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For the FI crowd: Is maintaining motivation to learn medicine a struggle?

Home Practice Management For the FI crowd: Is maintaining motivation to learn medicine a struggle?

  • Lithium Lithium 
    Participant
    Status: Physician
    Posts: 1177
    Joined: 02/15/2016

    So, I’m five years out of residency, but in the process of leaving my full-time job.  I’ve worked really hard all this time, saved like a fiend, and lived like Mr. Money Mustache, so my NW is 40-50x my annual expenses.  In hindsight I wish I would have slowed down, worked less, and maybe spent more, but I still can’t really complain.

    I was thinking next year I would just do some kind of IC or locum work in the 22% federal tax bracket range while I explore other interests/careers and travel.  Ideally, I would just work enough to not get bored or feel like a waste of space.  That might be a weekend a month.

    The problem?  My passion for the clinical science has waned commensurately with my excitement at getting a paycheck every two weeks.  My eyes glaze over pretty quickly when I try to read journal articles.  Usually I would much rather read a library book.  I purchased AudioDigest with my CME fund but quit listening to it because I prefer podcasts.  Conferences are torture.  Now I have to pay for CME myself, so I’ll be looking for the cheapest ways to keep up with licensing.  My field has such a limited knowledge base required that I can probably pass the MOC exam with zero studying.  However, I won’t be seeing and learning from my colleagues every day.  For all these reasons I’m becoming increasingly worried about not being on top of my game or knowing what I don’t know.

    I guess I am just looking to see if the senior members of the forum who have dealt with burnout have confronted these types of issues.  If I’m going to keep practicing for a few more years, I just need some kind of system to maintain competence that is cost-effective and time-efficient.

    #244366 Reply
    Avatar nephron 
    Participant
    Status: Physician
    Posts: 227
    Joined: 05/09/2019

    are you in psychiatry?   If you are in medicine, I would just recommend an uptodate subscription.  I read the articles when treating something that I don’t treat regularly to stay up to date.   I read the articles that I do treat regularly to make certain not much has changed.  In nephrology, not much changes from year to year.  I am pretty lazy about staying up to date on things, I get the major journal table of contents sent to my email and can read most of the abstracts without subscribing to the journals.   I know that isn’t a great way to stay up to date on things, but at least you get a sense if some paradigm has changed or something and if it has, I think up to date is pretty quick about updating their articles about it. The other nice part of the uptodate subscription is that every article you search for and click on gets you 0.5 cme hours so it doesn’t take that much clicking to get 100 hours or more a year.   I maybe biased towards uptodate because it was started by a nephrologist and still has a heavy nephrology tilt, my wife who is a surgical subspecialist tells me that the articles are basic and out of date in her field.   I cannot sit through a live cme lecture anymore, but I had difficulty sitting through a one hour lecture in college and I think that it just gets worse as you get older.

    #244371 Reply
    Liked by ENT Doc
    White.Beard.Doc White.Beard.Doc 
    Participant
    Status: Physician
    Posts: 937
    Joined: 02/06/2016

    Going part time in medicine can be a real issue in some specialties.  You have to ask yourself, “What is the minimal monthly clinical experience I need to stay on top of my game?”

    #244373 Reply
    Avatar wideopenspaces 
    Participant
    Status: Physician
    Posts: 1138
    Joined: 01/12/2016

    I was also going to suggest the uptodate idea. I’m also 5 years out and just starting to figure out what areas of psychiatry really interest me. I’ve found that I actually enjoy reading and learning about these niche areas ( perinatal psychiatry, mental health integration, physician mental health). The fact that you find everything boring makes me hope you can find your passion outside of medicine because clearly this isn’t your thing. Which is ok. I don’t think it’s an issue for you to work a weekend a month for a few years until you find a better fit. Would love to hear about it once you find your thing.

    #244393 Reply
    Lithium Lithium 
    Participant
    Status: Physician
    Posts: 1177
    Joined: 02/15/2016

    Thanks all.  Uptodate is ~$500 a year, but the psychiatric articles are pretty superficial and I just don’t think they would cut it as far as keeping me up with practice standards.  Actually I think I do best with question banks, though those aren’t cheap either.  This crap is all so expensive due to the MOC industrial complex.  Getting 40 hours of CME every 2 years isn’t that hard, but all of the other MOC garbage is a different story.  It’s hard to see myself sitting for the recertification exam in another five years.  I’m at the point where I just want to be spoon fed guidelines and have evidence be summarized for me rather than have to dig in to the weeds with different studies, break down strengths and weakness of study designs, etc.

    #244410 Reply
    Avatar Crazyroadtodublin 
    Participant
    Status: Physician
    Posts: 77
    Joined: 03/08/2016

    Yes. Decided not to recert.

    I have found conferences with friends the least painful way to keep up to date.  Increased malpractice insurance, eliminated disability, far more selective with which patients I treat.

    #244416 Reply
    CM CM 
    Participant
    Status: Physician
    Posts: 1169
    Joined: 01/14/2017
    I guess I am just looking to see if the senior members of the forum who have dealt with burnout have confronted these types of issues.

    Click to expand…

    Not me. My burnout was from the pace, the hours, the call, the lack of sleep, and the lack of adequate time and energy for exercise. I’ve always been interested in cardiology and still studied occasionally even when I was in financial services.

    I just need some kind of system to maintain competence that is cost-effective and time-efficient.

    Click to expand…

    Not sure what is available in Psy, but in cardiology the American College of Cardiology publishes a number of “self-assessment courses,” essentially review courses with tests for CME credit. I used these publications (and similar offerings from Mayo and Cleveland Clinic) to ace my board re-cert exam after a 13-year absence from medicine.

    Is there something comparable in Psy?

    Erstwhile Dance Theatre of Dayton performer cum bellhop. Carried bags for Cyd Charisse (gracious). Hosted epic company parties after Friday night rehearsals.

    #244418 Reply
    jfoxcpacfp jfoxcpacfp 
    Moderator
    Status: Financial Advisor, Accountant, Small Business Owner
    Posts: 8137
    Joined: 01/09/2016

    Have you considered talking to a physician career coach? Heather Fork at Doctors Crossing is an MD who helps doctors who are burned out or not happy with current career choices transition or decide when they really need a break but need encouragement or to talk it over with someone who can help. I’m sure there are others, but I haven’t done any research; a forum member mentioned her name so I scheduled an appt w/her to learn more.

    Full disclosure, I have recommended Dr. Fork to a client or two, but we have no financial or any other kind of relationship. Just now checked the Recommended Advisors list to see if there is a category for this area, but no. If there were, I would certainly have pointed the OP there. If you are one of her clients reading this, you might consider nudging her to talk to WCI about adding the listing. I believe it would be a very helpful resource for readers.

    Johanna Fox Turner, CPA, CFP, Fox Wealth Mgmt & Fox CPAs ~
    http://www.fox-cpas.com/for-doctors-only ~ [email protected]

    #244419 Reply
    Avatar EntrepreneurMD 
    Participant
    Status: Physician
    Posts: 334
    Joined: 06/10/2019

    Love what I do (FP) about 20 years into it, or else I wouldn’t be doing it. Admittedly though, I use hospitalists and my NP/PA make my workday load manageable. It wasn’t always that way. In the first 5 years or so of my career post residency, I did my own hospital work, did not have mid-levels, went to 2 nursing homes with nursing home and home health agency medical directorship responsibilities. Also have been doing a charity medical clinic once a month for years now (still do as I feel a need for this). Hours were too long.

    Then the first youngster got to kindergarten and that was my motivation for the lifestyle changes, shifting towards a more passive revenue stream. I realized it’s a marathon, not a sprint. Major changes. Left the group I was with and started my own practice having no idea how it would go but it’s been going pretty well.

    I felt exhausted prior, but never really burned out. My motivation of giving patients comfort, cure and hope didn’t allow me to feel that way I guess.
    If what you’re doing currently is not your passion, I agree find your passion. What I think I want out of life seems to shift every 5-10 years so I feel we have to constantly reinvent ourselves. As doctors, we don’t generally like change but seasons change. Hence my thread on success and happiness so I can modify what I do based on my changing definitions. Some here interpreted happiness as being joyful all the time. To me, how we manage the most challenging times in our life and coming out stronger on the other side makes me happy – after all the frowns.

    Great support from a large local extended family and faith in a God has also helped carry me through. Maintaining one’s health also helps to release endorphins.

    With all these things in place and my motivations for the patients I serve, keeping up on the educational aspects of medicine is not a problem – not just CME but everyday self-education to provide the best services possible. Never met a doctor who likes MOC requirements. Know your psychiatry education helps you get your patients to a much better place with their own struggles. But stay balanced for your own well being, read plenty of other things and carpe diem with your hobbies.

    While I save a lot, I also have spent as much as I needed so loosen those purse strings for your hobbies. There is a pathology to over-saving. I’m glad your good finances gives you choices. Having multiple choices is very important in life.

    Wish you well.

    #244433 Reply
    Avatar wideopenspaces 
    Participant
    Status: Physician
    Posts: 1138
    Joined: 01/12/2016

    This conference isn’t cheap but it gets you everything you need to stay up with moc stuff. It’s always held in a beautiful location and you don’t have to attend anything you don’t want to because you get access to watch online at your leisure. It’s probably the closest thing to spoon feeding that I can think of. But ultimately, maybe you don’t keep up with licensing and moc after a couple more years? It feels to me like you are holding on to medicine for some reason (security? Not wanting to give up on something you worked hard for? Fear of the unknown? ) and I think it’s worth exploring because I think it could be making you feel trapped and unhappy.

    2019 Psychiatry Conference

    #244442 Reply
    Lithium Lithium 
    Participant
    Status: Physician
    Posts: 1177
    Joined: 02/15/2016

    Have you considered talking to a physician career coach? Heather Fork at Doctors Crossing is an MD who helps doctors who are burned out or not happy with current career choices transition or decide when they really need a break but need encouragement or to talk it over with someone who can help. I’m sure there are others, but I haven’t done any research; a forum member mentioned her name so I scheduled an appt w/her to learn more.

    Full disclosure, I have recommended Dr. Fork to a client or two, but we have no financial or any other kind of relationship. Just now checked the Recommended Advisors list to see if there is a category for this area, but no. If there were, I would certainly have pointed the OP there. If you are one of her clients reading this, you might consider nudging her to talk to WCI about adding the listing. I believe it would be a very helpful resource for readers.

    Click to expand…

    I have considered a career coach but have held off because I feel like there is such a low barrier to entry and I don’t know who the “good ones” are.  However, word of mouth recommendations are pretty helpful, so I’ll look into Dr. Fork.

    #244443 Reply
    Lithium Lithium 
    Participant
    Status: Physician
    Posts: 1177
    Joined: 02/15/2016

    This conference isn’t cheap but it gets you everything you need to stay up with moc stuff. It’s always held in a beautiful location and you don’t have to attend anything you don’t want to because you get access to watch online at your leisure. It’s probably the closest thing to spoon feeding that I can think of. But ultimately, maybe you don’t keep up with licensing and moc after a couple more years? It feels to me like you are holding on to medicine for some reason (security? Not wanting to give up on something you worked hard for? Fear of the unknown? ) and I think it’s worth exploring because I think it could be making you feel trapped and unhappy.

     

    Click to expand…

    Pretty much.  It doesn’t feel like what I should be doing with the rest of my life, but until I figure out what that encore career is (I have some ideas, but I’m in zero rush and consider myself open to pretty much anything), it seems foolhardy to cut the cord.  Especially since once you cut ties with medicine, it is pretty tough to get back in.

    #244445 Reply
    MPMD MPMD 
    Participant
    Status: Physician
    Posts: 2509
    Joined: 05/01/2017
    Earnest refinancing bonus

    Have you considered talking to a physician career coach? Heather Fork at Doctors Crossing is an MD who helps doctors who are burned out or not happy with current career choices transition or decide when they really need a break but need encouragement or to talk it over with someone who can help. I’m sure there are others, but I haven’t done any research; a forum member mentioned her name so I scheduled an appt w/her to learn more.

    Full disclosure, I have recommended Dr. Fork to a client or two, but we have no financial or any other kind of relationship. Just now checked the Recommended Advisors list to see if there is a category for this area, but no. If there were, I would certainly have pointed the OP there. If you are one of her clients reading this, you might consider nudging her to talk to WCI about adding the listing. I believe it would be a very helpful resource for readers.

    Click to expand…

    I have considered a career coach but have held off because I feel like there is such a low barrier to entry and I don’t know who the “good ones” are.  However, word of mouth recommendations are pretty helpful, so I’ll look into Dr. Fork.

    Click to expand…

    PM me for another recommendation if anyone wants.

    #244454 Reply
    Avatar Anne 
    Participant
    Status: Physician
    Posts: 1174
    Joined: 11/07/2017

    There are certain things in medicine that I really enjoy reading about. Some are in my specialty and some are outside. Same with CME–I’ve been to some really fun CME events–nutrition conferences, Kona ironman sports medicine conference, etc.

    Some conferences that I wish existed (if they do, please tell me):
    Psychiatry for the non-psychiatrist
    How to co-treat chronic pain in personality disorders
    Interacting with difficult patients
    (I’ve been to conferences where these topics were an individual lecture or breakout session but I think they warrant an entire conference!)

    Maybe your niche in psychiatry Lithium is the intersection of personal finance with mental health? Just an idea.

    The thing about FI is it gives you such a huge amount of choice that it can be overwhelming to decide what to do.

    #244461 Reply
    Avatar billy 
    Participant
    Status: Physician
    Posts: 162
    Joined: 04/07/2016

    Similar to uptodate, doximity allows you to read articles for 0.5 cmes also, and is free (i think).

    #244468 Reply

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