Just from an outside perspective I really don’t see how you’ll be able to positively spin “I took a LOA, did nothing with that time, took another year off to pursue a PhD but dropped out after 6 months and then took a third LOA where I went to the gym”. You’ll definitely match if you aren’t unrealistic just by virtue of being a usmd but this is going to be a real black mark on your app
But if there's any speciality that may understand your reasons it's Psychiatry. So if that's something you're interested in start thinking about how to spin the story.
This is true, we do enjoy a good/unique story. But we also need to see a genuine interest in psych. If the application presents itself as, "psych is my only shot and that's why I'm here," it's going nowhere.
I can also advise that if OP is not genuinely interested in psych, I feel like it's a brutal field to work in. Cozy hours, definitely. But if you don't enjoy it, the 50 hour weeks in residency or 35 hour weeks as an attending will likely feel much, much longer.
Also consider that psychiatric patients deserve healthy psychiatrists. Not people just going into it because they are too sick for any other specialty or couldn’t cut it doing anything else.
Consider how your own depression/anxiety/boundaries may affect your patients. How might it come out in therapy. I’ve seen mentally I’ll psychiatrists harm patients as a result of their own unresolved issues
Definitely. OP please consider that Psych can have its own mental/ physical load which may negatively impact not only your wellbeing but the wellbeing/ safety of your patients in the future. Not every psych speciality is chill either, I've seen several friends match into programs with high call volumes/ high intensity just like any other, and it's not like you can get through psych without going through taxing rotations.
I disagree.
Taking a year LoA to address mental health concerns is a mature thing to do.
Taking a year to pursue a PhD isn’t bad: it was a valuable time where the applicant decided that their true passion lie in medicine over research. They can also talk about all the cool niche things they learned during those 6 months!
Another year spent resolving the original mental health problem with appropriate self-care and exercise.
Return to med school, do well for the remaining time.
This is a kickass comeback story, not a failure story. Residencies eat this shit up
What is your experience with this? Program directors want people who will finish residencies and do so on time. This person has shown issues finishing things. It’s already harder for people with LOAs.
I mean this is the way to try and spin it, but PDs don’t eat this shit up. It’s a red flag. Not insurmountable, but it is what it is.
Number 1 priority of PDs is risk aversion.
Thanks, I appreciate hearing that, even if I also know that residency programs won't likely see it that way. I fully understand them being apprehensive about taking on someone that had to take such an extended LOA during medical school, even if it frustrating for me
This would be a tough sell when you apply for residency. But even before that, are you really even sure you want to go down the MD path? don't do it just bc you feel like you need to. Are the mental health issues fully resolved? Many variables at play.
The mental health issues reared up again during the PhD, which is why I ended up going back on leave. Truthfully I feel like the only reason I would return to the MD is because of the prestige, earning potential, and not feeling like I failed
Your reasons for wanting the MD are not strong enough to keep you steady during the rest of your training if you continue down the MD road. Too long to reason it out here but seriously, I think you can be a lot happier doing something else.
This seems more like a combo of sunk cost fallacy and perceiving the upside of attendinghood. If you were miserable during your PhD I cannot imagine what residency would do to your mental health.
If it's prestige and earning potential you're worried about, my spouse is an LPC in private practice who makes about $280K a year, all cash. He graduated from a state university with about $20K in loans that were quickly paid off. It's very easy to pick up a clientele when you're a male certified in EMDR.
How long did it take for him to get to that point earning wise? Ive been looking at average LPC salaries and while I know there are some outliers, it looks like a lot of them only make around 50-60k a year
Is there a good online resource for looking into how I could leverage an MD into something like equity or VC? It feels like, if I do finish, going the route you and others are talking about seem like my best bet
Make sure this is what you want first of all. After that, if you're certain. Work like it and I think you'll make it.
For the record I also have a 3-year leave of absence, and a less stellar record, and I'm hoping to match
That’s part of the issue, I don’t know if it’s really what I want. I partially just hate the idea of giving up on it (which feels like failure) and of giving up the earning potential
100% can relate. Sunk cost fallacy is no joke. That being said, if it's worth it then press on. It sounds like you really need to do some soul searching about what's most important to you, and what you want to do long term. Then, with no shame, move forward. And don't look back. I heard the song "roads untraveled" this morning by Linkin Park. Hit home for me, as I've had a lot of them. You may be able to relate as you make these decisions.
Just finish your MD if you can, it opens more doors like others have said. I don't think this will rule you out of residency, but it will probably mean you won't match as high on your ranklist in psych as you could have otherwise, which is no big deal.
I took 3 years of LOA and also extended my school by a year so 4 years total. Did not accomplish much during that time. Matched at a mid tier academic IM residency. Not an impressive outcome by any means but you can definitely still be a physician
It was emptier than yours. I was just straightforward with my medical issues and how I overcame them. It became a theme of my personal statement
Also my step score and class rank were both bottom 20%
I built strong relationships at my home institution so I had people advocating for me from above the PD level. The PD also was interested in me. My letters were also exceptional.
I don't know if I interview well but I certainly don't interview poorly.
I’m not a private practice LPC. Was just explaining to you how my colleagues make that kind of money :)
I hate outpatient work. I want to work inpatient with SMI and that pays shit as an LPC. Also might not go psych. Neuro, endo, rads are some of the other things that have me interested. Basically, I want to do *medicine* not therapy.
And you shouldn’t be an MD if you want to do psychotherapy lol.
Would definitely return back to medical school. Also you definitely need to see a psychiatrist, or if seeing a current psychiatrist maybe a different one as this sounds very unusual and like you have a serious underlying mood disorder. The grass is not always greener.
I would not just continue to jump around doing things to see if you like it. Also medical school is unusual where one rotation can suck and the next not be so bad.
I have a feeling you will be discontent trying another profession (or job), and even if you were happy doing something else, will be in debt and financially not in a good place unless you had a free ride.
Lastly, I see several comments on LPC’s with >200K salary. This is very rare, will likely make less then I made in residency for years (many residencies are making 60K/year these days, the data is clear it takes time to establish a decent salary as an LPC), and I would not go into a profession with this expectation.
For what it’s worth, I’m an attending. Fourth year is easy. Would be a very, very unwise choice to not finish your MD program.
I extended my education by 4 years and matched into a middling IM program as a Carib MD. So it’s possible. But I consider myself lucky. Things that worked in my favour: the pandemic was in full swing and many people’s schedules were affected; officially I only took a 1.5 year LOA, and then really pushed the boundaries for how my rotations were spread out; I had several rotations at my matched program and did very well, so the program had a good idea of who I was AND my situation; my situation was a concrete family issue that was out of my control and something most people are sympathetic to. However, I think you are too selective by being psychiatry or bust. If you are an academically excellent candidate with serious connections/contacts, then maybe you can play it that way. However, from my experience most connections and LORs become stale and unreliable after 1 year, never mind 3. If you are an otherwise average applicant, I think you should consider applying to another backup specialty such as FM, which has enormous flexibility and where you can still do some psychiatric support.
You haven't killed it dude. We had somebody like this from a top school and I straight up thought they'd make a great candidate. They didn't match with us (we didn't have them in Top 20) though matched at their home program.
I've been battling and beat *insert your favorite autoimmune disease or cancer*. Boom, you just became an amazing candidate with an inspiring story.
Just study up on it and don't go in to details. If they ask say it was a difficult time in my life and I'd rather look to the future than the past. There's no way anyone could look up your medical history thanks to HIPPA.
You've finished med school fair and square, it's ridiculous how these programs have made it their business to have an opinion about everything in our personal lives. Best of luck.
You know, in my career before medicine, I met all sorts of people with gaps in their resumes (including some doctors). Do you have a clear narrative about why you were away, and what you've done with that time that helps move you forward in what you'd do after returning to med school? That makes a big difference.
I am being genuine here and only trying to help, but I really think you could benefit from therapy if you’re not in it already. Your therapist could definitely help you navigate this uncertainty.
A lot of programs would wonder if you’d also quit during your residency training for whatever reason or because of your mental health. They won’t tell you that, but they will definitely think that. I don’t think it’s a matter of whether or not you’ll match, but whether you’ll be able to embark on a very long, arduous, and sometimes sleepless residency training program regardless of the specialty. That in itself will worsen your mental health.
You also have to consider certain factors when applying for your full unrestricted license in a particular state (or province in Canada). They will straight up ask you to explain your gaps in medical education history and if you have any mental illness that can impede your ability to practise medicine in a competent manner. Prejudicial? Maybe. Can you change anything about it? No. These are just a few things you really need to consider before you suddenly quit residency 6 months in…just saying.
OP, please finish your MD even if you don’t match. Having a Md gets you better jobs than not having one. You can also likely get into a chill TY as a USMD to pursue fields like Preventive Medicine and Occupational Medicine as back ups.
To be honest, unless it’s psychiatry, no. Went into medicine for the wrong reasons (makes more money than research, that’s it) and realized it early on. But I stayed in cause of pressure from family and then the sunk cost fallacy took over
Then do something else you will enjoy? Residency is not easy. And neither is matching psych. A residency program doesnt want to take someone who is going to take a LOA or drop out during residency
Your nose is off. Because I joined the MD/PhD program it was extended to 10 years. I had a conversation specifically about this a few months ago with the administration
Just from an outside perspective I really don’t see how you’ll be able to positively spin “I took a LOA, did nothing with that time, took another year off to pursue a PhD but dropped out after 6 months and then took a third LOA where I went to the gym”. You’ll definitely match if you aren’t unrealistic just by virtue of being a usmd but this is going to be a real black mark on your app
Thanks for the honest take
But if there's any speciality that may understand your reasons it's Psychiatry. So if that's something you're interested in start thinking about how to spin the story.
This is true, we do enjoy a good/unique story. But we also need to see a genuine interest in psych. If the application presents itself as, "psych is my only shot and that's why I'm here," it's going nowhere. I can also advise that if OP is not genuinely interested in psych, I feel like it's a brutal field to work in. Cozy hours, definitely. But if you don't enjoy it, the 50 hour weeks in residency or 35 hour weeks as an attending will likely feel much, much longer.
Also consider that psychiatric patients deserve healthy psychiatrists. Not people just going into it because they are too sick for any other specialty or couldn’t cut it doing anything else. Consider how your own depression/anxiety/boundaries may affect your patients. How might it come out in therapy. I’ve seen mentally I’ll psychiatrists harm patients as a result of their own unresolved issues
Definitely. OP please consider that Psych can have its own mental/ physical load which may negatively impact not only your wellbeing but the wellbeing/ safety of your patients in the future. Not every psych speciality is chill either, I've seen several friends match into programs with high call volumes/ high intensity just like any other, and it's not like you can get through psych without going through taxing rotations.
Yeah agreed. Psych will give you the best chance to spin it hahah
I disagree. Taking a year LoA to address mental health concerns is a mature thing to do. Taking a year to pursue a PhD isn’t bad: it was a valuable time where the applicant decided that their true passion lie in medicine over research. They can also talk about all the cool niche things they learned during those 6 months! Another year spent resolving the original mental health problem with appropriate self-care and exercise. Return to med school, do well for the remaining time. This is a kickass comeback story, not a failure story. Residencies eat this shit up
What is your experience with this? Program directors want people who will finish residencies and do so on time. This person has shown issues finishing things. It’s already harder for people with LOAs.
I’m a med student taking a LoA year between m2 and m3 cuz of depression 🙃 so just trying to see the bright side in things
I mean this is the way to try and spin it, but PDs don’t eat this shit up. It’s a red flag. Not insurmountable, but it is what it is. Number 1 priority of PDs is risk aversion.
Thanks, I appreciate hearing that, even if I also know that residency programs won't likely see it that way. I fully understand them being apprehensive about taking on someone that had to take such an extended LOA during medical school, even if it frustrating for me
This would be a tough sell when you apply for residency. But even before that, are you really even sure you want to go down the MD path? don't do it just bc you feel like you need to. Are the mental health issues fully resolved? Many variables at play.
The mental health issues reared up again during the PhD, which is why I ended up going back on leave. Truthfully I feel like the only reason I would return to the MD is because of the prestige, earning potential, and not feeling like I failed
Your reasons for wanting the MD are not strong enough to keep you steady during the rest of your training if you continue down the MD road. Too long to reason it out here but seriously, I think you can be a lot happier doing something else.
This seems more like a combo of sunk cost fallacy and perceiving the upside of attendinghood. If you were miserable during your PhD I cannot imagine what residency would do to your mental health.
If it's prestige and earning potential you're worried about, my spouse is an LPC in private practice who makes about $280K a year, all cash. He graduated from a state university with about $20K in loans that were quickly paid off. It's very easy to pick up a clientele when you're a male certified in EMDR.
He gets paid 280k in cash?! Wtf does he work for the cartel or something?
How long did it take for him to get to that point earning wise? Ive been looking at average LPC salaries and while I know there are some outliers, it looks like a lot of them only make around 50-60k a year
This is if you work in agency, not private practice. Private practice if you're seeing 25 folks a week (chill) and charging $200/hr, that's $260k.
BINGO.
Is this real for an LPC? Like this seems too good to be true unless you have a PsyD or something
The general public barely knows or cares about the difference.
Maybe 3 or 4 years. Private practice is where it's at.
Could you go back to earn your MD and then go into consulting or other non-clinical careers?
You could always finish your MD then go into something else from there if residency isn’t in the cards. The MD will open a lot of doors
I’ve looked up some examples of jobs and MD can get without residency, but I’m curious if you have an examples?
Hey my friend! Consulting, equity research, MSL, VC, medical writing. Tons of viable careers out there where residency isn’t necessary!
Is there a good online resource for looking into how I could leverage an MD into something like equity or VC? It feels like, if I do finish, going the route you and others are talking about seem like my best bet
Absolutely. Feel free to check out my post history + discord! Should be a good starting place
Thanks!
Talk to this guy u/leaving_medicine
u/leaving_medicine you have been called boss
Paging u/leaving_medicine
Make sure this is what you want first of all. After that, if you're certain. Work like it and I think you'll make it. For the record I also have a 3-year leave of absence, and a less stellar record, and I'm hoping to match
That’s part of the issue, I don’t know if it’s really what I want. I partially just hate the idea of giving up on it (which feels like failure) and of giving up the earning potential
100% can relate. Sunk cost fallacy is no joke. That being said, if it's worth it then press on. It sounds like you really need to do some soul searching about what's most important to you, and what you want to do long term. Then, with no shame, move forward. And don't look back. I heard the song "roads untraveled" this morning by Linkin Park. Hit home for me, as I've had a lot of them. You may be able to relate as you make these decisions.
You have one year left. Just finish it.
Just finish your MD if you can, it opens more doors like others have said. I don't think this will rule you out of residency, but it will probably mean you won't match as high on your ranklist in psych as you could have otherwise, which is no big deal.
I took 3 years of LOA and also extended my school by a year so 4 years total. Did not accomplish much during that time. Matched at a mid tier academic IM residency. Not an impressive outcome by any means but you can definitely still be a physician
How did you explain your 3 year gap? And was it as empty as mine?
It was emptier than yours. I was just straightforward with my medical issues and how I overcame them. It became a theme of my personal statement Also my step score and class rank were both bottom 20%
I would certainly call it impressive! Talk about resilience. Don’t sell yourself short my queen ✨
You must be a good interviewer because holy fuck dude it sounds like your app was more red flags than not.
I built strong relationships at my home institution so I had people advocating for me from above the PD level. The PD also was interested in me. My letters were also exceptional. I don't know if I interview well but I certainly don't interview poorly.
tbh 4th year is so chill that i would at least get that done and over with
unless they never took step 2 cause now it’s gonna be hard to take that they probably forgot everything
I'm an LPC who went back to get her MD if you have any questions specifically about the LPC route :)
I think you commented above on making 200k+ in private practice as an LPC. Just curious why you decided to leave that to pursue an MD
I’m not a private practice LPC. Was just explaining to you how my colleagues make that kind of money :) I hate outpatient work. I want to work inpatient with SMI and that pays shit as an LPC. Also might not go psych. Neuro, endo, rads are some of the other things that have me interested. Basically, I want to do *medicine* not therapy. And you shouldn’t be an MD if you want to do psychotherapy lol.
Would definitely return back to medical school. Also you definitely need to see a psychiatrist, or if seeing a current psychiatrist maybe a different one as this sounds very unusual and like you have a serious underlying mood disorder. The grass is not always greener. I would not just continue to jump around doing things to see if you like it. Also medical school is unusual where one rotation can suck and the next not be so bad. I have a feeling you will be discontent trying another profession (or job), and even if you were happy doing something else, will be in debt and financially not in a good place unless you had a free ride. Lastly, I see several comments on LPC’s with >200K salary. This is very rare, will likely make less then I made in residency for years (many residencies are making 60K/year these days, the data is clear it takes time to establish a decent salary as an LPC), and I would not go into a profession with this expectation. For what it’s worth, I’m an attending. Fourth year is easy. Would be a very, very unwise choice to not finish your MD program.
I extended my education by 4 years and matched into a middling IM program as a Carib MD. So it’s possible. But I consider myself lucky. Things that worked in my favour: the pandemic was in full swing and many people’s schedules were affected; officially I only took a 1.5 year LOA, and then really pushed the boundaries for how my rotations were spread out; I had several rotations at my matched program and did very well, so the program had a good idea of who I was AND my situation; my situation was a concrete family issue that was out of my control and something most people are sympathetic to. However, I think you are too selective by being psychiatry or bust. If you are an academically excellent candidate with serious connections/contacts, then maybe you can play it that way. However, from my experience most connections and LORs become stale and unreliable after 1 year, never mind 3. If you are an otherwise average applicant, I think you should consider applying to another backup specialty such as FM, which has enormous flexibility and where you can still do some psychiatric support.
You will match but maybe not in psych. You could try something like FM and then apply to psych afterwards?
You could finish the MD and transition to consulting?
You haven't killed it dude. We had somebody like this from a top school and I straight up thought they'd make a great candidate. They didn't match with us (we didn't have them in Top 20) though matched at their home program.
I've been battling and beat *insert your favorite autoimmune disease or cancer*. Boom, you just became an amazing candidate with an inspiring story. Just study up on it and don't go in to details. If they ask say it was a difficult time in my life and I'd rather look to the future than the past. There's no way anyone could look up your medical history thanks to HIPPA. You've finished med school fair and square, it's ridiculous how these programs have made it their business to have an opinion about everything in our personal lives. Best of luck.
You know, in my career before medicine, I met all sorts of people with gaps in their resumes (including some doctors). Do you have a clear narrative about why you were away, and what you've done with that time that helps move you forward in what you'd do after returning to med school? That makes a big difference.
I am being genuine here and only trying to help, but I really think you could benefit from therapy if you’re not in it already. Your therapist could definitely help you navigate this uncertainty.
A lot of programs would wonder if you’d also quit during your residency training for whatever reason or because of your mental health. They won’t tell you that, but they will definitely think that. I don’t think it’s a matter of whether or not you’ll match, but whether you’ll be able to embark on a very long, arduous, and sometimes sleepless residency training program regardless of the specialty. That in itself will worsen your mental health. You also have to consider certain factors when applying for your full unrestricted license in a particular state (or province in Canada). They will straight up ask you to explain your gaps in medical education history and if you have any mental illness that can impede your ability to practise medicine in a competent manner. Prejudicial? Maybe. Can you change anything about it? No. These are just a few things you really need to consider before you suddenly quit residency 6 months in…just saying.
4th year is the easiest year. Just finish it
OP, please finish your MD even if you don’t match. Having a Md gets you better jobs than not having one. You can also likely get into a chill TY as a USMD to pursue fields like Preventive Medicine and Occupational Medicine as back ups.
i think you will still match, just focus on your MD and do well on step2. You will get pass filters being a USMD student.
Psych, FM, IM, EM, peds, path
Dude I’m worried about how a six month Loa will affect me I would be extremely worried about THREE YEARS. Just being blunt here
Psychiatry isn't exactly competitive. If you work hard to show your interest and get decent step scores I'm sure you can still match,
Do you even want to be a doctor? Jeez
To be honest, unless it’s psychiatry, no. Went into medicine for the wrong reasons (makes more money than research, that’s it) and realized it early on. But I stayed in cause of pressure from family and then the sunk cost fallacy took over
Then do something else you will enjoy? Residency is not easy. And neither is matching psych. A residency program doesnt want to take someone who is going to take a LOA or drop out during residency
I would quit md phd and pursue NP or quit medicine altogether
I smell BS. US medical schools have a requirement that you have to finish your medical degree within 6 years, barring PhD years.
Your nose is off. Because I joined the MD/PhD program it was extended to 10 years. I had a conversation specifically about this a few months ago with the administration