Dear MiM,
I was first introduced to MiM 7 years ago when I was on the path to do a clinical psychology PhD and considering changing my career to medicine. A great mentor was trying to encourage me in both my dream to someday have a family (I was single at the time) and to practice medicine. Fast forward and I am sitting in a "How to make a Match rank list" meeting, fighting back tears.
The problem is, I'm not sure I want to Match. Don't get me wrong, I love medicine and I don't feel that anyone led me astray. I can see myself practicing (probably part-time) in the future and being able to love my work. I am not discouraged by the notion of having a family in medicine. I simply do not think I have three more years in me. For months, I've been interviewing and trying to envision how my life would fit into each residency program and I've become increasingly discouraged. I am envious of my friends with their 8-5 jobs that support their lifestyle and am disheartened by the concept of spending a lifetime trying to make my lifestyle fit my career. My partner - who still loves me dearly and who has patiently supported me through a post-baccalaureate program and four difficult years of medical school (and poverty) - has talked about us splitting because he does not believe he can survive three more years of bending to my schedule and being alone so much of the time. (As an aside, I do not blame him for considering this, and I ask that you do not blame him either.) Add to that, there are no programs where we currently live. We have just begun to fall in love with where we live, we have many non-medical friends, my partner has a fantastic job (that is not transferable), and our families are within a reasonable drive. When I started down this path, a partner and a family were merely figments of my imagination. Now, I am the worst half of a relationship, the partner who is never available to be spontaneous and when I am, is exhausted and out of shape. I am the person who is hindering my partner's career and tying him where I need to be. And, perhaps even worse, I owe him everything because I could not have made it thus far without him. Plus, I have some health issues that may impede my fertility, and the clock is quickly winding down to when the risks of pregnancy far outweigh the benefits. Add all that to $400k of debt and I feel terrible while all my classmates around me excitedly making their Match lists.
So do I pack it all in now, graduate with my MD and move on with my life, ashamed but being free of the struggle for balance in medicine? Or do I go through the Match, probably lose my life partner and simply cross my fingers and hope that a) I make it through with my mental health relatively intact and b) I can overcome my resentment and still enjoy medicine? This is such a sensitive topic that I am afraid to reveal my reservations to my mentors and I have valued the fantastic insight of the MiM community thus far. Thank you, in advance, for your support!
Sincerely,
Struggling with the Match
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ReplyDeleteOh you dear one. Please know you're not alone in this. As someone who also "turned her back" on all that, my heart goes out to you. Nobody ever said you couldn't change your mind. Don't forget you're in charge of your life. That being said, you didn't explain why you wanted to leave medicine. If it's for lifestyle reasons, there are some specialities and residencies that are much less strenuous (olive view psych in la comes to mind). Don't underestimate the help of a good therapist in helping you out during this time. If I could go back in time, I would have extended my fourth year and gotten my mph, and sought therapy sooner.
ReplyDeleteAnd I'm sure I'm not the only one who noticed, but a lot of the language you're using to describe yourself as the "worst part of the relationship" is very concerning. You shouldn't been assuming 100% of the blame for the relationships problems. You shouldn't be carrying all this guilt, whether it's self-imposed or piled on by others.
I never comment on posts, but I felt compelled to reach out. Maybe none of it will be helpful. Maybe some of it will. Just know you're not alone and there are no wrong choices, only lessons (sorry so cheesy).
Thank you FPGL. You are correct that I am very skilled at self-berating. Thanks for pointing that out so I can try to reframe. As for my reasons to leave medicine, I think the primary reason is that I am burned out both physically and emotionally. I am terrified that residency is going to destroy any sense of self that I have remaining. Already, I find the frustrations of medicine far over-riding the pleasure I once received from it. And then there are the overwhelming lifestyle issues...
DeleteI interviewed in Family Medicine, which I love. I was hopeful it would be a little more family friendly in the long run and that I will have the flexibility to practice in a variety of settings.
Thanks for your support!
I want to tell you that you are brave and strong - firstly for following your dreams, and secondly for reaching out to others when it feels like the pieces don't fit anymore. Your life is yours - so you can change your mind if you need to. However, as somebody who has been in this position, I encourage you to talk to a good therapist, career counsellor, trusted mentors, or all three before you make a decision. There may be options to extend your 4th year, take a research term, or other academic pursuits that allow you to explore other interests while also giving you more time to consider your next steps. I will say that is possible to be happier than you ever dreamed in medicine if you find a good fit.
ReplyDeleteI also encourage you to to evaluate the way you describe yourself in your relationship. Medicine is often a jealous mistress, but you and your chosen path are not the source of 100% of the problems in your relationship. You say you couldn't have done this without him - but I think that you would have surprised yourself and done what you needed to do to achieve your goals. Challenges in your relationship make these life decisions much, much harder and more heart-wrenching than you expect. Is there an opportunity or desire for couples counselling or other support for the both of you?
Follow your heart, my dear, whichever way it leads you. Even if the right decision is the hardest one and seems insurmountable, trust that the universe will lay the road out in front of you once you are on it.
I just want to say that you are not alone. I'm afraid I can't offer any helpful advice, because I'm in a similar position. I went back to postbac, and then med school, met my (now) husband while there, and we had a baby last year. He is an intern and I'm finishing my fourth year, planning to match in 2017 because after graduation I will be finishing up an MPH I started while home with my daughter last year. I watch him and it is painful to imagine being away from my daughter as many hours as he is, and I wonder whether this is the right path. Three more years and I know I would be doing something I love, but at what price? Maybe there are other career paths that I would also love, without the same sacrifice. But as you say, talking to my usual sources means likely burning some bridges. So good luck! And I'm sure we will both find our answers over time. I feel lucky that I do have a year to sort this out, and as previous commenters suggested, maybe there is a plan that will allow you this time as well.
ReplyDeleteThanks, EE. It is really comforting to know I am not alone when it seems like everyone around me is celebrating. I have looked into taking another year but frankly, I can't afford it. My student debts already seem insurmountable and I really need to start receiving a paycheck (and not adding to the load). I wish you luck and hope you find what works for you.
DeleteI have similar feelings. I'm the one who wrote a post a few days ago if it's worth it as I just had a baby beginning of intern year. I too am contemplating just quiting medicine and going into pharma. My husband is thankfully totally understanding regardless of what I choose. i just want you to know you aren't alone. Plenty of people change their careers. Just do not do it for the sake of saving your relationship. Do what will make you happy.
DeleteIs this person really worthy of being your life partner? Someone who claims to love you dearly but also talks about splitting up because of his own needs? You deserve support and encouragement right now. Congratulations on making it this far. Talking to a good therapist is good advice.
ReplyDeleteI appreciate your viewpoint, Susan, but I feel he is truly worthy and, unfortunately, his needs have not been met for more than four years so it is entirely reasonable that he say it is about time he get what he needs. If I were in his place, I would certainly be asking the same.
DeleteYou are NOT the worst half of the relationship. Your partner should be telling you how lucky he/she is to have you, a future doctor, to share his/her life with. If this person doesn't feel that way, perhaps he/she should rethink the relationship, but I can tell you it is NOT your fault for pursuing medical training, and quitting medicine very likely would not fix this issue. You need someone who is a real partner. It is perfectly possible to support a partner in his/her career at the same time you are a resident.
ReplyDeleteI can relate to some of the sentiments you express, though. When my match day came around, all of my classmates were so happy and excited. I felt only dread, and that I was compromising what I really wanted for my family and for financial reasons. Being around all these people who had basically nothing holding them back from pursuing exactly what they wanted, where they wanted, and listening to them go on and on about how excited they were made me feel resentful and like I was somehow defective and doomed to a crappier career.
Two years later, I am very happy with my program, and realize that it actually was the best program for my interests. The dread will pass. Truth be told, residency isn't nearly as bad as I thought it would be. You are going to be fine. It is SO MUCH better than medical school, I can't even tell you. Well, maybe not the first couple of months, but after that definitely.
I do believe that there ARE some good career options for MDs in consulting and such which would bring in income and at the same time have a very good schedule
ReplyDeleteWow. This sounds like a really tough problem.
ReplyDeleteMy first thought is to echo what some of the other people above have said: If you're feeling overwhelmed, you don't need to match right away. Maybe you should focus some time on having a normal, 9-5 job for a year and see how it makes you feel. Does it, in fact, relieve pressure on your relationship? Does it make you happy? Or, do you miss the rewards of working like a dog to help sick people? Sometimes the grass seems greener on the other side, and sometimes it really is greener for you.
I also don't judge your partner for feeling the way he feels while you work like crazy. I think that some people are more suited to the role of being partner to a doctor based on their unique personality and I don't think it necessarily reflects how much or how little he supports you. Some people just need a lot of quality time with their spouse, and others don't. But I think that is a huge factor to consider and might be worthwhile exploring further, perhaps with the help of a therapist.
I really feel for you and your partner. You write that you feel you have to choose between your partner, your life together and medicine - that's tough. As you've pointed out, not just for you but your partner too, as medicine has such a huge impact on a partner, not to mention the debt. Sometimes when we face a decision, we make the right choice. Other times, we make the choice right. I've been where you are, although for me I felt I was forced to choose medicine over being the sort of hands on mother I wanted to be. Although now I am in a very family friendly job which I love, I continue to hate the juggle and would choose a simpler life in a heartbeat if I could. In previous threads, some have struggled to understand how one can love medicine yet if they had their time over again, not choose it: it is possible to hold something dear yet not feel it is worth the sacrifice and I get the feeling this is what you are questioning. Each person's decision will be different, a balanced choice based on what each of these things means to you and whether you can find a way for both to work for you. Your partner sounds as if he is struggling just as you are, with the 'cost' of medicine. Often the message we receive from mentors and others is to continue no matter what. Sometimes the bravest thing we can do is to say no, and make a conscious choice to turn in the other direction. I hope you come to a place where you feel that you can get off the medical training treadmill if that is the best choice for you. Equally, it would be great if you could continue training if you and your partner feel you can manage it. Sometimes the last mile of the marathon can look overwhelming, because you've already run the other 25. It won't be easy, but is finishing the marathon something you want to do - if not, stop now and be proud of the first 25 miles. If yes, continue and know it will be hard but what you want to do. If you aren't sure, keep putting one foot in front of the other to keep your options open whilst doing everything possible to work out if you want to finish - counselling, friends, MiM, introspection, options to help with the last mile, get an accurate view of what residency will look like for you and your partner - he may also be burnt out and have an overly negative (or accurate) view of the road ahead. Is another option to match and then make a decision once you actually know where you would have to live, what the program would entail, so you are choosing based on a known quantity than a nebulous concept of multiple possible programs? To put it another way, place caveats on your decision to continue that you can both live with eg if I match here and do this program or specialty then I'll continue but if I match there or do that program or specialty then I'll stop. You sound as if you have a wonderful relationship. That is worth hanging on to, as you've already mentioned. My perspective has always been my family come first - at the end of the day, if I lost my job I'd be upset. If I lost my family, I'd be devastated. I know I am a committed doctor, but I'm an even more committed wife and mum. What my husband and I have built together with our little family far outweighs the work I've put into my job. My decisions don't just impact my partner but also my children and I feel considerable responsibility to ensure I am choosing for all of us. Imbalance is perfectly fine for a time, as long as in the long run, the balance for our family works. I guess the only other thing is knowing yourself and how you handle resentment, because if you feel coerced into one path or the other, resentment may ultimately undo the one thing you were trying to preserve. Same for your partner. Give yourself permission to take a different direction if that is your ultimate decision. I honour your ability to stop, take stock, and consciously choose a future, a quality which will make you great at whatever you choose, whether that's matching or not
ReplyDeleteRegarding your student debt, could you graduate but not match, and actually try out working in consulting or pharma for 1-3 years? You would have a tougher road if/when you did interview again for residency, but sounds like the combination of real income and schedule that allows time for family and counseling, might be what you need to decide if you can gear up for a last push of training. The breathing room might also give you fresh thoughts about speciality choice (PM&R? Psych? Pathology and do procedures?). Or let you see that you could love a nonclinical career (and get the pay raise of being an MD). -- now a slightly tired IM R3
ReplyDeleteWhat everyone else said about 1 - get help. Talk to someone face-to-face; I suggest a therapist before you go to your mentors so you can have some emotional support. You do indeed sound burnt out and you are facing impossible choices - or at least it currently feels as if they are impossible choices.
ReplyDeleteI think the most important thing is not what you do, in the end, but how you feel about the decision process. That's something a therapist can help you (and your partner) with. It's worth investing the time and money.
Good luck. I do feel for you.