Deciding not to do residency after graduating med school

[criston]

I've heard of many med students in the U.S. decide not to do a residency and to instead pursue non-clinical careers, for example in startups, consulting, and I-banking, that may or may not be related to healthcare.  Does anyone have any experiences of themselves or classmates choosing not to apply for residency?  

I'm asking this because I'm a couple months into clerkship and haven't found the clinical years of medical school to be as enjoyable or as interesting as I had expected it to be. Many of my classmates feel the same way. I know it is still early, and I know that the "real practice" of medicine might be more rewarding (salary, choosing what you do) and may have more independence (i.e. setting your clinic hours, choosing how many days you work) than the constricted life of a medical student.  

[LittleDaisy]

20 minutes ago, criston said:

I've heard of many med students in the U.S. decide not to do a residency and to instead pursue non-clinical careers, for example in startups, consulting, and I-banking, that may or may not be related to healthcare.  Does anyone have any experiences of themselves or classmates choosing not to apply for residency?  

I'm asking this because I'm a couple months into clerkship and haven't found the clinical years of medical school to be as enjoyable or as interesting as I had expected it to be. Many of my classmates feel the same way. I know it is still early, and I know that the "real practice" of medicine might be more rewarding (salary, choosing what you do) and may have more independence (i.e. setting your clinic hours, choosing how many days you work) than the constricted life of a medical student.  

I know in medical school, a few classmates decided to quit medicine because they don't enjoy it very much.

In U.S, I believe that they don't restrict medical school admissions as we do in Canada, a lot of U. S medical students find them unmatched or unable to attain a job position after residency; which is why there are more medical students who decide not to go with residency after graduation.

Sadly, the people that I know who didn't go through residency are those who are unmatched and still unable to match despite maximizing their chance at CaRMS.

I would advise you speak to your medical school's guidance counsellor.

You only live life once, do what you would enjoy be doing, rather than doing medicine for stability and for its prestige. 

[indefatigable]

2 hours ago, LittleDaisy said:

In U.S, I believe that they don't restrict medical school admissions as we do in Canada, a lot of U. S medical students find them unmatched or unable to attain a job position after residency; which is why there are more medical students who decide not to go with residency after graduation.

The US has better odds for getting admitted and also way more residency spots than graduates - which allows IMGs to match a lot into primary care.  That's why some Carrib med schools have 90s match rates.  Nonetheless, IMG graduates have more trouble overall with matching.

US medical students seem to go for more lucrative specialties - technically the overall match rate isn't as high as Canada, but I think more people choose to re-apply after a research year or similar to very competitive specialties than within Canada.  

[indefatigable]

1 hour ago, criston said:

I've heard of many med students in the U.S. decide not to do a residency and to instead pursue non-clinical careers, for example in startups, consulting, and I-banking, that may or may not be related to healthcare.  Does anyone have any experiences of themselves or classmates choosing not to apply for residency?  

I'm asking this because I'm a couple months into clerkship and haven't found the clinical years of medical school to be as enjoyable or as interesting as I had expected it to be. Many of my classmates feel the same way. I know it is still early, and I know that the "real practice" of medicine might be more rewarding (salary, choosing what you do) and may have more independence (i.e. setting your clinic hours, choosing how many days you work) than the constricted life of a medical student.  

Expectations are high in medicine in terms of workload and responsibility -  but the alternative careers you mention are no better and probably worse in terms of autonomy and life-style.  A medical student has less responsibility than a staff physician, but a practicing physician may have more independence, depending on the specialty.  If you're really unhappy, then by all means seek counselling, look into other options - realize that there are many who would do almost anything to be in your shoes and that working in a full-time career is a different experience than being a student (no matter what the career).  

[shematoma]

58 minutes ago, criston said:

I've heard of many med students in the U.S. decide not to do a residency and to instead pursue non-clinical careers, for example in startups, consulting, and I-banking, that may or may not be related to healthcare.  Does anyone have any experiences of themselves or classmates choosing not to apply for residency?  

I'm asking this because I'm a couple months into clerkship and haven't found the clinical years of medical school to be as enjoyable or as interesting as I had expected it to be. Many of my classmates feel the same way. I know it is still early, and I know that the "real practice" of medicine might be more rewarding (salary, choosing what you do) and may have more independence (i.e. setting your clinic hours, choosing how many days you work) than the constricted life of a medical student.  

You're still early into your clerkship year, as you acknowledge. You surely haven't yet done all your core clerkship subjects. It's probably far too early to conclude you wouldn't enjoy your life in medicine.

I felt very similarly throughout all of medical school. I still feel that way often in residency. I probably wouldn't go in medicine again if I could go back 5 years in time... but it's much too late now. I think a lot about quitting and doing something different. The thing is that quitting is easy, finding something else to do isn't. All the things you mention are possibilities, but if you search online as to what you do can with an MD but no residency - the pickings are slim. Very slim. There are very few things that an MD alone enables you to do that you wouldn't otherwise. Some people go into startups, consulting, investment banking, etc, out of medicine, but they likely could have done those things without going into medicine. The economy and job market in general are good right now, and if you have skills and experience outside of medicine, you can certainly leverage those into a job.

If you have previous work experience or connections that you can take advantage of, then it might not be a bad idea to do so. If you don't, then I would work on a landing plan for leaving medicine - will you pursue a different degree? Will you look for a job?

In any event, I would avoid taking any action until you've completed your core clerkships and done a few electives... at the very least, in the field that you think you would be most interested in. As unattractive as medicine may be to you right now, keep in mind the grass will always look greener on the other side, until you're actually there and you realize maybe things weren't so bad in medicine after all. 2 months into clerkship is too early to draw a final conclusion.

[LittleDaisy]

1 hour ago, criston said:

I've heard of many med students in the U.S. decide not to do a residency and to instead pursue non-clinical careers, for example in startups, consulting, and I-banking, that may or may not be related to healthcare.  Does anyone have any experiences of themselves or classmates choosing not to apply for residency?  

I'm asking this because I'm a couple months into clerkship and haven't found the clinical years of medical school to be as enjoyable or as interesting as I had expected it to be. Many of my classmates feel the same way. I know it is still early, and I know that the "real practice" of medicine might be more rewarding (salary, choosing what you do) and may have more independence (i.e. setting your clinic hours, choosing how many days you work) than the constricted life of a medical student.  

I just want to comment that residency is tougher than clerkship, where you have graded responsibility, the toughest part is transitioning and being comfortable as a learner while being the <<junior attending>> during calls where you have to make important decisions (the senior on call is not always as much present as you want to be) .

If you do enjoy some part of medicine & clerkship, I would suggest that you go through clerkship and get your MD degree. If you do decide to quit after clerkship, at least you could attempt CaRMS if you decide to come back to medicine. 

I know people doing startups, consulting and i-banking, the job may look glamorous with less postgraduate education required, but the job security is not that great, once you start to make more than 100 k, they constantly try to replace you with young blood who cost 50% , and you have to work under someone.

Once you become an independent staff physician, the greatest part is that you work for yourself! Sure there are no benefits, pension, sick leave, maternity leave, but knowing that you don't work for anyone, and don't have to bend down, worrying about losing your job, don't have to compromise your values to cater the administration, is unique to medicine or to any profession where you work for yourself. 

I have seen a lot of people, even in healthcare professions, who are worried about losing their jobs in their 40-50s (hospitals are funded by the government, once the government restricts the funding, a lot of people are losing their jobs), that's where you don't want to end up if you choose to pursue another profession.

There are days where I don't enjoy residency that much, but then I think about how passionate I am about medicine and helping out my patients. You are too early into your clerkship to make a decision! 

[NLengr]

10 minutes ago, LittleDaisy said:

 

Once you become an independent staff physician, the greatest part is that you work for yourself! Sure there are no benefits, pension, sick leave, maternity leave, but knowing that you don't work for anyone, and don't have to bend down, worrying about losing your job, don't have to compromise your values to cater the administration, is unique to medicine or to any profession where you work for yourself. 

On the other hand, for many specialties, the job market is extremely limited and you run the risk of being underemployed. Even if you are employed, you run a real risk of having to take a job in a location you don't like. 

You trade great job security (once you have a job) for an extreme lack of job mobility. 

[JohnGrisham]

1 hour ago, criston said:

I've heard of many med students in the U.S. decide not to do a residency and to instead pursue non-clinical careers, for example in startups, consulting, and I-banking, that may or may not be related to healthcare.  Does anyone have any experiences of themselves or classmates choosing not to apply for residency?  

I'm asking this because I'm a couple months into clerkship and haven't found the clinical years of medical school to be as enjoyable or as interesting as I had expected it to be. Many of my classmates feel the same way. I know it is still early, and I know that the "real practice" of medicine might be more rewarding (salary, choosing what you do) and may have more independence (i.e. setting your clinic hours, choosing how many days you work) than the constricted life of a medical student.  

Stanford is one of those schools.

That said, do a 2 year FM residency at least, so you can get a medical license. Your more useful that way.

[Sickofitall]

6 minutes ago, JohnGrisham said:

Stanford is one of those schools.

That said, do a 2 year FM residency at least, so you can get a medical license. Your more useful that way.

 

This is the best advice. This way at least you have something to fall back on. 

[peace2014]

3 hours ago, LittleDaisy said:

I know in medical school, a few classmates decided to quit medicine because they don't enjoy it very much.

In U.S, I believe that they don't restrict medical school admissions as we do in Canada, a lot of U. S medical students find them unmatched or unable to attain a job position after residency; which is why there are more medical students who decide not to go with residency after graduation.

Sadly, the people that I know who didn't go through residency are those who are unmatched and still unable to match despite maximizing their chance at CaRMS.

I would advise you speak to your medical school's guidance counsellor.

You only live life once, do what you would enjoy be doing, rather than doing medicine for stability and for its prestige. 

The reason these medical students go to consulting or ibanking or startups is not because they can’t match. They decided to go because they wanted to use their skills to go into another field since most of them have prestigious Ivy League MD degrees. Their MD degree is versatile. I know a lot of people don’t want to hear it, but If you got a degree from a Canadian med school, the unfortunate truth is that if you can’t match, you also can’t get those lucrative consulting positions because Canadian MD degrees are not as versatile. Also I also don’t think it’s that bad for USMG to match and find employment. The reason USMG has a slightly lower match rate is that US MD students have a much higher proportion of students going into specialities and taking a gap year for research is not frowned upon compared to Canada. Plus US match rate is calculated as number of graduates that match to their speciality of choice, the placement rate (rate for getting into any residency program) for USMD or DO is like 99%+. The situation in the US is much better, but this is just my opinion and observations

[blah1234]

I think you have to understand the root cause of why you don't like medicine. If it is the work hours then many of the jobs you mentioned like Investment Banking will have similar to worse hours (although better renumerated hours). If it is the content of the work itself I would argue that you have no idea if you enjoy (or be good at) the content of these other jobs as well. However, as I have mentioned in the past I truly believe that medicine isn't a good fit for many students and that the system tries too hard to portray it as a perfect job. Residency will likely be more difficult than clerkship and the Staff life is easier in some regards and harder in others. 

1) Understand your financial situation. Are you required to go into some sort of high paying profession to service your loans? Medicine probably offers the easiest solution to this problem.

2) While you will have job security for things like FM, please note that many specialties have very restrictive job markets which can cause you and your family grief.

3) What are you looking for in a job? Good Hours? Prestige? Money? If you can determine what aspects of a job you're looking for you can narrow down the possibilities and maybe still find something in medicine.

I would argue that you should at least finish the MD so you can leverage that as a differentiating factor. For the majority of medical students, residency and staff life is the only realistic path forward as the reality is that many wouldn't be good at other "prestige" professions. However, if you are willing to hustle and deal with uncertainty you can find opportunities in non-clinical fields. The biggest problem is that you are no longer on the linear path of medicine which can be uncomfortable for many people. I think doctors underestimate how successful you can be in non-medical fields, but you'll likely have to work just as hard as you did in medicine to achieve that.

I know this doesn't sound like a lot of good news, but I think that's the reality of the situation. No matter what path you choose you will likely have to work hard to push through or to dig yourself out of this hole. I think without these systemic pressures a lot of my friends would have dropped out during residency. 

 

[LostLamb]

I know one person from my Med school class who did not apply for residency and leveraged having an MD to bring skills to the startup/finance world.

this individual had connections to facilitate this in the USA, and I believe some experience in those fields prior to medicine. To my knowledge he has never looked back, but kept an open mind until it was carms time and he ultimately decided against applying at that time. 

Unless you have a solid back up, there is a lot of risk to bank on doing something non-medical besides a residency post-Med school. 

I hope you do some soul searching and figure out what it is that you are seeking and not getting from medicine. 

[meyoumeyoumeyou]

OP - First of all, do not feel that you are alone. Many physicians are dissatisfied with their clinical careers and are looking for non-clinical opportunities. Including myself, an attending recently out of training.

Rest assured that there are many non-clinical and non-medicine opportunities out there, but most will require an MD degree and almost always residency and board certification in a specialty (including FM). When I interviewed for non-clinical, corporate positions, it was my clinical background that got me the interviews. Plus it's a safe fallback if corporate career doesn't pan out.

My advice: keep an open mind and try to find a specialty that you are interested in. Look into pathology, radiology, public health, etc. If by carms season there's nothing you like, do FM or IM for a general medical background because that's important for non-clinical careers. Also, look into learning 3rd and 4th and 5th languages - a big bonus if you ever decide to go global.

[ploughboy]

Early clerkship sucks.  You have no idea what the heck is going on, who everybody is and what their role is, you're at the bottom of the totem pole, and you don't speak the language/jargon of the service that you're on.  And once you've been on-service for a few weeks and are just getting the hang of who's who, what's what and figuring out some of the medical stuff, you move to a different service and start all over again.  Lather, rinse, repeat for a full year of feeling constantly off balance without any control over your life.

Don't make any irrevocable and life-altering decisions based on feeling crappy in early clerkship.  Suck it up, get through it, match to something, get yourself a CCFP or FRC.  Then at least you've got the ability to generate income from clinical work while you figure out if you really want to bail on medicine as a career.   You've also got a metric tonne more credibility for your future non-medical employer. 

You're probably in the weakest position of your career right now.  Even if you do make a hard right turn into something non-clinical, make that move from a relatively stronger position.  Don't do it right now.

[JohnGrisham]

13 hours ago, peace2014 said:

The reason these medical students go to consulting or ibanking or startups is not because they can’t match. They decided to go because they wanted to use their skills to go into another field since most of them have prestigious Ivy League MD degrees. Their MD degree is versatile. I know a lot of people don’t want to hear it, but If you got a degree from a Canadian med school, the unfortunate truth is that if you can’t match, you also can’t get those lucrative consulting positions because Canadian MD degrees are not as versatile. Also I also don’t think it’s that bad for USMG to match and find employment. The reason USMG has a slightly lower match rate is that US MD students have a much higher proportion of students going into specialities and taking a gap year for research is not frowned upon compared to Canada. Plus US match rate is calculated as number of graduates that match to their speciality of choice, the placement rate (rate for getting into any residency program) for USMD or DO is like 99%+. The situation in the US is much better, but this is just my opinion and observations

Agreed. Matching is not hard in the US and taking research year to March more competitively is not a death knell.

[Edict]

20 hours ago, peace2014 said:

The reason these medical students go to consulting or ibanking or startups is not because they can’t match. They decided to go because they wanted to use their skills to go into another field since most of them have prestigious Ivy League MD degrees. Their MD degree is versatile. I know a lot of people don’t want to hear it, but If you got a degree from a Canadian med school, the unfortunate truth is that if you can’t match, you also can’t get those lucrative consulting positions because Canadian MD degrees are not as versatile. Also I also don’t think it’s that bad for USMG to match and find employment. The reason USMG has a slightly lower match rate is that US MD students have a much higher proportion of students going into specialities and taking a gap year for research is not frowned upon compared to Canada. Plus US match rate is calculated as number of graduates that match to their speciality of choice, the placement rate (rate for getting into any residency program) for USMD or DO is like 99%+. The situation in the US is much better, but this is just my opinion and observations

It is better, overall. There is more demand for doctors there, its easier to get into medical school and there are more non-clinical career opportunities in the US that are well paying alternatives. In Canada, its not the case. A big part of this is actually because the Canadian population is much better educated and more ambitious as a result than the US population as a whole due our differing patterns of immigration. 

Another advantage America has is they have the critical mass to really develop niche fields and due to our location close to the US, we essentially end up serving like a vassal state. A lot of the more lucrative R&D type jobs are done in the US, and the more menial, dependent jobs are done in Canada. A classic example is our automotive industry. Its the big US car companies that do their R&D in Detroit and then build the cars in Canada due to government tax incentives, but the best jobs will always be at their HQ in Detroit and when they want to pack up and leave, we can't even stop them. We are proud of our automotive industry, but if you take a deeper look, we are actually just producing parts, we aren't actually innovating and creating. Same goes for our oil industry. We do the menial stuff like taking it out of the ground and our US overlords make the real profit by refining it. 

This plays a role in why our top law firms and investment banks don't take part in the big deals American firms do, and consequently make less money. We don't have a healthcare consulting industry because we just don't have the size and the private healthcare system to support one. Which does close a big door to the corporate world for MDs to take. 

[peace2014]

54 minutes ago, Edict said:

It is better, overall. There is more demand for doctors there, its easier to get into medical school and there are more non-clinical career opportunities in the US that are well paying alternatives. In Canada, its not the case. A big part of this is actually because the Canadian population is much better educated and more ambitious as a result than the US population as a whole due our differing patterns of immigration. 

Another advantage America has is they have the critical mass to really develop niche fields and due to our location close to the US, we essentially end up serving like a vassal state. A lot of the more lucrative R&D type jobs are done in the US, and the more menial, dependent jobs are done in Canada. A classic example is our automotive industry. Its the big US car companies that do their R&D in Detroit and then build the cars in Canada due to government tax incentives, but the best jobs will always be at their HQ in Detroit and when they want to pack up and leave, we can't even stop them. We are proud of our automotive industry, but if you take a deeper look, we are actually just producing parts, we aren't actually innovating and creating. Same goes for our oil industry. We do the menial stuff like taking it out of the ground and our US overlords make the real profit by refining it. 

This plays a role in why our top law firms and investment banks don't take part in the big deals American firms do, and consequently make less money. We don't have a healthcare consulting industry because we just don't have the size and the private healthcare system to support one. Which does close a big door to the corporate world for MDs to take. 

That is why it is so critical for Canadian med schools to teach students to have more diverse and innovative careers, not just narrowing them to “ I have to sacrifice all my time and efforts in order to practice rural family medicine” mentality that’s prevalent in Canadian medicine. Not all students are fit or want to be primary care physicians. In US it’s amazing how many MDs there are in pharma, biotech, tech, consulting, banking, government, etc... it’s absolutely astounding that our talented CMGs are not exposed to the alternatives by their med schools. Diversity is what makes a career truly meaningful, doing the same sh*t day in day out is miserable. No one finds that satisfying.

[indefatigable]

.

[Edict]

9 hours ago, tere said:

As Edict points out, those other types of careers are mostly available south of the border due to the critical mass that's present there with a more innovative economy. So those opportunities would much of the time mean leaving Canada (not that straightforward and not something many people want to do).

It's a little complicated.  There are more PhDs per capita in the US - in fact, historically a lot of US graduate students in STEM have been foreign.  There are also more R&D opportunities available - in contrast, PhDs in Canada have a higher chances of under/unemployment.  It does vary greatly by location - Silicon Valley, Boston & Seattle area have a much higher concentration of educated individuals (~15% of Google's jobs require PhDs).  

Yeah, but using PhDs isn't the best metric. The reason i'm saying this is because there are minorities in the US that produce doctors at lower rates per population, Whereas in Canada we mostly have minorities that produce doctors at higher rates per population. Its all in the numbers fundamentally. Getting into med school in Canada is much harder, we have less opportunities for IMGs than the US does, this is all because of the above.

[indefatigable]

10 hours ago, Edict said:

Yeah, but using PhDs isn't the best metric. The reason i'm saying this is because there are minorities in the US that produce doctors at lower rates per population, Whereas in Canada we mostly have minorities that produce doctors at higher rates per population. Its all in the numbers fundamentally. Getting into med school in Canada is much harder, we have less opportunities for IMGs than the US does, this is all because of the above.

I think you’re getting into a different topic rather than education of the population at large.  Both Canada and US have historically underrepresented minorities and there are initiatives to address that lack for indigenous and black students in medicine.  Canada also has a higher proportion of immigrants, due to its smaller population,with second generation immigrants generally achieving high levels of success including education.  But I think that’s a different issue than population education level.   

[Edict]

2 hours ago, tere said:

I think you’re getting into a different topic rather than education of the population at large.  Both Canada and US have historically underrepresented minorities and there are initiatives to address that lack for indigenous and black students in medicine.  Canada also has a higher proportion of immigrants, due to its smaller population,with second generation immigrants generally achieving high levels of success including education.  But I think that’s a different issue than population education level.   

Perhaps, I don't think we disagree. I guess my main point summed up is that we have less opportunity and more competition for those opportunities than in the US. 

[Borborygmi]

I know one classmate of mine who has delayed carms twice now because they aren't sure if medicine is right for them. I'm not sure what they will ultimately decide. It does happen.

[bearded frog]

As I said in the other thread, you can't transfer residencies that way.

[thestar10]

15 minutes ago, bearded frog said:

As I said in the other thread, you can't transfer residencies that way.

This is a scam.