What are the implications of not applying to residency?

[DO2015CA]

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Honestly just finish residency and take a year off.

Everyone keeps suggesting working abroad, but this is wayyyy harder than you think as an american. There's tons of visa/legal issues, no one wants to pay over the odds for an american (per diem or post-diff), and you're going to make way less than you would in america. You could get a humanitarian position in a "third world" country (the appropriate term is low-income country), but most of these are active disasters or war zones where you're not going to do much ~*traveling*~. Plus honestly, since so many of the foreign aid programs are disease specific, you're going to need to be an expert in that field (residency, fellowship, some program mgmt skills, etc etc).

If you want to travel, just travel. If you want to teach, just teach (could even tutor med students). Don't try to mix the two and live a millennial fantasy. The time for that was pre-med school.

You don’t have to do humanitarian trips with large organizations. There are plenty of churches that go on medical mission trips to more medically underserved but not necessarily war torn. The churches I’m aware of personally go to Peru and Vietnam yearly. They’re always looking for physicians to go. They go to the same clinics set up in the rural parts of the country. Those people work hard during the day but get to know the village/culture at night.

On the other hand, medical mission trips should be about altruism and not American vacationism. It should be about going somewhere that the country needs you most not where you can have a good time and take as many pictures as possible.

 

[JSReed]

You don’t have to do humanitarian trips with large organizations. There are plenty of churches that go on medical mission trips to more medically underserved but not necessarily war torn. The churches I’m aware of personally go to Peru and Vietnam yearly. They’re always looking for physicians to go. They go to the same clinics set up in the rural parts of the country. Those people work hard during the day but get to know the village/culture at night.

On the other hand, medical mission trips should be about altruism and not American vacationism. It should be about going somewhere that the country needs you most not where you can have a good time and take as many pictures as possible.

Hmm. Will have to disagree with you on the utility of "mission trips" (bc lets bet honest, they're all voluntourism masquerading as humanitarianism). But I guess that's a totally different ted talk...

 

[jurassicpark]

Hmm. Will have to disagree with you on the utility of "mission trips" (bc lets bet honest, they're all voluntourism masquerading as humanitarianism). But I guess that's a totally different ted talk...

I think people need to be aware of what voluntourism is, and if serving the needy is really a passion your organization and trip has to be evaluated carefully, and not just a way for you to take an expensive morally uplifting instagram trip. The flip side to that, they tend to get a bit dangerous. Look at the French ACTED group in Niger recently, horrible.

 

[JSReed]

I think people need to be aware of what voluntourism is, and if serving the needy is really a passion your organization and trip has to be evaluated carefully, and not just a way for you to take an expensive morally uplifting instagram trip. The flip side to that, they tend to get a bit dangerous. Look at the French ACTED group in Niger recently, horrible.

I had a colleague who got killed in Bamako a few years back, similar scenario. Highly unfortunate, terrible circumstances....but also part and parcel of the humanitarian sector (esp W africa right now). If you're trying to help the people who need it most (on a global scale), you're not going to be going to the hamptons.

 

[jurassicpark]

I had a colleague who got killed in Bamako a few years back, similar scenario. Highly unfortunate, terrible circumstances....but also part and parcel of the humanitarian sector (esp W africa right now). If you're trying to help the people who need it most (on a global scale), you're not going to be going to the hamptons.

I am so sorry to hear that. Humanitarianism has really taken a turn for the horribly dangerous these days, now that scum realize they can send a message or get money by preying on these defenseless NGOs.

 

[JSReed]

I am so sorry to hear that. Humanitarianism has really taken a turn for the horribly dangerous these days, now that scum realize they can send a message or get money by preying on these defenseless NGOs.

Not sure I'd go that far, it was always decently dangerous. IMO I'd say outright warfare is (generally) less frequent these days. There's a lot of anti-western sentiment but that's not necessarily something new. And honestly, given the political economic history of most of these places, I wouldn't trust us either.

Plus, when you're a doctor, your objective is to treat the patient regardless of where their allegiances lie.

 

[Eye-eye]

This makes me so frustrated because the day I finish residency is so far away. sooo far away.

I echo others' sentiments that the time will fly, especially once you get out of the classroom and set foot on the wards. Another thing to bear in mind is that some residencies have built in international experiences. That's not going to be for a full year or anything, unless you want to take one out in the middle of residency for global medicine (and I'm starting to get the impression that taking a year out for professional interests like that are not at all unheard of once you're actually in residency), but it's something. In ophtho, I feel like it's about half of the residency programs that have a history of international rotations for a few weeks or a month (whether optional or required), and a few have residency tracts for global ophtho. Now, ophtho lends itself well to it because you can go, cut out a cataract, and permanently improve their vision without the need for a ton of follow up for that specific issue, but I'm sure a lot of other fields have a decent number of programs with the option for international work for a short stent in residency. Just something that may help you get over the mental hurdle of the end of residency feeling so far away.

 

[Medisaint]

The OP's premise is completely inane and this whole thread is idiotic.

This BS reminds me of the "What do you want to do?" scene from Good Will Hunting.

So you are thinking about leveraging your $250K+ medical education to get a job teaching English in a foreign country? I suggest you become a shepherd, at least there won't be COVID-19.

You're jerking everyone around. Grow up.

 

[ChasingMavericks]

The OP's premise is completely inane and this whole thread is idiotic.

This BS reminds me of the "What do you want to do?" scene from Good Will Hunting.

So you are thinking about leveraging your $250K+ medical education to get a job teaching English in a foreign country? I suggest you become a shepherd, at least there won't be COVID-19.

You're jerking everyone around. Grow up.

I don't have that amount of debt.
Not to say I don't have debt, but towards the end of medical school I'm looking at around ~120k.
I don't want to abandon medicine as a whole, I just want to do this for a couple of years prior to starting residency.

Also, I fail to see how this thread is "idiotic"

 

[Eye-eye]

I don't have that amount of debt.
Not to say I don't have debt, but towards the end of medical school I'm looking at around ~120k.
I don't want to abandon medicine as a whole, I just want to do this for a couple of years prior to starting residency.

Also, I fail to see how this thread is "idiotic"

While medisaint's post may have had a harsh tone, I think what he meant by calling the post idiotic/comparing this to that Good Will Hunting scene is just pointing out that basically all of your replies here have stated it would be an idiotic choice to seriously risk your entire professional future on taking a year to teach English abroad before getting into residency. All the previous posts have pointed out why that's the case very well, and given several alternatives that are extremely reasonable, should allow you to achieve your goals, and, most importantly, don't risk throwing your future down the drain. If you're still considering taking a year off to teach English before securing a residency spot, I would echo his concern that the idea is a bit insane and you wouldn't be making a mature decision with good consideration for its implications on your future.

I get that this is something you're passionate about, I do. And it sucks that you won't be able to do it for a while. But unfortunately, that's life. I wanted to drop out of undergrad to do something completely different with my life, entirely sure it's what I would dedicate my entire future to. But everyone around me said "it'll still be there, just finish up school first, just in case." Even though I was sure I wouldn't change my mind, I heeded their advice. Over time, I realized that wasn't what I wanted to do with my future, and was extremely glad I hadn't dropped out. And it sucks that I can't do medicine and that, but I can still take part in that part of my life, just as you'll always be able to do international work, if you time it right. Even if I had left school and my old life behind, I wouldn't have regretted taking those few years to secure my future just in case. You're smart and you're a planner at least to some extent. If that weren't true, you wouldn't be in med school. Use that now. It's a few years of delayed gratification, yes. But trust me, when you look back, you will be glad you kept that impassioned and sometimes impulsive side in check and put all your ducks in a row before pursuing this particular passion.

 

[Medisaint]

I don't have that amount of debt.
Not to say I don't have debt, but towards the end of medical school I'm looking at around ~120k.
I don't want to abandon medicine as a whole, I just want to do this for a couple of years prior to starting residency.

Also, I fail to see how this thread is "idiotic"

You risk whatever you paid for your medical education in addition to 4 years of opportunity costs by making choices that lower your chances of being able to use your expensive degree. Even if you match, your ill-timed, two-year adventure runs the risk of damaging your application, limiting your residency prospects, and causing a ripple effect throughout your entire professional career.

If you fail to see how this is an idiotic premise on which to have a serious discussion then I will assume you are trolling.

 

[ChasingMavericks]

You risk whatever you paid for your medical education in addition to 4 years of opportunity costs by making choices that lower your chances of being able to use your expensive degree. Even if you match, your ill-timed, two-year adventure runs the risk of damaging your application, limiting your residency prospects, and causing a ripple effect throughout your entire professional career.

If you fail to see how this is an idiotic premise on which to have a serious discussion then I will assume you are trolling.

Okay I do understand that, but you also have to understand that this isn't just some random expedition or some random vacation. No.

It's something that would genuinely make me happy, an experience that I really want to have in my life. It's hard to put into words the exact feeling.

 

[AMEHigh]

I took time off during med school to live abroad, no regrets.

You should definitely go straight from med school to residency though if you want to get into residency and eventually practice medicine.

Once you finish residency you can decide where you want your career path to take you. Some people have "non-traditional" medical careers that allow for travel, living abroad, etc (I don't recommend "medical missions") and others take some time off (for a variety of reasons) and have no problem getting a job after some time away.

But yes I think it'd be silly to take time off after med school and before residency to specifically teach english abroad.

 

[QuizzicalApe]

thats so true..... i feel like i JUST started medical school, and i am already deep into fall semester M2.... studying for step 1. Then, - blink and ill be applying for residencies in just 1.5 years.

I just recently started med school myself, I think.
However, I've also been an attending for a little while.

 

[QuizzicalApe]

Okay I do understand that, but you also have to understand that this isn't just some random expedition or some random vacation. No.

It's something that would genuinely make me happy, an experience that I really want to have in my life. It's hard to put into words the exact feeling.

AMEHigh pointed something out that I think the rest of us glossed over: time off during medical school to do something. The concerns are much less if you attend a med school that is OK with gap years and you do a mid-medschool gap year to do this. The med school affiliated with my institution is very supportive of gap years which people have taken for research, to write a book, explore business ideas, etc.

Gaps between med school and residency are red flags and may get you screened out. A permitted gap within medical school not as much.

 

[Angus Avagadro]

Sorry if I missed this in an a post above, but what is the plan to pay off med school loans and life expenses if OP forgoes residency?

 

[Bloobury]

I feel like premeds need to read threads like this. As someone who took a bunch of years to work and travel prior to applying (this cycle), I regret nothing. I'm sorry you didn't have that experience, OP. I know plenty of MD's who feel shackled by their debt and regret all they missed on out on during their years of training, but I only know one person who didn't finish residency (had alcohol problems and left after intern year to do consulting after time off getting sober). I don't know anyone who would postpone residency to try to get a low-paid job abroad for a while. You should find some other way to scratch that itch. Travel when you get the chance. Volunteer as an English tutor via Skype, which you can do for people from anywhere in the world. Lots of folks in the US need literacy help too.

May others take heed, and take time to do all the things they want prior to committing to the process of medical school+residency(+/- fellowship).

 

[Goro]

Okay I do understand that, but you also have to understand that this isn't just some random expedition or some random vacation. No.

It's something that would genuinely make me happy, an experience that I really want to have in my life. It's hard to put into words the exact feeling.

It's something you should have done prior to medical school.

 

[M&L]

I just recently started med school myself, I think.
However, I've also been an attending for a little while.

Oh my god . Hahaha brilliant

 

[kraskadva]

It's something that would genuinely make me happy, an experience that I really want to have in my life. It's hard to put into words the exact feeling.

Why? And how do you know this would make you happy?

Edit: As somebody who has made a number of these seat-of-the-pants, jumping in head first moves in my life, I want to tell you in the strongest possible terms that - while they may be exciting, while they may give you a brief serotonin high from saying F* it and doing this thing that sounds cool - they do not "make you happy". Happiness can certainly be influenced by circumstances, but is not dependent on them. And that kind of lifestyle has as many or more unpleasant, slog through it moments than sticking with what you got now.
The stories people tell afterwards, that make it sound cool, are only brief highlights, selected specifically for their impressiveness. I've got plenty of those stories. But I have many many more stories about being poor and unhappy doing that than cool ones - it's just that nobody wants to hear about how I lived solely on ramen for 6 months and gave myself scurvy, or waded through months-years long major depressive episodes with no resources to get help. Suffice to say, it ain't all rainbows, roses, and cool parties with interesting people. That's just the spin that gets put on it.

Edit2: I don't regret choosing that path, but I also did it at a time in my life where it fit and I wasn't giving up other opportunities or f-ing up my life to do it. If I did it now, I would very deeply regret both throwing away all the hard work I put in to get to where I am now and losing the opportunities that becoming a doc will provide.

 

[twospadz]

Medical school students are some of the most sheltered people in this world. Dude, you have no idea how bad you are about to mess you life up. Finish residency. You can pursue your dream after residency. Or if its another career, do it part-time. But still finish.

 

[LunaOri]

I think you need to do some serious research about what it is like to teach English in another country. I don't know what dream you are pursuing, but I'm not sure you are seeing the realities clearly. Are you saying that you really don't want to be a physician, and this is a way to take time off before making a career change?

 

[RangerBob]

The good news is psych is likely to care more about service/stuff outside medicine than other specialties. The bad news is it's even more competitive, and if you're even competitive for psych, you'd likely only be able to get into the "less desirable" programs. The truth is even if you plan to finish residency, every program you apply to is going to question your dedication to medicine. They are going to wonder why they should interview/rank you above someone else who has shown steadfast dedication. I really don't intend to be mean here, but if I were a program director I probably wouldn't consider your application--I'd be very concerned you wouldn't even be able to function as a starting intern if you've been out of medicine for two years, and I'd question if you'd even stay through all 4 years of residency. I'd think highly of you as a person for doing service, but I would really question if you'd be a good resident, and if I (and your future co-residents) could depend on you.

Also, many program directors may very well question your story, and wonder if you just didn't get into the specialty you applied the first time around, and then failed to SOAP. Because your explanation just won't make sense to them, as it doesn't to most attendings here. Even if you have test great scores/grades, it'll be a case of "something just doesn't add up here." That's not something you want a prospective boss to be thinking.

If you just can't scratch the itch, do what you feel you have to do. Just understand it may mean sacrificing your medical career as others pointed out. If you're ok with that, go for it.

Otherwise, consider somehow incorporating service into you medical practice. Or just wait until finishing residency to do your service (though future employers will still see a long break as a red flag), or better yet, take time off during medical school via sabbatical. The latter is probably the best rout for you to take if your totally determined to do this one way or the other.

We all have made (or will make) lots of sacrifices in life. It's a normal part of being human and not unique to medicine, though we certainly sacrifice quite a bit in this field. I was all set to work as a backcountry ranger in my favorite national park. Everything was set up. It was going to be great. Then I met my wife and at the same time I also decided to go to med school. Technically I could've deferred starting my post-back work by another year. However, deferring a first date probably wouldn't have worked all that well...

 

[bears1992]

It sounds like you are getting upset because you aren’t getting the answer you want. I only know of one person who had a gap between residency and medical school. He was a Caribbean grad who taught anatomy at my school instead of pursing residency. He applied the past two years, didn’t get in anywhere so he’s doing a transitional year.

 

[LunaOri]

It's possible to take a year off after M1 or M2, but increasingly difficult after that, until you actually finish residency and become an attending.
One of my medical school classmates who is now in academic Family Medicine spends 6 months each year in the US and 6 months in Africa.

 

[HuskyMD Emeritus]

The longer you are out of medical school, the less likely you will match. Program directors will think you failed to match in the past, and therefore not want you in their programs. Many programs, especially surgery, have time limits between graduation and residency.
Over the years, when I screen CVs of potential associates for my department, I look at their prior work experiences and careers. Those with "interesting" experiences tend to not demonstrate commitment. Program directors and ultimately the medical group you want to work for, are looking not just for a good doctor, but one with commitment to the specialty and group.
If you are truly committed to a medical career, finish your training first.

 

[IMGASMD]

Wow. This thread just won’t die.
I’ve prepared this a week ago, hoping I don’t have to post it. But here it is.

——————————

Why are you all indulging in this unrealistic fantasy?

If you’re just MS1, then get out.
If you’re barely MS2, then get out.
If you’re hopefully not MS3, with probably over 6 figure loans, then you have a tough choice on your hand.
If you’re MS4, why don’t you try it out and check in with us in 2 years.

It’s stupid and irresponsible, wasting your time and everyone else’s effort. I really hope you’re a troll.

 

[Dave1980]

Okay I do understand that, but you also have to understand that this isn't just some random expedition or some random vacation. No.

It's something that would genuinely make me happy, an experience that I really want to have in my life. It's hard to put into words the exact feeling.

How do you function as a medical student with such poor executive function? You did a bad job planning your career arc and need better self-control if you feel like you need this experience ASAP and can't wait until after residency. I hope you are a troll.

 

[Eye-eye]

Okay I do understand that, but you also have to understand that this isn't just some random expedition or some random vacation. No.

It's something that would genuinely make me happy, an experience that I really want to have in my life. It's hard to put into words the exact feeling.

Dude, I ****ing get it. I really, really do, and tried to show in my last post how much I feel that I've been in your shoes. And your feeling that you need to do this may lead you to say "**** it, I'm doing this ****" regardless. That's your prerogative. But seriously, stop trying to get people on here to agree with you that it makes any sense. It just doesn't, from an objective perspective; subjectively, if you still feel it's worth risking your future, go for it. But I can basically guarantee you'll regret it come residency application season. And while others have stated you can do it during med school, if your gap your is teaching English, I'd be willing to bet my (large) med school loans that the vast majority of PDs are going to see it as you ****ing around for a year, not as meaningful service - if you want that, you can do what one of my classmates did and go build a hospital in the middle of nowhere in a third world country; that sort of thing could actually help you. But you can't take a gap year and have nothing to show for it, and you definitely can't take a gap year to do something nonmedical, and expect things to just work themselves out.

If you have to do it, just go do it and damn the consequences. We're not going to agree with you that it's a good idea, so I'd stop trying to make us understand. Your answers sound immature; you come for advice as to if something is reasonable and when everyone says "NO!!!" your responses are basically "you don't get it. I really want to." As incredulous as it may seem, many or most of us have been in your shoes at some point in our lives; we just either had the luxury of doing the impulsive thing when it didn't matter yet (premed) or shrugged it off and said, "you know, it can wait. I need to make sure my future is secure first. Any maybe I won't be able to do it all in the end, and that sucks, but you know what? That's life - I can't have my cake and eat it too, and sometimes I have to make hard choices." PDs are going to see this just as we do, as poor judgment and an indication that on a whim you may well throw away what others spend blood, sweat, and tears working for just to (in many cases) never get the opportunities you've had. Why would they risk you deciding mid-PGY1 that you don't love the 80-h work weeks and dropping out to go teach English for the rest of your life? It's going to look like you're not committed to medicine, immature, and a flake. They have thousands of other candidates knocking on the door without those red flags.

Sorry to be harsh. I've tried to tell you gently, because I do empathize, and I've been there. But you're still not hearing us, and it does concern me and make me worry about your maturity if you still are fine with risking throwing away your career for this. And before you **** yourself over, I want you to hear the real talk we're trying to give you: you are ****ing yourself over and will very likely regret this if you do it. Now stop trying to find validation on a website and go do some soul-searching as to if this is really still worth it.

 

[avatarftw]

A

 

[BidingMyTime]

You are highly educated. You will do the world far more good by finishing your residency, then joining Doctors Without Borders or a similar type of oversees medical work, then you would by chucking your education to teach English. I'm not a doctor, but I get that starting a residency, just like any major commitment, is scary. But you are in a position where you can do the hard thing and make a great positive impact, you will be glad in the future that you did so.