Thursday, March 25, 2010

Why Would You Quit?

I have met several women who have completed residency and maybe even practiced beyond that, but decide to quit and stay at home with kids. I wonder - why would a woman who has gone through all of that training just quit? It would seem like the hard part is behind them and I am perplexed by their decision but of course, I don't want to be so rude as to ask that question to them.

A lawyer and mother of two in Seattle.

I am going to try to tackle this question, even though it is not my current personal experience or decision. I actually went through residency with a woman who did this very thing. She went through medical school, a strenuous Ob/Gyn residency, and then worked in private practice for a couple of years. She was married to another physician who eventually completed an interventional radiology fellowship. During residency, she had two children, and then had a third when she was out in private practice. Once her husband finished his training, she quit practice to be a mother full-time. When people would ask her why, her answer was simple..."because I want to, and financially, we can do this, so why not?"

I know she loved her career, and she was a very skilled, caring, and compassionate physician, but she just wanted that time with her family more, and they were in a position to swing it. She didn't think of her choice as "quitting medicine," she viewed it as choosing her family. It is no different than the other career women (lawyers, executives, teachers, bankers) who make the very same choice. She always planned to return to a GYN-only practice once her children were school aged, and she became board-certified, and kept up with the field via conferences and CME (she had lots more time to read!!) I have since lost touch with her, but I have no doubt that she was very happy with her choice. While most physician-mothers are not as extreme, I see varying degrees of women choosing "lifestyle" specialties or different levels of "part-time" practice after residency.

Even though medicine does require more rigorous training than most careers, it does not necessarily change the way you feel about how your family life should be structured. There have been many times that I have considered cutting back practice hours, myself, in order to enjoy more family (and me!) time. I recently made a move that enabled me to still work full-time, but greatly reduced my time on-call, and therefore, my time away from my family. Currently, I am the bread-winner, and I still have some student loan debt that needs to be paid, so up and quitting is not a viable option for me. However, if I am able to become a partner in my current practice, reduce my in-office time, and still manage a decent living, then I will likely choose that path. There many different ways of finding a work and home balance for women today, and I am thankful that we have the ability to "choose medicine" and we can also "quit medicine" if this is the best thing for us and for our families.


  1. Although he's not a mother in medicine (does father count?), my husband is an example of this. He and I met in med school. We were lucky enough to match in the same city for residency; he in family medicine, me in neurosurgery. He went through 3 years of residency and then became faculty at his residency program for 3 more years while he waited for me to get done. We then moved back to our home state, where he spent 5 years as a private practitioner.

    After all that, he finally admitted that he dreaded going to work every day. It wasn't the patients - he enjoyed patient care - but it was the administrative stuff that he hated. The finances of a primary care office are difficult at best. He and his partners had vastly different priorities and personalities. There are always personnel issues and paperwork to deal with.

    After agonizing for 6 months, he decided to quit. He could have gone to another practice, but he was afraid it might have been the same thing all over again. Full time hospital work did not appeal to him. A frank assessment of his career up to that point showed him that teaching the residents for that 3 years was really what he loved the most.

    So, when a job offer came along for him to teach biology, anatomy and physiology to college students, he jumped at the chance. 3 years later, he's happy as a clam despite a 45-min commute one way to work. He advises the premed students and leads the Tri-Beta program. He won the college's most prestigious teaching award his first full-time year there.

    He was a wonderful doctor. I occasionally see one of his ex-patients, and they still bemoan his leaving. But this was so clearly the right decision for him. Admittedly, he still uses some of his knowledge and skills in his current position, but he will never be a clinician again. He doesn't regret it.

    It was a courageous decision to leave all that behind, one I'm not sure I could have made in his shoes.

    In the end, we must all find the niche where we are happy. I'm grateful he found his. And now he has summers off to spend with our son, which has been a blessing.

  2. Maybe this is less of an issue now that women have broken down most of the barriers that were formerly present. But it wasn't so very long ago that medical schools were resistent to admitting women in the first place because "they'll just get married and have kids and quit, wasting the time and money spent to train them." I suspect most of you are too young to remember this, but believe me, it was real.

  3. Love the gcs15 spin above - father in medicine. That is a great story.

    I have a couple of women friends that stopped medicine after starting a family. I hate the derogatory spin people try to put on this decision in hindsight -- "she just went to med school to marry a doctor." Makes me angry. We all make, and live with, our own choices in life. It's not our place to judge others.

  4. I can write about this from personal experience. After we had our 4th child (my husband is a physician in a busy private pulm practice) as well), I found that I just couldn't and wouldn't hack it any longer. I knew that was a possibility before I got pregnant, but really wanted the next child (we were actually trying for a 3rd, but had twins). I tried going back to work (as a PCP), but was very unhappy. Even w/ a wonderful nanny and a 3day/wk job, I couldn't get done what I wanted. At the end of the day,I did not have enough energy to give all 4 children the attention they needed. I wasn't reading any medical journals and knew I was pretty far behind (thank God for UpToDate). For me, it was a no-brainer. I was happier at home with my children than I was at work worrying about everything I had to do at home. My husband and I discussed it at length, and I felt that I wanted to stop working much more than he did (he really didn't). So I stopped. For over a year. And seriously considered staying out for good. I just recently went back at a very forgiving position (6hrs/wk) that will at least keep my resume current, and even then, I still feel the tug for home.


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