‘Why would I want that?’: My sister’s simple question reshaped my physician job search

My younger sister has just started college, and she was thinking about pursuing a career in medicine. A few weeks before she left home last summer, we looked over her course catalog together and started strategizing her pre-med classes.

“These courses are really hard,” I said. “They are designed to weed people out, so you really have to sacrifice and focus.”

I thought back to all the times — from college and medical school to residency and fellowship — that I had struggled on my journey to physicianhood. I wanted to prepare her for that pain. “This process will make you feel worthless,” I told her. “And you might even start to doubt yourself, but if you push through, you will make it.”

“But … why would I want that?” my sister asked, in her deadpan, Gen Z style. When I explained that it is the privilege of a lifetime to uplift humanity, she seemed unimpressed. “It just seems like there are other respectable and financially secure ways to help people that don’t require you to be unhappy.”

My pep talk had obviously backfired.

I am four months away from graduating from fellowship, the last step in my odyssey of medical training. I’ve been on this path for over 15 years, and her simple question stopped me in my tracks.

My hard-earned knowledge paled in comparison to her wisdom. I began to wonder why I would want something so miserable for my sister, just because I endured being forged by fire myself — and why I wanted it for myself.

As I embark on my first post-training job search, I’ve been haunted by her question.

It seems that many physicians, part of the “Great Resignation,” are similarly struggling. According to a recent study of the pandemic’s influence on U.S. health care workers, 1 in 3 doctors intend to scale back their working hours in the next year, and 1 in 5 doctors say it’s likely that they’ll leave their current practice altogether in the next two years. Clinicians have felt overburdened and undersupported in recent years, even more so during the pandemic, and this has had a damaging impact on their mental health — leading to burnout, anxiety, and depression.

The pressures I face at work are complicated by the pressures I face at home. As the parent of young children, I’m finding the intensity of caregiving around the clock to be exhausting. I’m not alone: A study published in November in JAMA Network Open found that women physicians with children are more likely than their male counterparts to have reduced their work hours during the pandemic in an effort to reduce work-family conflict.

Part-time work, however, solves one problem and causes others. You get paid less, while doing more unpaid labor in your time off. A dear friend from medical school, also a young mother, was told by her mentors in academic medicine that going part-time was career suicide.

Even with a full-time gig, women are undervalued. A recent study in Health Affairs revealed significant pay gaps persist between male and female doctors, leading to a $2 million dollar pay gap over a 40-year career.

I’ve explored a variety of opportunities, from academic medical centers and community hospitals to telemedicine companies. While my job prospects have been abundant, I’ve been highly stressed trying to find a position that will allow me to have it all: exercise my passion, pay me what I’m worth, and allow me to be present for my children. I’m starting to feel that this magical combination does not exist.

A mentor of mine has advised me that when looking for a job, you can reasonably expect to satisfy only two of three criteria: location, salary, and job description. For example, you might find a job in a highly desirable location, with a great salary, but the job is likely grueling. Or you might find a great job in a great location, but the salary leaves a lot to be desired.

I’ve heard time and time again that most new attending physicians don’t stay in their first jobs for very long. I assume this fact is shared with frantic job-seekers to help reduce the pressure of the hunt. But I’m starting to wonder if this advice is also offered to lure new graduates into situations they must simply endure. Much like we’ve been accustomed to enduring the trials of medical training.

I’m tired of enduring.

Last year, when I struggled through a Covid-19 infection, I felt frightened by my own mortality. Shaking with fever and chills, I thought about how I hadn’t really lived yet. I had done a lot over the past 15 years as a doctor-in-training, but I didn’t feel I was fully and freely living. I love what I do — in many ways it’s a privilege — but I don’t love that it has dominated my youth and taken so much of my time.

Instead of asking what kind of life a job will allow me to have, I’m thinking more critically about the type of opportunity I will allow into my life. I hope to reverse engineer my professional commitments to prioritize my personal ones. Perhaps it is my pandemic fever dream or the fact that I’m entering the workforce when many physicians are trying to exit it, but I hope to look back at this next chapter of my life with the satisfaction that I had time to really live it.

I asked my sister to be open to the suffering of medicine. I now feel ashamed of this advice. As a freshman in college trying to find her own path, my sister has inspired me to choose joy.