Despite my hospitalist career spanning over a decade, during which I've worked in many healthcare systems across five states, I often reflect upon my time in Ophthalmology residency back in 2010 and the tremendous stress I endured when contemplating changing specialties. We all inherently know that change is an inevitable part of life, but trying to make changes can be incredibly painful – there is often fear in making the wrong decision, in disappointing others, and in going against the establishment.
“Don’t leave. There are miserable people in this world, and then ones more miserable than the others. My assessment is that you’re in the second category.” I still remember this attending physician’s words and how they reverberated in my consciousness. I was terrified at his prophecy as PGY2 resident at the very start of my career. Earlier that week, I had requested a meeting with my residency program director and informed him that I intended to switch specialties. It was a painful meeting, almost as gut-wrenching as disappointing a supportive parent. He tried hard to talk me out of it, reminding me of the endless opportunities being an ophthalmologist would provide. My chairman asked sincerely if I didn’t want to help restore patients’ vision, and reminded me how hard I had worked to get my position in the first place.
Resigning was the most difficult professional decision I had ever made. The reality is that I knew I had to leave when I realized I went home every single day after the clinic, or the operating room, or after a busy on-call day – and would Google any viable escape options. I simply couldn’t shake the feeling that I had made a terrible mistake by choosing the wrong specialty. Ophthalmology itself actually wasn’t the problem. The residency itself wasn’t particularly grueling, I was in a city I loved, surrounded by smart and interesting people, and it was overall nice being part of a specialty where you could sometimes see immediate results.
The real issue was that I had chosen the wrong specialty for myself. I chose a specialty based on a few short electives in medical school and a year of research in a mouse lab at the NIH. I also had romanticized performing life-altering surgery in far-off lands. Finally, I cringe to admit this now, but I also chose based on some twisted logic of what I believed I deserved based on my academic performance. I should have instead chosen a field after carefully meditating about the day-to-day work of a decades-long career (and not the highlights). The result was that I found myself battling despair, and it became somewhat of a self-fulfilling spiral downwards. I finally decided to act after a mentor in a different specialty perfectly framed the potential consequences: “F*** it – worst-case scenario you lose a few years. In the grand scheme of things – big deal!” She was right, and the discomfort I experienced was the price I had to pay to get on my own personal correct trajectory.
Here is my advice for others considering a life-altering career change.
Be careful of the opinion of others.
My family thought I was insane. To outsiders, it seemed I had invested four years of college, four years of medical school, a research year, and fought hard to win a competitive residency spot in Manhattan. They thought I was throwing away a lottery ticket or euthanizing the golden goose. My mentors tried to tell me things would be much better after training. That wasn’t the issue. I just realized too late that I wanted to do something else entirely. It’s vital to remember that seeking advice and guidance is good – but ultimately no one can make the decision for you because you’re the only one it will have long-term and perhaps permanent consequences for.
You are not unique.
At the time, it was agonizing to think I was the only one in the world throwing away a “competitive” residency spot. Once I made the move, however, I realized that a new co-resident had left anesthesia, another ENT, and a third had changed from radiology. No one talks about their career pivots, but undoubtedly others have faced the same challenges you have. The more colleagues you talk to, the more diverse career choices you will find. Obviously, some people don’t even complete a residency, while other physicians complete residency and then go into non-clinical fields. You have many options that can lead to a fulfilling career.
Have a plan
If you want to continue in another residency, don’t do what I did and resign without a solid plan. I casually contacted some internal medicine program directors around NYC, but they informed me sadly that there were no open spots. I decided to resign anyway and figured I would just reapply through the match. Luckily, a spot outside the match opened up at the last minute, and I was able to stay at the same institution. If it had not – I’m not even sure I would have met the deadlines to successfully reapply.
Don’t burn bridges.
It’s important to be honest and professional towards your current program. The health care world is a small community, and your reputation will follow you. I gave my program a full four months’ notice, fulfilled all my on-call responsibilities, and even politely answered questions while they were interviewing and wooing my replacement. Also, FYI, I occasionally still have to explain the strange one-year ophthalmology position on my CV to this day and have the old program certify that I was in good standing – I believe no one speaks badly about my resignation process.
Remember that no job is perfect.
Fast forward to me being an internal medicine hospitalist for over a decade. The flexible schedule has allowed me to work internationally, I have lived and worked across five states and found my place in the hospital (versus the clinic). Despite all of these positives – not every day is rainbows. Far from it. Like many colleagues, I’m frustrated about documentation burdens, bureaucracy, and the Sisyphean task of attempting to be a compassionate and competent physician in our dysfunctional health care system. One thing I can say for sure… I don’t go home daily and Google my escape options.
Varun Verma is an internal medicine physician and co-founder, Andwise. He can be reached at his website, Varun Verma, M.D. and on X @varunvermamd. He writes about his own experiences as a physician on the Andwise blog and also hosts the Andwise podcast, where he talks to physicians about their financial journeys and careers in medicine.
