This is an interview with the founder of a website that helps residents who are thinking of quitting their medical training.
A while back, I wrote a post about a surgery resident that I mentored during the early years of her residency. After almost a year of training, I was surprised to hear that she’d decided to quit residency training and leave medicine. I wrote about this decision and her options afterwards (which I felt were pretty good).
The posts about on this topic must have touched a nerve, because they’re some of the most frequently read posts on my blog. It turns out, medical residency training is pretty hard, and many people think about quitting at some point in their training.
Residency training is hard
My six years of surgical training were some of the hardest years of my life. The “grit it and bear it” culture of medical training in the US makes it tough for me to write that sentence, even now, but it’s true.
The sheer level of work in residency and the life or death stakes makes for an incredibly stressful experience. In many programs, the startling lack of collegiality and support makes this even worse. I ended up sticking it out and now I generally like what I do as an attending surgeon.
But not everyone is so lucky. Some people decide during residency training that it’s really not for them. What are these people to do? The vast majority will stay put because of their student debt.
For those that do seriously decide to quit residency, though, there’s now some resources out there.
I’d like to introduce the mind behind ShouldIQuitResidency.com.
The following interview is paraphrased for clarity and brevity. We have no financial relationship, and for now, this physician is anonymous.
Who are you?
I’m a 33 year old ex-PGY2 in pediatrics. I quit residency in Spring 2021. In early 2021, I had an especially rough week at work which pushed me into an acute state of burnout, anxiety, and insomnia. This rendered me unable to function as a resident.
My program and I decided it would be best for me to take a leave of absence. The primary goal of the leave was to get better, and the secondary goal was to get some space from work so that I wasn’t answering the question “should I quit residency?” while in the throes of training.
After a few months of reading, meditating, walks, chats, and most importantly NOT working, I came to the conclusion that medicine wasn’t for me. More specifically, I realized that the cost of becoming an attending greatly outweighed my desire to practice medicine.
So I resigned from residency. Since then, I got my medical license (Virginia only requires one year of residency), started working as an MD consultant in a COVID testing company, and was able to discontinue all treatment for anxiety and insomnia.
While this job is temporary, I’m able to make more money while working MUCH less than I was in residency, so I have plenty of time to pursue passion projects. I plan to give myself a year to explore these passions before I start looking for a more traditional, stable job.
What else did you realize?
I’ve always had multiple interests, most of which involved both creative and analytical thinking. For example, prior to training, I enjoyed music, website creation, and software development.
When I chose to pursue medicine in 2012, I didn’t fully grasp that I would have to give up that part of myself. I’m sure it’s possible, but during residency, I definitely wasn’t capable of maintaining my outside interests.
I realized that for some of us, walking away from residency is the right choice. I realized that people grow and change, and it’s okay to take some time to question your decision to pursue medicine.
Who do you hope to serve?
I started my website to provide the resources I wish I had when I was considering quitting residency. The goal of the website is to help residents answer the question “should I quit residency?”
When I was trying to answer the question, I turned to the internet for help because I didn’t know anyone with experience in that area. But the resources were scattered, some were only partially relevant, and none really guided me through the process from beginning to end.
So my site provides a few things:
- a curated list of helpful resources
- a guide on how to begin tackling the question “should I quit residency?”
- how to proceed if you answer “yes”
- a more detailed account of my story to help remove the taboo from quitting and demonstrate that it is possible to quit and be happy.
With feedback, I hope to adapt the website to residents’ needs.
What is the problem with residency education today?
There is a problem with the blanket statement that “more work hours = more experience/learning = better doctors.” Of course this is true to a degree, but it has so many flaws.
First of all, increased work hours does NOT equate to an increase in learning when a huge proportion of those hours is spent doing scutwork. Second of all, at some point you get diminishing returns….
Also, this argument completely ignores resident well-being. Physicians have higher rates of suicide, depression, divorce, and substance abuse than the general population. These are literally occupational hazards that are preventable or at LEAST able to be mitigated.
How hypocritical can the system be that it promotes well-being of patients but completely ignores the well-being of its own workforce?
Finally, the current system is the perfect setup for exploitation of its workforce. “You’re tired after your 28-hour shift?? But you got all that valuable experience! You should be thanking us for this privilege!” Or “You’re a hero! You can do anything!”
Residents have basically no recourse for this type of exploitation.
How hypocritical can the system be that it promotes well-being of patients but completely ignores the well-being of its own workforce?ShouldIQuitResidency.com
What is the solution?
This is a problem with the system. Not with any individual. I don’t know how anyone can say with a straight face that medical students are now all of a sudden not “resilient” enough to handle residency. By getting into a residency program, they’ve proven their resilience. This notion is illogical, insulting, and frankly pretty dumb.
What’s the solution? We fix the system.
To be honest, I don’t know what concrete legal or political steps can be taken. But I’d love to learn. And I strongly believe that the simplest solution that will probably have the biggest positive effect is…wait for it…lowering work hours.
Just lower the freaking work hours. No more lectures, no questionnaires, no discussions. Residents are overworked. You solve that by lowering work hours. There are other more nuanced discussions that are important as well, but their importance might decrease if we first fix the work hour problem.
I want to clear a few things up. First of all, I don’t think everyone should quit medicine. But I do think it’s the right move for a select few. You can’t really know what medicine is like until you do it. If after spending a significant amount of time reflecting, you genuinely believe it’s not for you, then it’s ok to quit.
If you’re worried about your well-being or are having suicidal ideations, you should not be scared to immediately get help, possibly take a leave of absence, and determine whether or not it’s worth continuing.
Second, I don’t hate medicine itself. I am so grateful that most people graduate from medical training and become attendings. We need great doctors. There are aspects of medicine that I will miss greatly. But, like any other field, it’s constantly evolving and is not immune to the effects of the economic and sociopolitical environment at large.
In some ways it changes for the better, some for the worse. I think it’s core purpose, maintaining health and treating disease, has been lost as it becomes increasingly commercialized. We need to change its structure so that its core purpose can become its top priority once again. That is a gigantic problem to solve. But keeping physicians healthy seems like a good place to start.
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