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My Hiatus from Medicine: 3 Eye-Opening Revelations

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Today I reveal the eye-opening revelations I had about burnout and growth after taking a 5 month hiatus from practicing medicine.

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The resignation

In mid-September 2022, I resigned from the urology job that I’d held for 6 years. 

It was the only job that I’d known since I graduated residency in 2016.  After deciding against fellowship training, I went straight into practice after residency so I could finally start to support my family and parents. 

I took an employed position in a large urology group in Southern California.  In many ways, it was a great job, but it also became increasingly apparent over those years that it wasn’t the perfect fit for the long term.  

The job

My first mental whispers of concern came just a couple of years into my employment.  I’d achieved most of my early priorities with startling speed.  After just a couple of years, I was a skilled surgeon with a low complication rate and high patient satisfaction.  I was respected by my peers and already dabbling in various leadership roles that later transitioned into an appointment as chief of my department.  

When it came to finances, I was finally able to relax.  Despite the high cost of living in SoCal and my family’s startling annual spend rate, we were able to save about 30% of my family’s substantial dual income.  As the stock market boomed, our investments started to pick up momentum.  As I saw the balances rise month after month, the tension from my childhood of financial scarcity finally started to recede.

Read more: The Darwinian Doctor’s 13 Monthly Expenditures (with real numbers)

Something missing

But as I wrote about here in the early days of the blog, I wasn’t satisfied.  I felt like something was missing.  I needed new goals and new creative outlets and just wasn’t getting this from my medical career.

So I started this blog and explored first the world of personal finance, financial independence, and real estate investment.  

My love affair with real estate investment is still going strong, and is best documented in my quarterly “Anno Darwinii” posts.  These show the growth of the real estate portfolio that is rapidly becoming a strong source of passive income.  

Read more: Anno Darwinii Archives

The opportunity

Despite the positive work I was able to do as chief of my department, the frustrations I had as an employee remained.  Despite what I saw as pretty clear cut ways to improve the day to day situation of my department, the pace of changes seemed glacial.  I found myself making the same pleas for resources every quarter, only to be told that there was no way to get to my desired outcome.  My sense of burnout that had started in year two only increased through the pandemic.  I innately knew that it was going to take a drastic change to improve the status quo.

So when my wife got the job opportunity of a lifetime in Memphis, TN, it was surprisingly easy for me to agree to the move.  Within 8 weeks, we’d both resigned our jobs and started a new life in the Mid-South.  

Read more: Your Mom Is a Badass | Letters to My Sons

The 5 month hiatus

When I made the move, though, I didn’t realize that I was going to experience a 5 month long hiatus from medicine!  Despite very positive early negotiations with the urology groups in town, we eventually decided it wasn’t a great fit.  It took a few months to get to this point, after which I decided to pursue locum tenens urology.  

By the time I was ready to start my first traveling urology gig, about 5 months had elapsed. This was the longest stretch of time away from education or medicine since I applied to medical school!  

During this 5 month hiatus from medicine, I came to 3 eye opening revelations.  

#1 – Burnout can be cured in 2 months

The sense of freedom and relief after I quit my job was immense.  I desperately needed a break to recover from my burnout, so even the financial risks we faced were secondary.  Of course, it helped that we’d prepared well for a career move like this.  

But I really did need a change.  This wasn’t some temporary job stress that could be cured by a weekend getaway.  This was an insidious slow burn that had me teetering on the edge of frank burnout for years.  I often got pushed over the edge by a difficult patient or stubborn administrative issue, only to claw my way back to status quo through necessity or force of will.  

But after I quit, the speed of my recovery surprised me.  After only two months free from the stress of the day to day grind, I felt refreshed.  It was different from the refreshment you can get after a week off at the beach.  That relief is so temporary that it starts fading even before you get home.  That’s why the last few days of vacation are always tinged with dread.  

The relief I got after two months off straight was qualitatively different – somehow more complete and longer lasting.  While everyone is different, after my hiatus from medicine, the first of three revelations is that it takes me about two months to recover from burnout.

#2 – I still want to practice medicine 

After my burnout receded and the weeks continued to slip by, I realized something else:  I still want to practice medicine.  I missed meeting new patients in the clinic with issues that required my expertise.  I missed the social stimulation of having a team of nurses and colleagues.  And most of all, I missed the rush of the operating room.

As far as satisfying experiences go, there’s very little out there that can match surgery.  To start with a problem and solve it via a couple of hours in the OR is immensely rewarding.  And to later see the patient in the clinic, healed up and grateful, is the cherry on top.

So that’s the second of three revelations after my five month hiatus from medicine. I still like practicing medicine! This was a great realization. It means that all the years I spent training to become a urologic surgeon weren’t in vain.  I can still give back to the world via medicine and hope it will always be a part of my life in some form or another. 

#3 – I crave growth

The final revelation after my hiatus from medicine was that I crave continual evolution and growth.  

During the first few months of my hiatus, I spent the majority of my time managing our move, supervising our home renovation, and working on my blog and social media.  

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Although these tasks all took up plenty of time, I eventually realized that I was missing something.  I was missing the sense of accomplishment and growth I get from building our real estate empire.  Given the high relocation costs and interruption in my income, we’d decided to temporarily put a stop to new acquisitions.  

But in the months surrounding my hiatus from medicine, I just didn’t feel the same sense of continual progress anymore.  As I gradually detected my discontent, I learned that I need a sense of growth to be happy.  

Give me growth!

In fact, I think what I found most stifling in my previous job was that I didn’t see a reasonable path for continued growth.  I felt static in my clinical growth, with the only possible avenue for growth existing via the administrative route.  This didn’t seem appealing to me.  

Don’t get me wrong, I also get a sense of growth from this blog.  But either due to lack of skill, vision, or both, it’s been a fairly slow process.  Our real estate business has offered a much faster sense of growth with a more rapid return on my investment. 

So now, I realize that I do want my real estate business to grow bigger.  To make this vision a reality, I hired our first team member last month to formalize the business underpinnings of our company.  Now, with our bookkeeping, bank accounts, and legal aspects falling into line, it’s time for some more exponential growth!

Conclusion

There’s nothing like a hiatus from medicine to give you the mental space to make some serious revelations about yourself.  In my time off, I realized three things:

  1. Burnout is curable
  2. I still want to practice medicine
  3. I need a sense of continued growth to be happy

I’m very grateful for the time off, as I think it can be very difficult to reflect on your life when your every waking minute is dominated by work or family responsibilities.  

Since my hiatus, I’m back practicing medicine as a locum tenens urologist.  This allows me to bring my skills to where it’s needed the most, while still maintaining maximal freedom to work on business growth.  

There’s a lot left to say about the world of locum tenens and our plans for real estate growth, so stay tuned!

– The Darwinian Doctor


Have you ever taken an extended time off from work? Did you come to any revelations of your own? Let me know in the comments below, and please subscribe to the newsletter!

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10 comments

Doug Brockman April 15, 2023 - 7:33 pm

i found quitting and pursuing pickleball travelling reading and good food was all i needed not to go back to work again

Reply
The Darwinian Doctor April 17, 2023 - 8:29 am

I’m going to start playing pickleball this year! I’m a squash player at heart, but I think pickleball is going to be incredibly fun.

Reply
Wayne Warrington April 16, 2023 - 7:48 am

I felt the burn years ago. PGY20 here and full time EM. I resigned from one of the last EM groups in Hawaii in October 2021 and bought a new sailboat in Florida. I thought I would never look back if I could keep my finances in order, but 6 months in I started to miss it as well. I was shocked. I picked up some shifts at a facilitiy that I have worked as a locum for years but it had been almost 1 year between my last ER shift. I was told by a colleague that had I gone past two years out of the ED I might not be able to get med mal insurance. He had a colleague who did and has been banished to urgicare or worse. With no pathway back. I was wondering if you know or had considered this when you took your break. My older brother is a pilot, lives in Memphis actually, and if they got more that 6 weeks without flying they have to go back to modified flight school. But at least they have a pathway to get back on board. Us physicians usually just work until we drop or permanently retire.

Reply
The Darwinian Doctor April 17, 2023 - 8:31 am

I’ve definitely worried about this, and it’s something I’m considering now as I craft my return to medicine. In addition to call coverage, I’m likely going to transition to clinic and OR coverage as well to make sure I keep my skills sharp and my case logs respectable.

I’m wary of fully burning bridges, and I’m glad you’re also keeping that path back alive. Life changes, after all.

Congratulations on your new life, though. I’m sure it took a lot of courage to make that change.

Reply
Chris May 2, 2023 - 8:50 am

I apologize for the criticism, but being burned out after 6 years of work is weak sauce. Try working in a busy ER for 17 years. Then we can talk about burn out. When I am feeling stressed and close to burn out, I put my life into perspective by envisioning what life is like for those scraping by for survival in a favela or small village in Africa. That seems to slap my pity party into oblivion fairly quickly. if we are practicing medicine in the USofA we are blessed and some of the most privileged people in the history of this world.

Reply
The Darwinian Doctor May 4, 2023 - 7:45 pm

Thanks for the honest feedback. I sincerely appreciate that you took the time to write this. Doctors are so fortunate in so many ways.

However.

I think it’s possible to acknowledge that we are very fortunate to live in the United States, while still feeling unhappy, unsatisfied, or burnt out. What you are describing is utilizing the practice of gratitude, which is a very powerful way to find contentment in the status quo. I believe in this practice and agree it’s very effective to put things into perspective.

But an equally powerful realization is the knowledge that your tolerance for burnout or dissatisfaction might be different from another’s. That’s why I don’t judge when I hear that others are depressed or unhappy with their situation. Despite their outward signs of success and contentment, who knows what’s going on internally? Also dangerous is the temptation to compare your suffering to another’s and attempt to judge this comparison objectively. It’s an exercise in futility.

Reply
Chris May 7, 2023 - 4:41 pm

You are correct. I was being an insensitive hardo and should have dialed down the caffeine. Mea culpa.

Reply
The Darwinian Doctor May 8, 2023 - 6:49 am

Thanks Chris, it’s a good conversation to have and I’m glad we had it!

Reply
AJ Jones August 9, 2023 - 6:22 am

I find revelation # 3 interesting. When i graduated residency the idea that “this is it” hit me like truck. There were no morning reports to prep for, no moving on to the next pgy year, no next rotation to look forward towards. I was almost ready to go back to doing a fellowship in literally anything just to get that sense of growth.

Reply
The Darwinian Doctor August 9, 2023 - 10:49 am

It’s a sobering realization, isn’t it? I’ve since found growth in other areas outside of medicine. I’m not saying it’s not possible within medicine, but for me, I like the multidimensionality of having outside pursuits.

I hope you’ve also found the growth you were looking for!

Reply

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Dr. Daniel Shin

Dr. Daniel Shin

I’m Dr. Daniel Shin, a surgeon, investor, and educator on a mission to fast-track your financial freedom. From a $300,000 debt to a diverse investment portfolio, I’m now just years away from financial independence. Ready to join me on this journey? Let’s go!

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