Yesterday, I received the notice that I’ve officially withdrawn from medical school.

If there’s a more drastic way to “fail” at clerkship, I don’t know what it is.

But I don’t feel like I’ve failed. I feel like I’ve adjusted course. I feel like I made a mistake and have learned from it. I feel hopeful for the future for the first time in two years. And I hope that anyone who needs to hear this today knows: it’s okay if medicine is not for you.

I’m not sure exactly what my motivation is for writing this today. Part of it is cathartic, to get my experience off my chest. But the other part comes from how alone I felt while going through this process. I desperately needed someone else who had felt as I did, and it felt like everyone I knew in medical school was flourishing, like they’d found their calling in life. I know everyone has struggles and that there are others who felt as I do, but I couldn’t see them. And I don’t want anyone else going through this to feel alone. So here’s my story.

I began medical school with the intention of becoming a psychiatrist. It had been my dream since I was in the tenth grade, and every decision I made up until my acceptance letter had been to help get me here, to medical school. I turned down social events and dedicated all my free time to volunteering and researching. I remember in second year of undergrad working so hard that my only breaks came when I was eating dinner each night (incidentally, that was also the year when I got my first ‘B’). But May 12th 2015, it all paid off when I got my acceptance letter to U of T med. I cried so hard reading that letter that when I called my mom she assumed I had gotten rejected because I was so distraught. In reality, it was relief and happiness. I had worked so hard, but I had made it. I was going to accomplish my dream.

Then I began preclerkship. I struggled a little here – the hours had somehow gotten even longer than in undergrad (something I didn’t know I could physically do) and as psychiatry was my passion, I didn’t have a lot of interest in most of the material, but I persevered. I failed one exam when we had three exams in one week, and this shook me. I had never failed an exam in my life. But I was able to retake it and I got a 95% the second time. I learned that it was the hours that I was struggling with, not the material, and that gave me hope. I helped spearhead the Monologues in Medicine committee and the Resiliency curriculum. I was open about my struggles and advocated for medical student wellness. I tried to implement the teachings in my own life: I tried to make time for social interaction, to enforce breaks in my schedule, to make sure I was eating and drinking well. It was hard, but I made it. And I was looking forward to clerkship, to a time when I would be out of the classroom and into the hospital, really working.

Then clerkship hit.

On paper, clerkship doesn’t sound that bad. It’s a series of internships with exams at the end on the material you learned that rotation. But reality is different. In clerkship, you work a physician’s hours (or longer, since often my preceptors would go home and leave the notes and paperwork to me and the residents). I was working 12-13 hour days, and when you add in transit time, time for eating and showering in the morning, and sleeping a few hours each night, that does not leave a whole lot of time for anything else.

But I had to be aware of the little time I had, because it had to be carefully rationed out. In theory, you should be learning the exam material on the job, so most of your studying should come during your working hours. But in reality it doesn’t always work that way. Sometimes you’re assigned to a specific subspecialty and you only see one type of illness or one type of patient. Sometimes the things you learn day to day don’t translate to the sorts of questions they’ll ask on an exam. And sometimes there’s just so much material that you cannot hope to learn it all on rotation (I’m looking at you, internal medicine, where we were given no textbook or material to study, but instead were given a several pages long list of topics to know that ended with a statement along the lines of ‘and any other relevant topic in medicine’. Umm thanks?). So instead of my free time going to the self-care I so desperately needed, it instead went to studying. I stopped spending time with friends and family. I didn’t exercise. Most of my meals came from Uber Eats. My apartment was constantly a disaster. My life was medicine, and only medicine. And still I struggled on my exams. One I had to do remedial work. One I straight up failed (cough internal medicine cough).

Then there are the hours you spend on the ward. In theory, it should help fuel your passion for medicine. It should give you a sense of community. It should make you feel like you’re putting in all this work and all this time for a purpose. But again, reality is not so simple. The truth is that most medical students are abused in the work place. Maybe not always abuse as we tend to imagine it (though I have heard stories from other medical students who have experienced physical and sexual abuse in the work place, those are not my stories to share) but verbal abuse and humiliation run rampant in our workplace. It’s hidden under the thin veneer that it helps to be afraid when learning – that you’ll remember the information better if it comes with an emotion attached. Theoretically, that’s true, but only to a point. For me, I was so stressed that when I was abused and humiliated I heard nothing, learned nothing. I would just nod my head, apologize, and try desperately not to cry until I was alone. And I suspect that this veneer hides the truth, that medical school is simply a hazing culture. The mentality that “we went through this to be a doctor, so now you have to as well”. I also think that my supervisors were stressed and struggling themselves, and that leads to a lack of compassion that gets transferred down the pecking order to those beneath them.

And so I woke each morning, struggled to get out of bed while exhausted and depressed, put on a smile, went to work and tried to hold that smile for patients while getting verbally abused, and came home even more exhausted only to have to study even more material. Then I would stagger to bed, sleep five hours, wake up, and repeat. I couldn’t take care of myself beyond ensuring I had enough calories to continue on. And there was nothing more to my life than this. I missed my family and friends. I missed eating non-pre-packaged meals and living in a clean apartment. I missed my hobbies. And I missed feeling well – both physically and mentally. I became more and more anxious and depressed.

For two years, I did my best to try and be resilient. I went to OHPSA and got accommodations to my clerkship schedule. I was on medication and in therapy for my mental health. I tried to tell myself this was only temporary, I only had to keep holding on and it would get better. But then I looked ahead. Fourth year may not have the same exams as third year, but you’re transitioning and moving from city to city every two weeks. You need to impress your supervisors for reference letters. And in your free time, you need to be preparing for CaRMS and the LMCC. Then comes residency which is a whole other beast, with struggles and stresses of its own. And finally I realized that I simply wasn’t happy, and if I continued on this path, I wasn’t going to be happy. So I took a leave of absence to figure out where I wanted to go from here.

During that leave of absence I did career counselling. For the first time in my life, I looked beyond medicine at other options. And I realized there were other education and career paths that I could be on where I could be happier, both in the short and long term.

I won’t say that my decision to withdraw from medicine was easy. It took me two months to come to the decision. There were (and still are) a lot of factors I had to consider, not the least of which was the debt I had incurred in medical school. Even now, when I’m certain I’m making the right decision for me, I still cried when I got the email that I’ve been withdrawn. This was my dream for so long, and I put in so much time and effort, and worked so hard to achieve it. And, despite all the negatives, there are lots of things I will miss about medicine. But I can no longer put one dream ahead of my health and happiness. And leaving is the right decision for me.

I know there are people out there who love medicine, and thrive in medical school. I may not understand, but I am so happy for you. This post, however, is for those out there who are silently struggling. I just want you to know that you are not alone. Maybe medicine is the right path for you, and the struggle will be worth it. In that case, just know that you are not alone in struggling, that this is a hard path and it absolutely makes sense that you’re having a hard time. Please take care of yourself first. And maybe there are people out there reading this for whom medicine is not the right decision. I’m here to tell you that that’s okay too, because I know that’s not something you’re going to hear from many other people. But it’s okay. It’s okay to put yourself first and do what you have to do to take care of yourself. And if you have to leave, you’re still going to be okay. I know it feels like the end of the world, but it isn’t. There is life on the other side, and you will be happy again. Medicine is just a career, and you are so much more than just a medical student. Be happy.

– CC4