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Monday, September 1, 2014

Self advocacy - why is it so hard?

It’s funny how a few things collide, to suddenly make life crystal clear. It’s job application time for me, and I was lucky enough to receive three offers, strangely enough covering the gamut of work life balance from no after hours to full on subspecialty. After much deliberation, I chose the job that would best complement all my roles – mother, wife, doctor, furry friends owner, health advocate wannabe – you all know the list. I recognised I was burnt out, and at risk of leaving medicine altogether if I didn’t make an active decision to change my hours and where I was headed. Both my husband and I are in high level, full time roles, something I never felt comfortable with for the children. Here was my opportunity to make a change more in line with what I wanted for my family. I’m a firm believer in if-something-isn’t-right-fix-it, don’t just wish or whinge! Fast forward one week - past all the happiness at finally making a decision, the peace that the decision was right for me and mine, excitement of starting a new job, the daydreams and plans to incorporate fitness, walk the furry friends, spend more time with hubby and children - to today. I’m catapulted from a state of contented decision-making bliss into Guilt – guilt I now know is ‘doctor guilt’ (thank you Emily). It deserves a capital G, don’t you think, for the central place it often plays in women’s lives? So what happened?

Well a couple of things. Firstly, taking this new, wonderful job involves resigning from my current job, something that I’ve never had to do before (I’m yet to do this, because I’m waiting on a formal contract). It also means leaving a path I’d always thought I’d follow, and jumping into a reasonably unknown area for me. After making my decision, I had a conversation with the boss of the subspecialty I’d originally planned to follow, creating doubt in my mind that I’d made the correct choice. She wanted me to take her job offer, and I felt like I was letting her down in choosing not to. It was also ‘known’. After the ‘doctor guilt’ came self recrimination – in resigning, I am jumping ship, baling out, leaving colleagues in the lurch. In reality, my position is actually supernumerary at present, so in actual fact, no-one is left in the lurch, but my soon to be old hospital won’t remember that. I’m now the person I never thought I’d be – the one who leaves a post early.

This really forced me to choose what was important to me. I sat down and thought long and hard about my values, what I considered ethical, the life I wanted for my family, the sort of mother I wanted to be, and whether that married with my current workload (no surprises the answer is no). I pictured myself in each of the three jobs, and tried to see how I felt, what my reactions were. I read widely, trying to build a picture of my future career options. I came across an article about women failing to speak up when sexually harassed and why we are all so ingrained to be ‘good girls’, to not create waves, keep everyone else happy. I had many long chats with close medical friends, trusted senior colleagues, and my husband, who all agreed I should take this job. People who, like me, would never ordinarily leave a post early. I was told leaving a post early is common, people do it all the time. Not me though. Never me. In an ideal world, I would ask to start the new job when this one finishes, in five months time. That’s the path of least resistance.

But spending another week, let alone another month, in my current position is too long. My family needs to make a change now. As well as that, moving now saves me time at the end – possibly nearly a year of time (due to retrospectively counting some of this year, something that probably won’t happen if I don’t move until next year). The next five months in my current job is surplus to my training needs. So, for the first time in my life, I’ve chosen to do what is right for me. I’m going to take the community based, no after hours or on call job, and I’m going to start in 4 weeks. All I have to do now, is tell them. Resign. Although I’ve decided, I still question it, and probably will, until my contract arrives, and I have to make the decision final.

So I guess two questions. Has anyone else ever left a post early? Taken a leap of faith? Any advice on whether it turned out ok in the end? Fingers crossed.

11 comments:

  1. I've never left a post early - I did leave a practice (and the field of primary care entirely). It worked out just fine.

    I'm curious what "works out OK in the end" would mean for you. Sounds like the job you're taking is an excellent fit and the struggle is with your image of yourself. What does it mean to be the kind of person who leaves a post early?

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    1. Hi Jay,
      This is the reason I love MiM - comments really make me think! A person who leaves a post early is one who puts their own needs over and above loyalty to the hospital - and, where I come from, it's frowned upon. I guess I have an over developed sense of responsibility - something I'm realising from these comments - and loyalty. I took on a 12 month contract, winning the position over others, so I feel I'm disloyal for then moving on earlier. Your comments are very perceptive - it is a struggle with my own self image, and I hadn't realised that. Thank you.

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    2. You're welcome. I understand and share that struggle. We spend so long being dutiful during training that it feels very very strange to do something because we want to. Keep your eye on what works for you and your family. The hospital will always take care of itself :)

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  2. I agree that this seems like a no-brainer - you're saving yourself 5 months of misery in a job that's hard on your family, saving yourself 5 months of time that you would otherwise be wasting since you don't need it for training, AND if you're supernumerary, then you're not hurting anyone at your current job!

    It's so hard to do this, though, and like you, I don't know why. It really bothers me to have anyone be disappointed in me or displeased with me, even though often they're people whose opinions shouldn't really matter to me. I historically have always prioritized myself (including my family) below the needs of my institution or employer, and I'm starting to learn not to do that. I realize that my employer does what's best for them, and if I don't look out for myself and my family then no one will. It's still very hard to implement, though.

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    1. I hear you - that's my struggle. I realise the hospital always looks after itself, and it's depressing to see medicine changing within my generation, where bottoms on seats is so much more important that what an employee gives to the hospital in return.

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  3. I was an engineer before medical school, and I had to quit jobs. In the corporate world, there is no such thing as loyalty; the reality is that you have to do what's right for you above all. Same here. Let go of the guilt and move on; you will not regret it.

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    1. That's what is so weird about medicine too, I've decided. In the real world, a person can move jobs whenever it suits. In medicine, it's once a year!

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  4. Based on the reality of the (somewhat crappy) system my private practice is at odds with my training institution - we compete for business. It sucks. I love and cherish those relationships but it's hard to keep them up and keep business out of it. I do the best that I can.

    I also feel really guilty about doing all the legwork on a cytology thyroid paper in my fellowship - fully intended to write it but motherhood and private practice demands made me drop the ball.

    I agree - let it go and move on for what is best for you and your family. There is always regret and doctor guilt. Compartmentalize. Look forward. Sounds like you are doing the right thing for yourself and your family everything else will fall into place. Time marches on - people get along without us.

    Exciting! Enjoy and good luck to you.

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    1. Thank you Gizabeth, I really wondered what your take on this would be - I think Pathology is an area akin to what I'm going in to, so I was keen to see what you thought.

      Everyone is so generous with their thoughts and time - which makes MiM so awesome!

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  5. Just found my way here today and this post really hit home for me. I'm a veterinarian and I'm leaving my current job to start a new position in a little over 3 weeks. A big part of the reason I'm leaving is being on call with an almost two year old is difficult. The other reason for leaving is the drama of this clinic, but I still feel guilty about leaving. I'm not the only doc with kids (the others are all a lot older than my daughter) so I get a lot of, we've all been through this you'll survive. But I don't want to farm my daughter out to my parents or in laws just so I can be on call and she dislikes coming to the clinic with me. Well I gave verbal notice that I was leaving two days ago and my name was removed from the clinic sign less than an hour later. I feel like my name is Mud for screwing up the clinic schedule. But I can't worry more about my employer than I do my family.

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  6. Hi DocMac. It's taken me a long time to get to the point where I realised, I was trying to be someone I was never going to be - a mother in medicine who was unhappy with full time/on call/after hours workload. When I was in medical school, a mum a year ahead of me (I didn't have children) left, saying she had realised she would always be in conflict between medicine and family. That really impacted me, because I thought I'd be the same. It's taken me this long to make the same decision she did - not to leave, but to accept that I will always feel conflict between medicine and home. It's not medicine, or the age of my children, or the rotation I'm in - it's just me, and my values around mothering. So I've made a call to move to an area that honours that more, and that's given me the peace to weather the storm when I resign. I only wish I'd made the decision sooner, as you have, so I take my hat off to you. As for your practice, you mention they are full of drama - why would their response to your decision then, be anything less than dramatic? You've done the right thing, as have I, for you and yours. Incidentally, I resigned yesterday, not expecting my decision to be welcomed (let's face it, no one likes losing an employee) but was pleasantly surprised by the support and understanding I received. Hopefully your new practice will be a better match for the life you want.

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