To want to leave medicine?

[stresseddoc]

Just that!

For those with a medical background, I am currently an F4 - I completed foundation training and then have taken two years out with ad hoc locum work. Throughout this time, I've realised just how unhappy I am in this job. A big part of it is the general things that make medicine a difficult career (that I won't go into as I think we are all aware!) but part of it is just me - I'm not confident enough, too worried about litigation, unsure how I will cope emotionally when something goes wrong etc. Latterly, I've been taking psych shifts as I thought psych training might suit me more - but even the thought of this LTFT is just too much.

I also find change really, really difficult and the frequent rotation (and even more frequent moving around wards/teams) takes its toll on me to the point that I become very anxious and struggle to sleep or eat for a few weeks before and after changeover - I think a big part of this wobble is knowing that I'd have to move for training (DH and I are not in the part of the country that we intend to stay in) and I'm terrified at the thought of starting at a new trust.

I feel really lost and trapped. DH earns well and has a job with lots of travel opportunities (most turned down currently because of my job...) + we want to have children in the next few years. He thinks I just shouldn't work and we should travel/live abroad. It would be so easy but surely I'd come to regret that down the line?

I'd love to do something else but I have no idea what else I'd be good at - my confidence is currently such that I can't imagine anyone wanting to give me a job! There are big CV gaps where I haven't been locumming and I haven't had any form of interview since I applied for medical school!

Part of me thinks I'd be an absolute fool to give up such a stable career with good earning potential - but no part of me sees myself as a consultant medic and currently, my only reasons for wanting to stay in are 1. fear of regretting it 10 years down the line and 2. fears of upsetting my parents (which it will).

Any advice? Anyone left and regretted it? Anyone left and able to recommend alternative career opportunities?!

I don't have advice, although anyone would sympathise with medics these days.

What I do know is that living your life so that your parents can have a doctor in the family is a dreadful idea. Work on that.

Hi. psychiatrist here. Sounds really tough. Only you can make this decision, but I would say that I think locuming is the hardest way to do the job. What kept me going during the hard early years of training was the people who I was training with and the other professionals I got to know. You don’t necessarily have to move around that much particularly if you train in a big city. And even if you do you have weekly teaching where you see your friends and can have a moan. The first three years are the toughest then things get easier. And you’ll have a clinical supervisor and educational supervisor to look after you and encourage you. And the more you learn the more the job is interesting rather than scary. And you start just enjoying being with your patients and helping them rather than worrying all the time. Although you’ll always worry a bit.

Of course you can’t imagine being a consultant! Any more than than you felt like a doctor on the first day of med school (same kind of internal change in how you feel). But by the end of training you’ll be ready. Especially if you train part time. I can’t lie - my job is busy, tough and heartbreaking at times - but I work part time which helps, and I have lovely supportive colleagues who I’ve known for years and we all keep each other going.

I suppose what I’m trying to say is - yes it’s hard but I think the way you’re practising now is the hardest and getting into a training scheme with support, structure and certainty may make it a bit easier on you.

You have to live your life for yourself, not for your parents. You must be intelligent, having become a doctor, so I imagine that retraining will be an option, particularly if your husband earns enough to keep your finances stable.
Would he support you if you decided to study to be a lawyer / solicitor or an accountant, for example?

Not a medic myself but have spent almost all of my career working in hospitals and made wonderful friends with many so have a reasonable insight into your struggles. Please don't forget you are intelligent and have so many transferable skills. There are so many options out there so please don't feel your training is wasted. I think other medics are better placed to give advice on work and specialties.

You said your other half spoke about travelling - why not consider going somewhere like Aus/NZ to complete your training? Medics are highly respected and treated SO much better than UK. I studied/worked in both countries in my 20s and huge number of doctors had moved from UK for better lifestyle

Just don’t be a medic in the UK! Honestly Dh is a Consultant, he loves his specialty and he’s bloody good at it, but working in the NHS is killing him 😕

Could you go into medical research? A friend's ds changed to studying statistics and now works in that area. Obviously you have a great head so, once you stand back and accept it's not for you other opportunities will arise.

One additional point, OP. You could relocate if your DH has opportunities abroad in a more stable health care system but if you leave medicine, tell your parents and yourself you will always be a doctor now you've qualified. It's a profession rather than a job. Good luck.

Sorry to hear it can't add anything constructive except to say I'm always infinitely grateful to all the medical staff I have had interactions with throughout my life. You actually do a proper job with real-life outcomes and make a huge difference to so many people and there are very few jobs where you can say that. I hope you find a way that will make you happy. Good luck.

It sounds to me as if you were low in confidence so took time out to do F3 and F4 - but this has actually made your confidence worse.

Doing small numbers of locum shifts here and there is absolutely the worst way to do the job - you always have the lowest amount of skill, don't know anyone or where anything is.

Have you engaged at all with any doctor specific support or counselling schemes? I think you would find this really helpful.

If you can't see yourself as a consultant, have you considered that your eventual aim might be a staff grade doctor? - No rotation, work in the same unit for years, build up loads of skills and highly valued member of the team.

I’m an ITU nurse, so not a doc but can massively empathise with how you’re feeling. I agree with previous posters - stabilising into a training post I think would give you peer and senior support, and also access to free counselling and stuff from the trust. Also I have worked in Australia and looking to move back next year as it’s so much better. Have a look at that if your OH can get a visa - you could go temporarily and see if you like it. Good luck!

As hard as the role is you don’t sound well suited it. In many other professions we talk about multiple having careers yet in medicine and teaching, for example, we expect people to stay forever. Realise there is a high overhead of training particularly in medicine but lots of professional jobs require undergrad degrees plus post grad qualifications and years of experience, and people are still willing to switch without being perceived as a failure. I find it a very interesting (odd) dynamic. Better to have someone be a brilliant teacher/doctor for X years or decide they don’t like it etc. and move on than the current situation.

You clearly excel in some academic areas. Have you considered research or roles within Biotech/Pharma for example.

You might benefit from a mentor or perhaps some career coaching?

The only thing I would say is being a doctor is held up almost instinctively as a wonderful thing so this would benefit almost any career you went into. Anyone who was a doctor and is then something else, their past being a doctor is always mentioned as a credential. It will help you get jobs that are completely unrelated.

Wow, thank you all for such supportive messages - was half expecting everyone to tell me to get on with it! To answer a few:

verytired - it's so nice to hear from a psychiatrist. Those I work with are very jaded and don't recommend their career at all so it is really nice to hear something positive and definitely something to think about!

prescribingmum - again, something to think about. Out of my uni friend group I am the exception for not going off to New Zealand! They are all having a fab time. It's just so far away!

Annamagnani - you are completely right of course. I so wish I'd gone straight into some kind of training - I'd be nearly half way through now! I planned to spend these years in A+E building my skills but found this far too stressful so have cycled through a bit of gen med, a bit of geris and now psych. I feel really deskilled and cross with myself for allowing this. I know the BMA offers a counselling service so I should look into this.

As for my parents - they are supportive really. I don't think they are particularly motivated by having a medic child (well they shouldn't be as they have another one anyway 😁). I think they think I'd come to regret it. They did not work in the public sector and think I'd be very silly to give up the pension, stability etc.

What about doing a masters in public health? or Health Economics and becoming a clinical academic?

I would just get on with it and qualify, even if ltft. E.g. psych or go have short training amd geographical flexibility. Else you could be staff grade geris but then still have punishing shifts forever.
Once qualified you could stay in same job with stable team etc. And your income would double so could more easily work part time.
Would be difficult (not impossible) to go back to later
Lots of jobs are a bit crap, unless there is else you strongly want to do I would get on with it and can always change career later

Psych or gp! Darn autocorrect

3 years in A+E was a mad plan unless you are some kind of adrenaline junkie!

Plus everywhere you work, you build skills - A+E doctors are amazing at A+E but would be massively lacking in other specialties.

I think you are in desperate need of career guidance, and not being on a training programme is cutting you off from support.

Which I am most definitely not!

I think I was just so exhausted after foundation + COVID that I wanted any out and didn't ever take the time to see what was actually available or what would suit me.

I really will look into some counselling. I've cut myself off so much from medicine that now I just can't see myself ever going back into that environment but it's very difficult to tell what is actually not enjoying the job and what is just a total loss of confidence. Argh!

I love the idea of teaching/public health/research but really it's all just a bit pie in the sky (and avoidant...) as I have no idea how I'd get into any of it and would probably also feel not good enough there as well...

I think you need to go and get some careers advice asap. Find training post in an area medicine that interest you.

What about something like clinical genetics? Bit niche but rarely shifts, stable, usually small teams dr.

Consultant in a different specialty here. If training and rotations feel too overwhelming, have you considered staying in one department as a locally employed doctor? I know you want to move, but once you choose an area it’s only 1 more new place and you can live within an easy commute. You can then get settled and get to know the environment which makes life so much easier. Eventually when you have enough years experience you could move up to being a SAS doctor with a fixed job plan (which may not include on calls, depends on specialty) and opportunities to do more in medical education/appraisal/leadership in the future. Gives you maternity pay and job security too.

I would definitely advise taking some careers advice - even though you’re not a trainee, the director of medical education and team can be helpful, and most deaneries have a careers unit and are very keen to talk to anyone considering leaving medicine just to make sure you are making the right choice.

Obviously I'm biassed, as it's my specialty - but have you considered Palliative Medicine?

Very few adrenaline moments, massive need for doctors, generally get to go home on time. And most people in it are lovely (OK not all but that applies everywhere) and serious about teaching and supporting trainees.

However I think you have nailed it - your primary problem is that you think you are not good enough, so avoiding going on a training scheme, catastrophising about litigation. You need to sort this as even if you changed career, currently those feelings would go with you and spoil it.

Even though you aren't currently on a deanery contract, there is a huge amount of support out there for doctors if you want it (and I did get amazing psychotherapy support from 2 different deaneries in my training)

www.practitionerhealth.nhs.uk/about-practitioner-health

www.practitionerhealth.nhs.uk/other-sources-of-help

Thanks for all those who have suggested careers advice - I'm looking into this now. Hopefully this will give me a bit of clarity and perspective.

Deinonychus - I have considered this, yes. I've been doing a lot of googling to try and see what is available. I probably should have mentioned but I did something very similar (only for 8 weeks, I was covering some leave) in an old-age psychiatry department and really loved it. It was 9-5 every day so I never felt stressed and was able to give everything my all, I got to know my colleagues and patients and felt generally very content. Certainly would have stayed if I could have!

AnnaMagnani - I really love palliative care and actually think I'd be good at it. I was lucky enough to get a foundation job which was half pall care and it was the happiest I was during F1 and 2 by a long way. Unfortunately, I just don't think I could get through IMT to get there. I worked with an absolutely lovely consultant who spent a lot of time asking around to see if there were any trust grade jobs going for me but was told that kind of jobs doesn't really exist for post-F2. Thanks so much for the clarity though (and the links!). Really, really appreciated.

I'm a GP trainer and I know that at the moment GPs seem to be the at the front of the queue for bashing and the cause of all that is wrong in the NHS but I do love my job. A small team, continuity of care for my patients and I get great joy in taking trainees from (sometimes) quivering wrecks to confident independent GPs. Please don't underestimate the assault on doctors and nurses confidence and self esteem the past 2 years have caused. It's been awful and we have had a couple of GPs leave. The terrible stories of GP working conditions are all out there but there also lovely practices and you can train LTFT and have maternity leave without affecting your training. I have one trainee who has her training for almost 10 years having taken tome out for 3 pregnancies. Happy for you to DM me. I have 18 years experience as a trainer and 22 as a partner in practice. Please don't write yourself off. As other have said get done career guidance and think about practitioner help as PP has linked to.

IMT is not forever! If you had started IMT at the end of F2, you would have nearly finished it by now. And you would have spent most of it in the same hospital - got to know people, the wards, much less change than as a locum.

I thought I'd never pass PACES but I did on my 3rd go as I was about to give up. I also know a very senior Pall Med consultant who spent years as an SAS doctor as they retook it over and over again.

Some hospices are prepared to take on doctors who only have Foundation Training, it really depends on the people in charge and how difficult they have found it to recruit.

I am a Post-CCST dentist, about to become a consultant (ST5). I am thinking of totally changing careers as I just do not enjoy it, for various reasons.

Have you thought about taking an OOP, that would at least give you chance to explore other areas. I believe you can take an OOP now without having to justify it. Or, as I am considering, a leadership year (non-clinical) to see wether I am better suited to this type of role.

I struggle with the decision daily and realy have no clue as to what alternative career I would pursue!