It’s official. I have been unemployed for two weeks now. Going from full time junior doctoring to no work whatsoever is an adjustment. I’ve wanted to write since the day I finished, but every time I’ve opened my computer to say something I couldn’t. Today I’m finally feeling ready. What no one tells you is that you don’t magically go from burnout to elation the day after finishing residency.
In fact I was really surprised with my complex mix of emotions on the day of finishing. There was relief, happiness, pride, excitement, fear and I did tear up. Walking out of my last shift I cried happy tears, it was the hardest two years of my life, and I had completed them successfully.
Nightmare last shift
My last shift was not a joyful or easy one. There was no farewell party or send off. It was a Sunday shift covering the whole hospital with one other doctor and it started off with a bang. I arrived to a code blue, a woman frothing from the mouth and seizing. She was very difficult access and even the most skilled senior was struggling. Her skin began to tear in front of our eyes, paper thin and fragile.
As the most senior junior there I had to escort her to the CT scanner and be ready to administer more midazolam in case she seized again. On arrival to the code I was puffing after running from my car to get there in time.
After this it didn’t slow down for a second. Since it was the last week of the clinical year a lot of doctors in the week hadn’t cared about the weekend for their patients. There were almost ten patients with no blood forms in, medications weren’t charted properly, things had been missed. Those for discharge had nothing prepared. Scans had been ordered with IV contrast for patients with anaphylaxis to the agent…it just went on forever.
A balancing act
Two different seniors instructed me to take blood from their many patients who had none taken in the morning. It was a balancing act of actually caring for sick patients and fulfilling senior wishes of blood tests. All on my own. Plus there was a new ward clerk who panicked about every single phone call and would try to make me answer all of them. I repeatedly told her that wasn’t appropriate, but it continued throughout the day.
Then I was asked to replace an IV cannula for a patient that had hers fall out overnight. The night team hadn’t replaced it. On arrival to replace the IVC the patient looked terrible. It wasn’t a straight forward line like I expected. I took bloods including VBG and blood cultures and discussed with my senior immediately. She didn’t seem well at all and I voiced my concerns about whether she should go to the intensive care unit.
In the end my senior believed it was due to over oxygenation and she started to perk up after an hour or so. He wasn’t concerned. So she stayed on the ward. Throughout the day we kept checking in on her, but she remained stable. I managed to do the blood round, and review the many other unwell patients that day before handing over and heading home. I flagged the woman I was truly concerned about, and warned that she could crash.
Ending on a low note – and questioning myself again
When I got home from work the junior I handed over to texted me. She said I had been right and that woman had crashed. She coded, required two rounds of CPR and was transferred to ICU intubated. At this stage no one knew the cause.
My residency definitely ended on a sour note. I felt for the woman and her family. I wondered if there was more I could have done. Did I miss something? Should I have watcher her more closely? Maybe I should have pushed more for my senior to ask for an ICU review. It wasn’t the first time I’ve had to question a senior, but I had trusted his judgement. He was many years more experienced than myself.
In the end there was nothing I could do now. I could only hope she was getting the treatment she needed in the intensive care unit, and that she would recover. She wasn’t a healthy woman before that day, and already had a poor prognosis. Rationally I knew her outcome would’ve been bad either way. Still, I kept thinking back on that patient and I still do two weeks on.
Unemployed – the exciting yet scary unknown
Two weeks on I’ve been relaxing at home a lot since completing residency. When it’s a nice day I frequent the beach. Besides this I’ve not done anything remotely strenuous. It’s been nice and an amazing change of pace.
However the first week wasn’t all smooth sailing. There was a lot of anxiety there. What next? What am I supposed to do now? How am I going to support myself. What do I want to do with my life? Maybe I would like being a GP? Maybe I wouldn’t?
High school, then medical school, then internship/residency was so straight forward. You plod along and complete your years dutifully, until all of a sudden you’re finished. Time really flies by without you noticing. Now I’m in a strange moment in my life where I don’t need to complete anything really.
The freedom is exciting but the unknown can also be scary.
I’ve discussed this with a friend of mine who quit residency to work in cosmetics. She felt the exact same fear. Was she doing the right thing? What if it all went wrong?
Trusting the unknown
This post isn’t to tell you that I’ve now suddenly found my true calling in life. Unfortunately, things don’t usually go so smoothly and seamlessly. It’s to tell you that if you’ve just left medicine and feel completely lost and unsure you’re not alone.
It’s confusing and it’s different. Sometimes it’s even the first time you’ve ever felt completely free of needing to do something. For medics this can be super weird. The comfortable thing is to be so busy with your study and work that you don’t need to worry about any of this stuff.
Currently I’m trying to relax and believe that it will all work out eventually. I’m in my exploration phase where I see what works for me. It’s okay not knowing the future. I’ll continue to follow what interests me and see if it all comes together one day. I’m sure it will!