See Daniel Pink's book on the topic.)

Second, even in the US system, many start their educational paths to medicine while they're young and for many kinds of wrong reasons, including parents, perceived prestige, perceived amount of money earned, and the well-intentioned but nebulous idea of "helping people".

Third and most important, nobody really knows what it is like to be doing medicine until they're in residency. No amount of the unspokenly required clinical volunteering or shadowing will give you the idea before applying to medical school. Once in medical school, people start getting some clue on their clinical rotations, which is why we see such a shift from "wanting to serve the underserved" on their medical school applications (which may have been entirely sincere at the time) to wanting as little patient interaction as possible (thus choosing rads or anesthesia), choosing "the least medicine" medicine (psychiatry), or pragmatically choosing to make a bank while still having a life (derm). But nobody really knows what it's like until internship when it's too late to quit because of the medical school debt etc. Medical education is kind of a trap: people don't really know what they're getting themselves into until it's too late.

I have the benefit of being a "non-traditional" ie much older and having a decent prior career that I switched from, so I did quite a bit of soul searching before applying to med school. I did not even once regret going into medicine while in med school, and now in psych residency not only have I not regretted going into psychiatry (yet), but I'm loving it so much I'm reassured of my choice even on the crappies days I have on psych. However, my medicine rotation was such a miserable meaningless grind for me* that, if that was what my whole residency and future job were like, I would f^*^*//*&#$ quit.

* - hopefully I didn't offend any of my medicine colleagues. Obviously internal medicine is super important, and I have a lot of respect for you guys and your work, and I completely understand that this work may be fun and enjoyable to some people (though categorical medicine interns on that rotation were just as miserable as I was), but it is an exhausting meaningless grind *for me*.

 

[Crayola227]

The answer of your question may vary depending on the individual. I am an international medical graduate. In my country we are expected to make career related decisions when we are 17 years old which is the last semester of high school. On top of that ( sending regards to my family), my family somehow convinced the elementary school where i grew up to enroll me when I was 5 years old. So long story short I had to make that decision when I was 16 years old. When I found myself, as you fairly well explained above, I was 22-23 years old. I was holding an MD degree and diplomat in my hand and reciting many times what kind of bs i got involved with.

Then I came to US. I found psychiatry. Something so stigmatized in a 3rd world country that I finished my medical school without seeing any psych patient. I loved it and immediately fall in an illusion that If I started making a career in that field I would be extremely happy and successful. And again I was wrong. Psychiatry is what I liked and what I wanted to practice but not long after I started residency I found myself in a ****show where there is too much attitude, too much drama, too many inflated ego`s, too much scutwork and a little bit of psychiatry. People say it would change once you become an attending, I doubt but just because I want to see the end I will continue but as of now I can honestly say that I am full of regrets.

yeah, to be fair, I totally understand how cultural and family things play into this, as well as age, and I've found frequently that's what is behind a lot of instances of people regretting that MD/DO

it makes me feel bad, and mostly, it makes me really angry at people's families, where you have older members that "should" know better - but then again, they may well see things differently and have a different measuring stick for what career and life satisfaction should be based on

this is another reason why I get tired of the people whining about the US system that has people spending the time that they do obtaining a liberal arts degree - I think it is important in creating better physicians for our culture, on a number of levels

Malcolm Gladwell wrote something interesting about maximizing potential, and that the idea is that we maximize human capital by trying to shove people into careers they're "suited" for as soon as possible, and that it's actually a counterproductive way to deal with the human animal

 

[Crayola227]

Yeah, I wouldn't be so hard on people who found they really disliked medicine by the time they're done with residency.

First of all, people are notoriously bad at predicting what will make them happy in the future. (See Daniel Pink's book on the topic.)

Second, even in the US system, many start their educational paths to medicine while they're young and for many kinds of wrong reasons, including parents, perceived prestige, perceived amount of money earned, and the well-intentioned but nebulous idea of "helping people".

Third and most important, nobody really knows what it is like to be doing medicine until they're in residency. No amount of the unspokenly required clinical volunteering or shadowing will give you the idea before applying to medical school. Once in medical school, people start getting some clue on their clinical rotations, which is why we see such a shift from "wanting to serve the underserved" on their medical school applications (which may have been entirely sincere at the time) to wanting as little patient interaction as possible (thus choosing rads or anesthesia), choosing "the least medicine" medicine (psychiatry), or pragmatically choosing to make a bank while still having a life (derm). But nobody really knows what it's like until internship when it's too late to quit because of the medical school debt etc. Medical education is kind of a trap: people don't really know what they're getting themselves into until it's too late.

I have the benefit of being a "non-traditional" ie much older and having a decent prior career that I switched from, so I did quite a bit of soul searching before applying to med school. I did not even once regret going into medicine while in med school, and now in psych residency not only have I not regretted going into psychiatry (yet), but I'm loving it so much I'm reassured of my choice even on the crappies days I have on psych. However, my medicine rotation was such a miserable meaningless grind for me* that, if that was what my whole residency and future job were like, I would f^*^*//*&#$ quit.

* - hopefully I didn't offend any of my medicine colleagues. Obviously internal medicine is super important, and I have a lot of respect for you guys and your work, and I completely understand that this work may be fun and enjoyable to some people (though categorical medicine interns on that rotation were just as miserable as I was), but it is an exhausting meaningless grind *for me*.

you're right, of course

especially the point about people predicting what will make them happy

for some of the factors you mention though, like prestige, money, etc - it's pretty maddening because it's not like someone can't see that let down coming, you come to SDN and you'll hear all the reasons that's a really bad basis for a life plan

however I will say that over and over, people's clinical experience before med school did NOT prepare them for true roll up the sleeves dirty work and really rolling around in people's abject misery, and incurable suffering (there is only one cure for all human suffering.....), and note when I say incurable I don't mean unable to be ameliorated

we warn people to do their best not to be blindsided by this, and many are, and that I would argue is in fact preventable with proper planning and exposure

yes, I was prepared for A LOT of the reality, but you are correct that there are some aspects you'll never get until you're in those shoes

I can't help but think of that show Band of Brothers.... like, people's values led them into thinking going to war would be a great idea.... and boy did most have a horrible surprise waiting for them. It's fiction, but beyond being prepared for what you're going into (which we've discussed can only take you so far in being either prepared or ultimately satisfied with your choice), I think strength of conviction and your personal values are key. Think of Ghandi or MLK or such. There's a lot that people will suffer in order to follow their convictions, and that is where I think one can shoulder enormous burdens and still find fulfilment. That is why I think it's dangerous to go into medicine without that drive. There are ways to make money and have prestige with less personal cost. What I find over and over is that students are not willing to hear this or be truly honest about who they really are and what they actually want. It's a shame.

My only true gripe about practising medicine is only the extent to which I feel I have had to compromise my personal integrity and commitment to patient care, essentially conscientiousness, for the medical industrial complex. There just isn't enough time to do the job I think should be done.

 

[Crayola227]

All of that has to do with foresight.

Never mind, that there's hindsight ways of thinking about things. I mean, there's no good way of knowing what the level of regret would have been NOT going into medicine. Every path has its obstacles. It's possible to be unhappy doing anything. There are some unique challenges in medicine, but a lot of things that frustrate people are inherent to all kinds of employment, and basically a job is a job for a reason and most of people feel the need to be compensated to do it, for a reason. The only job I'm interested in doing "for free" is being a mother or launching into little appreciated mini-lectures on various topics (doctor means teacher in Latin... so there lies my passion).

You deal with bureaucracy just about anywhere. Customer service. Idiots. Problem solving. Waste. Stupid counterproductive rules. Ingrates. Feeling like what you do doesn't matter, isn't compensated fairly enough. Feeding the machine.

Some people didn't really belong in medicine, and it's sad. Some it was family, some did their best to choose wisely. However, I think for other people their regrets are a matter of perspective.