Friday, January 20, 2012

MiM Mailbag: Return to medical school?

Dear Mothers in Medicine,

Over the past month or so I have come across your blog and have become so interested in reading all of the wonderful stories and insight that you post. You might wonder how I came across it...well it's a bit of a complex story. After graduating college in 2009 I decided to pursue medical school. I really felt that I wanted to help people and work with children in my future, eventually enter pediatrics (at the same time though, I think I may have just fallen into this track as I had the "premed mindset" for a very long time). I gained acceptance and started medical school July 2011. Yet about a month into starting began to question my decision. Although I loved living on my own, and had a wonderful relationship with my peers and staff, I could not help thinking about my future and if it would really be anything but work-filled. On top of that I was being pushed to my limits, depleted really, and feeling anxiety and bouts of depression. By this past Christmas I decided to take a leave of absence to decide if medicine truly is the right path for me, as everything seemed to be spiraling in the wrong direction.

After being home for about a week now, my mind is more confused than ever. Is the stress/anxiety/depressive feelings something that will get better as school continues and I adjust? When I start practice will I be able to balance my career with family (mind you, having a family and being invested in them has always been my number one priority)? If I leave now, am I going to look back and regret this...but if I don't leave, what kind of impact is this going to have on my future health and family life? Would being a nurse practitioner satisfy me? Do I want to physically endure residency? And am I willing to sacrifice the next 7+ years of my life and give just so much of myself to a career when there are so many other things I yearn to invest my time in as well?

I know that ultimately the decision rests with me. I have tried speaking with others who have been through the same things as myself as well as those in the profession, but am still having a difficult time deciding whether returning to school would be my best option. It has been a difficult decision to even take a break from school as I have always been the overachiever who just pushes through no matter what-yet this was the first time my body made me take more drastic measure and really reevaluate where I'm heading.

Although you may not have the answers to all my questions I'm hoping that some of you might help shed some light on my fears and whether you ever went through any of this thinking. Looking back do you feel that this career has suited you well (family, health, lifestyle, and all other things considered) or would you have done things differently. Any advice would be much appreciated.

Look forward to hearing back from you all!

21 comments:

  1. I find this post extremely sad. A good friend of mine struggled with this and ended up quitting medical school at the end of her third year. She struggled with similar issues. And, I cannot say that everyone who finished medical school with me was happy they went into this career.

    However, I do not think I "sacrificed" the last 7 years. I met wonderful friends in medical school and we bonded over work and play. I got pregnant and had my son during 4th year of medical school and I was able to take off almost 5 months with him.

    I loved residency - and I did internal medicine. I almost did psychiatry as I did not know if I could handle the stress of internal medicine. There are plenty of residencies that are not as "hard" and allow you to live a more balanced life.

    I worked 36 hour shifts in my third year - something that is quickly fading with ACGME rules applying to residents. But those were some fun days.

    If you don't really love it, I doubt you will be fulfilled. It is hard work. If my friend had quit in 1st year, she wouldn't have $100,000 in debt to pay off.

    Get your depression treated - work on your decision after that.

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  2. I had some medical problems tat lead to academic troubles my 2nd year and I was dismissed. While appealing the decision I really asked myself "what would I do if i wasn't a doctor? and I couldn't come up with any answer, I had always imagined myself being a doctor and had never considered life another way. I knew that i had to fight and I finished and all is well now. I have 3 children I'm pregnant with my fourth and in my last year of fellowship. I contrast that to my classmates who similar to you were at medical school because they were good at science or their family wanted them to do it, etc. All external motivation and they were not happy, some wanted to drop out but by that point they would have been able to afford their loans so they felt compelled to finish. I agree with the previous poster and seeing a therapist and get evaluated and treated for depression and once your in a good space make the decision.

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  3. Medicine is slowly becoming more family friendly. I'm a fourth year student and mother of 2 happy, healthy little girls. My first was born 5 months before med school, and I got to spend every evening and weekend with her for the first 2 years, as well as that first free summer. My second was born at the start of my fourth year, and I designed my schedule to give me 5 full months at home. I have worked my ass off to get here, and the hard work is just beginning as I plan to go into OB/GYN. But on the interview trail I've seen that more and more programs are working to adhere to ACGME work hour regulations to attract top residents. The top 2 programs on my rank list average well below the 80 hour max.

    So if being a stay at home mom is your dream, marry rich. But if you just want to be a good mom, an involved mom, and a balanced mom, it's totally do-able.

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  4. It is absolutely worth it. Like first poster said we did 36 hours but it was fun. We saved lives, interacted with staff, peers, we shared this burden, we fought this war. There is too much in this country about fulfillment, investing in family. People just need to learn to live life, and stop feeling entitled to every moment "happiness". Some people cannot handle job routine, feeling they are not "happy". Learn to love what you do every day, do not do whatever it is you love.

    That said, med school sqeezed into 4 years, while in the rest of the world it is 6 years, is a load of stress. Learn to handle this temporary stress, as above posters suggested, get help.

    This profession gives me great satisfaction, but I suspect only because I am of different culture, and expect hard work, savor and value opportunities I have as a result of high paying job.

    I would not want to be a clerk with 30,000 a year entering data on the coumputer 8 hours a day. Sorry, have taste for international travel, interest for seeing world's cultural centers. I worked 16 years after highschool toward my first job as a physician in this country. So, cannot simpathize with having to "loose" 7 years.Put your other "wants" on hold for a short while, if you decide to do medicine. It is called maturity.

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  5. I agree with everything everyone has said above me! However, you mentioned nurse practitioner as an alternative and I think if you would be equally happy with that or even becoming a P.A. then you should absolutely choose that road instead. Less time in school, way less loans to pay off, less rigorous training, less responsibility in the job, less malpractice worries, the list goes on. Some people could never imagine replacing the MD with PA or NP but I think if that's something that would truly be an "equal" for you of fulfilling your dream then by all means go for it! Of course I'm just a pregnant 4th year student so what would I know :)

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  6. 1) The preclinical years of med school are nothing like what life will be like once you start seeing patients. Or what it's like to be a doctor.

    2) The hours are always going to be hard, but on the other hand, the hours for many other jobs aren't easy either. For instance, before I came to med school, I worked from 5AM - 5PM as a receiving supervisor, and at a consulting firm where my weekend could be destroyed at a moments notice. And so far, I haven't found anything I think is as cool as medicine. I think a lot of people (including myself) graduate from college and don't realize how hard most people work to support themselves (and how miserably many jobs are). I think a lot people feel like all they do is work, especially after they have kids.

    3) See a therapist. Depression is incredibly common among doctors, and it makes things way harder than they have to be.

    4) Make sure you're getting enough sleep.

    5) NP/PA might be a reasonable alternative. Though, if you have the type of personality where you want to be the person with the ultimate responsibility over the patient (no disrespect intended to NPs or PAs), you might not be happy in either of those professions.

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  7. I very much agree with what others have posted. I'm a fourth year medical student right now and will be going on to pediatric residency after graduation. I truly believe that everyone has considered whether or not the sacrifices they are making for medical school (and residency and their career in medicine) are worth it. That being said, the advice I give to anyone thinking about medical school is that if you can see yourself being happy doing something else, you should do that instead. As I near the end of this phase of training, I know I made the right decision for me, but it is not for the faint of heart. Yes, the first two years are a poor indicator of what you'll be doing for the rest of your life and even as a third and fourth year student. But you also have more freedom to plan your schedule. Though I have loved this last two years of school, they are/were way more tiring than the first two. Think about why you applied to medical school and about other professions where you can work with children. Seek counseling/treatment for your depression. Then see where you're at. Good luck!

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  8. Please get help for the depression before making any hard and fast decisions. The depression colors everything.

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  9. I think OGMD hit the nail on the head. Work is HARD in general - I actually decided not to go to medical school after HS because I too didn't want to "lose" 7 years.

    Fast forward to now, I'm 27, married, have a child, have a business degree and a CA (CPA equivalent) and have quit everything (well, not my marriage or kid!) to pursue medicine.

    I think its ultimately about being happy and for me, having a fulfilling job is extremely important. But I've also been depressed and know how everything seems hopeless, so PLEASE get some help. It can do wonders!

    All the best!

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  10. This is a difficult, intensely personal decision. I also share the other commenters that the time period spent training to be a physician is far from wasted time, esp if you consider how many of your friends and/or family do not enjoy what they do. I got married, have had my children, met great friends, and even been able to travel, although not as extensively as I would like. The issues with training are control over your schedule (as in you won't have it) and a prolonged period of time during which you aren't making money (or losing it as is the case with student loans). But neither one of these need to make you miserable.

    My one word of caution is this - the loans are a big deal. I have too much educational debt to quit and am fortunate that I have no intention of doing so. I do have friends who are not as lucky. Good luck with your decision.

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  11. I'm a third year med student and I agree that medicine definitely involves some sacrifice, but I think that's true of pretty much anything worth doing. Yes, I don't have as much free time as I'd like but that's okay. There is still time to enjoy yourself. Please get your depression treated, I imagine that will help. Good luck making your decision.

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  12. As when my "in real life" friends have faced this dilemma, I'm torn between encouraging you to press on, that things will get better, and that it'll all be worth it in the end ... versus encouraging you to do whatever will make you happiest and make your LIFE - not just your career - work best.

    My perspective is limited by being a third-year resident, but from where I stand, medical training and practicing medicine is HARD. The academic stresses of the first two years seem like a big deal until you move on to the clinical stresses of the last two years - being sleep-deprived, trying not to get lost in the hospital, navigating interactions with patients/residents/fellows/attendings, etc. Then that all pales in comparison when you're an intern/resident, actually responsible for people's lives, forever navigating the murky uncertain gray areas of medicine, watching people die, wondering if you've done the right things for them.

    All work may be hard in some respects, but there are lots of jobs where you never have to work for 28 hours straight and where you aren't responsible for people's lives. Maybe needing to take this leave of absence is your body telling you that this is not the life for you, giving you an opportunity to get out before you have too much more invested.

    Or maybe it's not. As someone else said, it's an intensely personal decision. There are certainly plenty of us who have found this process at times depleting, the hardest thing we've ever done, and yet somehow still love medicine enough to stay - and to feel lucky for the opportunity to do so. That could be you too.

    Happiness to you, whatever you choose ...

    -C

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  13. This is a tough decision, and I, too, contemplated quitting medical school. One suggestion I have is to lower your standards. If your goal is to get through medical school and residency with some balance, I think it's possible. But getting all top grades and board scores may not be. If you remind yourself that passing your courses is all you need to do, it may be more bearable than aiming for the highest possible grades ever. I am still trying to make peace with this philosophy myself, but I have found it to make medical school easier.

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  14. This is a tough decision, and I, too, contemplated quitting medical school. One suggestion I have is to lower your standards. If your goal is to get through medical school and residency with some balance, I think it's possible. But getting all top grades and board scores may not be. If you remind yourself that passing your courses is all you need to do, it may be more bearable than aiming for the highest possible grades ever. I am still trying to make peace with this philosophy myself, but I have found it to make medical school easier.

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  15. Knowing nothing about you, it's impossible to say if med school is right for you. I agree with everyone who says you need to treat your depression before you make a decision.

    I thought a lot about quitting when I was in med school. And even though I'm not unhappy with my career right now, I think I made a mistake going to med school. It wasn't the right career for me for many, many reasons, one of which being that I had a lot of trouble dealing with the stressful, demanding lifestyle. It only gets worse in the clinical years, and then much worse in residency. Yes, I know, there are other jobs that are stressful and demanding. But there are also jobs out there that aren't stressful or demanding!

    Sadly, I know a lot of doctors who say they regret their career decisions. And there are a lot who are happy. The worst thing is to see my friends who were so unhappy in med school still so unhappy now.

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  16. Hi! I see you are confused, I am also a confused person in general but I like to sit and think with what I have and what I don't.
    If you think you can get through this, ask yourself, no one else can make this decision for you.
    It's not going to be very hard after getting your degree.
    it is just adjusting. it is hard while adjusting but once you do, it's pretty much alright. just think if you can make that adjustment.
    first get happy, then make your decision. love

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  17. i'm a resident. i think i'd want you to know that if you quit, it's okay. you will find something just as meaningful to do in life.

    if you stick with it, and want balance, i'd encourage a specialty without call like family practice. that makes a HUGE work-life balance difference.

    take care.

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  18. Let me add my opinion after being in medicine for several decades, and yes, raising children and now enjoying grandchildren while I still practice.
    1. You are DEPRESSED. This is a
    medical diagnosis. It is not a lifestyle choice. Until you get treatment you cannot make any rational decision. Everything looks hopeless. Please get the best psychiatrist you can find, it may take a few tries, and get to work on this. It will take a few months until the fog starts to lift.
    2. Forget about randomly grasping at alternative professions. For instance, Nurse practitioner? You need to be an RN first, then another 2 years for NP. Since you didn't start out as a nurse, you are now up to the length of med. school.
    3. You are overthinking your future. Life happens. One tries to be best prepared, but also to enjoy things as you go. There will always be periods in life that are tough.
    You say - "but if I don't leave, what kind of impact is this going to have on my future health and family life? ... am I willing to sacrifice the next 7+ years of my life and give just so much of myself to a career when there are so many other things I yearn to invest my time in as well?" No one knows. You can't predict the future. Check with older friends in any profession or job. You get sick, kids get sick, spouse leaves after finding a "soul mate", job fires you, your practice goes bankrupt, the dog dies...
    Bottom line, you can't absolutely predict the future, as you are now trying to do.
    4. You are persistent enough, smart enough, to get into medical school. It may or may not be the right choice for you, but do not close off the pathway while you are DEPRESSED. It's a profession with endless possibilities for a fulfilling life that other professions don't offer. Don't turn it off yet.

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  19. A few things. I have thought about quitting medicine more than once. Each of these times, it has been in times of transistion. To get in to medical school in general, I'd say that you have been type A, always achieved the highest, been close to the best and have gotten praise for all of those things. When you get into medical school, you still have that pressure to achieve and be recognized. In the last 6+ years, I figured out about myself (amid some depression as well) that I had all of my self worth based on that constant "you're so smart"...and when it wasn't there, or I didnt have the test score to prove it to myself, I was left feeling horrible. I cried before nearly every test, was ready to quit between each year...and don't even mention residency, cause then you really don't have any test or "marker" of competition to keep that addiction going. I've come out on the other side realizing there is more to me, and I'm still discovering it. Alot of us are people pleasers and need praise from others to keep us going...and going through medical training you have to let go of it.

    I realize I sound incredibly crazy right now...but my point is that first you need to figure out what is causing you so much internal distress- is it truly the family aspect, or is it fear of being a failure, things getting too hard, loosing a sense of self-worth etc that is bothering you so much...then you may figure out what will motivate you to stay in, or get out.

    Good luck.

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  20. Hi There.
    I'm sorry to hear that you're struggling with this. I have suffered from depression throughout med school, and let me tell you it is possible to get through it. While it's not the right thing for everyone, there are other health care professionals who will be supportive of you, and help you take care of YOU first.

    Personally I knew that quitting or taking time off would probably contribute to my depression. Sometimes it's all you can do to just get through the day, but in the end for me it helps to have structure and get out of the house.

    Another thing is to not look at the next 7 or so years as a sacrifice. Life will continue to be busy when you're done with your training. It's important to find things to enjoy throughout med school and residency. Personally, residency is hard but also fun and gratifying because I'm finally involved in patient care.

    Good luck, and don't forget to take care of your depression first! Things will get better:)

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  21. I don't know what you decided. But let me tell you as an ex medic having left after 4 years. Unfortunately for me, I could never find peace with medicine and being a pessimist didn't help much. It only meant I looked forward and the future looked bleak. My main problem, I had a terrible family situation whereby my family lil by lil emotionally drained me. Looking back now, I know where things went wrong for me....I felt isolated and the lack of encouraging family support just made me weaker. The lack of pastoral support at the uni also made matters far worse. At the end, depression and misery consumed me and I lost my fighting spirit and my brain went into burnout, despite soldering on for so long and feeling that sense of relief and satisfaction each year when I rose above my struggles and progressed into the next year.

    Yes medical school requires sacrifices. Trust me, a dream always does. Let me tell you, you can't predict the future. There are some people who quit what they do and life just sweeps them off their feet and they are happier than they ever were. For others it isn't as bliss. Then there are those who never know what they want and life just happens and somehow they find contentment. In any case, point being, all these emotions are NATURAL as a medic. Medicine is such a long process, it's enough to go through many many life changes. The grass always looks greener on the other side. It's not always as green when you jump that fence.

    I personally miss medical school (I left a year ago) from time to time because the work ethic that I nurtured, the kind of people I was working alongside; nothing in the 'real' world quite meets the mark now. I often consider returning but then I know without emotional support and someone telling me it's ok to no longer get those grade As, it's ok to retake a paper, to keep going no matter what; I couldn't do it. But if my some miracle someone came to me and handed me that opportunity to finish off what I started for my own peace of mind, and promise me I wouldn't be alone, I'd return in a heartbeat. Actually, I think I'd get by just fine without what I've never had. It's the extra family drama that just pushed me over the edge.

    But hey such is life, we win some we lose some. At the end of the day if anything I appreciate the honour and opportunity I got to see life changing things. Only a medic gets that privilege ;-) So if you didn't return, be thankful for the journey. You worked hard for it, you got the chance to taste being a future Dr. I till today reminisce and although many tears come, I am thankful I got to live my dream, even if not fully :)

    I hope you are happy now :) xx

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