Post-match depression

[garlic]

I matched to my #1 specialty in a liveable location. With CaRMS being such a crapshoot these days, I understand how lucky I am to get to say that. This post is in no way meant to be a humble brag or call for congratulations. 

I am really struggling with the idea of being 6000 km away from LITERALLY everyone I know. My parents are old and both not in great health. My girlfriend is still in residency and obviously can't relocate; this feels like the nail in the coffin for our relationship. All my buddies matched back home and I'm the only one in our group who's leaving. 2 of my siblings just had kids and I won't be there to help out or watch them grow up. This cross-country move requires funds I don't really have without going into crazy debt.

Every day since the match, I have been crying. Also insomnia, lack of appetite, profound anhedonia. I hate waking up and having to face the day ahead. I often wish I could just not exist for a while. I keep wondering how I could've or should've done things differently throughout med school or during the CaRMS process. I feel like I effed up.

Any words of advice?

P.S. in general how hard is it to get a job in a city you did not train for residency? I can't think of anything except surviving these next 5 years and then taking any job (no matter how awful) so I can see my loved ones again.

[hero147]

Residency goes by quickly. Faster than undergrad, faster than medical school. You'll be so busy most of the time you won't have time to mope. If you are really invested in your relationship with your girlfriend, there are ways to make it work. You have 4 weeks of vacation to spend with each other as well as taking a couple of personal days to see each other on weekends sounds nice even if short lived. Plus there's things like skype/facebook messenger/whatsapp for the times you need her through the week. You will slowly adapt to a new life in your new city and make new lifelong friends. I would know because I was in your situation at the beginning of residency as well. I was homesick every day and it only hit when I started living here but slowly but surely I got used to it, made new friends and started a new life. I still am not happy being far from home, but it's a lot better than when I arrived.

[MSWschnoodle]

4 hours ago, garlic said:

I matched to my #1 specialty in a liveable location. With CaRMS being such a crapshoot these days, I understand how lucky I am to get to say that. This post is in no way meant to be a humble brag or call for congratulations. 

I am really struggling with the idea of being 6000 km away from LITERALLY everyone I know. My parents are old and both not in great health. My girlfriend is still in residency and obviously can't relocate; this feels like the nail in the coffin for our relationship. All my buddies matched back home and I'm the only one in our group who's leaving. 2 of my siblings just had kids and I won't be there to help out or watch them grow up. This cross-country move requires funds I don't really have without going into crazy debt.

Every day since the match, I have been crying. Also insomnia, lack of appetite, profound anhedonia. I hate waking up and having to face the day ahead. I often wish I could just not exist for a while. I keep wondering how I could've or should've done things differently throughout med school or during the CaRMS process. I feel like I effed up.

Any words of advice?

P.S. in general how hard is it to get a job in a city you did not train for residency? I can't think of anything except surviving these next 5 years and then taking any job (no matter how awful) so I can see my loved ones again.

So this was me post-carms last year almost verbatim. DM me if you want to chat about it. 

[hopeful_med]

I matched to my #1 specialty at #1 location. I still had post CaRMS blues up until July 1 because all my friends were being separated, big changes in my life, etc. I think it's common for many people to feel that way. The important thing is to talk to people you trust, and IT WILL GET BETTER

[mastersgrad]

I'm also feeling this depression.

I decided to rank location over speciality and it burned me. I matched to my top location but not my top speciality, when ranking I truly thought I would be happy in either speciality. But since the match I've just been sad everyday thinking of the would've, could've, should've.  I thought that I would be happy to stay with my partner, family and friends but now that the match is done I just feel major regret. 

[bearded frog]

People in my program go home across the country every 4-6 weeks. IMHO 2-5 years at a crappy place to do the specialty you want is worth it. You'll make friends with your fellow residents, many who are also moving away from friends and family to a new city. You're there to do a job, you'll be ok. And you can always try to transfer even if the odds are low.

[Buddy231]

I’m glad for this thread. I matched to number 1 and have deep regrets about both specialty and location. Already been looking at transfers and how to go about them. You are not alone. The match is a distressing, awful experience for some of us REGARDLESS of the result. 

[Intrepid86]

The number of people who match to one of their top choices and who still aren't happy is disturbing. The only depressing thing here is the lack of resilience and gratitude on display. Sure, this will be an adjustment, but it is by no means the end of the world. If these supposedly suboptimal situations build even a little more character, then that alone would be worth it.

[Bookmark311]

3 minutes ago, Intrepid86 said:

The number of people who match to one of their top choices and who still aren't happy is disturbing. The only depressing thing here is the lack of resilience and gratitude on display. Sure, this will be an adjustment, but it is by no means the end of the world. If these supposedly suboptimal situations build even a little more character, then that alone would be worth it.

You know some people have families and children, or elderly parents to take care of?  Uprooting when u r in ur late 20s is NOT easy.. it’s not abt lack of gratitude or resilience, but these people have responsibilities beside school 

 

I have not gone thru Carms yet, will go thru it next year,  and it’s a tough experience!

[Intrepid86]

1 minute ago, Bookmark311 said:

You know some people have families and children, or elderly parents to take care of?  Uprooting when u r in ur late 20s is NOT easy.. it’s not abt lack of gratitude or resilience, but these people have responsibilities beside school 

Hence the perennial advice to not rank places you don't want to be, and not rank things you don't want to do.

[JohnGrisham]

50 minutes ago, Buddy231 said:

I’m glad for this thread. I matched to number 1 and have deep regrets about both specialty and location. Already been looking at transfers and how to go about them. You are not alone. The match is a distressing, awful experience for some of us REGARDLESS of the result. 

Why was it your number 1 then? 

Sorry you feel like crap, but it sounds like you should have spent more time thinking of your options.

[Arztin]

On 3/10/2020 at 3:42 AM, garlic said:

I matched to my #1 specialty in a liveable location. With CaRMS being such a crapshoot these days, I understand how lucky I am to get to say that. This post is in no way meant to be a humble brag or call for congratulations. 

I am really struggling with the idea of being 6000 km away from LITERALLY everyone I know. My parents are old and both not in great health. My girlfriend is still in residency and obviously can't relocate; this feels like the nail in the coffin for our relationship. All my buddies matched back home and I'm the only one in our group who's leaving. 2 of my siblings just had kids and I won't be there to help out or watch them grow up. This cross-country move requires funds I don't really have without going into crazy debt.

Every day since the match, I have been crying. Also insomnia, lack of appetite, profound anhedonia. I hate waking up and having to face the day ahead. I often wish I could just not exist for a while. I keep wondering how I could've or should've done things differently throughout med school or during the CaRMS process. I feel like I effed up.

Any words of advice?

P.S. in general how hard is it to get a job in a city you did not train for residency? I can't think of anything except surviving these next 5 years and then taking any job (no matter how awful) so I can see my loved ones again.

Hey, I'm sorry about that. It sure sounds terrible.

There are many people going away from residency. For sure you will make new friends during residency! Also, you did get your specialty of choice after all!

Regretting, and overthinking at this point probably won't help.

What's important is what you do with the match. Take it one day at a time.

A few of my close friends had a ''disastrous'' match and now are very happy residents actually. I also made some really close friends during residency. 

Job-wise, it's kind of early to think about... But many people switch provinces after residency. I'm sure you will find mentors who will help you out regarding this during residency.

Stay strong and enjoy your summer!

3 hours ago, Intrepid86 said:

The number of people who match to one of their top choices and who still aren't happy is disturbing. The only depressing thing here is the lack of resilience and gratitude on display. Sure, this will be an adjustment, but it is by no means the end of the world. If these supposedly suboptimal situations build even a little more character, then that alone would be worth it.

Hmmm.... I'm not sure this kind of message helps...

[shematoma]

8 hours ago, Intrepid86 said:

The number of people who match to one of their top choices and who still aren't happy is disturbing. The only depressing thing here is the lack of resilience and gratitude on display. Sure, this will be an adjustment, but it is by no means the end of the world. If these supposedly suboptimal situations build even a little more character, then that alone would be worth it.

Wow. Your post strikes me as quite judgmental. Why is it necessary to characterize this person's (I will not assume their gender) feelings as a lack of resilience or gratitude? Are we not allowed to feel sad and depressed in life, even if things look great on the exterior? This person's reality is that they're about to move away from family, friends, girlfriend for 5+ years, and that's really hitting home. I think they deserve sympathy rather than scorn. Their feelings are quite valid. In fact, residents in Canada have committed suicide in very similar circumstances. Family, friends, significant others are precious, and moving away, combined with the stresses of residency, can take a serious toll on someone's mental health, to the point that it can be lethal. We need to take resident mental health seriously and not heap judgment on them.

To the OP, I hope you are still here and reading this thread, and don't get discouraged by some of the very insensitive replies you are getting. You are FAR from the only one in your shoes - I can speak for myself and many others personally, but we can't come out publicly because of exactly the kind of response you see above. Your struggles are real and you have every right to feel the way you do.

Now, the reality is that if you want to stay in your specialty (not knowing what it is, but regardless), you will most likely have to finish it where you matched. That is because as you can see in other threads, transfers are extremely tough unless you're willing to switch to FM, and even that is very tough and there's no guarantees. However people do move across the country all the time for jobs - you can use elective time to do rotations near your home to improve your chances of getting a job there. A lot of this depends on the exact specialty and how much demand there is for it, and if your specialty depends on being in a hospital vs. being able to open your own clinic or practice.

But right now do whatever you need to take care of yourself. You still have time before you move, and if you absolutely need to, look into the transfer process down the road. Some would say you're in a very enviable position but nothing is more important than your own health and well-being, so do what you must to stay alive and well.

[rockBottom]

The devastation of going unmatched can’t be compared to matching to a first choice specialty.  And there are much, much worse outcomes and situations than moving to an undesirable location - which I’m not saying is easy.  I think it’s just important to have perspective - regardless of how difficult things may seem.  Medical students aren’t the only people who have to move, etc 

[NeuroD]

On 3/12/2020 at 11:55 PM, Intrepid86 said:

The number of people who match to one of their top choices and who still aren't happy is disturbing. The only depressing thing here is the lack of resilience and gratitude on display. Sure, this will be an adjustment, but it is by no means the end of the world. If these supposedly suboptimal situations build even a little more character, then that alone would be worth it.

The reason it's disturbing is not because of what it shows about resident's character. Instead it's disturbing because it reveals that the magic/honeymoon phase/idealization of medicine that we all had before getting in, doesn't last very long once you're here.

Not even matching to your #1 choice, or landing your "ideal" job makes up for it.

[sangria]

59 minutes ago, PhD2MD said:

The reason it's disturbing is not because of what it shows about resident's character. Instead it's disturbing because it reveals that the magic/honeymoon phase/idealization of medicine that we all had before getting in, doesn't last very long once you're here.

I wonder how much of it is due to FOMO?

Having said that, OP or anybody else, I hope it gets better. I think whatever the reasons may be, transitioning to residency is a challenging time for most if not all of us. It's a big change for a lot of people -- it could be their first time away from friends/family/loved ones, especially more people are coupled up during med school. Transitioning to med school might have been less of a hurdle given how many people knew one another from undergrad, and given how preclerkship might have been more similar to undergrad. 

So it is completely understandable that it is an anxiety inducing time. If they can't vent on an anonymous forum to other people perhaps in the same boat, where else are they going to go?

[1029384756md]

On 3/10/2020 at 3:42 AM, garlic said:

I matched to my #1 specialty in a liveable location. With CaRMS being such a crapshoot these days, I understand how lucky I am to get to say that. This post is in no way meant to be a humble brag or call for congratulations. 

I am really struggling with the idea of being 6000 km away from LITERALLY everyone I know. My parents are old and both not in great health. My girlfriend is still in residency and obviously can't relocate; this feels like the nail in the coffin for our relationship. All my buddies matched back home and I'm the only one in our group who's leaving. 2 of my siblings just had kids and I won't be there to help out or watch them grow up. This cross-country move requires funds I don't really have without going into crazy debt.

Every day since the match, I have been crying. Also insomnia, lack of appetite, profound anhedonia. I hate waking up and having to face the day ahead. I often wish I could just not exist for a while. I keep wondering how I could've or should've done things differently throughout med school or during the CaRMS process. I feel like I effed up.

Any words of advice?

P.S. in general how hard is it to get a job in a city you did not train for residency? I can't think of anything except surviving these next 5 years and then taking any job (no matter how awful) so I can see my loved ones again.

 

[rmorelan]

Bit controversial topic but I think we need to talk about this a bit so there is a better understanding of what this process is like. 

It isn't unusual at all to have very mixed emotions with CARMS no matter what you get. For one thing people make a ton of friends in medical school and go through a shared bonding experience that is pretty unusual. Even if you stay at the same institution the majority of your friends are likely to move away (in my case I went from a class of 171 in my year, but I was very involved over many years to going to a school where 11 of us matched - and ended up just far enough away that realistically visiting friends/family was going to be an issue). Change on this scale - new job, new home, loss of contacts/friends and new milestone to concern ourselves with in the years to come hit very quickly. It is a fragile time for many. 

Plus you are so focused on achieving this one thing that of course it is hyped up to the maximum. The journey is quite often more rewarding than actually arriving ha. There is an almost inevitable  let down after as you can finally refocus on the bigger picture. 

You can be happy you got what you want and still be sad of what you are about to lose. You can be resilient enough to endure what is to come and still be challenged by it as well. Ignoring all that just sets up for the exact mental health issues our profession has. 

Edited March 14, 2020 by rmorelan

[rmorelan]

On 3/10/2020 at 3:42 AM, garlic said:

I matched to my #1 specialty in a liveable location. With CaRMS being such a crapshoot these days, I understand how lucky I am to get to say that. This post is in no way meant to be a humble brag or call for congratulations. 

I am really struggling with the idea of being 6000 km away from LITERALLY everyone I know. My parents are old and both not in great health. My girlfriend is still in residency and obviously can't relocate; this feels like the nail in the coffin for our relationship. All my buddies matched back home and I'm the only one in our group who's leaving. 2 of my siblings just had kids and I won't be there to help out or watch them grow up. This cross-country move requires funds I don't really have without going into crazy debt.

Every day since the match, I have been crying. Also insomnia, lack of appetite, profound anhedonia. I hate waking up and having to face the day ahead. I often wish I could just not exist for a while. I keep wondering how I could've or should've done things differently throughout med school or during the CaRMS process. I feel like I effed up.

Any words of advice?

P.S. in general how hard is it to get a job in a city you did not train for residency? I can't think of anything except surviving these next 5 years and then taking any job (no matter how awful) so I can see my loved ones again.

on to some practical point at least - in most fields getting a job in a particular city won't be that limited by your residency program - particularly so if it is any of the the bigger fields. Fellowships down the line are also a very good way to position yourself for many fields in any area you want to go. 

What advice would you give any patient that presented with those exact symptoms? Reach out and get help, take the time necessary to process through this huge change, understand that this isn't uncommon at all, and go from there as necessary to get through this. 

Edited May 8, 2020 by rmorelan

[shematoma]

15 hours ago, rmorelan said:

Bit controversial topic but I think we need to talk about this a bit so there is a better understanding of what this process is like. 

It isn't unusual at all to have very mixed emotions with CARMS no matter what you get. For one thing people make a ton of friends in medical school and go through a shared bonding experience that is pretty unusual. Even if you stay at the same institution the majority of your friends are likely to move away (in my case I went from a class of 171 in my year, but I was very involved over many years to going to a school where 11 of us matched - and ended up just far enough away that realistically visiting friends/family was going to be an issue). Change on this scale - new job, new home, loss of contacts/friends and new milestone to concern ourselves with in the years to come hit very quickly. It is a fragile time for many. 

Plus you are so focused on achieving this one thing that of course it is hyped up to the maximum. The journey is quite often more rewarding than actually arriving ha. There is an almost inevitable  let down after as you can finally refocus on the bigger picture. 

You can be happy you got what you want and still be sad of what you are about to lose. You can be resilient enough to endure what is to come and still be challenged by it as well. Ignoring all that just sets up for the exact mental health issues our profession has. 

I think this is a great point – we get so focused with the end result that we forget that the journey itself is sometimes what was so enjoyable, the anticipation of the final result was what motivated us and drove us to achieve. Sometimes getting exactly what you want can be a huge letdown when it finally happens.

I have met many residents who were initially unhappy, sometimes extremely unhappy with their new program/city but later became quite content once they made new friends and relationships and adapted to their new environment. On the other hand, sometimes the opposite happens too. And I don't think it's always related to the program or city itself – life is complex and always evolving and does not pause just because you were doing your medical training in another city.

By the time most of us have matched to residency, we are too far invested in this field to consider doing anything else. And no matter what happens, the best thing to do is probably to put your head down and plow through as far as you can go. At least give it a shot.

When I started residency, I said I would give myself at least six months before concluding that I was going to transfer or that it wasn't for me. It takes that long at least to adapt your new life – perhaps even longer. But things worked out and I settled in a lot better than I thought I ever could.

[bearded frog]

I can understand the melancholy that comes with the end of a journey and the apprehension of starting a new one, maybe you're happy you got the specialty or location you wanted but maybe its in something or somewhere you're not sure about, and that's ok. If you're sad you matched to a program that you ranked higher than a program you ranked lower, that's 100% on you and you made your choices, and no sympathy from me,

[garlic]

Thank you everyone for taking the time to write encouraging words and for sharing their personal stories. I have read and re-read your responses countless times. They've been a source of strength especially when I felt alone and self-conscious.

Importantly, I also showed this thread to my loved ones who were also struggling with my match result. They were amazed to hear how common disappointment and struggles are in this carms process, often through no fault of the applicants (who generally have put in unthinkable amounts of effort and emotional investment over 4+ years). Although unfortunate, it was also comforting for them to know that regret, sadness and fear can happen even when people get their preferred choices. Because of your responses, we all learned the spectrum of intense emotions that goes from getting what (one thinks) one wants to going unmatched.

The points brought up here helped my loved ones and I talk through difficult topics that actually extended beyond the superficial problem of "moving away." For example, my parents spoke about their fear of being abandoned in their old age. I also learned I was a protective factor when a friend was at a low point and thinking of ending his life. As many of you mentioned above, life is complex and perhaps these post-match feelings are influenced by/stem from things much more elaborate than disappointment over a result. It made me wonder how much each of us keep inside of ourselves, for whatever reasons...fear of being judged, no opportunity to be vulnerable, etc. Match day is such a huge deal for us M4's that it's easy to forget the way others may be feeling or affected.

To the people who commented about lack of resilence or that perhaps I should've spent more time on my ROL: I still appreciate your comments and contributions to this topic. However, I also encourage you to consider the impact of your words on those who are going through stressful, tumultuous, and quickly-changing times. There are many factors beyond inertia or lack of gratefulness that contribute to post-match emotions. I am truly happy for you if you have never felt so dejected/lost/frustrated. Because it sucks. But I ask you this, is compassion to a hurting stranger a bad thing? As we have all experienced, this field can be isolating, exhausting, thankless even on good days. Criticizing people for having worries/interests/responsibilities/goals outside of medicine is a huge contributor to burnout and perpetuates unhealthy bullying behaviour. I am cognizant that my situation could definitely be worse. But this is not a stress/sacrifice Olympics.

This past week has felt so long and I admit I've had some incredibly dark thoughts. But thank you all for showing me that I am not alone. That things will get better. That this is a distressing and confusing time for many of us, regardless of result.

Hoping everyone stays safe and healthy during this difficult time. Keep well

[indefatigable]

It's good to hear you were able to find solace with your loved ones and the forum has helped you overcome what is clearly a very distressing time for you.  Unquestionably, the culture of silence that exists in medicine, may contribute to the vast burnout and feelings of dissatisfaction.  Unfortunately, stressors or disappointment may surpass personal tolerance to such an extent that numbness sets in, indifference or even culpability.  It's important at these times to remember that everyone in the system has worked very hard to achieve personal and professional goals and the demands of further sacrifice can be draining.  Good luck.  

[canada747]

Hey man (or woman), sorry to hear you feel like this. I had a similar situation with moving for med school. It's a tricky conundrum, and one that too, will pass. I moved for med school after matching to my top med school. I was excited to go, excited to see a new city, and begin a new life. For me, that meant breaking up with my girlfriend (long distance wasn't in the cards).

Immediately, that euphoria of starting med school faded. I missed her, wanted to go home, and wanted my old life back. It's weird, and I sometimes wonder what life would have been like if I took the schools closer to home (which, were also great schools). I chose this school far away because on paper it seemed great -  significantly cheaper tuition (almost graduating debt free), fun city, new life etc. But a part of me was 100% left behind, and I don't think I've been the same person since I left. I'm not sure if it's simply because I'm older, because I'm in med school, or because I miss my day one friends and ex-gf.

I'm not sure what to tell you. Life will continue, and you can choose to make it just as good in the new place. In a weird way, it's the optimism that's important. I focused most on what I had lost by moving, rather than the opportunities and new things to be seen/gained. In the life story of "garlic", this will be a blip or a major turning point. Either way the story continues. You can here decide to do many things - break up with your gf, go long distance, or find a way to transfer/match to another program close to home. With respect to your parents, I'm sure you'll find a way to see them. At the end of the day, there are reasons why this was your top choice, and evidently those reasons outweighed the other "life" considerations when you chose it. If you remind yourself of why you chose those reasons, you'll never have a real regret. Unfortunately, as we get older our choices have consistent trade offs. We choose one or a few of the following, money/status/prestige/family/friends/free time, and relinquish some of the others.

Hopefully that helps somewhat. If you want, feel free to PM me. Life's hard, especially as we get older.