My FY3 Gap Year/Doctor Career Break Advice

Un-blinding myself from all the junior doctor demoralization.
Summit of Mount/Volcano Rinjani, Indonesia at 5am

This post will relate to the 48% (2014-2015 UK statistics), if not the predicted 63% (2015-2016) of junior doctors who want to take a career break, but don't know how/what to do or plan it.  It's difficult to make it seamless and fruitful, packed with goodies and life-changing experiences.

Planning this "FY3" year was and is understated-ly difficult to make productive and rewarding.

But it was the best thing I had ever done. 

(I will do it again.)

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 [Posts to follow/link]

 Volunteer For The Visayans - My experience as a Volunteer Doctor in Tacloban, Phillipines (Typhoon Yolanda/Haiyan)

 Life as a doctor in Singapore

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SO IN A NUTSHELL

This is what I wanted to achieve: explore alternative careers; secure specialty training somewhere; travel the world; volunteer.

This is where I went/did in 11 months:

• Hong Kong (base) [concluded no suitable alternative career in Asia/Australia, nor academic degree].
• Singapore (5 trips over 3 months: 2-weeks holiday + 1 weekend holiday + 1 weekend interview + 2 days interview + 1 day interview) - secured specialty training offer.  
• Indonesia (trekked Mount Rinjani; Lombok; Gili T islands)
• Japan (Osaka, Kyoto, Tokyo)
• Thailand (Bangkok weekend)
• Australia (New Year's)
• UK (INTENSE locuming: 7 weeks, 4 hospitals.)
• Norway (Oslo, weekend)
• Hong Kong (stopover)
• Tacloban, Philippines (Doctor volunteer/Medical mission) - 1 month
• Hong Kong (stopover)
• Miami
• Bolivia
• Peru
• Costa Rica
• Mexico
• UK
• Migrate to Singapore

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THE BASICS

1. So why do so many junior doctors take a career break after FY2?

The numbers have been incrementally increasing: 48% of 2-year-postgraduate doctors; the forthcoming year's predicted to be >60% with the NHS' ongoing  politics and demoralisation.  No other country does Doctor-Gap-Years as much as UK does, neither do they understand fully the concept of breaking or delaying your career pathway.  I spent at least 5 minutes per interview or interaction trying to explain this 'movement' with people abroad or not in the industry.

Possible reasons:

- Never taken a year out.

- Burning out physically, mentally, emotionally, psychosocially.

- Sacrificing/compromising so much of your personal and professional life for other people that you want to do something for yourself for once.

- Want to travel/volunteer.

- Want to study/Masters/BSc/career pivot/research/teaching.

- Work experience in a lateral field eg management, sales, pharmaceuticals.

- Didn't get the ST training they wanted or last minute change of mind on career path.

- Want to move abroad to work.

My reasons:

I didn't apply for NHS Specialist Training in FY2 at all.  I knew since university I wanted to take a gap year/career break, knowing I would 'burn out' from being on the conveyor belt since young. 

My FY2 year was great and rewarding - much better than FY1. I was feeling I was helping my patients and I was professionally very satisfied.  But I was 'bored' of where I personally was in Life. 

I am also the type with multiple interests, potentials and talents that I wanted to explore my potential in these further, pursue certain hobbies, read books and learn things other than medicine, and improve certain sets of life and professional skills that I wouldn't have the time if I was in full-time medical training.  

I also wanted 'to be young' with no responsibility of any one else but myself, as there are times where you have to be selfish to allow yourself to be the best you can be.

You need to be honest with yourself here and list WHY and WHAT would you like to achieve, and whether they are realistic and worth your time and effort.  Time is precious, remember.  This was a lesson I learnt in my first 5 months whilst brainstorming and seeking out opportunities, of which some were a waste of time and effort. You want to minimize your mistakes.

2. What do the majority of doctors do in their career break?

1. 6 months locum in UK (build up CV for specialty application) then 6 months travel.

2. 12 months Australia/NZ and reapply for specialty training in UK or stay abroad.  Australia mostly offer 12-month posts, whereas you can get 6-month posts in NZ.
3. Masters/Research/Teaching for 12 months.
4. Bum off the whole year and travel/volunteer, with the occasional locum.

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TIPS FROM MY JOURNEY

Tip 1) Confront the Brutal Facts
Be honest with yourself and know your limitations.
Have a BASE focus to stay grounded,
YET still have the unwavering faith that you can succeed and achieve your dreams. 
(Paradoxical concept.) 

Specialty choice: Upon finishing my FY2 (2 year postgraduate doctor), which was just beautifully happy due to my working environment, albeit hard-working, I confirmed my wish to pursue GP training with a strong interest in Sports Medicine or Humanitarian/Aid work. One key point to remember is that whilst you can respect what your peers'/seniors' opinions on what specialty your personality suits best, it is at the end of the day your career choice.

I was in a sea of confusion during FY2, trying to direct my CV somewhere, being a talented yet lost chicken.  But be patient. It can be annoying to be lost, but over time, the answer will naturally emerge.  It is important to have a base career focus, because on a gap year you can just absolutely lose your marbles. 

Alternative career research/dabbling: I am a multi-potentialite (Refer to TEDs Talk by Emilie Wapnick) with multiple interests, as are many doctors - we are all very similar.  I can pursue business, management, music, art... BUT you can forget or not realise at times where your true talent lies.

I was getting tired of Medicine, and friends/colleagues/peers talking about work during out-of-work circumstances. Without being superficial, I was initially curious about the careers with perks and rewards for hard work that came in the form of money bonus, travel, entertainment/food/drinks.  The 'noseying' was refreshing - I read more, put myself out there to meet new people, looked at candidate requirements and went to pursue some of those requirements.  However I found myself to only momentarily sway away from Medicine - I returned subconsciously and consciously.  I realised my true-calling to the doctor profession with no denial.  The reward of saving or helping someone's Life is irreplaceable, and beats any superficial possession/monetary rewards.  Obvious, but I was blinded by the demoralization of FY1/FY2 years.

I read books - both fiction and non-fiction, of which I didn't have the time to do before and learned so many new concepts and felt so much more refreshed and inspired.

I hypothetically could do management/music/art/business, but being capable would't make me the best in it nor the best candidate for a job. These were some of the brutal facts I eventually confronted after spending the time and effort researching and dabbling. In the end, it wasn't necessarily time wasted -  it was the time needed for me to appreciate certain things more.

I had 6 defined plans on my career break, scouring new ventures in business/management/PR/teaching... but 5 months into my Gap Year, I figured out how I could incorporate them into my itch and into ONE MASTER PLAN (it's going to take many years...) within Medicine.  This formed my base to stay grounded.

This was where I was going to keep my unwavering faith.

Don't let the junior doctor years dishearten or blind you,

as with a career break, I could see so much more six months later.

Tip 2)  Don't be afraid to put yourself out there (professionally, electronically and socially) and explore unchartered waters.

Since November 2014, I had been researching hard and emailing over 100 people regarding opportunities, jobs, and volunteering in Asia, South America and Australia.  It was tiring, time-consuming, endless, sometimes unfruitful. Fruits didn't start to emerge until about April 2015.

My interest in Australia waned after my medical elective.  There were attainable jobs in Perth, Adelaide and New Zealand, however they didn't appeal to me. Nevertheless, exploring waters, I applied for a Medical Resident post in Melbourne affiliated with Monash medical school in March. I conducted a telephone interview, which was awkward and at midnight, and I was unsuccessful with the feedback being 'we had no problem filling spaces with local applicants'.

Singapore was planted in my brain in early 2015, and I applied and interviewed in Manchester in April. 1 working day later, I had been offered a generic Medical Officer/SHO job.  Problem was that I had never been to Singapore, nor did I know anyone there to advise me at the time.  When I did visit, I  loved it (English speaking, excellent training and teaching, polite, hard working, friendly, amazing food, multicultural, efficient, clean, warm...) & then I pursued and secured a competitive specialty training post that even the Singaporean recruiting company said I had zero chance of getting (more to follow in a separate blog). It was fate.

America, Canada, Hong Kong were no-goes for medical jobs.

I sent out CVs to teaching institutions, universities, and other companies - just testing waters, but I managed to bear some fruits.  I emailed people for opportunities/observations.   I would meet and chat to random people, either feeling like a novice fish with big eyes asking questions, or pretending to know what I'm talking about and engaging in a 30 minute hot conversation about e.g. the wine industry with a wine manager, accepting business cards for possible future opportunities.  I set up voluntary teaching workshops, coaching high school students. I got briefly involved in the academic department of a medical school in Asia.

Sometimes it may seem like a waste of time, but opportunities can arise when you least expect it and depending on your luck and how porous and enthusiastic the recipient is.

The greater the effort/time you put in, the greater success rate.  I would put effort into your top 3 plans, more so on your top choice. You can forget about plan 4 onwards, until you fail the top 3. Prioritise. Focus. Tailor.

Tip 3) Embrace the loneliness that comes with a career break

I left UK in August for Asia - no friends, no job connections, little direction... embracing unemployment!  I travelled by myself around Asia, America, South America and Central America.

Especially when you're doing something different and away from your peers and family, your situation is unique and not many people will understand what you're doing or going through.

When in such an unstable, indefinite situation, it can deter away friendships and relationships.

You will feel lonely, even if you're out and about socializing. Superficial interactions will not fill your glass of water. Even if you are still in touch with family and friends, it's just that strange sense of loneliness that wafts in and out when you're the only character, your own protagonist of your story.

You will miss home soil, and re-think your choices.  You will feel odd without structure and no job and not meeting people through work.  This is all normal, BUT it is vital that you can see what the long-term goals are that are preceded by these small steps, and wait painfully patiently.

I joined a sports team, some pub quizzes and Tinder.  I made a handful of friends only whilst in Asia.

Tip 4) Have faith in some Delicious Ambiguity

A card I found in Singapore

So on the 14th June 2016, I officially migrated to a new country, Singapore - on a spontaneous, yet deemed illogical by the locals and my family/friends, yet this was a weighted decision I made. Not only that, but I now have no 'family home' in UK. The feelings of homelessness, unsettledness, looser safety network, question marks, and vulnerability are all natural in the migration process to somewhere new, especially with no family/friends there.  This quote/card at the Isetan department mall on Orchard Road in Singapore rings true to me at this moment in time of my life.  Have I made the right Life decision? - Well, I shall no longer say YOLO/Hakuna Matata/Pura Vida as my answer, but Delicious Ambiguity.

My last 11 months have been the best, yet rollercoaster-like of my 20s. To think, 11 months ago, I felt somewhat unexcited with my day-to-day life (but I was still very happy) thus I went to search for an adventure. That I did and I've ended up here in Asia.

But I realise now that the empire I had created in UK was my 'dream' empire - but it just needed ME to mature a year or two in order for me to realise how I had it all. That was the alarm bell for me for how I have changed.

I knew I was leaving something special behind, but it was also because I believed I could create another special universe elsewhere - risk-taking based on mere gut feeling.  So I am still digesting my year out and my 3 months here, but my messages for sure are that:

👉 The grass is certainly greener where you water it.

👉 Yes you're not a tree, so you can move if you are not thriving , but sometimes the surroundings/climate change over time and evolve that sometimes you just have to let it naturally do its thing with great patience and it may be the best thing you waited for.

Those things said, I'm sticking to my guns as literally Destiny brought me where I am today.

Bottomline

• Do listen to advice of others who have your best interest, but always trust your gut.
• Chase your ambitions that you have creatively formulated and personalised, yet confront the brutal facts that come with it.  You have to plod on like a plow horse - determined, focused.
• Conquer your fears. 
• Your patience will painfully be tested.  You have no control what's going to happen in the next few months, nevermind year.  This may affect your career path, location, romantic relationships, friendships, family relationships to some scale.
• Not everyone has the luxury of taking a career break as a doctor.  Appreciate and embrace this opportunity and don't waste it. It's your Life.

My 25th birthday card

FY2/SHO Doctor Update

So it's been a year since my first 'doctor' post where I was a FY1/House Officer at a central hospital.  All my rotations were constantly busy and rushed off my feet and full of sick patients but I learned/adapted to enjoy the adrenaline.  I did have further crying breakdowns up until March 2014 where I was actually HAPPY and appreciated what I was doing.  It was midway of my second job in March when the revelation came: Infectious Diseases - septic, immuno-compromised, exotic diseases.  I was doing my own ward rounds most of the time and all the jobs... being devoid of 2-supposed-SHOs.  I really was making a difference and I could recognise it because despite being the 'baby' of the team, I was solely responsible of them all. Yes, the pressure mounted time to time, but I learned to focus on all the positives and picture the patients' smiles.  My last job was the busiest with more sick-patients - a surgical job... but I strangely didn't mind it.


So what else happened over the FY1 year?

1. Mentally/educationally: 
• I became quicker.  I became harder. 
• I knew when and who to escalate to ...asap! (THE ULTIMATE survival skill for all FY1/HOs to take on board)
• Knowing how to prioritize patients ...and myself.
• I had made allies who knew about my working ethic and were there to help me (hail medical registrars!).
• Good note taking is always appreciated.  Also decreases your chances of possible litigation!
2. Physically
• I made sure I drank something and pee'd (...most of the time).
• Accept tea from the nurses/healthcare assistants if the opportunity arrives! Tea calms all qualms.
• (Unfortunately my eating cycle/habits were and still are erratic.)
• Drank less coffee meant less heart palpitations!
• When 'argh-frustrated' and home, I just stripped off into joggers and ran HARD...even if it's just for 5-10 minutes.
• Bubble baths and music.
• Music/herbal aids/wine/whiskey for insomniac nights.
3. Emotionally
• I learned to control my inner chimp (reference to Prof Steve Peters book 'Mind Management'... he lectured me back in university, but I only read his book recently as a FY2/SHO doctor). 
• Learned to not give a damn about those rubbish, responsibility-shafting, scapegoating colleagues. Learned to protect myself.  Stand up against bullying happening to others and yourself at the work place too.
• Let myself cry.  It's normal. 
4. Socially
• I quit alcohol from May 2014 onwards (for 3 months).  Went on night outs still and danced my heart away.  As much as I enjoyed those drunken nights and 6am-McDonalds-feasts, I appreciated not having a wasted day or hangover and that I had more money in my banks account and a healthier liver and stomach.  Gastritis/reflux improved.
• Every free weekend I went to see family or friends. Have fun. Indulged on food or shopping within reason :)
• Bond with other doctors. Make it a nicer environment to work in.  Listen to gossip, offer some of your own gossip.  Offer food. Bring food.  Offer tea!

I think as doctors, we look after so many patients that we forget what we have actually achieved.  We have so much power and control of people's lives that they have entrusted us with.  At the end of the day, as long as YOU are happy that you've saved this person from dying, relieved their suffering or bought them time, that's what most importantly matters (in my books anyway).  Please don't do it in the mindset of solely trying to impress a colleague, earn money, not get into legalities, add it to your CV, etc. - all that superficial blah, if you want to preserve your sanity at the end of the day.

I'm now a surgical FY2/SHO in a district hospital which I LOVE both the hospital and specialty!  I was a previously 'anti-surgery' but now I really enjoy surgery and the simplicity of it all.  I have 1 month left of surgery in my entire career (8 shifts actually!).  I won't be pursuing surgery, but I'm still going to do my Basic Surgical Skills course.  It was £600 out of my own pocket, but I know I'll enjoy it and appreciate having those skills in the future. 

Working environment really makes a difference.  I have such a lovely team, the nicest so far. Being nice makes a difference.  Being around nice people is a pleasure in itself.  You want to look forward to come to work. 

I look at the current FY1s now fondly.  Boy, do you mature a lot more than you think!  Also do you realise just how much you've achieved.  It's nice.  Commendable.  Tetley's aaahhhh.

Yes I still get bored doing the mundane jobs as a SHO still.  Yawn.  Discharge summaries/TTOs.  Dull. Dull. Dull.  Same with E-Portfolio/CV/exams never-ending hoops.

So now I'm at the stage of trying to decide what I want to do with my career and life.  I've done loads of taster days.  I've changed my mind SO many times in these past 3-4 months, it's becoming ridiculous.  I am taking a gap year... maybe two, but I want them to be productive.  I keep flitting from A&E to GP to Medical Registrar (Dermatology, Cardiology, Rheumatology, Sports Medicine) to Radiology.  I know I can and will be a passionate, good doctor... I just need to DECIDE and FOCUS to then just get loads of opportunities in that specialty lined up in this cut-throat-competitive-world-of-medicine!   Also need to get my head down for an exam next year... and I've not touched a book/revised for 19-20 months and I have a restless butt.  Also I need to decide where I want to settle in the future : UK, Australia/NZ, Singapore, Hong Kong, Canada, USA?  I also need to decide on when to fit in boys, settle down, babies, family, house, mortgage, (aka grown up stuff)... if ever!  (Think GP is a good road...)

So yeah, mid-twenties life crisis of an independent girl who highly prioritizes fun and adventures.

More hoops, more struggles, too much choice thus irritating-Life-uncertainties... but on the bright side, I am EXCITED for what Life has in store for me because:

THE WORLD IS YOUR OYSTER.

Disheartened NHS Junior Doctor FY1

"Why am I still here __ hours overtime?"

"Where is my life?"

"Medicine is not a job.  It is a way of living - a profession."

Swallows you up.

So I've finished the first 4 months (first job) of being a doctor/intern and despite being quite confident with my skills/abilities/professionalism, I can vouch that I've cried more times in this short period than I have my whole life, and I rarely cry - I'm tough, I've always been a happy bunny, I don't cry!  Yes, I know, everyone says it's a steep learning curve, blah blah blah, it get's better with experience, etc.  But it's not simply the learning curve that's been knocking me off the happy swing, but just the general... toll.  So I've often questioned, is this really worth it?  I like to be the optimistic visionary, but realistically, I don't think it's really going to get any better as a hospital physician... unless I become a GP or GUM clinician or Public Health doctor?

The high responsibility of being a doctor in the hospital and the long physical/emotional arduous days will not change.  You can't just finish at your designated time - a patient can deteriorate very quickly e.g. if septic...or majorly bleeding!  You make simple easy human errors which may end up harmful to the patient.  I've only made one simple (prescribing) mistake because I was just so tired, dehydrated and stressed during an understaffed, tremendously sick and distressed patients, weekend medical ward 12-13 hour cover (I hadn't eaten or went for a wee at all!) - thankfully no harm was caused.  It is very difficult to have a life when you come home, absolutely knackered emotionally/mentally/physically, dehydrated, actually go to the toilet, eat whatever is lying around, shower and sleep... and try to sneak in Eportfolio/work in...revision/learning? A long-term problem emerges of insomnia - so much adrenaline from your day continue to pumps, underlying unrecognised anxiety buzzes... you can't sleep despite you need sleep leading to a vicious cycle.

I tip my hats off to all the doctors of equal and senior rank to being such solid characters to survive being a doctor.

Shifts that are 12 hours (usually more in reality!) and nights on-calls are painful, because we don't have our protected lunch or loo breaks that you can end up having lunch at 6.30pm instead of 12pm, and you've not been to the toilet ALL DAY!  Where are our protected breaks as per other members of staff (nurses, ward clerks, health care assistants)?

Labs: if only they make it clear on the Trusts Intranet what are the requirements of certain tests (amount, whether it needs to go in separate tubes, number of tubes, timings, temperatures, etc.).  Also if you decide to REJECT an (important) sample, please state a reason. I don't enjoy re-stabbing patients saying 'sharp scratch' for something that was preventable.


I have interviewed prospective medical students for 2 years, and I train prospective medical students for their medical school interviews.  I have to say, as a high school student, no matter how much work experience you do, you have no idea what's involved in university... never mind the actual job/pressure.  People talk about the pressure and unglamourous side, but highlight the whole glamourous side of the 'rewarding' career.  All the 'negatives' about the career, you can't comprehend... and your ears listen to the glistening over the negatives.  There was the 16/17-year old me who wasn't fazed by any challenge, neither had I found anything a challenge, thus thinking medicine could be a walk in the park.  Invincible thinking of a youth.

Then you enter university, go to placements - nil responsibility, observe, skive placement/lectures, go have lunch with friends, go to the pub/union and dance/drink your hearts away.  I was rarely stressed in university, always enjoying myself and placements.  Exams are hard - not to be understated.  They  can nibble at your soul.  But nah, the 'responsibility'/'burden' during placements was completely overlooked to me as a student.  Thought medicine was interesting... thought it could be something I could do for life.

Now Doctor/Intern in the NHS.   First of all, I applied specifically for a hospital due to a specific specialty that I may want to specialise in (despite not being a favoured hospital of mine at all) - "Woo", got my first choice out of the 500 odd jobs ranked... I was ecstatic, excited... then very last minute prior to starting my post, they changed my job to something that was my weakest, disliked, disinterested job.  Last minute job changes happens a lot by the way.  Thought fate was meant to be, and so I have soldiered on and tried to get the most out of it but it still remains frankly unrewarding and uninspiring and frustrating.  I think I'm more frustrated about the uninspired-ness.  I've learned hardly anything but how to be a secretary. 

I've never had so much frustration, anger or sadness in my life ever.  This specialty also is one of those chronic ones where we're prolonging the lives of patients (no cure), who often get re-admitted for same recurring things... then dies.  Also it is disheartening when no matter how much effort you pour into helping someone, patients/relatives and colleagues can have such a high level of dissatisfaction.  Also when you lose continuation of follow-up, there's also no rewarding feeling.  Again, this is from the words of a first-year doctor. 


Certain colleagues too can nibble right at you and be dissatisfied and judging by the smallest of things...or expect you to get them everything that's a hand-reach away.  One thing that bugs me (a lot) is the hierachy.  Junior doctors are not slaves and secretaries. We've been trained to be doctors : we're not around to be full-time phlebotomists or secretaries...(or scapegoat), we are there to treat and help patients, examine and practice medicine.  We're not there to file your mess or run around chasing/looking for things whilst you stand there in your arrogance.  Just because we are junior and new (thus expected and accepted to make some mistakes) does not mean that we can be your scapegoats when things go wrong!  It's disheartening when you do things right but get wrongly accused; have staff (especially those up the ladder) unfairly point fingers at you; and have staff shove off their wrongdoings or angry patients/relatives unto you to deal with and solve!

"You're a junior doctor, everything you're going through we all had to go through that before.  It's all apart the process," is a poor 'traditional' attitude to have - that assumption and application of that needs to stop and change.  It is just an unhealthy cycle.  The stark hierarchy will never make the NHS/workplace 'more open or transparent' that the NHS has apparently tried to make it.  Because of this stereotype, it makes it hard for junior doctors to complain/raise their concern about their treatment where 'I can't complain because it'd make me look weak/less professional'. 
 
Colleagues - every work place has good and bad colleagues.  Unfortunately, when trying to look after sick patients, efficiency requires a process of speed.  I have had colleagues who are slow and/or chitchat-diddledaddle that I have had to rev up double mode to cover/correct for them.  If a colleague's weakness is speed, that's fine as long as they have patients' best interests and is considerate/thoughtful (which are very important qualities to me!), but when one is too relaxed and slow during understaffed/urgent times... it makes it difficult - patients health can be compromised.  I appreciate 'chilled' people as it'd make me feel more cruisey, so it's fantastic when there's chilled-efficiency but horrendous when there's chilled-inefficiency/laziness.  Also, if you attend to more patients, more of the responsibility of the ward falls onto you.  If things go wrong - it's you.  The (chief) Sister even thought I was a CT1/CT2 after 3.75 months of working with her (I'm just a Foundation House Officer Year 1... a 3.75-month old doctor!), just because I seem to have 'everything under control' or 'control of everything'!  (I'm just going to have to take that as a compliment.)

The legalities.  The amount of forms, documentation, extra bits of paper... extra steps and time to make sure someone can't sue us... or to NOT be scapegoat.  Absolute pain.

Often patients and the relatives just don't quite understand that we have to look after an overwhelming amount of patients.  NHS is free for all, but they do not staff us adequately especially during the weekends.  There are limited resources/money.  We can't offer you a 5* hotel service.  The hospital is not a hotel, mind.  Yes, we try to maintain your dignity and respect, and be nice out of our 'medical clinical care' - give you tea, find another blanket for you, make you comfortable - but if you're medically stable, we are naturally going to be designating more of our time and attention to the super sick.  When/if you're super sick, we'd direct our attentions to you.  I do not enjoy having to stick a needle in people's arms to take bloods or cannulate... and fail.  I understand the hospital and to be a patient is a scary situation - but I too have the fears.  I try my best at everything and I have your best interest. I give all of my patients excellent care, but there's only so much brain, energy and muscle in my body that I can give out... and patience.

Death - you learn to disengage yourself.  First declaration/cremation/verification of death - disengaged.  Doctors do cry too.  One day where I was working 5 hours over time, a dear patient died that night, I could not afford to stop working to cry, so instead I put my head down hiding my tears at the nurses station working away... dealing with other sick patients.

When you're in distress/in pain, upset, bereaving, afraid - I'm distressed. 

The basic pay for a FY1 doctor is about £22,636 a year.  You just don't have time to spend it.  Money goes out to tax, pensions, petrol (£50/week), to the gym where you have no time/energy to go to, and food/alcohol to just drown in.  Doctors either have no time to eat or forget to eat and lose weight, or are too tired to cook and eat absolute junk quick food/emotionally eat and gain weight - the former applies to my best friend, the latter applies to me.  It is funny how both my best friend and I were the happiest, such care-free, satisfied people pre-doctoring, and now dissatisfied.

When you're unhappy, you have to change things to make yourself happy right? Can quitting be an option that's considered correct, brave or cowardly?

Why do a job where you work your utter ass off and put so much soul into it - but you don't enjoy or feel inspired or feel any reward?  I tell myself to keep fighting - these challenges ought to have a happy ending/reaping rewards, right?   I don't know that many happy doctors to be honest.  It's a long forever-life-learning profession... endless exams, endless court cases.  10 years AFTER medical school until you're settled.  If I don't escape after FY2 and go do something I love or travel... I fear I might suffocate.  You only live once, and being a doctor absolutely swallows it up, and so

I promise myself to not get sucked in.

This doesn't make me a bad doctor.  I always want the best for my patients - I want them happy, I want myself to be happy.  But when you get to the point where you're exhausted out of your wits... it just becomes unbearable, unacceptable.  If I actually voiced this out to my family, colleagues, friends, best friend... they'd be surprised.  I hide all this sadness and frustration under my smiling, bouncy outward appearance and smile.  Everyone knows and says I am 'tough', 'efficient', 'a soldier'...even can be imagined as a female surgeon. (Never!)

Sorry for such a depressing entry.  Some things mentionned may be seen as petty, but all added up is a mound.  I could list so much more.  There are some upsides - some humorous colleagues or patients, being given a thank you card and chocolates to fuel your overtime hours, staff christmas parties, consultants/registrars dancing and tipsy, maybe some eyecandy if lucky.  May this be an insight for patients/relatives.  May this be a reminder to other doctors in the world, you're definitely >50% not alone if you're second-thinking your choice of career.

Am I headed for a burnout?  Maybe but only if  I am not able to find measures to apply the principles of Beneficence, Negligence, Autonomy to my soul that doctors apply to patients.