Help me to stop my future career from taking over my life!

April 19, 2009 9:10 AM

I need advice or a good book to read on how to (i)not let my career and continuing education take over my life and (ii) keep myself from being negatively transformed through stressful experiences.

I am preparing to graduate from my undergraduate institution and currently trying to decide the path I want to take for school. I will probably end up doing a dual medical/graduate program at a pretty prestigious university. Here's the thing: I come from a pretty humble background and am pretty much going to a no-name undergrad. I feel like I enjoy who I am as a person, but I am concerned that the pressure of a rather competitive school are going to turn me into someone that I don't want to become.

I feel very strongly about going into the field of medicine, and I really want to be the best doctor possible, but the transformation I have seen in others put under the stress of similar programs to mine worries me that the same thing is going to happen to me. I very much want to keep loving life and being able to enjoy the small things. I also have a great girl right now, and I don't want my schooling and career to wreck our relationship.

So I ask you, Metafilter: how can I balance becoming a successful doctor and living an enjoyable life? Am I searching for the impossible?

I'm taking a month off in May to backpack solo around Europe, so if you've got a book that you feel would be helpful, that would be appreciated as well!

posted by sciencemandan to Work & Money (7 answers total)

This is not the advice you want to hear, most likely, but I would defer your MD/PhD program for at least a year. Now that I've displeased you mightily, allow me to explain.
It's laudable that you want to have a part of yourself, your life, that stays true throughout the long slog that is advanced degree work. It's a good plan. However no book or simple words of advice are going to allow you to do that. The trajectory that you're on right now, undergrad straight to gradschool, is such that when you're 30, you'll never have lived your life outside the context of school. In my observations at my (top tier, prestigious blabbity blah) institution the most spectacular burnouts, or those who become miserable shells of themselves or those who lose their motivation and become aimless are those who didn't take a breath between undergrad and grad school.
I'm not going to pretend to draw a causal relationship between these two phenomenon, but to your question: How do you maintain yourself in the crucible of grad school? I suggest that for the others, who spent some time living independently, working, but just mainly living, outside the school context, there is a much more stable core of extracurricular experience to draw from when the going gets rough. This may help because, given the chance, gradschool will take over every functioning sector of your brain, and certainly all available time. Personally, what I feel I have are some outside, independent interests that make me very happy so that when the wave of work and responsibility comes crashing over me, I still know that there are things that I can do and think about to push back against the total consuming work. To extend the metaphor even more, when I'm drowning in work I know there are parts of myself that are still dry and unaffected that I can go hide in for a while if I need to. These are essentially hobbies, but important none-the-less. If, like me, you define yourself by what you do, it helps to have multiple definitions so that you're never the miserable doctor who is miserable, but the miserable doctor who paints, or builds birdhouses, or is also a photographer or something. I was able to develop these outside interests and integrate them into my life in the interval between undergrad and grad school. I was occupied, but not consumed by my job then, so I had the mental space to accommodate them. They've served me well since then and helped me balance the demands placed on me by giving me outlets for stress, small accomplishments that make me feel competent and perhaps most importantly, things to talk about with my friends and family that don't require a 2 hour primer on developmental genetics and cell biology.
Yikes, long, but here's a summary: Take some time ( a month is not sufficient) to build up a definition of yourself independent of school, that way when school starts to try to crush you, you have something that lies outside of its sphere of influence. At the same time you can pad your bank account, build up your relationship with your girl and generally allow yourself to have fun.
posted by Cold Lurkey at 10:31 AM on April 19, 2009 [1 favorite]

Response by poster: @Cold Lurkey,

Thanks so much for the advice! I am definitely willing to listen to a suggestion like this, but I have one question for you: what should I do during this year off?

Let me give you a bit more context. I got into an MD/PhD program at a pretty decent state school, but I got in MD only at a top tier school. I think I would be able to receive better training at the top tier school, but I would have to reapply MD/PhD as a first year medical student, which would mean I'd have a year of med school debt to pay off later.

If I take a year off, what could I do in that span of time to (as you mentioned) build other parts of my life while still maintaining my competitiveness as an MD/PhD candidate at the top school? Should I try to find a research job or work as an adjunct at my current undergrad (some of my professors have brought this up as a possibility)?

Also, my girlfriend is a year behind me in school, so she would still be at my original undergrad for a year, and I could see how taking a year off could help us figure out our future plans.
posted by sciencemandan at 10:41 AM on April 19, 2009

I completely agree with Cold Lurkey. I was one of those people who went straight from undergrad to grad and got intensely burned out. I ended up leaving to take some time for myself, and now I am working on my PhD again. The time off has made such a difference in how I approach school now and it is much easier to deal with the mental taxation of working on my degree.

During my time off I continued to work in science as a lab tech at an academic institution. I enjoy working at the bench so it was a job I could get into. The difference was that I only had to do it 40 hours a week, and when I came home at night and on weekends I had time to actually pursue (gasp) hobbies! Not like now, where I come home and spend hours reading papers and preparing talks, or studying for tests that require a painful amount of memorization and reasoning.

Staying in your field allows you to continue to gain experience, but at a slower pace and for more money. I used my downtime to do things such as learning how to grow orchids and becoming a really good cook. I used my weekends to take trips around and visit my friends and family. And since I earned a nice salary, I was also able to go on a few vacations outside of the country.

Now I'm even more dedicated to getting through grad school as quickly as possible, because I know how awesome life can be on the other end of things.
posted by sickinthehead at 11:08 AM on April 19, 2009 [1 favorite]

Stickinthehead's done what I would recommend. Go work in an academic lab in the interim. Benchwork is a good way to get experience and stay engaged in the field. I guess that makes you "still competitve" but that's probably not the best way to think about it. A technician's position is not one where the work will consume you. Technician gigs are pretty easy to get and most PIs are looking for people that are on the academic track (good motivation for putting in quality work).
Also if there's any doubt in your mind as to whether you really want/need the PhD, a year or so of lab work will give you very good appreciation of what awaits you. For some it whets the appetite, for others creates a knowledgeable distaste. My own prejudices are strong about the dual degree approach, but I suggest you think very long and hard about it. Neither degree is trivial and they require completely different mindsets and aptitudes. Not many people have the ability to do both really well. This is not to say that you can't do both, but you can best decide for yourself after you've had some serious time in the laboratory environment. Therefore I would recommend against the adjunct positions unless you are dedicated to teaching later in your career.
posted by Cold Lurkey at 1:32 PM on April 19, 2009

Nearly all of my colleagues currently finishing up residency training have a secret "dream career", the thing that we would do if we suddenly won the lottery and could take a break from medicine. (This doesn't mean that most of us don't like what we do, but we are all burnt out from the years of feeling overworked and incompetent, so a magical 2 year break would be fantastic.) Characteristics of a good secret dream career:

- focussed on big-picture issues -- philosophical questions if you have an artsy
bent, political or developmental problems if you're a change-the-world kind of guy.
- not at all high-pressure
- creative
- allowing for expression of individuality
- allowing for alone time

In other words, something that will nurture the parts of you that medicine makes you feel you have no time for. (Popular choices include artist, writer, baker, random person who files things in an NGO office, volunteer, traveller, political campaign person, etc.)

If you are interested in medicine and research, you probably already enjoy a lot of the things that are part of that life: breaking problems down into small pieces and working on the parts instead of the whole, thinking in terms of facts and algorithms, moving through life at a breakneck pace, dealing with tons of new people every day. These are all good things, and they will help you, but for your year off, you may want to explore the other side of you, the part that is creative and holistic and slow-moving. So try something different than what you're used to -- the "path untaken" stuff that you haven't done since grade school.
posted by TheLittlestRobot at 10:24 PM on April 19, 2009

Also, I'm sorry to tell you this, but medical training *will* be all-consuming -- there is just no way to work 110h per week and still have more than a rudimentary outside life, especially if your off time is spent worrying about patients you think you screwed up on, or reading up on the many many things that came up that day which you didn't know the answers to. However, the obsession comes with the pleasure of mastering something big and challenging, and of yeah, sometimes helping people. Plus, you don't have to worry quite yet, since the first two years of medical school are mostly academic -- it'll be more of what you're used to, and by the time you reach the clinical stuff, you'll have met lots of mentors who will show you what to do, as well as lots of horrifying examples of what not to do. Medicine is less homogeneous than it appears from the outside, so you *will* find lots of people who still care about maintaining balance in their lives -- you may just have to be temporarily a bit ruthless about which past-times you keep, and when you practice them.

I've actually been kind of fascinated with questions of personality/identity change during medical training lately, so I'd be happy to hear from you via MeMail if you have specific questions. Best of luck, and enjoy your summer/year off!
posted by TheLittlestRobot at 10:33 PM on April 19, 2009

Best answer: Oh man, one more thing (sorry, I apparently over-empathize). In terms of books addressing the coming-from-a-humble-background / maintaining-your-values stuff, a really great read is:

White Coat, Clenched Fist: The political education of an American physician This was written by a physician who trained in the 60's, but the details of medical training and the medical enculturation process have not changed, nor (sadly) have many of the issues of access to care. Though it is a personal memoir from a radicalized and political man, it is at its core a story about defining and maintaining your personal values.

Also, pediatrician Perri Klass has written a thoughtful series of essays called Treatment Kind and Fair: Letters to a young doctor, which discuss the changes that occur during medical training. She meant the book to be for her son, who was entering medical school when she wrote it.

Obviously, neither of these are how-to books, but they're both engrossing and thought-provoking reads.

Don't read "House of God" -- it is satirical, and will only confirm your deepest fears without giving you even a modicum of hope. It is only funny once you have actually been through the horrors of internship, and even then, only in a cruel and painful way.
posted by TheLittlestRobot at 11:00 PM on April 19, 2009 [1 favorite]