Taking some time off between finishing training and working?

[shahseh22]

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Hi,
I'm finishing up my fellowship in June and I'm in an unfortunate situation where it looks like my father is getting burned out taking care of my mom. It looks like we may need consider putting her in an assisted living facility but I want to still try and be there for her if I can after my training.

My question is if I take 6 months to a year of not working (or very minimal part time work), will this affect me from a licensing perspective?

I'm the eldest child and unfortunately my other siblings are not in a position to help out.

Thanks

 

[dpmd]

Shouldn't affect your license but may affect your skills if you don't work at all for a year. Part time would help that. I took 2 months off and it was wonderful (and I highly recommend it to anyone who can afford it) but to be honest even that time made me feel a little rusty though it might have just been normal imposter syndrome for people transitioning to attendinghood. You may want to consider whether you working a little more and hiring help for your dad with some of that money might be better than trying to be caregiver yourself. Between in home aides and adult day care/respite it might help keep her at home if that is what you all want.

 

[Raryn]

Won't affect your license but may be a problem when it comes to job search later. Part time work would fix that though - the problem is the gap. Find a locums or moonlighting gig and do a shift here and there, as long as your CV has something to put down for those months it will lead to no reprecussions.

 

[rokshana]

Agree with Raryn...I was in a similar position with my dad...locums gave me the flexibility to be home for 2 weeks of the month and had money to be able to help with hiring help to come help my mom with my dad...thought I would have to do hospitalist work but interestingly enough there is a lot of locums endocrine...you probably will be able to find locums in your specialty as well.

In fact you may find something in Your hometown as locums

 

[Piebaldi]

Hi,
I'm finishing up my fellowship in June and I'm in an unfortunate situation where it looks like my father is getting burned out taking care of my mom. It looks like we may need consider putting her in an assisted living facility but I want to still try and be there for her if I can after my training.

My question is if I take 6 months to a year of not working (or very minimal part time work), will this affect me from a licensing perspective?

I'm the eldest child and unfortunately my other siblings are not in a position to help out.

Thanks

I took some time off to travel after residency after studying for boards. I was super burnt out so I would encourage all who are able to swing it to take some time off.
I agree with the others - you might get a million questions and it may have some limitations in your ability to work at least initially if you are off for that long. That said locums here and there might fix that or a part time even if very part time where you are only working a few days a week.

 

[shahseh22]

I'm in Psychiatry so the good thing is I may be able to do telepsych but may be so busy with family stuff that I may not do it more than a few hours a week.

 

[gutonc]

I'm in Psychiatry so the good thing is I may be able to do telepsych but may be so busy with family stuff that I may not do it more than a few hours a week.

Just do something. Gaps in training/practice will always need to be explained on future licensing and credentialing applications. If you work even the equivalent of a few days each month, that's not a gap and you're golden.

 

[Mass Effect]

I'm in Psychiatry so the good thing is I may be able to do telepsych but may be so busy with family stuff that I may not do it more than a few hours a week.

In psychiatry, it's pretty normal to take about 2 months off. After that, you start to get questions and concerned looks. What I would do is get in with a locums company. Just work one weekend a month. You'll put it on your resume to avoid the gap.

 

[dpmd]

Just do something. Gaps in training/practice will always need to be explained on future licensing and credentialing applications. If you work even the equivalent of a few days each month, that's not a gap and you're golden.

I kinda forgot about that part. I stayed at the same place for my first job as where i did residency so even though i took two months off there was no actual gap to account for.

 

[gutonc]

I kinda forgot about that part. I stayed at the same place for my first job as where i did residency so even though i took two months off there was no actual gap to account for.

Agreed. Another possibility is to have a technical start date of (e.g. August 1) but not actually start working until a month or two later. Obviously this is unpaid, but gets around the work gap. This is clearly not an option for the OP who’s looking for 6-12 months.

 

[Slatches]

Any other profession but medicine can take a break and come back. This notion of gaps affecting skills is BS. We like to make things tough on us for no reason because in medicine we claim to be the best and brightest. Gimme a break. Now we are realizing that mid levels are doing what we do. Can’t take a break for 3 months and everyone raising eyebrows over your skills. Take a break man, you have one life with your family.

 

[deleted480308]

Any other profession but medicine can take a break and come back. This notion of gaps affecting skills is BS. We like to make things tough on us for no reason because in medicine we claim to be the best and brightest. Gimme a break. Now we are realizing that mid levels are doing what we do. Can’t take a break for 3 months and everyone raising eyebrows over your skills. Take a break man, you have one life with your family.

There is a difference between midlevels thinking they deserve permission to imitate us and them actually doing what we do.

Long gaps do impact your skill levels

 

[dpmd]

Any other profession but medicine can take a break and come back. This notion of gaps affecting skills is BS. We like to make things tough on us for no reason because in medicine we claim to be the best and brightest. Gimme a break. Now we are realizing that mid levels are doing what we do. Can’t take a break for 3 months and everyone raising eyebrows over your skills. Take a break man, you have one life with your family.

He isn't talking 3 months, he is talking 6 months to a year at the very start of his career, a time when people are still getting used to their fully independent role.

 

[ThoracicGuy]

Any other profession but medicine can take a break and come back. This notion of gaps affecting skills is BS. We like to make things tough on us for no reason because in medicine we claim to be the best and brightest. Gimme a break. Now we are realizing that mid levels are doing what we do. Can’t take a break for 3 months and everyone raising eyebrows over your skills. Take a break man, you have one life with your family.

Gaps affecting skills is a very real thing. Have YOU taken a long break from medicine?

 

[Raryn]

He isn't talking 3 months, he is talking 6 months to a year at the very start of his career, a time when people are still getting used to their fully independent role.

I'll be the first one to say I learned more my first 6 months of independent practice than my last year of fellowship. I can't imagine a year in between the two.

 

[Slatches]

Gaps affecting skills is a very real thing. Have YOU taken a long break from medicine?

If your skills waned because you took 6months to a year off then you suck! Don’t make medicine look like quantum physics. You aren’t coming up with the equation to describe the universe. You take a break and before you get back you refresh yourself. Medicine is a life long learning process and as long as you can recognize that you’d be fine.

 

[Slatches]

I'll be the first one to say I learned more my first 6 months of independent practice than my last year of fellowship. I can't imagine a year in between the two.

I would imagine so because the experience of being out there alone can’t be book learned. But don’t tell me you will not be able to manage a patient with Afib and PE for example because you took 6 months off. What changed in 6 months? New medicines that can’t be learned or procedures. Even if you forget, you can’t refresh your memory? If this is a challenge for some, then that’s ok. Not everybody has that difficulty. I know the culture in medicine frowns on gaps. But all that is BS. Today we have “Monkey see monkey do”, yes that’s how I see midlevels who didn’t do our length of training but they can handle bread butter stuff. Here we have a MD who took 6 months off and we think he is crap. Have you ever asked yourself, with all our expertise and criteria’s is our healthcare the best? Are our outcomes the best, when compared to other nations?

 

[Slatches]

I'll be the first one to say I learned more my first 6 months of independent practice than my last year of fellowship. I can't imagine a year in between the two.

I should say this. The core of medicine NEVER changes. The guidelines may change and some new medicines may come up. If you take 6 months and have trouble when you get back then you learned the “cook book” medicine.

 

[rokshana]

I should say this. The core of medicine NEVER changes. The guidelines may change and some new medicines may come up. If you take 6 months and have trouble when you get back then you learned the “cook book” medicine.

So exactly how long have you been out of medicine and hoping to get back in?

 

[ThoracicGuy]

If your skills waned because you took 6months to a year off then you suck! Don’t make medicine look like quantum physics. You aren’t coming up with the equation to describe the universe. You take a break and before you get back you refresh yourself. Medicine is a life long learning process and as long as you can recognize that you’d be fine.

You obviously have no insight on this. Are you a medical student? Resident? Taking 6 months to a year off immediately after finishing residency is not advisable. You WILL lose skills, whether surgical or medical. It will be harder to get into it when you come back. Can it be done, yes. I did it. I wouldn't recommend it. But then, I guess I suck, huh.

 

[rokshana]

I should say this. The core of medicine NEVER changes. The guidelines may change and some new medicines may come up. If you take 6 months and have trouble when you get back then you learned the “cook book” medicine.

And it’s not about just skills, though not working after residency will put you at a disadvantage , it’s about licensing and credentialing...gaps in work will follow him forever...you have to explain every gap , even as little as 10 days...better that he work a little...the attending money will help with taking care of his mother and keep h involved in clinical medicine...as someone who as actually done this (father instead of mother) I speak from actual experience that it is doable.

 

[TraumaLlamaMD]

How onerous is the licensing process if you do have a few month gap? Is it as simple as filling out a few lines (“took time to care for ill family member/travel/maternity leave”) with maybe a brief delay in processing, or do they really require more explanation than that?

 

[Raryn]

How onerous is the licensing process if you do have a few month gap? Is it as simple as filling out a few lines (“took time to care for ill family member/travel/maternity leave”) with maybe a brief delay in processing, or do they really require more explanation than that?

That will be fine for licensing, but it may cause issues with job search and credentialing. Some of those hospital bureaucrats are absolutely absurd.

 

[Slatches]

So exactly how long have you been out of medicine and hoping to get back in?

Why does my time line matter to you?

 

[Slatches]

You obviously have no insight on this. Are you a medical student? Resident? Taking 6 months to a year off immediately after finishing residency is not advisable. You WILL lose skills, whether surgical or medical. It will be harder to get into it when you come back. Can it be done, yes. I did it. I wouldn't recommend it. But then, I guess I suck, huh.

I wasn’t saying I’m recommending anyone to take time off. However, if you have to take it for personal reasons why not. You think being in Medicine is the end all be all. So if you loose skills, how long will it take you to get back? You loose the sharpness, and it all comes back in time, depending on the individual. There are people who’ve been out and matched and did well, yet we sit here and make everything a big deal. It’s a big deal because the PD or employer frowns on it. And yes, if you didn’t have the core medical knowledge and thinking you’d come back and look at algorithms you suck. Besides, you are not here to prove your worth to me. Do you.

 

[ThoracicGuy]

I wasn’t saying I’m recommending anyone to take time off. However, if you have to take it for personal reasons why not. You think being in Medicine is the end all be all. So if you loose skills, how long will it take you to get back? You loose the sharpness, and it all comes back in time, depending on the individual. There are people who’ve been out and matched and did well, yet we sit here and make everything a big deal. It’s a big deal because the PD or employer frowns on it. And yes, if you didn’t have the core medical knowledge and thinking you’d come back and look at algorithms you suck. Besides, you are not here to prove your worth to me. Do you.

You are saying talking 6 to 12 months isn't a big deal when it comes to medicine. I say you are wrong and I don't want people coming here and reading it and thinking it's a good idea for them to try.

And you didn't answer my question. Where are you in the process of education and training?

 

[Slatches]

And it’s not about just skills, though not working after residency will put you at a disadvantage , it’s about licensing and credentialing...gaps in work will follow him forever...you have to explain every gap , even as little as 10 days...better that he work a little...the attending money will help with taking care of his mother and keep h involved in clinical medicine...as someone who as actually done this (father instead of mother) I speak from actual experience that it is doable.

So if it’s doable why make it like a mountain. If there are gaps and you have to explain, so what. You explain your gaps. If you have the credentials and can do the job then what holds you back besides our stupid bureaucracy. I took 2 months of personal reason and I come back and they say “oh no you’ve lost skills”. Excuse me?
This is the bs that kills this country, we always want to make things seem monumental and elevated when our outcomes aren’t even next to other nations.

 

[Slatches]

You are saying talking 6 to 12 months isn't a big deal when it comes to medicine. I say you are wrong and I don't want people coming here and reading it and thinking it's a good idea for them to try.

And you didn't answer my question. Where are you in the process of education and training?

Again, I’m not encouraging anyone. I wouldn’t want to have gaps, but if I need the time off, I will. By the way, when you say “I don’t want people coming here and reading it”, is this a platform to direct what others should do? Aren’t people smart enough to glean what’s important and appropriate for them on a forum?
You want to know my training and level so you can judge me? Bruh, there is no difference between you and me. I’ll leave it like that.

 

[Slatches]

That will be fine for licensing, but it may cause issues with job search and credentialing. Some of those hospital bureaucrats are absolutely absurd.

Exactly, it’s the bureaucracy I’m talking about. Yet everyone is hanging on skills. How can you learn and practice medicine and leave for 3 months and your skills drop. If yours does, you suck! I said it! This isn’t quantum mechanics. Even if it was.. come on man.

 

[dpmd]

If your skills waned because you took 6months to a year off then you suck! Don’t make medicine look like quantum physics. You aren’t coming up with the equation to describe the universe. You take a break and before you get back you refresh yourself. Medicine is a life long learning process and as long as you can recognize that you’d be fine.

So you recognize that you have to refresh yourself but can't see how that means that there is a loss from the gap? No one claimed it is an insurmountable one, just that since it is known to be an issue that potential employers will factor it in. You can rail against that all you want I guess. We on the other hand are trying to actually help the person.

 

[dpmd]

Exactly, it’s the bureaucracy I’m talking about. Yet everyone is hanging on skills. How can you learn and practice medicine and leave for 3 months and your skills drop. If yours does, you suck! I said it! This isn’t quantum mechanics. Even if it was.. come on man.

You keep comparing it to hard sciences. It is like you have no comprehension of the art aspect. It isn't just bureaucracy. Long gaps (you keep trying to make it shorter with your 3 month and 2 month comments) will make people rusty. Not just people who suck. How? Because just like any activity that you don't do for a while you aren't as good at it when you start back. Not that you are terrible at it, or that you will have to start from scratch, but you aren't as good. It is worse the earlier in your career you do it because you simply aren't as good at it as you will be later. People who recognize that and implement strategies to address it are going to be a lot safer doctors then those who think it will be just like riding a bike like you seem to think. Actually though, someone who just recently learned to ride a bike then stopped for a year will have more trouble their first time back on one than an Olympic cyclist who has to take a similar break)

 

[ThoracicGuy]

Again, I’m not encouraging anyone. I wouldn’t want to have gaps, but if I need the time off, I will. By the way, when you say “I don’t want people coming here and reading it”, is this a platform to direct what others should do? Aren’t people smart enough to glean what’s important and appropriate for them on a forum?
You want to know my training and level so you can judge me? Bruh, there is no difference between you and me. I’ll leave it like that.

I want to know what level you are at so I and others can understand your point. From an attending standpoint that is fairly fresh from training, you have a significant lack of insight.

But I see interacting with you isn't very productive, so I'll leave it at that.

 

[Slatches]

I want to know what level you are at so I and others can understand your point. From an attending standpoint that is fairly fresh from training, you have a significant lack of insight.

But I see interacting with you isn't very productive, so I'll leave it at that.

What’s my lack of insight? As a fresh attending, go ahead and have fun in your career and not overly complicate medicine. There is nothing productive interacting with you either.

 

[Slatches]

You keep comparing it to hard sciences. It is like you have no comprehension of the art aspect. It isn't just bureaucracy. Long gaps (you keep trying to make it shorter with your 3 month and 2 month comments) will make people rusty. Not just people who suck. How? Because just like any activity that you don't do for a while you aren't as good at it when you start back. Not that you are terrible at it, or that you will have to start from scratch, but you aren't as good. It is worse the earlier in your career you do it because you simply aren't as good at it as you will be later. People who recognize that and implement strategies to address it are going to be a lot safer doctors then those who think it will be just like riding a bike like you seem to think. Actually though, someone who just recently learned to ride a bike then stopped for a year will have more trouble their first time back on one than an Olympic cyclist who has to take a similar break)

For the record, I’m not saying you will not be RUSTY. You will be rusty!! But you will get back to the swing of it and it’s not a big deal like you lot are making it. Again, it all depends on the individual. If you are talking about years out with no interaction with patients then heck yeah. The guy said he wanted 6 months to a year. So my take was: not bad, you can take that time off and get back. I did it!!
By the way, forget about hard science for a min, because that you can forget, but the art of medicine will not die off in 6 months to a year. You lot just make things complicated in medicine for no reason.
I am medicine nerd, I live it, so even if I’m off I’m still in it.

 

[Slatches]

So you recognize that you have to refresh yourself but can't see how that means that there is a loss from the gap? No one claimed it is an insurmountable one, just that since it is known to be an issue that potential employers will factor it in. You can rail against that all you want I guess. We on the other hand are trying to actually help the person.

Go ahead and help the person. Who’s stopping you. All I said is, as much as medicine is our career there is more to life. Your pick!! Let’s not crucify our colleagues who took time off by saying their less than us who didn’t. Again, the time lapse and the individual confidence are factors.

 

[dpmd]

For the record, I’m not saying you will not be RUSTY. You will be rusty!! But you will get back to the swing of it and it’s not a big deal like you lot are making it. Again, it all depends on the individual. If you are talking about years out with no interaction with patients then heck yeah. The guy said he wanted 6 months to a year. So my take was: not bad, you can take that time off and get back. I did it!!
By the way, forget about hard science for a min, because that you can forget, but the art of medicine will not die off in 6 months to a year. You lot just make things complicated in medicine for no reason.
I am medicine nerd, I live it, so even if I’m off I’m still in it.

So basically you take back your statement about there not being skill/knowledge loss and simply disagree that it is a valid concern when people return and are rusty because you think it is no big deal?

 

[rokshana]

So if it’s doable why make it like a mountain. If there are gaps and you have to explain, so what. You explain your gaps. If you have the credentials and can do the job then what holds you back besides our stupid bureaucracy. I took 2 months of personal reason and I come back and they say “oh no you’ve lost skills”. Excuse me?
This is the bs that kills this country, we always want to make things seem monumental and elevated when our outcomes aren’t even next to other nations.

You have obviously not done credentialing at any hospital , otherwise you would realize exactly what a pain this is...and that is if you are “clean”... have any issues or red flags and it can delay you for months...and even keep you from getting privileges.

 

[Slatches]

So basically you take back your statement about there not being skill/knowledge loss and simply disagree that it is a valid concern when people return and are rusty because you think it is no big deal?

I didn’t take back my statement. You don’t seem to follow, so let it go. I never said there is no rust. I said don’t make the rust seem like it’s an insurmountable task because if you know the basics, core stuff, you’d be back to the groove in no time. The ones who struggle are the ones who have to rely on algorithms. If you want to go back and forth with me, then we can exchange locations and meet!!

 

[dpmd]

I didn’t take back my statement. You don’t seem to follow, so let it go. I never said there is no rust. I said don’t make the rust seem like it’s an insurmountable task because if you know the basics, core stuff, you’d be back to the groove in no time. The ones who struggle are the ones who have to rely on algorithms. If you want to go back and forth with me, then we can exchange locations and meet!!

Is this supposed to be a threat?

 

[Slatches]

You have obviously not done credentialing at any hospital , otherwise you would realize exactly what a pain this is...and that is if you are “clean”... have any issues or red flags and it can delay you for months...and even keep you from getting privileges.

Isn’t that bureaucratic stuff? I agree and that’s why I said, that seems to be the pain. It’s not so much the “art of medicine”. That can always come back quick!!

 

[dpmd]

Apparently someone has some butthurt about how gaps are viewed in addition to their dislike of mid levels.

Just because someone is out for a while doesn’t mean they can’t succeed I. Residency especially if they have taken the boards recently. We like to make residency seem like some rocket science ****. Here we are fighting with mid levels and they basically do what a resident does after 2 years of Pa school. Stop this bs. Just say we prefer newer grads but don’t down play what a candidate who graduated med school but has been out. If they are are out with no recent clinical or something to show they are up to speed then yeah.

@ThoracicGuy I think this helps with context and goes to show you had the right idea about not discussing it further with them.

 

[Slatches]

Is this supposed to be a threat?

If you choose to interpret it that way. Meeting someone is a threat? Unless you are looking for a confrontation. Which in this case you shouldn’t, not with me anyway. I was going to threaten you I’d do it in your face!! But I’ll let civility and good manners rule this time. Peace out buddy, stay in your lane!

 

[dpmd]

You have obviously not done credentialing at any hospital , otherwise you would realize exactly what a pain this is...and that is if you are “clean”... have any issues or red flags and it can delay you for months...and even keep you from getting privileges.

Because, credentials committees have to try to ensure only those who will be competent in their specialty get privileges, not just because they want to screw with you. Not saying you don't already know this, but some people may not.

 

[Slatches]

Apparently someone has some butthurt about how gaps are viewed in addition to their dislike of mid levels.
@ThoracicGuy I think this helps with context and goes to show you had the right idea about not discussing it further with them.

I have no hurt! I made my opinion. If you don’t like it then walk up to me and tell me. Give it a go! Don’t sit behind a screen and say someone is butt hurt.

 

[Slatches]

Because, credentials committees have to try to ensure only those who will be competent in their specialty get privileges, not just because they want to screw with you. Not saying you don't already know this, but some people may not.

Agreed!!

 

[NotAProgDirector]

It really depends on the field, length, and timing.

A break of less than 3 months, and almost no one is going to care. You may be asked about it, but any reasonable and truthful explanation will be fine.

A break of 6-12 months will almost certainly come under some scrutiny. You may have a good reason to take a break like this, but the boards are gunshy because they have had people who have been in jail, or otherwise have a "big problem" and try to spin it as a "personal issue".

A break of > 2-3 years, and you will really start running into problems.

Breaks in the middle of your career are often expected - a sabbatical, for example. A break right after training finishes may come under more scrutiny. I tell my residents that they learn 50% of everything they need to know in residency, 25% in the first 6 months of practice, and 25% over the rest of their careers.

Being "rusty" when you return from a break is expected. This may be more or less of a problem based on field. Rusty in IM = you might need to look something up that you would have just known, no big deal. Rusty as a surgeon = not good in the OR is a HUGE problem.

 

[dpmd]

It really depends on the field, length, and timing.

A break of less than 3 months, and almost no one is going to care. You may be asked about it, but any reasonable and truthful explanation will be fine.

A break of 6-12 months will almost certainly come under some scrutiny. You may have a good reason to take a break like this, but the boards are gunshy because they have had people who have been in jail, or otherwise have a "big problem" and try to spin it as a "personal issue".

A break of > 2-3 years, and you will really start running into problems.

Breaks in the middle of your career are often expected - a sabbatical, for example. A break right after training finishes may come under more scrutiny. I tell my residents that they learn 50% of everything they need to know in residency, 25% in the first 6 months of practice, and 25% over the rest of their careers.

Being "rusty" when you return from a break is expected. This may be more or less of a problem based on field. Rusty in IM = you might need to look something up that you would have just known, no big deal. Rusty as a surgeon = not good in the OR is a HUGE problem.

You forgot the other possibility for rusty-you think you remember something so you don't look it up but it ends up being wrong.

 

[Slatches]

It really depends on the field, length, and timing.

A break of less than 3 months, and almost no one is going to care. You may be asked about it, but any reasonable and truthful explanation will be fine.

A break of 6-12 months will almost certainly come under some scrutiny. You may have a good reason to take a break like this, but the boards are gunshy because they have had people who have been in jail, or otherwise have a "big problem" and try to spin it as a "personal issue".

A break of > 2-3 years, and you will really start running into problems.

Breaks in the middle of your career are often expected - a sabbatical, for example. A break right after training finishes may come under more scrutiny. I tell my residents that they learn 50% of everything they need to know in residency, 25% in the first 6 months of practice, and 25% over the rest of their careers.

Being "rusty" when you return from a break is expected. This may be more or less of a problem based on field. Rusty in IM = you might need to look something up that you would have just known, no big deal. Rusty as a surgeon = not good in the OR is a HUGE problem.

Thank you for this. That’s the point I have been trying to make all along. There are some who think others are robots and can’t leave medicine for whatever the reason is. Because it’s a cardinal sin in medicine. This is speciality based, length and the individuals own competency and awareness.

 

[Slatches]

You forgot the other possibility for rusty-you think you remember something so you don't look it up but it ends up being wrong.

That’s on you. If you doubt yourself then go figure it out, double check. You think the ones who haven’t taken a break can’t make mistakes or do wrong? We are in a life long learning profession, stay humble keep evolving.

 

[rokshana]

Because, credentials committees have to try to ensure only those who will be competent in their specialty get privileges, not just because they want to screw with you. Not saying you don't already know this, but some people may not.

I get it, but sometimes they do go a bit overboard...I needed privileges at a hospital for endocrinology...and it took 2 months...now mind you , I was already active staff at this hospital for internal medicine...since 2015... reappointed just the year before in 2017...TWO MONTHS...active staff IN the dept of medicine...