rizt Posted October 20, 2023 Report Share Posted October 20, 2023 TLDR: depressed and burnt out FM R1. Multiple factors contributing. Attempt to switch specialties or grin and bear it for 1.5-2.5 (a +1 program) more years and then do whatever I want? Hello all, This might be a long post that goes a little tangent-y... Bear with me. I've been struggling with depression/burnout lately... Trying to determine whether it's residency-in-general, a sense of little free time and being further away from friends and family (though in the same province, and I'm reunited with my SO now), FM preceptor-mismatch, or the wrong specialty-for-me... Depression and burnout are not unfamiliar to me. Struggled with it while completing med school alone across the country from my SO and family/friends. It lifted during the break between school and residency, but has started to settle in again in the last month or so... I just feel like I have nothing to look forward to and it's all work every day. I'm feeling like, "is my life just going to always be work? And feel like this?" I don't want this, if this is how it is on the other side... It's hard to see through to the other side when the walls of shit are so high. Starting to wonder about the process of transfer within my university into a specialty 5yr program from FM? I'm not sure that's what I want to do right now, but I know I'm not happy with my fam med experiences so far at least. There might be an issue with FM preceptor mismatch - their approach to family medicine is absolutely killing my interest in this specialty... I intend to apply for a +1 Enhanced Skills (longstanding goal). Maybe I should try to look into switching programs? Recently spent some time in my +1 target specialty and enjoyed it; I know I enjoy it. But I ranked FM higher because I genuinely thought I'd enjoy it as well with the flexibility of adding a +1 to do what I want. I enjoyed FM well enough during clinical rotations in med school. It fits my life goals, is a shorter amount of training, and offers the flexibility I require in my career. My preceptor is great on paper, and would provide a valuable reference letter, but they are mentally exhausting to work with and their patient roster is NOTHING like one I would cultivate for myself and I'm finding myself depressed. We do work well together. I'm not the only one in my program who is feeling burnt out and depressed. Is this just normal? I can grind through this if it's normal, I've done it before (all four years of medical school). But, I'm worried my life will look and feel like this forever and it crushes me. I don't want a life like that... Some of my other co residents are the happiest they have ever been... This is what makes me think I might have ranked wrong?? Should I try switching out? Would I feel more engaged and excited in my target specialty, even though it's longer training? Or am I just going to feel like this in a 5 year program too, but with a longer training to grind through? It doesn't help that I feel COMPLETELY incompetent at times (to be expected, I know).. but I scoff when family or friends call me "doctor". I certainly don't feel like one. I feel dumb as shit... Thank you all in advance for your insights and advice/suggestions. /Rant Quote Link to comment Share on other sites More sharing options...
bearded frog Posted October 20, 2023 Report Share Posted October 20, 2023 10 hours ago, rizt said: TLDR: depressed and burnt out FM R1. Multiple factors contributing. Attempt to switch specialties or grin and bear it for 1.5-2.5 (a +1 program) more years and then do whatever I want? Hello all, This might be a long post that goes a little tangent-y... Bear with me. I've been struggling with depression/burnout lately... Trying to determine whether it's residency-in-general, a sense of little free time and being further away from friends and family (though in the same province, and I'm reunited with my SO now), FM preceptor-mismatch, or the wrong specialty-for-me... Depression and burnout are not unfamiliar to me. Struggled with it while completing med school alone across the country from my SO and family/friends. It lifted during the break between school and residency, but has started to settle in again in the last month or so... I just feel like I have nothing to look forward to and it's all work every day. I'm feeling like, "is my life just going to always be work? And feel like this?" I don't want this, if this is how it is on the other side... It's hard to see through to the other side when the walls of shit are so high. Starting to wonder about the process of transfer within my university into a specialty 5yr program from FM? I'm not sure that's what I want to do right now, but I know I'm not happy with my fam med experiences so far at least. There might be an issue with FM preceptor mismatch - their approach to family medicine is absolutely killing my interest in this specialty... I intend to apply for a +1 Enhanced Skills (longstanding goal). Maybe I should try to look into switching programs? Recently spent some time in my +1 target specialty and enjoyed it; I know I enjoy it. But I ranked FM higher because I genuinely thought I'd enjoy it as well with the flexibility of adding a +1 to do what I want. I enjoyed FM well enough during clinical rotations in med school. It fits my life goals, is a shorter amount of training, and offers the flexibility I require in my career. My preceptor is great on paper, and would provide a valuable reference letter, but they are mentally exhausting to work with and their patient roster is NOTHING like one I would cultivate for myself and I'm finding myself depressed. We do work well together. I'm not the only one in my program who is feeling burnt out and depressed. Is this just normal? I can grind through this if it's normal, I've done it before (all four years of medical school). But, I'm worried my life will look and feel like this forever and it crushes me. I don't want a life like that... Some of my other co residents are the happiest they have ever been... This is what makes me think I might have ranked wrong?? Should I try switching out? Would I feel more engaged and excited in my target specialty, even though it's longer training? Or am I just going to feel like this in a 5 year program too, but with a longer training to grind through? It doesn't help that I feel COMPLETELY incompetent at times (to be expected, I know).. but I scoff when family or friends call me "doctor". I certainly don't feel like one. I feel dumb as shit... Thank you all in advance for your insights and advice/suggestions. /Rant Number 1, your mental health takes priority. See a health care provider. If you need to take a LOA for medical reasons, do it, and don't worry about the ramifications at this point. Outside of that, if you strongly feel the need to make a change, chat with your program director(s) first. Program directors generally don't want unhappy residents. Maybe there is an option of switching preceptors/environments to one that is a better fit for you? Maybe there is something else that can be done to give you more variety or change things to work better for you. Transfer is certainly not impossible but definitely not guaranteed. Without knowing which school you're at and which 5 year program you're interested in (based on it being a +1 option and a 5 year core residency its either anaesthesia, EM, or obgyn, all highly compeditive specialties) it's difficult to comment on how realistic it would be. And honestly, these are usually more brutal residencies than FM, if you're getting burned out now, it's not going to magically fix things. If you had good experiences in that +1 specialty and had a preceptor/mentor who you connected with, there is no harm in approaching them with your feelings, and potentially as "soft" way of seeing if transfer is a possibility. Otherwise you will have to reach out to that specialty PD directly, and who knows, they may have an opening. Alternatively if you have a good relationship with your current PD they could reach out on your behalf as well. Alternative avenues would be transfer to a different school, although that would probably put you farther away from your family, and generally less likely vs within your school unless you live in a province with an intraprovincal transfer option, or applying to any 2nd round spots in CaRMS this year (although generally few, if any, spots in the three above specialties. Quote Link to comment Share on other sites More sharing options...
shikimate Posted October 20, 2023 Report Share Posted October 20, 2023 Looks like there are 3 issues here: 1) practice style - certainly can be a pain in the gluteus. Maybe just do the bear minimum and try to pass that block? I know you mentioned they could be a good reference, but there's good chance you can find other preceptors you like more. I know a lot of med student's epigenetics says you have to do everything as best as you can but honestly sometimes you gotta know where your limit is and coast PRN. During residency I found areas where I need to work hard and want to work hard, but also areas I know I won't need later and doesn't need to work that hard, so didn't need to break my back trying to do too much during those blocks. 2) specialty of choice - any 5 yr is a ton more exhausting than FM. I know someone who wanted a surgical subspecialty real bad and after 6 months of consecutive gen sx in R1 they called it quits and switched lol. You might like a few aspect of a field, but to complete a residency you'll definitely be exposed to blocks you don't like in that field as well, so unless you can do point (1) above, you'll struggle as well. 3) competency - you have to remember there are 2 components of competency. First and foremost is pass the exam, that should be your ultimate goal. Second is practical skills to do your job. Since your preceptor's patients are nothing like your future patients, then it's not as relevant if you feel competent. In that case, if you can do ok enough to pass the block, then just move on. Remember, doesn't matter how great somebody is at their job, they gotta pass their exam first. Then you can slowly learn on the job. Lastly, let me give you a reverse example on competence. A world expert in brain tumor with 20 years of experience is competent to do their job assessing brain tumors, but they probably would not be able to pass the general pathology exam now, even though they passed 20 years ago. It's an oxymoron, but slowly you'll get the idea. Quote Link to comment Share on other sites More sharing options...
medisforme Posted October 21, 2023 Report Share Posted October 21, 2023 On 10/19/2023 at 10:21 PM, rizt said: My preceptor is great on paper, and would provide a valuable reference letter, but they are mentally exhausting to work with and their patient roster is NOTHING like one I would cultivate for myself and I'm finding myself depressed. We do work well together. The independence (including creating your own schedule) and financial compensation makes life as a family physician much more enjoyable than a FM resident. Though I will just add unless you are planning on working only in your +1 you will only have so much control over your patient panel. With some (relatively rare) exceptions, you are required to take on patients that come to you, if you are advertising that you are accepting new patients. Provincial physician colleges look very unkindly on family docs that cherry pick their patient panel. Quote Link to comment Share on other sites More sharing options...
deeman101 Posted October 22, 2023 Report Share Posted October 22, 2023 Unfortunate situation. I feel for you. There is no easy answer or magic bullet that will turn this situation around. Every doctor who's reading this will have a natural tendency to try to fix it for you. But first and foremost the situation is as shitty as you think it is and others have unfortunately felt the same. One thing about how "hard" a rotation is or even a specialty is depends a lot on how much you enjoy it. A 5 year gen surg residency can feel easier and fly by for someone that's really into it vs someone who did FM based on let's say the cold calculus of money earned, hours worked, years until retirement rather than how much do they actually enjoy the job. It's good to hear you like your particular +1. At least it can mean once you get there your life enjoyment can improve a lot. I'd recommend priority 1 for you is passing. Priority 2, learn what to do AND what not to do based on what you are seeing. Enjoyable or not, there's something to still take away. And in terms of getting through a rough time, my method was to always spend a couple hours every night doing something I like. That's always meant cutting into sleep hours but for me it was worth it. A small escape. Quote Link to comment Share on other sites More sharing options...
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