Let me tell you a bit about my medical school journey. I was not the kid who knew from age 5 that she wanted to be a doctor. In fact, I really loved teaching my stuffed animals and thought that I might become a teacher one day. In high school and college, though, I gravitated toward writing. For a pre-med student, I wasn’t a particularly stellar Molecular Biology major. But I was pretty darn good in my humanities classes and I loved writing papers. When it came to laboratory research, my favorite parts were the literature reviews and the writing. I actually enjoyed writing my thesis, but I could have done without all of the actual tedious lab work. If I would have known that there was a life outside of a lucrative career in medicine, law or business, I would have maybe made some different choices.
Choosing a Career without Self-Awareness
At the time, however, those choices were right for me. I figured that my first “adult” decision was to pursue a career that was well-respected, well-paying and a good use of my “smarts”. Writers and artists made no money, so those options were not even considered, even though those things (writing, dance, music) were the things that made me the happiest. It takes some time, space and maturity to know yourself. However, the 18-year-old me, heck, even the 25-year-old me, had no real sense of self. They say that you are supposed to find yourself in college, but it took me several years beyond that point to really know what made me tick.
In 2013, I made it. Just kidding, but I did graduate from college. I graduated from Princeton with no idea what was going to happen next. I had an inclination to do an MD-PhD program because I liked the idea of helping people and I really liked research, and I figured, heck, why not do both. The only thing was that there was no way any program would accept me right out of college because of my grades, and MD-PhD programs are notoriously uber-competitive. I scrambled and got myself a job as a Research Technician because I thought that wet lab research was the only thing I was good at.
On Overcoming Obstacles
Despite all of the negative feedback I received, the doubts, and the lack of encouragement to pursue anything else, I stubbornly stood by my goal to pursue getting into an MD-PhD program. I proceeded over the next four years to retake undergraduate courses and take the MCAT. I completed a Master’s program and got published to prove to the naysayers that I could make it happen. And I totally did. Several of these dual degree programs offered me interviews. I even turned down a full-ride scholarship to an MD-only program because I wanted dedicated, protected and funded research time. Looking back, I wish I had thought that decision through a little bit harder.
Starting Medical School
When I started medical school in 2017, the impostor syndrome kicked in immediately. I wondered if I could handle the coursework, so I studied for hours and hours during our first block to make sure that I started out strong. The first exam came, and I did pretty well. I stayed consistent with my study schedule from then on, but I toned it down a bit. Although I made it a point to stop studying at 10pm every night, I still turned down social engagements and kept to myself. I didn’t want to be distracted the way I was in college. I made it through first and second year pretty smoothly. Step 1, the major licensing exam that every medical student takes after M2 year is completed, was looming on the horizon, but I was planning a wedding.
Taking Step 1
My classmates were already hitting the books up to 8 hours per day in the Fall season preceding the March/April 2019 test date. Meanwhile, I hadn’t even looked at the study material. I was confident that my careful studying of the in-class material over the past couple of years would get me through. Step-specific studying would just be brushing up on concepts. I enjoyed my wedding day in December 2018 and hit the books shortly afterward. About two months before my exam date, I set an ambitious goal for my test score and started to study. Though I scored slightly below my goal, I was still very happy with the result. The score was solid enough for me to get into some of the more competitive specialties for residency, if I so desired.
MD/PhD? Not For Me
In the MD-PhD program, you are expected to transition into the PhD portion of your training after completing Step 1. I fully looked forward to being in the lab, and I was excited to use my creativity and my hands to accomplish a large project that had the potential to help so many people. I did what I knew how to do to be successful: I had consistent work hours, stayed late when I needed to, communicated with my mentors and worked to determine the scope of a potential PhD project. However, with the exception of the mentor that I first rotated with who moved to another institution, I did not feel supported in my endeavors. I feel like I was passed over and dismissed because, as a Black woman, I do not fit the mold of an MD/PhD student.
Go Where I’m Wanted
What really set me to reconsidering the dual degree was an unfortunate conversation with one mentor. I already sent in the paperwork indicating to the department that I was going to work with this person for the duration of my PhD project, and I wanted to have one more clarifying conversation before I went out of town on break. What could have just been a professional disagreement led to him telling me that I am not cut out for doing academic research. I can take constructive criticism, but that personal point was another sign that I should go where I am valued. In this case, it was not Academia, at least not at that particular institution.
It Was Just Not Right for Me
I gave it another shot with an additional research rotation. I wanted to make sure that I had done all I could to make it work. In this particular lab, the female postdoc told me, as she was teaching me a new assay, not to pursue the PhD. At the same time, my dad’s Parkinson’s disease was progressing further. He was at the point where I knew that he would need full-time care in the near future. Between not feeling supported on the PhD side of things and not wanting to remain far away from where my dad was in South Florida, I decided to leave the MD-PhD program and finish the MD portion as fast as I could.
Starting Medical School Clerkships
By now, it was August 2019, and my MD cohort had already started their M3 rotations in April. Because I was thrown in, I missed all of the transition-to-clinic courses and did not get to choose my rotation schedule. My first rotation was Psychiatry. My classmates were able to hit the ground running on the first day of that clerkship. On the other hand, I hadn’t even had the EMR setup to where I could see patient charts. I wasn’t up and running until the third day of the clerkship, but I was already behind. The resident on my team seemed frustrated with me, and the attending barely spoke a word to me.
Everyday felt like a failure. I cried on my way home from the hospital almost daily, but I kept picking myself up and trying again. I continued this through my OB/GYN, Family Medicine and Pediatrics Clerkship. There were good days and bad days, but my clerkship grades weren’t bad. I had two advanced and two outstanding grades to show for my persistence. After the Pediatrics clerkship ended, the pandemic hit and everything shut down. We were not allowed to be onsite for anything. This was because there was not enough personal protective equipment for us to use. I also found out I was pregnant a couple of weeks after the Pediatrics clerkship ended. I started the Radiology online elective around that time feeling extremely tired and nauseous.
Pregnant and Thinking
During this time spent at home, I had a moment to reflect upon the previous six months. I was burned out. It was bad. I started to dread seeing patients and I was looking forward to the days being over. I wanted to get in, get out and go to bed. Most importantly, I no longer had the drive to soak up all of the information I needed to learn and become more effective as a student doctor, and I started to wonder if Medicine was the right place for me to be. From the beginning of M3 year, I was pretty certain that I wanted to go into Family Medicine. I studied hard on that rotation and did very well, but the faculty that I worked with seemed to disapprove.
I was told that I need to work on my empathy, and I was berated for doing the very things that I was encouraged to do by other faculty. Additionally, the person who was supposed to be my mentor went radio silent when it was time to start the project that we agreed to work on together. It sounds like I am complaining, and maybe someone else in my shoes would just shrug these things off. At the end of the day, I wanted to be on top of my game for my patients, and if I felt like my burnout was compromising patient care, It would be my responsibility to walk away. So I did, and I took a leave of absence from medical school.
During my leave of absence I had some time to think about what my future in medicine would look like. What was contributing to burnout in the first place?
- Coming home from a 15hr day lamenting that I don’t want to do medicine anymore
- Constantly looking up alternative careers
- Feeling like a failure in spite of my success
- Dreading coming in to work
- Starting to feel like I don’t know what my purpose is
These feelings started during my Family Medicine rotation (my preferred specialty), and extended after that. I needed a break, and when I finally took one with the LOA, I felt a lot better. That’s when I knew that something was not right. My long-term goal was to pick a career that gives me the time and flexibility to take care of other parts of me. However, I was not completely convinced that medicine was completely off the table. I still really liked Family Medicine.
On my Family Medicine Rotation, I was:
- Struggling with patients who needed social services we could not provide
- Sometimes having not so great days and learning not to take that personally
- Remembering why I went into medicine in the first place, which was to serve the underserved and reduce health disparities
- Knowing that I will need flexibility in my lifestyle to continue working
- Understanding that Family Medicine is one of those specialties that provides options for part-time work
I spent the rest of my pregnancy thinking through these points, but life changed anyway:
- Being pregnant and giving birth during the COVID-19 pandemic
- Having pregnancy complications, giving birth at 34 weeks via urgent C-Section
- Developing Postpartum Preeclampsia with severe features, that was almost missed
- Visiting my son in the NICU with limited visiting hours because of COVID
- Not having parents, family and friends come visit and help out as expected
- Developing severe Postpartum Depression
Pushing Myself to Go Back
At this point, the stakes were higher, and my goals changed completely. I needed to continue to leave space to process my trauma and to heal my depression. It was no longer an option to put my mental or physical health on the backburner. But the Type A person in me still continued to try to make the Doctor-Mom life work. I planned to return to medical school. It was not only my own personal pressure that I had to deal with, but I was also dealing with pressure from my husband and from my parents.
Just mentioning the possibility of leaving medical school distressed my mother, who was looking forward to me completing this huge accomplishment, and worried my husband. If I decided to leave medical school, my future income would be uncertain and so would our family’s financial future. Not wanting to disappoint myself or anyone else, I planned my return from my leave for the Summer term of 2021.
In the months leading up to my return, my Postpartum Depression worsened. Even with the medication that I was taking, and I started to feel anxiety around:
- Missing my baby’s milestones
- Keeping up a breastfeeding routine during demanding rotations
- Wondering if I can be a good doctor and a good mom
- Whether my marriage will survive these new stressors
- Finances – childcare, student loans, unemployment
- Whether we needed to move across state lines to increase the chances of my husband finding a job
- Doing all of this without a strong support network or family nearby
- Whether medicine is worth the physical sacrifice (COVID-19, etc.)
- Being with my dad as he is requiring more assistance, and what that looks like
- Not having the passion that makes the sacrifice worth it.
- Disappointing black and brown aspiring doctors and inadvertently discouraging them from pursuing such a necessary career
Essentially, I was having to make one of the hardest choices in my life. If I left medical school for good, I would not be able to open that door again unless I started from scratch, retaking the MCAT, etc. I continued to scour resources and hear how other women manage motherhood, life and medicine. The common denominator was having an excellent support system. But that was something that I would never be able to have so long as I stayed at this medical school because of the distance from home.
Burnout is Common and Balance is Fleeting
I heard stories from physicians who pivoted completely into a different career. Maybe they leveraged a side hustle so that they did not have to make career and life decisions based on finances. The goal was to be able to have alternative streams of income. This way, you can wait for the right job that gives you the balance and flexibility you need. In conference breakout groups, I also saw attending physicians who were completely burned out. Some wanted to change careers entirely, like trying their hand at interior design, for example. One attending decided to leave medicine completely after recovering from a severe case of COVID-19. It just seemed like in this particular moment in time, people were breaking down. They were being honest about what they truly wanted their lives to look like. I was doing the same thing.
The pandemic gave us permission to move on, grow up. We have to own our needs and change our lives so that those needs can be met. I had spent years stewing over the notion that women can have it all. I read Anne-Marie Slaughter’s article in The Atlantic in my senior year of college. At that point, I knew that I wanted a family and a career, and I knew that I would just make it work. I felt like things would change over time. By the time I became a mother, I would not feel like I needed to choose between myself, my family and my career.
Changing Careers is Scary
But here I am, almost a decade later, making the decision to leave a career before I even started it. This was a career that I had invested the entirety of my twenties building up. I had nothing to show for all of that work as I approached my 30th birthday. I know that I can do both, but do I want to? And is it the best choice for my family? There are such a complicated set of factors involved. But I was broken in a way that I had never been before, and it was time to change something.
Making My Final Decision
The day I was scheduled to start my Surgery rotation, I was still in the midst of recovering from depression. I couldn’t get out of bed in the morning and was dealing with a lot of dark, negative thoughts. I lacked the executive functioning to do anything worthwhile. Additionally, I wasn’t eating or showering, let alone spending any time mothering my child or nurturing my marriage. It was clear that I was not going to be ready anytime soon. I gave my notice to withdraw from the program. Medical schools will do anything to get you to graduate: extend your LOA, provide counseling, support, whatever you need. No additional time or counseling was going to change what I knew deep down that I needed to do.
Making the Leap to Leave Medical School
I left medical school and decided to stay home and write. I need time to heal from my depression, and figure out a game plan for taking care of my dad. Most importantly, I need to be a more present mom than I have been over the past 10 months. Writing is cathartic for me. It helps me process all of my emotions and feelings that I can’t express otherwise. I am hoping that in sharing my stories and experiences, I can help someone not feel so alone.
I may pursue another career path in the corporate world, and I am leaving the door open for that when the time is right. But right now, I have to follow my heart and not make decisions based on others’ opinions. I am finding healing in my daily bible study and in prayer. I know that God is making a way through this dark valley in my life. While I am still in the midst of this incredibly hard season, I am finding peace by resting in His word.
I am so thankful for all of my experiences in medical school.
I couldn’t see myself practicing medicine for the rest of my life. Black doctors are INCREDIBLY important. Every single reader who is dreaming of going to medical school should do it. Even if it takes a long way to get there, do it if it is your dream. I just know for myself that clinical practice is not for me. I don’t want to do a disservice to my patients by not being fully committed and 100% present while I am at work.
I feel incredibly at peace with my decision, after hemming and hawing for over a year. Part of me mourns the loss of what could have been, but the other part of me knows that this is the best decision for me and my family. Being a mom feels so natural to me, and I want to pour every single ounce of my being to the care of my son, my husband and my household. It energizes me.
At some point in the future, I might consider going back to work, perhaps getting an MPH and running a non-profit organization. In this season of my life, though, I feel called to grow deeper in my relationship with Jesus, to raise my son up to know and love the Lord, to take care of my aging parents, to build up my community, and to take care of my physical and mental health. I just know that finishing medical school and continuing with a career in medicine would require me to sacrifice those values that I have chosen to prioritize, and that is too great a cost.
“Having it all” is a myth. Time is finite, and you can’t do everything well. Some areas of your life will have to accommodate others. I think it is a great exercise to sit down and parse where your time is going to determine whether or not you are living a life that reflects your ultimate values and priorities. If something is not right, have the courage to change it. When you realize that your worth is not tied to titles, positions or accomplishments, it gives you the freedom to adapt your work to each season of life.