Hospitals, Policy, Startups

Entrepreneurial spirit may save urology resident who quit at start of third year

A surgical resident who was 11 years into his 15-year education to become a urologist […]

A surgical resident who was 11 years into his 15-year education to become a urologist called it quits the day before his 30th birthday. In addition to his investment of time to get this far, Sam Park has $100,000 in student loans. His story – told on an “Ask Me Anything” post on Reddit – starkly illustrates our insane medical education system (residents operating after a night of 3 hours of sleep) and the realities of being a doctor (limited job security and ongoing risk of lawsuits).

Whether you think Sam Park is crazy or brave, his story shows that medical education needs as much innovation as the business of healthcare. Here are snippets from his thread on Reddit that explain why he made this choice.

Just celebrated my dirty 30 today by applying for unemployment. I finished 4 years of college, 4 years of medical school, 1 year research fellowship, and 2 years of surgery residency.

2 weeks after starting my 3rd year of residency, I decided the 4 additional years were not worth it. Without any further plans besides being convinced that I would be miserable if I stayed, I turned in my letter of resignation for the day before my 30th birthday so that I can celebrate with my girlfriend and family – something I have not done since 2nd year of medical school.

When a person volunteers to be the subject of an “Ask Me Anything” thread, he or she has to provide proof of identity. Park shared the picture above – birthday dinner with his family — to prove that he was who he said he was. The reactions to his decisions were what you would expect.

Three of my attendings asked me repeatedly if I was going to kill myself (as if committing medical career suicide is on par with just killing myself).

Are you sure you’re not letting trauma induced depression drive you to bad decisions? How do you plan on getting out from under that loan?

My wife did the same thing as you though at a much earlier time – she did well after 1 year of med school and switched to nursing due to too much personal sacrifice – and her family literally almost disowned her. It took about 2-3 years for them to really get over the decision.

Park’s main concern is his own quality of life, but patient safety is also part of his argument for changing the system.

You cannot expect compassionate surgeons if you make surgery residents feel trapped, fatigued, and ashamed for shit that feels out of their control, that there’s nobility in operating on someone with only 2-3 hours of sleep, etc. … If we as a nation are demanding surveillance cameras on police, why aren’t patients asking for the same from their MD’s?

Park is careful to say that he does not regret any of his previous decisions and that the problems he describes are not limited to his residency program at the University of California, San Diego:

I’m not mad at my residency program, I don’t regret my training, I don’t regret the debt that I am in. I was lucky that I realized early in my career that medicine and more specifically, Urology, isn’t all that it is chalked up to be. I’m not pointing my finger directly at UCSD, I’m was talking about surgical residencies in general in the US.

There’s a certain bravado in not sleeping, getting worked to death, and having to go in for clinical duty. Unacceptable in this day and age. The mantra that surgery residents have to be beaten down, bitter, angry has to cease immediately. Why let it become a dog-eat-dog world, sometimes at the expense of patient safety?

Park said that he had been thinking about making a change for some time, but it was a presentation on risk management that sent him to his laptop to write a letter of resignation:

On July 2nd we had a presentation by risk management by an ER physician … He spoke about documenting correctly so that we don’t get ourselves sued, he listed several scenarios where physicians in our own hospital got immensely sued due to lack of good documentation which reflected that the doctors involved acknowledged a particular mistake was a devastating one until about 3 hours, which in the court of law made the physicians seem negligent. I WAS WIDE EYED during the whole talk.

That talk opened my eyes to the hostile side of medicine where as physicians we feel caged in a system designed with the protection of the patients in mind but there are so many ways well-meaning physicians will get punished the system – that was the defining “ah-ha” moment. We are in constant fear that our patients can potentially get back at us. Do you guys know what a VIP patient is? (No seriously, the RN’s will list VIP next to their names). These are lawyers (of course!), other doctors, and super rich people. Do you know why they are VIP? It should be changed to LIKELY TO SUE (LTS). …

… it feels like doctors are losing their autonomy and their minds. That disconnect in what we expect for doctors (and by we, I mean everyone who isn’t a licensed practicing physician because they know what’s up), and the reality of doctors being at mercy in the system they work in… that scared me more than my 6 figure loan.

Now that he has lifted his head from the trenches of surgical training, Park has noticed all the entrepreneurial opportunities in the healthcare industry. Maybe a startup will give him the control of his destiny that he is looking for:

In the past 3 days I have gotten phone calls, messages, emails from people who have business ideas, opportunities for MD’s in finance, consulting, working in small clinics, etc.! I’m busier but the biggest difference is this isn’t work, it’s exploring. It’s fun. Sure it can be stressful but not as stressful as someone bleeding out in front of me and the stress is only transient.

If more residents knew of opportunities available just for completing internship, I’m sure we’ll see a shift that starts small…. but can drastically change the usual career path and considerations in medicine…

I’m STOKED!!!!

Veronica Combs

Veronica is an independent journalist and communications strategist. For more than 10 years, she has covered health and healthcare with a focus on innovation and patient engagement. Most recently she managed strategic partnerships and communications for AIR Louisville, a digital health project focused on asthma. The team recruited 7 employer partners, enrolled 1,100 participants and collected more than 250,000 data points about rescue inhaler use. Veronica has worked for startups for almost 20 years doing everything from launching blogs, newsletters and patient communities to recruiting speakers, moderating panel conversations and developing new products. You can reach her on Twitter @vmcombs.

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