Sunday, February 15, 2009

Question re: opportunities if I don't finish my residency

I got another question today from a resident (a physician in training, not someone living in a skilled nursing facility). The question had to do with career opportunities for people who don't complete a medical or surgical residency. Since I get asked this quite often, I write about my response.

Here was my reply:

I hope I can provide some help since I know quite a few people who've been in similar situations. Let me start by saying that the types of non-clinical opportunities can vary depending on where you live. How open are you to relocating?

The next issue is more of a practical one: do you have student loans? If not, then you have tremendous flexibility to explore and find the "perfect" job for you. However, if you're burdened by student loans, then you have to make some career decisions based on the practical reality of loan repayment (unless you have other sources of income such as family, spouse, etc.)

You're absolutely right in saying that you would have many more opportunities if you complete your residency and become board certified in a medical or surgical speciality. However, life in residency can be very miserable and it can also change people in different ways so you have to know yourself and the type of things you're able and willing to personally handle. People with unhealthy coping skills may find themselves addicted to drugs and alcohol and heading down a very dangerous one-way path. I'm not suggesting that's going to happen to you, but I always like to emphasize the importance of coping with the strenuous work hours, the tremendous pressures, and the emotional burdens that are commonly encountered in the clinical setting.

Also remember that residency dramatically changes after your internship year. Instead of being the scut monkey who has to run around everywhere, you have more responsibility in teaching and guiding your team. With that added responsibility comes different pressures. Will that be a relief or an added burden for you compared to internship? Many people report that their 2nd year of residency was so much better compared to the first. Also, are you in the "right program?" I'm sure you're aware of how certain programs have a reputation for being very malignant while others are very "cush." Have you beein in touch with your friends and colleagues from medical school? What is life like for them?

Medical communications is very broad. I write about some of the basics here in my blog:

I've also written about CME here:

I've also written a little bit about opportunities for people with no residency experience:

I'd be happy to share more with you as you develop more specific questions about the world of medical communications.

As for working the working environment - this can be a tricky one. You have to assess the culture of each company. The corporate world can be harsh and people may easily work more than 80 hrs/week (you thought residency had long hours!). However, there are companies that are very family-friendly where people stay for many years (hence, they have a very low turnover rate). The most flexible path is to be a freelance medical writer or consultant. You don't need any residency experience to be an excellent medical writer. Some of the best writers are scientists, pharmacists, and nurses. You need strong writing skills and you have to be very motivated.

My final word of advice - discuss this matter with your program director sooner than later. He/she may provide you with some great advice and guidance. However, keep in mind that this individual may not be very knowledgeable about non-clinical opportunities.

Perhaps we can discuss this some more after you've had a chance to think about all these issues. I wish you the best and hope that you'll stay in touch.

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