Leaving medicine before completing housemanship

It goes beyond the comprehension of most people why anyone would want to leave medicine. It’s a relatively stable job that pays well. It’s also a job that gives back to the community. Exactly what I want out of a career, except that it requires a sort of mental and emotional grit I did not have. Don’t get me wrong, I’ve picked myself up, again and again, all my life. This time was a little different. 

I am one of many who have left clinical training, i.e. housemanship, twice, if I may add. The first time after planning my entire medical career ahead of me, and the second time after insisting that I should go back to finish what I started. See, I entered medicine without foreseeing failure, without foreseeing that my mental health would be so affected by it. I was forced to reevaluate my priorities and the trajectory my career should take instead. Here is my attempt at answering questions about my decision to leave medicine.

How did the whole fiasco of leaving medicine happen?

Nobody enters medicine predicting a mental breakdown. A couple of months into training and I found myself spiralling down a depressive pit. To the disappointment of many, I never really figured out what my triggers were. Maybe it was the mental and emotional demands of the job coupled with the exhaustion. I was thinking it could be a sensory overload, something I struggle with, or a personality trait. Some have suggested it was loneliness and the lack of knowing how to socialise. The high stakes that come with the job could probably have been it as well. Either way, it was a legitimate problem for me and my DASS scores were alarming. 

I had supportive bosses, but the urgency of the situation led me to seek professional help, which was convenient while working in a hospital. That eventually led to a year-long commitment to therapy. I knew I needed a break to allow myself to rest, recover, and come back stronger, so I took it. It was a difficult decision but definitely a calculated one.

When you’re at the very bottom, the only direction you can go is upwards.

Fast forward two years later, I came back stronger than ever. Be that as it may, it didn’t take long for me to fall into similar patterns. Pushing myself despite it didn’t help either. I needed to acknowledge my strengths and limitations and bow out. As painful as it was to let down everyone who believed in me, I objectively evaluated my options and favoured not compromising my mental health further.

What made medicine difficult for you?

Medicine requires a superhuman mastery of emotions. Death and heart-wrenching suffering are routine occurrences. Being excessively moved by them like I was can come at a great cost. 

I found it hard to deal with the emotional burden of patients having to face death, especially very young patients who plead for their mothers with fear and anxiety. It was difficult to see patients being abandoned by families, spending the rest of their days in the hospital with a terminal illness. A doctor screamed at a patient who was hesitating to go home after being treated for a massive cardiac event. Such dismissal of vulnerability when he was struggling financially and had no family was distressing to watch.

These things tend to take a toll if kept unchecked.

Was leaving medicine the best decision you’ve made then?

I’d say it was the best decision to take a break when I needed it. It was also the best decision to seek professional help. Was it the best decision to leave medicine altogether? I won’t deny the disappointment and regret. I wish I had it in me to pursue the medical career I had planned for myself because I worked very hard for it.

The first time I left I knew I had to stop myself from spiralling down into oblivion. The second time in, I was pushing myself to do it because I wanted to prove that I could. However, my parents didn’t want to see me being so inherently unhappy and unlike myself. They didn’t want me spending the last years of my 20s so affected mentally. 

Sometimes you fail no matter how hard you try and there’s nothing wrong with that. 

I most certainly don’t have regrets about putting my well-being first though. You see, it wasn’t that I wasn’t qualified or capable enough. I loved being a doctor, I was committed to continuous learning. I loved seeing patients, I placed great importance on work ethics, and I got things done as a house officer should. It’s unfortunate that the system and the training structure in itself lack flexibility and leave little room for self-care, and that does such a disservice to doctors who are wired a little differently like I am. There’s no cushion to fall on or an alternative offered in changing or modifying our training either.

Right now, I’m grateful to be doing something impactful to the community through public health, while being able to prioritise my well being. I still have gargantuan student debts to pay off having left service, but taking things a day at a time isn’t all too bad.

How supportive has your family been?

My family had a very good reason to encourage me to pursue medicine on top of my wanting to pursue it. Being a high-achieving kid,  nobody foresees failure. I sure didn’t. Besides, no parent willingly sets their kid up for a profession that requires therapy.

With all that said and done, my family has been incredibly supportive. From actively learning about mental health for my sake, to encouraging me to put my health and happiness first. I counsel the opinions of my family and we’ve all learned a lot from each other.

How do you regain a sense of direction after leaving medicine?

I left medicine the first time without a backup plan ahead of me. It wasn’t the best way to do it but compromising my mental health was not an option either. That being said, I went on what I now call my early sabbatical, which proved to be a very rewarding career decision. I knew I could give medicine another shot later so I was adamant about upskilling and taking up jobs that will add value to my resume tenfold. I wasn’t about to let leaving medicine negatively impact my career so I drafted a game plan which you can read more about here.

I’d audaciously cold email people who I thought were successful at what they do and ask for informational interviews. I wanted to learn what it took to get there. Needless to say, I got rejected countless times, even scorned for leaving medicine, but I persevered.

That eventually led to strings of successes. I met some accomplished people and was given incredible opportunities for over a year and a half. It was also why I knew I had it in me the second time leaving medicine. I knew I was capable of finding success elsewhere and still have a fulfilling and impactful career just the same.

I’ve concluded, like most of my friends who’re reaching their 30s, that no job is worth sacrificing mental health over.

A specialist once told me he hated his job but didn’t know how to leave, despite being in medicine for over 20 years. I want to love what I do in 20 years – without compromising my well being. 

I see where fear and hesitance is. In medicine, it’s easy to feel like you’re trained for nothing else and that you wouldn’t fit anywhere else on the job market. In reality, just like other degrees, you can come out of medical school and go into consultancy, tech, research, advocacy, humanitarian work and much more. Medical school equips you with a unique set of skills in addition to understanding the diversity of healthcare and its challenges. The way I see it, if you’re just as marketable as the next candidate, a medical degree isn’t a limitation, but a strength. Clinical training shouldn’t be the only pathway coming out of medical school. Healthcare is becoming more diverse and exciting with people seeking disruptive technology and innovation. 

Medical school is hard (and expensive), is it worth the trouble then?

I’d like to think of going to medical school and earning a medical degree no different than other degrees. Of course, when you embark on it, there’s no telling how things will turn out. We rarely know what we want out of a career coming out of high school.

I’ve learned fascinating things about the human body, about the art and science of healing, even the philosophy of it all. I took an eye-opening course on learning medicine through art! My university experience was so wholesome that I wouldn’t trade it for anything else.  

Yu Chian had the ability to take the most common and unremarkable of spaces — the pawnshop, the hospital, the factory, the streets — and elevate them to important landmarks – By painting them, he created an alternative narrative –

Georg Simmel on Chan Yu Chian’s work. There is such depth in the people we meet at hospitals that I think it’s very human to feel the depths of their emotion too.

What’s next for you?

I’m ambitious, and I want to be in control of my own narrative. Growing up reading about Lincoln, Mandela and Sugihara inspired me to have a career that can bring about change in the world and be impact-driven. I figured if I wasn’t doing that through direct patient care, I want to do it by empowering communities and leaders alike. 

I’ve always idealistically held on to the idea that living in society makes me duty-bound to its improvement. There are public health challenges that require our attention and I want to be part of the solution to them.

Above all, I am now an advocate for mental health. I want to get the conversation going, defiant of shame and stigma. 

So you wouldn’t return to medicine a third time?

If there were a chance to go back into medicine while being able to take care of my well being, I’d take it. For now, I should probably hold back on that. I’ve learned enough about myself to know that this path may not be for me. There are countless other ways I can contribute to society.

Speaking of mental health, what’s something you’d like to call out?

There is a fine line between being able and being too debilitated to seek help. Someone depressed will not feel empowered to reach out. The momentary window which allows them to doesn’t happen often. The responsibility falls on everyone else to continually check up on their friends, family, even colleagues. It’s important to cultivate habits involving each other to take care of mental health. 

I had the support of my family, friends, colleagues, therapist, even my spiritual leanings, which allowed me to change the narrative of my circumstances and come out of it stronger.  I hope help finds its way to doctors struggling with mental health as it once found me.

Someone mentioned these phenomenal lines on my favourite podcast, the CPSolvers – 

It is up to the medical fraternity to acknowledge mental health as a genuine problem and begin intervening. 

On that note, Smiling Mind has a free mindfulness programme made for healthcare workers on their app. It’s a great way to add a little therapy into busy routines.

What memories and lessons will you bring forward?

Patients want to feel heard, acknowledged, and be treated with kindness. Spending a month in a geriatrics ward, I saw patients who come in paralysed walking out completely able after a month or two. I’ve delivered the child of a friend I never thought I’d see again since parting ways in high school. I’ve learned from a palliative care specialist to celebrate the life of a patient as he approaches death. To think fondly of the life he’s lived, his passions, even his favourite colour, his relationship with God, and the legacy he’s leaving behind. No man is ever too common. 

My experience in medicine has been so incredibly rich. 

Coming out of it, I’ve acquired a renewed appreciation for life and all things undivided. I’ve learned how unpredictable life can be, and when that happens it’s really up to me to make decisions to move forward. Failures are just redirections into a more purposeful goal.

There is incredible power in connections as well. It’s what sustained me through the most difficult of times and nourished my wellbeing.

Medicine is coined a noble profession for a reason. What doctors do truly is remarkable. I may not carry on the battle but will remain in awe of the hard work and tenacity of doctors everywhere. Total rockstars.

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