Disillusioned With Career Choice - Is There Any Thing I Can Do?

[deepblue]

Just thought I'd post here to see if anyone has suggestions.

 

I matched into FM last year. My experience in clerkship was great, but now I'm getting the feeling that my perspective was skewed. I'm in residency now, and I'm beginning to realize its not for me.  Its not terrible, but I don't want to do this for the rest of my life. My favorite rotations have been off-service, and while I didn't love all of them, I find I much prefer being in the hospital. 

 

 

Since I barely have over a years worth of funding left to go, switching while in residency seems out of the question.  My school only does switches in January.  I really don't even know what I would switch to. I've heard of a re-entry program for physicians - has anyone heard anything about that? Is it a viable option? I've thought about using my second year as a chance to explore other specialties. Does this seem like a good idea?

 

Are there any other options?

[rmorelan]

you can still transfer potentially even if you are in FM to a 5 year - your funding may end but if there is anyone else switching down to FM (a more common event) then there are funding swaps effectively.

 

I have also  seen 3rd residents in a 5 year switch to another 5 year program and thus will be a resident longer than 5 years.

 

I guess the next big question is what do you want to do specialty wise?

[GrouchoMarx]

Try anyway. Have a specific goal in mind and have a plan to obtain it.

 

If you matched to Toronto you should take advantage of the postgrad office's assistance in getting you into the program you want.

 

If you can't do that, you have to work for a year and then apply for a return of service re-entry spot with the government. The agreement is only two years and can be for anywhere in ONtario except Ottawa and Toronto so its not too bad.

 

The 2nd round of carms is also an option but you have to prepare letters and other things for it. You also have to sign up for it knowing that there may not be anything available that you would like in the 2nd round.

[makingfetchhappen]

Just thought I'd post here to see if anyone has suggestions.

 

I matched into FM last year. My experience in clerkship was great, but now I'm getting the feeling that my perspective was skewed. I'm in residency now, and I'm beginning to realize its not for me.  Its not terrible, but I don't want to do this for the rest of my life. My favorite rotations have been off-service, and while I didn't love all of them, I find I much prefer being in the hospital. 

 

 

Since I barely have over a years worth of funding left to go, switching while in residency seems out of the question.  My school only does switches in January.  I really don't even know what I would switch to. I've heard of a re-entry program for physicians - has anyone heard anything about that? Is it a viable option? I've thought about using my second year as a chance to explore other specialties. Does this seem like a good idea?

 

Are there any other options?

You can work out of a hospital as a family doctor. I know 2 family doctors who do this, and I'm not even in med.

 

I don't know how numerous the opportunities are. You would need to research it.

 

There are also opportunities in long term care facilities for family doctors. This isn't the same as a hospital obviously, but there are some similarities, such as not having to manage your own practice.  

[deepblue]

I didn't match to Toronto, unfortunately. Not that I'm unhappy with my school, but it only sends out a letter every January, and in it it basically said that you can't transfer if you have 6 months of less of funding. The transfer is usually done in January, so the next time I'll have a chance to apply I will be ineligible. 

 

I'll try and contact them to see if its possible to switch outside of the transfer period. 

 

Any thoughts on how to explore other specialties? Most of my work days are tied up with clinical duties.

 

You can work out of a hospital as a family doctor. I know 2 family doctors who do this, and I'm not even in med.

I don't know how numerous the opportunities are. You would need to research it.

 

There are also opportunities in long term care facilities for family doctors. This isn't the same as a hospital obviously, but there are some similarities, such as not having to manage your own practice.  

 

This is something I've considered. I've arranged a few electives with  hospitalists and I'm hoping I'll like it, but I feel like I should have a contingency plan just in case.

[frozenarbitor]

You could also finish your residency and work a few years first. Then reapply to say internal medicine second round carms and train again for 5 years. I know a doctor who did that. That way you can moonlight during residency which can bring quite a bit more extra income. The few years you work as family doctor can also help you pay off all the loans or buy a house.

 

And FM allows you to do full time hospitalist work too. Other options include full time palliative care. Both are all inpatient work. You liked FM during clerkship, so there must be something about family medicine that you enjoy. FM provides so much flexibility that you can pretty much shape your career however you like. 

[Pokemon Trainer]

i'm only a first year so I dont know much but why not consider a +1 in something (i.e. emerg).  family is great in that there is so much variety and opportunity, i'm sure there are hospital-based positions for FM physicians in more rural places also.  

[bloh]

My only concern with what you are doing is that you don't know what else you like. Novelty is a powerful motivator so while you may be enjoying off-service rotations do you really want to do that for the rest of your life? Deliver babies forever? Scope GI bleeds all your life? Spend 30% of your time dealing with IBS patients? Do choles till you die? Spend the next 5 years doing 1 in 4 call, etc....

 

Without a clear alternative path that you feel strongly about, I'd suggest you finish FM and then think about re-entering the system later. You'll then hopefully completely write off FM and have a better idea of what you really like. Imagine switching into x program and then realizing its not as awesome as you thought; the misery would be many times worse.

[rmorelan]

My only concern with what you are doing is that you don't know what else you like. Novelty is a powerful motivator so while you may be enjoying off-service rotations do you really want to do that for the rest of your life? Deliver babies forever? Scope GI bleeds all your life? Spend 30% of your time dealing with IBS patients? Do choles till you die? Spend the next 5 years doing 1 in 4 call, etc....

 

Without a clear alternative path that you feel strongly about, I'd suggest you finish FM and then think about re-entering the system later. You'll then hopefully completely write off FM and have a better idea of what you really like. Imagine switching into x program and then realizing its not as awesome as you thought; the misery would be many times worse.

 

yeah if the problem was the first time an incorrect choice then obviously the second time around that has to be avoided. Since it seems like you are out of the running for transfer at this point then career change falls to the second round match in the future or the US route of course. With your FM in hand you will be able to better manage either of those options.

[placenta]

Out of curiosity, do residents have an option of dropping out and then re-enter CaRMS (so that one can participate in 1st round) if they are completely unhappy or/and not successful in transferring? I understand this is risky as you will lose your residency spot, but if you are really unhappy, this could be an option as well?? 

[rmorelan]

Out of curiosity, do residents have an option of dropping out and then re-enter CaRMS (so that one can participate in 1st round) if they are completely unhappy or/and not successful in transferring? I understand this is risky as you will lose your residency spot, but if you are really unhappy, this could be an option as well?? 

 

no they don't

 

In north america once you start ANY post graduate training you are then not allowed to participate in the first round again.

 

No matter what the OP does he will at best be able to go into the second round - the reason in part is that there is a transfer system in place for those inside of residency. They don't want people dropping out of the program to try and do something else.

 

I haven't looked into it but I am not exactly sure what the penalty otherwise is for dropping out. The general idea is if you are doing then you are basically leaving medicine (you could participate in the second round but they are going to question why you left a program hanging. That isn't exactly going to be a plus in the application process that is already very tough with limited options).

[placenta]

Oh boy!

[ktp09]

I have a similar question as well.

I'm a surgical resident in Ontario, but have been thinking about transferring to family medicine. 

However, I would like to transfer to fam med in different universities/cities as my circumstances have changed. 

In my case, should I then get in contact with PDs at these universities and apply for direct intra-provincial transfers? How successful would this be?

Or I guess I could go into 2nd iteration? 

 

Thanks for your inputs!

[GrouchoMarx]

no they don't

 

In north america once you start ANY post graduate training you are then not allowed to participate in the first round again.

 

No matter what the OP does he will at best be able to go into the second round - the reason in part is that there is a transfer system in place for those inside of residency. They don't want people dropping out of the program to try and do something else.

 

I haven't looked into it but I am not exactly sure what the penalty otherwise is for dropping out. The general idea is if you are doing then you are basically leaving medicine (you could participate in the second round but they are going to question why you left a program hanging. That isn't exactly going to be a plus in the application process that is already very tough with limited options).

 

This is a very big problem with the system.

[RiceWine]

I have a similar question as well.

I'm a surgical resident in Ontario, but have been thinking about transferring to family medicine. 

However, I would like to transfer to fam med in different universities/cities as my circumstances have changed. 

In my case, should I then get in contact with PDs at these universities and apply for direct intra-provincial transfers? How successful would this be?

Or I guess I could go into 2nd iteration? 

 

Thanks for your inputs!

 

I met another surgical resident who was doing the same thing (yay FM!). I believe the individual contacted the PD and the PD told the individual to do electives first in FM on site before transferring. 

[deepblue]

Thanks guys.

 

I agree, its premature to do anything if I don't have another specialty in my cross hairs. I have one that I'm considering, but I only did an elective in it as a medical student for 2 weeks. 

 

I'll let you guys know what happens, if anything. 

[ktp09]

I met another surgical resident who was doing the same thing (yay FM!). I believe the individual contacted the PD and the PD told the individual to do electives first in FM on site before transferring. 

Oh dear....do you know how many electives he was required to do (i.e. a month? 2 months)? 

This means now I have to approach my PD to do this, as I get zero elective time :/

[Maxime]

Switch if you don't like FM, I switched out 6 years ago for the same reasons as you, never looked back!