Should you take a break from residency?

Residency can be one of the most challenging experiences of a career in medicine. Sometimes it gets so challenging that residents feel they need a break.

For some, this may be a sensible choice, but it could have a downside. Residents who take time off—even for a concrete reason, such as their mental or physical health—may be shamed by other residents, hospital staff, and future employers.

But depending on how you spend your time off, such a break can be a highly worthwhile way to reinvigorate your passion for a career in medicine.

The plus side

Dr. Y, a second-year internal medicine resident based in Canada, spoke to MDLinx about hitting “pause” on his residency.

After much mental debate, I decided to take a leave of absence from residency. It was a scary decision because you rarely hear others openly discussing their vulnerability. In addition, taking time off feels so stigmatized because, as natural high achievers, we tend to view it as a sign of weakness or failure.

I broke my running records, had better daily routines, and felt clearer about my future. Overall, it has done a lot more good than I had initially imagined.

This was also my first time off where I didn't have to study, do extracurriculars, or research in more than 5 years.

Life is much better when we have the time and energy to embrace its wonders. It's only when we are fully recharged and rested that we can then seek further personal improvement. Life is so much better when we are not just defined by our profession [and] our achievements, but also by our curiosity, creativity, and happiness.

Use this precious time well

Taking time off from residency gives you the space and time you need for whatever you are dealing with, whether it is a mental health disorder, burnout, a medical issue, a sick family member, maternity leave, substance abuse, or another reason.

Wasting this time or not using it to better yourself can potentially hinder you, especially because when you return, your program director and colleagues may want to know how the break helped you.

Talk to your program director

Suppose you are planning on taking time off because you are experiencing an extreme hardship or a life transition. Discuss this with your program director, as paperwork and documentation will be needed.

If possible, do this in a cordial, quiet setting with sufficient advance time so your program director can rework the program’s call and rotation schedule to fill in for your absence.

Talk with upper-level residents you trust, your adviser, and maybe even a therapist. This choice should not be taken lightly and should be made with careful thought and planning.

If you are struggling with your mental health or a physical ailment that is interfering with your ability to do your job, and all of your coping skills are not helping, you may greatly benefit from some time off.

Factor these in

Possible ramifications to consider when considering a break from residency include:

• Colleagues may not be happy about it. Your co-workers may become grumpy because they have to fill in for your call schedules, so let them know why you are taking a break and ask for their understanding and support. This may help them have some compassion (but they still may be disgruntled because they will be even more overworked due to your leaving).

• You may not have health benefits. Your medical insurance is no longer valid during the time off. Research this ahead of time and plan alternative means of being covered if necessary.

• If you plan on entering a fellowship, be prepared for an off-cycle. Fellowships start at a particular time of year that usually coincides with residency graduation. If you take time away from residency and plan to enter a fellowship, be aware that you may have a “gap year,” meaning that you may have to apply and start the following year.

• You may have to start paying back your medical student loan debt. You usually can defer student loan payments when you’re in residency. But if you take a leave, you may want to check with your loan carrier to see if they will require you to begin making payments.

• Be prepared to answer some tough questions upon your return. Unfortunately, co-workers and future employers may ask (and judge or criticize) why you took time off. Have a well-thought-out explanation of your reasoning and the benefits you gained from your break. Be aware that if a future employer dwells on this, they may not be the right fit for you. A healthy workspace should understand and respect your decision.

Think about it

Residency can be one of the most difficult experiences of your medical career. However, it can also provide unlimited tools and knowledge, once-in-a-lifetime experiences, lessons, and friendships with fellow residents.

But if you feel you may benefit from some time away, take multiple variables into consideration before deciding if the time is right for a leave of absence. Taking a break may have professional, financial, and even social impacts.