4th yr med student considering leaving clinical medicine

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    I have to make a big decision soon. I’m applying for residencies in peds but I believe my heart just isn’t into any type of medicine. Peds was the only thing that I could possibly see myself doing, because kids make me smile. Absolutely nothing else in medicine can do that.

    It’s getting harder and harder for me to get up and go to my rotations. When the interviewing process starts, I’m going to have to fake some major enthusiasm. I’m so sad that I’ve done this with my life. I’m 25 and I’ve already accumulated over $100,000 in loans.

    I’m married to another med student (no kids) who is well adjusted and still likes medicine after these 4 years. Our options are to couples match (and have me stick it out for 3 MISERABLE years), or for me to get my md and look for a normal job in the city where he matches.

    I’m trying to figure out if this is normal 4th year burn out/getting petrified of residency, or will I never be happy practicing medicine? Will I regret not sticking with it for just 3 more years? These are questions only I can answer, but maybe someone will have some insight to help me think about these things.


    Hi jen_md2b…
    I’m sort of in the same position you are. I just finished my first year of med. school and I was wondering if medicine was really the path for me. I almost decided to quit, but am still drudging through. I never had that “burning passion” for medicine, but just figured that most other students probably didn’t either, and that I shouldn’t NOT do medicine because I didn’t have that. Did you feel the same way? What are your thoughts if you don’t do clinical medicine?


    I’m a board-certified Internist who’s left clinical medicine and has never been happier. For my story, see “Career Change–Have Courage” in this same General Discussion section.

    I’d like to emphasize that you’re not alone, even though it may feel that way. The difference is that you’ve more courage than the others because you’ve chosen to acknowledge how you feel.

    Of course, I can’t tell you what to do. I can just say that I kept on telling myself it was going to get better.

    In medical school, I thought, “Well, let me just get past the basic sciences and I’ll start to enjoy it” and “As soon as I have more responsibility for patients, it’ll be better.” In residency, “I don’t really have my own patients yet, no true autonomy. And all the overnight call and endless studying are terrible. It’ll get better.” In Chief Residency (I participated in a hospitalist practice), “Wait, I now have my own patients, lots of free time, I’ve passed my boards, but I’m still miserable!”

    I have a million other thoughts on the topic, so if you’re inclined, please feel free to email me. It’s a big world out there and just remember that you don’t have to go where the current momentum wants to take you. It’s OK to challenge the system. You’ll face many people who will challenge you back (“don’t you feel like you’re wasting your skills?” “how could you spend that much time and money on something and give it all up?” “But you’d make such a great pediatrician!” etc etc).

    My recommendation is to take some time to read some career change books. I’ve been recommending Leaving the Bedside: A Guide to Finding a Non-clinical Career in Medicine (out of print but available from Internet sites like Amazon) and What Color is Your Parachute. You’ll need to take a very objective approach to something fraught with lots of emotions, but stick with it; it’ll pay off in the end.

    Get yourself a good executive coach if you can afford it (you’ll only likely need a few sessions).

    Best of luck! You can do it. There is life and happiness beyond clinical medicine, though those around you may not want you to realize or believe it!

    Brenda MayBrenda May

    Don’t feel embarrassed or ashamed of wanting to change careers. One of the doctor’s I work with became a doctor because, at the time, it was a good career choice. He never had a passion for it but rather just approached it like any other rational decision he made. Needless to say, he is a butcher and a BAD doctor.
    He is an ER doctor in a small hospital because having his own practice would have been too much work. I have watched his work and he is terrible. He miss diagnoses appendicitis and cholecystitis on a frequent basis because he thinks the patients are just overreacting to an upset stomach and he even miss diagnosed a case of chicken pox.
    He and I talked about his decision to go into medicine and he said that he is too close to retirement and can’t really do anything else now but had he the chance to do it again, he would have chosen another career. I have seen it first hand and the the people that suffer the most are the patients. So please make sure that it is what you really want to do or your patients will be affected by your decision.


    I can also totally relate to your situation. I am a fourth year medical student with a 21 month old and I’m going through the app. process for psychiatry. I always wanted to be a doctor, so to speak. I say so to speak because, I don’t think that I was exposed to a lot of other options for careers. When you are growing up as a smart girl, everyone tells you you can be a doctor, etc. Although I have no regrets, I am very proud of my achievement, there have been many bleak moments when I just dragged my butt to rotation after rotation for months feeling very unfulfilled. My psychiatry rotations were the only ones where I felt fulfilled. For me the problem is that intellectually and academically I like medicine and science and the human body, but in practice it is very frustrating and demanding of your time. Going through school everyone tells you work hard it will all pay off, but in medicine you work hard forever!!! with some payoff and a whole lot of sacrifice. My current plan is to finish a psychiatry residency and see how it feels when I get done. But I am always keeping my eyes and ears open to careers people do when they leave medicine. And the most important thing that I have learned is that you have to do at least an intern year, but even better to do a residency, because the MD has weight behind it. You just really don’t know enough coming out of medical school, unless you are going to do something totally distinct from medicine. The book recommended in an earlier post, Leaving the bedside (I think!!) has a lot of suggestions and is probably at your school’ s library. Good luck and be true to yourself!!! Because in the end only you and your patients suffer, not friends, family or classmates.


    I totally LOVE medical school. Maaan….some days I think I’m just gonna BURST all over the ceiling and walls because I LOVE what I’m learning so much, even though it’s incredibly time consuming…..and the balancing act and all….

    BUT….prior to medical school, I was a social worker. In fact, I worked through my first year of medical school as a social worker too. I was TOTALLY unfulfilled in that field, and while people seemed to respect my work, I felt I was really bad at it….because I put NOTHING into what I was doing. I just went through the motions. I went into social work at a time that i knew I needed to do something, and it seemed to be the next best thing.

    I can’t say that I was unhappy or anything in what I was doing–I’m generally a happy person– but it didn’t make my guts burst. I’m so glad I took the leap to ditch that career (that was really financially going pretty good with a private practice that was a few years old) and move over into medicine.

    I know this is the flip side of the coin, but I say that if your choice of work doesn’t grab you, it’s crazy to spend your life wrapped up in it. Move on. Do some soul searching and do something you LOVE!!!




    I am a 24 yr. old BA/IT major that is thinking of going back to complete pre-med reqs and then on to med school. After reading this email chain it was making me sad, and then your’s at the end is so inspiring! I am having a tough time making this decision still though….I left pre-med b/c I was worried about a healthy work/life balance. I enjoy what I do and am very successful at it, but one day I realized that I’m giving ridiculous hours to a job that I’m not pationate about when I could be giving 10% more and do something I love – freakishly have loved forever….So, the question is, after going from making money and having a good balance, how did you switch to being poor, having no sleep and no social life? While most on this site are worried about enough time with thier spouse and kids, I am worried that I’d be too busy to find someone and devote enough time to build a relationship. Any advice? :rolleyes:



    Well, I suppose I just decided to do without extra spending cash and to forgo the joys of a social life for a while. Last year I worked a bit, but decided not to do that this year. This year I’m going to school and tending to my family. I have some time for my old friends (but I am very choosy about how that time is spent, and with whom).

    It’s important to make sure debt is manageable. What’s easy to manage with 60-70K yearly income may be impossible on student loans. So pay stuff off. Getting rid of financial worries is a must.

    I’ve always been a bit of a nerd, and I absolutely LOVE studying, so medical school is fun. I had a tough time adjusting to all the time off this summer, as I NEED intensity in my life. It’s kind of funny, because my favorite hobby is skydiving, which most consider to be pretty intense. I’ve made about 750 jumps over 8 years, and did quite a bit of jumping this summer….but I still need a PACE. Skydiving is fun, but nowhere near as fulfilling as filling up my noggin, and medical school surely has a helluva pace!!!! Anyway….I’m rambling.

    Giving up a financially stable career and going broke in medical school is certainly something that can be done. YOu can even do it with a family. Just know that medical school is INCREDIBLY time consuming, and the prospects down the road don’t seem any less demanding. For me, I MUST be challenged in this way, because it’s built into the core of who I am. But prior to medical school, I had no real concept of what it would require of me. I’m glad that I enjoy it, because it would be a nightmare to find yourself here if your heart wasn’t really into it….and if the benefits didn’t outweigh the costs…. It’s important to think about HOW you want the rest of your life to be. There are definately specialties that are easier on your time, but personally I don’t want to be a dermatologist. I am considering pm&r though….

    I’m waxing tangential again….so I’ll shut up.



    Dear Jen, I almost fell out of my chair when I read your post. It’s wicked scary! Did I have a dissosiative episode in August and write that post?? My name, also, is jennifer. I’m a 4th year facing the EXACT same issues as you (except my husband is not in medicine). I’ve been “sticking it out” since the first month of medical school, and like Lena, keep waiting for the grass to get greener. My residency apps are in and I’m dreading interviews, all the while I’m trying to figure-out what I’m going to do! I can’t sleep at night and find myself semi-sabotaging my chances for graduation by putting off scheduling rotations!! What’s the matter with me?!?! Medicine was my dream and nobody could have talked me out of it while I was applying. Now, I feel sad that this is the culmination of all my hard studying, sweat and many tears. Girl, I feel your pain. You are not alone.


    Dear Jen,

    It must be so hard to slog through med school without that burning desire to be a doctor. In my case, it’s all that gets me through! Whenever I’m struggling to complete an assignment or study for a test, I have to remind myself of how much I want to become a doctor and of how ecstatic I was in January when I got into med school. I don’t think I could do it without that goal in sight!

    So first of all, congratulations on making it this far- it is very hard to study when you aren’t totally motivated.

    But even though you are feeling some doubt at the moment, it’s not necessarily a permanent thing, and to be honest, I think it sounds totally normal. You are still young, and most people your age probably aren’t sure about what they want to do with the rest of their lives. One of my friends here says that she doesn’t know whether she wants to be a doctor anymore either, but she’s going to stick with med for the time being. And I have come across many ex-doctors during my course this year; people who practised medicine for a short while, then found it wasn;t for them and left to pursue other careers. Many of them are now doing very artistic things (eg. music, writing). But they don’t regret having done med school and practised for a while first.

    I think you should hang in there, Jen. I’m told that the residencies/internship which result in your final qualification as an MD are what makes all the years of med school worth it. If you leave before then (at least in Australia, that is)your degree isn’t worth anything because you don’t have a qualification. Even if you decide that you don’t want to practice medicine afterall, you should complete your qualification or all those years of hard work will have been for nothing!

    After some real experience in clinical medicine you might just find that your feelings change completely- you might decide you really DO want to be a doctor. Or, maybe you won’t feel differently, and you’ll decide do do something else instead. Either way, it’s unlikely that you would regret having completed your qualifications.

    Anyway, don’t lose sight of how far you’ve come and how much you’ve achieved. It’s possible that you just haven’t found your ‘niche’ in medicine just yet. I can’t emphasise enough the fact that you are NOT alone in your feelings- there are many ambivalent meddies out there who feel very lost and unsure in their career paths. I certainly don’t think that you will *never* be happy in medicine. I think it’s more likely to be a phase that many young doctors-to-be go through.

    Hang in there buddy! Best wishes for your upcoming applications, and I hope that you get what you want out of life.




    The support here is AMAZING and I just want to thank you all for posting your take on things. I felt so isolated 2 months ago when I posted – I mean, I really don’t feel comfortable talking about this stuff w/ my classmates. They all seem so excited about the future. The only indecision I’ve heard about in my class is what specialty to enter, NOT whether or not to do medicine at all!

    I share some of the same experiences as butterfymama in that growing up I was always told I was a smart girl and that I could be a doctor or lawyer or whatever I wanted. Somehow in my head it got twisted to mean that anything “less” than that was unacceptable. I look back and see how ridiculous this thought was!

    I have applied to residencies. I think right now it makes the most sense to finish it all. I need some security with these loans over my head. In three years I’ll have my liscense and maybe more doors will open because of that. I have ordered Leaving the Bedside(suggested by Lena-thanks!) in the hopes of finding something that’s more suited to me than clinical medicine. Meanwhile I’m just taking it day by day. For all those in similar situations-hang in there, and thanks for your support.


    I am totally feeling the same way you are. I’m currently a 4th year and I’m drudging my way through rotations. The past 4 years have been a great struggle. Medical school has put me into a sort of depression. Luckily I’ve had my husband there to support me, keep me going, and to wipe away my tears. When I get home each day, the last thing I want to do is read about more medicine. Most days I’m totally not motivated.

    I thought I had always wanted to do medicine, but now that I know the realities of it (overworked/underpaid residents, long hours, call, endless study, decreasing pay…)I’m not sure this is what I want for the rest of my life. I’m married (have been since my 2nd year)and I want a family life. Like you, I have a very large debt to think about. My options thus far are to take a year off after graduation to see if medicine is really my calling, or just do my internship year and try to get a job at a acute care clinic(or somewhere), or do a residency and use all the money to pay off my loans then get on with my life in some other career, or teach high school science and coach soccer(coaching/playing soccer is one of my favorite things to do). I also plan on reading that book Leaving the Bedside for other ideas.

    I’m so glad to have found someone else who feels the same way. Most people that I have mentioned this to think I’m crazy and giving up too much. But, if I’m not happy, is it really worth it? :confused:


    I just got the book “Leaving the Bedside” and it’s actually published by the AMA! I hope to find some answers there and perhaps some alternative choices than residency. I just feel so disappointed that I worked so hard to get into med school, worked ridiculously hard 1st and 2nd year,and now with graduation just months away, I have 3-4 more years of sleep deprivation & long hours, and even more studying. The part that has me the most freaked-out is the idea that this constant studying is NEVER going to end. I will always have something new to learn. It feels like a discipline that can never be mastered, and that’s frustrating and frightening.

    I’m not beating myself up over my decision to go to medical school. Medical school is much like parenthood, you have a pretty good idea what it’ll be like, but until you experience it, you will never fully understand.

    Anyone have ideas about what type of jobs are out there for an MD without clinical experience??



    What other types of work or activities are you interested in? Maybe you can work from this point to see how you could combine it with another field. Do you like writing? Or Public health? You could look into medical writing jobs or journalism. Do you have an interest in clinical research? Do you like working in interdisciplinary teams. I have worked in pharmaceutical & biotech research and project management and there are lots of opportunites in this area for MDs – some involve combining with another degree (such as MBA or JD, others you might be able to go directly in. Or there may be jobs within the government working for regulatory agencies.
    You can email (or pm) if you want more information.
    Good luck!
    LM 😎


    Hi Laramisa,

    I was wondering if you could give me more info on your experience with other opportunities for MDs outside of clinical medicine! I sent you a PM but I’m not sure if you received the message. Thanks a bunch!


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