Medical Residency Sucks
Editorial note: This blog was originally published on drlaurenwheeler.com in 2019 and was written for a clinician audience. Since then, I’ve certainly grown as a person, a writer, and a professional. I still think its important to leave this piece up, though, because it may be useful to others in a similar position. One day, I’ll even get around to publishing the other 4 posts I wrote in this series about how to gracefully leave residency training. ;)
Residency Sucks: But does it suck enough to leave?
If you are currently in a medical residency program, I suspect you may have considered quitting at some point. To be honest, there are very few (none?) jobs that require 4 years of grueling post-graduate level training and make you work 60-100 hours/week for <60k annually. Residency training is highly likely to make logical people re-evaluate their decision to enter or continue with it, in my opinion.
When compared to other hospital employees, residents earn the least per hour of work (see the math at the bottom of this post), including housekeeping staff in some cases. Residency causes sleep cycle disruptions so severe; I legitimately think a resident’s sleep-work schedule could be considered a human rights violation if imposed on prisoners.
That said, if you want to practice clinical medicine in the United States, medical residency is currently the only viable path to get there.
It is technically possible, though I can’t imagine advisable, to practice in ~33 states of the US after completing 12 months of residency training. That is – one can obtain an unrestricted license. It is not possible to become board-certified (read: hireable) in family medicine without 36 months of residency training.
So, if you are thinking of leaving your residency program – for any of the ranting reasons above, or for any personal reason – be aware that most of the working conditions are similar across the country as far as salary, hours, call, benefits, etc.
In fact, there is plenty of well-intentioned advice about staying in your current program available online (one example). Most of this type of advice seems to be written by people who chose to finish their programs and may or may not have ever seriously considered leaving themselves.
The piece of advice that I haven’t read online (but did hear from a friend) is that if you are miserable in your intern year, you can transfer and go somewhere else. If it’s the city you live in (e.g. your ex-boyfriend is stalking you, or your family is too close/too far away) that is causing you the most distress, you can move. If it’s a personal issue with your program/faculty/institution, there are others.
Mostly, the thing to remember is that YOU KNOW YOURSELF! (or you should try to be as introspective about this decision as possible at a minimum) If an external factor is a large contributor to your misery, then change it by transferring or resigning. If an internal factor (depression, substance abuse, etc) is to blame, then change that – seek counseling and build new coping skills—while staying in residency.
Obviously, all of those things are easier said than done. They are also worth it, in my opinion, to not be desperately unhappy.
So whether you decide to gut it out or transfer, it’s probably wise to get your program director on board, or at least your faculty advisor. These are the people who can, perhaps, give you good advice specific to your situation. They can also connect you with the resources you need to make a change for the better.
If you decide to gut it out and continue in your current program, you can stop reading now. If you are looking for a career change, stay tuned, more to follow on my experiences with that.
Math:
Medscape suggests that interns earn around 55k annually. Let’s assume an 80-hour workweek and 3 weeks of vacation a year. That comes to $10-15/hour depending on how you account for taxes. (salary to wage tool) The average hospital housekeeper wage is $12/hour.