Hi everyone, I posted this on r/findapath and was encouraged to post here too!
I've completed two years (pre-clinical) at a US MD program, but have been pretty miserable the entire time. Over the past year I've taken Step 1 three times and while my scores have improved with each attempt, I haven't passed. Alongside all of this, I've done a lot of self-reflection and have started to feel that medicine was something I was heavily nudged into by my family.
I was raised in an environment where medicine was treated as the end-all-be-all, the most prestigious and honorable path, and where careers outside of it were seen as a waste. I've come to realize that while I respect medicine, the parts of training that energize me most are psychological theory, human behavior, psychotherapy, and assessment. I really enjoy thinking deeply about the human condition, rather than the biomedical and acute care side of psych. I also believe this is where my strengths as a clinician would actually lie. Throughout my life I've sacrificed a lot of my own happiness to pursue a path that wasn't really mine, and at this point I'm in my mid-20s and I'm burnt out.
While I'm almost certain that I want to walk away from medicine, I have $250k+ in federal student loans (no private loans), which makes it really hard to think definitively about next steps. I'm currently living with my parents and dealing with a significant amount of guilt and pressure from them to keep studying for Step and finish my degree. I'm also financially dependent on my family right now, so gaining financial independence quickly is a top priority for me so that I can make a decision about my future without having to factor their opinions into my plans.
Paths I've been considering:
Clinical or counseling psychology PhD: this feels most aligned with my interests, but I know how competitive these programs are, and I don't want to rush into another degree without giving myself time to think. I also need to do a lot more research before I could apply for grad school again. Financial pro/con: PsyD (very, VERY expensive), funded Psych PhD (funded, but incredibly competitive to secure a position in), would also be jumping from one incredibly academically challenging path to another, which wouldn't help with burnout.
Social Work/MSW: this appeals to me, but I'm worried about the long-term financial implications given my loan burden and the average pay of social workers in the US. Also would need to take out additional loans for this route vs pursuing a funded PhD.
Something completely different: honestly, part of me just wants to walk away from academia entirely. I'm passionate about food, nutrition, homesteading, and the environment, and I dream about working on a farm or in the food industry somehow, but I genuinely just don't think this is in the cards for me in any capacity at the moment.
For additional context, I come from a fairly strict South Asian immigrant household, so family expectations are deeply intertwined with my decision-making in ways that are hard to fully separate out, though I am in therapy and have been doing a lot of work to separate myself and my values/wants from what my parents expect of me.
Wanted to add some context that might be useful. If I withdraw from my program, I'll leave with a Master's degree. I'm currently on a leave of absence and have been applying to psychology research positions in the meantime.
The good news is I don't have to make a final decision about withdrawing right now, but I am feeling family pressure to hurry up and retake my board exam. The reality is I have one attempt left, I'm still burnt out, and if I take it now I risk failing and automatically losing my spot in the program. So I'm trying to give myself the time I need to recover and to genuinely figure out whether I even want to stay in medicine. If I do stay, I need to be in a place where I can actually study well.
To give a sense of the road ahead if I stay: two more years of school, three licensing exams, 4 years of residency (if I pursue psychiatry), and likely fellowship. I understand the stability and earning potential that comes with becoming a physician, and I'm not dismissing that, I'm just trying to be honest with myself about what that road actually requires, and whether I have it in me.
Any thoughts, perspectives, or personal experiences would mean a lot. Thank you for taking the time to read this.
TL;DR: Two years into an MD program, burnt out/dealing with depression, and questioning whether medicine was ever truly my choice or my family's. Have taken Step 1 three times with one attempt left, currently on LOA. Have $250k+ in federal loans and am living with/financially dependent on my parents, which complicates everything. Considering a psych PhD, MSW, or something completely different, but don't want to rush into another degree while burnt out. Applying to psych research positions in the meantime. Looking for perspectives from people who've navigated something similar.
Thinking about withdrawing from medical school
byu/Ok_Schedule_5127 inStudentLoans
Posted by Ok_Schedule_5127
8 Comments
damn, three attempts at step 1 is rough and being stuck with family pressure on top makes it even worse 😂 taking that last attempt while you’re still burnt out seems like setting yourself up to fail tbh
with 250k in loans already, jumping into more debt for msw might not be the move right now. maybe focus in getting some research experience first like you mentioned – it’ll give you time to figure out if you actually want psychology without committing to another expensive degree. plus having some income (even if small) might help with that financial independence you need
the family guilt is real but you can’t spend your whole life living their dreams 💀
This might be sunk cost fallacy here but honestly the payoff of just finishing the stupid degree is worth it. Getting in is the hardest part. No one is saying you have to practice medicine when you’re done. You could do research. I just feel like you’ve invested so much with the loans and time you’re going to be really screwed with the payments if you don’t have the md salary whatever path that looks like. I would just tell yourself two years and get the md and cut out the other programs.
You probably won’t have access to more student loans to be able to complete those other academic programs you are considering given the new federal laws around borrowing. I’m very sorry.
If possible, take an extended leave (more than 1 year), ensure you are in the right type of therapy for you (whether CBT, DBT, etc) with daily mindfulness. Also try to make sure you’re on the right psychotropic medications including testing for ADHD (the best way would be to ask questions of your provider), then I would return to STEP 1 prep when you are mentally, emotionally, and physically ready.
Psychiatry is not exclusive from Psychology or even social work. They all overlap. I know you may not see it now but it can all be equally rewarding. I wish this country afforded us more flexibility in our academic choices.
Now, if your mental health is at more of a crisis stage where you could be at risk to yourself and staying in your program elevates your risk then by all means, leave now.
Psychiatrist isn’t an option?
Did you do poorly on the MCAT? What is going on with STEP? I am very familiar with the stress of the exam, I knew many people who really burnt out preparing for it before it was pass/fail and when the score itself mattered a lot. But outright failing 3 times is very unusual for someone who got into USMD school, and there must be more to your story to make sense of this. Like honestly, what do you think the problem is with the test taking?
I won’t sugar coat it, you will be facing a tough battle if you don’t finish the MD. I don’t know if the other career paths will be financially feasible.
I read what you said about everything, and I have empathy for the struggle and burnout and having other interests. But there has to be more to the picture here. It’s one thing to score low on STEP 1 and barely pass and it’s another thing to actually fail three times.
Regardless, let’s say you drop out now. I think the most feasible path would be a masters degree that reliably can lead to a PSLF eligible position. The PsyD would be financially stupid, honestly. Don’t try to do the PsyD after all this. And that’s assuming you could even get enough private loans to pay for it anyway. If you want to become a psychologist, you just need to be competitive enough to do a funded PhD.
Keep in mind that loving your job is a major privilege that most people just don’t get to have, and it can be a real mistake to believe that it’s necessary to get that privilege. Conceiving of loving your job as a necessity can really create misery. The primary purpose of a career and a job is to feed and house yourself and your future family if you have one. If you get to find meaning in the job, that is a secondary benefit.
I can only speak on some counseling programs in CA. Some of my coworkers went to a state school program and they were able to graduate debt free after qualifying for merit based scholarships. Other coworkers who took out loans for private grad school programs (close to $200K), applied for a service based scholarship (by the time their service based scholarship commitment ends, they would have been with the agency for 9 years).
I bet you have ADHD. I was diagnosed late with this. A lot of what you are describing as burnout could be untreated ADHD burnout.
Either way, I hope you are able to find happiness.
Do not drop out of med school to do phd in psychology.
Phd psychology comes with huge risk of lifetime poverty or under employment.