Women Leaving Medicine

[This is a guest post]

I am a family physician with sports medicine fellowship training, but I am currently working in occupational medicine because it was the only work I could find. It’s not because I’m a bad doctor (I don’t think…), it’s because I’m an Army wife. Since I finished residency four years ago, the Army has moved us three times. Even with the shortage of family practitioners, no one wants to hire me if I can’t commit to at least two years. So I’ve done what I can to keep my resume from having huge gaps. 

Two years ago my daughter and I moved to live with family while my husband deployed to Afghanistan. I volunteered at a faith based clinic because we were in a city that seemed to have an excess of doctors (and therefore no jobs). The volunteering turned into maternity cover and then job sharing, which was great, and allowed me to work part-time and thus keep my daughter from having both parents miss a year of her life.

When my husband got back, we moved and I started working in an occupational medicine clinic, also part-time, which I appreciated so I could once again not be outsourcing all my child care! After I had my second child about three months ago, I started looking for another job. I applied for a full time family practice locum job that came up through a recruiting agency. The message came back that the clinic felt that I perhaps didn’t have enough family practice experience.  And guess who the employer was? The Army!!  The very organization whose fault it is that I can’t get enough experience! I was equal parts angry and defeated.

Other recruiters have confirmed that if I don’t get family practice jobs soon and lose my pediatrics experience, I may have trouble getting hired in family practice. Because I’m not getting enough exposure to children? Like the two I’m raising?

So I’m wondering what to do now. I am going back to my occupational medicine job for a while, but I’m wondering if I need to take another tack.

Would I be more likely to get  a job if I got an MPH and moved into a less clinical track? I don’t think I’ll be able to get hired in sports medicine anymore, it’s been two years since fellowship and I haven’t worked in a single sports med clinic. And it seems the family practice option is not turning out to be as in demand as I thought. There has got to be another way.

I know the economy is bad and employers feel they have the upper hand, but if we’re so short on docs these days, how about some creative solutions so those of us with this expensive training can contribute to the solution?

[This is a guest post]

I am currently a resident in pathology, a field that requires fellowship training to find a job. The fellowships aren’t regulated by a match process so usually people will sign on for one two years before they finish residency. I signed a contract while 7 months pregnant for a competitive two year fellowship at my own institution. My husband is in surgery residency at the same place so it made the most sense. He is currently on research for a year so it made sense to have a child while he actually had free time. Now that our child is a few months old, the reality of being in a demanding fellowship while my husband is back in his clinical years is setting in. I have no desire to miss out on the next three years of my child’s life and don’t really think I want to continue to work given my husband cannot serve as a support person. Rather he needs me to serve as a support system due to surgery having much more demanding hours. I will finish out my residency but would like to get out of the fellowship but am not sure about how to gracefully do that since I am screwing over my own training program (if I can get out of my contract- is that even possible?). Does anyone have any experience with this/suggestions?

[This is a guest post]

I was referred to your blog by a friend who just finished her residency in anesthesiology. I’ve wanted to be an Ob/Gyn like Dr Huxtible from the Cosby Show all my life. I studied nursing as a pre-med degree and was about to go back from my pre-reqs when I got married (3 months after graduating). I took my first year of marriage off and after seeing the lives of the physicians I worked with I decided to not pursue medicine at the time. I am 31 currently and have 3 young kids (ages 3-6) and I am struggling with resentment towards them and my husband. I feel I gave up on my dreams for them. I feel like I am not living up to my fullest potential as I am passionate about the medical field and feel nursing isn’t what I envisioned for myself. Sometimes I wander if my angry outbursts and verbal abuse at times towards my kids is a result of my forsaken dreams. Am I sabotaging the sacrifice I made by scarring my kids as an angry, unhappy mother?

 I fortunately or unfortunately have a few pre-med friends who are almost finished with residency. They are adamant that I have a romanticized view of medicine even as a nurse and should pursue advanced practice nursing as a nurse midwife. My struggle is will this be a waste of time and be a detour in achieving my ultimate goal? Should I pursue my dream of being a doctor or take advice from those who have gone through it?

I read the posts on your blog and wonder if that will be me at the end if I decided to become a physician. Will I regret not being there for my kids now and when they are teenagers since I am looking at the next 9-11 years devoted to achieving this goal? What if I loose it all because I was selfish and pursued my dream? Could I wait till my kids were older and then went back to pursue medicine? When is the best time to go back?

Please advise if you can. I am currently working on receiving counseling to deal with my anger. Thanks!

[this is a guest post]

I have one year of dermatology residency, however, I took a one year leave of absence due to my daughter’s medical condition. I don’t think I will be able to return in July as she requires a lot of my resources. I may have to leave residency altogether and re-apply at a later date realizing the match gets harder each year. I’m wondering if there is any work I can do on a per diem basis in order to help my husband pay the bills? We can’t afford to stay in our current apartment on one income. I’m thinking maybe along the lines of a medical spa but I have no idea of what position I would be qualified for without having to go to esthetics school. Just curious about positions out there that look favorable on “some” MD experience. I have almost $300K in school loans so this is a really hard decision but my daughter needs me and I have no family support.

Hi, i recently graduated from medical school, and right now doing an internship in family medicine for 1 year. Im 24 years old and i feel like ive done it all wrong. Im sad all the time because eventho the internship is not going bad at all, i dont feel thats what my heart wants. I feel empty.

Ive read some posts in this page, and i feel like i still have time to go in a different path, but it makes me feel so sad to think that i made a wrong choice 6 years ago, and all that effort was for nothing.

I should be thinking on residency but i hate that idea, i hate it. Unlike most of you i didnt use loans. I live in the caribbean, so universities here are not too expensive. My parents payed it, and evento i dont have to work to give them the money back, as i would if i had taken loans, they will be very dissapointed of me.

Im sad, and ive thought of the worst things.. I dont want to feel like this anymore.

[This is a guest post]

I’m currently on a personal leave from a combined residency program. My daughter is almost 1 year old. I really don’t want to go back to residency but I really don’t want to return to internal medicine. I was miserable. How can I address this with my program directors? I’m afraid of being ostracized by the entire medical community (I know this is an exaggeration but this is how I feel on some level). But I don’t want to “just push through” because I want to be mentally sound for daughter’s sake. I don’t want her to see mommy miserable since she will look up to me as a female role model. Deep down I really do enjoy being a mom and sometimes I don’t feel guilty or miss work at all. I feel like I “should” go back so I can someday pay back my $200k loans. And because the economy is so poor I also feel like I “should” go back. Is there any thing else I might be happier doing? My daughter has acid reflux and food allergies- I don’t know if I will ever feel comfortable with any other caretaker with her. She’s a beautiful little girl, vibrant when she is feeling well. I feel ashamed to say this but I applied to a combined program because I was afraid I wouldn’t get into the stand alone residency. I hate internal medicine so much that I don’t plan on sitting for the boards. I wish I made a better choice in medical school.

[This is a guest post]

I am in my last year of residency and just delivered I am so busy with the lo and developed postpartum depression I was given extra time off but I am thinking of quitting as I am happier being with my child than at work. My psychiatrist recommend if I can take few yrs off and return later to finish my third year of residency is that possible?!?! I do want to practice medicine but now I want to spend time with my child, I started anti-dep meds but not helping me with my separation anxiety!!

[This is a guest post]

Good day all the lovely ladies!

I came across this blog about 2 years ago when I seriously contemplated leaving my residency. It was tremendously helpful to me that I wasn’t the only one.

Let me back it up. I am a Chinese Canadian who pretty much grew up in Canada and thinks like a Canadian with really traditional Asian parents. I partied way too much in my first year university and lost my FULL scholarship which included my food and housing. My mom won’t let it go, so to spite her I worked so very hard and got into medical school. Now in my 11th year of undergrad + post grad education I am finally realizing the joke was on me.

Last year about 6 months into my residency in family medicine (it’s only 2 years in Canada), I just couldn’t do it. I cried everyday going to work. I loved Saturdays and hated Mondays. I was scared of all the chest pains and SOB when I was on call. Finally I freaked out one day and called my program director. I was crying so hard she couldn’t make out my name. That’s when I took 3 months off. The first 2 months I got started to Celexa, counselling, basically the kiddie glove treatment. I was convinced that this wasn’t for me and instead I ran off to Honduras out of the blue to become a scuba diving instructor. I had always loved traveling and during medical school I did electives in Kingston, Jamaica, Haiti after the quake (crazy times), and Shanghai. Honduras was sketchy safety wise and tons of cheap drugs which I indulged in a few. I realized 2 weeks into my trip that perspective and a break was what I needed. The perspective I gained from the Honduras experience was that medicine is effing hard, but you pay your dues and it gets way better. Plust I only had 1.5 years to go, so I gritted my teeth and went back. Now I only have 7 months left. I am loving what I get to do. I have my bad days and weeks, but overall the celexa helped and the break absolutely gave the energy I needed to keep on going.

I keep on hearing about the USA and how much debt you all have, and how that’s taking away your choices etc. I just want to explain the Canadian system from an insider perspective.

1) medical school: my tuition in 2007 -2011, total of four years was 40,000$ CAD. Plus living expenses/books etc, comes out to 90,000$CAD. In Canada student loans are different. I didn’t have to pay interest until residency and they even forgave 25% of it. Now my debt is about 50,000$. My parents have helped a lil and residency also pays about 58,000$ per year. So When I graduate the debt is really no big deal.

2) Medical system: we are a free public healthcare. It’s true there are wait lines for surgeries and MRI scans. But I don’t really deal with insurance companies at all. I spend about 1 min per patient on billing, 2 min if it’s really complicated. Pts never pay me directly, i bill the government. All of the physician earnings are public and are published online x 10 years. My preceptor who is the greatest family doctor in the area works about 50 hr weeks, with a big call group, does deliveries and sees pts in hospital. He has about 1000 pts in the community and billed 370,000$ CAD last year. Mind you that’s before expenses and taxes. He has a big family but they live very very comfortably.

Lifestyle in Canada is pretty amazing too. I live close to Vancouver and I can kayak, hike, mountain bike, scuba dive, ski/snowboard all within a 2 hr drive in winter or summer. And shopping in seattle is only 2 hrs away.

Anyways my point is:

1) if you want to quit, don’t. Take a break, become yourself again, if that means going on meds, then so be it. make a decision when you are not depressed and stressed.

2) your local area/country isn’t the only place where you can practise medicine. The world is big, and the need is great. Go travel and find a place that fits you and rewards you!

my facebook is Wen Shuang N if you wanna chit chat one on one!

Disclaimed: I am not a recruiter!!

Hugs,

Wenshuang

[This is a guest post]

I’m currently on a personal leave from a combined residency program. My daughter is almost 1 year old. I really don’t want to go back to residency but I really don’t want to return to internal medicine. I was miserable. How can I address this with my program directors? I’m afraid of being ostracized by the entire medical community (I know this is an exaggeration but this is how I feel on some level). But I don’t want to “just push through” because I want to be mentally sound for daughter’s sake. Deep down I really do enjoy being a mom and sometimes I don’t feel guilty or miss work at all. I feel like I “should” go back so I can someday pay back my $200k loans. And because the economy is so poor I also feel like I “should” go back. Is there any thing else I might be happier doing? My daughter has acid reflux and food allergies- I don’t know if I will ever feel comfortable with any other caretaker with her.

[This is a guest post]

“I am an internal medicine intern who started my residency 4 months ago. I realize that this post may sound like the grumbling of a new intern who is overwhelmed by the terrible tribulations of residency, and perhaps it is just that, but I can’t stop thinking about the idea of quitting. I graduated from an Ivy league college and have always strived to accomplish great things with my career and join the ranks of prestigious professionals who have a long list of accomplishments too long to fit in their 5 page CV. I yearned for that career recognition, and that was what ultimately drove me to go to medical school. 

But it medical school, things changed. My clinical years were terrible for the perfectionist me. I’d measure my self worth by the amount of positive feedbacks I’d get, and would deprecate myself for the smallest things that I did wrong. I’ve never been the most articulate person previous to this, so as you can imagine, round presentations and calling consultants were certainly not my forte, which contributed to more self blame. But I gritted my teeth and toughed it out, telling myself that once I’m an attending, things will change. I didn’t find any specialty that I absolutely loved,  so in the end, I opted for Internal Medicine by default, partly because it gave me more time to decide, and partly because I was couples matching with my boyfriend (who is now my fiance). 

And now here we are, a few months into my residency, and I found myself desperately having second thoughts about my career choice. I liken the field of medicine to gambling - once you’re losing, it becomes so hard to cut your losses and go, so you keep sitting at the table hoping to win back your losses. First it was college, that you’ve already taken organic chemistry class so you might as well continue….then it’s because you don’t want to waste your MCAT score…then it’s because of medical school tuition, you’ve already paid and studied so hard, why not walk away with an MD degree? and now, I realize that an MD without residency is useless…as I so frustratingly found ZERO jobs on monsters.com or craigslist (it seems so sad that I’m even looking on these websites in the first place). And now in residency, the gambler mentality is telling me to stay, because I’ve come “this far already”, why not complete your training? and then there’s fellowship, etc. etc. etc. 

My desire to quit isn’t really motivated by family matters. My fiance and I have a very healthy and happy relationship (*knock on wood*) in residency, and I don’t think I want to have any children in the near future. I don’t know if I want to quit so badly because I just don’t find fulfillment in the medical career, or because I feel so inadequate right now and am terrified that I’m going to be a terrible resident, or I just have too high of an expectation from what a great career should be, or that I’m so terrified of failing. And I don’t know how I’ll ever discern the true reason, and I don’t know what else I could do if I weren’t going to be a doctor. The idea of finances or creative ventures such as writing doesn’t appeal to me very much, and what I truly love doing is traveling abroad, but I guess I can’t exactly make a living out of that…

Basically, for those of you who were kind and patient enough to read this far in my ridiculous rambling, I’m just very confused and would LOVE to hear any advice or comments that you may have…seriously, ANY advice would be so greatly appreciated!!!”