I’ve thought about this a lot over the past few weeks. Residency is ending. It’s been 7 yrs coming. There have been many ups and downs. The end is exciting and stressful. The costs at the end are nearly insurmountable - thousands upon thousands of dollars for boards, licensing and moving. The worry that you don’t know enough. The sadness about leaving this family and the excited anxiety about starting the next step. As I reflect upon this journey, I recognize that it has been amazing. It is an unbelievable honor to take care of patients. I love what I do. I love being a surgeon. I will be starting a fellowship next year back in my hometown and I couldn’t be happier about going home and training in a field that I love. I’m excited about my research. I love my future colleagues! I don’t regret my choice and I love my field and my patients. However, I also admit that 7 yrs has wreaked havoc on my life, my family, my husband, my child, my health, and my bank account. The direction of medicine worries me. I think the business of medicine is crowding out the practice of medicine. But, I realize that no field is perfect. I understand that. But there are other ways to live a life. Other ways that would give me a different sense of control. There are other ways to have challenging work that is not so hard emotionally, technically and physically EVERY DAY. Medicine is not just challenging, it is hard.
So, as I reflect upon these years in the few moments of silence and meditation, I think to myself, would I do this again. I think it’s important to reiterate that I actually don’t have regrets about my choice and I don’t dislike my job, I LOVE it in fact. My husband is still here, right by my side. My daughter is a fireball of wonderfulness who loves hearing about my day. I’ve missed many family functions and have not been there for my siblings and parents in the way I wish I could have been all the time, but they still love me and I have found ways to still be present. But when I really ask myself, knowing everything I know - Would I leave my job in finance and go to medical school and choose to be a physician? I think the answer may be no. What is your answer?
I am near the end of general surgery residency, and I work some with undergrads interested in medical school. I urge them all very strongly to consider PA scoop -less time, less debt, better lifestyle. I think I would do it again, but I would've at least strongly considered PA school
ReplyDeleteNo. Emphatically no. Like you, Cutter, it's not because I don't love my job. I am now working full time in a subspecialty that amazingly has office hours with no on call or after hours. Ought be happy, yeh? Well I am of sorts. I love, love, love my area of specialty. It's very rewarding on many levels and completely satisfies me. But. It is still part of a hospital department and I am still training. Which means no option to go part time (and sadly, as long as we have our current head of department, no option even when I'm finished training), more work than there are hours and more politics than I care to consider. If I could separate my 'job' from my 'work' and perform it part time, I would be completely happy. Even then, I would not do it all again. I know this because when HG declared he might become a doctor when he grew up, my heart sank. I thought of all those long, long years when he would be torn away from other things in his life. I recalled all the very many people I've met, know or love who have very rewarding lives without such a hard job. I still yearn to be a family that can book a camping trip for next Easter and know we'll definitely be there, and could be there year after year if we so wished. I wish for a simpler life. I'm done with juggling. The funny thing is, I did look ahead and see these conflicts - I recall when HG was born - I panicked, thinking how on earth am I going to manage being a doctor and picking him up from school at 3pm? What will I do with him (and now his sister, Bom) on school holidays? But everyone I spoke to in medicine reassured me that my feelings would change once the children were older, that it was new mum fear, that they'd regretted passing up the oppportunity to undertake a Masters because of their children yada yada ya. But you know what? I still feel the same way I felt back then, and I have struggled with school drop offs/pick ups and vacations. My husband and I have made it work, without assistance, through sheer determination, but it has taken its toll on both of us. We are lucky to still be happily married and very much in love, because it could have gone the other way. Just last night, my husband was saying he was under pressure and we needed help. That worries me, what with the high rates of male depression and suicide. So yes, we've reached a place where we are as balanced as we are ever going to be with medicine but I still would never do it again. I counsel my interns to consider their path of specialty. One of them, a young woman, was considering surgery. I told her, if she absolutely loved it and couldn't see herself doing anything else in medicine and in life, then go for it. But if her passion was less than that, or another area looked enticing, then choose otherwise. Because when you are trolling the hospital wards at 2am, wondering why on earth you chose this, you need to draw on that passion to get yourself through, to make it all worthwhile.
ReplyDeleteThanks so much for the post, Cutter. I recently read a fabulous book about surgical training called How to do a Liver Transplant. An engaging, honest read about one woman's path to becoming a liver transplant surgeon and having four children. Author Kellee Slater.
Thanks Jess for such an honest reply. So much of what you said sounds exactly like my life and how I feel. I will definitely read that book, may order it right now! Good luck to you and your husband, kudos for making it this far and being crazy in love!!
DeleteAbsolutely not, to the point that I'm on an indefinite hiatus from clinical practice to stay home with my kids.
ReplyDeleteI'm also a surgeon and have a daughter, and an luckily married to a wonderful man. I could've written your post myself. I would never choose this again, and I love my job and feel priveledged to be in it. But I feel that I sacrifice too much, personally and for my family. If I could do it again, I'd be a dentist or OMFS.
ReplyDeleteYou may know my answer already: yes, in a heartbeat. But I had only 3 years of residency, no kids until I was an attending (with a more predictable schedule), and feel like I have established a balance that works for me and my family. Things may feel differently when training is well behind you and you have more control over your life.
ReplyDeleteThank you for this post, Cutter. Do you have a post that discusses your process from switching from finance to medicine, and the reasons for making the switch? If so, I'd love to read it! Thanks again!
ReplyDeleteMel, I make some references to finance in older posts but I've never really discussed my decision. That's a good idea. I'll plan that for my next post!
DeleteThank you so much for your post. I've been rethinking my decision to go to PA school, but your post definitely calms my anxieties.
ReplyDeleteNo. Definitely PA school. More flexibility, less liability, good pay. Shoulda, coulda, woulda.
ReplyDeleteI distinctly remember when I was an undergrad and my college had a fair. Representatives from many med schools came out to hand out flyers, etc. The place was swarmed with pre-med students. There was just one representative from a PA school who was standing alone. As I walked by him, he got my attention and I stopped to talk to him. He told me about PA's which I had never heard of, and I thought, "Cute. Now onto the real stuff." And walked away. I frequently remember this incident and think, Why didn't I listen more?! Why was I not more open-minded?! If only.
No. I sacrifice too much time with my family, and one of my kids is special needs. I would never choose this again. Premeds get starry-eyed about the ever-holy "MD" and the deificiation of doctors. It's such BS. We are human, and we hurt when we are away from our kids and especially if one of our kids is special needs and needs us. Nothing is more important than my children, and medicine will always want to be. It loses everytime to them.
ReplyDeleteI'm in the "No" group. I think about the PAs and such, and I'm not sure if I would have gone that route either. I just don't know. But what I do know, if that even now, done with residency and life approaching a new, less stressful normal, the possibility of financial security on the horizen, it's still hard to justify all the things I went through to get here. Giving up over a decade of my life to my training. Missing countless of moments with my children. Not having my family be able to depend on me for anything other than a paycheck. The stress my marriage has gone through (even though we are in the fortunate group that came out of this still in love - I know many of my friends can't say that.) The massive amount of debt that I've accrued and will still be paying off at the time my oldest starts his college education.
ReplyDeleteI like my work, but as doctors we aren't supposed to just like it. We're supposed to sacrifice everything for it. And I just don't think it's worth it.
I appreciate your honesty. I am a mid-thirties mom considering medical school, and I have all my pieces of the puzzle ready to submit to AMCAS.
ReplyDeleteIn undergrad and grad school I was pre-med at a competitive university and involved in research, and after graduation decided to take a one year break from the intensity of academic life. In that one year of my early twenties I entered into the "real world" of marriage, sick and dying parents, kids (eventually 4 of them!) and life as a science teacher. I've worked in teaching since then at the university, community college, and high school levels and have taught everything from Bioethics to A&P cadaver labs to high school AP Chemistry. I currently live in South America and teach at an international school (with the same husband from age 22 and the same 4 kids) and will be transitioning back to the States in 2016 to do...something in science. One of the challenges of spending so many years in school (as a student or teacher) is that it's difficult to know what a career outside of the school environment is really like.
I have conducted about 15 interviews this past year with friends in different healthcare professions, at least 8 of them MDs. Only two said they would do it again, for many of the reasons you stated above. But all of them except one enjoy their jobs! It's just a tough cost-benefit balance.
Regardless, I continue to admire and be drawn to the journey of medicine. But I take the cost very seriously for my entire family. Wishing you many joys as you pursue a very worthwhile calling. I'm hoping the best years are still to come!
Late to the party...and my answer is yes. Unequivocally, completely and totally yes.
ReplyDeleteI'm almost 55 and knew nothing of PAs or NPs when I was applying to med school. I went directly from college. I trained as an internist, did a one-year primary care fellowship and am now practicing hospice and palliative medicine.
It helps that I graduated without debt. It helps a lot. My daughter was born when I was 39 and I would not be the parent that I am if she'd come along in my 20s or early 30s. I love my work, and I can support my family comfortably - I'm the primary wage-earner and always have been, even when I worked part-time. That's the last thing on my list, though. I love my work and I love my position in the team. I don't want to be the NP or PA. I want to be the doc.
Medicine has always been a business. I'm a third-generation doctor (both my grandfathers and my dad). There have always been trade-offs and there always will be. I wouldn't trade it for the world. I seriously doubt that my kid will be a doctor. If she wanted to, I'd cheer her on.
I love this post. And all the responses. I love the honesty. I'm currently finishing my 3rd year of anesthesia residency and have a 3.5 year old little one. Most days, I have to say that I would not do it again. Right now, no way. I'm too tired. My time is too constrained. Too often I feel I am not actually helping people, just performing unnecessary surgery.
ReplyDeleteBut then I get to save a life. This week, on call, I directly helped to save 2. What an awesome honor and privilege. Exactly why I wanted to do this profession. I will finish my training. I will be an attending. Forever? Probably not. But I'm trying to reserve my pessimism and judgment until I'm done with this grueling phase.
I must say, the PA option is very appealing and I know many happy PA moms. However, this is exactly the kind of thinking that keeps the men in the top jobs. I'm hoping we can channel our inner Sheryl Sandberg and "Lean In", and maybe make the training process less grueling for the next generation of women who want to be physicians.
For now, I take one day at a time, rely on my amazing husband, and realize that this phase will one day end... one day.