Once a medical student, always a medical student. We are goal-oriented perfectionists and mission-driven brainiacs, which drives us to write a story in our heads early on of what it will look like to graduate from medical school, land our top residency choice, and then seamlessly segue into our medical career. We imagine that life after med school will flow seamlessly. We feel pretty invincible. We work hard to get here (to med school), and we work hard to get out (to the real world). Here’s what it’s like to chase the pipe dream and it doesn’t go as planned.
During my final year in medical school at Indiana University, I traveled to and interviewed at fourteen different family medicine residency programs in six different states. Ultimately, I matched at the program that I ranked first. Whew!
[The National Residency Matching Program (NRMP) data from the 2021 Match stated that 46% of seniors from US allopathic schools got their number one choice, 72% matched in their top three, and 5% didn’t match at all. The numbers were similar for osteopathic seniors.]
Lesson learned: you might get your first or second choice … or you might not.
In the days before home computers and cell phones, I bravely moved from Indiana to Florida to start my internship. I knew a total of two people when I got here. It was humbling and terrifying yet incredible to live and work in a place that matched my personal mission statement. Residency was everything I imagined it would be–long hours, sleepless call nights, the steepest learning curve yet, camaraderie with fellow residents from different places on the globe, and one rotation after another.
When I finished residency, I planned to apply for an OB fellowship in the same program and then use (all of!) my skills to start a little practice of my own or join an already thriving private practice, perhaps in the Carolinas in a quaint, little water tower town.
Lessons learned: get your head out of the clouds, and collaborate with your mentors as you plan for the future. They are there to help you.
When I finished residency, my then-husband applied for graduate school. Since we might be moving, the OB fellowship was not in the cards nor was joining a practice with that “already thriving private practice” I mentioned. Instead, I found two jobs in urgent care medicine that felt like a good fit for the time being. Mind you, when I was in medical school, I did a two week rotation in urgent care, and I absolutely despised it! Much to my surprise, however, I grew to enjoy the pace and the daily surprises in the clinic.
I worked for a multiclinic urgent care business as well as for an emergency room in their fast-track area. The ER eventually offered me a full-time position with benefits. I quickly snatched it up, but I also had to cut ties with the urgent care clinic. When I told my employer that I was leaving his urgent care to work in the ER, I stated that I hoped his door was always open in the future. That employer told me that he couldn’t promise me that. I felt dejected. No one had ever said anything like that to me in medical school or residency. (Welcome to the real world, you prior, invincible medical student!)
So, I worked in the ER until one day … I didn’t. I got pink-slipped when the ER decided to no longer employ family physicians. I cried that day, but I went to work to fulfill my contract and did what I still do best–I cared for my patients.
Lessons learned: Be open to change and to surprises. Things will happen that are beyond your control. Keep caring for your patients even when your hopes are shattered. And never, never burn bridges. (You’ll see why later….)
When my ex-husband didn’t get accepted into a PhD program, I felt it was time to honor my family medicine training and chase the pipe dream medical career. I joined a multispecialty group and worked in an office with two other family practitioners and two OB/GYNs. I went into family medicine because I wanted to practice preventative medicine. I believed that you didn’t have to be sick to get better. I believed I could help my community thrive by educating them how to live their best and healthiest lives. (I was wearing those rose-colored glasses, I know.)
In reality, family medicine in this setting was reactive, not preventative medicine. I came to the hurtful realization that after years of striving for the family medicine dream, maybe this wasn’t meant to be. I was miserable. After a little over one year with this group, I bravely turned in my two weeks’ notice, and I quit my job without having another one lined up.
Lessons learned: Dreams may change. It’s all right to quit a job if you’re miserable. Accept this, and move forward.
After some soul-searching, a lot of leg work (Monster.com didn’t exist at this point!), and some contract negotiations, I found another new job at a privately owned urgent care practice close to home. I worked with a fantastic, well-trained staff, I had benefits, I had a good work-life balance, I had a great patient population, and I was getting paid well. Again, until I didn’t … One day I came into work, and my employer told me he was closing the practice.
Lesson learned: make sure your employer is paying his bills without having to take out a loan to do so.
Just three years after graduating from residency, I had left a job, gotten the ax from a job, quit a job, and now I was being let go from a job. Not exactly a dream come true. They say life comes full circle, and in my medical career, it certainly did. That previous employer who told me that he couldn’t promise the door would always be open? He heard I was back in the job pool and hired me again. I have now worked for this multiclinic urgent care company for twenty years!
The point of this story is that yes, you can chase the medical career pipe dream all you want. I encourage you to! I want you to! But, at the end of the day, your first job out of med school and residency will most likely not be your last one, and that is okay! Once a medical student, always a medical student … we are resilient, and we are brave.
Lesson learned: the dream will happen–it just might be a little convoluted along the way.
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