Should I Quit Medicine? How Did I End Up Here?

I’ve asked myself whether I should be a doctor many times throughout my life, from college, through medical school, residency, and into being an attending. If I questioned myself so often, how did I even end up here?

I grew up in a family of medical professionals and basically grew up with the expectation (probably a lot of it was self-imparted) that I will become a doctor. My motivation to meet this expectation and to receive approval from others was the driving force that helped push me through all the doubts.

The first time I questioned whether I should even pursue medicine was in college. I realized I was never excited about being the physician in a doctor/patient relationship and feared the responsibility of becoming one. Plus, the stress I put myself in to do well in school and strive for the perfect resume to get into medical school took a toll on my mental and physical health. I developed an eating disorder, my friendships seemed to take a back seat, and I limited my college experience because I “always had to study”. Is this even worth it?

When exploring other healthcare professions such as nursing, physical therapy, physician assistant, and dentistry, I was told “You can do so much more.”, “If you get your MD more doors will open for you.”, “But you’re so gifted.” “It will get so much better in medical school because you’re guaranteed to be a doctor.” These were from well-meaning people who I respected in life. Plus, I didn’t know what else I would do.

Even though I can admit my heart was never into patient care in a doctor/patient relationship, I did honestly feel like being a doctor is such a noble profession, and I should want to help people in that way. I told myself primary care is such a need, and I should want to do that. My goal to become a primary care doctor was what I wrote about in my application, and maybe part of the reason I miraculously got into medical school.

I questioned my path to becoming a doctor again in my third and fourth years of medical school because I never really got into the patient care aspect, if I was honest with myself. The smarter thing would have been to choose radiology or pathology, but I chose OBGYN. Part of it was because I didn’t get enough exposure to radiology/pathology specialties to really consider them, another part was because I thought I should want to do patient care, and primary care in particular. That being said, I did enjoy that rotation the most, I liked doing procedures, the patients were generally healthy, and at least I wouldn’t have to see clinic patients all day. Maybe I don’t like patient care because I don’t know much, maybe I would like patient care when I am more experienced…

Residency was when I was really struggling to see the light at the end of the tunnel. I was burnt out with nonstop work for 12-24hrs+ at a time, with few days off, the extra assignments we had to do (prepare presentations, prepare for M&M conferences, research projects), the acuity of patient care, the never-ending charting, the feeling of being hazed, being inexperienced and drowning in trying to learn more, feeling unappreciated, always trying to please my attendings, upper levels, and nurses, and being underpaid. I felt guilty going to the bathroom or eating and would only feel ok eating if my upper level or attending forced me to. My empathy for patients, my personal relationships, and medical students we were supposed to be teaching diminished. I really wanted to quit but also had this strong desire not to let my team down or the program down or my family down. I was having self-harm thoughts. I wanted to get a therapist, but I was so tired after work I could barely do anything other than sleep, do laundry, go grocery shopping; it was hard to find energy to even look for a therapist or even commit to an appointment. Is this all worth it? But I was told…it will get better.

My first job as an attending was in private practice, and to be honest the first and only job I considered. I was surprised someone wanted me. My work schedule was a lot lighter than residency, so in some ways I recovered from the intense burn out. I even enjoyed some of my patients, and sometimes I felt like I was doing a good job. However, different negatives seemed to weigh on me more heavily: the administrative tasks that don’t get compensated, all the messages and phone calls, the feeling of being a slave to your practice (I had to be available every day at all times for myself), malpractice fears, difficult patient encounters or circumstances, and on top of that the feeling of being undercompensated and wondering if it will ever be possible to be compensated well. The overhead was too high and funds were too tight. Is it all worth it?

I decided to make a career switch to being a hospitalist. No clinic and the administrative headaches that come with that. In addition, I never have to be on home call. I was expecting a baby, so this worked out well in terms of schedule. My compensation was significantly better. I should be happy. Other people would be so envious in my position, and I recognize that…

However, after a couple years in, I still wonder if it’s worth it. I like the job when things go well. But main fears of litigation and the difficult patient situation that could roll in the door anytime still haunt me. My heart still races before a case, and deep breaths don’t seem to remedy it. I still feel like a hamster on a wheel. I still don’t love being the physician, but now I don’t mind it as much because of the increased pay and schedule?

I am breaking free from my need to get approval from others. My husband has been so supportive to give me the freedom to be myself and do what I want. My mind wonders if I should pursue something nonclinical that is less taxing still and less stressful. I am perusing sites, Facebook groups, and podcasts like www.physiciansidegigs.com, www.passiveincomemd.com, and www.doctorscrossing.com sites and exploring. I am trying to discover what I am passionate about. All I know right now my passion is raising my child.

I am a little interested in Clinical Documentation Integrity, Utilization Management, and Informatics. CDI and Informatics seem to require memberships or extra training, and I’m not ready to dive into that yet. UM seems more doable, but no companies seem to be looking for OBGYNs. I’m learning about real estate investing and fantasize about being financially independent and retiring early. But even if I do retire early, I think I still would want a passion career?

My first step of this discovery journey was a tip from several podcasts I’ve been listening to regarding nonclinical jobs, to try to make your current job as good as it can get before quitting clinical medicine all together. For now, I am going to cut back on shifts and give myself room to breathe and reflect, spend time with my child. And see what that does. Maybe I just need inner work to get over all my fears. I know in my heart patient care was never my calling. But the upside is that it has given me the opportunity to take a step back.

I’m excided to see where this journey leads.