I hope my story will provide a frame of reference for how quitting residency can play out. I’ll try to keep it short and I’ll elaborate on specific points in the FAQ. If you find this helpful, there are plenty more stories in the Resources page.
My Decision to Quit
The morning I was supposed to switch from PICU nights to days I had a complete emotional breakdown. My brain just stopped working. It was so bad that I was questioning whether or not I’d be able to function as a resident, so I paged our chief resident on-call to talk it out. When she returned my page, I tried to explain my situation, but I couldn’t get a word out. It took me some time to control the emotional storm in my mind. Eventually I was able to explain that I had a rough week and was questioning my ability to function at work. She was completely understanding and let me call out.
[As an aside, there will be plenty of examples of how awesome and understanding my residency program was during this process. I decided to keep those details in, not to rub it in, but to serve as an example of how programs SHOULD handle this type of situation.]
It was a weird day. I tried to relax, but I spent most of my time worrying about what was wrong with me, how I could apologize to the resident covering my shift, and wondering whether or not I would be better the next day. Well, I did NOT feel better the next day. My mind was still mush. I think my week of PICU nights was just the perfect storm of poor sleep, several exceptionally bad outcomes, and my baseline sub-clinical anxiety all in a new environment of high acuity and a constant stream of tasks to be completed. So, after a few days with no improvement in my mental state, I realized this was going to be a whole situation. The chiefs connected me with a psychiatrist who was fortunately able to see me within a few days. During the first week or so, I touched base with the chiefs every 1-2 days. By the end of the first week, I still wasn’t able to return to work. I told the chiefs that the idea of quitting residency had crossed my mind, but I had no active plan to quit in the immediate future. They took it really well and said something along of lines of “that’s not shocking to me given everything that’s happening.” They didn’t gasp in disbelief or shame me, which was great.
It was probably clear to them at this point that I’d need extended time off, so they brought up the Leave of Absence as a long-term logistical/scheduling solution. I agreed to take it, primarily due to the fact that there was no way I could function at work, but also because I needed space from residency to properly answer The Question. I felt terrible that other residents had to cover for me. But I also couldn’t help but feel that if our medical training system is responsible for our deteriorating mental health, then it needs to take responsibility when residents require time off (a soapbox for another time). I checked in with my PD every 1-2 weeks during my leave.
At this point I was asking The Question (“should I quit residency?”) multiple times daily. I found myself in a bit of a conundrum though. I couldn’t tell if I was just asking because of this acute exacerbation of burnout/anxiety, or if it had been in my subconscious for years and was finally rearing its head. So I came up with a plan to make things more clear. I thought to myself, “If I treat this acute burnout/anxiety, feel better, and eventually stop asking The Question, then I’ll continue residency. On the other hand, if I keep asking even as I start feeling better, then I need to start taking it seriously.”
In order to execute this plan, I decided to do everything I could to get better. I engaged in some good old-fashioned shared decision-making with my psychiatrist and opted for medical management of anxiety and insomnia (I’ve never been great at sleep, but at this point it was TERRIBLE). I also started seeing the same therapist I had seen earlier in residency. This treatment, on top of my Leave of Absence, was a great setup for recovery.
Fast forward through a couple months of daily meditation, reading, journaling, and conversations with select family and friends, and I slowly started feeling better. But I kept asking The Question, and as my head cleared I could finally see the answer: yes, I wanted to quit residency. This acute situation uncovered a feeling I was too afraid to explore in the past: medicine just wasn’t a good fit for me. When I decided to pursue it at 24 years old, I thought it was the most fitting career path. Turns out I was wrong. But I couldn’t know that until I actually tried it.
So, after making my career transition plan, I spoke with my PD who started the logistical process. I also finally felt ready to talk to my friends in the program. Now that I was able to conceptualize wtf happened, I was actually excited to tell them. I DID initially wonder if they would think I was abandoning them or taking the easy way out. Or worse, I thought they may feel sorry for me. To my great relief, they were super supportive, understanding, and overall awesome. I clearly underestimated them!
Next: How I Got There