I am thinking seriously of quitting medicine all together... most reasons already expressed here on the site.

Has anyone here done that? did you regret it? what did you do with your debt?

If I do this I expect I'll never be out of debt. current school debt is 206K and adding $20 interest a day.

I don't have anyone to support me financially, but I also don't have children to support at this point and expect I won't be able to afford to have them in the future.

this is the biggest downside I can see.

any comments?

What type of training program are you in? What's your PGY level? This additional information will help us give "better" advice...

I'm a intern and in psych. so far this year have done neuro, medicine, er, and one month psych. find that I don't like adult psych at all... only child/adolescent... but have to do 3 years adult to even get to the 2 years of fellowship.

Of all the rotations... actually liked er most... but no way I'm switching... most programs require repeating intern year.

find that I hate medicine more and more as I go... love of field evaporating by the day for reasons spoken of by Drhope in the "unhappyMD" threads...
And the general idiocy of residency that is passed off as "education." find myself more and more unwilling to put up with this system and it's unreasonable demands.

shortly, current job sucks. future job less appealing. pretty much the only thing keeping me here now is the debt hanging over my head, with no other way to earn that much $ ever.

if that gives enough back ground...

I have not done any psych since medical school, but it seems to me like hospital psychiatry (i.e., locked ward) is VERY different from real-world, 50-minute-session psychiatry. Could it be that "future job less appealing" might be colored by the type of psych rotation you did this year?

Also, it seems to me that psych could be one of the fields most insulated from the negative trends in American medicine. Surely some people are still willing to pay out-of-pocket for a psychiatrist they trust -- or is that field totally controlled by insurance companies as well? Maybe someone with more experience with psych could comment further on that.

I hope things get better for you!

With your debt I'd recommend at least finishing th year and then see how you feel. Intern year before January is the worst part of all of your training. After you get past that bump it will seem a little better. Maybeyou could do an away rotation somewhere next year that is more inspiring. I am in FP, for example, and always wanted to do the Nepal Leprosy Trust rotation just to get that inspiration and sense of mission back. Maybe you could find something equivalent in psych.

it's true... things are likely to get better after first year. and outpatient practice is nicer than inpatient.

but at this point I have just about no more patience for this wretched archaic "education" system... and I'm in for 4.5 more years of it if I stay.

and reading from others out there it sounds like quality of life remains pretty low even after finishing residency.

whereas I haven't heard from too many people that have quit... and the ramifications of that decision

Gwenovere-
I am an MS2 and a far away from being where you are at but I was also in the working world as an RN for 5 years before med school.

We owned a house prior to school and our mortgage was for just under 150,000 dollars and the monthly interest and principle was right around a $1000 dollars. I am sure your student loan interest rate is better but you are most definetly looking at a significant mortgage-like payment right off the bat, before you pay for anything else in your life.

What are your other qualifications?

I guess my feeling is, I would stick out intern year because I have a few friends who are 2nd year residents and they all say intern year is awful. Also, maybe you should look at other programs for a more supportive environment. I have had friends say that their program is very unsupportive and others say that can't believe how awesome their program is. And, the reality is unless you are a stock market whiz or have wealthy family or something, the best earning power you are probably going to have will be as a physician, and with the reality of the med school debt it nearly makes it a necessity. I can just see that debt being a monkey on your back for a very very long time.

I used to work with a plastic surgeon who said, "The beauty of getting a medical degree is that there is something for everyone in medicine, every personality type can find something that suits them".

Maybe you should consider some medicine specific career counseling?

Sorry that you are going through this, best of luck.
-Plum

when I was an intern many many yrs ago, one of us dropped out with the plan to do locum tenens positions while she sorted thru things. i don't know how things went for her, but it makes me think you wouldn't be the only one...

do you know what the basic requirements are for that? is it just a license and step 3? and how is one qualified for it? is there any oversite?
how 'bout just some ER shift work under supervision?

Oh Gwenovere - you sound miserable!

There IS an overwhelming, sometimes, feeling here that medicine is horrible etc. I think it comes off that way b/c this is a place to vent - something we can't do very often in our real lives (at the office? to our partners? friends? - who wants to hear it?).

I have lots of women doctor friends, many of them women, and they really love medicine. I love medicine - I just had to find a better balance between work and home.

What frightens me about your situation is the debt. I only had $90K and it felt overwhelming - I had locked in at 8.5% for 30 years (Ugh.) We managed to get rid of it when we sold our house in CA and got the he** out. But $200K? Wow. I think you have to develop a plan to deal with that before you quit b/c it could rule your life.

When I was a resident, after I got my license (step 3 and intern year were all that we needed - I believe) I worked at our residency's urgent care center, and made about $40 an hour. I was covered under our residency's malpractice insurance policy. I'm not sure whether you would be able to be hired by a freestanding facility or a hospital ER without residency training. Its almost impossible to get hospital priv's (for ER work), or malpractice, or get contracted with health insurers (so you can get paid if you worked for an urgent care etc) without board certification. I don't think I'm wrong. I don't think a licence alone buys you much, these days.

I guess the question you have to ask yourself is: do you hate medicine enough that you're willing to take on the debt burden without a good way to pay it off? Or...can you gut through 3-5 years of residency to have enough income to deal with the debt? If you put energy into seeking non-traditional jobs (pharm companies/medical editing whatever) while you're in residency, maybe you could come out with a better career lined up.

Can you take a year off to decompress? Can you finish this year and see if your hatred eases? (it really does get better - I swear! Intern year was the hardest of my life!)

((((hugs))))) and keep breathing (not that they give you time for even that!)

thanks for the buck up "-)
I was really unhappy about medicine before I saw this site... so don't worry about that...
I only just recently found this site.

but I have pretty much come to the conclusion that if I don't go the traditional way finishing residency, etc. I will just never be able to pay off loans and will live the poor student lifestyle I always have...

which in itself doesn't bother me. I'd just like to like what I do, at least sometimes. even if it's working a small time job outside of medicine. never owning a house or having money for retirement...

I think that would be really bad to live always in poverty... but I guess worse is looking back before death and realizing you spent your biggest life investment in a job you hate.

and 3-5 years doesn't seem like that much... but given that I've already (like all md's here) spent at least 10 years nose to the grindstone...

I'm getting done with this. and the carrot just moves farther every step one takes. you think in college... well at least medical school classes will be more interesting than physics...and then in med school... just get through the exams.. then it'll be better in residency...

it just doesn't really ever get better... at least not so far.

but thanks for the buckup... "-)

Hi there,

My residency program director called the winter of our intern year "The Dark Season", and he was soooo right. Just reading your posts reminds me of the despair, exhaustion, and extreme level of frustration that my intern partners and I suffered through. I don't think we would have made it if we had not had great support from family and our senior residents.

I am not going to give you a "hey, it'll get better" pat on the back, because for me, it didn't. I left PT private FP practice a year ago, and you can read all about how much I have agonized about it in the Weblogs section. But (and that's a big BUT!) just as one's reasons for going into medicine are can vary, so are the reasons for leaving. I left for family reasons, and have not been this happy in years.

Unfortunately, the reality is that the amount of school loan debt you are facing is almost insurmountable without a completed residency. I would hate to see you trade the misery of being stuck in a career you hate for that of financial ruin. My advice (hey, it's free--just remember that you get what you pay for... ) is to finish your residency (even if you have to switch to a more supportive psych program to do it) and take your boards. After that, the amount and diversity of opportunity greatly increases (locums, part-time, adminstration, small town/large city, etc.) and you can begin to take large chunks out of your debt.

Many newly graduated residents fall into the trap of wanting to "finally live like a doctor". They buy a nice big house and a nice shiny new car, and spend the next 30 years paying everything, including their student loans, off. If you can stand to "live like a resident" for 2-3 more years and send most of your paycheck towards your loans, you will be in a much better position to walk away from medicine if you still hate it.

Your med school's financial aid department might have an advisor-type person who can help you figure out what kind of payments you would need to make, for how many years, etc. so you have a better idea of how long you might need to grit (and sometimes grind) your teeth while working in medicine. They also might have some advice about the amount of interest your loans are accumulating, so I would give them a call.

The short answer to your question is: yes, people do leave medicine. But you have to be emotionally and financially prepared to do so. Please feel free to PM me if you have any questions, and please remember that you are not alone.

:grouphug:

thanks for your thoughts...

the financial concerns are real. at this point I think the negs outweigh the positives... for staying in residency and medicine the next ten years only to pay off my debt (basically indentured servitude to the government)

the other choice is to just work some low wage $7 per hour job like I could have gotten out of high school... to have just enough to eat and rent. (just like college) and much less stress than medicine.

the latter is looking more appealing as time passes

and you can't take money or debt to the grave. even though they can take 15% of what you earn (or get in retirement/social security) up til then.

I know a guy who quit after intern year and now works at a medical school as an anatomy and clinical skills instructor. He earns somewhere around $50-60K but lives in a small town with a low cost of living, so he gets by. He says he views his student loan debt basically as a second mortgage payment. He says he's very happy about his decision to quit medicine because he knew he was miserable in it. However, he did recently get married and have a baby, so now he's starting to get a little more concerned long-term about providing for his kids.
I'm in a similar situation, as I'm married with 2 kids, one of whom has special needs. My husband earns a modest salary, basically just enough to pay our bills, no more, no less. He's probably never going to have much more earning power than he does now. I dropped out of my residency program just before the start of intern year and do not anticipate going back anytime soon, maybe never- it all depends on what happens with my son. Like you, I have six figures of debt. I'm at least glad I consolidated my loans at 2.8%, so I think my payments are *only* $825 or so a month. That's a lot of money, but if you can manage to live cheaply it might be doable. For example, my friend pays only $650 per month for his mortgage. People who live in CA or Boston or NYC might easily pay $1300-$1500 or even more for a house payment alone, so if you live somewhere cheap, you could have enough left over for student loans, too. So if you can earn at least $40-50K doing teaching or research or whatever, you might be able to swing it. It won't be easy, but mathematically, it might work.
I would definitely try to at least finish out intern year, if you possibly can without going insane. If you need to, maybe you could ask to take a month or two off without pay, just to have some time to regroup?

Gwenovere,

I dont have anything origingal to add, but I do feel for you. intern year S..KED. I was incredibly depressed, especially mid way through.

But the next 6 mo will go by fast. I kept telling myself "they can abuse, humiliate, and belittle me, but they can not stop time from passing". And it did pass.

Even if you stop after one year your options will be much greater than if you stop now. You can get your state license with completion of intern year and passing step 3.

You may be able to take some personal time, but that would stop time from passing as it would just prolong things.

Dont let them win - keep fighting
A

Please hang in there and finish your intern year. I quit a program 3 months into my PGY2 year. I am also single with no children and had my parents house to move back to for 6 months before I made the next move. I am now in a preventive medicine program so loans are still deferred/ in forebearacne etc. Even to qualify for many low paying admin "physician" jobs you need to be "licensed physican in the US" even though you may never see or go near a patient. I realized 2 months ago that I am truly a "single person household" and don't know when that may change. I am seriously considering going back and finishing either IM or anything that will take my prelim to have the flexibility and lets not play...income... that I have come all this way for. I happen to favor the cosmopolitan areas in the US because that is the setting in which I grew up and feel comfortable, hence, my cost of living will always be high.

Once you are out of the loop, it is alot tougher to return, as there is alot of explaining to do about why you left part way etc. I was just as frustrated and angry with "the establishment" as you are and was like "f&*)k medicine" etc. A year and some change later I have been able to sleep, eat properly, work out (sometimes), have a life etc and realize how burnt out I was. BUT, now I can look at the big picture a bit more clearly and realize that yes I was missing out on some things but I still like medicine in general, I just hated the setting I was in and the specific field that wrongfully chose.

I am not sure that your life will be happier doing manual labor or making $7 an hour, your brain power can be used in many areas, not just for seeing psych patients. Have you ever done manual labor? In college, my friend and I spent a summer broke and refused to ask our parents for money and figured that we should get jobs (you know for food and beer since our rent was being paid by our parents). We signed up with a temp agency and ended up at factory folding sheets! I lasted 2-3 days (5 hours a day mind you), my friend had a lot more drive and lasted 2 weeks. My mother and I still joke about it to this day. :rotfl:

My internship was pretty intense, I was in a pretty intense quaternary academic refferal center, my heme/onc and MICU months were back to back so I got to see my favorite patients die a month later. November was my lowest point in the year, and that was after 2 weeks of vacation in Miami. All of sudden,in December, it turned around, not sure how, by the spring I was actually pleasant to be around and felt like I knew something. By June I was feeling high, part of it was that I made it through and part of it was the excitement of starting my chosen field.

All to have it come crashing down within 90 days. I can honestly say that I have been where you are, I would feel phsyically ill and disgusted as soon as I walked into the hospital. I contemplated trying my best to stay, but it would be another 3 years of something I hated and there were not any fellowhips that I was interested in to make it worth it. I would even wish that I would be in a car accident to take me out of my misery. This was the end, I would be an attending in this field and could not see it. BUT I knew that I had my internship down and that I had some options (including my MPH).

All this to say (I know its a bit convoluted) stick out the next 6 months and then take time off or quit, but it will be a whole lot easier in the future if you "change your mind" again like I did and decide that medicine in and of itself is not necessarily the enemy, we just have to build our other skill sets and learn how the work the system to our benefit (like the patients do).

I just found this site..I am now 4 plus years out of psych residency and working part-time for a rural county mental health clinic. One good thing about psych is you can work part-time, do hospital, or ER psych, or private practice, do three different things at once, there are a lot of options once you finish residency even if you are just doing it to pay the bills, it's not horrible. Can't you moonlight after first year and make $50 an hour or more???? There are no child and adolescent trained psychiatrists around here (California) so you could easily practice that even if you haven't had the training, heck everybody else does. You would be desperately needed if you are willing to see kids. Also my residency got pretty easy starting second year. See if they will let you take time off. One guy in my residency took like 6 months off to study accupuncture. Also I worked half time for 6 months to spend time with my first son, (who I had in third year med school and I really needed a break to spend time with him). I owed 175K when I finished residency and it sucks. But if you are not independently wealthy what else are you going to do to earn money? You can't go bankrupt on student loans. I was like you (except psych was the only thing I half way liked about medicine by the time I was an intern) and we seem to be stuck at that point. I think you need to negotiate with your residency director to take some time off. They are desperate for psychiatrists (at least in California) and I don't think they'll want to lose you and have to fill your spot. YOu could also look into switching to a different residency program in psych. They are not all alike. You might find one you can tolerate.

Hi,

Sorry to hear of your misery! I would recommend like everyone else here to at least finish your internship, then you can apply for a medical license. Illinois has the cheapest and least painful of processes for licensure. It's all via mail. So at least you have a medical license that you might be able to do something with. You'll have to do some form of CME though to keep your license curren though. If you don't consider looking into other programs (maybe your current residency is to blame for your feelings)maybe consider teaching. What is your college degree in? For many states, there is a program for people with certain degrees to become teachers if they fill a high needs area without having to start from scratch with an education degree. The teacher classes are given as weekend seminars and over the summer breaks. You won't get paid much as a teacher but if you consolidate loans over 30 years your monthly payment might be managable. And in several years at teaching in the same school district you'd earn tenure and a higher pay check. And some of you loans might be repaid if you teach in underserved area...You could even moonlight during the summer break every so often just to earn some extra cash. Goodluck whatever you decide. Life will work out. It always does one way or another. Don't give up.

Sorry. I meant Indiana is one of the easier states to navigate the licensing process. Illinois...Indiana...they both start with "I". It's easy to see how I'd be confused, right?

Having said all that I did, if you can at least stick out until you finish internship, u will have more options.
I completed my internship and am licensed and registered as a medical practitioner.
It sounds like you're suffering from burnout and that's some serious s...t.
One of the problems with burnout is that u can't judge ur own performance very well and ur perceptions might be distorted. this will interfere with patient care, not to mention the havoc it can wreak on ur personal life. i know, I've been there.
IMHO u need to see someone, maybe a clinical or counselling psychologist, I did , it was one of the hardest things I ever had to do especially given my Psyche training. Didn't go for long, but it helped.
I'm not sure if there are any orgs. in the USA that offer help to doctors specifically or health care professionals, I believe that there's one in Canada.
Regardless of what u decide to do u need to attend to ur own health. :yes:

thanks for your feedback all...
I am considering it.